scholarly journals Current Status and Future Directions of mHealth Interventions for Health System Strengthening in India: Systematic Review (Preprint)

2018 ◽  
Author(s):  
Abhinav Bassi ◽  
Oommen John ◽  
Devarsetty Praveen ◽  
Pallab K Maulik ◽  
Rajmohan Panda ◽  
...  
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Health System ◽  
Health Systems ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Health Systems Strengthening ◽  
Noncommunicable Disease ◽  
Health Initiatives

BACKGROUND With the exponential increase in mobile phone users in India, a large number of public health initiatives are leveraging information technology and mobile devices for health care delivery. Given the considerable financial and human resources being invested in these initiatives, it is important to ascertain their role in strengthening health care systems. OBJECTIVE We undertook this review to identify the published mobile health (mHealth) or telemedicine initiatives in India in terms of their current role in health systems strengthening. The review classifies these initiatives based on the disease areas, geographical distribution, and target users and assesses the quality of the available literature. METHODS A search of the literature was done to identify mHealth or telemedicine articles published between January 1997 and June 2017 from India. The electronic bibliographic databases and registries searched included MEDLINE, EMBASE, Joanna Briggs Institute Database, and Clinical Trial Registry of India. The World Health Organization health system building block framework was used to categorize the published initiatives as per their role in the health system. Quality assessment of the selected articles was done using the Cochrane risk of bias assessment and National Institutes of Health, US tools. RESULTS The combined search strategies yielded 2150 citations out of which 318 articles were included (primary research articles=125; reviews and system architectural, case studies, and opinion articles=193). A sharp increase was seen after 2012, driven primarily by noncommunicable disease–focused articles. Majority of the primary studies had their sites in the south Indian states, with no published articles from Jammu and Kashmir and north-eastern parts of India. Service delivery was the primary focus of 57.6% (72/125) of the selected articles. A majority of these articles had their focus on 1 (36.0%, 45/125) or 2 (45.6%, 57/125) domains of health system, most frequently service delivery and health workforce. Initiatives commonly used client education as a tool for improving the health system. More than 91.2% (114/125) of the studies, which lacked a sample size justification, had used convenience sampling. Methodological rigor of the selected trials (n=11) was assessed to be poor as majority of the studies had a high risk for bias in at least 2 categories. CONCLUSIONS In conclusion, mHealth initiatives are being increasingly tested to improve health care delivery in India. Our review highlights the poor quality of the current evidence base and an urgent need for focused research aimed at generating high-quality evidence on the efficacy, user acceptability, and cost-effectiveness of mHealth interventions aimed toward health systems strengthening. A pragmatic approach would be to include an implementation research component into the existing and proposed digital health initiatives to support the generation of evidence for health systems strengthening on strategically important outcomes.

Patient Response Toward a Change in the System of Health Care Delivery

PEDIATRICS ◽  
1973 ◽  
Vol 52 (2) ◽  
pp. 289-293
Author(s):  
Kathleen J. Motil ◽  
W. John Siar
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Poor Quality ◽  
Emergency Rooms ◽  
Patient Response ◽  
Number Of Patients ◽  
Comprehensive Health ◽  
Crisis Care

With the emphasis being placed on comprehensive health care, outpatient clinics in major city hospitals have found it necessary to reevaluate their methods of health care delivery. An increasing number of patients who fail to schedule or keep medical appointments appear for crisis care, resulting in a higher cost of hospital operation due to unnecessary utilization of emergency rooms and the wasting of time of clerical and professional personnel, as well as poor quality of health care due to See the Table in PDF File sporadic clinic attendance. When comparing behavior patterns and attitudes of clinic patients under different methods of health care delivery, patient preferences become apparent.

scholarly journals The impact of the use of health information and communication technology on health care delivery in Manitoba, Canada

2014 ◽  
Vol 3 (6) ◽  
pp. 8 ◽  
Author(s):  
Israel R Kabashiki ◽  
Ngozi I Moneke
Keyword(s):  
Health Care ◽  
Health Information ◽  
Information And Communication Technology ◽  
Health Care Delivery ◽  
Communication Technology ◽  
Quality Of Health Care ◽  
Care Delivery ◽  
Wait Times ◽  
Information And Communication

Background: Health Information and Communication Technology (HICT) has the potential to reduce patient wait time and improves patient satisfaction. The Long wait times for patients to receive medical services are a big issue in Canada. The Canadian government has invested in Information and Communication Technology (ICT) to shorten patient referral wait times for medical services. Little was known about the association between ICT investments and the quality of health care delivery, and particularly between the use of ICT and referral wait times in the Manitoba Health System (MHS). Methods: The purpose of this quantitative correlational study was to determine if a relationship existed between the use of HICT and the quality of health care delivery in the MHS. The quality of health care delivery was measured in terms of referral wait time, health information sharing effectiveness, physicians’ satisfaction, and patients’ satisfaction. Conclusion: Findings indicated the absence of a significant association between HICT use and referral wait times. Significant correlations were found to exist between (1) HICT use and health information sharing effectiveness, (2) HICT use and physician’s satisfaction, and (3) HICT use and patient’s satisfaction. Four recommendations emerged from this study: First, patient satisfaction should be used as an indicator of the quality of health care delivery. Second, health knowledge repository and expert systems should be integrated into health ICT systems to minimize unnecessary referrals. Third, a mixed health system should be implemented to shorten wait times. Fourth, the portability of the Canadian Medicare should be enhanced to allow Manitobans in particular and Canadians in general to seek medical services abroad. This study was intended to contribute to the existing body of knowledge associated with ICT investments’ outcomes and health care delivery in the MHS.  

Managed care Medicaid

2017 ◽  
Vol 11 (2) ◽  
pp. 198-210 ◽  
Author(s):  
William Trombetta
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Care Quality ◽  
Market Segment ◽  
Economic Aspects ◽  
Content Type ◽  
The Poor

Purpose Providing health care to the poor is evolving in the new US marketplace. The Affordable Care Act has set goals enhancing access to health care, lowering costs and improving patient outcomes. A key segment in this evolution is the most vulnerable health-care population of all: Medicaid. This paper aims to provide a general review of how providing health care to Medicaid patients is changing including how socio-economic aspects of this vulnerable population affects the quality of the health care provided. Design/methodology/approach The paper is entirely secondary research; no primary research has been conducted. Findings Managed care Medicaid provides a risk-based model to treating a vulnerable health-care market segment. The jury is still out on whether managed care Medicaid (MCM) is improving health-care quality and saving cost, but the provision of health care to the Medicaid segment is definitely shifting from a fee-for-service model to value based payment. Very recent developments of new health-care delivery approaches present a positive outlook for improving quality and containing costs going forward. Research limitations/implications At this stage, whether or not MCM saves money or provides better health-care quality to this vulnerable population is a work in progress. Health-care marketing can impact socio-economic aspects of health care for the poor. There is a need to follow up on the positive results being documented in demonstration health-care delivery models. Practical implications At this point, there has been no long-term study of whether managed care Medicaid offers better quality of health care and cost savings. The research to date suggest that the quality of health-care delivery to the poor is improving at a lower cost to payers. Social implications Medicaid patients are an underserved market segment. Managed care Medicaid offers a new model that has the potential to provide quality care at acceptable cost. Critical to this vulnerable market segment is the need to integrate socio-economic aspects of the population with the delivery of health care. Originality/value There has been very little discussion of Medicaid overall in the marketing literature, much less any discussion of managed care Medicaid.

The case for integrated oral and primary medical health care delivery: Marshfield Clinic Health System

2020 ◽  
Vol 84 (8) ◽  
pp. 924-931
Author(s):  
R. Lamont (Monty) MacNeil ◽  
Helena Hilario ◽  
Megan M. Ryan ◽  
Ingrid Glurich ◽  
Greg R. Nycz ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Medical Health Care ◽  
Medical Health ◽  
Marshfield Clinic

scholarly journals The role of multilateral organizations and governments in advancing social innovation in health care delivery

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Beatrice Halpaap ◽  
Rosanna W. Peeling ◽  
François Bonnici
Keyword(s):  
Health Care ◽  
Sustainable Development ◽  
Health Systems ◽  
Health Care Delivery ◽  
Social Innovation ◽  
Care Delivery ◽  
Enabling Environment ◽  
Social Innovations ◽  
Multilateral Organizations ◽  
Innovation Approach

Abstract Background Despite great medical advances and scientific progress over the past century, one billion people globally still lack access to basic health care services. In the context of the 2030 Agenda for Sustainable Development social innovation models aim to provide effective solutions that bridge the health care delivery gap, address equity and create social value. This commentary highlights the roles of multilateral organizations and governments in creating an enabling environment where social innovations can more effectively integrate into health systems to maximize their impact on beneficiaries. Main text The integration of social innovations into health systems is essential to ensure their sustainability and the wide dissemination of their impact. Effective partnerships, strong engagement with and endorsement by governments and communities, regulations, trust and sometimes willingness are key factors to enhance system integration, replication and dissemination of the models. Three examples of social innovations selected by the Social Innovation in Health Initiative illustrate the importance of engaging with governments and communities in order to link, integrate and synergize their efforts. Key challenges that they encountered, and lessons learnt are highlighted. Multilateral organizations and governments increasingly engage in promoting and supporting the development, testing and dissemination of social innovations to address the health care delivery gap. They play an important role in creating an enabling environment. This includes promoting the concept of social innovation in health care delivery, spreading social innovation approach and lessons learnt, fostering partnerships and leveraging resources, convening communities, health system actors and various stakeholders to work together across disciplines and sectors, and nurturing capacity in countries. Conclusions Multilateral organizations and local and national governments have a critical role to play in creating an enabling environment where social innovations can flourish. In supporting and disseminating social innovation approach, multilateral organizations and governments have a great opportunity to accelerate Universal Health Coverage and the achievement of the Sustainable Development Goals.

scholarly journals Building health system resilience in the context of primary health care revitalization for attainment of UHC: proceedings from the Fifth Health Sector Directors’ Policy and Planning Meeting for the WHO African Region

2020 ◽  
Vol 14 (S19) ◽  
Author(s):  
Prosper Tumusiime ◽  
Humphrey Karamagi ◽  
Regina Titi-Ofei ◽  
Michelle Amri ◽  
Aminata Binetou Wahebine Seydi ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Health Systems ◽  
Health Sector ◽  
Health Systems Strengthening ◽  
Health Coverage ◽  
African Region ◽  
Health Service Provision ◽  
Primary Health

Abstract Background The recent 2018 Declaration of Astana recognized primary health care (PHC) as a means to achieve universal health coverage (UHC) and the health-related Sustainable Development Goals (SDGs). Following this declaration, country progress on operationalization of the PHC agenda and attainment of UHC has been stalled by the new challenges posed by the COVID-19 pandemic. The pandemic has also disrupted the continuity of essential health service provision and tested the resilience of the region’s health systems. Methods In accordance with this, the WHO Regional Office for Africa convened the Fifth Health Sector Directors’ Planning and Policy Meeting across the 47 Member States of the Region. The two-day forum focused on building health system resilience to facilitate service continuity during health threats, PHC revitalization, and health systems strengthening towards UHC. Results The Regional Forum provided evidence on building resilient health systems in the WHO African Region and engaged participants in meaningful and critical discussion. It is from these discussions that four key themes emerged: (1) working multisectorally/intersectorally, (2) moving from fragmentation to integration, (3) ensuring implementation and knowledge exchange, and (4) rethinking resilience and embracing antifragility. These discussions and associated groupings by thematic areas lend themselves to recommendations for the WHO. Conclusions This paper details the proceedings and key findings on building resilient health systems, the four themes that emerged from participant deliberation, and the recommendations that have emerged from the meeting. Deliberations from the Regional Forum are critical, as they have the potential to directly inform policy and program design, given that the meeting convenes health sector technocrats, who are at the helm of policy design, action, and implementation.

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