Introduction: Special Issue on Health Care and Business Ethics

2002 ◽  
Vol 12 (4) ◽  
pp. 409-412 ◽  
Author(s):  
Andrew C. Wicks
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Care Provider ◽  
Quality Care ◽  
The United States ◽  
Care Quality ◽  
Care Providers ◽  
Special Issue ◽  
Care System

Health care has been a hot topic within the United States for over a decade. Despite the many changes that have taken place, health care—and more specifically, versions of what have been termed “managed care”—continues to be a subject of intense debate and ongoing change. Whether the discussion is about access to care, quality of services, costs of care, or strains in the health care provider-patient relationship, a wide variety of stakeholders (e.g., patients, health care providers, health care organizations) have expressed frustration with the health care system. One of the central rallying cries behind the debate about health care is concern about the influence of “business” on health care. This special issue emerges out of the recognition that health care remains in flux, that health care continues to be a controversial subject among a wide array of stakeholders, and that the influence of business on health care is a key underlying source of tension.Part of this debate has to do with what constitutes a just health care system. On the one hand, people in our society want to have access to high-quality care. More specifically, they want to be able to utilize the latest technology, care that is available when they need it (especially in crisis), a highly skilled care provider they can trust and develop a relationship with, and to not have to wait to gain access. On the other hand, people want a health care system they can afford. They want a health care system that is efficient, that offers reasonably priced services, and that doesn’t unduly strain the financial resources of families or the state.

scholarly journals Experiences of everyday racism in Toronto’s health care system: a concept mapping study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Deb Finn Mahabir ◽  
Patricia O’Campo ◽  
Aisha Lofters ◽  
Ketan Shankardass ◽  
Christina Salmon ◽  
...  
Keyword(s):  
Health Care ◽  
Concept Mapping ◽  
Health Care System ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Institutional Racism ◽  
Care Providers ◽  
Racial Ethnic ◽  
Care System

Abstract Background In Canada, there is longstanding evidence of health inequities for racialized groups. The purpose of this study is to understand the effect of current health care policies and practices on racial/ethnic groups and in particular racialized groups at the level of the individual in Toronto’s health care system. Methods This study used a semi-qualitative study design: concept mapping. A purposive sampling strategy was used to recruit participants. Health care users and health care providers from Toronto and the Greater Toronto Area participated in all four concept mapping activities. The sample sizes varied according to the activity. For the rating activity, 41 racialized health care users, 23 non-racialized health care users and 11 health care providers completed this activity. The data analysis was completed using the concept systems software. Results Participants generated 35 unique statements of ways in which patients feel disrespect or mistreatment when receiving health care. These statements were grouped into five clusters: ‘Racial/ethnic and class discrimination’, ‘Dehumanizing the patient’, ‘Negligent communication’, ‘Professional misconduct’, and ‘Unequal access to health and health services’. Two distinct conceptual regions were identified: ‘Viewed as inferior’ and ‘Unequal medical access’. From the rating activity, racialized health care users reported ‘race’/ethnic based discrimination or everyday racism as largely contributing to the challenges experienced when receiving health care; statements rated high for action/change include ‘when the health care provider does not complete a proper assessment’, ‘when the patient’s symptoms are ignored or not taken seriously’, ‘and ‘when the health care provider belittles or talks down to the patient’. Conclusions Our study identifies how racialized health care users experience everyday racism when receiving health care and this is important to consider in the development of future research and interventions aimed at addressing institutional racism in the health care setting. To support the elimination of institutional racism, anti-racist policies are needed to move beyond cultural competence polices and towards addressing the centrality of unequal power social relations and everyday racism in the health care system.

Current Practices and Challenges of Medical Services on Health Care System of Mandalay General Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 131
Keyword(s):  
Health Care ◽  
General Hospital ◽  
Health Care Providers ◽  
Quality Care ◽  
Healthcare Providers ◽  
Medical Services ◽  
Tertiary Level ◽  
Care Providers ◽  
Level Hospital ◽  
Care System

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.

scholarly journals “Take the treatment and be brave”: Care experiences of pregnant women with rifampicin-resistant tuberculosis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242604
Author(s):  
Marian Loveday ◽  
Sindisiwe Hlangu ◽  
Jennifer Furin
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Health Care System ◽  
Health Care Providers ◽  
Physical Symptoms ◽  
Coding System ◽  
Care Providers ◽  
Convenience Sample ◽  
Care System

Background There are few data on the on the care experiences of pregnant women with rifampicin-resistant TB. Objective To describe the treatment journeys of pregnant women with RR-TB—including how their care experiences shape their identities—and identify areas in which tailored interventions are needed. Methods In this qualitative study in-depth interviews were conducted among a convenience sample from a population of pregnant women receiving treatment for RR-TB. This paper follows COREQ guidelines. A thematic network analysis using an inductive approach was performed to analyze the interview transcripts and notes. The analysis was iterative and a coding system developed which focused on the care experiences of the women and how these experiences affected their perceptions of themselves, their children, and the health care system in which treatment was received. Results Seventeen women were interviewed. The women described multiple challenges in their treatment journeys which required them to demonstrate sustained resilience (i.e. to “be brave”). Care experiences required them to negotiate seemingly contradictory identities as both new mothers—“givers of life”—and RR-TB patients facing a complicated and potentially deadly disease. In terms of their “pregnancy identity” and “RR-TB patient identity” that emerged as part of their care experiences, four key themes were identified that appeared to have elements that were contradictory to one another (contradictory areas). These included: 1) the experience of physical symptoms or changes; 2) the experience of the “mothering” and “patient” roles; 3) the experience of the care they received for their pregnancy and their RR-TB; and 4) the experience of community engagement. There were also three areas that overlapped with both roles and during which identity was negotiated/reinforced and they included: 1) faith; 2) socioeconomic issues; and 3) long-term concerns over the child’s health. At times, the health care system exacerbated these challenges as the women were not given the support they needed by health care providers who were ill-informed or angry and treated the women in a discriminatory fashion. Left to negotiate this confusing time period, the women turned to faith, their own mothers, and the fathers of their unborn children. Conclusion The care experiences of the women who participated in this study highlight several gaps in the current health care system that must be better addressed in both TB and perinatal services in order to improve the therapeutic journeys for pregnant women with RR-TB and their children. Suggestions for optimizing care include the provision of integrated services, including specialized counseling as well as training for health care providers; engagement of peer support networks; provision of socioeconomic support; long-term medical care/follow-up for children born to women who were treated for RR-TB; and inclusion of faith-based services in the provision of care.

Outside Looking In: A Pharmacist's Personal Journey With Family Elders

2019 ◽  
Vol 34 (3) ◽  
pp. 156-167
Author(s):  
Jeannette Y. Wick
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Transitions Of Care ◽  
Clinical Inertia ◽  
Older Individuals ◽  
Care Providers ◽  
Term Care ◽  
Personal Journey ◽  
Care System

Pharmacists who work in long-term care—or in any area of health care—are exposed to the health care system on a daily basis. While most of us recognize that the health care system has problems, especially at transitions of care, few of us appreciate fully how serious these problems can be. Certifying and accrediting agencies have encouraged health care providers to step out of their silos and work more collaboratively, and educators have emphasized understanding geriatric syndromes. A description of a personal journey through the health system—for both the patient and the caregiver—with two older individuals, this narrative discusses how difficult it is for patients to understand what's happening around them. It also discusses the clinical inertia in addressing geriatric issues and offers suggestions to health care providers facing similar situations.

HIV status, trust in health care providers, and distrust in the health care system among Bronx women

AIDS Care ◽  
2007 ◽  
Vol 19 (2) ◽  
pp. 226-234 ◽  
Author(s):  
C. O. Cunningham ◽  
N. L. Sohler ◽  
L. Korin ◽  
W. Gao ◽  
K. Anastos
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Care Providers ◽  
Hiv Status ◽  
Care System

The Latino Immigrants’ Experience in Obtaining Required Childhood Vaccinations

2017 ◽  
Vol 29 (4) ◽  
pp. 363-368
Author(s):  
Barbara S. deRose
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
The United States ◽  
Latino Immigrants ◽  
Main Theme ◽  
Care Providers ◽  
Foreign Born ◽  
The U.S ◽  
Care System

Introduction: Alarming increases in childhood disease outbreaks present particular threats to children of immigrants in the United States. The researcher explores issues Latino immigrants experience when vaccinating their children in U.S. health care system. Methodology: A purposive sample of 11 Latino immigrants who sought immunizations for their foreign-born children during their first 5 years in the United States was obtained. Interview questions, probes, and data collection methods were based on interpretive phenomenology. Results: Trust issues emerged as the main theme from the Latino immigrants’ perspective based on interactions with the health care system: trusting themselves as parents to vaccinate children, trusting/mistrusting the U.S. health care providers/facilities, and mistrusting the U.S. health care system. Discussion: The researcher reports disparities in access to health care within a family unit. Parental distress results when Latino immigrants experience health care disparities between U.S.-born and foreign-born children. This can be mitigated by making vaccination practices and health care policies consistent.

Disclosing Gender-Based Violence During Health Care Visits: A Patient-Centered Approach

2017 ◽  
Vol 35 (23-24) ◽  
pp. 5552-5573 ◽  
Author(s):  
Jessica R. Williams ◽  
Rosa M. Gonzalez-Guarda ◽  
Valerie Halstead ◽  
Jacob Martinez ◽  
Laly Joseph
Keyword(s):  
Health Care ◽  
Human Trafficking ◽  
Health Care System ◽  
Health Care Providers ◽  
Qualitative Content Analysis ◽  
Care Providers ◽  
Gender Based Violence ◽  
Patient Centered ◽  
Gender Based ◽  
Care System

The purpose of this study was to better understand victims’ perspectives regarding decisions to disclose gender-based violence, namely, intimate partner violence (IPV) and human trafficking, to health care providers and what outcomes matter to them when discussing these issues with their provider. Twenty-five participants from racially/ethnically diverse backgrounds were recruited from a family justice center located in the southeastern United States. Two fifths had experienced human trafficking, and the remaining had experienced IPV. Upon obtaining informed consent, semistructured, in-depth interviews were conducted. Interviews were audio recorded and transcribed verbatim. Qualitative content analysis was used to examine interview data. Five primary themes emerged. Three themes focused on factors that may facilitate or impede disclosure: patient–provider connectedness, children, and social support. The fourth theme was related to ambiguity in the role of the health care system in addressing gender-based violence. The final theme focused on outcomes participants hope to achieve when discussing their experiences with health care providers. Similar themes emerged from both IPV and human trafficking victims; however, victims of human trafficking were more fearful of judgment and had a stronger desire to keep experiences private. Cultural factors also played an important role in decisions around disclosure and may interact with the general disparities racial/ethnic minority groups face within the health care system. Recognizing factors that influence patient engagement with the health care system as it relates to gender-based violence is critical. The health care system can respond to gender-based violence and its associated comorbidities in numerous ways and interventions must be driven by the patient’s goals and desired outcomes of disclosure. These interventions may be better served by taking patient-centered factors into account and viewing the effectiveness of intervention programs through a behavioral, patient-centered lens.

A Qualitative Study of Herbal Medicine Use in the Ukraine

2012 ◽  
Vol 25 (1) ◽  
pp. 96-100 ◽  
Author(s):  
Duska M. Franic ◽  
Konstantin Kleyman
Keyword(s):  
Health Care ◽  
Herbal Medicine ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
The United States ◽  
Care Providers ◽  
Medicine Use ◽  
Herbal Medication ◽  
Synthetic Drugs

Introduction: Half of nearly all new immigrants in the United States come from only 10 countries, including the Ukraine. Immigrants bring facets of their culture to their new country; therefore, it is important for health care providers to have an appreciation and understanding of cultural differences in regard to the use of herbal medicine. Objectives: To determine health care provider and patient preferences for herbal versus synthetic medications, health care provider didactic training in pharmacognosy and trends in herbal medication use in the Ukraine. Methods: Ten health care providers, pharmacists and physicians, were interviewed to determine their views on herbal medicine use in Ukraine using semistructured in-depth face-to-face interviews. Results: Ukrainian practitioners and patients viewed herbal medicines as safer than synthetic drugs, appropriate and preferable for use in chronic and preventative programs. Synthetic drugs were viewed as more desirable for use in the acute setting. Preference for synthetic versus herbal medication was not price driven. Conclusions: The inclusion of pharmacognosy training in the US pharmacy curricula is recommended to facilitate US health care professional’s ability to provide pharmaceutical care both to new US immigrants and to the increasing number of US citizens utilizing herbal medications.

Health Care System in Pakistan: A review

2016 ◽  
Vol 2 (3) ◽  
pp. 211-216 ◽  
Author(s):  
Shumaila Arshad ◽  
Hira Waris ◽  
Maria Ismail ◽  
Ayesha Naseer
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Gender Discrimination ◽  
Health Care Systems ◽  
Cultural Beliefs ◽  
Care Providers ◽  
Health Seeking ◽  
Care Systems ◽  
Care System

Health systems are expected to serve the population needs in an effective, efficient and equitable manner. The factors determining the health behaviors may be seen in various contexts physical, socio-economic, cultural and political. Therefore, the utilization of a health care system, public or private, formal or non-formal, may depend on socio-demographic factors, social structures, level of education, cultural beliefs and practices, gender discrimination, status of women, economic and political systems environmental conditions, and the disease pattern and health care system itself. Policy makers need to understand the drivers of health seeking behavior of the population in an increasingly pluralistic health care system. Also a more concerted effort is required for designing behavioral health promotion campaigns through inter-sectoral collaboration focusing more on disadvantaged segments of the population. The paper reviews the health care providers, the national policies emphasizing health services as well as health care systems in Pakistan and the role of the pharmacist in health care system of Pakistan, health and economics of Pakistan and current budgeting policies and the importance of non government organizations in health care system of Pakistan.

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