scholarly journals What are key determinants of hospital admissions, readmission rate and day case rate within the South African medical schemes population?

2012 ◽  
Vol 13 (2) ◽  
pp. 83-96
Author(s):  
Nondumiso Gugu Khumalo ◽  
Michael Willie ◽  
Evelyn Thsehla
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Quantitative Data ◽  
Hospital Admissions ◽  
Health Care Utilisation ◽  
Unintended Consequences ◽  
Key Factors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Managed Care Programs

BACKGROUND: In South Africa, private hospitals absorb a high proportion of the total health expenditure on private health care. Between 2008-2010 private hospital expenditure which includes ward fees, theatre fees, consumables, medicines and per diem arrangements consumed between 40.5% and 40.9% of the total benefits paid by medical schemes from the risk pool, whilst in-hospital managed care fees ranged between 1.8% and 2.8% for the equivalent years.OBJECTIVE: The aim of this paper is to highlight key factors contributing to utilisation of hospital services within the medical schemes population and to recommend “appropriate” and cost effective strategies on hospital utilisation management.METHODS: A cross sectional survey informed by retrospective analysis of quantitative data was used. Researchers also triangulated quantitative data with systematic review of literature.RESULTS: The results show that demographic indicators such as age profile, dependency ratio, pensioner ratio and prevalence of chronic conditions are not the only key factors influencing hospital admissions, but rather the effectiveness of each medical scheme in containing hospital admissions is also influenced by available technical capacity on utilisation review and audit as well as the managed care methodology including the philosophy underpinning benefit option design.CONCLUSION: This study highlights the importance of “value based” managed care programs linked to benefit option design in health care utilisation management. The choice of one managed care program over the other often leads to tradeoffs whereby unintended consequences emanate. Medical schemes are therefore encouraged to continuously review their managed care programs to ensure value for money as well as better access and health outcomes.

scholarly journals The utilisation of public and private health care among Australian women with diabetes: Findings from the 45 and Up Study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255573
Author(s):  
Jon Adams ◽  
Erica McIntyre ◽  
Amie Steel ◽  
Brenda Leung ◽  
Matthew Leach ◽  
...  
Keyword(s):  
Health Care ◽  
Conventional Medicine ◽  
Health Care Expenditure ◽  
Health Care Utilisation ◽  
Self Report ◽  
Health Care Practitioner ◽  
Health Practitioner ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Diverse Range

Aim To describe the prevalence of health care utilisation and out-of-pocket expenditure associated with the management of diabetes among Australian women aged 45 years and older. Design Cross-sectional survey design. Methods The questionnaire was administered to 392 women (a cohort of the 45 and Up Study) reporting a diagnosis of diabetes between August and November 2016. It asked about the use of conventional medicine, complementary medicine (CM) and self-prescribed treatments for diabetes and associated out-of-pocket spending. Results Most women (88.3%; n = 346) consulted at least one health care practitioner in the previous 12 months for their diabetes; 84.6% (n = 332) consulted a doctor, 44.4% (n = 174) consulted an allied health practitioner, and 20.4% (n = 80) consulted a CM practitioner. On average, the combined annual out-of-pocket health care expenditure was AU$492.6 per woman, which extrapolated to approximately AU$252 million per annum. Of this total figure, approximately AU$70 million was spent on CM per annum. Conclusions Women with diabetes use a diverse range of health services and incur significant out-of-pocket expense to manage their health. The degree to which the health care services women received were coordinated, or addressed their needs and preferences, warrants further exploration. Limitations of this study include the use of self-report and inability to generalise findings to other populations.

Predictors of Health Care Utilisation in Community Dwelling New Zealand Māori

2004 ◽  
Vol 15 ◽  
pp. 1-10
Author(s):  
Ross Flett ◽  
Paul Hirini ◽  
Nigel Long ◽  
Michelle Millar
Keyword(s):  
Health Care ◽  
New Zealand ◽  
Emergency Services ◽  
Health Care Utilisation ◽  
Community Dwelling ◽  
Health Care Use ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Utilisation ◽  
Health Need

AbstractUsing Andersen's behavioural model of health care use we examined the predictors of health care utilisation (visits to general practitioners/family physicians, and hospital/outpatient and emergency services) via a cross sectional survey of 502 community dwelling New Zealand Māori (the indigenous population of New Zealand). We found that the model was of limited utility in accounting for variation in health care use in this group. In line with other research findings health need and worries about health emerged as the most salient predictors. We argue that this model may be limited in its applicability to this cultural group and that some re-evaluation of the ways in which health professionals have traditionally dealt with members of the Māori population, may be necessary.

Opportunistic infections among people living with HIV at reference health care centers in Morocco, 2015 (Preprint)

2019 ◽  
Author(s):  
Noureddine Sakhri ◽  
Fatima Zahra Meski ◽  
SOUMIA TRIKI
Keyword(s):  
Health Care ◽  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Clinical Stage ◽  
Bivariate Analysis ◽  
People Living With Hiv ◽  
Cross Sectional Survey ◽  
Pneumocystis Jiroveci ◽  
Cross Sectional ◽  
Health Care Centers

BACKGROUND Morbidity and mortality in HIV disease is due to immune-suppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. In 2015, the HIV prevalence is low in general population and concentrated among key populations. OBJECTIVE This study aimed to assess the prevalence and CD4 correlates of OIs among adult HIV-infected patients attending antiretroviral health care in Morocco, during 2015. METHODS We conducted a cross-sectional survey among all adult PLHIV for admitted in the health care centers during 2015, who had acquired infection disease. Patients’ opportunistic infection status was determined through clinical diagnosis and laboratory investigations. CD4 count was determined using flow cytometry technique. The clinical stage of HIV was identified by the classification of Centers for Disease Control and Prevention (CDC). We collected Socio-demographic and clinical data from patients’ medical records. We performed statistical analysis by using Epi-Info 7.2.0.1 software. The appropriate test was applied, bivariate analysis was made and the differences were significant when p<.05. RESULTS 299 HIV-infected cases were included; 53% were males. The most represented age group was 25-34 years (36.1%). The mean age of the cases was 38.7 ± 16.8. The prevalence of OIs was 47.8%. Tuberculosis (65/299, 21.7%), Pneumocystis jiroveci pneumonia (40/299, 13.4%) and Oral candidiasis (22/299, 7.4%) were the most frequently observed OIs. CONCLUSIONS Tuberculosis, pneumocystis and oral candidacies were the leading OIs, encountered by HIV-infected cases. Preventive measures and early diagnosis of HIV associated to OIs are crucial.

scholarly journals COVID-19 Psychological Impact on Health Care Workers in Saudi Arabia

2021 ◽  
Vol 18 (11) ◽  
pp. 6076
Author(s):  
Hasan S. Alamri ◽  
Wesam F. Mousa ◽  
Abdullah Algarni ◽  
Shehata F. Megahid ◽  
Ali Al Bshabshe ◽  
...  
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Health Care Workers ◽  
Psychological Impact ◽  
Psychological Outcomes ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Care Workers ◽  
The Impact

Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.

Perceived Oral Health Literacy, Behaviors, and Oral Health Care among Caregivers to the Homebound Population

2021 ◽  
pp. 108482232110084
Author(s):  
Agata Wilk ◽  
Lisa LaSpina ◽  
Linda D. Boyd ◽  
Jared Vineyard
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Literacy ◽  
Oral Care ◽  
Oral Health Care ◽  
The Body ◽  
Current Evidence ◽  
Oral Health Literacy ◽  
Cross Sectional Survey ◽  
Cross Sectional

This study aimed to explore the level of perceived oral health literacy (OHL) among caregivers of the homebound population in the Chicago metropolitan area and how caregivers’ OHL impacts their oral care to the homebound population. The relationships between demographic characteristics, perceived OHL levels, personal oral health behaviors, and oral health care to clients were also assessed. This cross-sectional survey research examined 69 caregivers of the homebound population employed by home health agencies. The OHL was determined by the validated Health Literacy in Dentistry Scale (HeLD-14). Independent t-tests, chi-square tests set at p < .05 significance level, and logistic regressions were used for analysis. The mean age of participants was 43. The HeLD-14 scores indicated a high perceived OHL among this group. Caregivers came from diverse groups, and the majority spoke a second language at home. About 93% performed oral self-care the recommended amount of time or more, while only 57% did it for their clients. Those who cleaned clients’ mouth twice a day had a higher OHL score ( M = 23 compared to M = 19). About 43% did not check for sores in the client’s mouth, and those who checked had a higher OHL score ( M = 25 compared to M = 19). Controlling for OHL, age was a good predictor of oral care frequency to clients. These findings provide current evidence and add to the body of knowledge on OHL among homebound individuals. The results provide insights for designing a preventive approach in oral health care to the homebound population.

scholarly journals Women and Leadership in Mixed Secondary Schools in Kenya; Do Stakeholder’s Attitudes Matter?

2017 ◽  
Vol 5 (1) ◽  
pp. 39
Author(s):  
ANNE Wangari Mberia
Keyword(s):  
Secondary Schools ◽  
Quantitative Data ◽  
Quantitative Methods ◽  
Survey Design ◽  
Group Discussion ◽  
Negative Attitude ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Women Leadership ◽  
Qualitative And Quantitative

Leadership is a process whereby an individual influences a group of individuals to achieve a common goal (Northhouse, 2011). In time and space, women leadership remains a subject talked about but hardly appreciated (Wren, 2013). Among the factors contributing to poor representation of women in leadership is stakeholder’s attitude (Coleman, 2005). The study sought to investigate stakeholder’s attitudes impeding women teachers' ascension to leadership positions in mixed public secondary schools, focusing in Tharaka South Sub – County, Kenya. The study employed descriptive cross-sectional survey design utilizing both qualitative and quantitative methods of data collection. Probability and non-probability sampling techniques were used to arrive at the sample size. Data was collected from women classroom teachers, heads of departments, school principals, education officers, education trade unionists, Parents and Teachers Association officials and School Board of Management officials. Questionnaires, interview guide and focus group discussion guides were used to collect both qualitative and quantitative data. Data analysis was assisted by computer software (Statistical Package for Social Sciences for quantitative data and NVIVO for qualitative data). The study established that education stakeholders have a general negative attitude towards women leadership in schools.

A survey of Cambodian health-care providers' HIV knowledge, attitudes and intentions to take a sexual history

2009 ◽  
Vol 20 (5) ◽  
pp. 346-350 ◽  
Author(s):  
G Webber ◽  
N Edwards ◽  
I D Graham ◽  
C Amaratunga ◽  
I Gaboury ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Theory Of Planned Behaviour ◽  
Sexual History ◽  
People Living With Hiv ◽  
Care Providers ◽  
Hiv Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Planned Behaviour

Cambodia has one of the highest prevalence rates of HIV in Asia and is scaling up HIV testing. We conducted a cross-sectional survey with 358 health care providers in Phnom Penh, Cambodia to assess readiness for voluntary testing and counselling for HIV. We measured HIV knowledge and attitudes, and predictors of intentions to take a sexual history using the Theory of Planned Behaviour. Over 90% of health care providers correctly answered knowledge questions about HIV transmission, but their attitudes were often not positive towards people living with HIV. The Theory of Planned Behaviour constructs explained 56% of the variance in intention to take a sexual history: the control providers perceive they have over taking a sexual history was the strongest contributor (51%), while social pressure explained a further 3%. Attitudes about taking a sexual history did not contribute to intention. Interventions with Cambodian health care providers should focus on improving skills in sexual history-taking.

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