Research in Health Services & Regions最新文献

{"title":"Differences in healthcare structures, processes and outcomes of neighbouring European countries: the example of Germany and the Netherlands","authors":"Lars Schwettmann, Axel Hamprecht, G. Seeber, Stefan Pichler, Andreas Voss, Lena Ansmann, Falk Hoffmann","doi":"10.1007/s43999-023-00031-9","DOIUrl":"https://doi.org/10.1007/s43999-023-00031-9","url":null,"abstract":"","PeriodicalId":220051,"journal":{"name":"Research in Health Services & Regions","volume":"1 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139264208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing unwarranted variation in hospital care – findings from a regional audit in Norway","authors":"H. P. Eide, P. Barach, E. Søreide, C. Thoresen, O. Tjomsland","doi":"10.1007/s43999-023-00033-7","DOIUrl":"https://doi.org/10.1007/s43999-023-00033-7","url":null,"abstract":"Abstract Background/Aim There has been increasing focus and research over the past decades on defining, identifying, visualizing and reducing unwarranted clinical variation in clinical practice. Both clinician-driven initiatives such as the US based “Choosing Wisely” campaign and the top-down driven “Evidence-based intervention programme (EBI)” launched by NHS UK to improve quality of care by reducing unnecessary interventions have shown marginal results. We present the findings from a mixed-methods audit performed to evaluate the compliance by senior hospital leaders of a new regional strategy to reduce unwarranted variation in outcomes and utilization rates. Methods Seventy-five mid- to senior-division and department leaders from eight hospital trusts in South-Eastern Norway Regional Trust (HSO) were invited to participate in evaluating the response and compliance of the regional leadership strategy for reducing unwarranted variation in patient outcomes and service utilization rates. Results The audit revealed that the aim of reducing unwanted variation was not clearly communicated by senior HSO management. There was varying use of data from the national quality registers and health atlases for quality improvement. One third of the clinical leaders reported a lack of scrutiny of their work and were insufficiently aware of the HSO’s top-management and the hospital’s Boards strategic expectations about the importance of reducing unwarranted variation in their hospital utilization. Conclusions We found that the strategic aim of reducing unwanted clinical variation was not clearly communicated by senior HSO management to hospital boards and senior management. The hospitals could benefit from a better understanding of causes of variation by strengthening their efforts to reduce unwarranted variation in utilization rates as a key element in improving health care quality and patient safety. The findings of the audit are relevant for other healthcare organizations trying to improve their quality and reduce unnecessary variation.","PeriodicalId":220051,"journal":{"name":"Research in Health Services & Regions","volume":"2 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136229530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“The trip actually opened our eyes to things that we were supposed to do and we were not doing”: developing primary health care system leadership in a low-income country with peer exchanges","authors":"Mawuli Kushitor, Kalifa Wright, Adriana Biney, Edmund W. Kanmiki, Pearl Kyei, James F. Phillips, John Koku Awoonor-Williams, Ayaga A. Bawah","doi":"10.1007/s43999-023-00030-w","DOIUrl":"https://doi.org/10.1007/s43999-023-00030-w","url":null,"abstract":"Abstract Background Health care systems in low and middle-income countries are decentralizing and devolving power to the periphery. Transferring power without systematic processes to develop and nurture leaders at the district compromises the effectiveness and sustainability of the decentralized health system. To address this problem, we developed an approach to leadership learning by observation and experience that improved the organization and performance of the health care system in a district in Ghana. Methodology Using two rounds of a longitudinal qualitative study, the study explores the determinants of implementing the Community-Based Health Planning and Services (CHPS) initiative in a district in Ghana. Insights were gained concerning the leadership regimes of two leaders who administered health services in a common geographic area at different points in time with remarkably contrasting outcomes. Insights of health workers who participated in both periods were elicited to clarify interview contexts. Ten focus group discussions (FGDs) and five expert interviews were conducted for each round of the study. The study was informed by a systems appraisal approach that utilized a thematic analytical framework. Results Providing district leaders with a practical observational experience had a significant influence on health care delivery in all aspects of health care provision at the district level. Exposing participants to models of best practices facilitated the replication of processes that improved the conduct of service delivery and CHPS implementation. Upon reflection, district leaders attributed performance constraints to their lack of understanding of practical ways of responding to complex district health system development needs. Observation from community members, volunteers, and health workers who witnessed the system development period corroborated narratives that leaders had expressed. Conclusion Effective leadership is optimally developed with participatory learning that provides leaders with direct access to fully functioning systems. Learning by observation can be structured and used to quicken the spread of managerial excellence.","PeriodicalId":220051,"journal":{"name":"Research in Health Services & Regions","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135824200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health and work: regional health reporting on employees in Germany","authors":"Matthias Richter, Karin Kliner, Dirk Rennert","doi":"10.1007/s43999-023-00028-4","DOIUrl":"https://doi.org/10.1007/s43999-023-00028-4","url":null,"abstract":"Abstract The vast majority of people work a large part of their live, therefore work inevitably has a major impact on health as well. In Germany, great efforts are made to improve health and well-being in the occupational context. To support this, the evaluation of health data especially from employees is one the main scopes in health reporting of the Federal Association of Company Health Insurance Funds (BKK Dachverband). These results are made available to the interested public via various publication channels, including interactive online diagrams. Data from the areas of incapacity to work, outpatient and inpatient care as well as drug prescriptions are applied. Due to the in large parts identically structured representations, comparisons across health care system sectors are also possible. The aim of this article is to describe the provided regional health care data of employees with focus on the interactive data provision, to show by example particularities in single sources and across sources. From this the impact of work as well as workplace health promotion on the health of employees and, in a broader sense, the quality of health care in Germany can be derived.","PeriodicalId":220051,"journal":{"name":"Research in Health Services & Regions","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134991021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin adherence in patients enrolled in the disease management program for coronary artery disease – comparison between patients’ and general practitioners’ self-reports and patient records","authors":"Babak Salam, Anne Schrimpf, Sebastian Münster, Markus Bleckwenn","doi":"10.1007/s43999-023-00029-3","DOIUrl":"https://doi.org/10.1007/s43999-023-00029-3","url":null,"abstract":"","PeriodicalId":220051,"journal":{"name":"Research in Health Services & Regions","volume":"26 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131491764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with early newborn care practices in Bangladesh: evidence from Bangladesh Demographic and Health Survey","authors":"Md. Saifullah Sakib, Tahmina Ferdous Tanny, Abu Sayeed Ripon Rouf, Mehedi Hasan Manik","doi":"10.1007/s43999-023-00027-5","DOIUrl":"https://doi.org/10.1007/s43999-023-00027-5","url":null,"abstract":"","PeriodicalId":220051,"journal":{"name":"Research in Health Services & Regions","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132463748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct and indirect barriers to hypothetical access to care among Canadian forces health services personnel","authors":"Jennifer Born, C. Frank","doi":"10.1007/s43999-023-00026-6","DOIUrl":"https://doi.org/10.1007/s43999-023-00026-6","url":null,"abstract":"","PeriodicalId":220051,"journal":{"name":"Research in Health Services & Regions","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129109041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health reforms across the world: are they heading in the same direction, and how much change can we expect?","authors":"T. Tenbensel","doi":"10.1007/s43999-023-00024-8","DOIUrl":"https://doi.org/10.1007/s43999-023-00024-8","url":null,"abstract":"","PeriodicalId":220051,"journal":{"name":"Research in Health Services & Regions","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125981564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic variation in the utilisation of specialist healthcare for patients with severe mental illness in Norway: a population-based registry study","authors":"H. K. Bedane, L. Lien, M. Holsen, Marte Bale, K. I. Osvoll, C. Thoresen, P. Holman","doi":"10.1007/s43999-023-00025-7","DOIUrl":"https://doi.org/10.1007/s43999-023-00025-7","url":null,"abstract":"","PeriodicalId":220051,"journal":{"name":"Research in Health Services & Regions","volume":"162 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125643113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An investigation of the bio-medical waste produced in India during the COVID-19 pandemic and Maharashtra state (pre-COVID-19 and post-COVID-19) analysis: a GIS-based approach","authors":"W. A. Bagwan","doi":"10.1007/s43999-023-00023-9","DOIUrl":"https://doi.org/10.1007/s43999-023-00023-9","url":null,"abstract":"","PeriodicalId":220051,"journal":{"name":"Research in Health Services & Regions","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122839217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}