International Journal of Healthcare Delivery Reform Initiatives最新文献

{"title":"A Simple Model for a Complex Issue","authors":"Hassan Qudrat-Ullah","doi":"10.4018/JHDRI.2011100105","DOIUrl":"https://doi.org/10.4018/JHDRI.2011100105","url":null,"abstract":"System dynamics models can facilitate the understanding of complex and dynamic biomedical systems such as in HIV/AIDS. Untangling the dynamics among various population stocks (e.g., susceptible population, infected population, HIV population, AIDS population) can be used to investigate the effective points of interventions in the HIV/AIDS cycle. With that in mind, the authors have developed a system dynamics model that can be used to examine various policy decisions for the prevention and the treatment of HIV/AIDS. The specific objectives of their study was to examine the growing number of AIDS-related deaths in Canada. They used the authors’ dynamic simulation model to evaluate the impact of various HIV/AIDS policy intervention scenarios centred on the reduction of the number of AIDS deaths in Canada. Their analysis suggests that more lives will be saved if effective preventive and treatment programs are implemented simultaneously. A simultaneous implementation of these programs will also result in a much smaller HIV-infected and AIDS populations.","PeriodicalId":352165,"journal":{"name":"International Journal of Healthcare Delivery Reform Initiatives","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134598763","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":"PPP’s Application in Greek Health Infrastructure and Personnel’s Response","authors":"Georgios N. Chatzipoulidis, Georgios N. Aretoulis, Glykeria P. Kalfakakou","doi":"10.4018/JHDRI.2011100101","DOIUrl":"https://doi.org/10.4018/JHDRI.2011100101","url":null,"abstract":"Financial crisis is particularly acute in Greece. Public Private Partnerships (PPPs), under these conditions, appear as a “reasonable” strategic decision. A PPP’s project implementation requires a high level of preparation, especially in the sensitive area of the National Health System (NHS). The implementation of PPPs projects in Health Sector, has recently initiated in Greece, while the relevant legal framework has been already voted since 2005. Many people express reservations about the extent and the content of this implementation. The aim of the current survey was to measure the satisfaction of health professionals in the public sector from the existing infrastructures and the assessment of their attitude to the prospect of PPP’s application to upgrade health infrastructure and health services. Results focus on the response of the hospital executive personnel towards PPP’s implementation. The research found a generally positive response to PPPs, while at the same time this approach is being characterized as a last resort. The positive reaction was identified in the involvement of the private sector, in providing support services during the contract, according to the current legislative framework. On the other hand, there is a significant opposition towards any prospect of transferring to the private investor, services related to medical and nursing care. PPP’s Application in Greek Health Infrastructure and Personnel’s Response","PeriodicalId":352165,"journal":{"name":"International Journal of Healthcare Delivery Reform Initiatives","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117277396","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 telematics infrastructure: The backbone of the German e-health card","authors":"M. Zwicker, Juergen Seitz, N. Wickramasinghe","doi":"10.4018/JHDRI.2011100102","DOIUrl":"https://doi.org/10.4018/JHDRI.2011100102","url":null,"abstract":"Today all OECD (Organization for Economic Cooperation and Development) countries are faced with the challenge of escalating healthcare costs. Most are agreed that e-health appears to offer a solution and thus we are witnessing the design, development and implementation of various e-health solutions. This is also true in Germany where the current focus is on the new e-health card concept. It is anticipated that the introduction of this e-health card will totally change the current healthcare system within Germany, primarily because it offers several new functions. Some of these functions are mandatory, while other functions are optional. Such an initiative however, brings with it several advantages and disadvantages. A particularly sensitive aspect here concerns data protection and data security. To address this consideration, the development of a new telematics infrastructure is critical and in some respects the backbone for the e-health card. Thus, the following provides an assessment of the telematics infrastructure behind the German e-health card.","PeriodicalId":352165,"journal":{"name":"International Journal of Healthcare Delivery Reform Initiatives","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131096651","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":"Predicting Diabetes amongst Native American Elders: The Importance of Comorbid Diseases and their Interactions","authors":"S. Upadhyaya, K. Farahmand, T. Baker-Demaray","doi":"10.4018/JHDRI.2011100103","DOIUrl":"https://doi.org/10.4018/JHDRI.2011100103","url":null,"abstract":"One in three Americans will be diabetic by 2050, and the rate of diabetes is disproportionately high among Native Americans, especially among Native elders age 55 and older. Early identification and prevention strategies have been regarded as the cornerstone of preventative medicine. The objective of the authors’ research was to identify factors related to diabetes and their interactions specifically among Native elders and develop a simple prediction model which can be used by healthcare professionals while interacting with Native elders in remote or rural areas. Data from a survey of 18,078 Native American elders was used in their study. After eliminating outliers using Pearson’s residuals and Cook’s distance, the area under the receiver operating characteristic curve was 0.7812 for men and 0.7230 for women. The results from the authors’ analysis provide additional perspective on how diabetes affects Native elders thus helping healthcare providers and policy makers when dealing with these community members.","PeriodicalId":352165,"journal":{"name":"International Journal of Healthcare Delivery Reform Initiatives","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125698117","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":"Clinical Commissioning Groups in the UK: A Knowledge Management Study","authors":"V. Baskaran, S. Johns, R. Bali, R. Naguib, N. Wickramasinghe","doi":"10.4018/JHDRI.2011100104","DOIUrl":"https://doi.org/10.4018/JHDRI.2011100104","url":null,"abstract":"School of Informatics, College of Continuing and Professional Studies, Mercer University, Atlanta, GA,","PeriodicalId":352165,"journal":{"name":"International Journal of Healthcare Delivery Reform Initiatives","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126958579","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":"Moving Beyond Repair: Perfecting Health Care","authors":"Joseph C. Onyeocha","doi":"10.4018/JHDRI.2011070105","DOIUrl":"https://doi.org/10.4018/JHDRI.2011070105","url":null,"abstract":"","PeriodicalId":352165,"journal":{"name":"International Journal of Healthcare Delivery Reform Initiatives","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129305450","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":"Analysis of Slot Allocation Strategies and their Impacts on Appointment Waiting Time in Context of Outpatient Clinics","authors":"Zhu Zhe-cheng","doi":"10.4018/JHDRI.2011070103","DOIUrl":"https://doi.org/10.4018/JHDRI.2011070103","url":null,"abstract":"One prevailing problem in outpatient clinics with appointment systems in Singapore is that patients have to wait a long time for an available slot once they make requests. Such a long wait may negatively impact on the access to healthcare facilities, patient safety and satisfaction, etc. In recent years, such a problem is becoming worse due to the aging society and growing population. Besides the pressure of increasing demand, healthcare service providers in outpatient clinics are facing other challenges such as the complexity of patient request types, e.g., urgent or normal requests, requests for new or follow-up visit, etc. How to allocate the limited slots to meet the requirements of different requests is one of the performance measurements in outpatient clinics. In this paper, discrete event simulation is applied to study different slot allocation strategies and their impacts on waiting time. The dynamics between new visits and follow-up visits are analyzed as well. DOI: 10.4018/jhdri.2011070103 30 International Journal of Healthcare Delivery Reform Initiatives, 3(3), 29-41, July-September 2011 Copyright © 2011, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited. Outpatient clinics with an appointment system have several advantages over walk-in outpatient clinics. Firstly, demand fluctuation can be absorbed by the appointment system. Over-utilization or under-utilization is less likely to happen than in walk-in outpatient clinics. Secondly, appointment-based outpatient clinics provide a better patient experience than walk-in outpatient clinics. Patients are able to choose their preferred doctors and continue to see the same doctor for their follow-up visits in appointment-based outpatient clinics. Thirdly, patient waiting time of a well planned appointment based clinic is shorter because the uncertainty of patient arrivals is mitigated by the pre-defined time slots. One important performance measure of an outpatient clinic is the waiting time. According to Gupta and Denton (2008), there are two types of waiting times in a typical outpatient clinic: indirect waiting time and direct waiting time. Indirect waiting time represents the period between a confirmed request and the assigned time slot. It is also known as appointment waiting time. Indirect waiting time is usually determined by the demand/supply relationship. A long indirect waiting time indicates a possible inaccessibility of healthcare facility and may cause higher no-show rate. Direct waiting time represents the physical waiting time a patient spends in the waiting area of the clinic. Long direct waiting time may affect patient satisfaction negatively. There are many research works studying the waiting time problems in outpatient clinics. Most of them focus on how to reduce the direct waiting time by proposing different scheduling rules (Bailey, 1952; Cayirli & Veral, 2003; Ho & Lau, 1999) or identifying factors cau","PeriodicalId":352165,"journal":{"name":"International Journal of Healthcare Delivery Reform Initiatives","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123818201","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 Implementation and Future Directions of e-Health Information Policy: Greece","authors":"E. Lappa, G. Giannakopoulos","doi":"10.4018/JHDRI.2011070101","DOIUrl":"https://doi.org/10.4018/JHDRI.2011070101","url":null,"abstract":"Information technology has the potential to transform working procedure in the health care sector. Clinicians have used Health Information Management and Technology (HIM&T) for more than two decades to assist in achieving better healthcare delivery outcomes. Medical knowledge is too complex for humans to master in a single mind, and to remember everything about each patient. Medical data consist of many kinds of data from different sources, requiring the development of many medical decision support systems. Creating and indexing records for hospitals and health systems present difficult challenges, because the medical records contain sensitive information. Increased computerization and other policy factors have contributed to privacy risks. Transforming from paper-based to Electronic Medical Records (EMR) allows healthcare providers to share information across their care ecosystem. Access to this digital lifeline, connecting the EMR to the digital web platforma, is critical to saving lives, preventing medical errors and improving efficiency of healthcare delivery. Choosing the international classification systems for patients, ICD, DRGs, grouped patients according to the resources consumption required for treatment and other clinical characteristics. Information Technology provides solutions to this problem. A vital element of healthcare delivery is to ensure that the patient is always at the centre of everything clinicians do. DOI: 10.4018/jhdri.2011070101 2 International Journal of Healthcare Delivery Reform Initiatives, 3(3), 1-9, July-September 2011 Copyright © 2011, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited. 1992 OECD taxonomy—where the financing is provided by a combination of social insurance and general taxation. Services are offered by both public and private providers. Since 2001, Regional Health Authorities have been established, currently named DYPE (Administration of Health Services Region) with the extensive responsibilities of setting national priorities and coordinating activities at the regional level. E-HEALTH STRATEGY IN GREECE Public health policies in Greece appear to have contributed to raising pull information, on National Health Level network. These include the development of basic infrastructures, electronic services and standards, as well as of project administration and management. One core objective is the National Health Information System infrastructure, supported by IASYS and interacts with its environment through the citizens’ health card and the professional card. This global strategy was made public in June 2006, titled “Quality and Safety of Health Care Services in an e-Government Environment,” specifically emphasizes e-Health Strategic patient document portal. The Hellenic Health Care System has planned to provide universal coverage to the population based on the principles of equity, equal access to health services for all and social","PeriodicalId":352165,"journal":{"name":"International Journal of Healthcare Delivery Reform Initiatives","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133925086","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":"Quality Assurance and Evaluation of Healthcare Reform Initiatives: Strategy for Improving the Quality of Health Care Services in Public Health Care Units, Management Model that Allows the Providing of High Quality Health Care and Efficient Brand-Building","authors":"Anna Rosiek, K. Leksowski","doi":"10.4018/JHDRI.2011070104","DOIUrl":"https://doi.org/10.4018/JHDRI.2011070104","url":null,"abstract":"This article describes a model of health-care services that ensure the high quality of health-care service and effective brand creation for a hospital. The problems described here that are connected to improving the quality of health care in Poland indicates that high quality of health care builds a positive and strong image of a health-care unit on the medical market. The contents of this article involve basic definitions of quality in health care and also the way the quality is understood and perceived from patient’s and hospital’s point of view. The article also describes a health care quality model, to which health care units should aspire in order to create a positive picture of said units, simultaneously improving and maintaining high quality of health care services. The article investigates the quality factors of health care services, which influence the healthcare units’ brand, its functioning on the market and patient-perceived quality of services. The described management model, which ensures efficient brand-building of healthcare units through services’ quality, takes into account changes in healthcare system and does so in order to ensure the improvement in healthcare units’ functioning. DOI: 10.4018/jhdri.2011070104 International Journal of Healthcare Delivery Reform Initiatives, 3(3), 42-53, July-September 2011 43 Copyright © 2011, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited. life, including the medical service sector. The changes affected not only structures, but also the patients’ thinking mode, their way of seeing a health care unit and the services it offers. Patients have become more demanding, they have started to behave like customers (clients) and expect the same quality of services as in the case of consumer goods. Such a situation is caused by the entry of medical services to the market of consumer goods, into the area of mutually competitive medical units. This new situation requires a medical organization to take into consideration patients’ needs, to listen to them and to improve the quality of its services. Specifics of medical service – its professional and interpersonal aspects – are extremely important in health care. Those specifics concern the highest values, that is: health and human life (Pędziwiatr, 1999). However, concentrating on providing high quality medical services in their technical aspect is not sufficient in contemporary market environment. Therefore, in order to obtain patient’s positive opinion on medical services provided by health care units, we have to take care of those factors which pertain directly to the image of a medical unit as seen by its customer. Those factors are highly subjective; they include: patient’s feelings and experience in previous contacts with a health care organization, his/her trust and satisfaction and also the commitment of the whole organization to the treatment process and improvement of patient","PeriodicalId":352165,"journal":{"name":"International Journal of Healthcare Delivery Reform Initiatives","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132428230","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":"Situational Analysis of E-Health Initiative using ICT in Emergency Care Services: The Case of Coimbatore in Tamilnadu State, India","authors":"P. Devika, N. Mathiyalagan","doi":"10.4018/JHDRI.2011070102","DOIUrl":"https://doi.org/10.4018/JHDRI.2011070102","url":null,"abstract":"India, with its billion inhabitants, requires better emergency services to meet the growing demand for faster critical care facilitation. The scientific advances in the field of information and communication technology have contributed to the implementation of various e-health initiatives by various state governments within the country to improve the quality, access, and delivery of emergency care. “108 Emergency Response Service” is an e-health project established by the government of Tamilnadu state in India to render emergency services to the people. A qualitative study of the effectiveness of Information and Communication technologies in this Emergency Response Service (108 Emergency Service) in Coimbatore district of Tamilnadu state (http://www. coimbatore.tn.nic) was done and recommendations to increase the effectiveness were provided. The results reveal that the efficiency and effectiveness of 108 ERS could be greatly enhanced by providing better telecommunication facilities in rural areas and by deploying Global Positioning System (GPS) and Geographic Information System (GIS) and Automatic Vehicle Location (AVL) technologies to reduce the response time of the emergency vehicles. DOI: 10.4018/jhdri.2011070102 International Journal of Healthcare Delivery Reform Initiatives, 3(3), 10-28, July-September 2011 11 Copyright © 2011, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited. Centre, 2010). Regardless of the apparent need for emergency care, EMS in India remains very poor (Das et al., 2008) The EMS spectrum constitutes a communication system, emergency transportation and pre-hospital care. Communication system provides telephone access to the EMS and facilitates the reception of emergency calls, dispatch of required services, delivery of life saving information, and enables communication with emergency response personnel. The victim’s chances of survival are high when definitive care is given within the first hour of the emergency (The Trauma Center Association of America, http://www.traumafoundation.org). Emergency transportation facilitates the quick transfer of the emergency victim from the scene of emergency to the nearest healthcare center. Pre-hospital care is essential for trauma type medical emergencies. In India, 80% of hospital fatalities occur in the first hour of admission (Jhampla, 2009). Such fatalities could be significantly reduced with reliable communication system, efficient emergency transportation and effective pre-hospital care. 1.1. Role of ICT in Emergency Response System The role of Information and Communication Technologies (ICT) starts right from establishing the necessary telecommunication networks and providing a common emergency number for emergency services to the delivery of required emergency services using relevant communication technologies. On dialing an emergency number, the call is connected to the dispatch center or communication cen","PeriodicalId":352165,"journal":{"name":"International Journal of Healthcare Delivery Reform Initiatives","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131096135","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}