Issues and Opportunities in Primary Health Care for Children in Europe最新文献_第2页

Appendix 1: List of MOCHA Scientists 附录1:摩卡科学家名单

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191020

引用次数: 0

Services and Boundary Negotiations for Children with Complex Care Needs in Europe 欧洲复杂照顾需要儿童的服务和边界谈判

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191014

M. Brenner, M. O'Shea, Anne Clancy, Stine Lundstroem Kamionka, P. Larkin, Sapfo Lignou, D. Luzi, Elena Montañana Olaso, M. Alma, F. Pecoraro, R. Satherley, Oscar Tamburis, K. Taylor, A. Warters, Ingird Wolfe, J. Berry, C. Noctor, Carol Hilliard

{"title":"Services and Boundary Negotiations for Children with Complex Care Needs in Europe","authors":"M. Brenner, M. O'Shea, Anne Clancy, Stine Lundstroem Kamionka, P. Larkin, Sapfo Lignou, D. Luzi, Elena Montañana Olaso, M. Alma, F. Pecoraro, R. Satherley, Oscar Tamburis, K. Taylor, A. Warters, Ingird Wolfe, J. Berry, C. Noctor, Carol Hilliard","doi":"10.1108/978-1-78973-351-820191014","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191014","url":null,"abstract":"Improvements in neonatal and paediatric care mean that many children with complex care needs (CCNs) now survive into adulthood. This cohort of children places great challenges on health and social care delivery in the community: they require dynamic and responsive health and social care over a long period of time; they require organisational and delivery coordination functions; and health issues such as minor illnesses, normally presented to primary care, must be addressed in the context of the complex health issues. Their clinical presentation may challenge local care management. The project explored the interface between primary care and specialised health services and found that it is not easily navigated by children with CCNs and their families across the European Union and the European Economic Area countries. We described the referral-discharge interface, the management of a child with CCNs at the acute–community interface, social care, nursing preparedness for practice and the experiences of the child and family in all Models of Child Health Appraised countries. We investigated data integration and the presence of validated standards of care, including governance and co-creation of care. A separate enquiry was conducted into how care is accessed for children with enduring mental health disorders. This included the level of parental involvement and the presence of multidisciplinary teams in their care. For all children with CCNs, we found wide variation in access to, and governance of, care. Effective communication between the child, family and health services remains challenging, often with fragmentation of care delivery across the health and social care sector and limited service availability.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132299015","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}

引用次数: 1

Workforce and Professional Education 劳动力和专业教育

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191016

M. Blair, H. Gage, Ekelechi MacPepple, P. Michaud, Carol Hilliard, Anne Clancy, E. Hollywood, M. Brenner, A. Al-Yassin, C. Nitsche

{"title":"Workforce and Professional Education","authors":"M. Blair, H. Gage, Ekelechi MacPepple, P. Michaud, Carol Hilliard, Anne Clancy, E. Hollywood, M. Brenner, A. Al-Yassin, C. Nitsche","doi":"10.1108/978-1-78973-351-820191016","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191016","url":null,"abstract":"Abstract \u0000Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127119869","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}

引用次数: 0

Listening to Young People 倾听年轻人的心声

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191008

K. Zdunek, M. Alma, J. A. Til, K. Groothuis-Oudshoorn, M. Boere-Boonekamp, D. Alexander

{"title":"Listening to Young People","authors":"K. Zdunek, M. Alma, J. A. Til, K. Groothuis-Oudshoorn, M. Boere-Boonekamp, D. Alexander","doi":"10.1108/978-1-78973-351-820191008","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191008","url":null,"abstract":"Abstract \u0000Children’s voices are seldom heard directly. Most often, children, particularly young children, are represented by adults acting on their behalf who may or may not best represent the child’s views or best interests. This can be beneficial or problematic, if the child’s needs are not appreciated or recognised. This chapter looks at the changing attitudes to listening to young people, and the growing recognition of the value of children’s needs, as well as the growing voices of the children themselves, who make their needs increasingly clear. The results of our Models of Child Health Appraised (MOCHA) interviews with children and young people via the DIPEx International organisation give us clear direction as to the importance children using primary care services place on being taken seriously, being listened to and being able to make their own decisions. Other researchers asked input from primary care professionals on children’s autonomy and how the current and future primary care systems can best address the needs of young people, as well as the placing of these issues in a wider cultural context, and how this influences and is influenced by children’s choices. Finally, we look at how the MOCHA country agents have reported the assessment of the importance and function of listening to young people in our research.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117237164","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}

引用次数: 0

Primary Care for Adolescents 青少年初级保健

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191003

P. Michaud, Johanna P. M. Vervoort, D. Jansen

{"title":"Primary Care for Adolescents","authors":"P. Michaud, Johanna P. M. Vervoort, D. Jansen","doi":"10.1108/978-1-78973-351-820191003","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191003","url":null,"abstract":"Abstract \u0000Adolescence is a time when a young person develops his or her identity, acquires greater autonomy and independence, experiments and takes risks and grows mentally and physically. To successfully navigate these changes, an accessible and health system when needed is essential. \u0000 \u0000We assessed the structure and content of national primary care services against these standards in the field of adolescent health services. The main criteria identified by adolescents as important for primary care are as follows: accessibility, staff attitude, communication in all its forms, staff competency and skills, confidential and continuous care, age appropriate environment, involvement in health care, equity and respect and a strong link with the community. \u0000 \u0000We found that although half of the Models of Child Health Appraised countries have adopted adolescent-specific policies or guidelines, many countries do not meet the current standards of quality health care for adolescents. For example, the ability to provide emergency mental health care or respond to life-threatening behaviour is limited. Many countries provide good access to contraception, but specialised care for a pregnant adolescent may be hard to find. \u0000 \u0000Access needs to be improved for vulnerable adolescents; greater advocacy should be given to adolescent health and the promotion of good health habits. Adolescent health services should be well publicised, and adolescents need to feel empowered to access them.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128335787","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}

引用次数: 0

Equity 股本

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191002

Mitch Blair, D. Alexander

引用次数: 0

The Conundrum of Measuring Children’s Primary Health Care 衡量儿童初级卫生保健的难题

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191012

I. Rocco, Barbara Corso, D. Luzi, F. Pecoraro, Oscar Tamburis, U. Hoang, H. Liyanage, F. Ferreira, S. de Lusignan, N. Minicuci

{"title":"The Conundrum of Measuring Children’s Primary Health Care","authors":"I. Rocco, Barbara Corso, D. Luzi, F. Pecoraro, Oscar Tamburis, U. Hoang, H. Liyanage, F. Ferreira, S. de Lusignan, N. Minicuci","doi":"10.1108/978-1-78973-351-820191012","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191012","url":null,"abstract":"Abstract \u0000Evaluating primary care for children has not before been undertaken on a national level, and only infrequently on an international level, an adult-focused perspective is the norm. The Models of Child Health Appraised (MOCHA) project explored the evaluation of quality of primary care for children in a nationally comparable way, which recognises the influence of all components of child well-being and well-becoming. Using adult-focused metrics fails to account for children’s physical and psycho-social development at different ages, differences in health and non-health determinants, patterns of disease and risk factors and the stages of the life course. To do this, we attempted to identify comparable measures of child health in the European Union and European Economic Area countries, we aimed to perform a structural equation modelling technique to identify causal effects of certain policies or procedures in children’s primary care and we aimed to identify and interrogate large datasets for key tracer conditions. We found that the creation of comparative data for children and child health services remains a low priority in Europe, and the largely unmet need for indicators covering all the healthcare dimensions hampers development of evidence-based policy. In terms of the MOCHA project objective of appraising models of child primary health care, the results of this specific work show that the means of appraisal of system and service quality are not yet agreed or mature, as well as having inadequate data to fuel them.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"2314 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116796281","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}

引用次数: 2

Child Centricity and Children’s Rights 以儿童为中心与儿童权利

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191009

K. Zdunek, M. Rigby, S. Deshpande, D. Alexander

引用次数: 3

Index 指数

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191021

引用次数: 0

Measurement Conundrums: Explaining Child Health Population Outcomes in MOCHA Countries 测量难题:解释MOCHA国家的儿童健康人口结果

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191013

H. Gage, Ekelechi MacPepple

{"title":"Measurement Conundrums: Explaining Child Health Population Outcomes in MOCHA Countries","authors":"H. Gage, Ekelechi MacPepple","doi":"10.1108/978-1-78973-351-820191013","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191013","url":null,"abstract":"Abstract \u0000The 30 MOCHA (Models of Child Health Appraised) countries are diverse socially, culturally and economically, and differences exist in their healthcare systems and in the scope and role of primary care. An economic analysis was undertaken that sought to explain differences in child health outcomes between countries. The conceptual framework was that of a production function for health, whereby health outputs (or outcomes) are assumed affected by several ‘inputs’. In the case of health, inputs include personal (genes, health behaviours) and socio-economic (income, living standards) factors and the structure, organisation and workforce of the healthcare system. Random effects regression modelling was used, based on countries as the unit of analysis, with data from 2004 to 2016 from international sources and published categorisations of healthcare system. The chapter describes the data deficiencies and measurement conundrums faced, and how these were addressed. In the absence of consistent indicators of child health outcomes across countries, five mortality measures were used: neonatal, infant, under five years, diabetes (0–19 years) and epilepsy (0–19 years). Factors found associated with reductions in mortality were as follows: gross domestic product per capita growth (neonatal, infant, under five years), higher density of paediatricians (neonatal, infant, under five years), less out-of-pocket expenditure (neonatal, diabetes 0–19), state-based service provision (epilepsy 0–19) and lower proportions of children in the population, a proxy for family size (all outcomes). Findings should be interpreted with caution due to the ecological nature of the analysis and the limitations presented by the data and measures employed.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134112932","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}

引用次数: 1