发布求助
文献互助 智能选刊 最新文献

Health Systems最新文献

筛选
英文 中文
A qualitative model of the HIV care continuum in Vancouver, Canada. 加拿大温哥华HIV护理连续体的定性模型
IF 1.2
Health Systems Pub Date : 2021-04-04 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2021.1906762
Benny Wai, Krisztina Vasarhelyi, Alexander R Rutherford, Chris Buchner, Reka Gustafson, Miranda Compton, Mark Hull, Jf Williams, Rolando Barrios
{"title":"A qualitative model of the HIV care continuum in Vancouver, Canada.","authors":"Benny Wai, Krisztina Vasarhelyi, Alexander R Rutherford, Chris Buchner, Reka Gustafson, Miranda Compton, Mark Hull, Jf Williams, Rolando Barrios","doi":"10.1080/20476965.2021.1906762","DOIUrl":"10.1080/20476965.2021.1906762","url":null,"abstract":"<p><p>A team of health care stakeholders and researchers collaboratively developed a qualitative model and graphic representation of the continuum of HIV care in Vancouver to inform delivery of antiretroviral therapy and other HIV health services. The model describes the patient journey through the HIV care continuum, including states of infection, health services, and care decisions. We used a Unified Modelling Language (UML) <i>activity diagram</i> to capture patient and provider activities and to guide the construction of a UML <i>state machine diagram</i>. The state machine diagram captures model agent states in a formalism that facilitates the development of system dynamics or agent-based models. These quantitative models can be applied to optimizing the allocation of resources, and to evaluate potential strategies for improved patient care and system performance. The novel approach of combining UML diagrams we present provides a general method for modelling capacity ---management strategies within complex health systems.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2021-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9154767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45634369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Using the theory of constraints to create a paradigm shift in organisation performance at a large primary care provider practice 利用约束理论在大型初级保健提供者实践中创造组织绩效的范式转变
IF 1.8
Health Systems Pub Date : 2021-02-14 DOI: 10.1080/20476965.2021.1876533
James F. Cox
{"title":"Using the theory of constraints to create a paradigm shift in organisation performance at a large primary care provider practice","authors":"James F. Cox","doi":"10.1080/20476965.2021.1876533","DOIUrl":"https://doi.org/10.1080/20476965.2021.1876533","url":null,"abstract":"ABSTRACT Healthcare is in crisis with increasing patients’ needs, rising medical technology investment, increasing expenses, and patients’ inability to pay. To address this crisis, a new, simple, effective, and holistic management methodology is needed to rapidly and economically improve each link’s performance in the healthcare supply chain (HCSC). The HCSC involves several links starting with the sick patient, then the primary care provider practice (PCPP) then the specialists … to the well-patient. Most HC research does not address this ill-structured, messy-problem environment: the causalities within a link and across the HCSC; the multiple criteria imposed by different HCSC stakeholders. Better management of the PCPP, the gatekeeper to other links is the leverage point to providing more, cheaper, better and timely healthcare. Action research at a PCPP using Theory of Constraint resulted in increases in revenue and net ordinary income; decreases in patient no-show rates and waiting times; and better provider utilization.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2021.1876533","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47368180","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
Covid-19 transmission modelling of students returning home from university. 针对大学毕业返乡学生的 Covid-19 传播模型。
IF 1.8
Health Systems Pub Date : 2021-01-17 eCollection Date: 2021-01-01 DOI: 10.1080/20476965.2020.1857214
Paul R Harper, Joshua W Moore, Thomas E Woolley
{"title":"Covid-19 transmission modelling of students returning home from university.","authors":"Paul R Harper, Joshua W Moore, Thomas E Woolley","doi":"10.1080/20476965.2020.1857214","DOIUrl":"10.1080/20476965.2020.1857214","url":null,"abstract":"<p><p>We provide an open-source model to estimate the number of secondary Covid-19 infections caused by potentially infectious students returning from university to private homes with other occupants. Using a Monte-Carlo method and data derived from UK sources, we predict that an infectious student would, on average, infect 0.94 other household members. Or, as a rule of thumb, each infected student would generate (just less than) one secondary within-household infection. The total number of secondary cases for all returning students is dependent on the virus prevalence within each student population at the time of their departure from campus back home. Although the proposed estimation method is general and robust, the results are sensitive to the input data. We provide Matlab code and a helpful online app (http://bit.ly/Secondary_infections_app) that can be used to estimate numbers of secondary infections based on local parameter values. This can be used worldwide to support policy making.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946042/pdf/THSS_10_1857214.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25526785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Socioeconomic differentials in the burden of paying for healthcare in India: a disaggregated analysis. 印度医疗保健负担的社会经济差异：分类分析。
IF 1.8
Health Systems Pub Date : 2020-12-15 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2020.1848356
Ramna Thakur, Shivendra Sangar
{"title":"Socioeconomic differentials in the burden of paying for healthcare in India: a disaggregated analysis.","authors":"Ramna Thakur,&nbsp;Shivendra Sangar","doi":"10.1080/20476965.2020.1848356","DOIUrl":"https://doi.org/10.1080/20476965.2020.1848356","url":null,"abstract":"<p><p>By using nationally representative consumption expenditure surveys (CES) conducted by the National Sample Survey Organisation (NSSO) in 1999-2000, 2004-05 and 2011-12, this paper has analysed the socioeconomic differentials in the burden of paying for healthcare in India. The study found that in all waves of data, the concentration of population reporting OOP health expenditure has shown a shift towards poor population, while the concentration of overshoot expenditure is still constant among the rich which is more pronounced in the rural areas of the country. Furthermore, Muslims and Sikhs among different religions, Scheduled Casts among social categories, self-employed and casual/agricultural labour among household types and rural areas among sectors are more likely to incur OOP health expenditure as compared to their counterparts. This study argues for the universal health insurance coverage to protect households from the significant burden of expenditure on critical healthcare.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2020.1848356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39756481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
"What's the evidence?"-Towards more empirical evaluations of the impact of OR interventions in healthcare. "证据是什么？"--对手术室干预措施对医疗保健的影响进行更多的实证评估。
IF 1.2
Health Systems Pub Date : 2020-12-15 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2020.1857663
Guillaume Lamé, Sonya Crowe, Matthew Barclay
{"title":"\"What's the evidence?\"-Towards more empirical evaluations of the impact of OR interventions in healthcare.","authors":"Guillaume Lamé, Sonya Crowe, Matthew Barclay","doi":"10.1080/20476965.2020.1857663","DOIUrl":"10.1080/20476965.2020.1857663","url":null,"abstract":"<p><p>Despite an increasing number of papers reporting applications of operational research (OR) to problems in healthcare, there remains little empirical evidence of OR improving healthcare delivery in practice. Without such evidence it is harder both to justify the usefulness of OR to a healthcare audience and to learn and continuously improve our approaches. To progress, we need to build the evidence-base on whether and how OR improves healthcare delivery through careful empirical evaluation. This position paper reviews evaluation standards in healthcare improvement research and dispels some common myths about evaluation. It highlights the current lack of robust evaluation of healthcare OR and makes the case for addressing this. It then proposes possible ways for building better empirical evaluations of OR interventions in healthcare.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39756482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A discrete-event simulation model of the kidney transplantation system in Rajasthan, India. 印度拉贾斯坦邦肾移植系统的离散事件模拟模型。
IF 1.8
Health Systems Pub Date : 2020-11-28 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2020.1848355
Mohd Shoaib, Utkarsh Prabhakar, Sumit Mahlawat, Varun Ramamohan
{"title":"A discrete-event simulation model of the kidney transplantation system in Rajasthan, India.","authors":"Mohd Shoaib,&nbsp;Utkarsh Prabhakar,&nbsp;Sumit Mahlawat,&nbsp;Varun Ramamohan","doi":"10.1080/20476965.2020.1848355","DOIUrl":"https://doi.org/10.1080/20476965.2020.1848355","url":null,"abstract":"<p><p>We present a discrete-event simulation model of the kidney transplantation system in an Indian state, Rajasthan. Organs are generated across the state based on the organ donation rate among the general population, and are allocated to patients on the kidney transplantation waitlist. The organ allocation algorithm is developed using official guidelines published for kidney transplantation, and model parameters were estimated using publicly available data to the extent possible. Transplantation outcomes generated by the model include: (a) the probabilities of a patient receiving an organ within one to 5 years of registration and (b) the average number of deaths per year due to lack of donated organs. Simulation experiments involving observing the effect of increasing the organ arrival rate and establishing additional transplantation centres on transplantation outcomes are also conducted. We also demonstrate the use of such a model to optimally locate additional transplantation centres using simulation optimisation methods.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2020.1848355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39756480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Increasing cardio-thoracic productivity at Erasmus MC. 提高Erasmus MC的心肺功能。
IF 1.8
Health Systems Pub Date : 2020-11-26 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2020.1848357
Maartje Zonderland, Jos Bekkers, Jasper van Bommel, Maarten Ter Horst, Wouter van Leeuwen, Femke van den Wall Bake, Willem Wiegersma, Ad Bogers
{"title":"Increasing cardio-thoracic productivity at Erasmus MC.","authors":"Maartje Zonderland,&nbsp;Jos Bekkers,&nbsp;Jasper van Bommel,&nbsp;Maarten Ter Horst,&nbsp;Wouter van Leeuwen,&nbsp;Femke van den Wall Bake,&nbsp;Willem Wiegersma,&nbsp;Ad Bogers","doi":"10.1080/20476965.2020.1848357","DOIUrl":"https://doi.org/10.1080/20476965.2020.1848357","url":null,"abstract":"<p><p>The Thoraxcenter of Erasmus MC started an improvement project in 2015 in order to increase the number of open-heart surgeries by 150 for three consecutive years (450 in total, +46%), and to decrease the access time from 12-14 to 2-3 weeks by the end of 2016. This was required to attain economy of scale in a highly competitive market. In this paper we describe the first year of the project, focusing on its structure and interventions taken, resulting in 165 additional open-heart surgeries carried out in 2016 and a significantly shorter access time of 2-3 weeks.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2020.1848357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39756483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Secondary Household Covid-19 Transmission Modelling of Students Returning Home from University 高校返乡学生Covid-19二次家庭传播模型研究
IF 1.8
Health Systems Pub Date : 2020-11-13 DOI: 10.1101/2020.11.11.20229559
Paul Robert Harper, Joshua W. Moore, Thomas E. Woolley
{"title":"Secondary Household Covid-19 Transmission Modelling of Students Returning Home from University","authors":"Paul Robert Harper, Joshua W. Moore, Thomas E. Woolley","doi":"10.1101/2020.11.11.20229559","DOIUrl":"https://doi.org/10.1101/2020.11.11.20229559","url":null,"abstract":"We estimate the number of secondary Covid-19 infections caused by potentially infectious students returning from university to private homes with other occupants. Using a Monte-Carlo method and data derived from UK sources, we predict that an infectious student would, on average, infect 0.94 other household members. Or, as a rule of thumb, each infected student would generate (just less than) one secondary within-household infection. The total number of secondary cases for all returning students is dependent on the virus prevalence within the student population at the time of their departure from campus back home. Correspondingly, we provide results for prevalence ranging from 0.5% to 15%, which is based on observed minimum and maximum estimates from Cardiff University's asymptomatic testing service. Although the proposed estimation method is general and robust, the results are sensitive to the input data. We therefore provide Matlab code and a helpful online app (http://bit.ly/Secondary_infections_app) that can be used to estimate numbers of secondary infections based on local parameter values","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62316834","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
Outcomes of managing healthcare services using the Theory of Constraints: A systematic review. 使用约束理论管理医疗服务的结果:系统回顾。
IF 1.8
Health Systems Pub Date : 2020-10-06 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2020.1813056
Gustavo M Bacelar-Silva, James F Cox, Pedro Pereira Rodrigues
{"title":"Outcomes of managing healthcare services using the Theory of Constraints: A systematic review.","authors":"Gustavo M Bacelar-Silva,&nbsp;James F Cox,&nbsp;Pedro Pereira Rodrigues","doi":"10.1080/20476965.2020.1813056","DOIUrl":"10.1080/20476965.2020.1813056","url":null,"abstract":"ABSTRACT Despite ever-increasing resources devoted to healthcare, lack of capacity and timeliness are still chronic problems worldwide. This systematic review aims to present an overview of the Theory of Constraints (TOC) implementations in healthcare services and their outcomes. We analysed 42 TOC implementations (15 full-text articles, 12 video proceedings, and 2 theses/disserations) from major scientific electronic databases and TOC International Certification Organization Conferences. All implementations reported positive outcomes, both tangible and intangible. The two main improvements reported by authors were in productivity (98%; n = 41) – more patients treated – and in the timeliness of care (83%; n = 35). Furthermore, the selected studies reported dramatic improvements: 50% mean reductions in patient waiting time; 38% reduction in patient length of stay; 43% mean increase in operating room productivity and 34% mean increase in throughput. TOC implementations attained positive results in all levels of the health and social care chain. Most TOC recommendations and changes showed almost immediate results and required little or no additional cost to implement. Evidence supports TOC as a promising solution for the chronic healthcare problem, improving quality and timeliness, both necessary conditions for providing effective healthcare.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2020.1813056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39756478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Patient-held health IT adoption across the primary-secondary care interface: a Normalisation Process Theory perspective. 患者持有的医疗信息技术在初级-二级护理界面的采用:标准化过程理论视角。
IF 1.8
Health Systems Pub Date : 2020-09-29 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2020.1822146
Stephen McCarthy, Ciara Fitzgerald, Laura Sahm, Colin Bradley, Elaine K Walsh
{"title":"Patient-held health IT adoption across the primary-secondary care interface: a Normalisation Process Theory perspective.","authors":"Stephen McCarthy,&nbsp;Ciara Fitzgerald,&nbsp;Laura Sahm,&nbsp;Colin Bradley,&nbsp;Elaine K Walsh","doi":"10.1080/20476965.2020.1822146","DOIUrl":"https://doi.org/10.1080/20476965.2020.1822146","url":null,"abstract":"<p><p>Patient-held Health Information Technologies (HIT) can reduce medical error by improving communication between patients and the healthcare team. Despite the proposed benefits, the roll-out of patient-held HIT solutions remains nascent, leaving considerable gaps in our understanding of the adoption challenges inherent. This paper adopts Normalisation Process Theory to study the factors which support or impede the adoption and \"normalisation\" of patient-held HIT, particularly across the primary-secondary care interface. The authors conducted an in-depth case study of HIT adoption across four GP practices, and the wards of a 350 bed hospital. 35 semi-structured interviews were completed. Findings point towards both user-specific and network-specific factors as significant challenges to normalisation across primary-secondary care. This includes factors related to interactional workability, skill set workability, relational integration, and contextual integration. We also discuss challenges specific to patient-held HIT adoption e.g., understanding the patient/clinician experience, supporting informal clinician networks, and spanning across IT boundaries.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2020.1822146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39756479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
首页 上一页 下一页 尾页
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整，为了账户安全，请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们：info@booksci.cn Book学术提供免费学术资源搜索服务，方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号：481959085
Book学术官方微信