International Journal of Health Services最新文献_第5页

Financial and Quality Metrics of A Large, Publicly Traded U.S. Nursing Home Chain in the Age of Covid-19. Covid-19时代美国一家大型上市养老院连锁店的财务和质量指标

IF 3.4 4区医学

International Journal of Health Services Pub Date : 2022-04-01 Epub Date: 2022-02-04 DOI: 10.1177/00207314221077649

David E Kingsley, Charlene Harrington

{"title":"Financial and Quality Metrics of A Large, Publicly Traded U.S. Nursing Home Chain in the Age of Covid-19.","authors":"David E Kingsley, Charlene Harrington","doi":"10.1177/00207314221077649","DOIUrl":"https://doi.org/10.1177/00207314221077649","url":null,"abstract":"Nursing homes faced serious challenges with large COVID-19 resident infection rates and deaths during the pandemic. This descriptive case study examined the structure, operations, strategies, care outcomes, and owners of The Ensign Group Inc. the second largest U.S. for-profit chain, between 2007 and 2021. Ensign, as a holding company, has a complex organizational structure that uses more than 430 corporate entities to manage its 228 nursing homes and senior living facilities. With mostly Medicare and Medicaid revenues and favorable government COVID-19 relief, Ensign grew rapidly, even during the pandemic, to $2.5 billion (all amounts in U.S. Dollars) in revenues with a market capitalization of $4.5 billion and strong profits and financial metrics in 2020 to 2021. The company used real estate purchasing, debt financing, and spin-off companies, and tax arbitrage to optimize shareholder value. Before and during the pandemic, its 198 nursing homes had low registered nurse and total nurse staffing levels and regulatory violations with below-average ratings, and they had high COVID-19 infection rates during the pandemic. Ensign's small board, executives, and institutional investors protected and enhanced shareholder interests rather than ensuring that its nursing homes met professional standards and regulatory requirements.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39888545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

The Opioid Epidemic: Task-Shifting in Health Care and the Case for Access to Harm Reduction for People Who Use Drugs. 阿片类药物流行:医疗保健中的任务转移和为吸毒者提供减少伤害的案例。

IF 3.4 4区医学

International Journal of Health Services Pub Date : 2022-04-01 Epub Date: 2020-04-08 DOI: 10.1177/0020731420914820

Ehsan Jozaghi

{"title":"The Opioid Epidemic: Task-Shifting in Health Care and the Case for Access to Harm Reduction for People Who Use Drugs.","authors":"Ehsan Jozaghi","doi":"10.1177/0020731420914820","DOIUrl":"https://doi.org/10.1177/0020731420914820","url":null,"abstract":"We are sadly experiencing unprecedented levels of overdose mortalities attributed to the increased availability of synthetic opioids in illegal markets. While the majority of attention in North America has focused on preventing drug overdose cases through the distribution and administration of naloxone, in addition to stricter regulations of opioid prescriptions and greater law enforcement in illegal markets, little attention has been given to other alternative models and treatments for people who use drugs that are tailored specifically to the health care needs of this marginalized population. Through this analysis, the implications of task-shifting in health care via the distribution of naloxone for an already marginalized population are discussed. Alternatively, the role of pioneering harm-reduction programs - such as supervised injection/consumption sites, a variety of opioids maintenance therapies, and social-structural interventions - are highlighted as crucial interventions in the current ongoing opioid crisis. Moreover, people with lived experiences of illegal drug use are discussed as having a pivotal role but being ultimately overshadowed by public health partners.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420914820","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37816995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Political Economy of Public Health Inequalities and Inequities in India: Complexities, Challenges, and Strategies for Inclusive Public Health Care Policy. 印度公共卫生不平等和不公平的政治经济学:包容性公共卫生保健政策的复杂性、挑战和战略。

IF 3.4 4区医学

International Journal of Health Services Pub Date : 2022-04-01 Epub Date: 2022-01-27 DOI: 10.1177/00207314211066748

Nitish Gogoi, S S Sumesh

引用次数: 0

Migration of Medical Professionals: The Case of Psychiatric Trainees in Spain. 医疗专业人员的迁移:西班牙精神病学受训人员的案例。

IF 3.4 4区医学

International Journal of Health Services Pub Date : 2022-04-01 Epub Date: 2021-03-22 DOI: 10.1177/00207314211003449

Rosa M Molina-Ruiz, Carlos Gomez-Sánchez-Lafuente, Victor Pereira-Sanchez, Mariana Pinto da Costa

{"title":"Migration of Medical Professionals: The Case of Psychiatric Trainees in Spain.","authors":"Rosa M Molina-Ruiz, Carlos Gomez-Sánchez-Lafuente, Victor Pereira-Sanchez, Mariana Pinto da Costa","doi":"10.1177/00207314211003449","DOIUrl":"https://doi.org/10.1177/00207314211003449","url":null,"abstract":"The social and economic situation in Europe seems to play a role in the migratory flow of doctors and other health professionals within the continent. However, little is known about the particular reality of workforce migration in Spain. The objective of this study was to explore the factors that motivate migration among junior doctors training in psychiatry in Spain. A semistructured questionnaire of 61 items was circulated to psychiatric trainees in Spain to explore the extent and the factors that influence the decisions regarding workforce migration. A total of 95 psychiatric trainees participated in the survey. More than two-thirds (n = 71, 74.7%) had \"ever\" considered migrating to another country, and more than one-fourth (n = 21, 29.5%) had already taken \"practical steps\" to go abroad. The main reasons to consider leaving the country were financial (n = 82, 86%) and the opportunity to progress professionally (n = 82, 84%). However, nearly half of the trainees (n = 47, 49%) were satisfied with their current income. While the majority of the psychiatric trainees in this survey had considered migrating abroad, these potential future migrations could lead to a loss of human capital with an important sociosanitary impact.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00207314211003449","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25503901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Health Care Utilization by Older Adults in Nepal: An Investigation of Correlates and Equity in Utilization. 尼泊尔老年人医疗保健利用:利用相关因素和公平性的调查

IF 3.4 4区医学

International Journal of Health Services Pub Date : 2022-04-01 Epub Date: 2021-01-11 DOI: 10.1177/0020731420981928

Saruna Ghimire, Devendra Raj Singh, Sara J McLaughlin, Renusha Maharjan, Dhirendra Nath

{"title":"Health Care Utilization by Older Adults in Nepal: An Investigation of Correlates and Equity in Utilization.","authors":"Saruna Ghimire, Devendra Raj Singh, Sara J McLaughlin, Renusha Maharjan, Dhirendra Nath","doi":"10.1177/0020731420981928","DOIUrl":"https://doi.org/10.1177/0020731420981928","url":null,"abstract":"This study aims to evaluate factors associated with health care utilization (HCU) and to assess vertical and horizontal equity in utilization among Nepali older adults. Data are from an existing cross-sectional study involving systematic random sampling of 260 older adults in Far-Western (Sudurpaschim) Province of Nepal. Andersen's theoretical framework was used to assess predisposing, enabling, and need factors that have the potential to influence health care utilization. Multivariable logistic regression analyses were conducted to examine potential correlates of HCU. Horizontal and vertical equity were assessed using concentration curve and index. More than one-third of participants had not visited a health facility in the prior 12 months. Nine in 10 participants did not know about the government's free health service for older adults. Joint/extended family type, Ayurvedic/Homeopathic health care preference, higher-income tertile, and presence of chronic conditions were associated with higher odds of health care utilization in adjusted analyses. The concentration curve for HCU lies below the line of equity, and the subsequent index is positive, indicating that HCU was concentrated among richer individuals. If the government of Nepal is to achieve its goal of universal health care, the existing pro-rich inequity in HCU needs to be addressed.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420981928","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38808065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Through An Equity Lens: Illuminating The Relationships Among Social Inequities, Stigma And Discrimination, And Patient Experiences of Emergency Health Care. 透过公平的镜头:阐明社会不平等，污名和歧视之间的关系，以及紧急医疗保健的病人经验。

IF 3.4 4区医学

International Journal of Health Services Pub Date : 2022-04-01 Epub Date: 2022-01-31 DOI: 10.1177/00207314221075515

Colleen Varcoe, Annette J Browne, Vicky Bungay, Nancy Perrin, Erin Wilson, C Nadine Wathen, David Byres, Elder Roberta Price

{"title":"Through An Equity Lens: Illuminating The Relationships Among Social Inequities, Stigma And Discrimination, And Patient Experiences of Emergency Health Care.","authors":"Colleen Varcoe, Annette J Browne, Vicky Bungay, Nancy Perrin, Erin Wilson, C Nadine Wathen, David Byres, Elder Roberta Price","doi":"10.1177/00207314221075515","DOIUrl":"https://doi.org/10.1177/00207314221075515","url":null,"abstract":"People who experience the greatest social inequities often have poor experiences in emergency departments (EDs) so that they are deterred from seeking care, leave without care complete, receive inadequate care, and/or return repeatedly for unresolved problems. However, efforts to measure and monitor experiences of care rarely capture the experiences of people facing the greatest inequities, experiences of discrimination, or relationships among these variables. This analysis examined how patients' experiences, including self-reported ratings of care, experiences of discrimination, and repeat visits vary with social and economic circumstances. Every consecutive person presenting to three diverse EDs was invited if/when they were able to consent; 2424 provided demographic and contact information; and 1692 (70%) completed the survey. Latent class analysis (LCA) using sociodemographic variables: age, gender, financial strain, employment, housing stability, English as first language, born in Canada, and Indigenous identity, indicated a six-class solution. Classes differed significantly on having regular access to primary care, reasons for the visit, and acuity. Classes also differed on self-reported discrimination every day and during their ED visit, ratings of ED care, and number of ED visits within the past six months. ED care can be improved through attention to how intersecting forms of structural disadvantage and inequities affect patient experiences.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39751374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

Risking Lives to Save Others During COVID-19: A Focus on Public Health Care Workers in Bangladesh and Egypt. COVID-19期间冒着生命危险拯救他人:关注孟加拉国和埃及的公共卫生保健工作者

IF 3.4 4区医学

International Journal of Health Services Pub Date : 2022-04-01 Epub Date: 2021-12-08 DOI: 10.1177/00207314211063748

Shahjahan Bhuiyan

{"title":"Risking Lives to Save Others During COVID-19: A Focus on Public Health Care Workers in Bangladesh and Egypt.","authors":"Shahjahan Bhuiyan","doi":"10.1177/00207314211063748","DOIUrl":"https://doi.org/10.1177/00207314211063748","url":null,"abstract":"The coronavirus (COVID-19) pandemic has been spreading around the world, causing a major public health crisis that has already claimed hundreds of thousands of lives. Street-level bureaucrats--health workers, teachers, street cleaners, police officers-, and so forth-are at the forefront in fighting against the pandemic. Of these, public health care workers, due to the nature of their involvement, should know and understand why they are risking their lives to save others during this pandemic. Based on the preliminary data gleaned from interviews with public health care workers in Bangladesh and Egypt, this ongoing research suggests they are risking their lives for reasons such as altruistic behavior, service to profession, adherence to bureaucratic accountability, and a desire to help mankind. The findings contribute to the existing literature about street-level bureaucratic behavior in atypical times such as these of the pandemic. This study is unique in that it comprehends that public health care workers of two culturally and geographically distinct countries are risking their lives for the same public-spirited cause.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894906/pdf/10.1177_00207314211063748.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39703106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Health Impact Assessment (HIA): A Comparative Case Study of Sri Lanka and Wales: What Can a Developing Country Learn From the Welsh HIA System? 健康影响评估(HIA):斯里兰卡和威尔士的比较案例研究:发展中国家可以从威尔士HIA系统中学到什么?

IF 3.4 4区医学

International Journal of Health Services Pub Date : 2022-04-01 Epub Date: 2020-07-13 DOI: 10.1177/0020731420941454

Yasaswi N Walpita, Liz Green

{"title":"Health Impact Assessment (HIA): A Comparative Case Study of Sri Lanka and Wales: What Can a Developing Country Learn From the Welsh HIA System?","authors":"Yasaswi N Walpita, Liz Green","doi":"10.1177/0020731420941454","DOIUrl":"https://doi.org/10.1177/0020731420941454","url":null,"abstract":"The health impact assessment (HIA) is increasingly recognized around the world as an effective governance tool to incorporate Health in All Policies to address the wider determinants of health. However, it is still poorly recognized and practiced in many developing countries, including Sri Lanka, where its applicability is most appropriate considering the complexity of social determinants of health and inequalities. This comparative case study aimed to explore the barriers for implementation of HIA in Sri Lanka in the areas of supportive policy framework, institutional infrastructure, capacity-building, and multi-sectoral collaboration and to compare them with a successful HIA system in a developed country (Wales) with a view toward identifying the \"best practices\" applicable in a developing country context. The case study revealed that there is an emerging government commitment in Sri Lanka to embrace the Health in All Policies approach and much potential in the health system to develop a centrally dedicated expert team with peripheral counterparts and multi-sectoral collaboration, which were the primary pillars of success in the Welsh system. However, there is a great need for capacity-building and for development of country-specific tools, which would facilitate the establishment and sustainability of HIA processes in Sri Lanka.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420941454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38147914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Disclosure of Pharmaceutical Industry Funding of Patient Organisations in Nordic Countries: Can Industry Self-Regulation Deliver on its Transparency Promise? 北欧国家医药行业对患者组织的资金披露:行业自律能否兑现其透明度承诺?

IF 3.4 4区医学

International Journal of Health Services Pub Date : 2022-03-01 DOI: 10.1177/00207314221083871

D. Pashley, P. Ozieranski, S. Mulinari

{"title":"Disclosure of Pharmaceutical Industry Funding of Patient Organisations in Nordic Countries: Can Industry Self-Regulation Deliver on its Transparency Promise?","authors":"D. Pashley, P. Ozieranski, S. Mulinari","doi":"10.1177/00207314221083871","DOIUrl":"https://doi.org/10.1177/00207314221083871","url":null,"abstract":"Pharmaceutical companies regularly fund patient organizations. It is important for patient organizations’ credibility that there be transparency regarding this financial support. In Europe, the pharmaceutical industry promises to deliver transparency through self-regulation, as opposed to legally binding provisions, but self-regulation's effectiveness is contested. We compared the industry's transparency of funding in four Nordic countries that, given their general reputation for high transparency, offered a critical test of self-regulation's ability to deliver on its transparency promise. For 2017–2019, we compared: national rules regarding funding disclosure; disclosure practices as evidenced by the availability, accessibility, and format of company transparency reports; and disclosure data, including payment descriptions and sums. Transparency problems differed in kind and magnitude between countries. In Norway and Finland, unlike in Sweden and Denmark, data on funding were difficult to access and analyze and sometimes seemed incomplete or missing. We explain that a key factor allowing for country differences is the freedom given to a country's pharmaceutical industry trade associations to form self-regulatory rules, provided they do not fall below the weak, European-level minimum requirements. Transparency could be improved by aligning rules and practices with the FAIR data principles: that is, corporate disclosures should be findable, accessible, interoperable, and reusable.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43091350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

2021 Climate and Health Review – Uncharted Territory: Extreme Weather Events and Morbidity 2021气候与健康评论-未知领域:极端天气事件和发病率

IF 3.4 4区医学

International Journal of Health Services Pub Date : 2022-03-01 DOI: 10.1177/00207314221082452

M. Sheehan

{"title":"2021 Climate and Health Review – Uncharted Territory: Extreme Weather Events and Morbidity","authors":"M. Sheehan","doi":"10.1177/00207314221082452","DOIUrl":"https://doi.org/10.1177/00207314221082452","url":null,"abstract":"Extreme weather events (EWEs) affected health in every world region during 2021, placing the planet in “uncharted territory.” Portraying the human impacts of EWEs is part of a health frame that suggests public knowledge of these risks will spur support for needed policy change. The health frame has gained traction since the Paris COP21 (United Nations Climate Change Conference) and arguably helped to achieve modest progress at the Glasgow COP26. However, reporting rarely covers the full picture of health impacts from EWEs, instead focusing on cost of damages, mortality, and displacement. This review summarizes data for 30 major EWEs of 2021 and, based on the epidemiological literature, discusses morbidity-related exposures for four hazards that marked the year: wildfire smoke; extreme cold and power outages; extreme, precipitation-related flooding; and drought. A very large likely burden of morbidity was found, with particularly widespread exposure to risk of respiratory outcomes (including interactions with COVID-19) and mental illnesses. There is need for a well-disseminated global annual report on EWE morbidity, including affected population estimates and evolving science. In this way, the public health frame may be harnessed to bolster evidence for the broader and promising frame of “urgency and agency” for climate change action.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42804298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5