The open health services and policy journal最新文献

{"title":"Post-traumatic stress disorder and the care of persons living with HIV/AIDS","authors":"S. Coughlin","doi":"10.2174/1874924001104010039","DOIUrl":"https://doi.org/10.2174/1874924001104010039","url":null,"abstract":"In conjunction with medical and scientific advances that have improved the survival and quality of life of persons living with HIV/AIDS, there has been increasing interest in examining post-traumatic stress disorder (PTSD) in HIV positive persons. Studies of comorbid HIV/AIDS and PTSD have focused on a wide variety of demographic, cultural, and socioeconomic subgroups of diverse populations including women [1-3], socioeconomically disadvantaged persons [4, 5], gay men [6], and adolescents and young adults in developed countries such as the U.S. and Great Britain [7]. Other studies have focused on adults or children in African countries impacted by the AIDS pandemic [8, 9]. In the U.S., PTSD rates have been reported to be 10.4% to 42.2% in treatment seeking and convenience samples of patients with HIV/AIDS [2, 10]. Several factors may account for the cooccurrence of HIV/AIDS and PTSD and other anxiety and mood disorders such as major depression. These include the potentially traumatic nature of being diagnosed with a diagnosis that is often perceived as life-threatening; the relatively high rates of traumatic exposures (physical assault, sexual trauma, or the sudden, unexpected death of a close family member or friend) that have been reported in studies of persons with HIV/AIDS; and patient perceptions of AIDS-related stigma [2, 11].","PeriodicalId":88329,"journal":{"name":"The open health services and policy journal","volume":"4 1","pages":"39-41"},"PeriodicalIF":0.0,"publicationDate":"2011-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68095182","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{"title":"How do Vested Interests Maintain Outdated Policy? The Case of Food Marketing to New Zealand Children","authors":"P. Field, R. Gauld","doi":"10.2174/1874924001104010030","DOIUrl":"https://doi.org/10.2174/1874924001104010030","url":null,"abstract":"This paper examines the role of powerful vested interest groups in determining public health nutrition policy. With childhood obesity now being classified as an epidemic, television food advertising to children is a relevant case study, which is reported on in this article. The study consisted of qualitative interviews with members of the New Zealand food advertising policy community and documentary analysis of relevant submissions to two government inquiries, websites and policy documents related to food advertising to children. The findings categorised the positions of three identifiable interest groups. Each group's use of evidence and other influence strategies was examined in relation to their impact on government policy. We found the food industry to be tightly coordinated in their influence activities, public relations, partnership agreements and the creation of scientific uncertainty. Non government organisations were less coordinated in their advocacy for regulation, relying heavily on the use of scientific evidence to support their position. As a result industry groups dominated the processes to produce a policy outcome where the government was not acting in its own best economic interest, in terms of reducing the longer-term costs of obesity, or that of the public. The evidence from this study supports international recommendations for new approaches to health policymaking. Government needs to lead a collaborative process between vested interest groups to ensure industry groups do not have the upper hand. Such approaches would enable policy with positive public health outcomes.","PeriodicalId":88329,"journal":{"name":"The open health services and policy journal","volume":"4 1","pages":"30-38"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68095172","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":"How Healthcare Studies Use Claims Data","authors":"Bryan Burton, P. Jesilow","doi":"10.2174/1874924001104010026","DOIUrl":"https://doi.org/10.2174/1874924001104010026","url":null,"abstract":"Claims data have become common during the past two decades. The electronic records include information entered on bills (claims) submitted by healthcare providers to third-party payers. They are an attractive data source; however, they contain limitations that threaten the validity of studies that use them. We reviewed 168 studies that employed claims data, published during 2000-2005 in five healthcare journals, to investigate how claims data are being used and whether their use is appropriate. Healthcare studies in our sample used claims data to select a sample, to establish healthcare costs, to determine whether specific treatments or procedures had been provided, to ascertain the cost- effectiveness of services, and to establish their accuracy as a stand-in for other measures. Most studies appropriately used claims data; however, there was a sizable percentage that used claims data in an inappropriate or questionable fashion.","PeriodicalId":88329,"journal":{"name":"The open health services and policy journal","volume":"47 1","pages":"26-29"},"PeriodicalIF":0.0,"publicationDate":"2011-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68095130","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":"Patient Centered Care - A Conceptual Model and Review of the State of the Art","authors":"R. Jayadevappa, S. Chhatre","doi":"10.2174/1874924001104010015","DOIUrl":"https://doi.org/10.2174/1874924001104010015","url":null,"abstract":"Background: Patient-centered care that encompasses informed decision making can improve treatment choice, quality of care and outcomes. Patient-centered care recognizes the need for major changes in the process of care that arranges health care system around the patient. Objective: Study objective was to evaluate and discuss the interplay of components of patient- centered care by developing a conceptual model of patient-centered care. Methods: Comprehensive literature review was conducted using Medline, CINAHL, and Cochrane databases. Included were English language studies addressing issues related to patient-centered-care and patient reported outcomes. Results: Though the concept of patient-centered care emerged in the early 50s, it exploded in the health care research policy arena exponentially in the late nineties. The conceptual model described here can aid objective and subjective evaluation of patient-centered care. As we strive to improve the quality of care, patient-centered care can play a pivotal role in this process. This however requires changes in our healthcare system so as to improve overall quality of care by minimizing wasteful health resource consumption. Conclusions: With healthcare costs projected to continue their rapid increase, the current paradigm of healthcare is unsustainable. More research is needed to explore the various attributes of patient-centered care, its acceptability, and comparative effectiveness in the healthcare arena.","PeriodicalId":88329,"journal":{"name":"The open health services and policy journal","volume":"4 1","pages":"15-25"},"PeriodicalIF":0.0,"publicationDate":"2011-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68095116","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":"Erosion in the Healthcare Safety Net: Impacts on Different Population Groups.","authors":"Lee Mobley,&nbsp;Tzy-Mey Kuo,&nbsp;Gloria J Bazzoli","doi":"10.2174/1874924001104010001","DOIUrl":"https://doi.org/10.2174/1874924001104010001","url":null,"abstract":"<p><p>Safety net hospitals (SNHs) have played a critical role in the U.S. health system providing access to health care for vulnerable populations, in particular the Medicaid and uninsured populations. However, little research has examined how access for these populations changes when contraction of the safety net occurs. Institutional policies, such as hospital closure or ownership conversion, could affect the supply of minority health care providers, thus exacerbating disparities in outcomes. We use multilevel logistic modeling of person-level hospital discharge data to examine the effects of contractions in the California safety net over the period of 1990-2000 on access to care as measured by changes in ambulatory care sensitive condition (ACSC) admissions, using geographic methods to characterize proximity to a contraction event. We found that presence of a contraction event was associated with a statistically significant increase in the predicted probability of impeded access, with an increase of about 1% for Medicaid-insured populations and about 4-5% for the uninsured. The Medicaid-insured group also maintained the highest rates of ACSC admissions over time, suggesting persistent access problems for this vulnerable group. This research is timely given continued budget problems in many states, where rising unemployment has increased the number of Medicaid enrollees by 6 million and uninsured individuals by 1.5 million, increasing pressure on remaining SNHs.</p>","PeriodicalId":88329,"journal":{"name":"The open health services and policy journal","volume":"4 ","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2011-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165171/pdf/nihms293936.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30120492","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}

{"title":"Quantitative Models for Causal Analysis in the Era of Genome Wide Association Studies.","authors":"Steven S Coughlin","doi":"10.2174/1874924001003010118","DOIUrl":"https://doi.org/10.2174/1874924001003010118","url":null,"abstract":"Causal inference in health research is a complex endeavor partly because the biomedical enterprise involves researchers from many disciplines including clinical medicine, epidemiology, genetics, basic sciences such as pathology and cell biology, and the behavioral sciences. A multidisciplinary approach is often needed to study health concerns and interpret findings, drawing upon expertise from epidemiologists, statisticians, physicians, nurses, geneticists, psychologists, and other practicing clinicians and researchers. In addition to the diversity of scientific disciplines and professions that are represented in many study groups, the range of health topics that can be studied is large and can include physical injuries such as traumatic brain injury; pain syndromes and other neurological conditions; chronic health conditions such as obesity, cancer, respiratory illnesses, and cardiovascular disease, gastrointestinal illnesses such as irritable bowel syndrome, infectious diseases such as H1N1 influenza and hepatitis C, psychiatric conditions such as post traumatic stress syndrome, depression, and suicide, adverse reproductive outcomes, and other health problems and concerns. Another feature of health research is that a range of study designs are employed by researchers including surveillance systems, observational studies with a case-control or cohort design, cross-sectional surveys, and randomized controlled trials. In recent years, observational studies include the large platforms of cases and controls that are identified for genome-wide association studies [1, 2]. In addition to statistical geneticists, the researchers who analyze data from genome-wide association studies and proteomics research often include persons with expertise in bioinformatics or machine learning techniques. \u0000 \u0000These three features of health research (diversity of scientific disciplines, wide variety of health topics of interest, and alternative study designs) create both challenges and opportunities for researchers attempting to identify causal associations with possible etiologic agents and new therapeutic targets, so that research findings can be translated into targeted clinical interventions and evidence-based therapies. For example, in studies with an observational design, where assignment of exposures is not under control of the investigators, assessments of causality can be more challenging than in randomized trials [3, 4]. \u0000 \u0000Investigations into the distribution and determinants of health conditions attempt to gain new knowledge through observation and inductive logic. Causal criteria commonly cited in epidemiology include temporal order of exposure and disease, biologic gradient or dose-response curve, biologic plausibility, biologic coherence, and consistency of findings, although some authors have recommended subsets of the criteria or refined definitions [5-7]. The strength of the observed association is also important in some assessments of causality. Crite","PeriodicalId":88329,"journal":{"name":"The open health services and policy journal","volume":"4 ","pages":"118-122"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150533/pdf/nihms-275621.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30061535","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}

{"title":"Support to Primary Health Care in Transitional Situations: Lessons Learned from the Field","authors":"S. D. Mortier, Ruth C Bullen, Hervé le Guillouzic","doi":"10.2174/1874924001003010123","DOIUrl":"https://doi.org/10.2174/1874924001003010123","url":null,"abstract":"In a war context, a transition period begins when the guns fall silent following a ceasefire or a peace agreement is signed. In a natural disaster context, it starts as soon as the search and rescue activities are over. Progression from the emergency to the transition phase is often a tedious process, involving a complex emergency context, unforeseen additional and emerging needs and the presence/withdrawal of stakeholders. Humanitarian aid commonly described in most emergencies often persists during the transition phase. It requires them to make a complete shift in its approach, planning, financing, performance monitoring and evaluation. In transition situations, the key is to develop national and international partnership in respect to primary health centres, with a clearly-defined, realistic and participative public health methodology. This paper, a review of some key humanitarian guidelines and peer reviewed studies, is presented with a methodological approach with a succession of practical questions, answers, and documented case examples and targets central, provincial and district health facilities and national and international public health workers facing the challenges of a fragmented and fragile post-emergency health service network.","PeriodicalId":88329,"journal":{"name":"The open health services and policy journal","volume":"3 1","pages":"123-140"},"PeriodicalIF":0.0,"publicationDate":"2010-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68095316","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 Expenditure Comparisons: Low, Middle and High Income Countries","authors":"S. Hopkins","doi":"10.2174/1874924001003010111","DOIUrl":"https://doi.org/10.2174/1874924001003010111","url":null,"abstract":"Cross-sectional health expenditure data are used to compare health expenditure aggregates and the contribution of the public and private sectors in a selection of 31 low, middle and high income countries. The comparative data illustrate the diversity of outcomes in terms of total health expenditure and its components even amongst countries with similar GDP per capita. Low and middle income countries on the whole, rely more heavily on private funding especially household out-of-pocket payments. Public funding is more prevalent for funding of curative care than for funding of pharmaceuticals in high, middle and low income countries. The results illustrate the usefulness of internationally comparable health expenditure data to undertake cross country comparisons. Such comparisons are crucial for contributing to evidence based policy.","PeriodicalId":88329,"journal":{"name":"The open health services and policy journal","volume":"3 1","pages":"21-27"},"PeriodicalIF":0.0,"publicationDate":"2010-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68095145","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":"Editorial: The Struggle to End Homelessness in Canada: How we Created the Crisis, and How We Can End it~!2009-08-20~!2009-09-28~!2010-03-22~!","authors":"S. Gaetz","doi":"10.2174/1874924001003020021","DOIUrl":"https://doi.org/10.2174/1874924001003020021","url":null,"abstract":"","PeriodicalId":88329,"journal":{"name":"The open health services and policy journal","volume":"3 1","pages":"21-26"},"PeriodicalIF":0.0,"publicationDate":"2010-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68095330","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 Future of Homeless Services: An Introduction~!2009-08-18~!2009-09-28~!2010-03-22~!","authors":"J. Olivet, Kristen Paquette, J. Hanson, E. Bassuk","doi":"10.2174/1874924001003020030","DOIUrl":"https://doi.org/10.2174/1874924001003020030","url":null,"abstract":"","PeriodicalId":88329,"journal":{"name":"The open health services and policy journal","volume":"3 1","pages":"30-33"},"PeriodicalIF":0.0,"publicationDate":"2010-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68094838","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}