Search results for: health system
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 23969

Search results for: health system

23969 Five Pitfalls in Defining a Health System and Implications for Research and Management

Authors: Macdonald Kanyangale, Sandram Naluso

Abstract:

Globally, researchers have struggled over time to adequately define the notion of health system to inform research. This study is significant because it proposes an integrative framework for a robust definition of the health system. The objective of this article is to examine major pitfalls in definitions of health system used in prior literature and implications of these for research and management. The study used methodological steps of a scoping review proposed by Arksey and O'Malley to identify and examine 24 definitions of a health system in articles selected from six databases and web search engines. Thematic analysis was used to delineate and categorise definitional pitfalls into broader themes. There are a plethora of five major pitfalls in the extant definitions of a health system which may easily scupper any unsuspecting researcher if not avoided or addressed in research. These definitional pitfalls are reductionist assumptions which ignore dynamic and complex connections, overly wide boundary and lack of specification of levels in a health system, and limited focus on process in a health system. In addition, there is the tendency of treating different components of the health system as equal and simplifying of the ontological complexity of the health system. Future scholars are advised to avoid or address the identified five major pitfalls if they are to develop robust definitions of an HS. The use of an integrative framework for a robust definition of a health system is recommended, while implications of the pitfalls are discussed as a basis and catalyst for complexity-informed research and managing interactively.

Keywords: complexity management, health system, pitfalls, reductionism, research

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23968 Policy and System Research for Health of Ageing Population

Authors: Sehrish Ather

Abstract:

Introduction: To improve organizational achievements through the production of new knowledge, health policy and system research is the basic requirement. An aging population is always the source of the increased burden of chronic diseases, disabilities, mental illnesses, and other co-morbidities; therefore the provision of quality health care services to every group of the population should be achieved by making strong policy and system research for the betterment of health care system. Unfortunately, the whole world is lacking policies and system research for providing health care to their elderly population. Materials and Methods: A literature review of published studies on aging diseases was done, ranging from the year 2011-2018. Geriatric, population, health policy, system, and research were the key terms used for the search. Databases searched were Google Scholar, PubMed, Science Direct, Ovid, and Research Gate. Grey literature was searched from various websites, including IHME, Library of the University of Lahore, World Health Organization (Ageing and Life Course), and Personal communication with Neuro-physicians. After careful reviewing published and un-published information, it was decided to carry on with commentary. Results and discussion: Most of the published studies have highlighted the need to advocate the funders of health policy and stakeholders of healthcare system research, and it was detected as a major issue, research on policy and healthcare system to provide health care to 'geriatric population' was found as highly neglected area. Conclusion: It is concluded that physicians are more involved with the policy and system research regarding any type of diseases, but scientists and researchers of basic and social science are less likely to be involved in methods used for health policy and system research due to lack of funding and resources. Therefore ageing diseases should be considered as a priority, and comprehensive policy and system research should be initiated for diseases of the geriatric population.

Keywords: geriatric population, health care system, health policy, system research

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23967 GSM Based Smart Patient Monitoring System

Authors: Ayman M. Mansour

Abstract:

In this paper, we propose an intelligent system that is used for monitoring the health conditions of Patients. Monitoring the health condition of Patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will Improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to Faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The propose system will provide an intelligent system that will generate initial diagnosing to the patient case. This will assist and advice clinicians at the point of care. The decision is based on demographic data and laboratory test results of patient data. Using such system with the ability of making medical decisions, the quality of medical care in Jordan and specifically in Tafial is expected to be improved. This will provide more accurate, effective, and reliable diagnoses and treatments especially if the physicians have insufficient knowledge.

Keywords: GSM, SMS, patient, monitoring system, fuzzy logic, multi-agent system

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23966 Influential Health Care System Rankings Can Conceal Maximal Inequities: A Simulation Study

Authors: Samuel Reisman

Abstract:

Background: Comparative rankings are increasingly used to evaluate health care systems. These rankings combine discrete attribute rankings into a composite overall ranking. Health care equity is a component of overall rankings, but excelling in other categories can counterbalance low inequity grades. Highly ranked inequitable health care would commend systems that disregard human rights. We simulated the ranking of a maximally inequitable health care system using a published, influential ranking methodology. Methods: We used The Commonwealth Fund’s ranking of eleven health care systems to simulate the rank of a maximally inequitable system. Eighty performance indicators were simulated, assuming maximal ineptitude in equity benchmarks. Maximal rankings in all non-equity subcategories were assumed. Subsequent stepwise simulations lowered all non-equity rank positions by one. Results: The maximally non-equitable health care system ranked first overall. Three subsequent stepwise simulations, lowering non-equity rankings by one, each resulted in an overall ranking within the top three. Discussion: Our results demonstrate that grossly inequitable health care systems can rank highly in comparative health care system rankings. These findings challenge the validity of ranking methodologies that subsume equity under broader benchmarks. We advocate limiting maximum overall rankings of health care systems to their individual equity rankings. Such limits are logical given the insignificance of health care system improvements to those lacking adequate health care.

Keywords: global health, health equity, healthcare systems, international health

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23965 Objective-Based System Dynamics Modeling to Forecast the Number of Health Professionals in Pudong New Area of Shanghai

Authors: Jie Ji, Jing Xu, Yuehong Zhuang, Xiangqing Kang, Ying Qian, Ping Zhou, Di Xue

Abstract:

Background: In 2014, there were 28,341 health professionals in Pudong new area of Shanghai and the number per 1000 population was 5.199, 55.55% higher than that in 2006. But it was always less than the average number of health professionals per 1000 population in Shanghai from 2006 to 2014. Therefore, allocation planning for the health professionals in Pudong new area has become a high priority task in order to meet the future demands of health care. In this study, we constructed an objective-based system dynamics model to forecast the number of health professionals in Pudong new area of Shanghai in 2020. Methods: We collected the data from health statistics reports and previous survey of human resources in Pudong new area of Shanghai. Nine experts, who were from health administrative departments, public hospitals and community health service centers, were consulted to estimate the current and future status of nine variables used in the system dynamics model. Based on the objective of the number of health professionals per 1000 population (8.0) in Shanghai for 2020, the system dynamics model for health professionals in Pudong new area of Shanghai was constructed to forecast the number of health professionals needed in Pudong new area in 2020. Results: The system dynamics model for health professionals in Pudong new area of Shanghai was constructed. The model forecasted that there will be 37,330 health professionals (6.433 per 1000 population) in 2020. If the success rate of health professional recruitment changed from 20% to 70%, the number of health professionals per 1000 population would be changed from 5.269 to 6.919. If this rate changed from 20% to 70% and the success rate of building new beds changed from 5% to 30% at the same time, the number of health professionals per 1000 population would be changed from 5.269 to 6.923. Conclusions: The system dynamics model could be used to simulate and forecast the health professionals. But, if there were no significant changes in health policies and management system, the number of health professionals per 1000 population would not reach the objectives in Pudong new area in 2020.

Keywords: allocation planning, forecast, health professional, system dynamics

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23964 A Multi-Agent Intelligent System for Monitoring Health Conditions of Elderly People

Authors: Ayman M. Mansour

Abstract:

In this paper, we propose a multi-agent intelligent system that is used for monitoring the health conditions of elderly people. Monitoring the health condition of elderly people is a complex problem that involves different medical units and requires continuous monitoring. Such expert system is highly needed in rural areas because of inadequate number of available specialized physicians or nurses. Such monitoring must have autonomous interactions between these medical units in order to be effective. A multi-agent system is formed by a community of agents that exchange information and proactively help one another to achieve the goal of elderly monitoring. The agents in the developed system are equipped with intelligent decision maker that arms them with the rule-based reasoning capability that can assist the physicians in making decisions regarding the medical condition of elderly people.

Keywords: fuzzy logic, inference system, monitoring system, multi-agent system

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23963 A Comparative Study of the Proposed Models for the Components of the National Health Information System

Authors: M. Ahmadi, Sh. Damanabi, F. Sadoughi

Abstract:

National Health Information System plays an important role in ensuring timely and reliable access to Health information which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, by using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system for better planning and management influential factors of performance seems necessary, therefore, in this study, different attitudes towards components of this system are explored comparatively. Methods: This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process, and output. In this context, search for information using library resources and internet search were conducted and data analysis was expressed using comparative tables and qualitative data. Results: The findings showed that there are three different perspectives presenting the components of national health information system, Lippeveld, Sauerborn, and Bodart Model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008 and Gattini’s 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities, and equipment. In addition, in the ‘process’ section from three models, we pointed up the actions ensuring the quality of health information system and in output section, except Lippeveld Model, two other models consider information products, usage and distribution of information as components of the national health information system. Conclusion: The results showed that all the three models have had a brief discussion about the components of health information in input section. However, Lippeveld model has overlooked the components of national health information in process and output sections. Therefore, it seems that the health measurement model of network has a comprehensive presentation for the components of health system in all three sections-input, process, and output.

Keywords: National Health Information System, components of the NHIS, Lippeveld Model

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23962 Health Assessment of Power Transformer Using Fuzzy Logic

Authors: Yog Raj Sood, Rajnish Shrivastava, Anchal Wadhwa

Abstract:

Power transformer is one of the electrical equipment that has a central and critical role in the power system. In order to avoid power transformer failure, information system that provides the transformer condition is needed. This paper presents an information system to know the exact situations prevailing within the transformer by declaring its health index. Health index of a transformer is decided by considering several diagnostic tools. The current work deals with UV-Vis, IFT, FP, BDV and Water Content. UV/VIS results have been pre-accessed using separate FL controller for concluding with the Furan contents. It is broadly accepted that the life of a power transformer is the life of the oil/ paper insulating system. The method relies on the use of furan analysis (insulation paper), and other oil analysis results as a means to declare health index. Fuzzy logic system is used to develop the information system. The testing is done on 5 samples of oil of transformers of rating 132/66 KV to obtain the results and results are analyzed using fuzzy logic model.

Keywords: interfacial tension analyzer (ift), flash point (fp), furfuraldehyde (fal), health index

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23961 Cost of Outpatient Procedures for Ostomized Patients Treated in the Public Health Network in Brazil and Its Impact on the Budget of the Unified Health System

Authors: Karina Guimaraes, Lilian Santos

Abstract:

This study has the purpose of planning and instituting monitoring actions as a way of knowing the scenario of assistance to the patient with stoma, treated in the public health network in Brazil, from January to November of the year 2016, from the elaboration of a technical document containing the survey of the number of procedures offered and the value of the ostomy services, accredited in the Unified Health System-SUS. The purpose of this document is to improve the quality of these services in the efficient management of available financial resources, making it indispensable for the creation of strategies for the implementation and implementation of care services for people with stomata as a strategic tool in the promotion, prevention, qualification and efficiency in health care.

Keywords: health economic, management, ostomy, unified health system

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23960 Comparative Analysis of Patent Protection between Health System and Enterprises in Shanghai, China

Authors: Na Li, Yunwei Zhang, Yuhong Niu

Abstract:

The study discussed the patent protections of health system and enterprises in Shanghai. The comparisons of technical distribution and scopes of patent protections between Shanghai health system and enterprises were used by the methods of IPC classification, co-words analysis and visual social network. Results reflected a decreasing order within IPC A61 area, namely A61B, A61K, A61M, and A61F. A61B required to be further investigated. The highest authorized patents A61B17 of A61B of IPC A61 area was found. Within A61B17, fracture fixation, ligament reconstruction, cardiac surgery, and biopsy detection were regarded as common concerned fields by Shanghai health system and enterprises. However, compared with cardiac closure which Shanghai enterprises paid attention to, Shanghai health system was more inclined to blockages and hemostatic tools. The results also revealed that the scopes of patent protections of Shanghai enterprises were relatively centralized. Shanghai enterprises had a series of comprehensive strategies for protecting core patents. In contrast, Shanghai health system was considered to be lack of strategic patent protections for core patents.

Keywords: co-words analysis, IPC classification, patent protection, technical distribution

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23959 Efficient GIS Based Public Health System for Disease Prevention

Authors: K. M. G. T. R. Waidyarathna, S. M. Vidanagamachchi

Abstract:

Public Health System exists in Sri Lanka has a satisfactory complete information flow when compared to other systems in developing countries. The availability of a good health information system contributed immensely to achieve health indices that are in line with the developed countries like US and UK. The health information flow at the moment is completely paper based. In Sri Lanka, the fields like banking, accounting and engineering have incorporated information and communication technology to the same extent that can be observed in any other country. The field of medicine has behind those fields throughout the world mainly due to its complexity, issues like privacy, confidentially and lack of people with knowledge in both fields of Information Technology (IT) and Medicine. Sri Lanka’s situation is much worse and the gap is rapidly increasing with huge IT initiatives by private-public partnerships in all other countries. The major goal of the framework is to support minimizing the spreading diseases. To achieve that a web based framework should be implemented for this application domain with web mapping. The aim of this GIS based public health system is a secure, flexible, easy to maintain environment for creating and maintaining public health records and easy to interact with relevant parties.

Keywords: DHIS2, GIS, public health, Sri Lanka

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23958 Patients’ Trust in Health Care Systems

Authors: Dilara Usta, Fatos Korkmaz

Abstract:

Background: Individuals who utilise health services maintain relationships with health professionals, insurers and institutions. The nature of these relationships requires service receivers to have trust in the service providers because maintaining health services without reciprocal trust is very difficult. Therefore, individual evaluations of trust within the scope of health services have become increasingly important. Objective: To investigate patients’ trust in the health-care system and their relevant socio-demographical characteristics. Methods: This research was conducted using a descriptive design which included 493 literate patients aged 18-65 years who were hospitalised for a minimum of two days at public university and training&research hospitals in Ankara, Turkey. Patients’ trust in health-care professionals, insurers, and institutions were investigated. Data were collected using a demographic questionnaire and the Multidimensional Trust in Health-Care Systems Scale between September 2015 and April 2016. Results: The participants’ mean age was 47.7±13.1; 70% had a moderate income and 69% had a prior hospitalisation and 63.5% of the patients were satisfied with the health-care services. The mean Multidimensional Trust in Health-Care Systems Scale score for the sample was 61.5±8.3; the provider subscale had a mean of 38.1±5, the insurers subscale had a mean of 12.9±3.7, and institutions subscale had a mean of 10.6±1.9. Conclusion: Patients’ level of trust in the health-care system was above average and the trust level of the patients with higher educational and socio-economic levels was lower compared to the other patients. Health-care professionals should raise awareness about the significance of trust in the health-care system.

Keywords: delivery of health care, health care system, nursing, patients, trust

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23957 Law Relating to Health and Health Care: A Systematic Mechanism and Critical Study with Reference to Bangladesh

Authors: MD. Kamruzzaman

Abstract:

As a developing country, Bangladesh has seen an increase in total GDP in recent years. But it can be further improved by developing “Health-Care” (HC) services because it has enormous infrastructure problems all over the country. Bangladesh's HC system is now clearly poised to undergo reform at any process level, including prevention, diagnosis, and treatment. Although the Bangladeshi government is trying to develop the HC sector, due to health corruption in this sector, the improvement has not accelerated yet. For this reason, lots of Bangladeshi people are facing acute diseases. Regarding the prevention, diagnosis, and treatment of disease, this research will illustrate the law relating to health and HC to ensure excellent health and well-being. Firstly, this paper investigates health under Bangladeshi law from different perspectives related to the HC system. A massive gap has been investigated in this research after comparing Bangladeshi and international health law (HL). Secondly, a practical scenario is investigated and compared with international HC law. It is evident that the Bangladeshi HC system did not achieve a satisfactory standard level concerning international law. A staggering 70% of Bangladesh's population lives in rural areas, with no restrictions on access to hospitals and clinics. However, it is clear that proper HC infrastructure and some new medical practices are urgently needed to ensure HC quality. Finally, this research provides suggestions for developing a HC system to ensure the health of all Bangladeshi people that needs to be immediately implemented by the Bangladeshi government. This research has practical implications in the HC system for any developing country to maintain their citizen's safety.

Keywords: HC system, law relating, bangladeshi HL, international HL, human HC suggestions

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23956 Health Percentage Evaluation for Satellite Electrical Power System Based on Linear Stresses Accumulation Damage Theory

Authors: Lin Wenli, Fu Linchun, Zhang Yi, Wu Ming

Abstract:

To meet the demands of long-life and high-intelligence for satellites, the electrical power system should be provided with self-health condition evaluation capability. Any over-stress events in operations should be recorded. Based on Linear stresses accumulation damage theory, accumulative damage analysis was performed on thermal-mechanical-electrical united stresses for three components including the solar array, the batteries and the power conditioning unit. Then an overall health percentage evaluation model for satellite electrical power system was built. To obtain the accurate quantity for system health percentage, an automatic feedback closed-loop correction method for all coefficients in the evaluation model was present. The evaluation outputs could be referred as taking earlier fault-forecast and interventions for Ground Control Center or Satellites self.

Keywords: satellite electrical power system, health percentage, linear stresses accumulation damage, evaluation model

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23955 The Impact of Health Tourism on Companies’ Performance: A Cross Country Analysis

Authors: Anna Paola Micheli, Carmelo Intrisano, Anna Maria Calce

Abstract:

This research focused on the capability of health tourism to improve the economic and financial performance of healthcare companies. It is assumed that health tourism companies have better profitability and financial efficiency because they can also count on cross-border demand differently from no health tourism companies. A three-level gap analysis was conducted: the first concerns health tourism companies located in Italy and in the other EU28 states; in the second Italian and EU28, no health tourism companies were compared; the third level is about the Italian system with a comparison between health tourism and no health tourism companies. Findings highlighted that Italian healthcare companies have better profitability performance if compared to European ones, but they present weaknesses in the financial position given the illiquidity and excessive leverage. Furthermore, studying the Italian system, we found that health tourism companies are more profitable than no health tourism companies.

Keywords: financial performance, gap analysis, health tourism, profitability performance, value creation

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23954 Health Payments and Household Wellbeing in India: Examining the Role of Health Policy Interventions

Authors: Shailender Kumar

Abstract:

Current health policy pronouncements in India advocate for insurance-based financing mechanism to achieve universal health coverage (UHC), while undermine the role of comprehensive healthcare provision system. UHC is achieved when all people receive the health services they need without suffering financial hardship. This study, using 68th & 71st NSS rounds data, examines their relative and combined strength in achieving the above objective. Health-insurance has been unsuccessful in reducing prevalence and catastrophic effects of out-of-pocket payment and even dismantle the effectiveness of traditional way of health financing system. Healthcare provision is the best way forward to enhance health and well-being of households in condition if India removes existing inadequacies and inequalities in service provision across districts/states and ensure free/low cost medicines/diagnostics to the citizens.

Keywords: health policy, demand-side financing, supply-side financing, incidence of health payment

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23953 Health Transformation Program and Effects on Health Expenditures

Authors: Zeynep Karacor, Rahime Hulya Ozturk

Abstract:

In recent years, the rise of population density and the problem of aging population took attention to the health expenditures. In Turkey, some regulations and infrastructure changes in health sector have occurred. These changes are called Health Transformation Program. The productivity of health services, patient satisfaction, quality of services are tried to be improved with this program. Some radical changes are applied in Turkish economy in this context. The aim of this paper is to present the effects of Health Transformation Program on health expenditures. In the first part of the paper, some information’s about health system and applications in Turkey are discussed. In the second part, the aims of Health Transformation Program are explained. And in the third part the effects of Health Transformation Program on health expenditures are examined.

Keywords: health transformation program, Turkey, health services, health expenditures

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23952 Advocating in the Criminal Justice System for Individuals Who Use Drugs: Advice from Advocates in the Greater Vancouver Area

Authors: Haley Hrymak

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For decades drug addiction has been understood to be a health problem and not a social problem. While research has advanced to allow for a more comprehensive understanding of the factors affecting addiction, the justice system has lagged behind. Given all that is known about addiction as a health issue and the need for effective rehabilitation to prevent further involvement with crime, there is a need for a dramatic shift in order to ensure individual's human right to health is being upheld within the Canadian criminal justice system. This research employs the qualitative methodology to interview advocates who work with substance users within the Greater Vancouver area to explore best practices for representing individuals with substance abuse issues within the Canadian justice system. The research shows that treatment, not punishment, is what is needed in order for recidivism to be reduced for individuals with substance abuse issues. The creative options that advocates employ to work within the current system are intended to provide a guide for lawyers working within the current criminal justice system.

Keywords: addiction, criminal law, right to health, rehabilitation

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23951 Biosignal Measurement System Based on Ultra-Wide Band Human Body Communication

Authors: Jonghoon Kim, Gilwon Yoon

Abstract:

A wrist-band type biosignal measurement system and its data transfer through human body communication (HBC) were investigated. An HBC method based on pulses of ultra-wide band instead of using frequency or amplitude modulations was studied and implemented since the system became very compact and it was more suited for personal or mobile health monitoring. Our system measured photo-plethysmogram (PPG) and measured PPG signals were transmitted through a finger to a monitoring PC system. The device was compact and low-power consuming. HBC communication has very strong security measures since it does not use wireless network. Furthermore, biosignal monitoring system becomes handy because it does not need to have wire connections.

Keywords: biosignal, human body communication, mobile health, PPG, ultrawide band

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23950 Priority Analysis for Korean Disaster Mental Health Service Model Using Analytic Hierarchy Process

Authors: Myung-Soo Lee, Sun-Jin Jo, Kyoung-Sae Na, Joo-Eon Park

Abstract:

Early intervention after a disaster is important for recovery of disaster victims and each country has its own professional mental health service system such as Disaster Psychiatric Assistant Team in Japan and Crisis Counseling Program in the USA. The purpose of this study was to determine key prior components of the Korean Disaster Psychiatric Assistant Team (K-DPAT) for building up Korean disaster mental health service system. We conducted an Analytic Hierarchy Process(AHP) with disaster mental health experts using pairwise comparison questionnaire which compares the relative importance of the key components of Korean disaster mental health service system. Forty-one experts answered the first online survey, and among them, 36 responded to the second. Ten experts were participated in panel meeting and discussed the results of the survey and AHP process. Participants decided the relative importance of the Korean disaster mental health service system regarding initial professional intervention as follows. K-DPAT could be organized at a national level (43.0%) or regional level (40.0%). K-DPAT members should be managed (59.0%) and educated (52.1%) by national level than regional or local level. K-DPAT should be organized independent of the preexisting mental health system (70.1%). Funding for K-DPAT should be from the Ministry of Public Safety and the system could be managed by Ministry of Health (65.8%). Experts agreed K-DPAT leader is suitable for key decision maker for most types of disaster except infectious disease. We expect new model for disaster mental health services can improve insufficiency of the system such as fragmentation and decrease the unmet needs of early professional intervention for the disaster victims.

Keywords: analytic hierarchy process, decision making, disaster, DPAT, mental health services

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23949 Assessing the Adoption of Health Information Systems in a Resource-Constrained Country: A Case of Uganda

Authors: Lubowa Samuel

Abstract:

Health information systems, often known as HIS, are critical components of the healthcare system to improve health policies and promote global health development. In a broader sense, HIS as a system integrates data collecting, processing, reporting, and making use of various types of data to improve healthcare efficacy and efficiency through better management at all levels of healthcare delivery. The aim of this study is to assess the adoption of health information systems (HIS) in a resource-constrained country drawing from the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model. The results indicate that the user's perception of the technology and the poor information technology infrastructures contribute a lot to the low adoption of HIS in resource-constrained countries.

Keywords: health information systems, resource-constrained countries, health information systems

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23948 Variation in Youth and Family Experiences of System of Care Principles in Community Mental Health

Authors: James D. Beauchemin

Abstract:

This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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23947 Iranian Sexual Health Needs in Viewpoint of Policy Makers: A Qualitative Study

Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi

Abstract:

Introduction: Identifying sexual health needs, developing appropriate plans, and delivering services to meet those needs is an essential component of health programs for women, men, and children all over the world, especially in poor countries. Main Subject: The aim of this study was to describe the needs of sexual health from the viewpoint of health policymakers in Iran. Methods: A qualitative study using thematic content analysis was designed and conducted. Data gathering was conducted through semi-structured, in-depth interviews with 25 key informants within the healthcare system. Key informants were selected through both purposive and snowball sampling. MAXQUDA software (version 10) was used to facilitate transcription, classification of codes, and conversion of data into meaningful units, by the process of reduction and compression. Results: The analysis of narratives and information categorized sexual health needs into five categories: culturalization of sexual health discourse, sexual health care services, sexual health educational needs, sexual health research needs, and organizational needs. Conclusion: Identifying and explaining sexual health needs is an important factor in determining the priority of sexual health programs and identification of barriers to meet these needs. This can help other policymakers and health planners to develop appropriate programs to promote sexual and reproductive health.

Keywords: sexual health, sexual health needs, policy makers, health system, qualitative study

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23946 Exchanging Radiology Reporting System with Electronic Health Record: Designing a Conceptual Model

Authors: Azadeh Bashiri

Abstract:

Introduction: In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. Background: This study, provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. Methods: This is a cross-sectional study that was conducted in 2013. The student community was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also, Visual Paradigm software was used to design a conceptual model. Result: Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. Conclusion: According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, provide the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

Keywords: structured radiology report, information needs, minimum data set, electronic health record system in Iran

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23945 A System Dynamics Model for Analyzing Customer Satisfaction in Healthcare Systems

Authors: Mahdi Bastan, Ali Mohammad Ahmadvand, Fatemeh Soltani Khamsehpour

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Health organizations’ sustainable development has nowadays become highly affected by customers’ satisfaction due to significant changes made in the business environment of the healthcare system and emerging of Competitiveness paradigm. In case we look at the hospitals and other health organizations as service providers concerning profit issues, the satisfaction of employees as interior customers, and patients as exterior customers would be of significant importance in health business success. Furthermore, satisfaction rate could be considered in performance assessment of healthcare organizations as a perceived quality measure. Several researches have been carried out in identification of effective factors on patients’ satisfaction in health organizations. However, considering a systemic view, the complex causal relations among many components of healthcare system would be an issue that its acquisition and sustainability requires an understanding of the dynamic complexity, an appropriate cognition of different components, and effective relationships among them resulting ultimately in identifying the generative structure of patients’ satisfaction. Hence, the presenting paper applies system dynamics approaches coherently and methodologically to represent the systemic structure of customers’ satisfaction of a health system involving the constituent components and interactions among them. Then, the results of different policies taken on the system are simulated via developing mathematical models, identifying leverage points, and using scenario making technique and then, the best solutions are presented to improve customers’ satisfaction of the services. The presenting approach supports taking advantage of decision support systems. Additionally, relying on understanding of system behavior Dynamics, the effective policies for improving the health system would be recognized.

Keywords: customer satisfaction, healthcare, scenario, simulation, system dynamics

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23944 Assessment of Routine Health Information System (RHIS) Quality Assurance Practices in Tarkwa Sub-Municipal Health Directorate, Ghana

Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei

Abstract:

Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.

Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality

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23943 An Extensible Software Infrastructure for Computer Aided Custom Monitoring of Patients in Smart Homes

Authors: Ritwik Dutta, Marylin Wolf

Abstract:

This paper describes the trade-offs and the design from scratch of a self-contained, easy-to-use health dashboard software system that provides customizable data tracking for patients in smart homes. The system is made up of different software modules and comprises a front-end and a back-end component. Built with HTML, CSS, and JavaScript, the front-end allows adding users, logging into the system, selecting metrics, and specifying health goals. The back-end consists of a NoSQL Mongo database, a Python script, and a SimpleHTTPServer written in Python. The database stores user profiles and health data in JSON format. The Python script makes use of the PyMongo driver library to query the database and displays formatted data as a daily snapshot of user health metrics against target goals. Any number of standard and custom metrics can be added to the system, and corresponding health data can be fed automatically, via sensor APIs or manually, as text or picture data files. A real-time METAR request API permits correlating weather data with patient health, and an advanced query system is implemented to allow trend analysis of selected health metrics over custom time intervals. Available on the GitHub repository system, the project is free to use for academic purposes of learning and experimenting, or practical purposes by building on it.

Keywords: flask, Java, JavaScript, health monitoring, long-term care, Mongo, Python, smart home, software engineering, webserver

Procedia PDF Downloads 355
23942 Primary Health Care Vital Signs Profile in Malaysia: Challenges and Opportunities

Authors: Rachel Koshy, Nazrila Hairizan Bt. Nasir, Samsiah Bt. Awang, Kamaliah Bt. Mohamad Noh

Abstract:

Malaysia collaborated as a ‘trailblazer’ country with PHCPI (Primary Health Care Performance Initiative) to populate the Primary Health Care (PHC) Vital Signs Profile (VSP) for the country. The PHC VSP provides an innovative snapshot of the primary health care system's performance. Four domains were assessed: system financing, system capacity, system performance, and system equity, and completed in 2019. There were two phases using a mixed method study design. The first phase involved a quantitative study, utilising existing secondary data from national and international sources. In the case of unavailability of data for any indicators, comparable alternative indicators were used. The second phase was a mixed quantitative-qualitative approach to measure the functional capacity based on governance and leadership, population health needs, inputs, population health management, and facility organisation and management. PHC spending constituted 35% of overall health spending in Malaysia, with a per capita PHC spending of $152. The capacity domain was strong in the three subdomains of governance and leadership, information system, and funds management. The two subdomains of drugs & supplies and facility organisation & management had low scores, but the lowest score was in empanelment of the population under the population health management. The PHC system performed with an access index of 98%, quality index of 84%, and service coverage of 62%. In the equity domain, there was little fluctuation in the coverage of reproductive, maternal, newborn, and child health services by mother’s level of education and under-five child mortality between urban and rural areas. The public sector was stronger in the capacity domain as compared to the private sector. This is due to the different financing, organisational structures, and service delivery mechanism. The VSP has identified areas for improvement in the effort to provide high-quality PHC for the population. The gaps in PHC can be addressed through the system approach and the positioning of public and private primary health care delivery systems.

Keywords: primary health care, health system, system domains, vital signs profile

Procedia PDF Downloads 95
23941 Wireless Based System for Continuous Electrocardiography Monitoring during Surgery

Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

Abstract:

This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: electrocardiography, monitoring, surgery, wireless system

Procedia PDF Downloads 335
23940 Tele-Monitoring and Logging of Patient Health Parameters Using Zigbee

Authors: Kirubasankar, Sanjeevkumar, Aravindh Nagappan

Abstract:

This paper addresses a system for monitoring patients using biomedical sensors and displaying it in a remote place. The main challenges in present health monitoring devices are lack of remote monitoring and logging for future evaluation. Typical instruments used for health parameter measurement provide basic information regarding health status. This paper identifies a set of design principles to address these challenges. This system includes continuous measurement of health parameters such as Heart rate, electrocardiogram, SpO2 level and Body temperature. The accumulated sensor data is relayed to a processing device using a transceiver and viewed by the implementation of cloud services.

Keywords: bio-medical sensors, monitoring, logging, cloud service

Procedia PDF Downloads 481