44,185 results match your criteria care reform

Risk factor management and atrial fibrillation.

Europace 2021 Apr;23(Supplement_2):ii52-ii60

Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.

The management of atrial fibrillation (AF) is multifaceted and treatment paradigms have changed significantly in the last century. The treatment of AF requires a comprehensive approach which goes beyond the treatment of the arrhythmia alone. Risk factor management has been introduced as a crucial pillar of AF management. Read More

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New Horizons -Addressing Healthcare Disparities in Endocrine Disease: Bias, Science, and Patient Care.

Marshall H Chin

J Clin Endocrinol Metab 2021 Apr 10. Epub 2021 Apr 10.

Section of General Internal Medicine, Department of Medicine, University of Chicago.

Unacceptable healthcare disparities in endocrine disease have persisted for decades, and 2021 presents a difficult evolving environment. The COVID-19 pandemic has highlighted the gross structural inequities that drive health disparities, and anti-racism demonstrations remind us that the struggle for human rights continues. Increased public awareness and discussion of disparities present an urgent opportunity to advance health equity. Read More

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Foster Care: How We Can, and Should, Do More for Maltreated Children.

Soc Policy Rep 2020 Nov 30;33(3):1-40. Epub 2020 Nov 30.

Professor of Human Development and Family Sciences and is Associate Director of the Population Research Center, both at the University of Texas at Austin. She has published extensively on the topic of physical punishment and is an internationally recognized expert on the effects that physical punishment by parents or by school personnel has on children. She earned her Ph.D. in Child Development from the University of Texas at Austin.

Foster care provides round-the-clock substitute care for nearly 700,000 U.S. children who are temporarily or permanently separated from their family of origin each year. Read More

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November 2020

Heeding the Call for Urgent Primary Care Payment Reform: What Do We Know about How to Get Started?

J Am Board Fam Med 2021 Mar-Apr;34(2):424-429

From the Eugene S. Farley Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Denver (SBG, LAG); Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, D.C. (JMW).

The COVID-19 pandemic has added further urgency to the need for primary care payment reform. Fee-for-service payments limit the flexibility of practices to respond to crises and leave practices without sufficient revenues when visit volumes decrease. Historic fee-for-service payments have been inadequate, and prior implementations of prospective payments have encountered challenges; there is a need to bring forward the best available evidence on how to design prospective payments for payers and policymakers. Read More

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Keeping Patients at the Center of Family Medicine Scholarship.

J Am Board Fam Med 2021 Mar-Apr;34(2):249-250

In addition to the collection of veterans' health articles, this edition of the journal contains a wide range of family medicine research reports, commentaries, clinical reviews, and scholarly observations. These articles clearly exemplify a key strength of family medicine scholarship: the focus is on our patients. Two articles look at modern care of patients with venous thromboembolic disease-the first on acute management and the second on long-term care. Read More

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Prepared and motivated to work in midwifery continuity of care? A descriptive analysis of midwifery students' perspectives.

Women Birth 2021 Apr 5. Epub 2021 Apr 5.

School of Nursing and Midwifery, Griffith University, Logan Campus, 68 University Dr, Meadowbrook, Queensland 4131, Australia; Transforming Maternity Care Collaborative, Australia.

Background: Internationally, midwifery education and maternity services are evolving to promote midwifery continuity of care. It is unclear whether current Australian midwifery education programs are graduating a midwifery workforce prepared and motivated to work in this way.

Aim: To discover how well midwifery students in Australia feel they have been prepared and motivated to work in midwifery continuity of care when they enter practice. Read More

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"Improved coordination of care after acute myocardial infarction in Poland since 2017: Promising early results".

Health Policy 2021 Mar 25. Epub 2021 Mar 25.

Jagiellonian University Medical College, Faculty of Health Science, Institute of Public Health.

A new model of complex patient care after acute myocardial infarction (AMI) has been in operation in Poland since late 2017, comprising invasive treatment, cardiac rehabilitation and scheduled outpatient follow-up. Its stated objectives are to improve secondary prevention measures, quality of care and long-term health outcomes in AMI-patients. The model implements all key aspects of post-MI care recommended by the European Society of Cardiology (ESC), representing the first nation-wide model of structured and comprehensive post-MI care that closely follows ESC guidelines. Read More

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Leading health reform: a critical review of 'leadership' within allied health competency standards.

Aust Health Rev 2021 Apr 9. Epub 2021 Apr 9.

ObjectiveThe study examined if, when and how select allied health professional standards currently articulate the Health LEADS Australia themes.MethodsEighteen allied health professional standards were searched to locate references to leadership. Data were extracted and analysed inductively, deductively and thematically as a meta-synthesis. Read More

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Correlation among experience of person-centered maternity care, provision of care and women's satisfaction: Cross sectional study in Colombo, Sri Lanka.

PLoS One 2021 8;16(4):e0249265. Epub 2021 Apr 8.

Institute for Maternal and Child Health-IRCCS "Burlo Garofolo"-Trieste, Italy.

Person-centered maternity care (PCMC) is defined as care which is respectful of and responsive to women's and families' preferences, needs, and values. In this cross-sectional study we aimed to evaluate the correlations among the degree of PCMC implementation, key indicators of provision of care, and women's satisfaction with maternity care in Sri Lanka. Degree of PCMC implementation was assessed using a validated questionnaire. Read More

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Structural vulnerability: migration and health in social context.

BMJ Glob Health 2021 Apr;6(Suppl 1)

Department of Anthropology, University of California San Francisco, San Francisco, California, USA.

Based on the authors' work in Latin America and Africa, this article describes and applies the concept 'structural vulnerability' to the challenges of clinical care and healthcare advocacy for migrants. This concept helps consider how specific social, economic and political hierarchies and policies produce and pattern poor health in two case studies: one at the USA-Mexico border and another in Djibouti. Migrants' and providers' various entanglements within inequitable and sometimes violent global migration systems can produce shared structural vulnerabilities that then differentially affect health and other outcomes. Read More

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Treading the Thin Line: Pharmacy Workers' Perspectives on Medication Abortion Provision in Lusaka, Zambia.

Stud Fam Plann 2021 Apr 7. Epub 2021 Apr 7.

MSI Reproductive Choices, London, W1T 6LP, UK.

Context: Despite liberal abortion laws, safe abortion access in Zambia is impeded by limited legal awareness, lack of services, and restrictive clinical policies. As in many countries with restricted abortion access, women frequently seek abortions informally from pharmacies.

Methods: We conducted 16 in-depth interviews in 2019 to understand the experiences and motivations of pharmacy workers who sell medication abortion (MA) drugs in Lusaka. Read More

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Prevalence of musculoskeletal disorders amongst flower farm workers in Kenya.

S Afr J Physiother 2021 9;77(1):1515. Epub 2021 Mar 9.

Department of Public Health, Faculty of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.

Background: Work-related musculoskeletal disorders (WMSDs) are a global public concern for health and social-care systems, as well as individuals. They are the second-most prevalent cause of disability globally.

Objectives: The primary objective was to determine the prevalence of WMSDs amongst flower farm workers. Read More

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Clinical Use of Neurophysiological Biomarkers and Self-Assessment Scales to Predict and Monitor Treatment Response for Psychotic and Affective disorders.

Curr Pharm Des 2021 Apr 6. Epub 2021 Apr 6.

Director of the Scientific Research Institute, The Medical University of Plovdiv. Bulgaria.

Psychoses and affective disorders are severe mental illnesses with a considerable negative effect on an individual and global scale. They are among the most damaging and socially significant diseases, which contribute to permanent disabilities for the patients. The aim of this review is to analyse the capacity of neuroscientific methods as tools to reform psychiatry into a biologically valid medical discipline. Read More

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[The impact of territorial care in the treatment of people diagnosed with schizophrenia and delusional disorders in a Rio de Janeiro community].

Salud Colect 2021 Mar 17;17:e3020. Epub 2021 Mar 17.

Doctora en Psiquiatría, Posdoctora en Epidemiología Psiquiátrica. Profesora Titular, Departamento de Psiquiatria, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.

Care for people diagnosed with schizophrenia and delusional disorders involves many challenges, especially in territorial contexts of pronounced social vulnerability. In Rio de Janeiro, the two decades after the passing of Federal Law 10,216 on Psychiatric Reform in 2001 have been characterized by the transition from a hospital-centered model to one based on community services. Taking the case of a community in Rio de Janeiro, data was extracted from the medical records of 94 patients diagnosed with schizophrenia, schizotypal disorders, and delusional disorders (ICD-10 codes F20 to F29) in five public health services. Read More

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Establishing a national HTA program for medical devices in Italy: Overhauling a fragmented system to ensure value and equal access to new medical technologies.

Health Policy 2021 Mar 27. Epub 2021 Mar 27.

Drugs and Medical Devices, Ministry of Health, Via Ribotta 5, 00144 Rome (Italy).

Differing contexts have greatly influenced HTA development in various countries, with considerable effort recently made by international HTA networks (e.g., EUnetHTA) and the European Union (EU) to make HTA a more coherent, equal, and efficient process. Read More

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Wiad Lek 2021 ;74(2):351-354


Objective: The aim: Is to study and analyze the dynamics of the indicators of the emergency medical service of the Ukrainian and the Poltava region in the context of the reforms of the healthcare system in Ukraine.

Patients And Methods: Materials and methods: In this work, the indicators of development of the emergency medical service of the Ukrainian and the Poltava region were studied and analyzed.

Conclusion: Conclusions: The provision of emergency medical care in the Poltava region is provided by the Poltava Regional Center for Emergency Medicine and Disaster Medicine. Read More

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An application of agent-based modeling to explore the impact of decreasing incarceration rates and increasing drug treatment access on sero-discordant partnerships among people who inject drugs.

Int J Drug Policy 2021 Mar 30;94:103194. Epub 2021 Mar 30.

Rollins School of Public Health, Emory University, Atlanta, GA, USA.

Background: People who inject drugs (PWID) lag behind other key populations in HIV care continuum outcomes. The impacts of criminal justice reform and increasing drug treatment access on HIV have been underexplored.

Methods: We developed agent-based models (ABM) of sexual partnerships among PWID and non-PWID, and injection equipment-sharing partnerships among PWID in five US cities (Baltimore, Boston, Miami, New York City, San Francisco) over 3 years. Read More

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Factors Associated with the Establishment of New Occupational Therapist Positions in Norwegian Municipalities after the Coordination Reform.

Health Serv Insights 2021 16;14:1178632921994908. Epub 2021 Mar 16.

Departement of Nevromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Norway.

Community-based occupational therapy is an increasingly important domain of work for occupational therapists. In Norway, this has been emphasized by the Coordination reform (2012), which assigned municipalities increased responsibility to protect and promote the health of their inhabitants. However, even if approximately 400 positions have been established between 2012 and 2017, little is known whether they have contributed to increased and/or more equal coverage across municipalities. Read More

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Implementing a Social Accountability Approach for Maternal, Neonatal, and Child Health Service Performances in Ethiopia: A Pre-Post Study Design.

Glob Health Sci Pract 2021 Apr 1;9(1):123-135. Epub 2021 Apr 1.

Addis Ababa University, Schools of Public Health, Addis Ababa, Ethiopia.

Background: Social accountability approaches, such as the community scorecard (CSC), can improve the performance of health systems in low-income countries by providing a mechanism for obtaining and incorporating community input. This longitudinal study assessed the effects of CSCs implemented by primary health care units (PHCUs) on health system performance in Ethiopia.

Methods: This study used a pre-post design and was conducted from October 2018 to September 2019 in 159 PHCUs in 31 districts in Amhara and Southern, Nations, Nationalities and Peoples' regional states. Read More

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Between the Forty-Yard Lines: Health Care Reform and its Impact on the Changing Landscape of Urologic Practice.

Kevin R Loughlin

Urol Clin North Am 2021 May;48(2):xi-xiii

Vascular Biology Research Program at Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. Electronic address:

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Ten-year follow-up of patient-centered comprehensive care using case completion curriculum.

Sang E Park

J Dent Educ 2021 Apr 1. Epub 2021 Apr 1.

Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA.

Introduction: The purpose of this study was to evaluate the patient-based comprehensive model in the student teaching practice at Harvard School of Dental Medicine (HSDM) as a result of the case completion curriculum. The patient-centered assessment system was implemented in 2009 as a clinical reform in clinical education to redirect predoctoral clinical learning from a student requirement-driven assessment system to a patient-centered treatment delivery model.

Methods: The sample for the 10-year retrospective cohort study consisted of the graduating classes of 2010 through 2019 at HSDM and all data regarding case completion and student feedback were obtained from the Office of Dental Education. Read More

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Use of Selected Recommended Clinical Preventive Services - Behavioral Risk Factor Surveillance System, United States, 2018.

MMWR Morb Mortal Wkly Rep 2021 Apr 2;70(13):461-466. Epub 2021 Apr 2.

Clinical preventive services play an important role in preventing deaths, and Healthy People 2020 has set national goals for using clinical preventive services to improve population health (1). The Patient Protection and Affordable Care Act (ACA) requires many health plans to cover certain recommended clinical preventive services without cost-sharing when provided in-network (covered clinical preventive services).* To ascertain prevalence of the use of selected recommended clinical preventive services among persons aged ≥18 years, CDC analyzed data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), a state-based annual nationwide survey conducted via landline and mobile phones in the United States, for 10 clinical preventive services covered in-network with no cost-sharing pursuant to the ACA. Read More

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Medicine, Machines, and Medical Education.

Steven A Wartman

Acad Med 2021 Mar 30. Epub 2021 Mar 30.

S.A. Wartman is president emeritus, Association of Academic Health Centers, Washington, DC.

While advances in science and technology continue to be at the forefront of the evolution of medical practice, the 21st century is also undergoing a unique and profound cultural shift that is changing the very nature of what it means to be a medical professional, namely humankind's transition to an information-based internet society. Medical care will increasingly depend on computer-generated probabilities guided and supported by a growing variety of health care-related professions, including statisticians, technologists, and information managers. Perhaps the biggest challenge to the profession will come from the erosion of professional autonomy, driven by smart machines, social networks, and internet search engines. Read More

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Reducing administrative costs in US health care: Assessing single payer and its alternatives.

Health Serv Res 2021 Mar 31. Epub 2021 Mar 31.

Clinical Excellence Research Center, School of Medicine, Stanford University, Stanford, California, USA.

Objective: Excess administrative costs in the US health care system are routinely referenced as a justification for comprehensive reform. While there is agreement that these costs are too high, there is little understanding of what generates administrative costs and what policy options might mitigate them.

Data Sources: Literature review and national utilization and expenditure data. Read More

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Association of Hospital Safety Net Status With Outcomes and Resource Use for Extracorporeal Membrane Oxygenation in the United States.

J Intensive Care Med 2021 Mar 30:8850666211007062. Epub 2021 Mar 30.

Divisions of Cardiac Surgery, Cardiovascular Outcomes Research Laboratories, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Purpose: Safety net hospitals (SNH) have been associated with inferior surgical outcomes and increased resource use. Utilization and outcomes for extracorporeal membrane oxygenation (ECMO), a rescue modality for patients with respiratory or cardiac failure, may vary by safety net status. We hypothesized SNH to be associated with inferior outcomes and costs of ECMO in a national cohort. Read More

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Implementing Integrated Care in Practice - Learning from MDTs Driving the Integrated Care Programme for Older Persons in Ireland.

Int J Integr Care 2021 Mar 18;21(1):15. Epub 2021 Mar 18.

Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, Ireland.

The importance of multidisciplinary teams (MDTs) as critical implementation drivers emerged from this case study conducted with three pioneer sites implementing integrated care for older persons in Ireland as part of the Integrated Care Programme for Older Persons (ICPOP). We describe the practices of MDTs learning to deliver integrated care in service delivery settings, including the framework, resourcing, strategies, challenges and barriers they encounter. The study was conducted by a team of researchers in collaboration with ICPOP at both national programme and pioneer site levels. Read More

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[Thoughts on the role of the advanced practice nurse in emergency care and the patient pathway].

Soins 2021 Mar;66(853):46-51

Département de formation du personnel non médical, École du Val-de-Grâce, 1 place Laveran, 75005 Paris, France; Laboratoire Éducations et pratiques de santé (UR 3412), Université Sorbonne Paris Nord, 74 rue Marcel-Cachin, 93000 Bobigny, France; Faculté des sciences infirmières, Université de Montréal, pavillon Marguerite-d'Youville, 2375 chemin de la Côte-Sainte-Catherine, Montréal (Québec) H3T 1A8, Canada. Electronic address:

Abroad, advanced practice in emergency medicine has had positive effects on populations. In France, following the reform of emergency departments, advanced practice nurses in emergency medicine will become a reality. This new profession raises certain fears. Read More

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[Advocating a new health order].

Guy Vallancien

Soins 2021 Mar;66(853):26-27

c/o Soins, Elsevier Masson, 65 rue Camille-Desmoulins, 92442 Issy-les-Moulineaux cedex, France. Electronic address:

Le système de santé français reste à ce jour encore trop médico-centré Une véritable révolution doit s'opérer afin de le faire évoluer, nécessitant de revoir nos schémas de pensée habituels et d'intégrer les évolutions technologiques telles que l'intelligence artificielle D'autres acteurs peuvent y contribuer, comme les infirmiers en pratique avancée, grâce à une formation solide et une volonté politique forte. Read More

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Towards healthy China 2030: Modeling health care accessibility with patient referral.

Soc Sci Med 2021 Mar 13;276:113834. Epub 2021 Mar 13.

CAUPD Beijing Planning and Design Consultants Co., Beijing, China.

One primary action plan in the Healthy China 2030 initiative is to build innovativepatient referral models for health care reform in China. To ensure people have sufficient and equitable health care access when the patient referral policy is enforced, a systematic evaluation of its effects on the health care system is needed. In this paper, we focus on one health policy metric, the health care accessibility, by considering the patient transfer between different levels of health care facilities under the context that the need for specialized treatment cannot be fulfilled by a low-level facility. Read More

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Private Services and the Fragmentation of Maternity Care in Poland.

Med Anthropol 2021 Mar 26:1-13. Epub 2021 Mar 26.

Department of Midwifery, Centre for Postgraduate Medical Education, Warsaw, Poland.

As a result of reforms aimed at adjusting it to the market economy, the Polish health care system has become a complicated mix of public and private services. Using as an example maternity services, I show how private services allow a subtle process of patient selection to emerge, contributing to the fragmentation of public care. The process of selection is based on social relations formed between health care providers and patients through the use of private services. Read More

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