The complexity of the healthcare organization with emphasis on efficiency and productivity has led to an increase in value conflicts as well as moral and ethical conflicts. The aim of this study was to explore nurse m...The complexity of the healthcare organization with emphasis on efficiency and productivity has led to an increase in value conflicts as well as moral and ethical conflicts. The aim of this study was to explore nurse managers’ perceptions of ethical conflicts when caring for older patients who wish to die. A qualitative method was employed and data were collected by means of a focus group interview with eight nurse managers. The results revealed one theme: A struggle due to responsibility for decision making and four sub-themes:?Understanding the meaning of free will, wondering about how serious the death wish is, providing more worthy elder care and lack of competent healthcare professionals to provide safe care. Nurse managers’ have no structure for bringing ethical conflicts to the attention of their leaders or the next level of the organization. Consequently, they appear to need supervision, support and clear, flexible lines of communication with leadership.展开更多
Primary Health Care Services Sector (PHCSS) of Dubai Health Authority (DHA) provides many services dedicated to seniors. However, there have been no studies to date that consulted the seniors themselves regarding thes...Primary Health Care Services Sector (PHCSS) of Dubai Health Authority (DHA) provides many services dedicated to seniors. However, there have been no studies to date that consulted the seniors themselves regarding these services. Thus, this study was conducted to investigate the age-friendliness of outpatient clinic’s services provided in PHCSS from perspective of elderly service recipients. Methods: Three focus groups were designed. The focus groups included receivers of care (senior patients and caregivers for senior patients) and healthcare providers (physicians, nurses, administrators and medical record officers). The discussed topics in the focus groups were based on WHO’s recommended three domains of improvement for an age-friendly Primary Health Care (PHC): Information, education and training, community-based health care management systems, and the physical environment.展开更多
Objective:Barriers to healthcare in Ghana are multifaceted.Many people,including patients and providers,face them at different levels.To address these barriers,there is a need to explore the role of an intercultural h...Objective:Barriers to healthcare in Ghana are multifaceted.Many people,including patients and providers,face them at different levels.To address these barriers,there is a need to explore the role of an intercultural healthcare system.This paper explores and provides the first evidence on ways through which an intercultural healthcare system can reduce the sociocultural and economic barriers to healthcare in Ghana.Methods:Focus group discussions with 35 participants comprising 17 healthcare users,11 formal healthcare providers and 7 alternative healthcare providers were conducted to gather data.Thematic analyses were performed on the transcribed data and presented based on a posteriori inductive reduction approach.Results:Findings reveal that an intercultural healthcare system in Ghana can help reduce barriers to healthcare,especially cultural,social and economic barriers,by fostering an enhanced relationship between culture and healthcare,promoting affordable healthcare and promoting effective communication between healthcare providers and users.Weak institutional support,lack of strong political will and commitment,lack of training to meet standards of practice,poor registration and regulatory measures,and lack of universal acceptance inhibit implementation of an intercultural healthcare system in Ghana.Conclusion:The support for intercultural healthcare system and the agreement on its perceived ability to reduce social,cultural and economic healthcare barriers for service users offer an opportunity for policymakers to demonstrate a stronger political will and improved commitment for effective education and training,enforcement of regulatory measures,inclusion of intercultural healthcare in medical school curricula across the country,and community engagement.展开更多
目的比较分析实施疾病诊断相关分组(diagnosis related group,DRG)支付方式改革地区的基础病组同病同价支付政策,为该政策的优化与推广提供参考建议。方法检索全国省级医疗保障局网站和190个实施DRG支付方式改革城市的医疗保障局网站,收...目的比较分析实施疾病诊断相关分组(diagnosis related group,DRG)支付方式改革地区的基础病组同病同价支付政策,为该政策的优化与推广提供参考建议。方法检索全国省级医疗保障局网站和190个实施DRG支付方式改革城市的医疗保障局网站,收集2019年1月1日—2024年5月31日其官网发布的DRG政策文件,应用Excel软件整理资料,采用比较分析法归纳总结基础病组政策的地区覆盖、医疗机构覆盖和病组覆盖现状。结果DRG基础病组同病同价支付政策覆盖地区数量少且不均衡,共16个省、2个直辖市及3个自治区的76个地市实施了该政策,占实施DRG付费城市总数的40%,且主要集中于东部地区。医疗机构覆盖面存在差异,大部分地区的基础病组政策覆盖所有级别的医疗机构,部分地区的基础病组政策主要在二级和三级医疗机构实施。病组遴选标准基本一致,以常见、多发,诊疗技术成熟、难度低和医疗费用稳定且差异小为主要纳入标准。地区间基础病组数量、权重和分布不均衡,纳入的基础病组数量为3~117不等,权重区间为0.16~1.57,以内科治疗为主,哮喘和高血压是最常见的基础病组。结论建议进一步扩展DRG基础病组同病同价支付政策覆盖的地区范围,因地制宜确定医疗机构覆盖范围,分阶段扩展病种覆盖范围,加强政策实施效果评价。展开更多
文摘The complexity of the healthcare organization with emphasis on efficiency and productivity has led to an increase in value conflicts as well as moral and ethical conflicts. The aim of this study was to explore nurse managers’ perceptions of ethical conflicts when caring for older patients who wish to die. A qualitative method was employed and data were collected by means of a focus group interview with eight nurse managers. The results revealed one theme: A struggle due to responsibility for decision making and four sub-themes:?Understanding the meaning of free will, wondering about how serious the death wish is, providing more worthy elder care and lack of competent healthcare professionals to provide safe care. Nurse managers’ have no structure for bringing ethical conflicts to the attention of their leaders or the next level of the organization. Consequently, they appear to need supervision, support and clear, flexible lines of communication with leadership.
文摘Primary Health Care Services Sector (PHCSS) of Dubai Health Authority (DHA) provides many services dedicated to seniors. However, there have been no studies to date that consulted the seniors themselves regarding these services. Thus, this study was conducted to investigate the age-friendliness of outpatient clinic’s services provided in PHCSS from perspective of elderly service recipients. Methods: Three focus groups were designed. The focus groups included receivers of care (senior patients and caregivers for senior patients) and healthcare providers (physicians, nurses, administrators and medical record officers). The discussed topics in the focus groups were based on WHO’s recommended three domains of improvement for an age-friendly Primary Health Care (PHC): Information, education and training, community-based health care management systems, and the physical environment.
文摘Objective:Barriers to healthcare in Ghana are multifaceted.Many people,including patients and providers,face them at different levels.To address these barriers,there is a need to explore the role of an intercultural healthcare system.This paper explores and provides the first evidence on ways through which an intercultural healthcare system can reduce the sociocultural and economic barriers to healthcare in Ghana.Methods:Focus group discussions with 35 participants comprising 17 healthcare users,11 formal healthcare providers and 7 alternative healthcare providers were conducted to gather data.Thematic analyses were performed on the transcribed data and presented based on a posteriori inductive reduction approach.Results:Findings reveal that an intercultural healthcare system in Ghana can help reduce barriers to healthcare,especially cultural,social and economic barriers,by fostering an enhanced relationship between culture and healthcare,promoting affordable healthcare and promoting effective communication between healthcare providers and users.Weak institutional support,lack of strong political will and commitment,lack of training to meet standards of practice,poor registration and regulatory measures,and lack of universal acceptance inhibit implementation of an intercultural healthcare system in Ghana.Conclusion:The support for intercultural healthcare system and the agreement on its perceived ability to reduce social,cultural and economic healthcare barriers for service users offer an opportunity for policymakers to demonstrate a stronger political will and improved commitment for effective education and training,enforcement of regulatory measures,inclusion of intercultural healthcare in medical school curricula across the country,and community engagement.
文摘目的比较分析实施疾病诊断相关分组(diagnosis related group,DRG)支付方式改革地区的基础病组同病同价支付政策,为该政策的优化与推广提供参考建议。方法检索全国省级医疗保障局网站和190个实施DRG支付方式改革城市的医疗保障局网站,收集2019年1月1日—2024年5月31日其官网发布的DRG政策文件,应用Excel软件整理资料,采用比较分析法归纳总结基础病组政策的地区覆盖、医疗机构覆盖和病组覆盖现状。结果DRG基础病组同病同价支付政策覆盖地区数量少且不均衡,共16个省、2个直辖市及3个自治区的76个地市实施了该政策,占实施DRG付费城市总数的40%,且主要集中于东部地区。医疗机构覆盖面存在差异,大部分地区的基础病组政策覆盖所有级别的医疗机构,部分地区的基础病组政策主要在二级和三级医疗机构实施。病组遴选标准基本一致,以常见、多发,诊疗技术成熟、难度低和医疗费用稳定且差异小为主要纳入标准。地区间基础病组数量、权重和分布不均衡,纳入的基础病组数量为3~117不等,权重区间为0.16~1.57,以内科治疗为主,哮喘和高血压是最常见的基础病组。结论建议进一步扩展DRG基础病组同病同价支付政策覆盖的地区范围,因地制宜确定医疗机构覆盖范围,分阶段扩展病种覆盖范围,加强政策实施效果评价。
