ABSTRACT
@#The aim of this study was to identify factors that affect the dental service delivery in a dental clinic from the context of Papua New Guinean dental providers and to make practical recommendations to improve dental service delivery. This qualitative descriptive study used individual interviews with seven dental providers to identify the factors that were affecting quality dental service delivery in a dental clinic in Papua New Guinea. The factors influencing the quality of dental service fell into three categories and 8 themes. The categories were environmental factors with themes of resources and facilities, leadership and management, partnership development and collaboration; provider-related factors with themes provider competence, provider motivation and satisfaction; and required measures with the themes of a new dental clinic building, renovation of the main clinic area and organizational structure. Quality dental service is achieved when there is a supportive working environment with availability of (new) physical amenities and dental resources, and proper management and organizational structures with supportive visionary leadership. This would encourage teamwork and partnership development internally within the dental team and externally with its stakeholders. Furthermore, it would increase staff motivation and satisfaction internally and partnership development internally within the dental staff and externally with its stakeholders. Consider creating a new dental clinic. Develop a contract between the University and the Hospital to resolve the property ownership issues. Create a clear organizational structure and improve management interaction with clinical staff so that management is supportive. Improve the quality of dental supplies and create an efficient material ordering system. Ensure fairness to staff and respect to procedures are compliantly maintained to encourage teamwork. Reward clinical staff for mentoring and teaching dental students. Create access to continuing professional development for the clinical staff.
ABSTRACT
Introduction: Numerous health indicators from different domains and comprehensive systems for describing health of community at state or district level are in vogue. Some sub-district information is also available from Health Management Information System but the numbers of indicators are many. Here composite health index of sub-district level is calculated similar to documented procedure. Objective: To develop block wise composite health index in an average district, Yavatmal district using available data. Methods: We grouped health indicators in following four categories; health outcomes, health system, other determinants and utilization of services. From these categories we selected four, three, two and one indicator respectively. Almost all the information is collected from already available data. There are 16 blocks in Yavatmal district. Block wise information of all indicators was first compiled. The block having best value was given 100 marks and remaining blocks were given proportionately less marks. The block wise total marks were calculated. The total score was converted into index by dividing by 1,000. Results: The composite health index ranged from 0.369 to 0.794. The median was 0.425 and interquartile range was 0.126. Out of ten, nine health indicators had normal distribution. We observed positive correlation between urbanization and composite health index. The Yavatmal block obtained highest composite index 0.794 and was an outlier. Principal component analysis extracted four components which contributed 82.06% to total variance. Conclusion: Using only ten indicators and simple method blocks composite health index can be developed which may be used to compare blocks or even districts.
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Objective:To explore the health seeking behavior, utilization of health services and the economic burden of the elderly patients with diabetic foot ulcer ( DF) , with aim to provide policy evidence for improving their DF prevention and treatment outcomes. Methods: The purposive sampling method was applied to recruit 15 elderly DF patients treated in the 454 th Hospital of Chinese PLA from December 2013 to January 2014. After informed con-sent, they were in-depth interviewed. Results: The elderly with DF had a higher demand for the health services. They emphasized on treatment and neglected prevention. The utilization and efficiency of health services were affected by patients' economic level, medical insurance, capacity of community services, and so on. Conclusion:In order to improve the treatment outcome and quality of life for the elderly DF patients, it's necessary to strengthen patients' health education, to build a community-based and integrated health care system on DF prevention, treatment and management, and to develop the policies for reducing DF related economic burden.
ABSTRACT
Objective To study the impacts of health insurance schemes on the equity of health services access and the financial protection for disease risk exposure of the elderly population.Methods The descriptive statistics method and econometrics models.Results Full coverage of the health insurance fails to eliminate the inequity in health services access.For example,the two-week clinical visit rate and hospitalization rate of the high-income group are 1.57 and 1.21 times higher than those of the low-income group;the disease risk economic protection function of the health insurance falls below requirement,as the out-of-pocket ratio is as high as 30%~40%;the security for urban workers is far better than urban residents,as the utilization level of outpatient service and hospitalization service of senior workers are 1.18 and 1.33 times that of senior urban residents respectively.Conclusion Despite the full population coverage of health insurance schemes,it is a long way to go before the goal of universal health coverage. Future reforms should aim at filling the financial gaps between different health insurance schemes.
ABSTRACT
O objetivo deste estudo foi avaliar o acesso e a utilização dos serviços de Atenção Primária a Saúde (APS) em população rural no município de Jequitinhonha, Minas Gerais. Foram realizadas entrevistas com todos os 190 indivíduos com 18 anos ou mais de idade residentes no povoado do Caju para obter informações socioeconômicas, demográficas e sobre as necessidades de saúde, acesso e utilização dos serviços de saúde. A análise dos dados foi feita utilizando o teste Qui-quadrado de Pearson, odds ratio com Intervalo de Confiança de 95% e regressão logística. Os resultados mostraram que a maioria dos indivíduos não possui um serviço de saúde de uso regular. Apesar disso, 65,8% dos entrevistados relataram ter realizado pelo menos uma consulta com profissional de saúde no período de 12 meses anteriores à entrevista, principalmente as mulheres (OR 3,55; IC 1,85 6,79) e aqueles que consideraram seu estado de saúde deficiente (OR 2,03; IC 1,01-4,08). Foi encontrada uma taxa de internação hospitalar durante o ano relativamente alta (11,6%), que pode ter sido resultado de problemas no acesso aos serviços de APS. Em geral, os que procuraram o hospital foram principalmente aqueles que receberam algum tipo de ajuda (OR 3,07; IC 1,18 - 8,00) e que consideraram seu estado de saúde deficiente (OR 3,04; IC 1,16 7,98). Quanto à utilização, 31,6% dos indivíduos utilizaram algum serviço de saúde nos últimos 30 dias anteriores a entrevista, principalmente os que possuíam quatro ou mais eletrodomésticos em casa (OR 5,72; IC 1,23 26,54) e os portadores de hipertensão (OR 19,91; IC 8,02 49,41). Os motivos que determinaram a última utilização foram principalmente a busca por medicamentos (46,7%) e a presença de queixas ou sintomas de doenças (23,3%) sendo o serviço mais utilizado o posto de saúde do Caju (75,0%). Se não considerarmos as utilizações relacionadas à busca de medicamentos, a taxa de utilização cai para 15,8% e apenas a presença de restrições de atividades habituais...
Subject(s)
Humans , Primary Health Care , Health Services Accessibility , Rural Population , Brazil , Qualitative Research , Surveys and Questionnaires , Socioeconomic FactorsABSTRACT
Se revisaron los datos disponibles sobre la cobertura de la atención prenatal en América Latina. En la comparación de las coberturas recientes de atención prenatal entre los países resalta que sólo Bolivia tuvo una cobertura menor al 50 por ciento, mientras que en Chile, Cuba, República Dominicana y Puerto Rico las coberturas de atención prenatal son superiores al 90 por ciento. En relación con las tendencias en el tiempo, se encontró que las coberturas de atención prenatal aumentaron entre los años setenta y ochenta en la República Dominicana, Ecuador, Guatemala, Honduras, México y Perú, mientras que disminuyeron en Bolivia y Colombia. En Cuba y Puerto Rico, aumentó el número de promedio de consultas prenatales. El aumento de la atención en Guatemala y Honduras se debe al aumento relativo del papel de las parteras empíricas, con respecto a las instituciones. Se compararon los datos más recientes sobre la vacunación antitetánica de las embarazadas con los datos más recientes de atención prenatal. Se observa que las tasas de vacuna antitetánica siempre son mucho más bajas que las de atención prenatal, excepto en Costa Rica. En Bolivia, Guatemala y Perú las tasas de vacunación son menores a la mitad de las tasas de atención prenatal. Mejorar el contenido de la atención debe ser objetivo paralelo al aumento de los servicios prenatales.
Available data on the coverage of prenatal care in Latin America were reviewed. In recent years, only Bolivia had a coverage of prenatal care of less than 50 per cent. More than 90 per cent of pregnant women received prenatal care in Chile, Cuba, the Dominican Republic, and Puerto Rico. Prenatal care increased between the 1970 and 1980 in the Dominican Republic, Ecuador, Guatemala, Honduras, Mexico, and Peru. The coverage of prenatal care decreased in Bolivia and Colombia. The mean number of visits increased in Cuba and Puerto Rico. The increase of prenatal care in Guatemala and Honduras is due to increased care by traditional birth attendants, compared to the role of health care institutions. We compared the more recent data on tetanus immunization of pregnant women to the more recent data on prenatal care. The rates of tetanus immunization are always lower than the rates of prenatal care attendance, except in Costa Rica. The rates of tetanus immunization was less than half as compared to the rates of prenatal care in Bolivia, Guatemala, and Peru. To improve the content of prenatal care should be an objective complementary to the increase of the number of attending women.