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  Subjects -> HEALTH AND SAFETY (Total: 1292 journals)
    - CIVIL DEFENSE (18 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (521 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (379 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (106 journals)
    - PHYSICAL FITNESS AND HYGIENE (101 journals)
    - WOMEN'S HEALTH (81 journals)

HEALTH AND SAFETY (521 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 20)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 4)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 25)
American Journal of Health Promotion     Hybrid Journal   (Followers: 22)
American Journal of Health Studies     Full-text available via subscription   (Followers: 8)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 179)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 8)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 2)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 2)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 5)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 1)
Behavioral Healthcare     Full-text available via subscription   (Followers: 4)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 6)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 9)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 18)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 15)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 11)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 10)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 18)
Case Reports in Women's Health     Open Access   (Followers: 2)
Case Studies in Fire Safety     Open Access   (Followers: 11)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 10)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 1)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 13)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 4)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access  
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 3)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 3)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription  
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 1)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 8)
Evidence-based Medicine & Public Health     Open Access   (Followers: 4)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 3)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 10)
Frontiers in Public Health     Open Access   (Followers: 8)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 11)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 4)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 7)
Global Journal of Public Health     Open Access   (Followers: 9)
Global Medical & Health Communication     Open Access  
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 4)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 14)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 9)
Health and Social Work     Hybrid Journal   (Followers: 46)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 11)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 10)
Health Issues     Full-text available via subscription   (Followers: 1)
Health Policy     Hybrid Journal   (Followers: 32)
Health Policy and Technology     Hybrid Journal  
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 20)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 47)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 9)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 10)
Health, Risk & Society     Hybrid Journal   (Followers: 10)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 10)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 2)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 4)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 32)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 1)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 19)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 13)
International Journal of Health & Allied Sciences     Open Access   (Followers: 1)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 7)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 2)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 12)
International Journal of Health Research     Open Access   (Followers: 4)
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services     Full-text available via subscription   (Followers: 9)

        1 2 3 | Last

Journal Cover Health Systems
  [2 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2047-6965 - ISSN (Online) 2047-6973
   Published by Springer-Verlag Homepage  [2345 journals]
  • Demand and capacity modelling for acute services using discrete event
           simulation
    • Authors: Eren Demir; Murat M Gunal; David Southern
      Pages: 33 - 40
      Abstract: Increasing demand for services in England with limited healthcare budget has put hospitals under immense pressure. Given that almost all National Health Service (NHS) hospitals have severe capacity constraints (beds and staff shortages), a decision support tool (DST) is developed for the management of a major NHS Trust in England. Acute activities are forecasted over a 5-year period broken down by age groups for 10 specialty areas. Our statistical models have produced forecast accuracies in the region of 90%. We then developed a discrete event simulation model capturing individual patient pathways until discharge (in accident and emergency, inpatient and outpatients), where arrivals are based on the forecasted activity outputting key performance metrics over a period of time, for example, future activity, bed occupancy rates, required bed capacity, theatre utilisations for electives and non-electives, clinic utilisations and diagnostic/treatment procedures. The DST allows Trusts to compare key performance metrics for thousands of different scenarios against their existing service (baseline). The power of DST is that hospital decision makers can make better decisions using the simulation model with plausible assumptions that are supported by statistically validated data.
      PubDate: 2017-03-01
      DOI: 10.1057/hs.2016.1
      Issue No: Vol. 6, No. 1 (2017)
       
  • Large-scale clinical implementation of PROMIS computer adaptive testing
           with direct incorporation into the electronic medical record
    • Authors: M. O. Papuga; C. Dasilva; A. McIntyre; D. Mitten; S. Kates; J. F. Baumhauer
      Abstract: The objective of this research was to assess the implementation of collecting patient-reported outcomes data in the outpatient clinics of a large academic hospital and identify potential barriers and solutions to such an implementation. Three PROMIS computer adaptive test instruments, (1) physical function, (2) pain interference, and (3) depression, were administered at 23,813 patient encounters using a novel software platform on tablet computers. The average time to complete was 3.50 ± 3.12 min, with a median time of 2.60 min. Registration times for new patients did not change significantly, 6.87 ± 3.34 to 7.19 ± 2.69 min. Registration times increased for follow-up (p = .007) from 2.94 ± 1.57 (p < .01) min to 3.32 ± 1.78 min. This is an effective implementation strategy to collect patient-reported outcomes and directly import the results into the electronic medical record in real time for use during the clinical visit.
      PubDate: 2017-04-12
      DOI: 10.1057/s41306-016-0016-1
       
  • Using cognitive and causal modelling to develop a theoretical framework
           for implementing innovative practices in primary healthcare management in
           New Zealand
    • Authors: David Rees; Robert Y. Cavana; Jacqueline Cumming
      Abstract: The continuing rise in chronic health conditions requires major changes in how healthcare is managed and delivered. While research has identified a number of factors key to bringing this about, implementing these changes requires an understanding of how the factors interact over time in different contexts. In this research study, seven senior health experts in New Zealand were interviewed, using cognitive mapping, to ascertain their thinking about major implementation challenges to enhance primary healthcare systems. The resulting cognitive maps were then consolidated and developed into a causal loop diagram, which describes a set of interlinked feedback loops representing the processes involved in implementing changes. It is concluded that these systems methods are very effective in better understanding the contextual and behavioural factors necessary for the development of a theoretical framework to support the successful implementation of innovative primary healthcare programmes.
      PubDate: 2017-03-28
      DOI: 10.1057/s41306-017-0029-4
       
  • A systematic literature review of operational research methods for
           modelling patient flow and outcomes within community healthcare and other
           settings
    • Authors: Ryan Palmer; Naomi J. Fulop; Martin Utley
      Abstract: An ambition of healthcare policy has been to move more acute services into community settings. This systematic literature review presents analysis of published operational research methods for modelling patient flow within community healthcare, and for modelling the combination of patient flow and outcomes in all settings. Assessed for inclusion at three levels – with the references from included papers also assessed – 25 “Patient flow within community care”, 23 “Patient flow and outcomes” papers and 5 papers within the intersection are included for review. Comparisons are made between each paper’s setting, definition of states, factors considered to influence flow, output measures and implementation of results. Common complexities and characteristics of community service models are discussed with directions for future work suggested. We found that in developing patient flow models for community services that use outcomes, transplant waiting list may have transferable benefits.
      PubDate: 2017-03-23
      DOI: 10.1057/s41306-017-0024-9
       
  • Care and Flow: Using Soft Systems Methodology to understand tensions in
           the patient discharge process
    • Authors: Michael Emes; Stella Smith; Suzanne Ward; Alan Smith; Timothy Ming
      Abstract: Many hospitals face a daily struggle to manage capacity, especially where wards contain patients with a combination of health and social care needs. In this study, Soft Systems Methodology was used to understand the process of discharging patients from an acute hospital and to answer the question ‘Why do patients with complex needs often spend longer on the wards than is necessary?’. Through a series of twenty structured interviews, several problems with the discharge planning process were identified. Problems included ineffective communication, slow processing of paperwork, limited forward planning, no clear ownership of the process and delays in finding care in the community. The persistence of these problems despite longstanding guidance on discharge planning can be understood by recognising the tension between two different philosophies in hospitals – a traditional ‘Care’ mindset focusing on the immediate needs of patients on the wards, and a planning-focused ‘Flow’ mentality, where the hospital’s responsibility to the wider community dominates. Soft Systems Methodology was found to be an effective approach for discussing discharge planning and highlighting this tension. Based on the insights gained from the interviews, three practical initiatives have now been implemented to reconcile the tension and thereby reduce delays in the hospital.
      PubDate: 2017-03-07
      DOI: 10.1057/s41306-017-0027-6
       
  • Organizing multidisciplinary care for children with neuromuscular diseases
           at the Academic Medical Center, Amsterdam
    • Authors: Nikky Kortbeek; M. F. van der Velde; N. Litvak
      Abstract: The Academic Medical Center (AMC) in Amsterdam, The Netherlands, recently opened the ‘Children’s Muscle Center Amsterdam’ (CMCA). The CMCA diagnoses and treats children with neuromuscular diseases. The patients with such diseases require care from a variety of clinicians. Through the establishment of the CMCA, children and their parents will generally visit the hospital only once a year, while previously they used to visit on average six times a year. This is a major improvement, because the hospital visits are both physically and psychologically demanding for the patients. This paper describes how quantitative modelling supports the design and operations of the CMCA. First, an integer linear program is presented that selects which patients are to be invited for a treatment day and schedules the required combination of consultations, examinations and treatments on one day. Second, the integer linear program is used as input to a simulation study to estimate the capacity of the CMCA, expressed in terms of the distribution of the number patients that can be seen on one diagnosis day. Finally, a queueing model is formulated to predict the access time distributions based upon the simulation outcomes under various demand scenarios. Its contribution on the case under study is twofold. First, we design highly constrained appointment schedules for multiple patients that require service from multiple disciplines’ resources. Second, we study the effect of the trade-offs between scheduling constraints and access times. As such, the contribution of this case study paper is that it illustrates the value of applying Operations Research techniques in complex healthcare settings, by designing context-specific combinations of mathematical models, thereby improving delivery of the highly-constrained multidisciplinary care.
      PubDate: 2017-02-28
      DOI: 10.1057/s41306-016-0020-5
       
  • Logistics for Emergency Medical Service systems
    • Authors: Melanie Reuter-Oppermann; Pieter L. van den Berg; Julie L. Vile
      Abstract: Emergency Medical Service (EMS) systems worldwide are complex systems, characterized by significant variation in service providers, care pathways, patient case-mix and quality care indicators. Analysing and improving them is therefore challenging. Since EMS systems differ between countries, it is difficult to provide generic rules and approaches for EMS planning. Nevertheless, the common goal for all service providers is to offer medical assistance to patients with serious injuries or illnesses as quickly as possible. This paper presents an overview of logistical problems arising for EMS providers, demonstrating how some of these problems are related and intertwined. For each individual planning problem, a description as well as a concise literature overview of solution approaches considered is given. A summary table classifies the literature according to the problems addressed and connects it to the proposed taxonomy.
      PubDate: 2017-02-27
      DOI: 10.1057/s41306-017-0023-x
       
  • Improving the process efficiency of catheterization laboratories using
           simulation
    • Authors: Srimathy Mohan; Qing Li; Mohan Gopalakrishnan; John Fowler; Antonios Printezis
      Abstract: As the size of the population suffering from cardiac problems increases, the number of catheterization procedures performed is growing rapidly. The high costs associated with catheterization laboratories (cath labs) make managing these resources a critical task that impacts the efficiency and operating costs of hospitals as well as the quality of care. This study describes a discrete event simulation model developed to analyze the various factors that affect utilization of cath labs at a 337-bed full-service hospital in Scottsdale Arizona and provide decision support for improving the efficiency of the cath lab operations. The simulation model helped evaluate the performance of the existing approach at the hospital and compare alternative policies to improve operational efficiency. We consider both operational and patient satisfaction metrics and illustrate the tradeoffs between the two. Our analysis recommends reducing the initial time allotted to each case from 120 to 90 min, including a 30-min lunch buffer and end of the day buffer to absorb any delays, and potentially rescheduling inpatients when emergent cases have to be scheduled or other cases are taking longer than anticipated. We also perform detailed parametric analysis to develop more generic recommendations. The facility under study implemented our recommendations and realized a 19% increase in utilization as well as a 71% decrease in overtime.
      PubDate: 2017-02-14
      DOI: 10.1057/s41306-017-0025-8
       
  • Awareness and utilization of Rashtriya Swasthaya Bima Yojana and its
           
    • Authors: Shikha Gupta
      Abstract: Rashtriya Swasthya Bima Yojana (RSBY), a national flagship health insurance scheme of India, was launched in 2008 with an aim to improve access to cashless inpatient care for the families below poverty line. Delhi being the national capital of India was one of the first states where this scheme was implemented. The objectives of this study were to find out the awareness of the scheme among the enrolled families, utilization of its services, and the extent to which RSBY provided cost-free access to inpatient care to its enrolled beneficiaries. A mixed method study was conducted in ten slum areas of East and North East Delhi. Data were collected through the household survey with 120 families having RSBY cards (service recipients) and qualitative interviews with 30 professionals responsible for managing various aspects of the RSBY program. Quantitative data were analysed using statistical package of social sciences (SPSS) whereas thematic analysis was done for qualitative data. The findings suggest that RSBY benefitted only 20% of the families among the total sample. It appeared that families who were relatively more aware about the range of benefits and operational mechanisms of the scheme were able to utilize its benefits as compared to others who were not. However, the families who utilized or tried to utilize the RSBY benefits were not satisfied with the scheme and faced many problems while accessing hospital care through RSBY. They faced refusals for the treatment by RSBY empaneled hospitals, demands for extra money, and poor quality treatment provided to them. These situations forced few families to approach another public or private hospitals in case of illness and incur significant out-of-pocket expenditure on emergency health care despite having RSBY insurance coverage. The data obtained through the interviews illuminated the challenges associated with the implementation of RSBY from service provider’s perspective. The study recommends that if RSBY scheme aspires to cover the entire Indian poor population under its umbrella of risk protection, the government should adopt rigorous administrative mechanisms with robust monitoring and evaluation systems at different levels to ensure quality and timely healthcare is provided to the beneficiaries.
      PubDate: 2017-02-14
      DOI: 10.1057/s41306-017-0022-y
       
  • Organizational citizenship behavior and implementation of evidence-based
           practice: Moderating role of senior management’s support
    • Authors: Sajid Haider; Antonio Fernandez-Ortiz; Carmen de Pablos Heredero
      Abstract: This study sought to empirically examine the link between OCB and EBP implementation, and tested senior management’s support as a moderator of this relationship. A cross-sectional survey design was used. Data were based on the survey of participants’ perceptions of the study variables. The participants were professionals involved in the treatment of acute myocardial infarction at five hospitals in Madrid Community of Spain. Hypothetico-deductive method was applied, and partial least squares structural equation modeling (PLS-SEM) was used for data analysis. The relationship between OCB and EBP implementation was supported. A significant moderating effect was also found, which indicates that with an increase in senior management’s support OCBs become more important for explaining their effect on EBP implementation. The findings of this research are promising to organizations and agencies that take into account the importance of implementing EBP. This research provides conditions valuable to successful use of EBP. Especially, where senior management interacts positively with other variables such as OCB, the likelihood of EBP implementation and its effectiveness may increase. An improvement in these factors and their interaction is liable to guide an improved continuity in healthcare resulting from positive organizational ethos.
      PubDate: 2017-02-14
      DOI: 10.1057/s41306-017-0026-7
       
  • Procurement in public & private hospitals in Australia and Costa Rica
           – a comparative case study
    • Authors: Alexander Budgett; Mohan Gopalakrishnan; Eugene Schneller
      Abstract: This article summarizes exploratory research conducted on supply chain management practices in public hospital systems in the Australian State of Victoria and in Costa Rica. Victoria is the site of a clearly articulated (centralized) supply chain strategy as opposed to Costa Rica, where there is a strong presence of government procurement rules but no such articulated strategy. Importantly, both systems have mixed governance structures (public vs private) and had a willingness to share information pertaining to their purchasing practices. Relatively open-ended interviews, analyzed utilizing MAXQDA 11, allowed us to scrutinize the influence of public policy, supply chain integration, supply chain/clinician collaboration, value analysis teams and group purchasing. We found that centralization of procurement was prevalent in public hospitals in both countries, with more regional centralization in Victoria, Australia due to its size. Also, Private hospital systems are encouraged to take advantage of the centralized procurement policy of the government in both the countries. While standardization was achieved in both countries by better integrating procurement and information technology functions, collaboration between clinicians led to more standardization.
      PubDate: 2017-02-08
      DOI: 10.1057/s41306-016-0018-z
       
  • Non-parametric frontier estimation of health care efficiency among US
           states, 2002–2008
    • Authors: Richard S. Gearhart
      Abstract: This paper examines cross-state health care efficiency rankings using modern non-parametric estimators. Cross-state efficiency rankings are robust to minor modifications in the input–output combinations used for estimation. This paper finds that there is no clear relationship between health care efficiency rankings and per capita health care expenditures in that state in the models used for this paper, even though this is a key variable that policymakers target. It also finds that Massachusetts, in one dataset, has shown significant productivity improvement from 2005 to 2008, the time period during which its health care reform was launched. In a second dataset, from 2002 to 2007, productivity regressed in Massachusetts. This may hint that efficiency gains from structural health care reform can outweigh population behavioral inefficiencies from using the ER as a source of primary care with insurance coverage expansion. I also find that states that chose to expand Medicaid were less efficient, on average, than states that did not choose to expand Medicaid. Simple variable comparisons suggest that this is an artifact of the data and political decision making, rather than people migrating for Medicaid or productive inefficiency.
      PubDate: 2017-01-25
      DOI: 10.1057/s41306-016-0015-2
       
  • Catheter-associated urinary tract infections: challenges and opportunities
           for the application of systems engineering
    • Authors: Eduardo Pérez; Berkcan Uyan; David P. Dzubay; Susan H. Fenton
      Abstract: In the United States about 100,000 people die annually from healthcare-associated infections (HAIs). Catheter-associated urinary tract infections (CAUTI) are the second most common type of HAI in the US, accounting for about 15% of HAIs. CAUTIs pose a significant treat to patients, which consequences could be as minor as an extra day in the hospital or as serious as death. Although studies show that implementing best practices and educating healthcare workers can help prevent HAIs, CAUTI prevention continues to pose a challenge to healthcare quality. Therefore, decreasing CAUTI rates has been targeted as one of the focus areas for several healthcare national initiatives. This survey paper considers research published from 2004 to 2015 on risk factors associated with CAUTIs and current preventive interventions. The goal of the survey is to provide a comprehensive taxonomy that aggregates and compare studies on CAUTIs and to identify future research opportunities for the development of system interventions that can be used to manage CAUTIs.
      PubDate: 2017-01-17
      DOI: 10.1057/s41306-016-0017-0
       
  • Rapid diagnoses at the breast center of Jeroen Bosch Hospital: a case
           study invoking queueing theory and discrete event simulation
    • Authors: Maartje van de Vrugt; Richard J. Boucherie; Tineke J. Smilde; Mathijn de Jong; Maud Bessems
      Abstract: When suspected tissue is discovered in a patient’s breast, swiftly available diagnostic test results are essential for medical and psychological reasons. The breast center of the Jeroen Bosch Hospital aims to comply with new Dutch standards to provide 90% of the patients an appointment within three working days, and to communicate the test results to 90% of the patients within a week. This case study reports on interventions based on a discrete time queueing model and discrete event simulation. The implemented interventions concern a new patient appointment schedule and an additional multi-disciplinary meeting, which significantly improve in both the appointment and diagnostics delay. Additionally, we propose a promising new patient schedule to further reduce patient waiting times and staff overtime and provide guidelines for how to achieve implementation of Operations Research methods in practice.
      PubDate: 2016-12-12
      DOI: 10.1057/s41306-016-0013-4
       
  • An experimental comparison of mobile texting programs to help young adults
           quit smoking
    • Authors: Linda Brafford Squiers; Erik Augustson; Derick Brown; Bridget Kelly; Brian Southwell; Jill Dever; Suzanne Dolina; Janice Tzeng; Sarah Parvanta; Sidney Holt; Amy Sanders; Brittany Zulkiewicz; Yvonne Hunt
      Abstract: Text messaging interventions may offer promise for health systems, but we need more evidence. We investigated efficacy of three text messaging programs in helping smokers quit. Arm 1 had cessation assessment and quit date reminder messages. Arm 2 had Arm 1 messages plus quit date preparation messages. Arm 3 had Arm 1 and Arm 2 messages plus 6 weeks of post-quit date messaging. Smokers aged 18–29 interested in quitting were randomly assigned to a study arm. We surveyed participants at baseline, and at 3, 8, 20, and 32 weeks (n = 4,027). At 8 weeks, scores on psychological measures were higher in Arm 3 than in Arm 2 or Arm 1. Seven-day smoking abstinence was higher in Arms 3 and 2 than in Arm 1 after controlling for background and psychological measures. Arm 3 affected quitting the most, suggesting motivational text messages before, on, and after an individual’s quit date may increase quitting.
      PubDate: 2016-10-21
      DOI: 10.1057/s41306-016-0014-3
       
  • Comparing comparables: an approach to accurate cross-country comparisons
           of health systems for effective healthcare planning and policy guidance
    • Abstract: With rising healthcare costs, using health personnel and resources efficiently and effectively is critical. International cross-country and simple worker-to-population ratio comparisons are frequently used for improving the efficiency of health systems, planning of health human resources and guiding policy changes. These comparisons are made between countries typically of the same continental region. However, if used imprudently, inconsistencies arising from frail comparisons of health systems may outweigh the positive benefits brought by new policy insights. In this work, we propose a different approach to international health system comparisons. We present a methodology to group similar countries in terms of mortality, morbidity, utilisation levels, and human and physical resources, which are all factors that influence health gains. Instead of constructing an absolute rank or comparing against the average, the method finds countries that share similar ground, upon which more reliable comparisons can then be conducted, including performance analysis. We apply this methodology using data from the World Health Organization’s Health for All database, and we present some interesting empirical relationships between indicators that may provide new insights into how such information can be used to promote better healthcare planning and policy guidance.
      PubDate: 2016-10-01
      DOI: 10.1057/hs.2015.21
       
  • Sensitivity to model structure: a comparison of compartmental models in
           epidemiology
    • Abstract: Compartmental models have provided a framework for understanding disease transmission dynamics for over 100 years. The predictions from these models are often policy relevant and need to be robust to model assumptions, parameter values and model structure. A selection of compartmental models with the same parameter values but different model structures (ranging from simple structures to complex ones) were compared in the absence and presence of several policy interventions to assess sensitivity to model structure. Models were fitted to data to assess if this might reduce this sensitivity. The compartmental models produced wide-ranging estimates of outcome measures but when fitted to data, the estimates obtained were robust to model structure. This finding suggests that there may be an argument for selecting simple models over complex ones, but the complexity of the model should be determined by the purpose of the model and the use to which it will be put.
      PubDate: 2016-10-01
      DOI: 10.1057/hs.2015.2
       
  • Needs forecast and fund allocation of medical specialty positions in
           Emilia-Romagna (Italy) by system dynamics and integer programming
    • Abstract: Each year Emilia-Romagna health managers have to negotiate the number of medical specialization grants to be financed by the National government and define the number of additional grants to be funded by the regional budget. The final goal of this study is to provide a Decision Support System for grant allocation to medical specializations within Emilia-Romagna over a 20-year planning horizon. We have developed a System Dynamics (SD) model that represents regional medical specialist human resources and forecasts population needs over the planning horizon. The SD model provides a requirement indicator for each medical specialization. On the basis of these indicators, an Integer Programming model computes optimal assignments of medical specialization grants. We then define three demand scenarios and show how regional and national funded grants can be managed in order to reduce future gaps by comparing our results with current policies.
      PubDate: 2016-10-01
      DOI: 10.1057/hs.2015.11
       
  • ESI XXXI: OR applied to health in a modern world
    • Authors: Roberto Aringhieri; Vincent Knight; Honora Smith
      PubDate: 2016-09-21
      DOI: 10.1057/s41306-016-0012-5
       
  • Lessons from mixing OR methods in practice: using DES and SD to explore a
           radiotherapy treatment planning process
    • Authors: Jennifer Sian Morgan; Val Belton; Susan Howick
      Abstract: Mixing Operational Research (OR) methods is becoming more commonplace. Discrete-Event Simulation (DES) and System Dynamics (SD) are popular modelling methods previously applied to a range of situations for various purposes, which are starting to be mixed in healthcare. However, the practicalities of mixing DES and SD in practice remain unclear. Radiotherapy treatment is a complex multi-stage process where technology and best practice continue to evolve. This paper describes a project undertaken to explore the treatment planning process using mixed OR methods. It presents insights obtained through mixing OR methods within a real-world project. The model development process, the role of each modelling method and the benefits of undertaking a mixed OR methods project design are described. Lessons for mixing DES and SD, and more generally mixing OR methods, are discussed.
      PubDate: 2016-06-17
      DOI: 10.1057/hs.2016.4
       
 
 
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