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Purchasing in health care financing refers to the transfer of pooled funds to health care providers for the provision of health care services. There is limited empirical work on purchasing arrangements and what is required for strategic purchasing in low- and middle-income countries. We conducted this study to critically assess the purchasing arrangements of the county departments of health (CDOH) who are the largest purchasers of health care in Kenya.
The Affordable Care Act (ACA) aims to expand health insurance coverage and minimize financial barriers to receiving health care services for individuals. However, little is known about how the ACA has impacted individuals with mental health conditions. This study finds that the implementation of the ACA is associated with an increase in rate of health insurance coverage among nonelderly adults with serious psychological distress (SPD) and a reduction in delaying and forgoing necessary care. The ACA also red...
Formal home care services (those typically delivered by health care providers or volunteer organizations) are different from informal home care services (given by family, friends or neighbours), and thus represent a partial picture of all home care provided. Home care has been associated with decreased mortality, improved quality of life, and reduced hospitalizations and health care costs.
The Department of Veterans Affairs (VA) is amending its medical regulations by standardizing the delivery of care by VA health care providers through telehealth. This rule ensures that VA health care providers can offer the same level of care to all beneficiaries, irrespective of the State or location in a State of the VA health care provider or the beneficiary. This final rule achieves important Federal interests by increasing the availability of mental health, specialty, and general clinical care for all ...
The economics of health and the economics of health care are not the same, and in fact can be competitors for resources in some cases. Using a traditional supply/demand framework can clarify the forces at work in person-centric health economics. Use of cost-effectiveness analysis, employing a broader systems perspective that incorporates sectors other than health care, and nudging individuals to better health habits are three strategies that can help to drive a shift from health care to health.
Health financing and delivery reforms designed to achieve universal health coverage (UHC) need to be informed by an understanding of factors that both promote access to health care and undermine it. This study examines the level of health care utilisation in Timor-Leste and the factors that drive it.
Although the USA spends more on health care than any other comparable nation, Americans are less healthy than citizens of high-income countries that spend far less. Over the past 12 years, the number of physicians per capita in the USA has been a concerning problem that may contribute to the disparity between health care costs and health status. Some have argued that remediating the shortage of primary care physicians will improve patient health. Others assert that the relationship between health care costs...
A health system's commitment to delivering culturally competent care is essential in creating a culture of respect for patients, clinicians, and administrative staff. As the diversity of the health care workforce grows, gaining an understanding of the perspectives among different health care personnel and the value that they place on organizational cultural competence is a first step in developing more effective team environments.
The rising burden of inflammatory bowel disease (IBD) has the potential to have a negative impact on the quality of care delivered to patients with IBD. Quality of care has been described by the World Health Organization as "the extent to which health care services provided to individuals and patient populations improve desired health outcomes." Variation in care has been identified as a key barrier to achieving quality of care in IBD. Assessment of quality of care attempts to minimize variation in care. Qu...
Montefiore Health System’s collaborative care model integrates medical care with treatment for behavioral health issues that can be handled in a primary care setting. · Patients who are identified with behavioral issues are assigned a care manager at the Montefiore Care Management Organization, who coordinates with the primary care physician and behavioral health team to develop a plan of care. · The care manager provides telephonic case management follow-up with patients after their primary care visits...
Prioritisation of end-of-life care by policymakers has been the subject of extensive rhetoric, but little scrutiny. In England, responsibility for improving health and care lies with 152 regional Health and Wellbeing Boards.
The Veterans Choice Program (VCP) was launched in 2014 to address the growing concerns about the timeliness and quality of Veterans Health Administration (VHA) care. Given that many sex-specific health services, such as mammography and maternity care, are not routinely provided in all VHA facilities, women Veterans may disproportionately rely on VCP care. Understanding the provision and coordination of VCP care is crucial in order to ensure that care is not fragmented across the 2 health care systems.
In recent decades, Brazil has witnessed a proposal to create an extensive basic health care network as the main portal of entry to a universal public health system. Based on the recognition of consistent strides in that direction, the article addresses four issues on some important challenges for the consolidation of the basic health care proposal: (1) the use of the term "basic health care" as opposed to the usual, hegemonic concept of "primary health care"; (2) the disconnect or mismatch between the polic...
The quality of asthma primary care may vary between countries, health care practices, and health care professionals (HCPs). Identifying and explaining such differences is critical for health services improvement.
Health care organizations are embracing integrated primary care (IPC), in which mental health and behavioral health are addressed as part of routine care within primary care settings. Behavioral medicine concerns, which include health behavior change and coping with medical conditions, are common in primary care populations. Although there are evidence-based behavioral interventions that target a variety of behavioral medicine concerns, integrated behavioral health providers need interventions that are suff...
Advance care planning (ACP) provides clarity on goals and preferences for future health-care decisions, the timeliness of which is critical for persons with dementia.
Given the startling statistic that the rate of women dying of pregnancy-and childbirth-related complications in the United States is increasing, it seems logical that the U.S. health system would focus on improving outcomes in this area of care. But not all health plans address this disparity in health care delivery.
The support of families in the care of children with medical complexity (CMC) requires the integration of health care provider (HCP) medical knowledge and family experience. Care plans largely represent HCP information and care maps demonstrate the family experience. Understanding the intersection between a care plan and care map is critical, as it may provide solutions to the widely recognized tension between HCP-directed care and patient- and family-centered care (PFCC).
Care coordination among health care providers is essential for high-quality care and it is strongly associated with overall ratings of doctors. Care coordination may be especially important for sicker and chronically ill patients because of the multiple providers involved in their care. This study examines whether the association of care coordination with global ratings of one's personal doctor varies by number of chronic conditions and self-rated health.
Group antenatal care is an innovative model of health care in which all components of antenatal care-clinical, educational, and supportive-happen in a group context with health care professionals as facilitators. CenteringPregnancy is the most studied model of group antenatal care, now widely implemented in the United States. This model has been shown to be effective in improving health and behavioral outcomes in the United States, but there is less known about the experience adapting group antenatal care i...
Increasing numbers of children are receiving care for behavioral health conditions in emergency departments (EDs). However, studies of mental health-related care coordination between EDs and primary and/or specialty care settings are limited. Such coordination is important because ED care alone may be insufficient for patients' behavioral health needs.
Homelessness is a well-known social determinant of health, but health status also correlates with housing instability, a broader term that encompasses everything from trouble paying rent to living in overcrowded conditions and to moving frequently. UnitedHealthcare Community Plan-Arizona gives beneficiaries shelter with the hope that health care spending on them will go down.
This review provides an evidence-based approach to improve health, reduce excessive medical costs, and optimize productivity for health care employees and their families. What opportunities and challenges are unique or specific to health care organizations particularly as aligned with value and competitive advantage in achieving the Quadruple Aim?
Improvement in population health has become a key goal of health systems and payers in the United States. Because 80% of health outcomes are driven by social determinants of health beyond medical care and health care access, such improvements require attention to factors outside of the conventional areas of expertise for clinicians. Yet primary care physicians often graduate from training programs with few skills in population and community health.
Although Canada operates a universal health care insurance system, equitable access to required health care services when needed still poses a challenge for some. The aim of this study was to examine the relationship between patient attachment to a family physician and self-perceived unmet health care needs (UHN) in Canada, after adjusting for predisposing, enabling, and need factors of the behavioral model of health services use.