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A scoping literature review of collaboration between primary care and public health.

https://arctichealth.org/en/permalink/ahliterature126812
Source
Prim Health Care Res Dev. 2012 Oct;13(4):327-46
Publication Type
Article
Date
Oct-2012
Author
Ruth Martin-Misener
Ruta Valaitis
Sabrina T Wong
Marjorie Macdonald
Donna Meagher-Stewart
Janusz Kaczorowski
Linda O-Mara
Rachel Savage
Patricia Austin
Author Affiliation
School of Nursing, Dalhousie University, 5869 University Ave., Halifax, Nova Scotia, Canada. ruth.martin-misener@dal.ca
Source
Prim Health Care Res Dev. 2012 Oct;13(4):327-46
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Canada
Communication
Cooperative Behavior
Decision Making
Health Care Reform - methods - organization & administration
Humans
Primary Health Care - economics - organization & administration
Public Health - economics - methods
Abstract
The purpose of this scoping literature review was to determine what is known about: 1) structures and processes required to build successful collaborations between primary care (PC) and public health (PH); 2) outcomes of such collaborations; and 3) markers of their success.
Collaboration between PC and PH is believed to enable more effective individual and population services than what might be achieved by either alone.
The study followed established methods for a scoping literature review and was guided by a framework that identifies systemic, organizational and interactional determinants for collaboration. The review was restricted to articles published between 1988 and 2008. Published quantitative and qualitative primary studies, evaluation research, systematic and other types of reviews, as well as descriptive accounts without an explicit research design, were included if they addressed either the structures or processes to build collaboration or the outcomes or markers of such collaboration, and were published in English.
The combined search strategy yielded 6125 articles of which 114 were included. Systemic-level factors influencing collaboration included: government involvement, policy and fit with local needs; funding and resource factors, power and control issues; and education and training. Lack of a common agenda; knowledge and resource limitations; leadership, management and accountability issues; geographic proximity of partners; and shared protocols, tools and information sharing were influential at the organizational level. Interpersonal factors included having a shared purpose; philosophy and beliefs; clear roles and positive relationships; and effective communication and decision-making strategies. Reported benefits of collaboration included: improved chronic disease management; communicable disease control; and maternal child health. More research is needed to explore the conditions and contexts in which collaboration between PC and PH makes most sense and potential gains outweigh the associated risks and costs.
PubMed ID
22353204 View in PubMed
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The 2015 National Cancer Program in Sweden: Introducing standardized care pathways in a decentralized system.

https://arctichealth.org/en/permalink/ahliterature284148
Source
Health Policy. 2016 Dec;120(12):1378-1382
Publication Type
Article
Date
Dec-2016
Author
Jens Wilkens
Hans Thulesius
Ingrid Schmidt
Christina Carlsson
Source
Health Policy. 2016 Dec;120(12):1378-1382
Date
Dec-2016
Language
English
Publication Type
Article
Keywords
Antineoplastic Protocols - standards
Continuity of Patient Care
Health Care Reform - methods
Health Policy
Humans
National Health Programs
Patient satisfaction
Politics
Sweden
Waiting Lists
Abstract
Starting in 2015, the Swedish government has initiated a national reform to standardize cancer patient pathways and thereby eventually speed up treatment of cancer. Cancer care in Sweden is characterized by high survival rates and a generally high quality albeit long waiting times. The objective with the new national program to standardize cancer care pathways is to reduce these waiting times, increase patient satisfaction with cancer care and reduce regional inequalities. A new time-point for measuring the start of a care process is introduced called well-founded suspicion, which is individually designed for each cancer diagnosis. While medical guidelines are well established earlier, the standardisation is achieved by defining time boundaries for each step in the process. The cancer reform program is a collaborative effort initiated and incentivized by the central government while multi-professional groups develop the time-bound standardized care pathways, which the regional authorities are responsible for implementing. The broad stakeholder engagement and time-bound guidelines are interesting approaches to study for other countries that need to streamline care processes.
PubMed ID
27823827 View in PubMed
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Market-orienting reforms in rural health care in Sweden: how can equity in access be preserved?

https://arctichealth.org/en/permalink/ahliterature296545
Source
Int J Equity Health. 2018 08 17; 17(1):123
Publication Type
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't
Date
08-17-2018
Author
Linn Kullberg
Paula Blomqvist
Ulrika Winblad
Author Affiliation
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. Linn.Kullberg@pubcare.uu.se.
Source
Int J Equity Health. 2018 08 17; 17(1):123
Date
08-17-2018
Language
English
Publication Type
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Evaluation Studies as Topic
Health Care Reform - methods
Health Care Sector - standards
Health Equity - standards
Health Policy
Humans
Rural Health
Rural Health Services - standards
Sweden
Abstract
Health care provision in rural and urban areas faces different challenges. In Sweden, health care provision has been predominantly public and equitable access to care has been pursued mainly through public planning and coordination. This is to ensure that health needs are met in the same manner in all parts of the country, including rural or less affluent areas. However, a marketization of the health care system has taken place during recent decades and the publicly planned system has been partially replaced by a new market logic, where private providers guided by financial concerns can decide independently where to establish their practices. In this paper, we explore the effects of marketization policies on rural health care provision by asking how policy makers in rural counties have managed to combine two seemingly contradictory health policy goals: to create conditions for market competition among health care providers and to ensure equal access to health care for all patients, including those living in rural and remote areas.
A qualitative case study within three counties in the northern part of Sweden, characterized by vast rural areas, was carried out. Legal documents, the "accreditation documents" regulating the health care quasi-markets in the three counties were analyzed. In addition, interviews with policy makers in the three county councils, representing the political majority, the opposition, and the political administration were conducted in April and May 2013.
The findings demonstrate the difficulties involved in introducing market dynamics in health care provision in rural areas, as these reforms not only undermined existing resource allocation systems based on health needs but also undercut attempts by local policy makers to arrange for care provision in remote locations through planning and coordination.
Provision of health care in rural areas is not well suited for market reforms introducing competition, as this may undermine the goal of equity in access to health care, even in a publicly financed health care system.
PubMed ID
30119665 View in PubMed
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Centralising acute stroke care and moving care to the community in a Danish health region: Challenges in implementing a stroke care reform.

https://arctichealth.org/en/permalink/ahliterature278187
Source
Health Policy. 2015 Aug;119(8):1005-10
Publication Type
Article
Date
Aug-2015
Author
Karla Douw
Camilla Palmhøj Nielsen
Camilla Riis Pedersen
Source
Health Policy. 2015 Aug;119(8):1005-10
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Centralized Hospital Services - methods - organization & administration
Community Health Services - organization & administration
Denmark
Health Care Reform - methods - organization & administration
Humans
Program Development
Stroke - therapy
Stroke Rehabilitation - methods
Abstract
In May 2012, one of Denmark's five health care regions mandated a reform of stroke care. The purpose of the reform was to save costs, while at the same time improving quality of care. It included (1) centralisation of acute stroke treatment at specialised hospitals, (2) a reduced length of hospital stay, and (3) a shift from inpatient rehabilitation programmes to community-based rehabilitation programmes. Patients would benefit from a more integrated care pathway between hospital and municipality, being supported by early discharge teams at hospitals. A formal policy tool, consisting of a health care agreement between the region and municipalities, was used to implement the changes. The implementation was carried out in a top-down manner by a committee, in which the hospital sector--organised by regions--was better represented than the primary care sector-organised by municipalities. The idea of centralisation of acute care was supported by all stakeholders, but municipalities opposed the hospital-based early discharge teams as they perceived this to be interfering with their core tasks. Municipalities would have liked more influence on the design of the reform. Preliminary data suggest good quality of acute care. Cost savings have been achieved in the region by means of closure of beds and a reduction of hospital length of stay. The realisation of the objective of achieving integrated rehabilitation care between hospitals and municipalities has been less successful. It is likely that greater involvement of municipalities in the design phase and better representation of health care professionals in all phases would have led to more successful implementation of the reform.
PubMed ID
26094752 View in PubMed
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The Krever Commission--10 years later.

https://arctichealth.org/en/permalink/ahliterature160253
Source
CMAJ. 2007 Nov 20;177(11):1387-9
Publication Type
Article
Date
Nov-20-2007
Author
Kumanan Wilson
Author Affiliation
Department of Medicine, University of Toronto, Toronto, Ont. kumanan.wilson@uhn.on.ca
Source
CMAJ. 2007 Nov 20;177(11):1387-9
Date
Nov-20-2007
Language
English
Publication Type
Article
Keywords
Blood Banks - organization & administration
Blood Transfusion
Canada
Communicable Diseases - transmission
Health Care Reform - methods
History, 20th Century
History, 21st Century
Humans
Public Health - trends
Safety Management - methods
Notes
Cites: Lancet. 2004 Feb 7;363(9407):417-2114962520
Cites: CMAJ. 2001 Jul 10;165(1):59-6511468958
Cites: Transfusion. 2002 May;42(5):549-5512084162
Cites: Vox Sang. 2002 Aug;83(2):146-5512201844
Cites: CMAJ. 2003 Apr 29;168(9):1149-5012719320
Cites: N Engl J Med. 2003 Sep 25;349(13):1236-4514500806
Cites: CMAJ. 2007 Jul 31;177(3):24217664439
Cites: Br J Haematol. 2006 Jan;132(1):13-2416371015
Cites: Transfus Med Rev. 2006 Apr;20(2):97-10916565024
Cites: Vox Sang. 2006 Oct;91(3):221-3016958834
Cites: Soc Sci Med. 2007 Jan;64(1):174-8517014945
Cites: MMWR Morb Mortal Wkly Rep. 2007 Feb 23;56(7):141-317318113
Comment In: CMAJ. 2008 Mar 11;178(6):730-118332390
PubMed ID
18025432 View in PubMed
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Health care reform planners and wicked problems: Is the wickedness of the problems taken seriously or is it even noticed at all?

https://arctichealth.org/en/permalink/ahliterature147694
Source
J Health Organ Manag. 2009;23(5):477-93
Publication Type
Article
Date
2009
Author
Harri Raisio
Author Affiliation
University of Vaasa, Vaasa, Finland. harri.raisio@uwasa.fl
Source
J Health Organ Manag. 2009;23(5):477-93
Date
2009
Language
English
Publication Type
Article
Keywords
Cognition
Decision Making, Organizational
Finland
Health Care Reform - methods - organization & administration
Health Priorities
Health promotion
Humans
Interviews as Topic
National Health Programs
Organizational Case Studies
Organizational Innovation
Problem Solving
Abstract
The purpose of this paper is to examine the planning of the National Health reform especially the "guarantee for care" reform within it--from the perspective of the concept of wicked problems. This concept asserts that it is of the utmost importance to see the true level of complexity of the problems in order to survive them. The paper tries to the answer the question of how the planners of the health care reforms see the problems they are trying to solve.
This is an interview study. A total of 12 people who participated in the planning of the examined reforms at some level were interviewed. The interview method was a semi-structured thematic interview. The research analysis is theory-originated content analysis.
The hypothesis is that the planners of the examined reforms do not focus enough on the complexity of the problems they tried to solve. The research, however, shows that the wickedness of the problems was often noticed. Unfortunately it was not taken as seriously as it should have been. In other words, the planners mostly saw that the problems were very complex, but even then the solutions were only like solutions for tame problems or messes.
The paradigm shift from Newtonian science--which sees the world as a deterministic system--to a more complexity-endorsing view is on its way. The world is a dynamic and open system, which cannot be controlled. The paper makes its own contribution, from the perspective of health care problems and reforms, to advance this paradigm shift.
PubMed ID
19862877 View in PubMed
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Using Federal Funds To Buy Obamacare For Native Americans.

https://arctichealth.org/en/permalink/ahliterature297939
Source
Health Aff (Millwood). 2018 01; 37(1):8-12
Publication Type
Journal Article
Date
01-2018
Author
Jessica Bylander
Author Affiliation
Jessica Bylander ( jbylander@projecthope.org ) is a senior editor at Health Affairs, in Bethesda, Maryland. She is reporting this series during a yearlong Reporting Fellowship on Health Care Performance sponsored by the Association of Health Care Journalists and supported by the Commonwealth Fund.
Source
Health Aff (Millwood). 2018 01; 37(1):8-12
Date
01-2018
Language
English
Publication Type
Journal Article
Keywords
Alaska
Alaska Natives
Health Care Reform - methods
Health Services Accessibility
Humans
Indians, North American
Insurance, Health - economics
Patient Protection and Affordable Care Act - economics
United States
United States Indian Health Service - economics
Abstract
In Alaska and other states, tribes are experimenting with programs that provide private health insurance to members for free.
PubMed ID
29309225 View in PubMed
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15 records – page 1 of 2.