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Person-centred integrated care and end of life
Published in Shibley Rahman, Living with frailty, 2018
In developed countries, health systems are pressured to reconsider the restructuring of services provided to new clusters of patients with complex needs, as growth in clinical specialisation – due to the rapid expansion of medical knowledge and technologies – tends to fragment patient care. Integrated care initiatives endeavour to align healthcare provision with evolving patient needs (Calciolari and Ilinca, 2016). Modern healthcare systems have largely been designed around single-organ disease-based services, with increasing specialism notable within hospital care. Historically, this has also been reflected in primary care, because general practitioner incentivisation schemes, such as the UK Quality and Outcomes Framework, are constructed using disease-based targets, and clinical guidelines are usually designed around single long-term conditions (Turner et al., 2014).
The Aims of Operative Surgery
Published in Hutan Ashrafian, Surgical Philosophy, 2015
13. Which of the two hospitals (or healthcare institutions) offer the most rigorous patient safety and ethics?Which of the two surgeons has the most ability?With whom lie the advantages derived from Science, Anatomy and Research, and which healthcare institute offers the best operating environment and staff, who offers the best value and quality of care with the most safety?On which side is adherence to national/international guidelines most rigorously enforced?Which healthcare institute offers the strongest professional staff, surgeons and researchers?On which side are the surgeons and surgical trainees more highly trained?In which healthcare institution is there the greater constancy in reward, incentivisation and support (or training) for failing staff?
Descriptive Epidemiology of Diabetes
Published in Medha N. Munshi, Lewis A. Lipsitz, Geriatric Diabetes, 2007
Much of the health-care bill for diabetes patients is paid for by the taxpayers through Medicare and Medicaid. This financial imperative, as well as the public health goal to decrease morbidity and mortality due to chronic diseases and the significant evidence base for diabetes management interventions, has led to interest in the use of health policy to improve diabetes care. Policy interventions, through legislation and regulation at the state and federal level and through larger insurers, are being directed toward health-care insurers such as Managed Care Organizations (MCOs), group practices, individual physicians, and even patients. Some incentivization schemes involve indirect financial incentives to improve diabetes care. For example, MCOs can be ranked according to the scores of their beneficiary population on clinical quality performance indicators for diabetes. A large employer might encourage employees to choose MCOs with good scores during insurance enrollment by using advertising or favorable pricing. Large group practices can similarly report performance on diabetes clinical quality performance indicators to insurance companies or employer groups in hopes of favorable contracts or advertising. Individual physician profiling for performance on diabetes quality indicators can be used for educational purposes, maintenance of certification, or quality assurance.
Controlling reproduction: women, society, and state power
Published in Sexual and Reproductive Health Matters, 2023
State motivation for imposition of reproductive policies can be linked to population sizes that are considered either too big or too small. Bearing in mind that 59% of the world’s territories now have a total fertility rate (TFR) of 2.1 or less, useful summaries of the situation in several countries include those whose governments are reacting to such below-replacement level fertility. There are interesting discussions of family policies in these countries, some of which are now in the ultra-low fertility rate bracket (TFR less than 1.3). Incentivisation is covered briefly in relation to India (but omitted from the index) but I felt there could have been more analysis here.6 A key point the authors make is that states not only shape the sizes of populations but their composition too. The eugenic origins of laws and policies are well covered. Oppressed people who get targeted include those living in poverty, Indigenous Peoples and people of colour. Minorities are treated differently too, including on the basis of religion and migrant status. For example, foreign workers are deported from Singapore if they have a child.
Determining global citizenship capabilities for speech-language pathologists and other health professionals: a study protocol
Published in Speech, Language and Hearing, 2021
CaraJane Millar, Lindsay B. Carey, Anne E. Hill, Tracy Fortune, Bernice A. Mathisen
There are a number of biases that may arise in this study including selection bias and withdrawal bias which could distort the findings toward consensus or dissent. In order to avoid selection bias, appropriate exclusion and inclusion criteria have been put in place, including referrals from different tertiary institutions and the use of various overseas study programmes. Withdrawal bias may occur in this study, given that there are multiple points of participant contact, thus increasing the possibility of attrition (i.e. surveys, focus groups). Incentivisation aims to mitigate attrition; a strategy will include sharing the research findings with participating universities and respondents, especially as it is likely that they will show interest in the findings given their involvement in mobility programmes and the paucity of resources available.
Use of the Behaviour Change Wheel to design an intervention to improve the implementation of family-centred care in adult audiology services
Published in International Journal of Audiology, 2021
Katie Ekberg, Barbra Timmer, Simone Schuetz, Louise Hickson
To address gaps in psychological capability, the intervention functions of education and training met all of the APEASE criteria and were supported by management. In order to target reflective motivation (believing that family member attendance and involvement is important), education was identified as the most appropriate intervention function. Training was chosen as the best intervention function to address gaps in automatic motivation (emotional discomfort) and social opportunity (a supportive organisational culture of FCC that provides consistent training). Environmental restructuring was chosen to address aspects of physical opportunity which included a lack of FCC materials and the physical set-up of the appointment rooms. Lastly, incentivisation was chosen to address reflective motivation because there was already a staff reward program in place at the organisation and management supported staff receiving reward points for their participation in the intervention. The remaining intervention functions of persuasion, coercion, and restriction were determined to not be acceptable in the given context, and modelling and enablement were seen as impractical as organisational involvement at an interstate/international level would have been required. In summary, the following four intervention functions were chosen for each of the target behaviours: education, training, environmental restructuring, and incentivisation.