BMC Health Services Research via MedWorm.com MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'BMC Health Services Research' source. Wed, 08 Feb 2012 18:50:18 +0100 Screening mammography beliefs and recommendations: a web-based survey of primary care physicians http://www.medworm.com/index.php?rid=5668384&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F32 This study explored primary care physicians' (PCPs) perceptions of the influence of clinical practice guidelines for SM; the recommendations for SM in response to the hypothetical case scenarios; and the factors associated with perceived SM effectiveness and recommendations in the US from June to December 2009 before recently revised United States Preventive Services Task Force (USPSTF) guidelines. Methods: A nationally representative sample of 11,922 PCPs was surveyed using a web-based questionnaire. The response rate was 5.7% (684); (41%) 271 family physicians (FP), (36%) 232 general internal medicine physicians (IM), (23%) 150 obstetrician-gynaecologists (OBG), and (0.2%) 31 others. Cross-sectional analysis examined PCPs perceived effectiveness of SM, and recommendation for SM in respon... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5668384 Mon, 06 Feb 2012 05:00:00 +0100 5668384 An assessment of the accuracy and availability of data in electronic patient tracking systems for patients receiving HIV treatment in central Mozambique http://www.medworm.com/index.php?rid=5649634&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F30 Conclusions: Electronic patient tracking systems have been deployed to respond to the growing monitoring, evaluation and reporting requirements. In our cross-sectional study of clinics in Manica and Sofala provinces of Mozambique, we found high levels of completeness and reliability for key variables indicating that these electronic databases provided adequate data not only for monitoring and evaluation but also for research. Routine evaluations of the completeness and reliability of these databases need to occur to ensure high quality data are being used for reporting and research. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5649634 Thu, 02 Feb 2012 05:00:00 +0100 5649634 Service quality of private hospitals: The Iranian patients' perspective http://www.medworm.com/index.php?rid=5649633&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F31 Conclusion: The results showed that SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5649633 Thu, 02 Feb 2012 05:00:00 +0100 5649633 The Association between Socioeconomic Status and Traditional Chinese Medicine Use among Children in Taiwan http://www.medworm.com/index.php?rid=5649637&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F27 Conclusions: Children and adolescents with high SES were more likely to use TCM and especially girls aged 10-18 years. Our findings point to the high use of complementary and alternative medicine among children and adolescents. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5649637 Wed, 01 Feb 2012 05:00:00 +0100 5649637 How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's Hospital, Stockholm, Sweden http://www.medworm.com/index.php?rid=5649636&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F28 Conclusions: Drawing on Spear and Bowen's theoretical propositions, this study explains how a package of lean-like changes translated into better care process management. It adds new knowledge regarding how lean principles can be beneficially applied in healthcare and identifies changes to professional roles as a potential challenge when introducing lean thinking there. This knowledge may enable health care organizations and managers in other settings to configure their own lean program and to better understand the reasons behind lean's success (or failure). (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5649636 Wed, 01 Feb 2012 05:00:00 +0100 5649636 Effectiveness of a multidisciplinary care program on recovery and return to work of patients after gynaecological surgery; design of a randomized controlled trial http://www.medworm.com/index.php?rid=5649635&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F29 DiscussionThe discrepancy between expected physical recovery and actual return to work after gynaecological surgery contributes to the relevance of this study. There is strong evidence that long periods of sick leave can result in work disability, poorer general health and increased risk of mental health problems. We expect that this multidisciplinary care program will improve peri-operative care, contribute to a faster return to work of patients after gynaecological surgery and, as a consequence, will reduce societal costs considerably.Trial registration: Netherlands Trial Register NTR2087 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5649635 Wed, 01 Feb 2012 05:00:00 +0100 5649635 Patients' experiences of quality of long-term care among the elderly: comparing scores over time http://www.medworm.com/index.php?rid=5649638&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F26 Conclusions: Both hypotheses were confirmed: almost all indicator scores improved over time and long-term care organizations for the elderly with substandard performance improved more than those with a performance which was already relatively good. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5649638 Tue, 31 Jan 2012 05:00:00 +0100 5649638 Hardship financing of healthcare among rural poor in Orissa, India http://www.medworm.com/index.php?rid=5639292&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F23 Conclusions: Rural poor households are subjected to considerable and protracted financial hardship due to the indirect and longer-term deleterious effects of how they cope with out-of-pocket healthcare costs. The social network that households can access influences exposure to hardship financing. Our findings point to the need to develop a policy solution that would limit that exposure both in quantum and in time. We therefore conclude that policy interventions aiming to ensure health-related financial protection would have to demonstrate that they have reduced the frequency and the volume of hardship financing. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5639292 Fri, 27 Jan 2012 05:00:00 +0100 5639292 Socio-economic variation in CT scanning in Northern England, 1990-2002. http://www.medworm.com/index.php?rid=5639291&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F24 This study aimed to assess socio-economic variation among young people having CT scans in Northern England between 1990 and 2002 inclusive. Methods: Electronic data were obtained from Radiology Information Systems of all nine National Health Service hospital Trusts in the region. CT scan data, including sex, date of scan, age at scan, number and type of scans were assessed in relation to quintiles of Townsend deprivation scores, obtained from linkage of postcodes with census data, using chi2 tests and Spearman rank correlations. Results: During the study period, 39,676 scans were recorded on 21,089 patients, with 38,007 scans and 19,485 patients (11344 male and 8132 female) linkable to Townsend scores. The overall distributions of both scans and patients by quintile of Townsend deprivation... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5639291 Fri, 27 Jan 2012 05:00:00 +0100 5639291 P.Re.Val.E.: outcome research program for the evaluation of health care quality in Lazio, Italy http://www.medworm.com/index.php?rid=5639290&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F25 Conclusions: P.Re.Val.E. highlighted aspects of patient care that merit further investigation and monitoring to improve healthcare services and equity. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5639290 Fri, 27 Jan 2012 05:00:00 +0100 5639290 Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support (SMARTSteps) in a Medicaid managed care plan: study protocol http://www.medworm.com/index.php?rid=5630244&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F22 DiscussionOutcomes will provide evidence regarding real-world implementation of ATSM within a Medicaid managed care plan serving safety net settings. The evaluation trial will provide insight into translating and scaling up health information technology interventions for linguistically and culturally diverse vulnerable populations with chronic disease.Trial Registration: National Clinical Trials Registry ClinicalTrials.gov NCT00683020 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5630244 Thu, 26 Jan 2012 05:00:00 +0100 5630244 Factors influencing integration of TB services in general hospitals in two regions of China: a qualitative study http://www.medworm.com/index.php?rid=5630245&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F21 Conclusion: The process of integration identifies similarities and differences between sites in more affluent East China and poorer West China. Integration of TB services in the hospitals needs to address the challenges of stakeholder motivations and resource allocation. Effective inter-organizational collaboration could help to improve the efficiency and quality of TB service.Key words: TB control, service delivery, integration, hospitals, China (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5630245 Wed, 25 Jan 2012 05:00:00 +0100 5630245 Use of global coronary heart disease risk assessment in practice: a cross-sectional survey of a sample of U.S. physicians http://www.medworm.com/index.php?rid=5630246&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F20 Conclusions: Reported awareness of tools to calculate global CHD risk appears high, but the majority of physicians in this sample do not use CHD risk assessments in practice. A minority of physicians in this sample use global CHD risk to guide prescription decisions or to motivate patients. Educational interventions and system improvements to improve physicians' effective use of global CHD risk assessment should be developed and tested. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5630246 Tue, 24 Jan 2012 05:00:00 +0100 5630246 Informal payments and intra-household allocation of resources for health care in Albania http://www.medworm.com/index.php?rid=5621060&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F17 Conclusions: The differences between households should be taken into account by public policies which should compensate this by redistribution mechanisms targeting disadvantaged groups. Governments should implement effective measures to deal with informal patient payments. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5621060 Mon, 23 Jan 2012 05:00:00 +0100 5621060 Validation of key behaviourally based mental health diagnoses in administrative data: suicide attempt, alcohol abuse, illicit drug abuse and tobacco use http://www.medworm.com/index.php?rid=5621059&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F18 Conclusions: Administrative data-based diagnoses among VHA records have high specificity, but low sensitivity. The accuracy level varies by different diagnosis and by different patient subgroup. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5621059 Mon, 23 Jan 2012 05:00:00 +0100 5621059 Summarizing activity limitations in children with chronic illnesses living in the community: a measurement study of scales using supplemented interRAI items http://www.medworm.com/index.php?rid=5621058&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F19 Conclusions: Unpaid caregivers, usually parents, can provide assessors lacking either medical or nursing training with reliable and valid information on the activity limitations of children. One can summarize these data in scales that are both internally consistent and valid. Researchers and clinicians can use supplemented interRAI items to provide guidance for professionals and programs serving children, as well as older persons. This research emphasizes the importance of developing medical information systems that allow one to integrate information not only across care settings but also across an individual's life course. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5621058 Mon, 23 Jan 2012 05:00:00 +0100 5621058 Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System http://www.medworm.com/index.php?rid=5610684&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F15 Background: While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. Methods: A cohort of 56,500 patients of 60-years-old and over, hospitalized for hip fracture during the period 2002 to 2005 in all the public hospitals in 8 Spanish regions, were followed up using administrative databases to identify the time to surgical repair... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5610684 Wed, 18 Jan 2012 05:00:00 +0100 5610684 Effect of genetic testing for risk of type 2 diabetes mellitus on health behaviors and outcomes: Study rationale, development, and design http://www.medworm.com/index.php?rid=5610683&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F16 DiscussionThe utility, feasibility, and efficacy of providing patients with genetic risk information for common chronic diseases in primary care remain unknown. The study described here will help to establish whether providing type 2 diabetes genetic risk information in a primary care setting can help improve patients' clinical outcomes, risk perceptions, and/or their engagement in healthy behavior change. In addition, study design features such as the use of existing clinic personnel for risk counseling could inform the future development and implementation of care models for the use of individual genetic risk information in primary care.Trial RegistrationClinicalTrials.gov NCT00849563 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5610683 Wed, 18 Jan 2012 05:00:00 +0100 5610683 Involving patients in HTA activities at local level: A study protocol based on the collaboration between researchers and knowledge users http://www.medworm.com/index.php?rid=5599117&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F14 DiscussionThis project is likely to influence future HTA practices because it directly targets knowledge users' need for strategies that increase patient involvement in HTA. By documenting the processes and outcomes of these involvement strategies, the project will contribute to the knowledge base related to patient involvement in HTA. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5599117 Mon, 16 Jan 2012 05:00:00 +0100 5599117 Ethnic Diversity Outpatient Clinic in Paediatrics http://www.medworm.com/index.php?rid=5583789&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F12 Conclusion: Integration of a MOC in the general POPD is feasible and appreciated by the parents, provides more insight in the problems ethnic minority children and their parents face and shows promising directions for optimizing adherence in these children. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5583789 Wed, 11 Jan 2012 05:00:00 +0100 5583789 Determinants of condom uptake among HIV voluntary counselling and testing clients: experiences from a hospital-based study in south India http://www.medworm.com/index.php?rid=5583788&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F13 Conclusions: Because the components of testing and counselling impact the condom use habits of men and women differently, understanding the dynamics of condom use negotiation between partners is essential to optimizing impact on Indian couples. Clients' predicted condom uptake ranged between 4% and 47% depending on factors like gender, serostatus, and services provided. Personalized risk reduction counselling is associated with increased chance of condom use, with larger gains in HIV negative women and HIV positive men. HIV negative men are least likely to start using condoms and least impacted by additional counselling. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5583788 Wed, 11 Jan 2012 05:00:00 +0100 5583788 Parent-reported health care expenditures associated with autism spectrum disorders in Heilongjiang Province, China http://www.medworm.com/index.php?rid=5583794&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F7 Conclusion: For families with ASD children, the economic burden of health care is substantially higher than the provincial average. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5583794 Tue, 10 Jan 2012 05:00:00 +0100 5583794 Predictors of dropout in the German disease management program for type 2 diabetes http://www.medworm.com/index.php?rid=5583793&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F8 Conclusions: Overall, dropout rates for the German disease management programs for type 2 diabetes were low compared to other studies. Factors assessed at the time of program enrolment were predictive of later dropout and should be further studied to provide information for future program improvements. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5583793 Tue, 10 Jan 2012 05:00:00 +0100 5583793 Treating childhood pneumonia in hard-to-reach areas: A model-based comparison of mobile clinics and community-based care http://www.medworm.com/index.php?rid=5583792&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F9 Conclusions: Current evidence does not support the hypothesis that mobile clinics are more effective than CHWs. A CHW strategy therefore warrants consideration in high-mortality, hard-to-access areas. Uncertainty remains, and parameter values may vary across contexts, but the model allows preliminary findings to be updated as new or context-specific evidence becomes available. Decision analytic modelling can guide needed field-based research efforts in hard-to-access areas and offer evidence-based insights for decision-makers. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5583792 Tue, 10 Jan 2012 05:00:00 +0100 5583792 Does GP training in depression care affect patient outcome? - A systematic review and meta-analysis. http://www.medworm.com/index.php?rid=5583791&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F10 Conclusions: This is the first overview of randomized controlled trials introducing GP training for depression care. Provider training by itself does not seem to improve depression care; however, if combined with additional guidelines implementation, results are promising for new-onset depression patient samples. Additional organizational structure changes in form of collaborative care models are more likely to show effects on depression care. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5583791 Tue, 10 Jan 2012 05:00:00 +0100 5583791 Handover Patterns: An Observational Study of Critical Care Physicians http://www.medworm.com/index.php?rid=5583790&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F11 Conclusions: Clinical handover practice of faculty-level critical care physicians did not conform to any of the three predefined structuring schemes. Further research is needed to examine whether alternative approaches to handover communication can be identified and to identify features of high-quality handover communication. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5583790 Tue, 10 Jan 2012 05:00:00 +0100 5583790 Measuring the value of older people's production: a diary study http://www.medworm.com/index.php?rid=5583797&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F4 Conclusions: An explicit investigation of the content of the entitlement is needed to justify the choice of valuation method for each activity. In a questionnaire addressing older people's production, each question must be adjusted to the type of production. In order to fully understand this production, it is important to consider the degree of free choice to conduct an activity, as well as health-related quality of life. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5583797 Mon, 09 Jan 2012 05:00:00 +0100 5583797 Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study. http://www.medworm.com/index.php?rid=5583796&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F5 Conclusion: The interRAI LTCF appears to be a reliable instrument. It enables the creation of databases that can be used to govern the provision of long-term care across different health systems in Europe, to answer relevant research and policy questions and to compare characteristics of NH residents across countries, languages and cultures. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5583796 Mon, 09 Jan 2012 05:00:00 +0100 5583796 Primary health care staff's perceptions of childhood tuberculosis: a qualitative study from Tanzania http://www.medworm.com/index.php?rid=5583795&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F6 Conclusions: Inadequate awareness of the burden of childhood tuberculosis, limited knowledge of the wide spectrum of clinical presentation and lack of clinical decision support strategies is detrimental to the health staff's central responsibility of suspecting and referring children with tuberculosis especially in the early disease stages. Activities to improve case identification should focus on skills required by primary health care staff to fulfil their responsibility and reflect primary health care level capacities and challenges. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5583795 Mon, 09 Jan 2012 05:00:00 +0100 5583795 The burden of knowing: balancing benefits and barriers in HIV testing decisions. A qualitative study from Zambia http://www.medworm.com/index.php?rid=5561637&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F2 Conclusions: This study draws on social stigma theory to enhance the understanding of the continuity of HIV related stigma in the presence of ART, and argues that the burden of knowing an HIV status and the related reluctance to get HIV tested can be understood both as a form of label-avoidance and as strong expressions of the still powerful embodied memories of suffering and death among non-curable AIDS patients over the last decades. Hope lies in the emerging signs of a reduction in HIV related stigma experienced by those who had been tested for HIV. Further research into innovative HIV testing service designs that do not add to the burden of knowing is needed. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5561637 Thu, 05 Jan 2012 05:00:00 +0100 5561637 Listening to health workers: lessons from Eastern Uganda for strengthening the programme for the prevention of mother-to-child transmission of HIV http://www.medworm.com/index.php?rid=5561636&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F3 Conclusions: The voices of health workers in this study revealed that it is imperative for government, civil society organizations and donors that the PMTCT programme addresses the challenges of shortage of critical PMTCT supplies, continuous health worker training and follow-up and support for mothers as urgent needs to strengthen the PMTCT programme. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5561636 Thu, 05 Jan 2012 05:00:00 +0100 5561636 Outcomes Associated with Matching Patients' Treatment Preferences to Physicians' Recommendations: Study Methodology http://www.medworm.com/index.php?rid=5561638&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F12%2F1 We describe the methodology used in a study aiming to assess treatment outcomes when patients' preferences for treatment are closely matched to recommended treatments.MethodParticipants included patients with moderate or severe psoriasis attending outpatient dermatology clinics at the University Medical Centre Mannheim, University of Heidelberg, Germany. A self-administered online survey used conjoint analysis to measure participants' preferences for psoriasis treatment options at the initial study visit. Physicians' treatment recommendations were abstracted from each participant's medical records. The Preference Matching Index (PMI), a measure of concordance between the participant's preferences for treatment and the physician's recommended treatment, was determined for each participant a... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5561638 Tue, 03 Jan 2012 05:00:00 +0100 5561638 The effectiveness of an intervention in increasing community health clinician provision of preventive care: A study protocol of a non-randomised, multiple-baseline trial. http://www.medworm.com/index.php?rid=5553139&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F354 This study aims to assess the effectiveness of a multi-strategic practice change intervention in increasing clinician's routine provision of preventive care across a network of community health services. Methods: A multiple baseline study will be conducted involving all 56 community health facilities in a single health district in New South Wales, Australia. The facilities will be allocated to one of three administratively-defined groups. A 12 month practice change intervention will be implemented in all facilities in each group to facilitate clinician risk assessment of eligible clients, and clinician provision of brief advice and referral to those identified as being 'at risk'. The intervention will be implemented in a non-random sequence across the three facility groups. Repeated, cross... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5553139 Fri, 30 Dec 2011 05:00:00 +0100 5553139 A survey of engagement and competence levels in interventions and activities in a community mental health workforce in England http://www.medworm.com/index.php?rid=5553141&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F352 Conclusions: There was a reasonable competence level in the community-setting mental health workforce, but competence varied with professional groups and cluster activities. New staff and other non-qualified support professionals need to receive efficient training, and the training content is more important than frequency to increase level of competence. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5553141 Thu, 29 Dec 2011 05:00:00 +0100 5553141 Earlier Surgical Intervention in Congenital Heart Disease results in better outcome and resource utilization. http://www.medworm.com/index.php?rid=5553140&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F353 Conclusion: This study concluded that significant expenditure is incurred by people with CHD; with the implication that resources could be saved by earlier detection and awareness campaigns. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5553140 Thu, 29 Dec 2011 05:00:00 +0100 5553140 Mapping private pharmacies and their characteristics in Ujjain district, Central India http://www.medworm.com/index.php?rid=5553142&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F351 Conclusion: This is the first mapping of pharmacies & their characteristics in India. It provides evidence of the urban dominance and close relationship between healthcare provider location and pharmacy location. The implications of this relationship are discussed. The study reports a lack of qualified staff in the presence of a high proportion of clients attending without a prescription. The study highlights the need for the better implementation of regulation. Besides facilitating regulation & partnerships, the data also provides a sampling frame for future interventional studies on these pharmacies. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5553142 Wed, 28 Dec 2011 05:00:00 +0100 5553142 Counting on commitment; the quality of primary care-led diabetes management in a system with minimal incentives http://www.medworm.com/index.php?rid=5545384&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F348 Background: The aim of the present study was to assess the performance of three primary care-led initiatives providing structured care to patients with Type 2 diabetes in Ireland, a country with minimal incentives to promote the quality of care. Methods: Data, from three primary care initiatives, were available for 3010 adult patients with Type 2 diabetes. Results were benchmarked against the national guidelines for the management of Type 2 diabetes in the community and results from the National Diabetes Audit (NDA) for England (2008/2009) and the Scottish Diabetes Survey (2009). Results: The recording of clinical processes of care was similar to results in the UK however the recording of lifestyle factors was markedly lower. Recording of HbA1c, blood pressure and lipids exceeded 85%. Reco... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5545384 Wed, 28 Dec 2011 05:00:00 +0100 5545384 Lifetime Economic Burden of Prostate Cancer http://www.medworm.com/index.php?rid=5545383&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F349 Conclusions: Prostate cancer places a significant burden on U.S. health-care systems with average life-time PCa-related costs in excess of $30,000. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5545383 Wed, 28 Dec 2011 05:00:00 +0100 5545383 What is the 'problem' that outreach work seeks to address and how might it be tackled? Seeking theory in a primary health prevention programme. http://www.medworm.com/index.php?rid=5545382&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F350 Conclusions: The paper draws conclusions about the role of outreach in contributing to the implementation of inequalities focused primary prevention and identifies further research needed in the theoretical development of both outreach as an approach and candidacy as a conceptual framework. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5545382 Wed, 28 Dec 2011 05:00:00 +0100 5545382 Something is amiss in Denmark: A comparison of preventable hospitalisations and readmissions for chronic medical conditions in the Danish Healthcare system and Kaiser Permanente http://www.medworm.com/index.php?rid=5538949&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F347 Conclusions: There are substantial differences between the DHS and KP in the rates of preventable hospitalisations and subsequent readmissions associated with chronic conditions, which suggest much opportunity for improvement within the Danish system. Reductions in hospitalisations also could improve patient welfare and free considerable resources for use towards preventing disease exacerbations. These conclusions may also apply for similar public systems such as the US Medicare system, the NHS and other systems striving to improve the integration of care for persons with chronic conditions. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5538949 Thu, 22 Dec 2011 05:00:00 +0100 5538949 Which health care facilities do adult Malawian antiretroviral therapy patients utilize during intercurrent illness? A cross sectional study http://www.medworm.com/index.php?rid=5526645&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F345 Conclusions: ART patients often seek health care outside their own clinic, which may have detrimental effects, and has consequences for ART counseling content and reporting of ART information in health passports. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5526645 Wed, 21 Dec 2011 05:00:00 +0100 5526645 Cost of Community Integrated Prevention Campaign for Malaria, HIV, and Diarrhea in Rural Kenya http://www.medworm.com/index.php?rid=5526644&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F346 Conclusions: A large-scale, rapidly implemented, integrated health campaign provided services to 80% of a rural Kenyan population with relatively low cost. Scaling up this design may provide similar services to larger populations at lower cost per person. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5526644 Wed, 21 Dec 2011 05:00:00 +0100 5526644 Is the maturity of hospitals' quality improvement systems associated with measures of quality and patient safety? http://www.medworm.com/index.php?rid=5526646&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F344 Conclusions: We assessed associations between hospitals' quality improvement systems and clinical outcomes. From this data it seems that having a more developed quality improvement system is associated with lower rates of adjusted hospital complications. A number of methodological and logistic hurdles remain to link hospital quality improvement systems to outcomes. Further research should aim at identifying the latent dimensions of quality improvement systems that predict quality and safety outcomes. Such research would add pertinent knowledge regarding the implementation of organizational strategies related with quality of care outcomes. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5526646 Tue, 20 Dec 2011 05:00:00 +0100 5526646 Treatment adherence among sputum smear-positive pulmonary tuberculosis patients in mountainous areas in China http://www.medworm.com/index.php?rid=5516183&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F341 Conclusions: In these remote and poor areas of China, the TB control program is not fully functioning according to the guidelines. The majority of patients are not treated under direct observation, while direct observation by health care staff was associated with better adherence, both to drug therapy and re-examinations. Insufficient adherence increases the risk of unsuccessful treatment outcomes and development of drug resistance. Measures should be taken urgently in these areas to strengthen implementation of the international Stop TB strategy. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5516183 Fri, 16 Dec 2011 05:00:00 +0100 5516183 Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study http://www.medworm.com/index.php?rid=5516182&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F342 Conclusions: A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various contents and originated from diverse organisational contexts, innovators' accounts converged to the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context. The innovators, operating themselves as important champions and being often willing to lead constructive efforts of implementation to different contexts, can contribute to the promulgation and spread of the novelties significantly. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5516182 Fri, 16 Dec 2011 05:00:00 +0100 5516182 Using network analysis to map the formal clinical reporting process in pediatric palliative care: a pilot study http://www.medworm.com/index.php?rid=5516181&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F343 Conclusions: Families have anecdotally reported frustration with poor continuity of care. Network analysis can be a useful tool in describing the discontinuity of care experienced by families dealing with complex and chronic conditions. This tool could be expanded to other systems such as electronic health records and many other health care situations. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5516181 Fri, 16 Dec 2011 05:00:00 +0100 5516181 Juvenile obesity and its association with utilisation and costs of pharmaceuticals - results from the KiGGS study http://www.medworm.com/index.php?rid=5506492&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F340 Conclusions: This is the first study to estimate excess drug costs for obesity based on a representative cross-sectional sample of the child and adolescent population in Germany. The results suggest that obese children should be classified as a priority group for prevention. This study complements the existing literature and provides important information concerning the relevance of childhood obesity as a health problem. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5506492 Fri, 16 Dec 2011 05:00:00 +0100 5506492 The courage to change: Patient perceptions of 12-Step fellowships http://www.medworm.com/index.php?rid=5506493&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F339 Conclusions: Our findings increased the understanding of factors most likely to influence decisions to attend TSGs in SUD treatment contexts with uncommon TSG participation. Our results suggested that the majority of patients may be sufficiently influenced by highlighting the potential gains of TSG participation. Treatment programs that do not focus on self-help group attendance during and after treatment should consider implementing facilitative measures to enhance utilization of these fellowships. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5506493 Thu, 15 Dec 2011 05:00:00 +0100 5506493 Do we have the right models for scaling up health services to achieve the Millennium Development Goals? http://www.medworm.com/index.php?rid=5506496&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F336 Conclusions: The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current strategies to achieve the MDGs. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5506496 Wed, 14 Dec 2011 05:00:00 +0100 5506496 Models of Inter Professional Working for older people living at home: a survey and review of the local strategies of English health and social care statutory organisations http://www.medworm.com/index.php?rid=5506495&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F337 Conclusion: Health and social care organisations and their managers recognise the value and importance of IPW. There is a theoretical literature on what supports IPW and what it can achieve. The need for precision may not be so necessary for the terms used to describe IPW. However, there is a need for shared identification of both user/patient outcomes that arise from IPW and greater understanding of what kind of model of IPW achieves what kind of outcomes for older people living at home (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5506495 Wed, 14 Dec 2011 05:00:00 +0100 5506495 Cost effectiveness of total knee arthroplasty from the health care providers' perspective before and after introduction of an interdisciplinary clinical pathway - is investment always improvement? http://www.medworm.com/index.php?rid=5506494&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F338 Conclusions: The introduction of an interdisciplinary clinical pathway does not necessarily inprove patient related outcome. On the contrary, cost effectiveness from the health care providers' perspective may even turn out remarkably reduced in the setting considered here (functional outcome assessment after treatment by a full service health care provider).Key words: Total Knee Arthroplasty (TKA), clinical pathway, WOMAC index, process costs, cost effectiveness (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5506494 Wed, 14 Dec 2011 05:00:00 +0100 5506494 Factors affecting the use of patient survey data for quality improvement in the Veterans Health Administration http://www.medworm.com/index.php?rid=5495745&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F334 Conclusions: Interviews with VA staff provided promising examples of how systematic processes for using survey data can be implemented as part of wider quality improvement efforts. However, prospective studies are needed to identify the most effective strategies for using patient feedback to improve specific aspects of patient-centered care. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5495745 Mon, 12 Dec 2011 05:00:00 +0100 5495745 Effects on incident reporting after educating residents in patient safety: a controlled study http://www.medworm.com/index.php?rid=5495744&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F335 Conclusions: Patient safety education can have immediate and long-term positive effects on knowledge, skills and attitudes, and modestly influence the reporting behavior of residents. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5495744 Mon, 12 Dec 2011 05:00:00 +0100 5495744 Are prescribing doctors sensitive to the price that their patients have to pay in the Spanish National Health System? http://www.medworm.com/index.php?rid=5488219&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F333 Conclusions: Doctors working in the Spanish NHS seem to be sensitive to the price that can be afforded by patients when they fill in prescriptions, although alternative hypothesis could also explain the results found. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5488219 Thu, 08 Dec 2011 05:00:00 +0100 5488219 The discriminative power of patient experience surveys http://www.medworm.com/index.php?rid=5477705&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F332 Conclusions From a statistical point of view, the discriminative power appears limited. The sample sizes required for reliable estimates are often substantial and deserve careful consideration when setting up measurements. Future research should evaluate the discriminative power by validating differences between providers in patient experiences with other indices and should explore other, more sensitive measures of patient experiences regarding treatment-related changes in physical functioning. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5477705 Tue, 06 Dec 2011 05:00:00 +0100 5477705 A randomized trial of an intervention to improve use and adherence to effective coronary heart disease prevention strategies http://www.medworm.com/index.php?rid=5477706&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F331 Conclusion: A computerized intervention that involves patients in CHD decision making and supports adherence to effective prevention strategies can improve adherence and reduce predicted CHD risk.Clinical trials registration number: NCT00494052 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5477706 Mon, 05 Dec 2011 05:00:00 +0100 5477706 Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature http://www.medworm.com/index.php?rid=5470067&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F330 Conclusions: Primary health care is the setting where timely access to safe and appropriate medicines is most critical for the well-being of any population. The gradual growth over time of legislative authority and in the numbers of non-medical prescribers, particularly nurses, in some countries suggests that the acceptability of non-medical prescribing is based on the perceived value to the health care system as a whole. Our review suggests that there are substantial gaps in the knowledge base to help evidence based policy making in this arena. We suggest that future studies of non-medical prescribing in primary care focus on the broad range of patient and health service outcomes and include economic dimensions. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5470067 Fri, 02 Dec 2011 05:00:00 +0100 5470067 Voices from the frontline: Counsellors' perspectives on TB/HIV collaborative activities in the Northwest Region, Cameroon http://www.medworm.com/index.php?rid=5459218&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F328 Conclusions: In order to achieve a sustainable collaboration between TB and HIV services, adequate planning, investment and strengthening of the health system including human resources, infrastructure and ensuring uninterrupted supplies of medicines are essential. A multidisciplinary approach to service delivery particularly focusing on harnessing the enormous potentials of traditional healers in TB/HIV prevention and control would also be indispensible. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5459218 Wed, 30 Nov 2011 05:00:00 +0100 5459218 Bridging health technology assessment (HTA) with multicriteria decision analyses (MCDA): field testing of the EVIDEM framework for coverage decisions by a public payer in Canada http://www.medworm.com/index.php?rid=5459217&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F329 Conclusions: By promoting systematic consideration of all decision criteria and the underlying evidence, the framework allows a consistent approach to appraising healthcare interventions. Further testing and validation are needed to advance MCDA approaches in healthcare decisionmaking. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5459217 Wed, 30 Nov 2011 05:00:00 +0100 5459217 Non-adherence to drug therapy and drug acquisition costs in a national population - a patient-based register study http://www.medworm.com/index.php?rid=5459220&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F326 Conclusions: Our estimate indicates that drug acquisition costs related to non-adherence represent a substantial proportion of the economic resources in the health care sector. A low rate of primary non-adherence, combined with a high rate of secondary non-adherence, contributes to a large degree of unnecessary medical spending. Thus, efforts of different types of interventions are needed to improve secondary adherence. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5459220 Mon, 28 Nov 2011 05:00:00 +0100 5459220 Leadership, staffing and quality of care in nursing homes http://www.medworm.com/index.php?rid=5459219&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F327 Conclusions: Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is complex. Increasing staffing levels or the ratio of registered nurses alone is not likely sufficient for increasing quality of care. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5459219 Mon, 28 Nov 2011 05:00:00 +0100 5459219 Testing the WHO responsiveness concept in the Iranian mental healthcare system: a qualitative study of service users http://www.medworm.com/index.php?rid=5442780&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F325 Conclusions: The results showed that the concept of responsiveness developed by the WHO is applicable to mental health services in Iran. These findings might help policy-makers' better understanding of what is useful for the improvement of mental health services. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5442780 Fri, 25 Nov 2011 05:00:00 +0100 5442780 How much time do nurses have for patients? A longitudinal study quantifying hospital nurses' patterns of task time distribution and interactions with health professionals http://www.medworm.com/index.php?rid=5442786&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F319 Background: Time nurses spend with patients is associated with improved patient outcomes, reduced errors, and patient and nurse satisfaction. Few studies have measured how nurses distribute their time across tasks. We aimed to quantify how nurses distribute their time across tasks, with patients, in individual tasks, and engagement with other health care providers; and how work patterns changed over a two year period. Methods: Prospective observational study of 57 nurses for 191.3 hours (109.8 hours in 2005/2006 and 81.5 in 2008), on two wards in a teaching hospital in Australia. The validated Work Observation Method by Activity Timing (WOMBAT) method was applied. Proportions of time in 10 categories of work, average time per task, time with patients and others, information tools used, and... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5442786 Thu, 24 Nov 2011 05:00:00 +0100 5442786 A systematic review of integrated working between care homes and health care services. http://www.medworm.com/index.php?rid=5442785&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F320 Conclusions: Despite evidence about what inhibits and facilitates integrated working there was limited evidence about what the outcomes of different approaches to integrated care between health service and care homes might be. The majority of studies only achieved integrated working at the patient level of care and the focus on health service defined problems and outcome measures did not incorporate the priorities of residents or acknowledge the skills of care home staff. There is a need for more research to understand how integrated working is achieved and to test the effect of different approaches on cost, staff satisfaction and resident outcomes. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5442785 Thu, 24 Nov 2011 05:00:00 +0100 5442785 Mortality associated with timing of admission to and discharge from ICU: a retrospective cohort study. http://www.medworm.com/index.php?rid=5442784&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F321 Conclusions: In this study, ICU discharge at night but not admission was associated with a significant increased risk for death. Further studies are needed to examine whetherminimizing night time discharges from ICU may improve outcome. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5442784 Thu, 24 Nov 2011 05:00:00 +0100 5442784 The IRYSS-COPD appropriateness study: objectives, methodology, and description of the prospective cohort http://www.medworm.com/index.php?rid=5442783&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F322 DiscussionThe IRYSS-COPD Appropriateness Study will validate the appropriateness criteria developed by the RAND/UCLA Appropriateness Methodology and thus better delineate the requirements for admission or discharge of patients experiencing exacerbations of COPD. The study will also provide a better understanding of the determinants of outcomes of COPD exacerbations, and evaluate the equity and variability in access and outcomes in these patients. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5442783 Thu, 24 Nov 2011 05:00:00 +0100 5442783 A multi-region assessment of population rates of cardiac catheterization and yield of high-risk coronary artery disease http://www.medworm.com/index.php?rid=5442782&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F323 Conclusions: Our study demonstrates a consistent finding, over time and across jurisdictions, of linearly increasing detection of high-risk CAD as population rates of cardiac catheterization increase. This internationally-relevant finding can inform country-level planning of invasive cardiac care services. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5442782 Thu, 24 Nov 2011 05:00:00 +0100 5442782 Economic evaluation of increasing population rates of cardiac catheterization http://www.medworm.com/index.php?rid=5442781&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F324 Conclusion: A strategy of increasing cardiac catheterization rates among eligible patients is associated with a cost per QALY similar to that of other funded interventions. However, there is significant model uncertainty. A decision to increase population rates of catheterization requires consideration of the accompanying opportunity costs, and careful thought towards the most appropriate strategy. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5442781 Thu, 24 Nov 2011 05:00:00 +0100 5442781 A web-based appointment system to reduce waiting for outpatients: A retrospective study http://www.medworm.com/index.php?rid=5442787&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F318 Background: Long waiting times for registration to see a doctor is problematic in China, especially in tertiary hospitals. To address this issue, a web-based appointment system was developed for the Xijing hospital. The aim of this study was to investigate the efficacy of the web-based appointment system in the registration service for outpatients. Methods: Data from the web-based appointment system in Xijing hospital from January to December 2010 were collected using a stratified random sampling method, from which participants were randomly selected for a telephone interview asking for detailed information on using the system. Patients who registered through registration windows were randomly selected as a comparison group, and completed a questionnaire on-site. Results: A total of 5641 p... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5442787 Tue, 22 Nov 2011 05:00:00 +0100 5442787 Reconstruction versus conservative treatment after rupture of the anterior cruciate ligament: cost effectiveness analysis http://www.medworm.com/index.php?rid=5423444&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F317 Conclusion: ACL reconstruction for reestablishment of knee stability seems cost effective in the Swiss setting based on currently available evidence. This, however, should be reinforced with randomized controlled trials comparing the two treatment strategies. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5423444 Sat, 19 Nov 2011 05:00:00 +0100 5423444 Patterns of Long Term Care in 29 European countries: evidence from an exploratory study. http://www.medworm.com/index.php?rid=5423445&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F316 Conclusions: The analysis carried out is an explorative and descriptive study, which is an attempt to reveal patterns and trends of LTC in Europe, allowing comparisons between countries. It also stimulates further researches with lower aggregated data useful to gain meaningful policy-making evidence.Please see related article: http://www.biomedcentral.com/1741-7015/9/124 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5423445 Fri, 18 Nov 2011 05:00:00 +0100 5423445 Why caretakers bypass primary health care facilities for child care - a case from rural Tanzania. http://www.medworm.com/index.php?rid=5423446&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F315 Conclusion: The observation that people are willing to travel long distances to get better quality services calls for health policies that prioritize quality of care before quantity. In a situation with limited resources, utilizing available resources to improve quality of care at available facilities could be more appropriate for improving access to health care than increasing the number of facilities. This would also improve equity in health care access since the poor who can not afford travelling costs will then get access to quality services at their nearer PHC facilities. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5423446 Thu, 17 Nov 2011 05:00:00 +0100 5423446 Expert Delphi survey on research and development into drugs for neglected diseases http://www.medworm.com/index.php?rid=5409969&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F312 Conclusions: While not all features of orphan drug regulations and of the MRDT draft received equal support, the view was expressed that a regulatory instrument would be a desirable and feasible measure to promote R&D for neglected diseases. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5409969 Wed, 16 Nov 2011 05:00:00 +0100 5409969 Implementation of patient education at first and second dispensing of statins in Dutch community pharmacies: the sequel of a cluster randomized trial http://www.medworm.com/index.php?rid=5409968&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F313 Conclusion: The intensive implementation program did not increase the frequency of providing EAFD and EASD of statins in community pharmacies.Trial registration number NCT00509717 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5409968 Wed, 16 Nov 2011 05:00:00 +0100 5409968 A framework and a measurement instrument for sustainability of work practices in long-term care http://www.medworm.com/index.php?rid=5409967&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F314 The objective of this study is to develop a theoretical framework and measurement instrument for sustainability. To this end sustainability is conceptualized with two dimensions: routinization and institutionalization. Methods: The exploratory methodological design consisted of three phases: a) framework development; b) instrument development; and c) field testing in former improvement teams in a quality improvement program for health care (N teams = 63, N individual =112). Data were collected not until at least one year had passed after implementation.Underlying constructs and their interrelations were explored using Structural Equation Modeling and Principal Component Analyses. Internal consistency was computed with Cronbach's alpha coefficient. A long and a short version of the instrume... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5409967 Wed, 16 Nov 2011 05:00:00 +0100 5409967 Consumer evaluation of complaint handling in the Dutch health insurance market http://www.medworm.com/index.php?rid=5409971&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F310 Conclusions: Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and technical quality do not influence consumer satisfaction evaluations and trust in the company to the same extent. Therefore, it is important for managers to be aware of the type of consumer satisfaction they are measuring when evaluating the handling of complaints within their company. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5409971 Tue, 15 Nov 2011 05:00:00 +0100 5409971 Association between mental health conditions and rehospitalization, mortality, and functional outcomes in patients with stroke following inpatient rehabilitation http://www.medworm.com/index.php?rid=5409970&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F311 Conclusions: Patients with stroke with pre-existing mental health conditions may need additional psychotherapy interventions, which may potentially improve stroke outcomes post-hospitalization. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5409970 Tue, 15 Nov 2011 05:00:00 +0100 5409970 Perceptions and practices of pharmaceutical wholesalers surrounding counterfeit medicines in a developing country: a baseline survey http://www.medworm.com/index.php?rid=5401542&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F306 Conclusion: A number of wholesalers think counterfeit medicines are medicines without registration, and/or do not have any uniform ideas on the issue and what to do, when they find or suspect counterfeits. Furthermore, their strict adherence to anti-counterfeiting measures is urgently needed. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5401542 Fri, 11 Nov 2011 05:00:00 +0100 5401542 Quality of hospital care for sick newborns and severely malnourished children in Kenya: A two-year descriptive study in 8 hospitals. http://www.medworm.com/index.php?rid=5401541&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F307 Conclusion: Routine records are inadequate to assess newborn care and thus for monitoring newborn survival interventions. Quality of documented inpatient care for neonates and severely malnourished children is poor with limited improvement after the dissemination of clinical practice guidelines. Further research evaluating approaches to improving care for these vulnerable groups is urgently needed. We also suggest pre-service training curricula should be better aligned to help improve newborn survival particularly. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5401541 Fri, 11 Nov 2011 05:00:00 +0100 5401541 What stops children with a chronic illness accessing health care: a mixed methods study in children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) http://www.medworm.com/index.php?rid=5401540&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F308 This study used a mixed-methods approach to examine factors associated with time taken to access specialist services. Methods: Time-to-assessment was analysed as a continuous "survival-time" variable in Cox regression models using data from self-completed assessment forms for children attending a regional specialist CFS/ME service between January 2006 and December 2009. Semi-structured interviews about barriers experienced in accessing healthcare for their child were conducted with nine parents of children aged (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5401540 Fri, 11 Nov 2011 05:00:00 +0100 5401540 Diagnosis of chronic conditions with modifiable lifestyle risk factors in selected urban and rural areas of Bangladesh and sociodemographic variability therein http://www.medworm.com/index.php?rid=5401539&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F309 Conclusion: IAPs play important roles in chronic disease care, particularly in rural areas. Input and cooperation from IAPs are needed to minimize rural health disparities. More research on IAP knowledge and practices regarding chronic disease is needed to properly utilize this potential healthcare resource. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5401539 Fri, 11 Nov 2011 05:00:00 +0100 5401539 Healthcare Costs in Patients with Metastatic Lung Cancer Receiving Chemotherapy http://www.medworm.com/index.php?rid=5401543&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F305 Conclusion: Our study sheds additional light on the burden of metastatic lung cancer among patients receiving chemotherapy, in terms of total cost thru end of life as well as component costs by setting and type of service, and may be useful in informing medical resource allocation in this patient population. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5401543 Thu, 10 Nov 2011 05:00:00 +0100 5401543 Effectiveness of classroom based crew resource management training in the intensive care unit: study design of a controlled trial http://www.medworm.com/index.php?rid=5389318&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F304 DiscussionIt is expected that the CRM training acts as a generic intervention that stimulates specific interventions. Besides effectiveness and cost-effectiveness, the assessment of the barriers and facilitators will provide insight in the implementation process of CRM.Trial registrationDutch Trial register: NTR1976. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5389318 Thu, 10 Nov 2011 05:00:00 +0100 5389318 Health care help seeking behaviour among prisoners in Norway http://www.medworm.com/index.php?rid=5389321&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F301 Conclusions: This study suggests that sleep problems and drug use are most frequently associated with health service use. The differences in health care use between prisons suggest that the implementation of prison health care standards should be addressed. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5389321 Fri, 04 Nov 2011 04:00:00 +0100 5389321 Treatment options for subjective tinnitus: Self reports from a sample of general practitioners and ENT physicians within Europe and the USA. http://www.medworm.com/index.php?rid=5389320&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F302 Conclusions Despite a large variety of treatment options, the low success rates of tinnitus therapy lead to frustration of physicians and patients alike. For subjective tinnitus in particular, effective therapeutic options with guidelines about key diagnostic criteria are urgently needed. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5389320 Fri, 04 Nov 2011 04:00:00 +0100 5389320 Sociodemographic and geographic characteristics associated with patient visits to osteopathic physicians for primary care http://www.medworm.com/index.php?rid=5389319&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F303 Conclusions: Health care reform provides unprecedented opportunities for DOs to reach historically underserved populations and to overcome the "pediatric primary-care paradox." (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5389319 Fri, 04 Nov 2011 04:00:00 +0100 5389319 Different patient subgroup, different ranking? Which quality indicators do patients find important when choosing a hospital for hip- or knee arthroplasty? http://www.medworm.com/index.php?rid=5389323&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F299 Conclusions: This study provides a first insight into which quality indicators patients find important when choosing a hospital for THA/TKA, and shows that subgroups of patients differ in the value they attach to these indicators. More extended research is needed to establish the indicators that should at least be presented in succinct overviews of comparative healthcare information for patients choosing a hospital for THA/TKA. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5389323 Thu, 03 Nov 2011 04:00:00 +0100 5389323 For money or service? A cross-sectional survey of preference for financial versus non-financial rural practice characteristics among Ghanaian medical students. http://www.medworm.com/index.php?rid=5389322&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F300 Conclusions: Interventions to improve rural practice conditions are likely to be more persuasive than salary incentives to Ghanaian medical students who are willing to work in rural environments a priori. Policy experiments should test the impact of these interventions on actual uptake by students upon graduation. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5389322 Thu, 03 Nov 2011 04:00:00 +0100 5389322 Practical considerations to guide development of access controls and decision support for genetic information in electronic medical records http://www.medworm.com/index.php?rid=5389327&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F294 DiscussionAs health care systems increasingly implement electronic medical record systems (EMRs) they must carefully consider how to use information from this wide spectrum of genetic tests, with whom to share information, and how to provide decision support for clinicians to properly interpret the information. Although some characteristics of genetic tests overlap with other medical test results, there are reasons to make genetic test results widely available to health care providers and counterbalancing reasons to restrict access to these test results to honor patient preferences, and avoid distracting or confusing clinicians with irrelevant but complex information. Electronic medical records can facilitate and provide reasonable restrictions on access to genetic test results and deliver... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5389327 Wed, 02 Nov 2011 04:00:00 +0100 5389327 Questionnaire of Chronic Illness Care in Primary Care - psychometric properties and test-retest reliability http://www.medworm.com/index.php?rid=5389326&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F295 Conclusions: The QCPC is an appropriate instrument to assess the structure of chronic illness care. Unlike the ACIC, the QCPC can be used by health care providers without CCM training. The QCPC can detect the actual state of care as well as areas for improvement of care according to the CCM. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5389326 Wed, 02 Nov 2011 04:00:00 +0100 5389326 Effect of an institutional development plan for user participation on professionals' knowledge, practice, and attitudes. A controlled study. http://www.medworm.com/index.php?rid=5389325&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F296 Conclusion: This is the first controlled study on the effect on professionals from implementing a development plan to enhance user participation in a mental health hospital. The plan had no effect on professionals' knowledge, practice, or attitudes. This can be due to the quality of the development plan, the implementation process, and/or the suitability of the outcome measures. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5389325 Wed, 02 Nov 2011 04:00:00 +0100 5389325 Does quality of care for hypertension in primary care vary with postcode area deprivation? An observational study. http://www.medworm.com/index.php?rid=5389324&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F297 Conclusions: Participants from more deprived areas received at least the same, and sometimes better, quality of care than those from less deprived areas. Quality of care for hypertension in general practice may not follow the inequitable distribution seen with some other conditions. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5389324 Wed, 02 Nov 2011 04:00:00 +0100 5389324 Improving inpatient postnatal services: midwives views and perspectives of engagement in a quality improvement initiative http://www.medworm.com/index.php?rid=5363193&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F293 Conclusions: This was the first UK study to undertake a review of in-patient postnatal services. Involvement of midwives at the outset was essential to the success of the initiative. Midwives play a lead role in the planning and organisation of in-patient postnatal care and it was important to obtain their feedback on whether revisions were pragmatic and achieved anticipated improvements in care quality. Their initial involvement ensured priority areas for change were identified and implemented. Their subsequent feedback highlighted further important areas to address as part of CQI to ensure best quality care continues to be implemented. Our findings could support other maternity service organisations to optimise in-patient postnatal services. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5363193 Tue, 01 Nov 2011 04:00:00 +0100 5363193 Inequalities in utilisation of general practitioner and specialist services in 9 European countries http://www.medworm.com/index.php?rid=5363198&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F288 Conclusions: We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5363198 Mon, 31 Oct 2011 04:00:00 +0100 5363198 Long-term medical utilization following ventilator-associated pneumonia in acute stroke and traumatic brain injury patients: a case-control study http://www.medworm.com/index.php?rid=5363197&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F289 Conclusions: VAP has a significant impact on medical expenses and utilization, both during the index hospitalization during which VAP developed and in the longer term. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5363197 Mon, 31 Oct 2011 04:00:00 +0100 5363197 DRG coding practice: a nationwide hospital survey in Thailand http://www.medworm.com/index.php?rid=5363196&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F290 Conclusion: Hospital providers should not be assumed capable of producing high quality DRG codes, especially in resource-limited settings. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5363196 Mon, 31 Oct 2011 04:00:00 +0100 5363196 Determining level of care appropriateness in the patient journey from acute care to rehabilitation http://www.medworm.com/index.php?rid=5363195&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F291 Conclusions: A high proportion of patient days did not meet acute level of care criteria, due predominantly to inefficiencies in care processes, or to patients being more appropriate for an alternative level of care, including rehabilitation. The rehabilitation team was the most accurate in determining ongoing medical stability, but at the cost of a longer acute stay.To avoid inpatients remaining in acute care in a state of 'terra nullius', clinical models which provide rehabilitation within acute care, and more efficient movement to a rehabilitation setting, is required. Utilization review could have a decision support role in the determination of medical stability. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5363195 Mon, 31 Oct 2011 04:00:00 +0100 5363195 A pharmacist-led intervention for increasing the uptake of Home Medicines Review (HMR) among residents of retirement villages (PHARMER): protocol for a cluster randomised controlled trial http://www.medworm.com/index.php?rid=5363194&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F292 This study is the first to develop and test an intervention to improve the uptake of HMR among Australian residents in retirement villages, with a view to decreasing medication risk. A multi-faceted interventional approach will be used as suggested by stakeholders. The trial is expected to be complete by late 2011 and results will be available in 2012.Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12611000109909 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5363194 Mon, 31 Oct 2011 04:00:00 +0100 5363194 A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol http://www.medworm.com/index.php?rid=5349417&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F285 DiscussionThe protocol is based on the premise that future research, policy and practice need to address the sociology of improvement in equal measure to the science and technique of improvement, or at least expand the discipline of improvement to include these critical organisational and cultural processes. We define the 'organisational and cultural characteristics associated with better quality of care' in a broad sense that encompasses all the features of a hospital that might be hypothesised to impact upon clinical effectiveness, patient safety and/or patient experience. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5349417 Wed, 26 Oct 2011 04:00:00 +0100 5349417 The World Health Organization multicountry survey on maternal and newborn health: study protocol http://www.medworm.com/index.php?rid=5349416&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F286 Discussion: Implementing the systematic identification of near-miss cases, mapping the use of critical evidence-based interventions and analysing the corresponding indicators are just the initial steps for using the maternal near-miss concept as a tool to improve maternal and newborn health. The findings of projects using approaches similar to those described in this manuscript will be a good starter for a more comprehensive dialogue with governments, professionals and civil societies, health systems or facilities for promoting best practices, improving quality of care and achieving better health for mothers and children. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5349416 Wed, 26 Oct 2011 04:00:00 +0100 5349416 Does long-term care use within primary health care reduce hospital use among older people in Norway? A national five-year population-based observational study http://www.medworm.com/index.php?rid=5349415&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F287 Conclusions: We found a weak positive adjusted association between LTC-rates and HD-rates. Opposite to common belief, we found that increased volume of LTC by itself did not reduce pressure on hospitals. There still is a need to study integrated care models for the elderly in the Norwegian setting and to explore further why municipalities far away from hospital achieve lower use of hospital beds. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5349415 Wed, 26 Oct 2011 04:00:00 +0100 5349415 Time intervals from first symptom to treatment of cancer: a cohort study of 2,212 newly diagnosed cancer patients http://www.medworm.com/index.php?rid=5349418&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F284 Conclusion: System delay accounted for a substantial part of the total delay experienced by cancer patients. This points to a need for shortening clinical pathways if possible. A long patient delay calls for research into patient awareness of cancer. For all delay components, special focus should be given to the 4th quartile of patients with the longest time intervals and we need research into the quality of the diagnostic work-up process. We found large variations in delay for different types of cancer. Improvements should therefore target both the population at large and the specific needs associated with individual cancer types and their symptoms. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5349418 Tue, 25 Oct 2011 04:00:00 +0100 5349418 Challenges to the Provision of Diabetes Care in First Nations Communities: Results from a National Survey of Healthcare Providers in Canada http://www.medworm.com/index.php?rid=5337670&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F283 Conclusions: Addressing patient factors was considered the highest impact strategy for improving diabetes care. While this may reflect "patient blaming," it also suggests that self-management strategies may be well-suited for this context. Program planning should focus on training programs for CHRs, who provide a unique link between patients and clinical services. Research incorporating patient perspectives is needed to complete this picture and inform quality improvement initiatives. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5337670 Fri, 21 Oct 2011 04:00:00 +0100 5337670 Narcotic analgesic utilization amongst injured workers: using concept mapping to understand current issues from the perspectives of physicians and pharmacists http://www.medworm.com/index.php?rid=5337673&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F280 Conclusions: Participants depicted factors driving NA utilization among injured workers as complex. Patient-level factors were perceived as most influential on over-utilization, while system-level factors were considered most amenable to intervention. This has implications for intervention design, suggesting that systemic/structural factors should be taken into account in order to address this important health issue. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5337673 Thu, 20 Oct 2011 04:00:00 +0100 5337673 Development of quality indicators for monitoring outcomes of frail elderly hospitalised in acute care health settings: Study Protocol http://www.medworm.com/index.php?rid=5337672&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F281 DiscussionThe approach to quality indicators proposed in this protocol has four distinct advantages over previous efforts: the quality indicators focus on outcomes; they can be collected as part of a routinely applied clinical information and decision support system; the clinical data will be robust and will contribute to better understanding variations in hospital care of older patients; The quality indicators will have international relevance as they will be built on inter-RAI assessment instrument, an internationally recognised clinical system. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5337672 Thu, 20 Oct 2011 04:00:00 +0100 5337672 Inputs to quality: supervision, management, and community involvement in health facilities in Egypt, 2004 http://www.medworm.com/index.php?rid=5337671&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F282 Conclusions: Although the data precede the recent reform efforts of the MOHP, they provide a baseline against which future progress can be measured. Targeted efforts to improve facility-level management are critical to supporting quality improvement initiatives directed at improving the quality of health care throughout the country. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5337671 Thu, 20 Oct 2011 04:00:00 +0100 5337671 Economic evaluation of three populational screening strategies for cervical cancer in the county of Valles Occidental: CRICERVA clinical trial. http://www.medworm.com/index.php?rid=5337675&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F278 DiscussionIG3 is expected to be more cost-effective intervention than IG1 and IG2, with greater detection of HPV infections, epithelial lesions and cancer than other strategies, albeit at a greater cost.TRIAL REGISTRATION: Clinical Trials.gov Identifier NCT01373723 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5337675 Wed, 19 Oct 2011 04:00:00 +0100 5337675 Evaluating the value of a web-based natural medicine clinical decision tool at an academic medical center http://www.medworm.com/index.php?rid=5337674&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F279 Background: Consumer use of herbal and natural products (H/NP) is increasing, yet physicians are often unprepared to provide guidance due to lack of educational training. This knowledge deficit may place consumers at risk of clinical complications. We wished to evaluate the impact that a natural medicine clinical decision tool has on faculty attitudes, practice experiences, and needs with respect to H/NP. Methods: All physicians and clinical staff (nurse practitioners, physicians assistants) (n=532) in departments of Pediatrics, Family and Community Medicine, and Internal Medicine at our medical center were invited to complete 2 electronic surveys. The first survey was completed immediately before access to a H/NP clinical-decision tool was obtained; the second survey was completed the fol... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5337674 Wed, 19 Oct 2011 04:00:00 +0100 5337674 Provider experiences of the implementation of a new tuberculosis treatment programme: A qualitative study using the normalisation process model http://www.medworm.com/index.php?rid=5324840&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F275 Conclusion: The normalization process model assisted in categorising the challenges experienced during implementation of the intervention. The results suggest that issues remain that need to be resolved before the programme is implemented more widely. Considerable work is needed in order to embed the intervention in routine clinic practice. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5324840 Mon, 17 Oct 2011 04:00:00 +0100 5324840 Health-related rehabilitation services: assessing the global supply of and need for human resources http://www.medworm.com/index.php?rid=5324839&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F276 Conclusion: The evidence base on human resources for health-related rehabilitation services remains fragmented, the result of limited availability and use of quality, comparable data and information within and across countries. This assessment offered the first global baseline, intended to catalyze further research that can be translated into evidence to support human resources for rehabilitation policy and practice. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5324839 Mon, 17 Oct 2011 04:00:00 +0100 5324839 High rates of adherence and treatment success in a public and public-private HIV clinic in India: potential benefits of standardized national care delivery systems http://www.medworm.com/index.php?rid=5324838&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F277 This study aimed to understand patient characteristics and treatment outcomes from different HIV healthcare settings in Bangalore, India. Methods: Participants from public, private and public-private HIV healthcare settings were recruited between 2007 and 2009 and were administered structured interviews by trained staff. Self-reported adherence was measured using the visual analogue scale to capture adherence over the past month, and a history of treatment interruptions (defined as having missed medications for more than 48 hours in the past three months). In addition, CD4 count and viral load (VL) were measured; genotyping for drug resistance-associated mutations was performed on those who were in virological failure (VL>1000 copies/ml). Results: A total of 471 individuals were included i... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5324838 Mon, 17 Oct 2011 04:00:00 +0100 5324838 Using discrete event simulation to compare the performance of family health unit and primary health care centre organizational models in Portugal http://www.medworm.com/index.php?rid=5324841&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F274 Conclusions: Reorganization of PHCCs into FHUs might increase accessibility of patients to services and efficiency in the provision of primary care services. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5324841 Sat, 15 Oct 2011 04:00:00 +0100 5324841 Systemic factors of errors in the case identification process of the national routine health information system: A case study of Modified Field Health Services Information System in the Philippines http://www.medworm.com/index.php?rid=5316669&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F271 Conclusions: The results suggest three characteristics of definitions of indicators such as those that are (1) unsupported by the current conditions in the health system, i.e., (a) data are required from a facility that cannot directly generate the data and, (b) definitions of indicators are not consistent with its corresponding program; (2) incomplete or ambiguous, which allow several interpretations; and (3) complete yet easily misunderstood by health workers.Taking systemic factors into account, the case identification step needs to be reviewed and designed to generate intended data in health information systems. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5316669 Fri, 14 Oct 2011 04:00:00 +0100 5316669 Pay-for-performance in disease management: a systematic review of the literature http://www.medworm.com/index.php?rid=5316668&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F272 Conclusion: The number of P4P schemes to encourage disease management is limited. Hardly any information is available about the effects of such schemes on healthcare quality and costs. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5316668 Fri, 14 Oct 2011 04:00:00 +0100 5316668 How and why are communities of practice established in the healthcare sector? A systematic review of the literature http://www.medworm.com/index.php?rid=5316667&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F273 Conclusions: In keeping with Wenger and colleagues' description, CoPs in the healthcare sector vary in form and purpose. While researchers are increasing their efforts to examine the impact of CoPs in healthcare, cultivating CoPs to improve healthcare performance requires a greater understanding of how to establish and support CoPs to maximise their potential to improve healthcare. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5316667 Fri, 14 Oct 2011 04:00:00 +0100 5316667 Predicting recovery at home after Ambulatory Surgery http://www.medworm.com/index.php?rid=5316671&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F269 Conclusions: The variable ambulatory surgical incapacity proved to be a goodpredictor of the patient's status at home.These predictions could be used to assist in educating patients and theircarers about what to expect after discharge, as well as to improve theiroverall level of satisfaction. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5316671 Thu, 13 Oct 2011 04:00:00 +0100 5316671 An intervention to improve care and reduce costs for high-risk patients with frequent hospital admissions: a pilot study http://www.medworm.com/index.php?rid=5316670&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F270 Conclusions: A pilot intervention for high-cost patients shows promising results for health services usage. We are currently expanding our model to serve more patients at additional hospitals to see if the pilot's success can be replicated.Trial registration: Clinicaltrials.gov Identifier: NCT01292096 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5316670 Thu, 13 Oct 2011 04:00:00 +0100 5316670 The impact of hospital revenue on the increase in Caesarean sections in Norway. A panel data analysis of hospitals 1976-2005. http://www.medworm.com/index.php?rid=5316673&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F267 Background: There has been a marked increase in the number of Caesarean sections in many countries during the last decades. In several countries, Caesarean sections are carried out in more than 20 per cent of births. These high Caesarean section rates give cause for concern, both from an economic and a medical perspective. A general opinion among epidemiologists is that the increase in the number of Caesarean sections during the last decade has been greater than could be expected in relation to medical risk factors. Therefore, other explanations must be sought. We studied one potential explanation; the effect that the increase in hospital revenue per bed during the period 1976-2005 has had on the Caesarean section rate in Norway. During this period, hospital revenue increased by about 260 ... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5316673 Wed, 12 Oct 2011 04:00:00 +0100 5316673 Paucity of qualitative research in general medical and health services and policy research journals: analysis of publication rates http://www.medworm.com/index.php?rid=5316672&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F268 Conclusions: This analysis suggests that qualitative research it is rarely published in high impact general medical and health services and policy research journals. The factors that contribute to this persistent marginalization need to be better understood. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5316672 Wed, 12 Oct 2011 04:00:00 +0100 5316672 Community based service providers' perspectives on frequent and/or avoidable admission of older people with chronic disease in rural NSW: a qualitative study http://www.medworm.com/index.php?rid=5305524&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F265 Conclusions: The factors underlying frequent and/or potentially avoidable admission are numerous and complex. Identifying strategies to improve services or interventions for this group requires understanding patient, carer and service providers' perspectives. Improving accessibility of services is also complex, and includes consideration of patients' social, emotional and psychological ability and willingness to use services as well as those services being available and easily accessed. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5305524 Wed, 12 Oct 2011 04:00:00 +0100 5305524 Health worker motivation in the context of HIV care and treatment challenges in Mbeya Region, Tanzania: a qualitative study. http://www.medworm.com/index.php?rid=5305523&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F266 Conclusion: HIV-related challenges undermine motivation among health workers in Mbeya, Tanzania with the burden falling most heavily on lower status workers. Strained relations between health workers and the community they serve, further undermine motivation of health workers. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5305523 Wed, 12 Oct 2011 04:00:00 +0100 5305523 The estimation of patients' views of organizational aspects of a general dental practice by general dental practitioners: a survey study http://www.medworm.com/index.php?rid=5305526&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F263 Conclusion: On most aspects GDPs and patient have different views, except for social desirable aspects. Given the increasing assertiveness of patients, it is startling the GDP's estimated only half of the patients' views correctly. The findings of the study can assist GDPs in adapting their organizational services to better meet the preferences of their patients and to improve the communication towards patients. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5305526 Tue, 11 Oct 2011 04:00:00 +0100 5305526 Protocol for implementation of family health history collection and decision support into primary care using a computerized family health history system http://www.medworm.com/index.php?rid=5305525&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F264 This study integrates a computerized family health history system within the context of a routine well-visit appointment to overcome many of the existing barriers to collection and use of family history information by primary care providers. Results of the implementation process, its acceptability to patients and providers, modifications necessary to optimize the system, and impact on clinical care can serve to guide future implementation projects for both family history and other tools of personalized medicine, such as health risk assessments. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5305525 Tue, 11 Oct 2011 04:00:00 +0100 5305525 Patients' experience of choosing an outpatient clinic in one county in Denmark: results of a patient survey http://www.medworm.com/index.php?rid=5305527&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F262 Conclusions: Outpatients' awareness and utilisation of free choice of health care provider was low. Awareness of freedom of choice of provider differed significantly by specialty and patient's gender, education and employment. Female patients and students were especially likely to choose the clinic by themselves. Most outpatients chose the clinic closest to their home, the GP's recommendation and short waiting time being the second and third most important factors behind choice. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5305527 Mon, 10 Oct 2011 04:00:00 +0100 5305527 The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in Northern Greece. http://www.medworm.com/index.php?rid=5305528&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F261 Conclusions: Internal marketing has a positive effect on the job satisfaction of hospital staff in Northern Greece. Also, doctors and male personnel seem to have greater levels of job satisfaction. Staff with time-defined work contracts with the hospital are more satisfied than permanent staff, and as the staff age, there is a slight decline in job satisfaction. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5305528 Sun, 09 Oct 2011 04:00:00 +0100 5305528 Market Access Agreements for pharmaceuticals in Europe: diversity of approaches and underlying concepts. http://www.medworm.com/index.php?rid=5297958&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F259 DiscussionWe distinguished and defined from the health care payer perspective three kinds of MAA: Commercial Agreements (CA), Payment for Performance Agreements (P4P) and Coverage with Evidence Development (CED). Apart from CA, the agreements assumed collection and analysis of real-life health outcomes data, either from a cohort of patients (CED) or on per patient basis (P4P). We argue that while P4P aim at reducing drug cost to payers without a systematic approach to addressing uncertainty about drugs' value, CED were implemented provisionally to reduce payer's uncertainty about value of a medicine within a defined time period.SummaryWe are of opinion that while CA and P4P have a potential to reduce payers' expenditure on costly drugs while maintaining a high list price, CED address initi... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5297958 Sat, 08 Oct 2011 04:00:00 +0100 5297958 Urbanization and physician maldistribution: a longitudinal study in Japan http://www.medworm.com/index.php?rid=5297957&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F260 Conclusions: A policy that increased the number of physicians and the physician to population ratios between 1998 and 2008 in all geographic areas of Japan, irrespective of size, did not lead to a more equal geographical distribution of physicians. The ratios of physicians to population in small rural STMs increased because of concurrent trends in urbanization and not because of a rise in the number of practicing physicians. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5297957 Sat, 08 Oct 2011 04:00:00 +0100 5297957 The economic disease burden of measles in Japan and a benefit cost analysis of vaccination, a retrospective study http://www.medworm.com/index.php?rid=5297963&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F254 Conclusions: Although the model has some limitations, we conclude that the policy of immunizing infants soon after their one-year birthday is economically effective. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5297963 Fri, 07 Oct 2011 04:00:00 +0100 5297963 Can vouchers make a difference to the use of private primary care services by older people? Experience from the healthcare reform programme in Hong Kong http://www.medworm.com/index.php?rid=5297962&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F255 Conclusions: Our study showed that despite a reasonably high awareness of the voucher scheme, its usage was low. The voucher alone was not enough to realize the government's policy of greater use of the private primary care services. Greater publicity and more variety of media promotion would increase awareness but the effectiveness of vouchers in changing older people's behaviour needs to be revisited. Designating vouchers for use of preventive services with evidence-based practice could be considered. In addition to the demand-side subsidies, improving transparency and comparability of private services against the public sector might be necessary. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5297962 Fri, 07 Oct 2011 04:00:00 +0100 5297962 Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study http://www.medworm.com/index.php?rid=5297961&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F256 Conclusions: The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and confidentiality of electronic information exchange can be improved by developing tools to evaluate the... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5297961 Fri, 07 Oct 2011 04:00:00 +0100 5297961 Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis http://www.medworm.com/index.php?rid=5297960&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F257 The objective of this study is to identify factors associated with outpatient contacts at community mental health services of patients with schizophrenia or related disorders. Methods: This cross-sectional study analyzed 1097 patients. The main outcome measure was the total number of outpatient consultations during one year. Independent variables were related to socio-demographic, clinical and use of service factors. Data were collected from clinical records. Results: The multilevel linear regression model explained 46.35% of the variance. Patients with significantly more contacts with ambulatory services were not working and were receiving welfare benefits (p=0.02), had no formal education (p=0.02), had a global level of severity of two or three (four being the most severe) (p (Source: BM... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5297960 Fri, 07 Oct 2011 04:00:00 +0100 5297960 The Procedural Index for Mortality Risk (PIMR): an index calculated using administrative data to quantify the independent influence of procedures on risk of hospital death http://www.medworm.com/index.php?rid=5297959&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F258 Conclusions: We derived and internally validated an index that uses administrative data to quantify the independent association of a broad range of therapeutic procedures with risk of death in hospital. This scale will improve risk adjustment when administrative data are used for analyses. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5297959 Fri, 07 Oct 2011 04:00:00 +0100 5297959 Statistical software applications used in health services research: analysis of published studies in the U.S. http://www.medworm.com/index.php?rid=5297965&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F252 Conclusions: The findings highlight a need for HSR investigators to identify more consistently the specific analytical software used in their studies. Knowing that information can be important, because different software packages might produce varying results, owing to differences in the software's underlying estimation methods. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5297965 Thu, 06 Oct 2011 04:00:00 +0100 5297965 Using linked routinely collected health data to describe prostate cancer treatment in New South Wales, Australia: a validation study http://www.medworm.com/index.php?rid=5297964&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F253 Conclusions: Cancer Registry and hospital inpatient data accurately captured radical prostatectomy and brachytherapy treatment, but not external beam radiotherapy or disease stage. Medicare claims data substantially improved the accuracy with which all major treatments were recorded. These administrative data combined are valid for population-based studies of some aspects of prostate cancer care. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5297964 Thu, 06 Oct 2011 04:00:00 +0100 5297964 Should breast cancer survivors be excluded from, or invited to, organised mammography screening programmes? http://www.medworm.com/index.php?rid=5287093&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F249 The objective of this article is to discuss the many contradictory aspects of this matter.DiscussionProblems with mammographic surveillance of breast cancer survivors include: weak evidence of a reduction in mortality; lack of evidence in favour of one setting or the other; lack of evidence-based guidelines for the frequency and duration of surveillance; disproportionate emphasis placed on the first few years post-treatment, probably dictated by surgical and oncological priorities; a variety of screening policies, as these women are permanently or temporarily or partially excluded from many - but not all - organised screening programmes worldwide; an even greater disparity in follow-up protocols used in the clinical setting; a paucity of data on compliance to mammographic surveillance in b... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5287093 Tue, 04 Oct 2011 04:00:00 +0100 5287093 Implementation and first-year screening results of an ocular telehealth system for diabetic retinopathy in China http://www.medworm.com/index.php?rid=5287092&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F250 Conclusions: BCDRT was a reliable and valid system for DR screening, and offers the potential to increase DR annual screening rates in local residents. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5287092 Tue, 04 Oct 2011 04:00:00 +0100 5287092 Assessment of variation in the Alberta Context Tool: The contribution of unit level contextual factors and practice specialty in Canadian pediatric acute care settings http://www.medworm.com/index.php?rid=5287091&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F251 Conclusion: The findings reported here represent the third published argument for validity of the ACT and adds to the evidence supporting its use to discriminate patient care units by all 10 contextual factors. We found evidence of relationships between a variety of individual and unit-level variables that explained much of this between-unit variation for each of the 10 ACT concepts. Future research will include examination of the relationships between the ACT's contextual factors and research utilization by nurses and ultimately the relationships between context, research utilization, and outcomes for patients. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5287091 Tue, 04 Oct 2011 04:00:00 +0100 5287091 Stages of change: A qualitative study on the implementation of a perinatal audit program in South Africa http://www.medworm.com/index.php?rid=5275184&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F243 Conclusion: Insights into the factors necessary for the successful implementation and maintenance of an audit programme and the process of change involved may also be transferable to similar low- and middle-income public health settings where the reduction of the neonatal mortality rate is a key objective in reaching Millennium Development Goal 4. A tool for reflecting on the implementation and maintenance of an audit programme is also proposed. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5275184 Fri, 30 Sep 2011 04:00:00 +0100 5275184 Video calls from lay bystanders to dispatch centers -- risk assessment of information security http://www.medworm.com/index.php?rid=5275183&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F244 Conclusions: Given proper implementation, we found no risks to information security that would advocate against the use of video calls between lay bystanders and Emergency Medical Communication Centers. The identified threats should be used as input to formal requirements when planning and implementing video calls from mobile phones for these call centers. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5275183 Fri, 30 Sep 2011 04:00:00 +0100 5275183 Evaluating Complex Interventions and Health Technologies Using Normalization Process Theory: Development of a Simplified Approach and Web-Enabled Toolkit http://www.medworm.com/index.php?rid=5275182&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F245 Conclusion: Normalization Process Theory has been developed through transparent procedures at each stage of its life. The theory has been shown to be sufficiently robust to merit formal testing. This project has provided a user friendly version of NPT that can be embedded in a web-enabled toolkit and used as a heuristic device to think through implementation and integration problems. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5275182 Fri, 30 Sep 2011 04:00:00 +0100 5275182 Filmless versus film-based systems in radiographic examination costs: an activity-based costing method http://www.medworm.com/index.php?rid=5275181&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F246 Conclusions: The costs of radiographic examinations using a filmless system and a film-based system were calculated using the ABC method. Our results provide clear evidence that the filmless system is more effective than the film-based system in providing greater value services directly to patients. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5275181 Fri, 30 Sep 2011 04:00:00 +0100 5275181 Systematic review of cost and cost-effectiveness of different TB-screening strategies http://www.medworm.com/index.php?rid=5275180&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F247 Conclusion: The available studies on cost-effectiveness provide strong evidence in support of the use of IGRAs in screening risk groups such as HCWs, immigrants from high-incidence countries and close contacts. So far, only two studies provide evidence that the IGRA-only screening strategy is more cost-effective. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5275180 Fri, 30 Sep 2011 04:00:00 +0100 5275180 A systematic exploration of differences in contextual factors related to implementing the MOVE! Weight Management Program in VA: A Mixed Methods Study http://www.medworm.com/index.php?rid=5275179&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F248 Conclusions: Key organizational factors at local VA medical centers were strongly associated with MOVE! implementation. Results pointed to recommendations that can help accelerate large-scale dissemination of complex weight management programs. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5275179 Fri, 30 Sep 2011 04:00:00 +0100 5275179 Barriers to effective discharge planning: A qualitative study investigating the perspectives of frontline healthcare professionals http://www.medworm.com/index.php?rid=5262315&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F242 Conclusions: A systematic approach to develop the structure and key processes of the discharge planning system is critical in ensuring the quality of care and maximizing organization effectiveness. In this study, important views on barriers experienced in hospital discharge were provided. Suggestions for building a comprehensive, system-wide, and policy-driven discharge planning process with clearly identified staff roles were raised. Communication and coordination across various healthcare parties and provisions were also suggested to be a key focus. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5262315 Thu, 29 Sep 2011 04:00:00 +0100 5262315 Clinicians adopting evidence based guidelines: a case study with thromboprophylaxis http://www.medworm.com/index.php?rid=5262317&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F240 Conclusions: Senior clinicians are the key enablers for practice change. They will need to be convinced that guideline compliance adds value to their patient care. Then with the support of systems in the organisation designed to minimize the effects of care fragmentation, they will drive practice changes in their teams. We believe that evidence based practice is only possible with a coordinated program that addresses individual, cultural and organisational constraints. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5262317 Wed, 28 Sep 2011 04:00:00 +0100 5262317 Health services performance for TB treatment in Brazil: a cross-sectional study http://www.medworm.com/index.php?rid=5262316&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F241 Conclusions: Two types of obstacles are faced for health service performance in TB treatment in the cities under analysis, mainly in the Northeast. The first is structural and derives from difficulties to access health services and actions. The second is organizational and derives from the way health technologies and services are distributed and integrated. Incentives to improve care organization and management practices, aimed at the integration of primary, secondary and tertiary services, can contribute towards a better performance of health services in TB treatment. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5262316 Wed, 28 Sep 2011 04:00:00 +0100 5262316 The use of reproductive healthcare at commune health stations in a changing health system in Vietnam http://www.medworm.com/index.php?rid=5262320&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F237 Conclusions: Women choice of providers for FP and RH services that help them plan and protect their pregnancies is driven by socio-economic factors. While the CHS retains significant utilization rates, it is under challenge by preferences for hospital-based delivery and the growing use of private ANC services. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5262320 Tue, 27 Sep 2011 04:00:00 +0100 5262320 Safety Culture in the Maternity Units: a census survey using the Safety Attitudes Questionnaire http://www.medworm.com/index.php?rid=5262319&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F238 Conclusions: The high mean total score on team work and safety climate in the more experienced group of midwives is a predominant finding for the maternity units of Cyprus. In Cyprus where facilities are small in size and midwives know each other, share more responsibility towards patient safety. It could be suggested that younger midwives need more support and teamwork practice to enhance the safety and teamwork climate towards self-confidence. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5262319 Tue, 27 Sep 2011 04:00:00 +0100 5262319 Implementing knowledge into practice for improved neonatal survival; a cluster-randomised, community-based trial in Quang Ninh province, Vietnam http://www.medworm.com/index.php?rid=5262318&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F239 DiscussionThe intervention is participatory and dynamic, focused on developing a learning process and a problem-solving cycle. The study recognises the vital role of the local community as actors in improving their own and their newborns' health, and applies a bottom-up approach where change will be accomplished by an increasing awareness at and demand from grass root level. By utilising the existing healthcare structure this intervention may, if proven successful, be well suited for scaling up.Trial registrationCurrent Controlled Trials ISRCTN44599712 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5262318 Tue, 27 Sep 2011 04:00:00 +0100 5262318 The cost associated with administering risperidone long-acting injections in the Australian community http://www.medworm.com/index.php?rid=5262321&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F11%2F236 Conclusions: The national average saving per two-weekly risperidone long-acting injection avoided is $75.14. In 2009 in Australia, this would have saved ~$11 million for injection administration costs alone if all patients taking two-weekly risperidone LAI had instead been treated with a therapeutically equivalent long-acting injectable antipsychotic requiring one less injection per month. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=5262321 Mon, 26 Sep 2011 04:00:00 +0100 5262321