Showing papers on "Health management system published in 1999"

[Evidence-based health care].

Abstract: Health care evidence based is a 90's trend of health professionals interested in the scientific development of effectiveness and efficiency research into the health management and introducing scientific evidence into the health decision-making process. The development of health services research, outcome management and evidence based medicine, makes possible the new orientation of heath systems toward health care evidence based. That means health services provided with the maximum quality, effectiveness, appropriateness and taking into account the informed patients preferences. If we want to see health care evidence based fully working among managers and clinicians, we need the development of information systems directed to the measurement of clinical outcomes in terms of effectiveness and efficiency, as well as specific plus tailored training programs and, pushing focused research areas into the improvement of health services provided at hospital and primary care levels.

Integrating cost information with health management support system: an enhanced methodology to assess health care quality drivers.

Abstract: Changes in health care delivery, reimbursement schemes, and organizational structure have required health organizations to manage the costs of providing patient care while maintaining high levels of clinical and patient satisfaction outcomes. Today, cost information, clinical outcomes, and patient satisfaction results must become more fully integrated if strategic competitiveness and benefits are to be realized in health management decision making, especially in multi-entity organizational settings. Unfortunately, traditional administrative and financial systems are not well equipped to cater to such information needs. This article presents a framework for the acquisition, generation, analysis, and reporting of cost information with clinical outcomes and patient satisfaction in the context of evolving health management and decision-support system technology. More specifically, the article focuses on an enhanced costing methodology for determining and producing improved, integrated cost-outcomes information. Implementation issues and areas for future research in cost-information management and decision-support domains are also discussed.

Home health management system

Abstract: PROBLEM TO BE SOLVED: To provide a health management system which automatically makes a detailed check presupposing an individual health history as to daily health data and gives advice about health and sickness at any time, and predicts sickness accompanying the changes of weather and takes previous treatments. SOLUTION: For this health management system, a computer network system equipped with a two-way video, audio, and data communication function is structured among a health care contact member HM, a care center CS, and a medical institution CD; and daily health data on members are monitored on terminal equipment TE at a service center and the medical institution and stored as member's individual databases and model discriminants which make clear the correlation between weather factors affecting the functions of the body and sickness are prepared to predict sickness accompanying the changes of weather. COPYRIGHT: (C)2001,JPO

Country experience in organizing for quality: Zambia.

Abstract: This article describes the activities of the Quality Assurance Program (QAP) within the Central Board of Health (CBH) in Zambia. QAP provides training and technical support to quality assurance (QA) to District Health Management Teams (DHMTs) and health centers. DHMT members were trained as QA facilitators. Training in target districts first addressed the setting and monitoring of standards. Training later focused on development of problem solving capacity. Health providers were trained by central staff to self-assess to measure performance to agreed standards and to respond to client-user needs. The Directorate of Monitoring and Evaluation provides training and oversight in QA to the DHMTs and their health centers. Training generally consists of a sensitization workshop week-long training in dynamic standard setting 5-day training in development of monitoring indicators at the district and facility level and 2-week skills training in use of QA tools. CBH monitors quality by quarterly performance audits supervision visits by DHMTs and the health management information system (HMIS). The new HMIS was piloted in 15 districts and is being established nationwide. CBH developed a manual of standards for 6 priority health areas: reproductive health and family planning HIV/AIDS and sexually transmitted diseases child health and nutrition tuberculosis and water and sanitation. 85 QA teams operate in 90% of the districts. Problem solving methods have led to team building among professionals increased competence of staff to address problems and capacity building for management.

An informational approach to health management in low-income countries.

Abstract: This thesis investigates the introduction of new information management strategies intended to promote an informational approach to management at the operational health service level in low-income countries. There is a lack of in-depth empirical research into the health information systems planning and implementation process in low-income countries which develops an understanding based on existing theory and research. Furthermore, a training package for managers, which is intended to strengthen health information management in low-income countries, has been introduced without independent evaluation. In order to understand the practice and attempts at improving information support to district level management in low-income countries, two ethnographic case studies are presented. The first follows the introduction of PHC MAP, the package mentioned, and the second follows the implementation of a non- computer-based health management information system in Uganda. The research methodology is informed by several approaches which fit within the interpretative, rather than the positivist tradition. Hence, the research question developed from the desire to understand and examine empirical situations. Furthermore, an exploratory approach was utilised rather than identifying theoretical frameworks prior to the field investigation. After the initial fieldwork, the diffusion of innovation framework, the concept of organisational forces existing in dynamic equilibrium, and different information systems development methodologies proved useful in interpreting the evidence collected. My research indicates that the design of PHC MAP and the health management information system focused on technological issues, to the detriment of the wider issues of technological innovation management, and organisational change. The implications of this research, for the practice of introducing new information strategies in order to develop an informational approach to management, are explored.

Evaluating Interventions to Health Organisation

Abstract: The subject of this chapter is research into health management and policy interventions. It considers why there is relatively little research into organisational changes, management methods and health reforms. It notes the research problems and designs which have been used to evaluate quality methods and which can be used to study other interventions. Finally the chapter considers how managers can gain access to and assess research which could help them in their decisions. The chapter does not argue for evidence-based management, but does propose that managers and policy makers make a greater use of evaluation research. It proposes that the reasons they do not are as much the fault of researchers as they are due to the politicisation of health and the nature of decision making in health care.

Primary health care revitalization in Azerbaijan.

Abstract: Of Azerbaijan's 7,564,800 inhabitants, 52.2% live in urban and 47.8% in rural areas. With the transition to market-oriented economy, health problems have worsened. Expenditures for health care fell from 2.9% of GDP in 1990 to 1.2% in 1997. In case of illness, 37% of population prefer self-treatment, and 68% of treatment refusals are due to the inability of patients to pay for the treatment. Maternal mortality rate increased from 10.5 deaths per 100,000 live births in 1991 to 52 deaths per 100,000 live births in 1996. However, diphteria has been reduced to sporadic cases, whereas polio has not been reported since 1996. A pilot reform of primary health care was initiated in one of the districts, and soon expanded to four more districts. The aims were the improvement of health management, rationalization/optimization through development of traditional services, organization of preventative activities, rational use of drugs, institution of sustainable financial mechanisms through affordable fees for services, drug sales within health facilities with corresponding management and the accounting systems for the revenues, development of the exemption system, and community participation in district health. Increased patient attendance to health facilities, improved access to the vulnerable population health services, empowered health system management, better quality of care, and reduced overall individual expenditures were observed.

The Prospect for Occupational Health Nursing Activities in Small and Medium Sized Workplaces

Abstract: The Prospect for Occupational Health Nursing Activities in Small and Medium Sized Workplaces: Moon-Hee JUNG. Department of Nursing, College of Medicine, Hanyang University—In Korea, nurses perform their services in different ways according to the scale of the workplace: In large workplaces they work as full-timers and in small and medium ones they work as visiting nurses, placed by health management agencies. Regardless of their ways of service, occupational health nurses conduct a large part of health management affairs. Health management affairs have so far aimed at decreasing occupational diseases, but when working conditions are improved and occupational diseases decrease, their goals will be changed, aiming at the health promotion and the prevention of general diseases which have been steadily increasing. As occupational health nursing activities are expected to be changed to accomplish such goals, the roles of nurses are also expected to be expanded. The expected role of nurses is to provide high quality professional services suitable for the scale of the workplace, the nursing activity methods and the goals of health management. In practice, however, there are not a few restraints on them to adequately perform such roles. Most of all, because of poor working conditions, their turnover is high and their term of service is short. In relation to this, the tendency to replace them with less experienced nurses may give rise to quite a few problems in maintaining reliable relationships with workplaces as well as providing professional services. Therefore, in order to produce high-quality professional services, it is necessary to improve the working conditions of nurses so as to secure nurses who can work for a long time. What is most important is to allow occupational health nurses to perform standard services by function. (J Occup Health 1999; 41: 47-50)

National information system on hospital treatment.

Abstract: National information system on hospital treatment (HOSTREAT) supports health management system applied by the Ministry of Health and its professional services at the Public Health Institute of Slovenia. The main project objective was data quality, having in mind advanced analytical methods such as knowledge discovery in databases. The step was a huge one, as the related national statistics rests on every single hospital event, called an episode. By the project definition, an episode covers therapeutic treatment of one sick or injured person in one hospital within one health service specialty. So, many problems arose within the three years of project phases. Much research work was to be done on programming tools and the information system itself. This paper deals with five strategic problems and corresponding corrective actions.

Health, illness, and homeless women: A phenomenological study

Abstract: The purpose of this phenomenological study was to provide a description of the way homeless women view and handle their health. A convenience sample consisted of ten women theoretically representative of the women in an emergency shelter population. Respondents completed a demographic form and participated in an audiotaped interview. Interviews were transcribed and summarized. Data were analyzed for meanings and thematic relationships using phenomenology methodology. The emerging categories were belief system, health needs, health management, and health care roles. Belief system, encompassing a deity or self as users of the environment and survivors of the situation, canopied like an umbrella over needs, management and roles. Sense of control and positiveness derived from the belief system were overriding influences in perceptions of health. Health needs of concern were physiological, developmental, or psychological in nature. Physiological needs were related to communicable diseases, chronic illnesses, or pregnancy. Developmental needs centered on dependent children. Psychological needs were associated with histories of family instability and substance or physical abuse. Health management included health promotion and protection. Health promotion activities focused on nutrition, exercise, personal hygiene, environmental hygiene, children, and attitude. Health protection included primary prevention avoiding specific health problems, secondary prevention facilitating early diagnosis and intervention, and tertiary prevention restoring optimum performance. Health care roles functioned as manipulators, participators, or spectators within the environment and situation. Manipulators exhibited proactive responses to health needs and management by exercising control and choice. Participators' responses were reactive choosing involvement with less control. Spectators expressed passive responses associated with lack of control and negativeness. Findings indicated perceptions and management of health were more effective as a positive force and endeavor in which control existed. Respondents demonstrated considerable resilience in discovering ways to overcome and thrive. Homeless women were knowledgeable about health promotion and chose to access health care that was acceptable to them. Providers must listen to their needs and locate in the homeless environment with health promotion and prevention activity that fosters the individual's role as responsible for decisions. Further research in other environments is wan-anted to determine if beliefs, knowledge, and behaviors can be replicated.