eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
155
157
10.15171/ijhpm.2014.47
2844
Patient Mobility in the Global Marketplace: A Multidisciplinary Perspective
Neil Lunt
neil.lunt@york.ac.uk
1
Russell Mannion
r.mannion@bham.ac.uk
2
Department of Social Policy and Social Work, University of York, Heslington, York, UK
Health Services Management Center, University of Birmingham, Birmingham, UK
There is a growing global market in healthcare and patients. And while there is a small body of evidence emerging around this phenomenon commonly known as medical tourism there remain significant unanswered policy and research questions which need to be addressed. We outline some of the key issues set against the six key disciplinary preoccupations of the journal: epidemiology, health economics, health policy ethics, politics of health, health management, and health policy.
https://www.ijhpm.com/article_2844_0e19d41d8904ab54295fa0d11545f353.pdf
Medical Tourism
Patient Mobility
Cross-Border Care
International Patients
Private Healthcare
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
159
160
10.15171/ijhpm.2014.40
2835
Exploring the Dimensions of Doctor-Patient Relationship in Clinical Practice in Hospital Settings
Saurabh Shrivastava
drshrishri2008@gmail.com
1
Prateek Shrivastava
prateekbobhate@gmail.com
2
Jegadeesh Ramasamy
tbcaremumbai4@gmail.com
3
Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Kancheepuram, India
Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Kancheepuram, India
Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Kancheepuram, India
The Doctor-Patient Relationship (DPR) is a complex concept in the medical sociology in which patients voluntarily approach a doctor and thus become a part of a contract in which they tends to abide with the doctor’s guidance. Globally, the DPR has changed drastically over the years owing to the commercialization and privatization of the health sector. Furthermore, the dynamics of the DPR has shown a significant change because of the formulation of consumer protection acts; clauses for professional misconduct and criminal negligence; establishment of patient forums and organizations; massive expansion of the mass media sector leading to increase in health awareness among people; and changes in the status of the doctors. Realizing the importance of DPR in the final outcome and quality of life of the patient, multiple measures have been suggested to make a correct diagnosis and enhance healing. To conclude, good DPR is the crucial determinant for a better clinical outcome and satisfaction with the patients, irrespective of the socio-cultural determinants.
https://www.ijhpm.com/article_2835_14f19dbe5229b49b695d3641a9e14881.pdf
Doctor
Doctor-Patient Relationship (DPR)
Communication
Hospital
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
161
166
10.15171/ijhpm.2014.37
2834
Limited Knowledge of Chronic Kidney Disease and Its Main Risk Factors among Iranian Community: An Appeal for Promoting National Public Health Education Programs
Peyman Roomizadeh
roomizadeh@gmail.com
1
Diana Taheri
d_tahererir@hotmail.com
2
Amin Abedini
amin69.med@gmail.com
3
Mojgan Mortazavi
mmortazav3@hotmail.com
4
Mehrdad Larry
laarryms@hotmail.com
5
Bahareh Mehdikhani
bm_mehdikhani@hotmail.com
6
Seyed-Mojtaba Mousavi
mousamoj@hotmail.com
7
Farid-Aldin Hosseini
p_roomi4144@hotmail.com
8
Aidin Parnia
p_roomi4144@yahoo.com
9
Manouchehr Nakhjavani
nakhjavbanim@hotmail.com
10
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Endocrinology and Diabetes Division, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
Endocrinology and Diabetes Division, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Endocrinology and Diabetes Division, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
Background The aim of this survey was to explore the baseline knowledge of the Iranian community about Chronic Kidney Disease (CKD) definition and its two main risk factors, i.e. diabetes and hypertension. This study also introduced a model of public education program with the purpose of reducing the incidence of CKD in high-risk groups and thereby decreasing the economic burden of CKD in Iran. Methods This cross-sectional study was conducted on world kidney day 2013 in Isfahan, Iran. Self-administered anonymous questionnaires evaluating the knowledge of CKD and its risk factors were distributed among subjects who participated in a kidney disease awareness campaign. Chi-square test and logistic regression analysis were used to examine the differences in the level of knowledge across different socio-demographic groups. Results The questionnaires were completed by 748 respondents. The majority of these respondents believed that “pain in the flanks” and “difficulty in urination” was the early symptoms of CKD. Roughly, 10.4% knew that CKD could be asymptomatic in the initial stages. Only 12.7% knew diabetes and 14.4% knew hypertension was a CKD risk factor. The respondents who had a CKD risk factor (i.e. diabetes and/or hypertension) were significantly more likely than respondents without CKD risk factor to select “unmanaged diabetes” [Odds Ratio (OR)= 2.2, Confidence Interval (CI) (95%): 1.4–3.6] and “unmanaged hypertension” [OR= 1.9, CI(95%): 1.2–3.0] as “very likely to result in CKD”. No more than 34.6% of all respondents with diabetes and/or hypertension reported that their physician has ever spoken with them about their increased risk for developing CKD. Conclusion The knowledge of Iranian population about CKD and its risk factors is low. Future public health education programs should put efforts in educating Iranian community about the asymptomatic nature of CKD in its initial stages and highlighting the importance of regular renal care counseling. The high-risk individuals should receive tailored education and be encouraged to adopt lifestyle modifications to prevent or slow the progression of CKD.
https://www.ijhpm.com/article_2834_99440f9f3630c500deb75464c049b32e.pdf
Chronic Kidney Disease (CKD)
Knowledge
Diabetes
Hypertension
Prevention
Iran
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
167
174
10.15171/ijhpm.2014.38
2836
Strategic Collaborative Quality Management and Employee Job Satisfaction
Ali Mohammad Mosadeghrad
mosadeghrad@gmail.com
1
Health Management and Economics Research Centre, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran
Background This study aimed to examine Strategic Collaborative Quality Management (SCQM) impact on employee job satisfaction. Methods The study presents a case study over six years following the implementation of the SCQM programme in a public hospital. A validated questionnaire was used to measure employees’ job satisfaction. The impact of the intervention was measured by comparing the pre-intervention and post-intervention measures in the hospital. Results The hospital reported a significant improvement in some dimensions of job satisfaction like management and supervision, organisational policies, task requirement, and working conditions. Conclusion This paper provides detailed information on how a quality management model implementation affects employees. A well developed, well introduced and institutionalised quality management model can improve employees’ job satisfaction. However, the success of quality management needs top management commitment and stability.
https://www.ijhpm.com/article_2836_48a7d515be7af72a95b39763952c3a32.pdf
Strategic Collaborative Quality Management
Employee Job Satisfaction
Hospital
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
175
180
10.15171/ijhpm.2014.39
2837
National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure?
Olayinka Ilesanmi
ileolasteve@yahoo.co.uk
1
Akindele Adebiyi
adebiyi20012002@yahoo.com
2
Akinola Fatiregun
akinfati@yahoo.com
3
Department of Community Health, Federal Medical Centre, Owo, Ondo State, Nigeria
Department of Community Health, Federal Medical Centre, Owo, Ondo State, Nigeria
Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
Background The major objective of the National Health Insurance Scheme (NHIS) in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE) is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE. Methods The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done. Results The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars) and the range was 7,000–680,000 naira (46.7–4,533 US dollars) in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars) and the range was 10-17,700 naira (0.1–118 US dollars) in 2012. In all, 67 (9.4%) households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9%) and CHE occurred in 42 (6.6%) households. CHE occurred in 14 (10.9%) of the households in the lowest quintile compared to 3 (2.5%) in the highest wealth quintile (P= 0.004). The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI): 4.7 (1.3–16.8), P= 0.022. Non enrolled households were two times likely to have CHE, though not significant Conclusion Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE.
https://www.ijhpm.com/article_2837_a1c2a72b48a82940a19afb06e2e8f6f6.pdf
National Health Insurance Scheme (NHIS)
Catastrophic Health Expenditure (CHE)
Households
Wealth Quintiles
Cost
Healthcare Utilization
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
181
185
10.15171/ijhpm.2014.43
2840
Does Tuberculosis Have a Seasonal Pattern among Migrant Population Entering Iran?
Mahmood Moosazadeh
mmoosazadeh1351@gmail.com
1
Narges Khanjani
narges.khanjani@gmail.com
2
Abbas Bahrampour
abahrampour@yahoo.com
3
Mahshid Nasehi
mnasehi@yahoo.com
4
Mazandaran University of Medical Sciences, Sari, Iran
Neurology Research Center, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
Department of Biostatistics and Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, Iran
Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
Background There are few quantitative documents about the seasonal incidence of tuberculosis (TB) among immigrant populations. Concerning the significant role of recognizing seasonal changes of TB in improving the TB control program, this study determines the trend and seasonal temporal changes of TB among immigrants entering Iran. Methods In this longitudinal study, data from the Iranian TB register Program (from 2005 to 2011) was used. The aggregated number of monthly and seasonal TB cases was obtained by adding the daily counts. Data was analyzed by Chi-square, Independent T-test, ANOVA, and Poisson regression using Stata 11 and SPSS 20 software. Results Among 74,155 registered patients with TB, 14.3% (10,587) were non-Iranian who had immigrated to Iran from 29 different countries. The highest aggregated number of seasonal and monthly incidence of TB in immigrants was observed in spring (2824, P= 0.007) and in May (1037, P< 0.001). The number of non-Iranian patients with TB increased significantly over the years (β= 0.016, P= 0.001). Conclusion This study shows that immigrants constitute a significant portion of TB patients recorded in Iran and this trend is increasing. Also, the peak incidence of this disease is the second month of the spring.
https://www.ijhpm.com/article_2840_78407f40ceb377be090637c5fbf160b4.pdf
Tuberculosis (TB)
Seasonality
Iran
Migrant
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
187
191
10.15171/ijhpm.2014.44
2841
The Financial Cost of Preventive and Curative Programs for Breast Cancer: A Case Study of Women in Shiraz-Iran
Nahid Hatam
hatamn@sums.ac.ir
1
Vahid Keshtkar
keshtkarv@sums.ac.ir
2
Asiyeh Salehi
nasim.salehi@griffithuni.edu.au
3
Hamidreza Rafei
4
School of Health Administration and Medical Information, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Griffith Health Institute, Griffith University, QLD, Australia
School of Health Administration and Medical Information, Shiraz University of Medical Sciences, Shiraz, Iran
Background This cross-sectional study was conducted to compare the average costs of breast cancer screening and treatment among women with the age of 25 and over in Shiraz-Iran. Methods Three majors hospitals affiliated with Shiraz University of Medical Sciences (SUMS) were selected for data collection. Financial documents and interviews with the hospitals’ financial officers were used for data collection. Results Finding shows that the total cost of screening would be 5,847,544.96 US dollars for age groups of 25–34 and 35 and above, demonstrating the huge expense of screening programs. On the other hand, the average cost of breast cancer treatment for each patient would be 3608.47, 996.89, and 311.47 US dollars for mastectomy, radiotherapy, and chemotherapy, respectively. In addition, the total average cost for treatment of 2217 patients would be 1,466,988.9 US dollars, which is much less than screening programs expenses. Conclusion It is concluded that although screening can be effective for improving quality of life and treatment effectiveness, considering the high costs of screening, it is not economical in Iran. Screening methods within suitable intervals, and also considering patients’ medical history have been recommended by the present study.
https://www.ijhpm.com/article_2841_a5c9c4771dc4c2899b897d33c42efafe.pdf
Breast Cancer
Screening
Treatment
Cost-Effectiveness
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
193
197
10.15171/ijhpm.2014.46
2843
Improving Immunization Rates of Underserved Children: A Historical Study of 10 Health Departments
Donald Haley
rhaley@unf.edu
1
Health Administration Programs, Public Health Department, Brooks College of Health, University of North Florida, Florida, USA
Background Despite high immunization rates, hundreds of thousands of poor and underserved children continue to lack their necessary immunizations and are at risk of acquiring a vaccine-preventable disease. Local Health Departments (LHDs) and public health clinicians figure prominently in efforts to address this problem. Methods This exploratory research compared ten (10) North Carolina LHDs with respect to immunization delivery factors. The study sample was identified based on urban designation as well as county demographic and socio-economic indicators that identified predicted “pockets” of underimmunization. Survey instruments were used to identify specific LHD immunization delivery factors. Results It was found that hours of operation, appointment policies, use and type of tracking systems, and wait times influence a health department’s ability to immunize underserved children. This exploratory research is of particular importance, because it suggests that the implementation of specific policy interventions may reduce the morbidity and mortality related to vaccine-preventable diseases in poor and underserved children. This research also highlights the significance of the nurses’ role in the policy making process in this important area of community health assurance. Conclusion To improve childhood immunization rates, policy-makers should encourage adequate and appropriate funding for LHDs to adopt service delivery factors that are associated with higher-performing local health departments. LHDs should study the population they serve to further refine service delivery factors to meet the population’s needs.
https://www.ijhpm.com/article_2843_8f768301e5c0dcc9d9b29d70cb2660ed.pdf
Health Status
Immunizations
Public Health Department
Children
Uninsured
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
199
200
10.15171/ijhpm.2014.41
2838
Toward More Compassionate Healthcare Systems; Comment on “Enabling Compassionate Healthcare: Perils, Prospects and Perspectives”
Beth Lown
blown@mah.harvard.edu
1
The Schwartz Center for Compassionate Healthcare, Boston, MA, USA
Compassion is central to the purpose of medicine and the care of patients and their families. Compassionate healthcare begins with compassionate people, but cannot be consistently provided without systemic changes that enable clinicians and staff to collaborate and to care. We propose seven essential commitments to foster more compassionate healthcare organizations and systems: a commitment to compassionate leadership, to teach compassion, to value and reward compassionate care, to support clinical caregivers, to involve and partner with patients and families, to build compassion into the organization of healthcare delivery, and a commitment to deepen our understanding of compassion and its impact through research. Acting on these commitments will help us attend with care to the ill, injured, and vulnerable in every interaction.
https://www.ijhpm.com/article_2838_eb9385eac7b3fbf76eb6065928088d1d.pdf
Compassion
Healthcare Quality
Professional-Patient Relations
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
201
202
10.15171/ijhpm.2014.42
2839
Sharpening the Health Policy Analytical Rapier; Comment on “The Politics and Analytics of Health Policy”
Martin Powell
m.powell@bham.ac.uk
1
Health Services Management Centre, School of Social Policy, The University of Birmingham, Birmingham, UK
This commentary on the Editorial ‘The politics and analytics of health policy’ by Professor Calum Paton focuses on two issues. First, it points to the unclear links between ideas, ideology, values, and discourse and policy, and warns that discourse is often a poor guide to enacted policy. Second, it suggests that realism, particularly ‘programme theory’ are useful tools for health policy analysis. ‘Market reform’ cannot be reduced to a simple ‘four legs good, two legs bad’ verdict, and programme theory might suggest that certain mechanisms may be good for one outcome in a particular context, but bad for another.
https://www.ijhpm.com/article_2839_d6fed134fc1b5ea872ae7e7a2d3a6dab.pdf
Health Policy
British National Health Service (NHS)
Discourse
Realism
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2014-05-01
2
4
203
204
10.15171/ijhpm.2014.45
2842
Ingredients for Good Health Policy-Making: Incorporating Power and Politics into the Mix
Yusra Shawar
yusra.shawar@jhu.edu
1
Department of Public Administration and Public Policy, American University, Washington, USA
https://www.ijhpm.com/article_2842_47994110c904ba24c33d58ac43012ad5.pdf
Health Policy
Power
Politics
Policy Analysis
Policy Theory