<p> In recent years, the financial barrier to access for prescription contraceptives has been lifted due to the Affordable Care Act. However, there is still a barrier to access because those who want it still need to get a prescription from a provider. This business plan proposes the establishment of Azura Digital Health, a scheduling tool that obstetricians and gynecologists can use to schedule their appointments, while also offering patients convenience for birth control prescriptions and assistance with finding the women&rsquo;s health provider that is right for them. Allowing patients to choose their provider can increase quality for their health, since they can choose the doctor they feel is best for them. Additionally, the convenience of getting their birth control prescription helps patients get a simple prescription for what they need in a timely manner. The scheduling tool allows providers to market themselves and broaden their patient base, as Azura Digital Health would do that work for them. Azura Digital Health hopes to improve women&rsquo;s healthcare quality, breaking the barrier to prescriber access.</p>

No description available.

The aim of the study described in this thesis is to contribute to our knowledge and understanding of the professional activities of the offshore medic, in particular, their professional position and current status. The study had three stages. Stages one and two were the pilot and main questionnaires. Stage three was an interview survey. The study also sought to place the professional position of the offshore Medic against a background of sociological literature, outlining the characteristics of both the established and semi-professions. The questionnaire and interview surveys sought to obtain the Medic's personal perceptions with other offshore personnel. The study strongly suggests that Medics do not perceive their professional position and status among colleagues, both onshore and offshore as being very high. While Medics do not seem to leave offshore employment readily, many would prefer to be in another form of employment. Most were committed because of the higher salaries paid offshore. All respondents were involved with administrative duties which have very little connection with emergency care or the prevention of ill-health. In some cases, these duties were almost full time occupations. Medics felt that these non-medical tasks tended to erode away professional status. There was also a constant effort to protect patient confidentiality which created tensions. There was little evidence for the frequently supposed total autonomy given to medics to regulate their day to day activity. There was a strong feeling that counselling and health promotion activities were necessary in the offshore situation. Respondents felt strongly that onshore management should encourage active health promotion and counselling by formulating appropriate policy and ascribing health promotion work to the offshore Medics.

<p> Over one-third (78.6 millions) of U.S. adults are obese. Weight management in the typical health care practice is inadequate with fewer than half of primary care physicians consistently providing guidance on diet, physical activity, or weight control. Because 60 percent of Americans get their health insurance through their jobs, employers often bear the bulk of the obesity costs, but are also well-positioned to implement effective lifestyle interventions. The Patient Protection and Affordable Care Act (PPACA) of 2010 included provisions for the incentives and penalties employers and health plans can impose on employees&rsquo; health insurance premiums based on the participation and goal completion in wellness programs giving a major boost to a now rapidly-growing multi-billion dollar workplace wellness industry. Fit4Life, LLC intends to offer on-site wellness, fitness, and nutritional services to medium- to large-size employers with fitness facilities in the Los Angeles Metropolitan area. The company&rsquo;s unique combination of fitness, nutritional, and medical expertise rarely offered by other providers in the Los Angeles area and the convenience of the on-site service model, paired with low start-up and overhead costs are the major strengths likely to contribute to Fit4Life, LLC&rsquo;s success. </p>

It is widely assumed that the Private Health Sector in South Africa caters only for the 16% of the population who can afford to belong to a Medical Aid. However, a number of patients who consult private general practitioners self-fund their health expenses because they do not belong to a Medical Aid. This study measured the proportion of Medical Aid as compared to the Non-Medical Aid encounters in private general practice and the nature and cost of the encounters and medical management differences between these two groups.

背景：中國在發展城市社區衞生服務/基層醫療的過程中，基於當地經濟社會發展情況和特點，主要形成了政府辦政府管、院辦院管、以及私營三種模式。近年來中國學者對大陸社區衞生服務/基層醫療的研究主要關注于服務的基本現狀與功能的描述性研究，以及患者主觀層面的滿意度調查等，對城市社區衞生/基層醫療組織形式與服務模式建設的研究相對缺乏。初級衞生評價工具( Primary Care Assessment Tool, PCAT) 由美國約翰霍普金斯大學初級衞生保健政策中心開發，將初級醫療的五個核心方面進行量化，從患者對社區衞生服務/層醫療服務的客觀體驗角度出發，客觀評價醫療服務品質。本研究關注於基層醫療服務的過程層面，作為珠江三角洲六城市基層醫療研究項目的一部分，聯合廣州醫學院公共衛生與全科醫學學院，在廣東省衞生署以及香港智經研究中心的大力支持下，其他學者將研究基層醫療服務的結構和結果層面。 / 目的：本研究關注從病人體驗角度出發，在城市社區衞生/基層醫療服務的過程層面，評價和比較三種不同的社區衞生服務/基層醫療模式，以及不同地區在實施國家初級衞生政策時的不同策略所導致的在初級醫療五個核心方面的差異。 / 方法：首先，本研究進行了全面的文獻檢索，回顧了PCAT工具在全球和地區的應用。其次，本研究根據國際上認可的跨文化翻譯過程將PCAT（成人簡化版）翻譯成中文官方語言（普通話）並使其與中國國情相適應，並通過問卷的信度和效度分析，證明中文PCAT成人簡化版在評價社區衞生服務/基層醫療的過程層面方面具有較高的可靠性和有效性。進而，本研究採用多階段整群抽樣方法，在珠江三角洲六個城市的社區衞生中心，由訓練有素的調查員進行現場訪談。最後，本研究採用多元線性回歸和多元方差分析統計分析，評估和比較了不同城市和不同模式下，社區衞生服務/基層醫療服務五個核心方面的PCAT分數的差異。 / 結果：中文PCAT（成人簡化版）包含了九個不同維度，從五個方面評價初級保健服務過程，具有良好的結構效度。克隆巴赫係數反映了問卷具有良好的內部一致性。本研究共調查了3,360名在社區衞生服務中心接受基層醫療服務的成人患者，問卷整體回收率達86.1。本研究基於PCAT 分數從不同城市和不同服務模式角度分別評價和比較了社區衞生服務/基層醫療服務的過程。研究發現，與院辦院管及私營模式相比，政府主導模式下的社區衞生服務/基層醫療服務使用者具有更好的病人體驗，主要是因為政府主導模式下，社區衞生服務在首診利用及基層醫療服務協調統籌維度層面達到更高的水準。 / 結論：本博士論文研究確立了中文PCAT（成人簡化版）在評價社區衞生服務/基層醫療服務過程的可靠性和有效性。本研究率先在中國大陸採用PCAT 工具對廣東省珠江三角洲地區城市社區衞生服務/基層醫療模式開展了大規模調查。該項研究可以填補目前中國大陸在PCAT應用以及城市社區衞生服務/基層醫療模式研究方面的空白，探索適合中國國情的社區衞生/基層醫療服務發展道路，為中國大陸進一步發展及完善初級衞生體系提供翔實的政策依據。 / Backgrounds: China’s current healthcare reform has an overall goal towards re-strengthening primary care. Establishment and expansion of primary care network based on community health centres (CHCs) in urban areas has been prioritized. Due to various socio-economic status of local population and policy context across urban areas in mainland China, primary care is delivered by three main organisational models: government-owned CHCs, hospital-owned CHCs, and privately-owned CHCs with each model being adopted in various localities. This PhD study focuses on studying the process of primary care provided under different CHC models in the six cities of Pearl River Delta (PRD) and it is part of a larger study entitled “A Study of Comparing Primary Care Services among Six Cities in the Pearl River Delta funded by Bauhinia Foundation Research Centre, in which other co-investigators have studied the structure and outcome of the primary care. / Objectives: This PhD study aims to use the Primary Care Assessment Tool (PCAT) within Donabedian’s framework of structure, process and outcome to measure and compare the quality attributes of primary care from patient’s perspective under different CHC models in the six cities of PRD where each city has different responses to the national policy for delivering primary care services. / Methods: A comprehensive literature search was conducted to review the utilization of PCAT both globally and locally. The PCAT - Adult Edition (short version) was translated into Mandarin Chinese following an internationally recognized procedure and was cross-culturally adapted into Chinese context. The reliability and validity of the PCAT instrument were evaluated through test-retest approach, exploratory factor analysis, and internal consistency reliability analysis. Multistage cluster sampling method was adopted to select CHCs in the six cities of PRD. All interviews were conducted on-site by trained interviewers. Statistical analysis including multiple linear regression and multivariate analysis of covariance were used to assess and compare the quality attributes of primary care (PCAT scores) provided by different organisational models of CHCs in the six cities of PRD. / Results: The Mandarin Chinese version of PCAT-AE (short version) contains nine primary care scales with good construct validity. Cronbach’s alpha within all the nine primary care scales achieved moderate to high internal consistency reliability. A total number of 3,360 adult primary care service users were surveyed on-site at CHCs with an overall response rate of 86.1%. Descriptive city-by-city analysis based on the PCAT scores was conducted to depict primary care process in each of the six cities. Primary care service users under government-owned CHC model reported receiving better primary care experiences than those under privately-owned CHC model and hospital-owned CHC model, largely because of the greater achievements in first contact utilization and better score in the coordination domain (information system). / Conclusions: The Mandarin Chinese version of PCAT-AE (short version) was found to be reliable and valid as a measure of primary care in mainland China from patients’ perspective. The study suggested that the government-owned CHCs had better quality attributes than other organisational models, and offered a direction for quality improvement in the five domains of primary care. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Wang, Haoxiang. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references. / Abstract also in Chinese; some appendixes also in Chinese. / ABSTRACT --- p.i / ABSTRACT (IN CHINESE) 摘要 --- p.iii / ACKNOWLEDGEMENTS --- p.v / TABLE OF CONTENTS --- p.viii / LIST OF APPENDICES --- p.xii / LISTS OF TABLES --- p.xiii / LISTS OF FIGURES --- p.xv / ABBREVIATIONS --- p.xvi / PREFACE --- p.xvii / Chapter CHAPTER 1: --- BACKGROUND --- p.1 / Chapter 1.1 --- What is Primary Care? --- p.1 / Chapter 1.2 --- Why Primary Care? --- p.2 / Chapter 1.3 --- Healthcare Reform in mainland China --- p.3 / Chapter 1.4 --- Primary Care in Mainland China: A Brief History and Current Status --- p.8 / Chapter 1.5 --- Three CHC models of primary care delivery in urban areas --- p.13 / Chapter 1.5.1 --- Hospital and Hospital-owned CHCs --- p.13 / Chapter 1.5.2 --- Government and Government-owned CHCs --- p.14 / Chapter 1.5.3 --- Private sector and Privately-owned CHCs --- p.15 / Chapter 1.6 --- Pearl River Delta: an open window for primary care research --- p.16 / Chapter 1.7 --- Primary Care Assessment Tool: assessment of primary care from an international perspective --- p.21 / Chapter SUMMARY OF CHAPTER 1 --- p.23 / Chapter CHAPTER 2: --- LITERATURE REVIEW OF PRIMARY CARE ASSESSMENT TOOL --- p.25 / Chapter 2.1 --- Introduction --- p.25 / Chapter 2.2 --- Criteria for review and search strategy --- p.26 / Chapter 2.3 --- Key messages from the literature review --- p.28 / Chapter 2.4 --- Research gaps in the literature --- p.33 / Chapter 2.5 --- Conclusion --- p.34 / Chapter SUMMARY OF CHAPTER 2 --- p.36 / Chapter CHAPTER 3: --- ADAPTION OF PRIMARY CARE ASSESSMENT TOOL IN MAINLAND CHINA --- p.38 / Chapter 3.1 --- Introduction --- p.38 / Chapter 3.2 --- Methods --- p.39 / Chapter 3.2.1 --- Translation of PCAT --- p.39 / Chapter 3.2.2 --- Validation of the translation --- p.40 / Chapter 3.2.3 --- Face validity and peer evaluation --- p.40 / Chapter 3.2.4 --- Pilot test and test-retest reliability --- p.41 / Chapter 3.3 --- Results --- p.43 / Chapter 3.3.1 --- Translation of PCAT into Mandarin Chinese and validation of the translation --- p.43 / Chapter 3.3.2 --- Face validity --- p.46 / Chapter 3.3.3 --- Demographic characteristics of the survey sample in the pilot test --- p.46 / Chapter 3.3.4 --- Test-retest reliability --- p.48 / Chapter 3.4 --- Discussion --- p.48 / Chapter SUMMARY OF CHAPTER 3 --- p.51 / Chapter CHAPTER 4: --- VALIDATION OF MANDARIN CHINESE VERSION OF PRIMARY CARE ASSESSMENT TOOL --- p.53 / Chapter 4.1 --- Introduction --- p.53 / Chapter 4.2 --- Methods --- p.54 / Chapter 4.2.1 --- Study design and study subjects --- p.54 / Chapter 4.2.2 --- Scoring --- p.55 / Chapter 4.2.3 --- Factor analysis and construct validity --- p.57 / Chapter 4.2.4 --- Item analysis and internal reliability --- p.61 / Chapter 4.3 --- Results --- p.62 / Chapter 4.3.1 --- Demographic profile --- p.62 / Chapter 4.3.2 --- Analysis of the correlation matrix --- p.63 / Chapter 4.3.3 --- Factor analysis and construct validity --- p.63 / Chapter 4.3.4 --- Item analysis --- p.66 / Chapter 4.3.5 --- Internal reliability of the primary care scales --- p.67 / Chapter 4.4 --- Discussion --- p.68 / Chapter SUMMARY OF CHAPTER 4 --- p.70 / Chapter CHAPTER 5: --- PRIMARY CARE PROFILES IN SIX CITIES OF PEARL RIVER DELTA --- p.72 / Chapter 5.1 --- Introduction --- p.72 / Chapter 5.2 --- Methods --- p.73 / Chapter 5.2.1 --- The instrument to assess primary care --- p.73 / Chapter 5.2.2 --- Training of the interviewers and the assessment of inter-rater reliability --- p.74 / Chapter 5.2.3 --- Study location and sampling framework --- p.75 / Chapter 5.2.4 --- Target population --- p.76 / Chapter 5.2.5 --- Identification of primary care source --- p.76 / Chapter 5.2.6 --- Data collection --- p.77 / Chapter 5.2.7 --- Statistical analysis --- p.78 / Chapter 5.3 --- Results --- p.79 / Chapter 5.3.1 --- Inter-rater reliability, response rate, and demographic characteristics --- p.79 / Chapter 5.3.2 --- Comparison of primary care assessment scores in the six cities (city-by-city analysis) --- p.80 / Chapter 5.3.2.1 --- Primary care service users and primary care quality attributes in City A --- p.83 / Chapter 5.3.2.2 --- Primary care service users and primary care quality attributes in City B --- p.89 / Chapter 5.3.2.3 --- Primary care service users and primary care quality attributes in City C --- p.94 / Chapter 5.3.2.4: --- Primary care service users and primary care quality attributes in City D --- p.99 / Chapter 5.3.2.5 --- Primary care service users and primary care quality attributes in City E --- p.105 / Chapter 5.3.2.6 --- Primary care service users and primary care quality attributes in City F --- p.110 / Chapter 5.2.3 --- Factors associated with overall primary care experience --- p.115 / Chapter 5.2.4 --- Comparison of primary care assessment scores among the three CHC organisational models --- p.116 / Chapter 5.2.4.1 --- Presence of ‘hukou’ registry and primary care experience --- p.118 / Chapter 5.2.4.2 --- Presence of medical insurance and primary care experience --- p.119 / Chapter 5.2.4.3 --- Presence of chronic disease and primary care experience --- p.122 / Chapter 5.4 --- Discussion --- p.124 / Chapter 5.4.1 --- Patient characteristics and primary care profiles in the six cities --- p.124 / Chapter 5.4.1.1 --- Ageing --- p.126 / Chapter 5.4.1.2 --- Household registry --- p.126 / Chapter 5.4.1.3 --- Medical insurance --- p.127 / Chapter 5.4.2 --- Factors significantly associated with primary care assessment scores --- p.128 / Chapter 5.4.2.1 --- Healthcare utilization and health characteristics --- p.128 / Chapter 5.4.2.2 --- Socio-demographic characteristics --- p.129 / Chapter 5.4.3 --- Primary care experience in the government-owned CHC --- p.130 / Chapter 5.4.3.1 --- Separation between revenue and expenditure --- p.130 / Chapter 5.4.3.2 --- Central planning and multi-sectoral collaboration --- p.130 / Chapter 5.4.3.3 --- Towards health equality --- p.131 / Chapter 5.4.3.4 --- First contact --- p.132 / Chapter 5.4.3.5 --- Suboptimal service capacity --- p.132 / Chapter 5.4.4 --- Primary care experience in the privately-owned CHC --- p.133 / Chapter 5.4.4.1 --- Lower healthcare utilization --- p.133 / Chapter 5.4.4.2 --- Insufficient funding support --- p.134 / Chapter 5.4.5 --- Primary care experience in the hospital-owned CHC --- p.135 / Chapter 5.4.5.1 --- Large service capacity --- p.135 / Chapter 5.4.5.2 --- Tackling aging population with chronic diseases --- p.136 / Chapter 5.4.5.3 --- CHCs in the less socio-economic developed urban area --- p.136 / Chapter 5.4.5.4 --- Disparities due to socio-demographic status --- p.137 / Chapter 5.4.6 --- Study limitations --- p.137 / Chapter 5.4.7 --- What is already known and what this study adds --- p.139 / Chapter SUMMARY OF CHAPTER 5 --- p.141 / Chapter CHAPTER 6: --- CONCLUSION AND POLICY IMPLICATIONS --- p.144 / Chapter 6.1 --- Conclusion --- p.144 / Chapter 6.2 --- Policy implications for mainland China --- p.146 / REFERENCES --- p.150 / APPENDICES --- p.161

<p> <i>Purpose:</i> Implement and evaluate a formal evidence-based risk screening protocol in a rural clinic setting to optimize early identification of prediabetes and T2DM in asymptomatic, non-pregnant adults age 18&ndash;44. </p><p> <i>Significance:</i> Absence of an evidence-based risk screening protocol contributed to under/overutilization in laboratory test referral and inconsistency in prescribed treatments among clinic providers. Early identification of prediabetes and initiation of appropriate treatment plans may assist in preventing T2DM and its associated complications. </p><p> <i>Methodology:</i> Quality improvement project utilizing a retrospective, randomized representative sample of charts, <i>n</i> = 30 and a convenience sample of participants, <i>n</i> = 40. The American Diabetes Association Diabetes Risk Test (ADA DRT) served as a prediabetes risk screening tool. Provider adherence to ADA DRT risk screening and laboratory test referral, type of laboratory test ordered, the relationship between demographic characteristics and the ADA DRT score, participant follow-up, and treatment ordered based on risk screening and laboratory results were analyzed using group data. </p><p> <i>Results:</i> Thirteen (35.7%) participants had laboratory values in the prediabetes or T2DM range and 100% of treatment ordered are substantiated by ADA guidelines. Using the ADA DRT tool, risk screening was completed in 100% of eligible participants; accordingly, appropriate utilization of laboratory test referral improved by 33.33%. </p><p> <i>Recommendation:</i> Incorporation of best-practices for risk screening and laboratory test referral for early identification of prediabetes is needed. APRNs are instrumental in promoting efficacious screening strategies and preventative treatment aimed at improving health outcomes. The benefits of using the ADA DRT as a prediabetes risk screening protocol in primary care should be elucidated in a prospective study.</p><p>

No description available.

Thesis (MPH)--University of Limpopo, 2009. / Background Primary Health Care is a basic mechanism that brings healthcare as close as possible to the people. In South Africa, it is seen as a cost effective means of improving the health of the population. It is provided free of charge by the government. This service should be accessible to the population so as to meet the millennium health goals. Aims The aims and objectives of the study were: • To investigate whether Primary Health Care services were accessible to the communities of Tshwane Region. • To determine the utilization of the health care services in the three Community Health Care centres of Tshwane Region. Methodology Data were collected at the three Community Health Care centres of Tshwane Region using self-administered questionnaires. A document review of the Community Health Care centres records was conducted to investigate the utilization trends of services. Descriptive statistics were used. The analysis was based on the information that was elicited from the questionnaires that the people who utilize the Community Health Care centres of Tshwane Region provided. The extracted data emanating from the records from the three centres were also used. Results The study demonstrated that in terms of distance, the Community Health Care centres of Tshwane Region are accessible as most participants lived within 5km. They traveled 30 minutes or less to the clinic. The taxi and walking was the most common form used to access the clinic. The services were utilized with the Tuberculosis clinic being the most visited. Generally, people were satisfied with the service and their health needs are met. Conclusion The Community Health Care centres of Tshwane Region are accessible and utilized effectively. Key words: Primary Health Care, accessibility, utilization.

Thesis (MPH) -- University of Limpopo, 2011.