Bakgrund: Prioriteringar inom primärvård och psykiatrisk vård skiljer sig åt och skapar problem i integreringen när patienter remitteras mellan vårdinrättningarna. Människor som lever med somatisk och psykisk samsjuklighet upplever ofta vården som otillräcklig. Patienter känner sig mer tillfreds med vården när det finns en samverkan mellan de involverade vårdenheterna. Syfte: Syftet var att beskriva hur vuxna patienter med samsjuklighet uppfattar samverkan mellan somatisk och psykiatrisk vård. Metod: Studien är en strukturerad litteraturstudie med induktiv ansats. Resultat: Analysen frambringade tre kategorier; negativa aspekter av vårdens samverkan, positiva aspekter av vårdens samverkan och samverkan ur ett helhetsperspektiv. Att inblandade parter tog ansvar för omvårdnaden och en icke- fragmenterad vårdorganisation, som hade tät samverkan mellan vårdenheter, upplevdes som positivt. Brist på kontinuitet i patientens omvårdnad skapade frustration. För patienter med psykisk ohälsa kan fragmenterade vårdinsatser vara ett hinder. Om psykiatrisk- och somatisk vård samverkar så att båda instanserna är tillgängliga inom samma enhet gynnar det patienterna. Slutsats: Det finns både organisatoriska och personalrelaterade faktorer som behöver förbättras. God samverkan, tydligt ansvar och en holistisk omvårdnad var de viktigaste fynden i denna litteraturstudie. / Background: Priorities in primary- and psychiatric care differs, generating problems with integration, when patients are referred between care facilities. People with somatic and mental illness often experience care as inadequate. Patients feel more satisfied with the care when there is a cooperation between the care units. Aim: The aim was to describe how adult patients with comorbidity perceive the cooperation between somatic and psychiatric care. Method: The study is a structured literature study with an inductive approach. Result: Three main themes emerged; negative aspects of care cooperation, positive aspects of care cooperation and cooperation from a holistic perspective. It was perceived as positive if parties involved took responsibility for nursing and a non-fragmented care organization that had close cooperation between care units was perceived as positive. Lack of continuity in patient care created frustration and for patients with mental illness fragmented care interventions were an obstacle. If psychiatric-and somatic care cooperate so that access to both instances within the same unit is possible, it is beneficial to the patients. Conclusion: There are both organizational and personnel-related factors in need of improvement. Good cooperation, clear guidelines and a holistic care perspective were the most important findings of this literature study.

No description available.

Thesis (M. Dev.) --University of Limpopo, 2013 / Section 27 of the Constitution of the Republic of South Africa, 1996 provides that everyone has a right to have access to health care. South Africa embraces the concept of universal health care coverage. Access to health care has four dimensions: geographic accessibility, availability, financial accessibility and acceptability. If there were barriers to access to health care, the stake-holders would be duty-bound to design interventions requisite to address those barriers. The aim of the study was to establish whether health care users enjoy the right to have access to health services at Ratshaatsha Community Health Centre (RCHC). The study used a combination of quantitative and qualitative research designs. While a questionnaire was used to collect quantitative data, focused group discussions and participant observations were employed to collect qualitative data. The following are the main findings of the study. Human rights instruments clearly spell out the indivisible and mutually supportive rights that persons have. There are barriers that often affect the rights to have access to health services at RCHC. For instance, the RCHC is not within a 25 km radius of some of the consumers of health care. The roads that link up the health care users and RCHC are in poor condition. The community is generally poverty-stricken. Many cannot afford, among others, the costs of basic needs, transport fares and opportunity costs. Travelling distance and time, scarce skills and lack of medication and equipment rank among demand-side and supply-side barriers to access to health care. Health care users often choose to consult churches and traditional healers. It is recommended that government should, among others, co-ordinate primary health care services in collaboration with churches and traditional healers; commission research into traditional health medicine and healing procedures and protocols of other health care providers; develop policy on cross-referral of patients; improve community participation; set minimum norms and standards for the delivery of alternative health care services; establish health care management guidelines for churches and traditional healers; integrate health care provisioning into IDPs; and provide health care in an integrated intergovernmental manner.

INTRODUCTION. The perinatal mortality rate is of concern worldwide. In South Africa at the time of the study, 2000, it was estimated to be of the order of 40/1000 live births. However in the setting in which this study took place, namely Tembisa, (Ekhuruleni, Gauteng, South Africa) it was said to be 50/1000 live births. One of the patient- related avoidable factors that has been found to be associated with perinatal and to a lesser extent maternal mortality, is either no, or late initiation of antenatal care. It has been found in an area which, is in many respects similar to Tembisa that 50% of women go the private general practitioner (PGP) for confirmation of pregnancy but, due of lack of funds, do not continue care with the private practitioner but, initiate care in the public sector and in a proportion of these women, this is at an advanced gestational age, making it difficult to prevent or intervene if there are problems in the pregnancy. As (PGP’s) are well placed in the district to render antenatal care, it was decided to perform a study looking at the effect of involving them in the antenatal care of women who presented to them for confirmation of pregnancy. METHODS Sixteen general practitioners agreed to be part of the study. The women who confirmed their pregnancy and who were going to deliver in Tembisa hospital were included in the study after giving written informed consent. They comprised the intervention group, the first antenatal visit was performed, the findings were recorded on the antenatal card which is used in the public sector and which was introduced to the private practitioner at 2 workshops held by the Department of Obstetrics and Gynaecology, University of Pretoria prior to the study. The woman was then to attend antenatal care with the private practitioner until delivery. The private general practitioners waived the costs normally associated with this care for the period of the study. The control group consisted of the women who confirmed their pregnancies in the public health care sector known as the public service health care workers group (PSHCWG). Data collection took place in the postnatal ward of Tembisa hospital over the period of 3 months. By means of systematic sampling, 100 cards from the PGPG and 100 cards from the PSHCWG were obtained. The 2 groups were compared with respect to gestational age at initiation of care and a modified version of the Quality Check for Antenatal Records Score (MQCARS), an audit score which, when applied to the antenatal card, gives a measure of the effectiveness of record keeping, and whether problems in the antenatal period are detected and appropriately managed. RESULTS. There was a statistically significant difference between the two groups in terms of gestational age at initiation of care [PGPG mean gestational age -19.96 (5.86), PSHCW 25.96(5.98,) p<0.0001]. The majority of women in the PGPG initiated care in the 2nd trimester (79%) while the majority of the women in the PSHCWG (53%) confirmed their pregnancies in the third trimester. Six per cent of PGPG confirmed their pregnancies in the first trimester compared to the PSHCWG (3%). The two groups differ significantly with respect to the total MQCARS with the PGPG group performing better [(8.16 (1.55) vs. 16.34(2.58), p<0.0001]. The associated sub- scores are statistically different [History score 5.99 (0.10) vs.7 (0.96), Examination score 9.59(1.29) vs.8.03 (1.85) Interpretation Score 2.55(0.50) vs.2.80 (0.49)]. CONCLUSION Despite the limitations of the study it is felt that if private general practitioners in Tembisa are involved in the antenatal care of those women who confirm their pregnancies with them, there is a reduction in the gestational age at initiation of care. There is a small difference between the two groups in record keeping, detection and management of problems. / Dissertation (MCur)--University of Pretoria, 2011. / Nursing Science / unrestricted

Date: 2020-06-05 Level: Bachelor thesis in Business Administration, 15 cr Institution: School of Business, Society and Engineering, Mälardalen University Authors: Lovisa Bodin (96/11/06), Jonna Lundin (97/12/05), Julia Öhrberg Nyberg (98/05/18) Title: Digitalization within the health care Tutor: David Freund Keywords: Health care centers, digital health care, primary care, digital health care services Research Questions: How does health centers get affected by the digital health care providers? How does the health centers relate to this impact organizationally? Purpose: The purpose with this study is to describe how digital health care providers affect health centers organizationally and investigate if and how health centers acts on the basis of the digital health care providers. Method: The study is based on a qualitative method with five semi-structured interviews which were processed through a thematic analysis. Conclusion: Health centers are affected financially, through extended competition and greater workload by digital health care providers. Therefore, health centers have adapted their way of working and, among other things, have started or discussed about offering other services that improve their accessibility to approach what characterizes the digital health care providers. Some health centers are adopting the same services that digital health care providers offer, while there are health centers that develops alternative services to improve their accessibility. / Datum: 2020-06-05 Nivå: Kandidatuppsats i företagsekonomi, 15 hp Institution: Akademin för Ekonomi, Samhälle och Teknik, Mälardalens högskola Författare: Lovisa Bodin (96/11/06), Jonna Lundin (97/12/05), Julia Öhrberg Nyberg (98/05/18) Titel: Digitalisering inom hälso- och sjukvården Handledare: David Freund Nyckelord: Vårdcentraler, digital vård, primärvård, digitala vårdtjänster Frågeställning: Hur påverkas vårdcentralerna av digitala vårdverksamheter? Hur förhåller sig vårdcentralerna organisatoriskt till den påverkan? Syfte: Syftet med den här uppsatsen är att beskriva hur digitala vårdverksamheter påverkar vårdcentraler organisatoriskt och undersöka om och i sådana fall hur vårdcentralerna agerar utifrån påverkan från de digitala vårdverksamheterna. Metod: Studien grundas på en kvalitativ metod där fem semi-strukturerade intervjuer genomförts som sedan behandlats genom en tematisk analys. Slutsats: Vårdcentraler påverkas ekonomiskt, via utökad konkurrens och större arbetsbelastning av de digitala vårdverksamheterna. Därför har vårdcentraler anpassat sitt arbetssätt och bland annat börjat eller fört diskussioner om att erbjuda andra tjänster som förbättrar deras tillgänglighet för att närma sig det som utmärker de digitala vårdverksamheterna. En del vårdcentraler tar efter de tjänster som digitala vårdverksamheter erbjuder medan det finns vårdcentraler som utvecklar alternativa tjänster för att förbättra tillgängligheten.

Institute for Rural Development / PhDRDV

(in English): The work deals with issue of social worker's role in hospital from point of view of medical social workers working with senior citizens. In theoretical part is presented profession of medical social worker and its specifics in Czech Republic: history, legislation, education, competences and a role of medical social worker in multidisciplinary team. It is focused also on health care and social services provided to the target group of senior citizens in our country. Practical part is focused on presentation and interpretation of data gained from qualitative research which was realized by semi-structural interviews with medical social workers in chosen faculty hospitals in Prague. Keywords (in English): social work in health care, medical social worker, senior citizens, social services, health care services

This thesis acquaints the reader with specifics in health care business, it defines closely a field of influence of a medical rehabilitation and also describes a provision of health care services in the field of physiotherapy. The main goal of the thesis is to prepare basis and elaboration of the business plan for establishing of a private health care facility and an independent physiotherapeutic practise in Tachov district in the Czech Republic. The theoretical part describes the health care system in the Czech Republic, further defines medical rehabilitation and it specifies field of physiotherapy closely. At the same time in my thesis, I mentioned a theoretical basis for establishing of a company including a brief and clear instruction on how to proceed in setting up a private health care facility "step by step". In the practical part, an analysis of the internal and external environment in the area of the newly developed health care facility in Tachov district is performed. Furthermore, in this part, a SWOT analysis is processed and described, which determines the strengths, weaknesses and opportunities and threats for the new enterprise. In this part of thesis it is crucial the preparation of the business plan, which takes into account demographic data, the location of health care facility and...

Refugees who have fled from the ongoing civil war in Syria that arrived in Germany often develop post-traumatic stress symptoms (PTSS). The aim of this study was to determine health care services utilization (HCSU), health care costs and health-related quality of life (HrQoL) of Syrian refugees with mild to moderate PTSS without current treatment in Germany. The study was based on the baseline sample of a randomized controlled trial of a self-help app for Syrian refugees with PTSS (n = 133). HCSU and HrQoL based on the EQ-5D-5L and its visual analogue scale (EQ-VAS) were assessed with standardized interviews. Annual health care costs were calculated using extrapolated four-month HCSU and standardized unit costs. Associations between health care costs, HrQoL and PTSS severity were examined using generalized linear models. Overall, 85.0% of the sample utilized health care services within four months. The mean total annual health care costs were EUR 1920 per person. PTSS severity was not associated with health care costs. The EQ-5D-5L index score and the EQ-VAS score was 0.82 and 73.6, respectively. For Syrian refugees with higher PTSS severity, the EQ-5D-5L index score was lower (−0.17; p < 0.001). The HCSU and the resulting health care costs of Syrian refugees with mild to moderate PTSS without current treatment are low and those with a higher PTSS severity had a lower HrQoL.

This study investigated the registered nurses' perceptions of the bureaucratic view of power in health care services in the Tshwane metropolitan region. The study further sought to describe how power affects the role of registered nurses in an organisation that is perceived to be predominantly bureaucratic in its' approach to management. A quantitative descriptive exploratory approach was adopted. Data was drawn from 121 respondents by random distribution of questionnaires to three selected health care services in the Tshwane metropolitan region. The findings revealed that registered nurses were largely divided in their perception of the bureaucratic view of power in health care services. Almost half of the respondents indicated that great strides had been taken by organisations in transforming health care services in accordance with the White Paper (1997) on Transformation of the Health System in South Africa and the recommendations of the 2001 Health Summit. The others indicated that registered nurses still needed to break out of the restraints of their dependant role towards taking ownership of health care services by equally bearing the burden of the organisation with management. / Health Studies / M.A.(Health Studies)