BMC Health Services Research

http://www.biomedcentral.com/1472-6963

List of Papers (Total 5,195)

Primary care focus and utilization in the Medicare shared savings program accountable care organizations

Background Although Accountable Care Organizations (ACOs) are defined by the provision of primary care services, the relationship between the intensity of primary care and population-level utilization and costs of health care services has not been examined during early implementation of Medicare Shared Savings Program (MSSP) ACOs. Our objective was to evaluate the association ...

Cost-effectiveness analysis for a tele-based health coaching program for chronic disease in primary care

Background The burden of chronic disease and multimorbidity is rapidly increasing. Self-management support interventions are effective in reduce cost, especially when targeted at a single disease group; however, economical evidence of such complex interventions remains scarce. The objective of this study was to evaluate a cost-effectiveness analysis of a tele-based health-coaching ...

What is a hospital bed day worth? A contingent valuation study of hospital Chief Executive Officers

Background Decreasing hospital length of stay, and so freeing up hospital beds, represents an important cost saving which is often used in economic evaluations. The savings need to be accurately quantified in order to make optimal health care resource allocation decisions. Traditionally the accounting cost of a bed is used. We argue instead that the economic cost of a bed day is ...

Measuring medication adherence in patients with incident hypertension: a retrospective cohort study

Background Though pharmacy claims data are commonly used to study medication adherence, there remains no standard operational definition for adherence especially for patients on multiple medications. Even when studies use the same terminology, the actual methods of calculating adherence can differ drastically. It is unclear whether the use of different definitions results in ...

Rankings matter: nurse graduates from higher-ranked institutions have higher productivity

Background Increasing demand for baccalaureate-prepared nurses has led to rapid growth in the number of baccalaureate-granting programs, and to concerns about educational quality and potential effects on productivity of the graduating nursing workforce. We examined the association of individual productivity of a baccalaureate-prepared nurse with the ranking of the degree-granting ...

Impacts of a navigation program based on health information technology for patients receiving oral anticancer therapy: the CAPRI randomized controlled trial

Background The emergence of oral delivery in cancer therapeutics is expected to result in an increased need for better coordination between all treatment stakeholders, mainly to ensure adequate treatment delivery to the patient. There is significant interest in the nurse navigation program’s potential to improve transitions of care by improving communication between treatment ...

Evaluation of medicines dispensing pattern of private pharmacies in Rajshahi, Bangladesh

Background In developing country like BANGLADESH, people depend more on pharmacies due to expediency, shorter waiting time, cost reduction, availability of credit and flexible opening hours. The aim of this study was to investigate medicines dispensing patterns of the pharmacies in RAJSHAHI, BANGLADESH and to identify and analyze contribution of drugsellers and quacks in irrational ...

Got spirit? The spiritual climate scale, psychometric properties, benchmarking data and future directions

Background Organizations that encourage the respectful expression of diverse spiritual views have higher productivity and performance, and support employees with greater organizational commitment and job satisfaction. Within healthcare, there is a paucity of studies which define or intervene on the spiritual needs of healthcare workers, or examine the effects of a pro-spirituality ...

Community health service center-based cardiac rehabilitation in patients with coronary heart disease: a prospective study

Background Despite considerable efforts to encourage participation, even in some developed countries, proportion of patients participating in institution-based cardiac rehabilitation (CR) programs remained sub-optimal. The present study was designed to investigate the acceptability of community health service center (CHSC)-based Cardiac Rehabilitation (CR), and examine its ...

Adherence to treatment guidelines: the association between stroke risk stratified comparing CHADS 2 and CHA 2 DS 2 -VASc score levels and warfarin prescription for adult patients with atrial fibrillation

Background Ischemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS 2 , and more recently the CHA 2 DS 2 -VASc, for predicting stroke in patients with AF ...

Social networks and expertise development for Australian breast radiologists

Background In this study, we explore the nexus between social networks and expertise development of Australian breast radiologists. Background literature has shown that a lack of appropriate social networks and interaction among certain professional group(s) may be an obstacle for knowledge acquisition, information flow and expertise sharing. To date there have not been any ...

Case management of patients with Type 2 diabetes mellitus: a cross-sectional survey in Chongqing, China

Background Type 2 diabetes mellitus has been identified as one of the priority diseases and included in the essential public health service package in China. This study investigated the frequency of follow-up visits and contents of care for case management of patients with Type 2 diabetes in Chongqing located in the western China, in terms of the regional practice guideline; and ...

An education programme influencing health professionals to recommend exercise to their type 2 diabetes patients – understanding the processes: a case study from Oxfordshire, UK

Background Increasing levels of physical activity decreases the risk of premature mortality associated with chronic diseases e.g., coronary heart disease, type 2 diabetes, stroke. Despite this, most adults in England do not meet physical activity guidelines. Physical activity advice and signposting offered to at-risk patients by primary care providers is recommended. However, ...

An investigation of stigmatizing attitudes towards people living with HIV/AIDS by doctors and nurses in Vientiane, Lao PDR

Background Despite global efforts, HIV-related stigma continues to negatively impact the health and well-being of people living with HIV/AIDS. Even in healthcare settings, people with HIV/AIDS experience discrimination. Anecdotal evidence suggests that healthcare professionals in the Lao People's Democratic Republic, a lower-middle income country situated in Southeast Asia, ...

The effect of the TIM program (Transfer ICU Medication reconciliation) on medication transfer errors in two Dutch intensive care units: design of a prospective 8-month observational study with a before and after period

Background The transfer of patients to and from the Intensive Care Unit (ICU) is prone to medication errors. The aim of the present study is to determine whether the number of medication errors at ICU admission and discharge and the associated potential harm and costs are reduced by using the Transfer ICU and Medication reconciliation (TIM) program. Methods This prospective 8-month ...

Usefulness of an educational lecture focusing on improvement in public awareness of and attitudes toward depression and its treatments

Background There is an urgent need to establish effective strategies for suicide prevention. Stigma against depression may be a potential anti-protective factor for suicide. Thus, we investigated baseline levels of awareness and attitudes toward depression and its treatment among the general population by our original 18-item questionnaire, which we aimed to validate in the present ...

Study protocol: improving the transition of care from a non-network hospital back to the patient’s medical home

Background The process of transitioning Veterans to primary care following a non-Veterans Affairs (VA) hospitalization can be challenging. Poor transitions result in medical complications and increased hospital readmissions. The goal of this transition of care quality improvement (QI) project is to identify gaps in the current transition process and implement an intervention that ...

Informing the implementation of evidence-informed decision making interventions using a social network analysis perspective; a mixed-methods study

Background Workforce development is an important aspect of evidence-informed decision making (EIDM) interventions. The structure of formal and informal social networks can influence, and be influenced, by the implementation of EIDM interventions. Methods In a mixed methods study we assessed the outcomes of a targeted training intervention to promote EIDM among the staff in three ...

Managed care and inpatient mortality in adults: effect of primary payer

Background Because managed care is increasingly prevalent in health care finance and delivery, it is important to ascertain its effects on health care quality relative to that of fee-for-service plans. Some stakeholders are concerned that basing gatekeeping, provider selection, and utilization management on cost may lower quality of care. To date, research on this topic has been ...

Identification of factors that support successful implementation of care bundles in the acute medical setting: a qualitative study

Background Clinical guidelines offer an accessible synthesis of the best evidence of effectiveness of interventions, providing recommendations and standards for clinical practice. Many guidelines are relevant to the diagnosis and management of the acutely unwell patient during the first 24–48 h of admission. Care bundles are comprised of a small number of evidence-based ...

The challenges of assessing patients' medication beliefs: a qualitative study

Background An estimated 50% of patients do not take their medication as prescribed, with medication adherence associated with adverse outcomes and higher costs of care. The Necessity-Concerns Framework identified individual’s beliefs about their medication as playing a key role in adherence, and UK Clinical Adherence Guidelines recommend eliciting and incorporating individual’s ...

Challenges, uncertainties and perceived benefits of providing weekend allied health services—a managers’ perspective

Background Health services that operate 7 days per week are under pressure to show the increased cost of providing weekend services can be measured in improved patient outcomes. The evidence for weekend allied health services in acute medical and surgical wards is weak and there is wide variation between the services offered at different hospitals. Methods This qualitative study ...

Reducing medical claims cost to Ghana’s National Health Insurance scheme: a cross-sectional comparative assessment of the paper- and electronic-based claims reviews

Background A robust medical claims review system is crucial for addressing fraud and abuse and ensuring financial viability of health insurance organisations. This paper assesses claims adjustment rate of the paper- and electronic-based claims reviews of the National Health Insurance Scheme (NHIS) in Ghana. Methods The study was a cross-sectional comparative assessment of paper- ...

Addressing the gaps in diabetes care in first nations communities with the reorganizing the approach to diabetes through the application of registries (RADAR): the project protocol

Background Type-2 diabetes rates in First Nations communities are 3-5 times higher than the general Canadian population, resulting in a high burden of disease, complications and comorbidity. Limited community nursing capacity, isolated environments and a lack of electronic health records (EHR)/registries lead to a reactive, disorganized approach to diabetes care for many First ...

A cross sectional observational study of research activity of allied health teams: is there a link with self-reported success, motivators and barriers to undertaking research?

Background Team-based approaches to research capacity building (RCB) may be an efficient means to promote allied health research participation and activity. In order to tailor such interventions, a clearer understanding of current patterns of research participation within allied health teams is needed. Different self-report measures exist which evaluate a team’s research capacity ...