Search

Background: patient involvement in the design, planning and delivery of health services is acknowledged to be a local and national priority. Aims: to improve service quality through a quality improvement initiative to explore patient preferences for involvement in health services design, planning and delivery. Methods: a questionnaire was developed to: assess patient preferences for involvement in hospital service development; and explore differences in responses between patient subgroups. Findings: 162 patients were recruited. Most were positive about being engaged in all service developments, not just those used personally. Involvement through questionnaires with infrequent email communication was favoured over attendance at public meetings. Time was a greater barrier to being involved than distance or remuneration. Conclusion' Patients valued involvement in health service development, but finding free time during working hours was difficult. There were no differences in preferences for involvement between subgroups defined by gender, ethnicity, home situation or health. [ABSTRACT FROM AUTHOR]

Citizen report cards on health care providers have been identified as a potential means to increase citizen engagement, provider accountability and health systems performance. Research in high-income settings indicates that the wording, presentation and display of performance information are critical to achieve these goals. However, there are limited insights on developing effective report card designs for middle- and low-income settings. We conducted cognitive interviews to assess consumers’ understanding, interpretation of and preferences for displaying information for a health care report card in rural Tajikistan. We recruited a convenience sample of 40 citizens (20 women and 20 men aged 18–45) from rural areas of two provinces of Tajikistan (Soghd and Khatlon oblasts). The interview protocol was adapted from the model of cognitive interviews used in social science research to improve survey questionnaires. We used multivariate regression to assess understanding and interpretation of the report card; chi2 tests to assess differences in preferences for displaying information; and tests of proportions to assess the preferred comparison group. Respondents understood the main idea of the report card and are not confused by the indicators or display. However, many respondents had difficulties making comparisons, and when asked to identify worst-performing services. Respondents preferred detailed rankings using school grades, comparisons of their local clinic with the regional or national average performance, and the use of color in the report card. We found some heterogeneity across the two provinces. Overall, our findings are promising regarding the citizens’ comprehension of health care report cards in rural Tajikistan, while underscoring the challenges of effectively providing health care performance information to communities. Cognitive interviews and iterative testing can support an effective implementation of reporting initiatives. [ABSTRACT FROM AUTHOR]

The article discusses the ethical implications of citizen participation and new health technologies in Europe. Topics include the importance of growing citizen involvement in health research and healthcare, the growing prominence of personalised medicine at European Union (EU) level, and the role of health technologies in the participation of citizen in health and medicine.

The article focuses on the commitment made by several stakeholders of regional health organizations to their communities. Particular focus is given to the principles of health plans including citizens' participation in health insurance coverage, focusing on the patients' requirements for improving health care financing, and innovations in health plans.

Health systems worldwide are grappling with the need to control costs to maintain system viability. With the combination of worsening economic conditions, an aging population and reductions in tax revenues, the pressures to make structural changes are expected to continue growing. Common cost control mechanisms, e.g. curtailment of patient access and treatment prioritization, are likely to be adversely viewed by citizens. It seems therefore wise to include them in the decision making processes that lead up to policy changes. In the context of a multilevel iterative mixed-method design a quantitative survey representative of the German population (N = 2031) was conducted to probe the acceptance of priority setting in medicine and to explore the practicability of direct public involvement. Here we focus on preferences for patients' characteristics (medical aspects, lifestyle and socio-economic status) as possible criteria for prioritizing medical services. A questionnaire with closed response options was fielded to gain insight into attitudes toward broad prioritization criteria of patient groups. Furthermore, a discrete choice experiment was used as a rigorous approach to investigate citizens' preferences toward specific criteria level in context of other criteria. Both the questionnaire and the discrete choice experiment were performed with the same sample. The citizens' own health and social situation are included as explanatory variables. Data were evaluated using corresponding analysis, contingency analysis, logistic regression and a multinomial exploded logit model. The results show that some medical criteria are highly accepted for prioritizing patients whereas socio-economic criteria are rejected. [ABSTRACT FROM AUTHOR]

In this article the authors discuss the potential of personalization to become more of a general organizing feature for welfare services in Great Britain in the 21st century. The ideas discussed in the article are the result of a two-day meeting organized by the University of Birmingham’s Health Services Management Centre (HSMC) and Great Britain's Centre for Welfare Reform (CWR) to explore the implications of self-directed support for future welfare reform. Topics include increased personalization in health care, the extension of personalization into services for children with disabilities and their families, and personalization in community development.

Copyright of Österreichische Zeitschrift für Soziologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Australian mental health system reform continues to be guided by an outdated vision to design a 'perfect' mental health system. It is then expected that consumers and carers will fit in to it. From the experiences of the past 15 years it is clear that this approach is ineffective. The new vision of mental health system reform should embrace recovery and wellbeing principles to encourage consumer self-directedness and self-determination, and to support the individual consumer to build their own unique support system which wraps around their personal goals, needs and priorities. In order to advance mental health system reform, it must be responsive to, and driven by, consumer and carer needs. [ABSTRACT FROM AUTHOR]

In Colombia, the participation of the citizens in the decisions that affect his life, it is regulated in the political constitution. Several spaces are foreseen, levels and types of participation, nevertheless, there exists the worry that in the stage of the included world the possibilities of participation of the community in the capture of decisions in health, have scanty real possibility. In this one article there are described the generalities of participation and globalization and the opportunities and threats are discussed for the participation of the Colombian citizens under the influence of the globalization. [ABSTRACT FROM AUTHOR]

The idea of including patient perspectives in health-services planning and evaluation is increasingly embraced by Canadian health authorities. This article argues that the validity of a particular method is not simply a matter of its scientific rigour; rather, it depends on what one considers to be the meaning and purpose of patient involvement. Perspectives on patient involvement can be conceptualized in terms of a continuum from consumerism (patients as customers who deserve to be satisfied) to participatory democracy (patients as citizens with a right to participate in shaping public services). These ideologies are associated with different methods (market research versus participatory research) and, crucially, yield different results. Evidence from diverse sources suggests that, as methods move across the continuum towards participatory democracy, 1) participants move from expressing simple opinions to considering broader issues, context and complexity, and 2) participants' perspectives shift from individualism (personal interest) towards collectivism (common interest). As well, different approaches have different strengths and risks in terms of the ultimate goal of patient involvement: change to services. This article outlines the implications of the “politics of methodology” for decisions about how best to involve patients in the design and evaluation of health services. [ABSTRACT FROM AUTHOR]

Public participation in health-service management is an increasingly prominent policy internationally. Frequently, though, academic studies have found it marginalized by health professionals who, keen to retain control over decision-making, undermine the legitimacy of involved members of the public, in particular by questioning their representativeness. This paper examines this negotiation of representative legitimacy between staff and involved users by drawing on a qualitative study of service-user involvement in pilot cancer-genetics services recently introduced in England, using interviews, participant observation and documentary analysis. In contrast to the findings of much of the literature, health professionals identified some degree of representative legitimacy in the contributions made by users. However, the ways in which staff and users constructed representativeness diverged significantly. Where staff valued the identities of users as biomedical and lay subjects, users themselves described the legitimacy of their contribution in more expansive terms of knowledge and citizenship. My analysis seeks to show how disputes over representativeness relate not just to a struggle for power according to contrasting group interests, but also to a substantive divergence in understanding of the nature of representativeness in the context of state-orchestrated efforts to increase public participation. This divergence might suggest problems with the enactment of such aspirations in practice; alternatively, however, contestation of representative legitimacy might be understood as reflecting ambiguities in policy-level objectives for participation, which secure implementation by accommodating the divergent constructions of those charged with putting initiatives into practice. [Copyright &y& Elsevier]

Based on a spring 2008 survey of 1,003 randomly selected Massachusetts firms, this paper examines views and responses of employers to health care reform after employer and individual mandates went into effect. A majority of firms view reform as "good for Massachusetts." The percentage of firms with three or more workers offering coverage increased from 73 percent to 79 percent. Massachusetts employers are less likely than employers nationally to indicate plans to terminate coverage or restrict eligibility for health benefits, which suggests that crowd-out is not occurring. [ABSTRACT FROM AUTHOR]

Florida is among the first states to implement Medicaid reform using a competitive consumer choice model. Using data from a 2006-07 Kaiser Family Foundation survey of Medicaid recipients newly enrolled in Florida's reform program, we examine how well they understood the changes taking place and their experiences in selecting a health plan. We find important gaps in people's understanding of major components of the reform: About 30 percent were not aware that they were enrolled in reform, and more than half had trouble understanding plan information. These problems were not particular to any group but instead were experienced broadly across the full Medicaid population. [ABSTRACT FROM AUTHOR]

Our annual Employer Health Benefits Survey contains findings from interviews with 1,927 public and private employers surveyed during the first five months of 2008. Average annual premiums in 2008 are $4,704 for single coverage and $12,680 for family coverage. These amounts are about 5 percent higher than premiums were last year. Enrollment in high-deductible health plans with a savings option increased to 8 percent of covered workers, up from 5 percent in 2007. Deductibles in preferred provider organizations, the plan type with the largest enrollment, increased from 2007 levels. This paper also provides new insights into firms' offering wellness programs and retiree health benefits. [ABSTRACT FROM AUTHOR]

Objective: Patient involvement in health service planning and evaluation is considered important yet not widely practiced. This study explored stakeholder beliefs about patient participation in performance indicator selection to better understand hypothesized barriers. Methods: Interviews with 30 cancer patients and health professionals from two teaching hospitals were analyzed qualitatively. Results: All groups believed patients, not members of the public, should be involved in the selection of indicators. Ongoing, interactive methods such as committee involvement, rather than single, passive efforts such as surveys were preferred. Health professionals recommended patients assume a consultative, rather than decision-making role. Older patients agreed with this. Conclusion: Variable patient interest, health professional attitudes, and a lack of insight on appropriate methods may be limiting patient involvement in this, and other service planning and evaluation activities. More research is required to validate expressed views among the populations these stakeholders represent, and to establish effective methods for engaging patients. Practice implications: Efforts to encourage a change in health professional attitude may be required, along with dedicated organizational resources, coordinators and training. Methods to engage patients should involve deliberation, which can be achieved through modified Delphi panel or participatory research approaches. [Copyright &y& Elsevier]

Considers the benefits of globalization of the world economy but the risks of infectious diseases. The need to invest a global health; The presentation of ideas for industrialized countries to be involved in global health; Suggested means for coordination.

Debates about the theory and practice of participation and participatory strategies have become consistent features of policy development throughout the world. In Australia, as elsewhere, governments routinely employ strategies such as community consultation as a means of creating opportunities for participation. It has been argued that these measures are as much an attempt to contain or manage the demand for representation by a myriad of interest and pressure groups as they are an expression of democratic principles or highly valued public opinion. Nevertheless, governments and interest groups alike have been advocating expanded consultation programs and seeking to refine the process of consultation in order to achieve optimum benefits for all parties. Much of this attention is focused on the mechanics of how to undertake consultation exercises which are efficient and effective. By contrast, this paper discusses the structural factors in a government bureaucracy which will facilitate or impede consultation with communities. It draws on the findings of a research consultancy conducted by the authors for one large commonwealth government department in Australia. The research suggests that while the skills and performance of individual officers are important, there are several key organisational indicators in the government bureaucracy itself which will determine its ability to consult effectively. Keywords: community consultation; government decision-making; health policy and participation [ABSTRACT FROM AUTHOR]

El artículo ofrece información sobre el II Congreso Internacional de Sistemas de Salud, el cual se celebró en Bogotá, Colombia, del 2 al 5 de octubre de 2012 bajo la organización de la Pontificia Universidad Javeriana. El congreso se centró en el tema de ciudadanía y financiamiento de los sistemas de salud.

This study aimed to understand the problems within the Indigenous health policy process in Australia and how weaknesses in the process impact on policy implementation. Using semi-structured questions, 23 key stakeholders in the policy-making process were interviewed. Three main themes dominated; a need for increased Indigenous involvement in policy formulation at the senior Australian Government level, increased participation of Indigenous community-controlled health organisations in the policy-making process and, most importantly, ensuring that policies have the necessary resources for their implementation. The emergence of these specific themes demonstrated weaknesses in policy process from the formulation stage onward. Tackling these would, according to our informants, significantly enhance the effectiveness of the policy process and contribute to further improvement of the health of Indigenous Australians. [ABSTRACT FROM AUTHOR]