Asia-Pacific Journal of Health Management (ACHSM)
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Exploring Clinician Barriers and Enablers in Referring Patients to a Virtual Hospital for Acute Care: - ACHSM Asia-Pacific Health Leadership Congress in Brisbane 2024
No full textBackground: Virtual hospitals offer a promising solution to alleviate pressures on traditional healthcare systems by providing acute care in patients' homes. Despite the implementation of a virtual hospital model in South Australia, referral rates remain below expectations.
Aim: To explore clinician attitudes, beliefs, barriers, and enablers influencing referrals to a virtual hospital for acute care.
Methods: A qualitative exploratory study was conducted using semi-structured interviews with nine clinicians who had experience referring patients to the virtual hospital. Data were analysed thematically using a grounded theory approach.
Results: Four key themes emerged: (1) Complexity of the healthcare ecosystem leading to duplication and navigation challenges; (2) Ambiguity in patient selection criteria causing uncertainty in referrals; (3) Higher social complexity and non-medical care needs acting as barriers; (4) Interoperability issues and the need for effective change management.
Conclusions: Addressing the identified barriers through refining referral pathways, clarifying eligibility criteria, enhancing support for patients with complex needs, and improving system interoperability could increase referral rates to the virtual hospital. Engaging clinicians in the co-design of virtual care models is essential for successful implementation
Building the Nursing Workforce of The Future: - ACHSM Asia-Pacific Health Leadership Congress in Brisbane 2024
No full textThe supply, retention and distribution of a quality nursing workforce is critical to ensure Australians have access to health and aged care, when and where they need it. The nursing supply and demand study projects the supply and demand of Australia’s nurses until 2035 across all sectors and geographical levels.
The results of the study predict an undersupply of nurses over the next 12 years, which indicates Australia may not have the number of nurses required to keep pace with the demand for nursing services in the community overall
Determinants of Digital Health Information Search (DHIS) Behaviour: Extending UTAUT with healthcare behaviour constructs: - 2nd International Healthcare Management Conference 2022: Navigating the New Normal with Focus on Healthcare Accessibility, Innovation and Sustainability
No full textIntroduction: As the availability of huge amounts of digital health information content increases, the popularity of Digital Health Information Search (DHIS) has increased. This paper explores the determinants that influence the intention to DHIS by the public by extending the UTAUT model with health behaviour constructs like health consciousness, attitude towards health information, and trust in DHI.
Method: The instrument was created by adapting scales from previous studies. Survey forms were circulated through online platforms with the snowball sampling technique. With the 345 finalized sample, analysis was carried out, and structural equation modelling (SEM) is used for data analysis with the help of SPSS v.26 and AMOS v.26.
Results: Sample demographics show that 60% of the respondents have experience of 5 years in using smartphones, and 70% of respondents use the smartphone from 1 to 6 hours per day. We see that less time was spent on digital health information (DHI). For searching DHI, respondents use Google/other browsers and for sharing it, WhatsApp is the most used app. The reliability of scales was checked in SPSS, which resulted in Cronbach's alpha value greater than 0.7 for all scales. The hypothesis testing resulted in all the constructs showing a significant relationship. We see that performance expectancy, social influence, and trust in DHI showed a strong significant relation with the intention to DHIS.
Conclusion: This study extends the literature in information systems adoption studies by adding a combination of the technology acceptance model with health constructs. Factors influencing the intention to DHIS are accessibility, influence from peers, and information reliability are more concerned. This study shows the importance and need for genuine DHI from valid healthcare providers, in which the creators of healthcare information, like Government and private healthcare providers, have to be more conscious
COVID-19 And Palliative Care: A bibliometric analysis
No full textCOVID-19 continues to disrupt the life of people worldwide. One of the most vulnerable sections affected by the pandemic is very old and seriously ill people. The present study provides a detailed analysis of the trends in the global scientific production on COVID-19 and palliative care. An analysis of the documents searched from the Scopus database was interpreted by Biblioshiny, an R-based software for bibliometric analysis. A descriptive examination of sources, authors, and records was done, and network analysis of conceptual, intellectual, and social structures. The research revealed ongoing research on this topic in the recent two years. The United States, the UK, India, and Spain have all done extensive research on the subject. The study's findings may aid medical practitioners and policymakers in focusing on critical sections in palliative care in the context of COVID-19. The study also identifies crucial areas in the chosen issue and guides future researchers on developing themes, contexts, and possible collaborations
Understanding Workplace Spirituality in Health Care Systems: Practice and challenges
No full textPurpose of the Study: The purpose of this paper is to make an enquiry into work place spirituality in health care systems. Based on a theoretical study of spirituality and its growing importance in health care systems; workplace spirituality is discussed with doctors and elements of spirituality which are applied in treating patients are identified. The study has also explored the individual level and system level challenges while practicing spirituality through the identified elements in the health care systems.
Methodology adopted: This is an inductive form of research which involved enquiry into the existing literature of spirituality and further records the focused discussions of doctors for capturing the idea of spirituality in health care systems, identification of elements of spirituality and implementation challenges of spiritual elements in health care systems.
Findings: The idea of spirituality in healthcare systems includes the trust and belief in supreme power, peace of mind, spiritual care and identifying spirituality as an asset. Gratitude and prayers, counseling, inclusion of the yogic techniques and investment of self in the work are identified as elements of spirituality in healthcare systems. Analysis of data also implied challenges in implementation of spirituality in health care systems.
Practical implications: The findings of the study have identified the elements of spirituality in health care systems not addressed in the previous research. The present study suggests to consider the emotional labor and stress of the doctors developed in the treatment process as the role of doctors is crucial in maintaining the integral health of patients. The implementation challenges of spiritual practices in health care systems are also discussed
Out-of-Pocket Expenditure in Hypertension Related Care in India: Estimates from National Sample Survey 2017-18
No full textBackground: Studies estimating treatment cost associated with hypertension care in the Indian context are limited and show considerable variations.
Objective: To estimate the extent of out-of-pocket expenditure (OOPE) for hypertension care at the population level and its financial impact on households in India.
Methods: We analysed the data of the 75th round of the of NSSO survey (India) on the social consumption of health care conducted in 2017-18. OOPE was assessed after deducting the amount reimbursed by insurance from the total medical expenditure per episode of hypertension-related hospitalisation and outpatient visit during the survey period. OOPE for hypertension care was considered catastrophic if exceeding 10% of the household’s monthly per capita expenditure. The determinants of catastrophic health expenditures were examined using a multivariate logistic regression analysis.
Results: A total of 1,351 and 6,379 individuals reported hypertension-related hospitalization and outpatient care, respectively, in the survey. The overall hypertension-related hospitalization rate was 54 per 100,000 persons. OOPE associated with hypertension-related hospitalisation were on an average INR 3,491 (SD 6,176) and INR 24,565 (SD 37,343) in public hospitals and private hospitals, respectively. The OOPE for hypertension related to outpatient visit was INR 277 (SD 571) in public facilities but was in the range of INR 457 (SD 556) – INR 695 (SD 1,431) based on the type of private hospitals/clinics. OOPE on medicines constituted on an average 43% (95% CI: 32-52%) and 66% (95% CI: 54-64%) of public sector hospitalisation and outpatient care respectively. The risk of catastrophic expenditure due to hypertension care was 41% among the poorest households.
Conclusion: Direct expenses on drugs and diagnostic tests contribute significantly to OOPE. The on-going public health efforts towards controlling hypertension need to ensure better access to essential hypertensive drugs and diagnostic tests in public facilities
Ensuring Emotional Fitness of Healthcare Workers Through Employee Champion Role of Human Resource Management
No full textObjective: The study examines Human Resource champion approach in combating the emotional health problems of healthcare workers. The objectives of the study include identifying the different emotional needs of Health care workers; mapping the various Human Resource Champion roles towards each of the identified emotional needs of the healthcare workers and the different levels of emotional well-being. Methods: Based on a mini review the purpose of the paper is to create a unique synthesis and proposal for utility of healthcare organizations The exploration included terms of search in combination and in particular related to emotional fitness of healthcare workers, COVID-19, HR role in managing employee stress, , workplace stress, employee champion and HR champion. The potential chances of subjectivity in selection of the papers cannot be overlooked though the various databases used for review include Google scholar, Web of Science, Semantic Scholar which provides the most cited work.
Results: The study reports a negative influence of pandemic on HCW’s mental health. The identified needs of Healthcare workers during the pandemic include caring, protecting, hearing, preparing and supporting them. The identified needs have been mapped towards the various HR champions ie physical, social, financial, emotional, work-life integration and meaning in work champion. The various practices that were available and were considered feasible have also been evaluated. The fulfillment of the specific emotional needs of HCW’s can lead to emotional well- being at different levels including essentials, belonging, purpose and flourishing.
Conclusions: The findings of the study reveal that different employee champions can nurture the specific emotional needs of healthcare workers thereby leading to fulfillment of their emotional well-being at different levels. Some champion roles are more visible (Physical and financial champion) as compared to Work- life integration, Social, Emotional, Meaning in work champions in the healthcare organizations
Direction, Opportunities and Insight
No full textThe final issue of the journal for the year enables the publication of articles that report on research and experience related to opportunities for innovation, quality, workforce, access and consumer understanding. In addition to system and services readiness in relation to the translation of research as well as operational readiness related to incidents and access surge....
Improving the Recruitment and Retention of Healthcare Professionals in Rural Areas: Evidence from the medical doctors of six districts of India
No full textBackground: The Human Resource in Health (HRH) crisis is one of the most critical constraints to achieving health and development goals. In this study, the WHO's recommendations were used to highlight the health workforce issues in remote and rural areas with a prime focus on four major policy domains: education, regulatory, financial incentives, and professional and personal support.
Objectives: Medical doctors are one of the essential frontline health workers for primary health care in rural India. This study adopted World Health Organization's (WHO's) human resource policy framework to evaluate doctors' responses in understanding the recruitment and retention of medical doctors in rural areas.
Materials and Methods: A cross-sectional, descriptive study was conducted in the rural and remote areas of Odisha state, India. A multistage sampling procedure was used to select the participants, who were all government medical doctors working in rural and remote locations. The primary outcome measure is percentage responses using WHO’s Human Resource policy framework
Results: Medical doctors working in rural and remote areas perceived the practice as challenging. They were mainly least satisfied with the items asked in the professional and personal support domain. However, more than half of the doctors (56.7%) are eager to work in remote and rural areas for the next three years.
Conclusion: Public health administrators and policymakers should create an enabling environment and design interventions encouraging doctors to stay in remote areas. Most importantly, this includes a political and financial commitment to achieve targeted interventions
Assessment of Occupational Burnout And Its Determinants, Causes of Occupational Stress, And Its Coping Strategies Among Nurses Working In The Psychiatric Wards: A mixed-method study
No full textAims: This study assessed occupational burnout and its determinants, causes of occupational stress, and its coping strategies amongst 13 nurses working in the psychiatry wards in India.
Methods: This was a longitudinal mixed-method study. The qualitative component comprised interviewing each participant under the steps of “free listing” and “pile sorting” to assess the causes of occupational stress and its coping strategies. The occupational burnout experiences were assessed using the Maslach Burnout Inventory.
Results: Low-level depersonalization scores were present among six (46.1%) participants. Scores under this component of burnout were negatively correlated with years of work experience in providing nursing care for admitted psychiatric patients (rs = -0.548, p=0.05). Median scores of the emotional exhaustion scale (p=0.047) and of the depersonalization scale (p=0.016) were significantly higher among participants working at the government hospital. The major cause of occupational stress was poor infrastructure and treatment facilities with a salience score of 0.154. The most adopted strategies to tide over occupational stress were reading books and meditation with a salience score of 0.128 and 0.109 respectively.
Conclusion: Extended work experience of participants was associated with their better ability to understand and empathize more with the patients as reflected by the low depersonalization scores. Two components of occupational burnout were found to be higher among nurses working in the government hospital. Organizational relationships were a more common cause of occupational stress than client-related matters among the participants. Recreational activities were the most common coping strategies adopted by the participants to deal with stress