1,721,025 research outputs found
Performance measurement and user-centeredness in the healthcare sector: Opening the black box adapting the framework of Donabedian
Full text link: The framework of Donabedian is widely applied to performance assessment at the healthcare system level. Donabedian categorised the care quality measurement around three dimensions, namely structure, process, and outcomes. The first dimension concerns the inputs; the second one, the combinations of factors and inputs; the last one, the effectiveness in terms of patients' health status. Donabedian early included in the last dimension the patient satisfaction. Nevertheless, nowadays, outcomes are generally measured through hard endpoints, such as re-admissions and mortality indicators. Recently, the Patient-Reported Outcome Measures (PROMs) have been included among the outcome measures within the Donabedian framework. How to move the concept of patient-centeredness to a macro level, including the patient point of view in care quality measurement, evaluation, and improvement? This paper integrates the Donabedian structure-process-outcome framework, by incorporating in the proper dimension the patient-indicators, namely the abovementioned PROMs and Patient-Reported Experience Measures (PREMs). While PROMs are clearly measures of outcome, PREMs can be collocated in the process dimension, since they can be useful for mapping processes and care pathways, in a lean perspective, as well as in the outcome dimension, because inherently linked to outcome, and enablers of patient-centeredness
The online communication of healthcare organisations in the 'post-truth' era: An analysis of 167 websites in Italy
Full text linkIntroduction: The advent of the Internet and the availability of health information online has posed new challenges and opportunities to the healthcare sector. The amount of people who surf the Internet for health-related purposes is dramatically increasing. Actually, the ‘post-truth’ phenomenon had interested also the healthcare field, where the quality of the online information is really variable. In addition, the health literacy of people and their consequent capacity to correctly understand and therefore use health-related information is crucial. The quality and usability of information provided by the healthcare organizations online appear very important, in order to avoid the risks of fake news as well as of a misunderstanding of information. The websites can be used as a powerful channel for improving the access to care, the use of healthcare services, the health literacy and the empowerment of people.
Methods: By analysing the websites of 167 healthcare organizations from 13 Italian Regions, we verified whatever online communication of Italian public hospitals and local healthcare authorities was readable and comprehensible for people with different level of education and different level of literacy, by using the Gulpease Index and by measuring the adoption of words from the Italian Fundamental Vocabulary the data refers to December 2015.
Results: The results showed that, in Italy, the healthcare organisations’ online communication is still not structured by taking into consideration literacy and health literacy of people who may surf the Internet. In fact, the websites were difficult to read and understand for people with a low educational level according to both the indexes used. The healthcare organisation’s websites appeared built on the healthcare organisations’ needs, rather than on those of the potential readers. The healthcare management of the Regions recognized the importance of these findings. For this reason, the Collaborative of the Italian Regions, coordinated by the MeS Laboratory of Sant’Anna School, decided to monitor and evaluate these aspects by introducing specific indicators in the healthcare Performance Evaluation System they voluntarily adopted.
Implications: In the ‘post-truth’ era, it is important to consider the risks of more readable and comprehensible information available on other than the healthcare organisations’ websites. This suggests an urgent consideration of the health literacy of people, in addition to their information needs. The availability of our findings was fundamental to inform managers of Italian regional healthcare systems and support them in addressing this issue and working for an equal access to good quality but also comprehensible and readable information online
Patient satisfaction, e-health and the evolution of the patient-general practitioner relationship: Evidence from an Italian survey
No full textScientific and public interest in the use of the Internet for health-related purposes has grown considerably. Concerns regarding its impact on patient-doctor relationship and risks for patients have inflamed the debate. Literature provides scarce evidence in this field. This paper investigates whether a patient's decision to use the web also depends on previous experience and satisfaction with healthcare
Incentivizing ICT in healthcare: A comparative analysis of incentive schemes in Italian Regions
No full textBackground: The use of Information and
Communication Technologies (ICTs) in healthcare
has been presented as a potential solution to the
current challenges that healthcare systems have to
face. The introduction of ICTs may need initial investments
and, moreover, may produce changes in the
routine practice of the healthcare system. Financial
incentives are expected to be an effective managerial
tool to communicate a strategic vision and a
mandate, to improve the adherence to the strategy
and to promote a consistent individual behaviour.
In this perspective, financial incentives are assumed
to accelerate the ICTs adoption and use in healthcare.
The aim of this study was to investigate whether and
how Italian Regional healthcare systems use the Chief
Executive Officers’ (CEOs) reward scheme to stimuli
the implementation of ICT in healthcare.
Materials and methods: A content analysis was
conducted on the Italian Regional acts on healthcare
CEOs incentive schemes, that were approved
in the period 2010–2012 and with a legal validity
that ranged from 1 to 4 years (until 2014). The
acts cover around 60% of the Italian Regions. ICT
goals were identified, categorized, and compared
using descriptive statistics.
Results: This study identified two areas on which
financial incentives related to ICTs were mainly
focused: (i) ICT infrastructure and architecture; (ii)
flows and processing of economic and financial
data. The use of technology to better store and
process medical data (i.e. EHR-like systems) were
only marginally present. Use of e-Health and mHealth
solutions for providing healthcare services,
valorization of ‘health big data’ in a community
care perspective, more advanced applications of
technology for monitoring or preventing diseases
were not incentivized for CEOs in Italy.
Conclusion: The use of ICTs in healthcare appears
to be of general interest in Italy: a great number of
Italian Regions introduced specific goals into CEOs
financial schemes. Efforts in this field seem to be
not linked to the objectives of better care at sustainable
cost, while it appears important to ensure a
better and wider presence of enabling environments
and to implement ICT-based control systems.
Keywords: ICT, Financial incentives, Incentive
scheme, Healthcare CEO, Italy, Region
E-patient (r)evolution: quando è il paziente a coinvolgere il medico.
No full textLo scopo di questo studio è fornire un contribuito al framework teorico di riferimento, con evidenze sui comportamenti di scelta della popolazione della Regione Toscana riguardo l’uso di internet quale strumento per reperire informazioni sulla salute. Dai risultati emerge che sono i più giovani e istruiti, con una insoddisfazione del sistema sanitario e con cattive esperienze con le Asl in termini di burocrazia e prontezza del front-office a consultare più internet, ma coloro i quali hanno un buon rapporto con il proprio medico di famiglia sono più propensi a condividere tali informazioni derivanti dalla rete con il medico stesso
The COVID-19 emergency as an opportunity to co-produce an innovative approach to health services provision: the women's antenatal classes move on the web
Full text linkThe COVID-19 pandemic has strongly affected healthcare organizations, leading to the need for reorganizing also maternal care services during pregnancy. The Regional Health Authorities in Tuscany (Italy) promoted the creation of online antenatal classes (ACs). This study illustrates the innovative approach to deliver ACs online and discusses how the collaborative approach in co-producing this innovative solution co-creates value in healthcare. The action research design was based, on one hand, on the indirect involvement of users by analyzing qualitative data collected through a continuous survey to pregnant women and, on the other one, on the direct involvement of managers and health professionals in meetings and workshops. The authors encompassed all necessary changes in organizational practices and facilitated the collaborative process implementation and analysis. The main findings are that moving ACs online has been a relevant choice, since the need of pregnant women to share information and receive emotional support increased in times of crisis. Additionally, in the perspective of health professionals, the new online ACs model emerged as a valuable solution not only for the contingent situation, but also in a long-term perspective to reach more women during pregnancy and to early support them throughout the maternal care pathway. This study shows that the collaborative approach to co-innovate healthcare services provision, such as with ACs online, facilitates the creation of, long-lasting, and integrated solutions in healthcare, to be used also after pandemic period. Finally, despite this action-research is context-specific, the findings presented in this paper may help other healthcare organizations innovate their own strategies in ACs’ provision
Segmenting Adolescents Around Social Influences on Their Eating Behavior: Findings From Italy
Full text linkAdolescence is a fundamental period in everyone’s life. Teenagers have for the first time the possibility to take on responsibility about their choices in many domains, building their own “lifestyle.” Among these domains, food is one of the most important considering the implications for their future health.
Deep knowledge of teenagers’ behaviors and of factors affecting their choices can support tailored health policy and social marketing interventions for this population. The purpose of this article is to prospectively segment teenagers around food socialization factors as influencing factors of food preferences, attitudes, and behaviors of adolescents. A cluster analysis (CA) was performed on a sample of 4,749 respondents aged 15 and 18 years coming from Tuscany (Italy). Considering food wellbeing and consumer socialization frameworks, the CA used three food socialization variables related to influences and source of information/advices at intrapersonal, interpersonal, and broader societal levels. Five distinct groups were identified and described, showing deep differences in the adolescents’ food behaviors corresponding to different socialization patterns. Adolescents who reported broader food socialization at all investigated levels present better lifestyle habits. Social marketers, policy makers, and health professionals can work on specific influencing food socialization factors for tailoring marketing interventions and increasing their positive impact on adolescents’ food behaviors
Promoting healthy eating habits among youth according to their preferences: Indications from a discrete choice experiment in Tuscany
Full text linkBasic ICT adoption and use by general practitioners: an analysis of primary care systems in 31 European countries
Full text linkThere is general consensus that appropriate development and use of information and communication technologies (ICT) are crucial in the delivery of effective primary care (PC). Several countries are defining policies to support and promote a structural change of the health care system through the introduction of ICT. This study analyses the state of development of basic ICT in PC systems of 31 European countries with the aim to describe the extent of, and main purposes for, computer use by General Practitioners (GPs) across Europe. Additionally, trends over time have been analysed
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