Abstract:
BACKGROUND:The precipitous closure of rural maternity services in British Columbia (BC), Canada, and internationally has demanded a reevaluation of how to meet the perinatal surgical needs of rural women in accordance with the Triple Aim objectives of safety, cost-effectiveness, and satisfaction of all key stakeholders. There is emerging international evidence that General Practitioners with Enhanced Surgical Skills (GPESS) are a well-positioned health service solution due to their generalist nature in low-volume settings. A realist review was undertaken to evaluate international evidence on efficacious models of perinatal surgical care. This article presents findings of the safety of such practice, one discrete part of the full realist review. METHODS:This paper was derived from a larger review, which used a realist review methodology to guide the approach, and adhered to the RAMESES quality standard for realist reviews. Seven academic databases were searched in December 2013, using year (1990) and language (English) limiters in keeping with a rapid review approach. Mining of bibliographies in addition to consultation with international experts led to further inclusion of academic and grey literature up to March 2014. RESULTS:Two hundred fifty-four articles were originally identified; 119 articles were removed from consideration for lack of fit, resulting in the review of 191 articles from the peer reviewed and grey literature. Of these, 53 pertained to safety and are considered herein. Evidence on the safety of GPESS was consistent in the literature cited. Clinical, case study, and qualitative evidence demonstrates that perinatal surgical care is equally safe when provided by GPESS and specialist physicians. CONCLUSION:Findings allow health planners to confidently build perinatal surgical services around the contribution of GPs with enhanced surgical skills and focus on educational, regulatory, and continuing professional development mechanisms to ensure their sustainability. Volume-to-outcomes associations are variable and inconclusive with regards to safety, suggesting the need for more evidence. These findings, and the attendant health services planning directions, are reassuring as they suggest the viability of local models of care where feasible.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Kornelsen J,McCartney K,Williams Kdoi
10.1186/s12913-016-1629-6subject
Has Abstractpub_date
2016-08-13 00:00:00pages
381issue
1issn
1472-6963pii
10.1186/s12913-016-1629-6journal_volume
16pub_type
杂志文章,评审abstract:BACKGROUND:Research on team effectiveness in healthcare has focussed on whether effective teams yield positive outcomes for patients and on the effectiveness of team interventions to improve performance. Limited understanding exists of what works for whom within an effective team, or how and why the context in which th...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-018-3331-3
更新日期:2018-07-11 00:00:00
abstract:BACKGROUND:Currently, hospital nursing care workers (hereafter referred to as HNCWs) have become an important part of the healthcare system in China. They exist in nearly all of the public hospitals and in some private hospitals, making up 20 to 30% of the total nursing staff and providing 30 to 40% of basic nursing ca...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3281-9
更新日期:2018-06-22 00:00:00
abstract:BACKGROUND:Frequent pages can disrupt workflow, interrupt patient care, and may contribute to physician burnout. We hypothesized that paging volumes followed consistent temporal trends, regardless of the medical or surgical service, reflecting systems based issues present in our hospitals. METHODS:A retrospective revi...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-019-4844-0
更新日期:2019-12-23 00:00:00
abstract:BACKGROUND:The phased withdrawal of oral polio vaccine (OPV) and the introduction of inactivated poliovirus vaccine (IPV) is central to the polio 'end-game' strategy. METHODS:We analyzed the cost implications in Chile of a switch from the vaccination scheme consisting of a pentavalent vaccine with whole-cell pertussis...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05115-7
更新日期:2020-04-09 00:00:00
abstract:BACKGROUND:Predicting pharmacy service fees is crucial to sustain the health insurance budget and maintain pharmacy management. However, there is no evidence on how to predict pharmacy service fees at the population level. This study compares the status of pharmacy services and constructs regression model to project an...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3067-0
更新日期:2018-05-03 00:00:00
abstract:BACKGROUND:Due to an increasing demand in health care services plans to substitute selective physician-conducted medical activities have become attractive. Because administration of a blood transfusion is a highly standardized procedure, it might be evaluated if obtaining a patient's consent for a blood transfusion can...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-2928-x
更新日期:2018-02-17 00:00:00
abstract:BACKGROUND:Social Prescribing is a service in primary care that involves the referral of patients with non-clinical needs to local services and activities provided by the third sector (community, voluntary, and social enterprise sector). Social Prescribing aims to promote partnership working between the health and the ...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-018-2893-4
更新日期:2018-02-07 00:00:00
abstract:BACKGROUND:The Transmural Trauma Care Model (TTCM) is a refined post-clinical rehabilitation approach, in which a multidisciplinary hospital-based team guides a network of primary care physical therapists in the treatment of trauma patients. The objective of this study was to assess the effectiveness of the TTCM compar...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4547-6
更新日期:2019-11-08 00:00:00
abstract:BACKGROUND:The objective was to solve two problems of an already validated scale measuring inpatient opinion on care: 1) a high non-response rate for some items due to the "not applicable" response option and 2) a skewed score distribution with high ceiling effect. METHODS:The EQS-H scale ("échelle de qualité des soin...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-197
更新日期:2007-12-03 00:00:00
abstract:BACKGROUND:Several previous studies conducted on cancer registry data and hospital discharge records (HDR) have found an association between hospital volume and the recourse to breast conserving surgery (BCS) for breast cancer. The aim of the current study is to depict concurrent time trends in the recourse to BCS and ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-167
更新日期:2007-10-18 00:00:00
abstract:BACKGROUND:Since the mid-1990s, a growing number of North Korean defectors have been arriving in South Korea, many of whom have various somatic and mental disorders. The health status of defectors is an important predictor of their successful resettlement. Therefore, this study examined the frequency of physician visit...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0736-0
更新日期:2015-03-07 00:00:00
abstract:BACKGROUND:Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is pre...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-87
更新日期:2008-04-17 00:00:00
abstract:BACKGROUND:Industry partnerships can help leverage resources to advance HIV/AIDS vaccine research, service delivery, and policy advocacy goals. This often involves capacity building for international and local non-governmental organizations (NGOs). International volunteering is increasingly being used as a capacity bui...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-378
更新日期:2013-10-02 00:00:00
abstract:BACKGROUND:Reimbursement systems provide incentives to health care providers and may drive physician behaviour. This review assesses the impact of reimbursement system on socioeconomic and racial inequalities in access, utilization and quality of primary care. METHODS:A systematic search was performed in Web of Scienc...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-016-1805-8
更新日期:2016-10-04 00:00:00
abstract:BACKGROUND:Clinicians informally assess changes in patients' status over time to prognosticate their outcomes. The incorporation of trends in patient status into regression models could improve their ability to predict outcomes. In this study, we used a unique approach to measure trends in patient hospital death risk a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-171
更新日期:2011-07-21 00:00:00
abstract:BACKGROUND:Health systems research is increasingly being conducted in low and middle-income countries (LMICs). Such research should aim to reduce health disparities between and within countries as a matter of global justice. For such research to do so, ethical guidance that is consistent with egalitarian theories of so...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-016-1868-6
更新日期:2016-11-15 00:00:00
abstract:BACKGROUND:Concerns have been raised regarding the reasonableness of using personal health responsibility as a principle or criterion for setting priorities in healthcare. While this debate continues, little is known about clinicians' views on the role of patient responsibility in clinical contexts. This paper contribu...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05364-6
更新日期:2020-06-03 00:00:00
abstract:BACKGROUND:A rapid increase of Medicaid expenditures has been a serious concern, and housing stability has been discussed as a means to reduce Medicaid costs. A program evaluation of a New York City supportive housing program has assessed the association between supportive housing tenancy and Medicaid savings among New...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2816-9
更新日期:2018-01-10 00:00:00
abstract:BACKGROUND:Previous studies have shown that patients' anxiety and dissatisfaction are predictors for increased postoperative pain and reduced efficacy of pain treatment. However, it remains to be shown whether patient anxiety and concern are predictors for the perceived quality of treatment and patient reported outcome...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-244
更新日期:2012-08-08 00:00:00
abstract:BACKGROUND:Although the prevalence of depression in Vietnam is on par with global rates, services for depression are limited. The government of Vietnam has prioritized enhancing depression care through primary healthcare (PHC) and efforts are currently underway to test and scale-up psychosocial interventions throughout...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3416-z
更新日期:2018-08-16 00:00:00
abstract:BACKGROUND:The aim of this study is to evaluate the performance of the first certified regional trauma network in Germany, the Trauma Network Eastern Bavaria (TNO) addressing the following specific research questions: Do standard and maximum care facilities produce comparable (risk-adjusted) levels of patient outcome? ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1468-5
更新日期:2016-07-11 00:00:00
abstract:BACKGROUND:Increasingly, nurse practitioners (NPs) are deployed in teams along with general practitioners (GPs) to help meet the demand for out-of-hours care. The purpose of this study was to explore factors influencing collaboration between GPs and NPs in teams working out-of-hours. METHODS:A descriptive qualitative ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2548-x
更新日期:2017-08-23 00:00:00
abstract:BACKGROUND:In response to persistently poor levels of maternal, newborn and child health (MNCH) in rural India, the National Rural Health Mission (NRHM) was launched to support the provision of accessible, affordable and quality health care in deprived and underserved communities. The Accredited Social Health Activists...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-15-S1-S5
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:A novel point-of-care ultrasound (PoCUS) training program was developed to train rural healthcare providers in Kenya on the Focused Assessment with Sonography for Trauma (FAST), thoracic ultrasound, basic echocardiography, and focused obstetric ultrasonography. The program includes a multimedia manual, pre-c...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3196-5
更新日期:2018-08-06 00:00:00
abstract:BACKGROUND:Academic detailing (AD; also known as educational visiting) facilitates the translation of evidence into practice and has been widely adopted internationally to facilitate practice change. The potential of AD linked to a specific patient and delivered by a specialist physician to general practitioners has no...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12913-015-0861-9
更新日期:2015-05-09 00:00:00
abstract:BACKGROUND:To evaluate the cost-effectiveness of trimetazidine (TMZ) as add-on therapy to standard-of-care (SoC) compared to SoC alone in patients with chronic stable angina who did not respond adequately to first line therapy with b-blockers, nitrates or calcium channel antagonists in Greece. METHODS:A Markov model w...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1779-6
更新日期:2016-09-27 00:00:00
abstract:BACKGROUND:Evidence-based clinical algorithms (EBCA) are knowledge tools to promote evidence use by codifying evidence into action plans to facilitate appropriate care. However, their impact on process and outcomes of care varies considerably across practice settings and providers, highlighting the need for tailoring o...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4008-2
更新日期:2019-03-20 00:00:00
abstract:BACKGROUND:Strong management skills are key to improving performance of health systems. Action learning, a technique to develop management skills, has been used successfully with health managers but not usually among lower level managers or in low and middle-income countries (LMICs). METHODS:This study uses a qualitat...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-018-3693-6
更新日期:2018-11-29 00:00:00
abstract:BACKGROUND:Smoking during pregnancy is a major public health concern and an NHS priority. In 2010, 26% of UK women smoked immediately before or during their pregnancy and 12% smoked continuously. Smoking cessation support is provided through free at the point of use Stop Smoking Services for Pregnant women (SSSP). Howe...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-107
更新日期:2014-03-04 00:00:00
abstract:BACKGROUND:UK and US policy initiatives have suggested that, in the future, patients and clinicians in mainstream medicine could use genetic information to prevent common illnesses. There are no studies on patients' experience and understanding of the process of testing for common genetic susceptibilities in mainstream...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-82
更新日期:2007-06-12 00:00:00