Healthcare delivery model

  • 文章类型: Journal Article
    淋巴水肿是一种进行性淋巴疾病,可增强身体和心理社会痛苦。尽管有影响,据报道,患者在整个医疗保健系统中遇到淋巴无知。这项横断面研究旨在总结医疗系统中淋巴水肿患者的临床特征和相互作用。包括两个淋巴水肿患者队列:全球注册分析队列包括为国际数字淋巴注册做出贡献的淋巴水肿患者,而相互作用队列包括发起有关与医疗系统相互作用的问卷调查的患者。全球注册用于获取附属淋巴水肿患者的人口统计学和临床特征。然后将有关医疗保健经验和对淋巴医疗保健满意度的23项在线问卷分发给相互作用队列。从2474名参与者获得完整的回答。参与者的平均年龄为57.5±16.1岁,51.4%有癌症史。参与者报告了诊断和治疗的重大延误。癌症相关和非癌症相关的淋巴水肿患者报告了相似的程度,认为医生对他们的淋巴水肿不感兴趣;然而,非癌症相关的淋巴水肿患者报告了更多的护理不满。最终,患者继续面临淋巴水肿诊断和治疗的延误。我们开发了一个基于证据的模型,突出了改善淋巴教育和医疗保健所需的改革领域。
    Lymphedema is a progressive lymphatic disease that potentiates physical and psychosocial distress. Despite its impact, patients reportedly encounter lymphatic ignorance throughout the healthcare system. This cross-sectional study aims to summarize clinical characteristics and interactions of lymphedema patients within the healthcare system. Two lymphedema patient cohorts were included: The Global Registry Analysis Cohort included lymphedema patients who contributed to an international digital lymphatic registry and the Interactions Cohort included patients who initiated a questionnaire about interactions with the medical system. The global registry was used to obtain demographic and clinical characteristics from affiliated lymphedema patients. A 23-item online questionnaire on healthcare experiences and satisfaction with lymphatic healthcare was then distributed to the Interactions Cohort. Complete responses were obtained from 2474 participants. Participants were a mean age of 57.5 ± 16.1 years and 51.4% had a cancer history. Participants reported substantial delays in diagnosis and treatment. Cancer-related and non-cancer-related lymphedema patients reported similar levels of perceived physician disinterest in their lymphedema; however, non-cancer-related lymphedema patients reported more care dissatisfaction. Ultimately, patients continue to face delays in lymphedema diagnosis and treatment. We developed an evidence-based model highlighting areas of reform needed to improve lymphatic education and healthcare.
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  • 文章类型: Journal Article
    印度的医疗保健系统迫切需要一种新的医疗保健提供模式,以增加医疗保健的可及性并改善边缘化人群的健康状况。初级保健中心(PHCs)的难以接近和利用不足对生活在偏远地区的人们造成了不成比例的影响。因此,对于设计师来说,这是当务之急。工程师,卫生专业人员,和政策制定者以协作的心态共同制定创新的干预措施,以可持续地管理整个PHCs的可访问性,促进预防性健康,从而改善难以到达的社区的健康结果。本文研究了印度背景下关于初级医疗保健障碍的现有文献,PHCs失败的原因和前进的方向。本文进一步分析了有关现有移动医疗单位(MMU)作为常规PHC的替代解决方案的文献,并尝试提取与现有的常规静态PHC相比,提出移动初级健康中心(mPHC)的主要经验教训。目的是找出现有文献中的研究空白,并尝试为未来的研究人员解决相同的问题。设计师,工程师,卫生专业人员和政策制定者考虑提出移动初级保健中心(mPHC)的想法,作为向服务不足的社区提供基本医疗服务的主要交付模式。
    Indian healthcare system is in immediate need of a new healthcare delivery model to increase healthcare accessibility and improve the health outcomes of the marginalized. Inaccessibility and underutilization of Primary Health Centers (PHCs) disproportionately affect people living in remote areas. It is thus imperative for the designers, engineers, health professionals, and policymakers to come together with a collaborative mindset to develop innovative interventions that sustainably manage the accessibility of PHCs at large, promote preventive health, and thus improve the health outcomes of hard-to-reach communities. This article examines the available literature on barriers to primary healthcare in Indian context, the reason of failure of PHCs and the way forward. The article further analysis literature on existing Mobile Medical Units (MMUs) as an alternate solution to conventional PHCs and attempt to extract the major lessons to propose a mobile Primary Health Center (mPHC) in contrast to the existing conventional static PHCs. The intention is to find out the research gaps in the existing literature and try to address the same for future researchers, designers, engineers, health professionals and policy makers to think forward to make this idea of a mobile Primary Health Center (mPHC), as the main delivery model to cater basic healthcare services to the underserved communities.
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  • 文章类型: Journal Article
    目前的医疗保健方案仍处于受损状态,无论是缺乏基础设施,医药和人力资源,尤其是在印度农村。此外,由于缺乏意识等几个原因,农村地区的病情恶化,适当的道路,以及缺乏适当的医疗保健模式。德里州政府,印度,建立“Mohalla”诊所,为德里及周边地区的居民提供基本的医疗保健,关注城市贫民。基本卫生服务,比如接种疫苗,计划生育,和咨询,可以在莫哈拉诊所买到,一个医生,一个护士,药剂师,并配备了实验室技术员。尽管起步良好,运营成本低,莫哈拉诊所倡议仍在努力按照设想覆盖所有德里州。这项研究分析了德里的“Mohalla”诊所的运营挑战,并提出了为偏远地区的其他初级医疗保健基础设施服务实施的经验教训。分析基于系统(基础设施,设施,和服务)对55名受访者进行的文献综述和定性访谈的优势和局限性,包括医生,护士,以及使用SUTD-MIT(新加坡科技设计大学-麻省理工学院工业设计中心)的产品服务系统(PSS)访谈模板的11个Mohalla诊所中的患者。结果表明,可以从德里莫哈拉诊所的模式中吸取教训,以供其他州在其初级医疗保健部门实施。为了实现全民健康覆盖(UHC),德里莫哈拉诊所由于几个限制而不足。因此,为了实现UHC,印度的医疗体系需要一种新的医疗服务模式。因此,我们应该根据从研究中获得的见解提出一种新的医疗保健提供模式。所提出的一种这样的递送模型是移动初级健康中心(mPHC)。这个可折叠的系统可以带到遥远的地区,部署了几个小时,运行门诊(OPD),崩溃,回到基地。
    The present healthcare scenario is still in its compromised state, whether it is the lack of infrastructure, medicines and human resources, especially in rural India. Moreover, the condition worsens in rural areas due to several reasons like lack of awareness, proper roads to access, and lack of proper delivery of healthcare model. The state government of Delhi, India, set up the \"Mohalla\" Clinics to provide essential healthcare to residents of Delhi and the surrounding areas, focusing on the urban poor. Essential health services, such as vaccinations, family planning, and counselling, are available at the Mohalla Clinics, where a doctor, a nurse, a pharmacist, and a lab technician are staffed. Despite a strong start and low operating costs, the Mohalla Clinic initiative still struggles to cover all Delhi state as envisioned. This study analyses the operational challenges of Delhi\'s \"Mohalla\" Clinics and proposes lessons to be implemented for other primary healthcare infrastructure services for remote areas. The analysis is based on the systems (infrastructure, facilities, and services) strengths and limitations from a literature review and qualitative interview conducted among 55 respondents, including doctors, nurses, and patients among 11 Mohalla Clinics using the SUTD-MIT (Singapore University of Technology and Design-Massachusetts Institute of Technology Industrial Design Centre) interview template for Product Service System (PSS). The results show that there are lessons to learn from the model of Delhi Mohalla Clinics for other states to implement in their primary healthcare sectors. To achieve Universal Health Coverage (UHC), the Delhi Mohalla Clinic falls short due to several limitations. Thus, to achieve UHC, the Indian healthcare system needs a new healthcare delivery model. Hence, we ought to propose a new healthcare delivery model based on the gained insights from the study. One such delivery model proposed is a mobile Primary Health Center (mPHC). This collapsible system can be taken to far-flung regions, deployed for some hours, run the Out-Patient Department (OPD), collapsed, and returned to base.
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