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'Social Work and Human Services Best Practice' is organised about the 10 key issues of child protection, young offenders, adult offenders, mental health, disability, healthcare, ageing, working in rural and remote communities, Indigenous Australians, and migrants and refugees. Comprehensive consideration is given to the practical, theoretical, legal and political aspects of working in these areas and effective strategies for doing so are identified.

Background Health care in many countries entails long waiting times. Avoidable healthcare visits by young adults have been identified as one probable cause. Objective The aim of this study was to explore healthcare providers experiences and opinions about young adults healthcare utilisation in the first line of care. Method This study used latent qualitative conventional content analysis with focus groups. Four healthcare units participated: two primary healthcare centres and two emergency departments. This study included 36 participants, with 4-7 participants in each group, and a total of 21 registered nurses and 15 doctors. All interviews followed an interview guide. Results Data were divided into eight categories, which all contained the implicit theme of distribution of responsibility between the healthcare provider and the healthcare user. Young adult healthcare consumers were considered to be highly influenced by external resources, often greatly concerned with small/vague symptoms they had difficulty explaining and unable to wait with. The healthcare providers role was much perceived as being part of a healthcare structure-a large organisation with multiple units-and having to meet different priorities while also considering ethical dilemmas, though feeling supported by experience. Conclusion Healthcare personnel view young adults as transferring too much of the responsibility of staying healthy to the healthcare system. The results of this study show that the discussion of young adults unnecessarily seeking health care includes an underlying discussion of scarcity of resources. Patient or Public Contribution The conduct of this study is based on interviews with young adult patients about their experiences of seeking healthcare. ; Funding Agencies|Region Ostergotland [LIO-720671]; Forskningsradet i Sydostra Sverige [FORSS-749601]

International audience ; This chapter addresses the increasing role of digital healthcare in the overall Chinese healthcare system. As described in previous chapters, the healthcare system faces many issues, such as the confrontational relationship between doctors and patients, the poor access for populations in rural areas, the significant mark-up throughout distribution channels, a financially heavy burden for chronic diseases, poor quality of healthcare supply and inefficient hospital operation except Level 3 hospitals that have to deal with an over-demand. Many solutions have been proposed, such as the multiplication of healthcare suppliers, the establishment of general practitioners as gatekeepers for hospital admissions, the implementation of public health insurance schemes or the government support for reforms in favour of private health insurance and private healthcare providers. However, they have not proven sufficient to solve all problems yet. Digital healthcare is likely to play an increasing part in addressing these issues. One of the strengths of e-health is the quick and widespread adoption of mobile platforms. This may help solve access challenges, through online appointment registration systems, models of online-offline services, two-communication platforms between patients and physicians, sharing information through the Electronic Health Record (EHR) and Electronic Medical Record (EMR) systems, the generalized implementation of a DRG-based payment system, making patients more increasingly active actors in maintaining the health status, and improving the online drug market. On the flip side, this also raises many concerns regarding the confidentiality of personal medical data and the monopoly situation of some internet companies.

International audience ; This chapter addresses the increasing role of digital healthcare in the overall Chinese healthcare system. As described in previous chapters, the healthcare system faces many issues, such as the confrontational relationship between doctors and patients, the poor access for populations in rural areas, the significant mark-up throughout distribution channels, a financially heavy burden for chronic diseases, poor quality of healthcare supply and inefficient hospital operation except Level 3 hospitals that have to deal with an over-demand. Many solutions have been proposed, such as the multiplication of healthcare suppliers, the establishment of general practitioners as gatekeepers for hospital admissions, the implementation of public health insurance schemes or the government support for reforms in favour of private health insurance and private healthcare providers. However, they have not proven sufficient to solve all problems yet. Digital healthcare is likely to play an increasing part in addressing these issues. One of the strengths of e-health is the quick and widespread adoption of mobile platforms. This may help solve access challenges, through online appointment registration systems, models of online-offline services, two-communication platforms between patients and physicians, sharing information through the Electronic Health Record (EHR) and Electronic Medical Record (EMR) systems, the generalized implementation of a DRG-based payment system, making patients more increasingly active actors in maintaining the health status, and improving the online drug market. On the flip side, this also raises many concerns regarding the confidentiality of personal medical data and the monopoly situation of some internet companies.

International audience ; This chapter addresses the increasing role of digital healthcare in the overall Chinese healthcare system. As described in previous chapters, the healthcare system faces many issues, such as the confrontational relationship between doctors and patients, the poor access for populations in rural areas, the significant mark-up throughout distribution channels, a financially heavy burden for chronic diseases, poor quality of healthcare supply and inefficient hospital operation except Level 3 hospitals that have to deal with an over-demand. Many solutions have been proposed, such as the multiplication of healthcare suppliers, the establishment of general practitioners as gatekeepers for hospital admissions, the implementation of public health insurance schemes or the government support for reforms in favour of private health insurance and private healthcare providers. However, they have not proven sufficient to solve all problems yet. Digital healthcare is likely to play an increasing part in addressing these issues. One of the strengths of e-health is the quick and widespread adoption of mobile platforms. This may help solve access challenges, through online appointment registration systems, models of online-offline services, two-communication platforms between patients and physicians, sharing information through the Electronic Health Record (EHR) and Electronic Medical Record (EMR) systems, the generalized implementation of a DRG-based payment system, making patients more increasingly active actors in maintaining the health status, and improving the online drug market. On the flip side, this also raises many concerns regarding the confidentiality of personal medical data and the monopoly situation of some internet companies.

International audience ; This chapter addresses the increasing role of digital healthcare in the overall Chinese healthcare system. As described in previous chapters, the healthcare system faces many issues, such as the confrontational relationship between doctors and patients, the poor access for populations in rural areas, the significant mark-up throughout distribution channels, a financially heavy burden for chronic diseases, poor quality of healthcare supply and inefficient hospital operation except Level 3 hospitals that have to deal with an over-demand. Many solutions have been proposed, such as the multiplication of healthcare suppliers, the establishment of general practitioners as gatekeepers for hospital admissions, the implementation of public health insurance schemes or the government support for reforms in favour of private health insurance and private healthcare providers. However, they have not proven sufficient to solve all problems yet. Digital healthcare is likely to play an increasing part in addressing these issues. One of the strengths of e-health is the quick and widespread adoption of mobile platforms. This may help solve access challenges, through online appointment registration systems, models of online-offline services, two-communication platforms between patients and physicians, sharing information through the Electronic Health Record (EHR) and Electronic Medical Record (EMR) systems, the generalized implementation of a DRG-based payment system, making patients more increasingly active actors in maintaining the health status, and improving the online drug market. On the flip side, this also raises many concerns regarding the confidentiality of personal medical data and the monopoly situation of some internet companies.

Introduction: Imbalanced distribution of healthcare providers between urban and rural areas is one of the difficulties facing health service provision in Indonesia. Several regulations have been made by the governmentto solve the problem. The objective of this paper is to describe the provision of human resources for healthcare services in Indonesia. Methodology: A review of medical related electronic databases, CINAHL and Ovid MEDLINE, was undertaken from their commencement date until the end of January 2017. The grey literature from the Indonesian government, the World Health Organisation and the World Bank websites was also searched. Results: There were 92 articles identified from the CINAHL and 222 articles from the Ovid MEDLINE databases. Five articles were included from the two databases and five documents from grey literature with ten articles to be reviewed. Discussion: Nurses and midwives account for the largest proportion of healthcare providers in Indonesia. The ratio of healthcare providers in Indonesia is lower than the average of South-East Asian and other lower middle income countries. More than half of the healthcare providers in Indonesia provide care in community health centres. Several regulations have been proclaimed to improve the imbalanced proportion of healthcare providers across the country. Conclusion: Indonesia continues to develop strategies towards successful distribution of healthcare providers across the country. A study investigating the impact of the programs reducing the imbalanced distribution of healthcare providers on health outcomes is essential for Indonesia.

Myanmar transitioned to a civilian government in March, 2011. Although the democratic process has accelerated since then, many problems in the field of healthcare still exist. Since there is a limited overview on the healthcare in Myanmar, this article briefly describes the current states surrounding health services in Myanmar. According to the Census 2014, the population in the Republic of the Union of Myanmar was 51,410,000. The crude birth rate in the previous one year was estimated to be 18.9 per 1,000, giving the annual population growth rate of 0.89% between 2003 and 2014. The Ministry of Health reorganized into six departments. National non-governmental organizations and community-based organizations support healthcare, as well as international non-governmental organizations. Since hospital statistics by the government cover only public facilities, the information on private facilities is limited. Although there were not enough medical doctors (61 per 100,000 population), the number of medical students was reduced from 2,400 to 1,200 in 2012 to ensure the quality of medical education. The information on causes of death in the general population could not be retrieved, but some data was available from hospital statistics. Although the improvement was marked, the figures did not reach the levels set by Millennium Development Goals 4 and 5. A trial prepaid health insurance system started in July 2015, to be followed by evaluation one year later. There are many international donors, including the Japan International Cooperation Agency, supporting health in Myanmar. With these efforts and support, a marked progress is expected in the field of healthcare.

This article sets out the moral failure of single-tier basic healthcare. Single-tier basic healthcare has been advocated on the grounds that the provision of healthcare should be divorced from ability to pay and unequal access to basic healthcare is morally intolerable. However, single-tier basic healthcare encounters a host of catastrophic moral failings. Given the fact of human pluralism it is impossible to objectively define 'basic' healthcare. Attempts to provide single-tier healthcare therefore become political processes in which interest groups compete for control of scarce resources with the most privileged possessing an inbuilt advantage. The focus on outputs in arguments for single-tier provision neglects the question of justice between individuals when some people provide resources for others without reciprocal benefits. The principle that only healthcare that can be provided to everyone should be provided at all leads to a levelling-down problem in which advocates of single-tier provision must prefer a situation where some individuals are made worse-off without any individual being made better-off compared to plausible multi-tier alternatives. Contemporary single-tier systems require the exclusion of non-citizens, meaning that their universalism is a myth. In the light of these pathologies it is judged that multi-tier healthcare is morally required.

[Italiano]: Una delle sfide che ha maggiormente segnato il dibattito pubblico degli ultimi anni ha riguardato lo sforzo di salvaguardare la sostenibilità dell'assistenza sanitaria in relazione al cambiamento demografico. Il progressivo invecchiamento della popolazione, nonché la tendenziale cronicizzazione delle malattie, richiede l'impiego di metodiche di cura con requisiti tecnologici-assistenziali sempre più avanzati e costosi, che in Italia gravano e mettono in difficoltà, sia da un punto di vista sanitario sia economico, il Sistema Sanitario Nazionale. Tale criticità è emersa anche durante la pandemia da COVID-19, comprovando la necessità di ripensare al modello di gestione della cronicità, ancora troppo centrato su una prospettiva specialistica e/o ospedaliera, per renderlo più idoneo a rispondere alle problematiche assistenziali dei pazienti nel rispetto delle risorse economiche disponibili. A questo proposito, può risultare di grande interesse l'Outcome Research, intesa come area di ricerca che si avvale della Real World Evidence (RWE), poiché dalle analisi delle evidenze prodotte nel mondo reale è possibile confermare o meno la validità delle decisioni politiche attuate al fine di migliorare la governance e la qualità dei servizi erogati. Questo lavoro intende proporre una fotografia dettagliata della prevalenza delle patologie croniche, e delle relative comorbidità, in Regione Campania ma, nel contempo, vuole anche essere un efficace strumento di conoscenze a disposizione di quei decisori impegnati nella programmazione delle politiche e delle strategie sanitarie. /[English]: One of the main challenges in the healthcare sector in recent years has concerned the effort to ensure the healthcare sustainability in view of demographic change. Due to the progressive increasing of aging and chronic conditions, it is necessary to employ treatment methods with increasingly advanced and costly technological and care requirements that the Italian Health System has to deal with both from a health and economic ...

Introduction: There have been two major transitions for healthcare in Indonesia: the implementation of government decentralisation and universal health insurance. A universal public health insurance called Badan Penyelenggara Jaminan Sosial (BPJS) was launched in January 2014 and aims to cover all Indonesian people. Objective: The objective of this paper is to discuss the funding of healthcare in Indonesia through a comparison with other South East Asian countries. Methodology: A search for relevant literature was undertaken using electronic databases, Ovid Medline, ProQuest Central, and Scopus from their commencement date until December 2015. The grey literature from the Indonesian government, the WHO's and World Bank's website, has been included. Results: There were nine articles from Ovid Medline, eight from ProQuest Central, and 12 from Scopus that met the criteria. Seventeen articles were duplicates leaving 12 articles to be reviewed. Nine documents have been identified from grey literature. Discussion: Most people in Indonesia sought health services from the private sector and were out-ofpocket financially or did not receive the required care. The private sector delivered 62.1% of health services compared to 37.9% by the government. Despite some inappropriate use of previous health insurance, the BPJS is expected to have improved management and will cover all citizens by the end of 2019. Conclusion: Indonesia has undergone a series of changes to health system funding and health insurance. There are lessons that can be learnt from other countries, such as Thailand, Cambodia, and Vietnam, so that Indonesia can improve its health funding. Abbreviations: BPJS – Badan Penyelenggara Jaminan Sosial.

Healthcare in South Africa is in a crisis. Problems with infrastructure, management, human resources and the supply of essential medicines are at a critical level. This is compounded by a high burden of disease and disparity in levels of service delivery, particularly between public and private healthcare. The government has put ambitious plans in place, which are part of the National Development Plan to ward 2030. In the midst of this we find the individual person and their family and community staggering under the suffering caused by disease, poverty, crime and violence. There is a more than 70% chance that this person and their family and community are trying to make sense of this within a spiritual framework and that they belong to a faith-based community. This article explores the valuable contribution of spirituality, spiritual and pastoral work, the faith-based community (FBC) and faith-based organisations (FBOs) to holistic people-centred healthcare in South Africa. ; Dr André de la Porte is participating in the research project, 'Spirituality and Health', directed by Dr Stephan de Beer, Centre for Contextual Ministry and Department of Practical Theology, Faculty of Theology, University of Pretoria. ; http://www.hts.org.za ; am2016 ; Practical Theology

Federal and state governments, as well as third party payees, have created incentives for cost containment policies within healthcare settings. The purpose of this study is to determine the extent healthcare financial managers (HCFMs) believe various healthcare reform measures and cost containment strategies are effective and to descriptively compare the perception of effectiveness by type of organization (for profit, not for profit, and outside CPA/consulting firm). Eighty-four HCFMs, from 36 states, agree that the majority of healthcare reform measures are moderately or very effective. In general, accounting practices that HCFMs have direct decision making authority over were deemed effective (i.e. accounting systems that reduce administrative costs) regardless of type of agency employed. Surprisingly, accounting systems that provide more accurate allocation of indirect-overhead costs were not considered effective by not-for profit organizations. On the other hand, analyzing variances between expectations and actual cost/revenue, closely monitoring supply and equipment costs, and reducing administrative costs were rated effective by all three groups.

BACKGROUND: Changes to the method of payment for healthcare providers, including pay‐for‐performance schemes, are increasingly being used by governments, health insurers, and employers to help align financial incentives with health system goals. In this review we focused on changes to the method and level of payment for all types of healthcare providers in outpatient healthcare settings. Outpatient healthcare settings, broadly defined as 'out of hospital' care including primary care, are important for health systems in reducing the use of more expensive hospital services. OBJECTIVES: To assess the impact of different payment methods for healthcare providers working in outpatient healthcare settings on the quantity and quality of health service provision, patient outcomes, healthcare provider outcomes, cost of service provision, and adverse effects. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase (searched 5 March 2019), and several other databases. In addition, we searched clinical trials platforms, grey literature, screened reference lists of included studies, did a cited reference search for included studies, and contacted study authors to identify additional studies. We screened records from an updated search in August 2020, with any potentially relevant studies categorised as awaiting classification. SELECTION CRITERIA: Randomised trials, non‐randomised trials, controlled before‐after studies, interrupted time series, and repeated measures studies that compared different payment methods for healthcare providers working in outpatient care settings. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. We conducted a structured synthesis. We first categorised the payment methods comparisons and outcomes, and then described the effects of different types of payment methods on different outcome categories. Where feasible, we used meta‐analysis to synthesise the effects of payment interventions under the same category. Where it was not possible to perform ...

Modern mental healthcare in Poland has its foundations in the 19th century, when the country was subject to three different organisational and legal systems – of the Austrian, Prussian and Russian Empires. These differences prevailed even after the First World War. Professionals lobbying for a mental health act had no success. The Second World War left mental healthcare with significant losses among its professional groups. More than half of all Polish psychiatrists lost their lives; some of them were exterminated as Jews, some as prisoners of the Soviets. The Nazi occupation in Poland had dramatic consequences for people with a mental disturbance, as Action T4 turned into genocide on the Polish territory. The majority of psychiatric in-patients were killed. After the Second World War, the mental health system had to be rebuilt, almost from scratch. Major political changes in the country across the second part of the 20th century and revolutionary changes in mental healthcare around the world influenced psychiatric services. The purpose of this paper is to describe mental healthcare in Poland today.