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PubMed1998

Priority setting in health care: burden of disease cannot be jettisoned.

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Australia↗

PubMed2006

Risk perceptions, barriers, and motivators to tractor ROPS retrofitting in the New York state farm community.

The prevalence of tractor rollovers among agricultural workers has made the retrofitting of tractors with rollover protective structures (ROPS) and seat belts a public health priority for agricultural health and safety specialists. To address this concern, the New York Center for Agricultural Medicine and Health (NYCAMH) developed a seven-question survey, designed to assess perceptions of risk as well as potential motivators and barriers to retrofitting. Data from 465 phone surveys were gathered from New York State farmers representing various commodities and farm sizes. Analysis of responses to three qualitative questions contained in the survey indicated that most farmers in New York understand the importance of ROPS but lack the proper motivation to consider retrofitting. It appears that more convenient safety strategies, cost, and age of the tractor compete with a farmer's initiative to retrofit. In addition, survey responses illustrate that although many farmers believe ROPS are important in a general sense, many believe that this safety measure is not necessary for them in particular. Frequent motivators to retrofitting are concerns about safety, although the authors conclude that a more thorough analysis of these "general safety concerns" in qualitative interviews is important.

Accident Prevention↗

PubMed2005

[Stroke units in Chile].

Stroke is a major public health problem in Chile, with an incidence similar to that of many industrialized nations, it accounts for 10% of all deaths and ranks 5th in number of healthy years of life lost to a disease. Organized inpatient care for stroke patients has been shown in systematic reviews of randomized clinical trials to be effective in preventing death, disability and institutional care, without increasing length of stay compared to usual care. Organized stroke unit care is provided by multidisciplinary teams that exclusively manage stroke patients in a dedicated ward (stroke ward) of which there are various possible models; acute stroke units which accept patients acutely but discharge early (usually within 7 days). This could include an "intensive" model of care with continuous monitoring and high nurse staffing levels; comprehensive (i.e. combined acute and rehabilitation) stroke units which accept patients acutely but also provide rehabilitation for at least several weeks if necessary. The way in which stroke units affect outcome is through reduction of complications of immobility and probably non specific neuroprotection. Stroke units should deliver high quality evidence based interventions to all eligible patients and should maintain high standards of care through staff training, guidelines and protocols, audit and quality assurance. Given that stroke is one of the fifty six health priorities in the health reform, inpatient stroke care should be delivered through stroke units organized in hospitals throughout Chile.

Chile↗

PubMed2003

The nurse's role in improving indigenous health.

The health status of indigenous peoples is a global concern with mortality and hospitalisation data indicating that the health of indigenous groups falls below that of other ethnic groups within their countries. The preliminary findings of grounded theory research project undertaken with a group of 23 New Zealand Maori women about their health priorities and 'mainstream' health service needs provide the foundation for an exploration of issues impacting on the health status of indigenous people. The role that nursing and nurses have in improving access and use of health services by indigenous people will be discussed. Strategies are suggested that nurses can utilise within their practice when working with local indigenous groups.

Cultural Diversity↗

PubMed1999

Health sector reform in the Republic of Macedonia.

AIM: To evaluate the results of current reforms in Macedonian health sector. METHOD: Description and situation analysis, covering the period 1991-1997, are focused on demographic and vital indicators, morbidity and mortality data, elements of health care system, legislation, health insurance, health care financing, and elements of health care reforms. RESULTS: The Republic of Macedonia experienced changes in the social and economic situation, similar to those in other countries in transition. The growing number of dependents (young and old persons) impact high health expenditures. High priority health problems were infant and premature adult mortality. As an inheritance of the former political system, the development of different parts of health care services was unbalanced and insurance and local network of health facilities were highly decentralized. The reforms addressed health financing and reimbursement, organization and management of health services, and pharmaceutical policies and supply. The legislation was revised, but new revision is needed. CONCLUSIONS: Health care reforms were needed in Republic of Macedonia in order to overcome the problems associated with early phase of transition. The disadvantages of the current reforms are: lack of proper political will for the implementation of activities according to the planned schedule, initial over-utilization of hospital care, and no significant changes in financing of the public sector facilities. The advantages are that the health system did not disintegrate, universal access to health services was maintained, free choice of physician was promoted, and public/private mix of services was established and financed by the Health Insurance Fund.

Delivery of Health Care↗

PubMed2000