History[ edit ] The first move towards a national health insurance system was launched in Germany inwith the Sickness Insurance Law. Other countries soon began to follow suit. In the United Kingdomthe National Insurance Act provided coverage for primary care but not specialist or hospital care for wage earners, covering about one third of the population.
Odds ratios were adjusted for maternal country of birth, maternal age, area deprivation, plurality, parity and population density. Discussion We used routinely collected health data and GIS in this study to demonstrate the feasibility of using metrics of geographic access to health services in public health and health services research.
We used two GIS functionalities to quantify geographic access to general practices by density and proximity. Previous studies used simple CBs as density metrics to capture variables of interest.
Therefore, we constructed PRNBs to generate more realistic buffers. Women who smoked during pregnancy had significantly fewer general practices close to their residence than women who did not smoke during pregnancy. This finding makes intuitive sense.
However, a regression model showed no associations between the number of general practices and smoking during pregnancy. In the adjusted regression model, these two associations to number of general practices in the vicinity remained significant.
This was an unexpected finding because we had hypothesised that increased general practice numbers would mean greater access to general practitioners and hence visits earlier in pregnancy. Our findings may have been unexpected but are not surprising.
Our general practice metrics density and proximity measures are geographic or physical measures, and are only one component of accessibility to health services. Other important aspects include affordability, cultural acceptability and whether care is available when needed.
With increasing sophistication of GIS software and computational hardware, car travel time on the road network the quickest route between two points is another geographic access metric for health services that is now being widely used.
In addition, travel time computation in GIS does not take into account unpredictable local conditions such as traffic congestion and inclement weather or temporal conditions such as weekdays and weekends.
Day 1 | Day 2 | Download Brochure Some of the biggest challenges of delivering a successful clinical study are identifying, measuring and understanding the . A good Feasibility Study helps to objectively decide whether to proceed with a proposed project. A Feasibility Study should have broad considerations when . Appendix: Supplementary Material to Feasibility Study of Supply and Demand for Diabetes Prevention Programs in North Carolina This appendix is available for download as a Microsoft Word document [DOC – KB].
There are some barriers although not insurmountable ones to using GIS. Its application in health research requires significant resources, technical skills and organisational commitment. Although some GIS software is freely available, it may have limited functionality, so may not be fit for purpose.
GIS software with full functionality can be expensive to purchase and maintain. Further, application of network analysis on large datasets can be computationally intensive, requiring high-end, expensive computer hardware.
High-level skills are required in preparing, exploring, modelling and presenting the data. One limitation of our study is that we calculated geographic access to general practices, rather than access to general practitioners themselves, as measures of access to primary healthcare.
Large group practices five or more general practitioners per practice 22 are more common than solo or smaller group practices, and it would have been important to adjust for this.
Unfortunately, we did not have the necessary information. Women may have visited general practices closer to their place of employment. A common assumption in studies investigating geographic access to health services is that people will use health services closest to where they live or work, but this may not necessarily be true.
Further, hospital factors, such as lack of resources, may be the cause of late first antenatal visits, rather than women choosing to delay antenatal visits.
Finally, although not a study limitation, it should be noted that, because of the large number of subjects in our study, small differences, whether meaningful or not, are likely to be statistically significant. Conclusion This study aimed to demonstrate the feasibility of using metrics of geographic access to health services in public health and health services research.
We used a number of GIS functionalities to quantify density and proximity metrics of access to general practices to determine whether geographic access to general practitioners was associated with smoking during pregnancy and late first antenatal visit.
There were generally no, or only weak, associations between geographic access and smoking during pregnancy or late first antenatal visit.In the following section, the feasibility of surveying health care contexts, in connection to implementation of guidelines such as the SNGSC, is discussed, as well as the feasibility and acceptability of the data collection procedures used in this study.
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An AHMC Executive Team will travel to the site in order to conduct a survey and interview board members, community leaders, and other key influential stakeholders that can have a positive influence on the success of the project. The care homes were purposively sampled to obtain a diverse sample based on ownership, size and type of care provided (nursing and/or residential), to enable the evaluation of feasibility and acceptability of the trial design and methodologies across a range of long-term care settings.
PORTSMOUTH -- The director of a federal agency studying the PFC exposure at the former Pease Air Force Base believes there should be a national health study done on the chemical's health effects. Full Index. This is the full index of HAAD Health Facility Guidelines parts A to F.
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