Despite some serious past efforts to clarify its multiple dimensions and meanings, access to health care has remained a rather elusive concept, hampering the work of health care policymakers and professionals as they ...
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Despite some serious past efforts to clarify its multiple dimensions and meanings, access to health care has remained a rather elusive concept, hampering the work of health care policymakers and professionals as they endeavor to effect meaningful health care reform. This article provides perhaps the most detailed clarification of the access concept, especially the crucial linkages among the various access dimensions, and presents a comprehensive conceptual framework for evaluation and planning activities as they relate to people's access to health care services. The proposed conceptual model recognizes access as the outcome of a process involving the interplay between the characteristics of the health care service system and of potential users in a specified area, and moderated by health care related public policy and planning efforts. An elaborate typology of access, incorporating four pairs of access dimensions, is also derived. This atomization of the concept allows us to focus on specific aspects of the access to health care problem, and to develop precise outcome indicators Of health System performance for evaluative purposes. Further, it enables the ''cess concept and its pertinent dimensions to be put into proper perspective when assessing the health care access situation in a specific national or regional context. The relevance of the proposed access model and the typology to health care planning in general, and to spatial planning of health care service systems in particular, is also discussed.
Assembling information about individuals over time allows health managers and researchers to describe the progression of diseases, the care history of individuals and the sequences of care episodes that potentially re...
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Assembling information about individuals over time allows health managers and researchers to describe the progression of diseases, the care history of individuals and the sequences of care episodes that potentially result in improving individuals' health status. However, current mental health statistics generally focus on sets of events rather than groups of individuals making it impossible to distinguish between two different persons being admitted and the same person being admitted twice. Accurate figures on treatment prevalence cannot be generated and multiservice users across time or across agencies will inflate the statistics used to plan needed services. The capacity to link consistently defined bits of information together is critical to developing a reliable information system. This article examines the adequacy of using unique identifier codes to accomplish linkage by focusing on one example of record linkage that incorporates mental health information from both community and institutional sectors in one region of Ontario, Canada. Findings indicate that unique ''cradle to grave'' identifiers do not guarantee accuracy if manual transcription is involved.
A needs assessment for child mental health program development involving a collaboration between a state university clinical psychology training program and a coalition of publicly funded child-serving agencies is des...
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A needs assessment for child mental health program development involving a collaboration between a state university clinical psychology training program and a coalition of publicly funded child-serving agencies is described. The benefits of the joint research effort for all partners are highlighted as well as the lessons learned about the processes of such a partnership. Application of the results included curricular modifications to the university's training program, the addition of new programming and the improvement of existing services to address child mental health needs, and interventions to increase community awareness of available services.
Use of the paradigm shifts advocated by futurists and the supporters of total quality management can facilitate access to new options for mental health systems. New views and innovative systems, however become difficu...
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Use of the paradigm shifts advocated by futurists and the supporters of total quality management can facilitate access to new options for mental health systems. New views and innovative systems, however become difficult to maintain in the context of increasingly rapid and unexpected change occurring in the environment. One strategy that can be employed is the use of leverage, a term usually associated with finance or politics.
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