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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (31 March 2020) | Viewed by 14164

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Special Issue Editors

Prof. Dr. John Amson Capitman

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Guest Editor

Central Valley Health Policy Institute, California State University Fresno, Fresno, CA, USA
Interests: health policy; health equity; social and environmental determinants

Dr. Tania Pacheco-Werner

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Guest Editor

Central Valley Health Policy Institute, Fresno State University, Fresno, United States
Interests: policy analysis; immigrant and men’s health; health-seeking behavior; food and environment systems; methodology

Special Issue Information

Dear Colleagues，

Community-based individual health care services have, among their goals, reducing the impacts of social and environmental determinants of health. In most countries around the world, racial/ethnic and social class groups that have been historically devalued, economically exploited, or politically excluded continue to experience poorer living conditions and greater exposures to environmental degradation. Health care services offered by primary care and health promotion providers sometimes seek to assist individuals in minimizing the influence of social and environmental factors by improving access to care, incentivizing disease prevention and chronic condition self-management, introducing community health workers and peer group programs, broad dissemination of innovative medical interventions, educating care providers and patients about managing their health, and engaging providers and patients in policy advocacy. Although many of these strategies have proven effective in improving health outcomes for individuals and populations, there are many remaining questions about the relative efficacy and cost-effectiveness of targeted improvements in living and environmental conditions compared to health care interventions and the pathways through which health outcomes improvements are obtained. While a broad literature exists on the contributions of race/ethnicity, social class, and residential location to health disparities, far less is known about how these populations impacts are produced and how individual health services can mitigate the effects of macro-individual factors.

This Special Issue in the International Journal of Environmental Research and Public Health is devoted to recent findings on “Community-Based Health Care as a Response to Social and Environmental Determinants of Health Inequities” to make substantial contributions to knowledge gaps in understanding when and how individual health care services and health system reforms are effective in addressing health inequalities related to living conditions and environmental exposures.

A wide range of topics will be included in this issue, related to, but not limited to implementation and evaluation of community based health care interventions, their impacts on social and environmental determinants of health inequalities, measurement of program adoption, fidelity and outcomes, characteristics of individuals, health conditions, and community contexts associated with relative intervention impacts, the roles of provider and patient advocacy, and provider and participant knowledge, attitude and behavior change associated with community based health care services interventions that improve health outcomes for historically devalued or excluded groups.

Prof. Dr. John Amson Capitman
Dr. Tania Pacheco-Werner
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

health outcomes
clinical care
community health
health equity
social and environmental determinants
intervention
evaluation
health system reform

Published Papers (3 papers)

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Research

15 pages, 743 KiB

Open AccessFeature PaperArticle

Profile of Long-Term Care Recipients Receiving Home and Community-Based Services and the Factors That Influence Utilization in Taiwan

by Chia-Mei Shih, Yu-Hua Wang, Li-Fan Liu and Jung-Hua Wu

Int. J. Environ. Res. Public Health 2020, 17(8), 2649; https://doi.org/10.3390/ijerph17082649 - 13 Apr 2020

Cited by 12 | Viewed by 3308

Abstract

In response to the irreversible aging trend, the Taiwan government has promoted the Long-Term Care (LTC) policy 1.0 launched in 2007 and the LTC policy 2.0 reform since 2016. This study aimed to explore the utilization of formal home and community-based care under LTC policy 1.0 to add scientific support for the on-going LTC policy 2.0 reform. Methods: By using Andersen and Aday’s behavioral model of healthcare utilization, the long-term care dataset was analyzed from 2013 to 2016. A total of 101,457 care recipients were identified after data cleaning. Results: The results revealed that about 40.7% of the care recipients stayed in the care system for more than two years. A common factor influencing the length of home and community-based services (HCBS) utilization period included need factors, where more dependent recipients leave the LTC system regardless of their socio-economic status. However, the utilization period of non-low-income households is significantly affected by the level of service resources. Conclusion: For long-term care needs, the phenomenon of a short utilization period was concerning. This study adds information which suggests policy should reconsider care capacity and quality, especially for moderate to severely dependent recipients. This will allow for better understanding to help maintain care recipients in their own communities to achieve the goal of having an aging in place policy. Full article

(This article belongs to the Special Issue Community-Based Health Care)

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13 pages, 2081 KiB

Open AccessArticle

Healthcare Associated Infections—A New Pathology in Medical Practice?

by Septimiu Voidazan, Sorin Albu, Réka Toth, Bianca Grigorescu, Anca Rachita and Iuliu Moldovan

Int. J. Environ. Res. Public Health 2020, 17(3), 760; https://doi.org/10.3390/ijerph17030760 - 25 Jan 2020

Cited by 38 | Viewed by 6670

Abstract

Background: Hospital-acquired infections (HAI) contribute to the emotional stress and functional disorders of the patient and in some cases, can lead to a state of disability that reduces quality of life. Often, HAI are one of the factors that lead to death. The purpose of this study was to analyze the cases of HAI identified in public hospitals at the county level, through case report sheets, as they are reported according to the Romanian legislation. Methods: We performed a cross sectional study design based on the case law of the data reported to the Mures Public Health Directorate, by all the public hospitals belonging to this county. We tracked hospital-acquired infections reported for 2017–2018, respectively, a number of 1024 cases, which implies a prevalence rate of 0.44%, 1024/228,782 cases discharged from these hospitals during the studied period. Results: The most frequent HAIs were reported by the intensive care units (48.4%), the most common infections being the following: bronchopneumonia (25.3%), enterocolitis with Clostridioides difficile (23.3%), sepsis, surgical wound infections and urinary tract infections. At the basis of HAI were 22 pathogens, but the five most common germs were Clostridioides difficile, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus. Bronchopneumonia have been most frequently reported in intensive care units, the most common being identified the Acinetobacter baumannii agent. Sepsis and central catheter infections also appeared predominantly in intensive care units, more often with Klebsiella pneumoniae. The enterocolitis with Clostridioides difficile, were the apanage of the medical sections. Infections with Staphylococcus aureus have been identified predominantly in the surgical sections at the level of the surgical wounds. Urinary infections had a similar distribution in the intensive care units, the medical and surgical sections, with Klebsiella pneumoniae being the most commonly incriminated agent. Conclusions: We showed a clear correspondence between the medical units and the type of HAI: what recommends the rapid, vigilant and oriented application of the prevention and control strategies of the HAI. Full article

(This article belongs to the Special Issue Community-Based Health Care)

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14 pages, 621 KiB

Open AccessArticle

Residents’ Awareness of Family Doctor Contract Services, Status of Contract with a Family Doctor, and Contract Service Needs in Zhejiang Province, China: A Cross-Sectional Study

by Xiaopeng Shang, Yangmei Huang, Bi’e Li, Qing Yang, Yanrong Zhao, Wei Wang, Yang Liu, Junfen Lin, Chonggao Hu and Yinwei Qiu

Int. J. Environ. Res. Public Health 2019, 16(18), 3312; https://doi.org/10.3390/ijerph16183312 - 9 Sep 2019

Cited by 56 | Viewed by 3775

Abstract

In China, family doctor services originated in 2009. After two years, the Chinese government proposed the establishment of a family doctor contract system suitable for China’s national conditions. Then, in 2016, a multi-department jointly issued an important document, which further clarified the development goals of family doctor contract services in the next five years. Zhejiang Province has been exploring responsible doctor contract services since 2012, which was promoted throughout the province in 2015. Objectives: The aim of this study was to investigate the residents’ awareness of Zhejiang Province, China, of family doctor contract services, the status of signing such a contract, and the demand for service items in the contracted service package. Further, we sought to explore the relevant influential factors in order to provide a reference and evidence-based recommendations for the further development of family doctor contract services. Design: We enrolled 3960 residents from nine counties in Zhejiang Province using a multistage stratified random sampling method. A survey using a self-designed questionnaire was used to collect the demographic data, residents’ awareness of family doctor contract services, the status of contracting, and demand for different items from October to December 2017. Data were analyzed by SPSS 21.0. Results: In total, 3871 residents returned valid questionnaires, with a response rate of 97.75%. The awareness rate of residents of family doctor contract services was 71.58% (2771/3871). Age, education level, and chronic medical history status were the influencing factors affecting residents’ awareness. The contracted rate was 50.43% (1952/3871). Age, education level, personal monthly income, chronic disease history, and awareness of family doctor contract services were the influencing factors. Residents who have a contract with family doctors have a higher demand for family doctor contract services, and different residents have different needs for the project because of their physical condition, education level, marital status, household registration, and personal monthly income level. The top three needs of the residents for contracted services were health consultation (84.64%), regular physical examination (81.71%), and increasing the proportion of medical insurance reimbursements (80.06%). Conclusions: The awareness rate of family doctor contract services and the contracting rate are unsatisfactory among residents of Zhejiang Province. It is suggested that the government should more heavily publicize family doctor contract services, expand the coverage, introduce personalized contract schemes to meet the needs of different groups, and promote the rapid development of family doctor contract services in Zhejiang Province. Full article

(This article belongs to the Special Issue Community-Based Health Care)

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