Base de dados : MEDLINE
Pesquisa : N02.421.816 [Categoria DeCS]
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  1 / 10990 MEDLINE  
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[PMID]:29446902
[Au] Autor:Pontious JM
[Ti] Título:Turning out the lights for Rural Medicine.
[So] Source:J Okla State Med Assoc;109(6):175, 2016 06.
[Is] ISSN:0030-1876
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Orçamentos
Fechamento de Instituições de Saúde
Hospitais Rurais
Serviços de Saúde Rural
[Mh] Termos MeSH secundário: Hospitais Rurais/economia
Seres Humanos
Oklahoma
Serviços de Saúde Rural/economia
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE


  2 / 10990 MEDLINE  
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[PMID]:28466547
[Au] Autor:Inch J; Notman F; Watson M; Green D; Baird R; Ferguson J; Hind C; McKinstry B; Strath A; Bond C; Telepharmacy Research Team
[Ad] Endereço:Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
[Ti] Título:Tele-pharmacy in rural Scotland: a proof of concept study.
[So] Source:Int J Pharm Pract;25(3):210-219, 2017 Jun.
[Is] ISSN:2042-7174
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Technology enables medical services to be provided to rural communities. This proof of concept study assessed the feasibility and acceptability of delivering community pharmacy services (CPS; including advice, sale of over-the-counter products and dispensing of prescriptions) by tele-technology (the Telepharmacy Robotic Supply Service (TPRSS)) to a rural population in Scotland. METHODS: Data collection included the following: postal surveys to local residents; focus groups/ interviews with pharmacists, other healthcare professionals (HCPs) and service users, at baseline and follow-up; TPRSS logs. Interviews/focus groups were audio-recorded, transcribed and thematically analysed. Descriptive statistics were reported for survey data. RESULTS: Qualitative results: Pre-installation: residents expressed satisfaction with current pharmacy access. HCPs believed the TPRSS would improve pharmacy access and reduce pressure on GPs. Concerns included costs, confidentiality, patient safety and 'fear' of technology. Post-installation: residents and pharmacy staff were positive, finding the service easy to use. Quantitative results: Pre-installation: almost half the respondents received regular prescription medicines and a third used an over-the-counter (OTC) medicine at least monthly. More than 80% (124/156) reported they would use the TPRSS. There was low awareness of the minor ailment service (MAS; 38%; 59/156). Post-installation: prescription ordering and OTC medicine purchase were used most frequently; the video link was used infrequently. Reasons for non-use were lack of need (36%; 40/112) and linkage to only one pharmacy (31%; 35/112). DISCUSSION: Community pharmacy services delivered remotely using tele-technology are feasible and acceptable. A larger study should be undertaken to confirm the potential of the TPRSS to reduce health inequalities in rural areas.
[Mh] Termos MeSH primário: Farmácia/tendências
Serviços de Saúde Rural/tendências
Telemedicina/tendências
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Serviços Comunitários de Farmácia
Prescrições de Medicamentos/estatística & dados numéricos
Estudos de Viabilidade
Feminino
Acesso aos Serviços de Saúde
Seres Humanos
Masculino
Meia-Idade
Medicamentos sem Prescrição
Farmacêuticos
População Rural
Escócia
Fatores Socioeconômicos
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Nonprescription Drugs)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1111/ijpp.12376


  3 / 10990 MEDLINE  
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[PMID]:28461286
[Au] Autor:Zhan X; Zhang Z; Sun F; Liu Q; Peng W; Zhang H; Yan W
[Ad] Endereço:Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
[Ti] Título:Effects of Improving Primary Health Care Workers' Knowledge About Public Health Services in Rural China: A Comparative Study of Blended Learning and Pure E-Learning.
[So] Source:J Med Internet Res;19(5):e116, 2017 May 01.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Primary health care workers (PHCWs) are a major force in delivering basic public health services (BPHS) in rural China. It is necessary to take effective training approaches to improve PHCWs' competency on BPHS. Both electronic learning (e-learning) and blended learning have been widely used in the health workers' education. However, there is limited evidence on the effects of blended learning in comparison with pure e-learning. OBJECTIVE: The aim of this study was to evaluate the effects of a blended-learning approach for rural PHCWs in improving their knowledge about BPHS as well as training satisfaction in comparison with a pure e-learning approach. METHODS: The study was conducted among PHCWs in 6 rural counties of Hubei Province, China, between August 2013 and April 2014. Three counties were randomly allocated blended-learning courses (29 township centers or 612 PHCWs-the experimental group), and three counties were allocated pure e-learning courses (31 township centers or 625 PHCWs-the control group). Three course modules were administered for 5 weeks, with assessments at baseline and postcourse. Primary outcomes were score changes in courses' knowledge. Secondary outcome was participant satisfaction (5-point Likert scale anchored between 1 [strongly agree] and 5 [strongly disagree]). RESULTS: The experimental group had higher mean scores than the control group in knowledge achievement in three course modules: (1) module 1: 93.21 (95% CI 92.49-93.93) in experimental group versus 88.29 (95% CI 87.19-89.40) in the control group; adjusted difference, 4.92 (95% CI 2.61-7.24; P<.001); (2) module 2: 94.05 (95% CI 93.37-94.73) in the experimental group vs 90.22 (95% CI 89.12-91.31) in the control group; adjusted difference, 3.67 (95% CI 1.17-6.18; P=.004); (3) module 3: 93.88 (95% CI 93.08-94.68) in the experimental group versus 89.09 (95% CI 87.89-90.30) in control group; adjusted difference, 4.63 (95% CI 2.12-7.14; P<.001). The participants in the experimental learning group gave more positive responses with the four issues than control group participants: (1) the increase of interest in learning, 1.85 (95% CI 1.22-2.80; P=.003); (2) the increase of interaction with others, 1.77 (95% CI 1.20-2.60; P=.004); (3) the satisfaction with learning experience, 1.78 (95% CI 1.11-2.88; P=.02); and (4) achievement of learning objectives, 1.63 (95% CI 1.08-2.48; P=.02). CONCLUSIONS: Among PHCWs in rural China, a blended-learning approach to BPHS training could result in a higher knowledge achievement and satisfaction level compared with a pure e-learning approach. The findings of the study will contribute knowledge to improve the competency of PHCWs in similar settings.
[Mh] Termos MeSH primário: Educação a Distância/métodos
Pessoal de Saúde/educação
Internet
Aprendizagem
Atenção Primária à Saúde
Saúde Pública/educação
Serviços de Saúde Rural
Saúde da População Rural
[Mh] Termos MeSH secundário: Adulto
China
Avaliação Educacional
Feminino
Seres Humanos
Masculino
Meia-Idade
Atenção Primária à Saúde/recursos humanos
População Rural
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.6453


  4 / 10990 MEDLINE  
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[PMID]:28453715
[Au] Autor:Pan B; Towne SD; Chen Y; Yuan Z
[Ad] Endereço:Department of Health Statistics, School of Public Health, Nanchang University, Nanchang, People' Republic of China.
[Ti] Título:The inequity of inpatient services in rural areas and the New-Type Rural Cooperative Medical System (NRCMS) in China: repeated cross sectional analysis.
[So] Source:Health Policy Plan;32(5):634-646, 2017 Jun 01.
[Is] ISSN:1460-2237
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective : The main aim of the New-type Rural Cooperative Medical System (NRCMS) put into effect in 2003 was to reduce financial barriers in accessing health care services among vulnerable populations. The aim of this study was to assess the association between NRCMS and income related inequality in hospital utilization among rural inhabitants in Jiangxi Province, China. Methods : A multistage stratified random cluster sampling method was adopted to select 1838, 1879, and 1890 households as participants in 2003/2004, 2008 and 2014, respectively. The Erreygers Concentration index (EI) of two measures of hospital inpatient care including admission to hospital and hospital avoidance, were calculated to measure income-related inequality. The decomposition of the EI was performed to characterize the contributions of socioeconomic and need factors to the measured inequality. Results : An affluent-focused (pro-rich) inequity was observed for hospital admission adjusting for need factors over time. The level of inequity for hospital admission decreased dramatically, while hospital avoidance decreased marginally, and with a high value (EI, -0.0176) in 2008. The implementation of the NRCMS was associated with decreased inequity in 2008 and in 2014, but the associations were limited. Income contributed the most to the inequality of hospital utilization each year. Conclusion : The coverage of the NRCMS expanded to cover nearly all rural inhabitants in Jiangxi province by 2014 and was associated with a very small reduction in inequalities in admission to hospital. In order to increase equitable access to health care, additional financial protections for vulnerable populations are needed. Improving the relatively low level of medical services in township hospitals, and low rate of reimbursement and financial assistance with the NRCMS is recommended.
[Mh] Termos MeSH primário: Disparidades em Assistência à Saúde/estatística & dados numéricos
Hospitais/utilização
Serviços de Saúde Rural/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
China/epidemiologia
Estudos Transversais
Disparidades em Assistência à Saúde/economia
Seres Humanos
Seguro Saúde
Serviços de Saúde Rural/economia
População Rural/estatística & dados numéricos
Fatores Socioeconômicos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/heapol/czw175


  5 / 10990 MEDLINE  
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[PMID]:29240660
[Au] Autor:Mboineki JF; Zhang W
[Ad] Endereço:Joanes Faustine Mboineki, MSc, is Tutorial Assistant, The University of Dodoma College of Health and Allied Sciences, Tanzania; and Student, School of Nursing, Zhengzhou University, China. Weihong Zhang, PhD, is Professor, School of Nursing, Zhengzhou University, China.
[Ti] Título:Healthcare Provider Views on Transitioning From Task Shifting to Advanced Practice Nursing in Tanzania.
[So] Source:Nurs Res;67(1):49-54, 2018 Jan/Feb.
[Is] ISSN:1538-9847
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting-delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants-is practiced, compromising quality of care. Advanced practice nursing is underutilized. OBJECTIVE: The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses. METHODS: A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes. RESULTS: Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania. CONCLUSION: Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles-particularly the nurse practitioner role-can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.
[Mh] Termos MeSH primário: Prática Avançada de Enfermagem/organização & administração
Papel do Profissional de Enfermagem
Atenção Primária à Saúde/organização & administração
Serviços de Saúde Rural/organização & administração
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Pessoal de Saúde/organização & administração
Seres Humanos
Programas Nacionais de Saúde/organização & administração
Tanzânia
Análise e Desempenho de Tarefas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1097/NNR.0000000000000259


  6 / 10990 MEDLINE  
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[PMID]:28460530
[Au] Autor:McGrail MR; Wingrove PM; Petterson SM; Humphreys JS; Russell DJ; Bazemore AW
[Ad] Endereço:School of Rural Health, Northways Rd Churchill VIC 3842 Australia. matthew.mcgrail@monash.edu.
[Ti] Título:Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.
[So] Source:Rural Remote Health;17(2):3925, 2017 Apr-Jun.
[Is] ISSN:1445-6354
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors. This bi-national study of Australia and the USA, two developed nations with similar geographic and rural access profiles, investigates the extent to which variations in community amenity indicators are associated with spatial variations in the supply of rural primary care doctors. METHODS: Measures from two dimensions of community amenity: geographic location, specifically isolation/proximity; and economics and sociodemographics were included in this study, along with a proxy measure (jurisdiction) of a third dimension, environmental amenity. Data were chiefly collated from the American Community Survey and the Australian Census of Population and Housing, with additional calculated proximity measures. Rural primary care supply was measured using provider-to-population ratios in 1949 US rural counties and in 370 Australian rural local government areas. Additionally, the more sophisticated two-step floating catchment area method was used to measure Australian rural primary care supply in 1116 rural towns, with population sizes ranging from 500 to 50 000. Associations between supply and community amenity indicators were examined using Pearson's correlation coefficients and ordinary least squares multiple linear regression models. RESULTS: It was found that increased population size, having a hospital in the county, increased house prices and affluence, and a more educated and older population were all significantly associated with increased workforce supply across rural areas of both countries. While remote areas were strongly linked with poorer supply in Australia, geographical remoteness was not significant after accounting for other indicators of amenity such as the positive association between workforce supply and coastal location. Workforce supply in the USA was negatively associated with fringe rural area locations adjacent to larger metropolitan areas and characterised by long work commutes. The US model captured 49% of the variation of workforce supply between rural counties, while the Australian models captured 35-39% of rural supply variation. CONCLUSIONS: These data support the idea that the rural medical workforce is maldistributed with a skew towards locating in more affluent and educated areas, and against locating in smaller, poorer and more isolated rural towns, which struggle to attract an adequate supply of primary care services. This evidence is important in understanding the role of place characteristics and rural population dynamics in the recruitment and retention of rural doctors. Future primary care workforce policies need to place a greater focus on rural communities that, for a variety of reasons, may be less attractive to doctors looking to begin or remain working there.
[Mh] Termos MeSH primário: Recursos Humanos em Saúde/organização & administração
Médicos de Atenção Primária/provisão & distribuição
Atenção Primária à Saúde/organização & administração
Distribuição Espacial da População/estatística & dados numéricos
Serviços de Saúde Rural/recursos humanos
[Mh] Termos MeSH secundário: Austrália
Meio Ambiente
Acesso aos Serviços de Saúde
Seres Humanos
Isolamento Social
Fatores Socioeconômicos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.22605/RRH3925


  7 / 10990 MEDLINE  
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[PMID]:29385378
[Au] Autor:Iglehart JK
[Ad] Endereço:Mr. Iglehart is a national correspondent for the Journal.
[Ti] Título:The Challenging Quest to Improve Rural Health Care.
[So] Source:N Engl J Med;378(5):473-479, 2018 Feb 01.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Disparidades nos Níveis de Saúde
Serviços de Saúde Rural
Saúde da População Rural
[Mh] Termos MeSH secundário: Política de Saúde
Acesso aos Serviços de Saúde
Hospitais Rurais
Seres Humanos
Cobertura do Seguro
Expectativa de Vida
Medicaid
Patient Protection and Affordable Care Act
Atenção Primária à Saúde/recursos humanos
Serviços de Saúde Rural/economia
Serviços de Saúde Rural/recursos humanos
Serviços de Saúde Rural/normas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMhpr1707176


  8 / 10990 MEDLINE  
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[PMID]:29360298
[Au] Autor:Raduege TJ; Thomson Reuters Accelus.
[Ti] Título:Healthcare Reform: Delivery Reform.
[So] Source:Issue Brief Health Policy Track Serv;2017:1-71, 2017 Dec 26.
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Assistência à Saúde/organização & administração
Reforma dos Serviços de Saúde/organização & administração
[Mh] Termos MeSH secundário: Organizações de Assistência Responsáveis
Serviços de Saúde Comunitária
Redução de Custos
Cuidado Periódico
Necessidades e Demandas de Serviços de Saúde
Serviços de Assistência Domiciliar
Seres Humanos
Reembolso de Seguro de Saúde
Programas de Assistência Gerenciada
Medicaid
Medicare
Administração dos Cuidados ao Paciente
Patient Protection and Affordable Care Act
Assistência Centrada no Paciente
Projetos Piloto
Indicadores de Qualidade em Assistência à Saúde
Qualidade da Assistência à Saúde
Reembolso de Incentivo
Serviços de Saúde Rural
Governo Estadual
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE


  9 / 10990 MEDLINE  
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[PMID]:29359902
[Au] Autor:Raduege TJ; Thomson Reuters Accelus.
[Ti] Título:Healthcare facilities.
[So] Source:Issue Brief Health Policy Track Serv;2017:1-61, 2017 Dec 26.
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Instalações de Saúde
Administração de Instituições de Saúde
Administração Hospitalar
Hospitais
[Mh] Termos MeSH secundário: Organizações de Assistência Responsáveis
Prestação Integrada de Cuidados de Saúde
Governo Federal
Reforma dos Serviços de Saúde
Seres Humanos
Reembolso de Seguro de Saúde
Medicaid
Medicare
Administração dos Cuidados ao Paciente
Equipe de Assistência ao Paciente
Patient Protection and Affordable Care Act
Atenção Primária à Saúde
Qualidade da Assistência à Saúde
Reembolso de Incentivo
Serviços de Saúde Rural
Governo Estadual
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE


  10 / 10990 MEDLINE  
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[PMID]:29359900
[Au] Autor:Steiner DJ; Thomson Reuters Accelus.
[Ti] Título:Emergency care.
[So] Source:Issue Brief Health Policy Track Serv;2017:1-40, 2017 Dec 26.
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Serviços Médicos de Emergência/organização & administração
Serviço Hospitalar de Emergência/organização & administração
[Mh] Termos MeSH secundário: Assistência Ambulatorial
Instituições de Assistência Ambulatorial
Reforma dos Serviços de Saúde
Gastos em Saúde
Acesso aos Serviços de Saúde
Linhas Diretas
Seres Humanos
Cobertura do Seguro/economia
Seguro Saúde/economia
Reembolso de Seguro de Saúde
Tempo de Internação
Serviços de Saúde Mental
Mortalidade
Transtornos Relacionados ao Uso de Opioides
Cuidados Paliativos
Patient Protection and Affordable Care Act
Projetos Piloto
Reembolso de Incentivo
Serviços de Saúde Rural
Provedores de Redes de Segurança
Governo Estadual
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE



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