Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the ...Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the sustainable development goals.In Ghana,scholarly research on the forms and prevalence of IPV is available,however knowledge of the prevalence of IPV among PLHIV is limited.To understand the prevalence of IPV among PLHIV and the intersectional factors that contribute to it,this study examined the overall prevalence of IPV among PLHIV and the associated sociodemographic factors across ten regions of Ghana.Methods:We administered face-to-face survey questionnaires to 661 randomly selected antiretroviral therapy(ART)clients using Research Electronic Data Capture tools.We used descriptive statistics(mean,standard deviation,minimum,and maximum),pairwise correlation,and multivariate regression analysis to look at the data.Results:The clients of ART experienced various forms of IPV,including sexual,physical,emotional,and economic violence and controlling behaviour.The overall prevalence of IPV among PLHIV was 27.5%.This result,although on par with the global IPV average(27%),is 1.5%higher than the national rate(26%).The Upper West Region had the highest prevalence in all the categories of IPV analysed,followed by Oti Region in second place and the Upper East Region in third,except for the prevalence of sexual violence,where Greater Accra Region ranks second.In specific regions of Ghana,sociodemographic factors shaped by patriarchal and economic considerations contribute to a higher prevalence of IPV among people living with HIV.Conclusion:The findings have implications for developing policies and interventions that address the specific factors associated with HIV-induced IPV in different regions of Ghana.These interventions should also include screening PLHIV receiving ART for their IPV status regardless of gender and deploying culturally appropriate education at the community level to foster empathy towards intimate partners living with HIV.展开更多
Background and Goals: Although health care quality improvement has traditionally involved extensive work with paper records, the adoption of health information technology has increased the use of electronic record and...Background and Goals: Although health care quality improvement has traditionally involved extensive work with paper records, the adoption of health information technology has increased the use of electronic record and administrative systems. Despite these advances, quality improvement practitioners now and for the foreseeable future need guidance in defining populations of individuals for study and in selecting and analyzing sample data from such populations. Statistical data analysis in health care research often involves using samples to make inferences about populations. The investigator needs to consider the goals of the study, whether sampling is to be used, and the type of population being studied. While there are numerous sampling strategies designed to conserve resources and yield accurate results, one of these techniques—use of the finite population correction (FPC)—has received relatively little attention in health care sampling contexts. It is important for health care quality practitioners to be aware of sampling options that may increase accuracy and conserve resources. This article describes common sampling situations in which the issue of the finite population correction decision often arises. Methods: This article describes 3 relevant sampling situations that influence the design and analysis phases of a study and offers guidance for choosing the most effective and efficient design. Situation 1: The study or activity involves taking a sample from a large finite target population for which enumerative inferences are needed. Situation 2: The population is finite and the study is enumerative. A complete enumerative count of “defects” in the process is needed so that remediation can occur. Here, statistical inference is unnecessary. Situation 3: The target population is viewed as infinite;such populations are “conceptual populations” [1] or “processes”. Results: The article shows how savings in resources can be achieved by choosing the correct analytic framework at the conceptualization phase of study design. Choosing the right sampling approach can produce accurate results at lower costs. Several examples are presented and the implications for health services research are discussed. Conclusion: By clearly specifying the objectives of a study and considering explicitly whether the data are a sample or a population, the practitioner may be able to design a more efficient study and thereby conserve resources. This article provides a conceptual framework in the form of three situations, several examples, and an algorithm (Figure 1) to help the intervention planner determine how to classify the study and when to apply the FPC.展开更多
For patients receiving chemotherapy, drugs represent the largest cost. Clinical chemotherapy Pathways have become a critical strategy to identify unnecessary drug costs and to implement mechanisms to deliver lower cos...For patients receiving chemotherapy, drugs represent the largest cost. Clinical chemotherapy Pathways have become a critical strategy to identify unnecessary drug costs and to implement mechanisms to deliver lower cost alternatives without sacrificing outcomes or quality of care. This paper describes the steps of development of a functioning pathways program beginning in an environment of full-risk capitation, including drugs. The next steps involved quantitating the potential impact of such a program and then collaborating with a payer to test the concept. When these studies showed promise, the practices adopting pathways used them as a backbone for drug management in the Oncology Care Model. These experiences very likely represent steps in a continuum towards placing more of the drug delivery costs at risk. The potential for again considering capitated payments is discussed.展开更多
基金supported by the Christian Health Association of Ghana under Global Fund New Funding Model 3(NFM 3)HIV/TB Community Systems Strengthening programme(CSS)。
文摘Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the sustainable development goals.In Ghana,scholarly research on the forms and prevalence of IPV is available,however knowledge of the prevalence of IPV among PLHIV is limited.To understand the prevalence of IPV among PLHIV and the intersectional factors that contribute to it,this study examined the overall prevalence of IPV among PLHIV and the associated sociodemographic factors across ten regions of Ghana.Methods:We administered face-to-face survey questionnaires to 661 randomly selected antiretroviral therapy(ART)clients using Research Electronic Data Capture tools.We used descriptive statistics(mean,standard deviation,minimum,and maximum),pairwise correlation,and multivariate regression analysis to look at the data.Results:The clients of ART experienced various forms of IPV,including sexual,physical,emotional,and economic violence and controlling behaviour.The overall prevalence of IPV among PLHIV was 27.5%.This result,although on par with the global IPV average(27%),is 1.5%higher than the national rate(26%).The Upper West Region had the highest prevalence in all the categories of IPV analysed,followed by Oti Region in second place and the Upper East Region in third,except for the prevalence of sexual violence,where Greater Accra Region ranks second.In specific regions of Ghana,sociodemographic factors shaped by patriarchal and economic considerations contribute to a higher prevalence of IPV among people living with HIV.Conclusion:The findings have implications for developing policies and interventions that address the specific factors associated with HIV-induced IPV in different regions of Ghana.These interventions should also include screening PLHIV receiving ART for their IPV status regardless of gender and deploying culturally appropriate education at the community level to foster empathy towards intimate partners living with HIV.
文摘Background and Goals: Although health care quality improvement has traditionally involved extensive work with paper records, the adoption of health information technology has increased the use of electronic record and administrative systems. Despite these advances, quality improvement practitioners now and for the foreseeable future need guidance in defining populations of individuals for study and in selecting and analyzing sample data from such populations. Statistical data analysis in health care research often involves using samples to make inferences about populations. The investigator needs to consider the goals of the study, whether sampling is to be used, and the type of population being studied. While there are numerous sampling strategies designed to conserve resources and yield accurate results, one of these techniques—use of the finite population correction (FPC)—has received relatively little attention in health care sampling contexts. It is important for health care quality practitioners to be aware of sampling options that may increase accuracy and conserve resources. This article describes common sampling situations in which the issue of the finite population correction decision often arises. Methods: This article describes 3 relevant sampling situations that influence the design and analysis phases of a study and offers guidance for choosing the most effective and efficient design. Situation 1: The study or activity involves taking a sample from a large finite target population for which enumerative inferences are needed. Situation 2: The population is finite and the study is enumerative. A complete enumerative count of “defects” in the process is needed so that remediation can occur. Here, statistical inference is unnecessary. Situation 3: The target population is viewed as infinite;such populations are “conceptual populations” [1] or “processes”. Results: The article shows how savings in resources can be achieved by choosing the correct analytic framework at the conceptualization phase of study design. Choosing the right sampling approach can produce accurate results at lower costs. Several examples are presented and the implications for health services research are discussed. Conclusion: By clearly specifying the objectives of a study and considering explicitly whether the data are a sample or a population, the practitioner may be able to design a more efficient study and thereby conserve resources. This article provides a conceptual framework in the form of three situations, several examples, and an algorithm (Figure 1) to help the intervention planner determine how to classify the study and when to apply the FPC.
文摘For patients receiving chemotherapy, drugs represent the largest cost. Clinical chemotherapy Pathways have become a critical strategy to identify unnecessary drug costs and to implement mechanisms to deliver lower cost alternatives without sacrificing outcomes or quality of care. This paper describes the steps of development of a functioning pathways program beginning in an environment of full-risk capitation, including drugs. The next steps involved quantitating the potential impact of such a program and then collaborating with a payer to test the concept. When these studies showed promise, the practices adopting pathways used them as a backbone for drug management in the Oncology Care Model. These experiences very likely represent steps in a continuum towards placing more of the drug delivery costs at risk. The potential for again considering capitated payments is discussed.
