Background: Faced with growing healthcare demand, the Saudi government is increasingly relying on privatization as a tool to improve patient access to care. Variation in children's access to surgical care between public (PB) and private providers (PV) has not been previously analyzed.
Objectives: To compare access to pediatric surgical services between two coexisting PB and PV.
Design: Retrospective comparative study.
Settings: A major teaching hospital and the largest PV group in Saudi Arabia.
Patients And Methods: The outcomes for children who underwent inguinal herniotomy (IH) between May 2010 and December 2014 at both providers were with IH serving as the model. Data collected included patient demographics, insurance coverage, referral pattern and access parameters including time-to-surgery (TTS), surgery wait time (SWT) and duration of symptoms (DOS).
Main Outcome Measure(s): TTS, SWT and DOS.
Results: Of 574 IH cases, 56 cases of in-hospital referrals were excluded leaving 290 PB and 228 PV cases. PV patients were younger (12.0 vs 16.4 months, P=.043) and more likely to be male (81.6% vs 72.8%, P=.019), expatriates (18% vs 3.4%, P < .001) and insured (47.4% vs 0%, P < .001). The emergency department was more frequently the source for PB referrals (35.2% vs 12.7%, P < .001) while most PV patients were self-referred (72.8% vs 16.7%, P < .001). Access parameters were remarkably better at PV: TTS (21 vs 66 days, P < .001), SWT (4 vs 31 days, P < .001) and DOS (33 vs 114 days, P < .001).
Conclusion: When coexisting, PV offers significantly better access to pediatric surgical services compared to PB. Diverting public funds to expand children's access to PV can be a valid choice to improve access to care in case when outcomes with the two providers are similar.
Limitations: Although it is the first and largest comparison in the pediatric population, the sample may not represent the whole population since it is confined to a single selected surgical condition.
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http://dx.doi.org/10.5144/0256-4947.2017.290 | DOI Listing |
JMIR Pediatr Parent
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Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Background: With the increasing implementation of patient online record access (ORA), various approaches to access to minors' electronic health records have been adopted globally. In Sweden, the current regulatory framework restricts ORA for minors and their guardians when the minor is aged between 13 and 15 years. Families of adolescents with complex health care needs often desire health information to manage their child's care and involve them in their care.
View Article and Find Full Text PDFPsychol Serv
January 2025
Department of Psychiatry, University of Colorado-Anschutz Medical Campus.
Partial hospitalization programs (PHPs) are increasingly relied upon to provide intensive mental health treatment for youth with acute and severely impairing mental health symptoms, yet very few interventions have been adapted to fit this unique delivery context. Transdiagnostic treatments hold promise for addressing the complex clinical presentations and workflow needs of PHP programs, but more work is needed to understand factors that influence successful implementation. We conducted a formative implementation process evaluation to identify barriers and facilitators of acceptability, appropriateness, and feasibility of implementing an evidence-based transdiagnostic intervention in a PHP setting and further targets for intervention and implementation adaptation.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden.
Health is multifaceted, with divergent interpretations in diverse cultures and groups of individuals. The ways individuals understand health might aid in developing future interventions. There is scant knowledge on how adolescents with depression conceptualise health.
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Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
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View Article and Find Full Text PDFJAMA Pediatr
January 2025
Vascular Assessment and Management Service, Department of Anaesthesia and Pain, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Queensland, Australia.
Importance: Pediatric peripheral intravenous catheter (PIVC) insertion can be difficult and time-consuming, frequently requiring multiple insertion attempts and often resulting in increased anxiety, distress, and treatment avoidance among children and their families. Ultrasound-guided PIVC insertion is a superior alternative to standard technique (palpation and visualization) in high-risk patients.
Objective: To compare first-time insertion success of PIVCs inserted with ultrasound guidance compared with standard technique (palpation and visualization) across all risk categories in the general pediatric hospital population.
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