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  • 1
    Online Resource
    Online Resource
    Provider Perspectives on Safety in Primary Care in Albania
    Wiley ; 2016
    In:  Journal of Nursing Scholarship Vol. 48, No. 6 ( 2016-11), p. 552-560
    Details
    In: Journal of Nursing Scholarship, Wiley, Vol. 48, No. 6 ( 2016-11), p. 552-560
    Abstract: The purpose of this study was to determine the safety attitudes of specialist physicians (SPs), general physicians (GPs), and nurses in primary care in Albania. Design The study was cross‐sectional. It involved the SPs, GPs, and nurses from five districts in Albania. A demographic questionnaire and the adapted Safety Attitudes Questionnaire (SAQ)‐Long Ambulatory Version A was used to gather critical information regarding the participant's profile, perception of management, working conditions, job satisfaction, stress recognition, safety climate, and perceived teamwork. Methods The onsite data collectors distributed questionnaires at the primary care clinics and then collected them. Descriptive statistics were used to summarize the responses. The significance of mean difference among SPs, GPs, and nurses was tested using analysis of variance. Findings Five hundred twenty‐three questionnaires were completed. The concept of patient safety in relation to job satisfaction received the highest ratings. Stress recognition had low ratings. There was a high level of teamwork in SPs, GPs, and nurses. Healthcare staff agreed that it was difficult to discuss errors in their primary healthcare center. Physicians in contrast to nurses were most likely to affirm that they do not make errors in hostile situations. Conclusions Errors are difficult to discuss. It was clear that primary care staff, such as physicians, never considered the likelihood of errors occurring during tense situations. Clinical Relevance Staff at primary healthcare centers are used to adverse events and errors. Despite the demand for safety improvement and the existing evidence on the epidemiology of outpatient medical errors, most research has only been conducted in hospital settings. Many patients are put at risk and some are harmed as a result of adverse events in primary care. Adequate communication and technical skills should be utilized by primary care providers (PCPs) for improvement of patient safety. The patient safety measures should include assessment of the safety attitudes of PCPs.
    Type of Medium: Online Resource
    ISSN: 1527-6546 , 1547-5069
    URL: Issue
    URL: Article
    DOI: 10.1111/jnu.2016.48.issue-6
    DOI: 10.1111/jnu.12236
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2116095-8
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  • 2
    Online Resource
    Online Resource
    Perceived organizational commitment and job satisfaction among nurses in Albanian public hospitals: A cross-sectional study
    Informa UK Limited ; 2016
    In:  International Journal of Healthcare Management Vol. 9, No. 2 ( 2016-04-02), p. 110-118
    Details
    In: International Journal of Healthcare Management, Informa UK Limited, Vol. 9, No. 2 ( 2016-04-02), p. 110-118
    Type of Medium: Online Resource
    ISSN: 2047-9700 , 2047-9719
    URL: Article
    DOI: 10.1179/2047971915Y.0000000019
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2016
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  • 3
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    Online Resource
    Differences between Rural and Urban Practices in the Response to the COVID-19 Pandemic: Outcomes from the PRICOV-19 Study in 38 Countries
    MDPI AG ; 2023
    In:  International Journal of Environmental Research and Public Health Vol. 20, No. 4 ( 2023-02-19), p. 3674-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 20, No. 4 ( 2023-02-19), p. 3674-
    Abstract: This paper explores the differences between rural and urban practices in the response to the COVID-19 pandemic, emphasizing aspects such as management of patient flow, infection prevention and control, information processing, communication and collaboration. Using a cross-sectional design, data were collected through the online PRICOV-19 questionnaire sent to general practices in 38 countries. Rural practices in our sample were smaller than urban-based practices. They reported an above-average number of old and multimorbid patients and a below-average number of patients with a migrant background or financial problems. Rural practices were less likely to provide leaflets and information, but were more likely to have ceased using the waiting room or to have made structural changes to their waiting room and to have changed their prescribing practices in terms of patients attending the practices. They were less likely to perform video consultations or use electronic prescription methods. Our findings show the existence of certain issues that could impact patient safety in rural areas more than in urban areas due to the underlying differences in population profile and supports. These could be used to plan the organization of care for similar future pandemic situations.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph20043674
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2175195-X
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  • 4
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    Online Resource
    Out of pocket payments and access to NCD medication in two regions in Albania
    Public Library of Science (PLoS) ; 2022
    In:  PLOS ONE Vol. 17, No. 8 ( 2022-8-10), p. e0272221-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 8 ( 2022-8-10), p. e0272221-
    Abstract: The financial burden from noncommunicable diseases (NCDs) is a threat worldwide, alleviated only when good social protection schemes are in place. Albeit the Government in Albania has committed to Universal Healthcare Coverage (UHC), Out-of-Pockets (OOPs) persist. Through this study, we aimed to assess the OOPs related to consultations, diagnostic tests, and medicine prescriptions as self-reported by people suffering from NCDs. Methods A household survey was conducted in two regions of Albania. The present analysis includes respondents who suffered from chronic health conditions and consulted a health care provider within the last 8 weeks (n = 898). Mixed logistic regression models with random intercepts at the level of communities were employed in order to assess the association of OOPs with age, gender, urban vs. rural residency, health insurance, marital status, barriers experienced, type of chronic condition(s) and region. Results Of those who consulted a provider, 95% also received a drug prescription. Among them, 94% were able to obtain all the drugs prescribed. Out-of-pocket payments occurred throughout the NCD treatment process; specifically, for consultation (36%), diagnostic tests (33%), and drugs purchased (88%). Drug expenditures accounted for 62% of all household expenditures. Respondents with health insurance were less likely to pay for consultation and drugs. The elderly (patients above 60 years old) were less likely to pay for consultations and tests. Those who lived in urban areas were less likely to pay for drugs and consultations. Patients encountering any form of barrier when seeking care had increased odds of OOPs for consultations (OR; 2.25 95%-CI; 1.57; 3.23) and tests (OR; 1.71 95%-CI; 1.19; 2.45). Conclusion Out-of-pocket payments by NCD patients principally made up through the purchase of prescribed drugs, remain important. Tackling the high costs of drugs will be important to accelerate the UHC agenda. Here, it is important to raise the population’s awareness on patients’ knowledge of their entitlements to health insurance, and on the current health reforms.
    Type of Medium: Online Resource
    ISSN: 1932-6203
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1371/journal.pone.0272221
    DOI: 10.1371/journal.pone.0272221.g001
    DOI: 10.1371/journal.pone.0272221.t001
    DOI: 10.1371/journal.pone.0272221.t002
    DOI: 10.1371/journal.pone.0272221.t003
    DOI: 10.1371/journal.pone.0272221.t004
    DOI: 10.1371/journal.pone.0272221.s001
    DOI: 10.1371/journal.pone.0272221.s002
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2022
    detail.hit.zdb_id: 2267670-3
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  • 5
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    Online Resource
    Image_1.JPEG
    Frontiers Media SA ; 2021
    In:  Frontiers in Public Health Vol. 9 ( 2021-3-16)
    Details
    In: Frontiers in Public Health, Frontiers Media SA, Vol. 9 ( 2021-3-16)
    Abstract: Aim: Assess the use of different health care service providers by adults (aged 18–59) and elderly (aged & gt; =60) who suffer from non-communicable disease (NCD) and explore relationships between sociodemographic variables and care-seeking behaviors. Methods: A cross-sectional survey was conducted in the districts of Diber and Fier in December 2018, using random cluster sampling. Descriptive statistics were used to compare the care-seeking behaviors of adults and elderly people. We employed binary and multinomial logistic regression to assess factors associated with the type of health service provider used. Analyses were adjusted for clustering within districts of residence. Results: Out of 3,799 respondents, 1,116 (29.4%) suffered from an NCD. Of these, 95% sought to obtain care for their chronic condition through public healthcare providers. The elderly were more likely to use primary healthcare services (PHC) to initiate care when facing health problems (56%), compared to those aged 18–59 years (49%, p & lt; 0,001). Over the last 8 weeks, 82% (914/1,116) of participants sought care. Binary and multinomial logistic regression analyses, adjusted for socio-demographic variables, showed that the elderly were more likely to choose PHC services (OR 1.56; 95% CI: 1.04; 2.35). Moreover, individuals who suffered from hypertension used PHC services more frequently than hospitals (OR 1.94; 95% CI: 1.32; 2.85). A positive association was found between living in an urban area and seeking care for NCDs at polyclinics (OR 10.1; 95% CI: 2.1; 50.1). There was no significant gender difference observed with regard to the type of provider consulted. Conclusion: Public facilities were reported as the main providers for initiating care and the main providers used in the 8 weeks prior to the interview. While a majority of elderly people visited a PHC to initiate treatment (and follow up) on their chronic conditions, a substantial proportion of adults (aged 18–59) initiated and sought regular NCD care at a hospital. Educating patients and caregivers on active participation in NCD prevention, management, and control through the PHC level should be a long-term effort, along with the establishment of well-structured referral mechanisms and integrated care systems.
    Type of Medium: Online Resource
    ISSN: 2296-2565
    URL: Article
    URL: Article
    DOI: 10.3389/fpubh.2021.616014
    DOI: 10.3389/fpubh.2021.616014.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2711781-9
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  • 6
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    Online Resource
    The European Health Data Space fails to bridge digital divides
    BMJ ; 2022
    In:  BMJ
    Details
    In: BMJ, BMJ
    Type of Medium: Online Resource
    ISSN: 1756-1833
    URL: Article
    DOI: 10.1136/bmj-2022-071913
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 1479799-9
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  • 7
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    Online Resource
    Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study
    Springer Science and Business Media LLC ; 2023
    In:  International Journal for Equity in Health Vol. 22, No. 1 ( 2023-07-28)
    Details
    In: International Journal for Equity in Health, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2023-07-28)
    Abstract: Although overall health status in the last decades improved, health inequalities due to non-communicable diseases (NCDs) persist between and within European countries. There is a lack of studies giving insights into health inequalities related to NCDs in the European Economic Area (EEA) countries. Therefore, the aim of the present study was to quantify health inequalities in age-standardized disability adjusted life years (DALY) rates for NCDs overall and 12 specific NCDs across 30 EEA countries between 1990 and 2019. Also, this study aimed to determine trends in health inequalities and to identify those NCDs where the inequalities were the highest. Methods DALY rate ratios were calculated to determine and compare inequalities between the 30 EEA countries, by sex, and across time. Annual rate of change was used to determine the differences in DALY rate between 1990 and 2019 for males and females. The Gini Coefficient (GC) was used to measure the DALY rate inequalities across countries, and the Slope Index of Inequality (SII) to estimate the average absolute difference in DALY rate across countries. Results Between 1990 and 2019, there was an overall declining trend in DALY rate, with larger declines among females compared to males. Among EEA countries, in 2019 the highest NCD DALY rate for both sexes were observed for Bulgaria. For the whole period, the highest DALY rate ratios were identified for digestive diseases, diabetes and kidney diseases, substance use disorders, cardiovascular diseases (CVD), and chronic respiratory diseases – representing the highest inequality between countries. In 2019, the highest DALY rate ratio was found between Bulgaria and Iceland for males. GC and SII indicated that the highest inequalities were due to CVD for most of the study period – however, overall levels of inequality were low. Conclusions The inequality in level 1 NCDs DALYs rate is relatively low among all the countries. CVDs, digestive diseases, diabetes and kidney diseases, substance use disorders, and chronic respiratory diseases are the NCDs that exhibit higher levels of inequality across countries in the EEA. This might be mitigated by applying tailored preventive measures and enabling healthcare access.
    Type of Medium: Online Resource
    ISSN: 1475-9276
    URL: Article
    DOI: 10.1186/s12939-023-01958-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2092056-8
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  • 8
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    Online Resource
    Factors associated with the utilisation of primary care services: a cross-sectional study in public and private facilities in Albania
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 12 ( 2020-12), p. e040398-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 12 ( 2020-12), p. e040398-
    Abstract: To identify key factors influencing the utilisation of governmental and private primary healthcare services in Albania. Design A cross-sectional health facility survey using a 4-point Likert scale questionnaire to rank the importance of factors driving services utilisation. Setting Exit interviews with patients who consulted one of 23 primary care providers (18 public and 5 private) in Fier district of Albania from the period of July–August 2018. Participants Representative sample of 629 adults ≥18 years of age. Main outcomes measures (1) Factors influencing the decision to visit a governmental or private primary care provider and (2) the association of sociodemographic characteristics and patients’ decision to attend a given provider. Data were analysed using mixed logistic regression models. Results Nearly half of the participants in this study were older than 60 years (45%). The majority (63%) reported to suffer from a chronic condition. Prevailing determinants for choosing a provider were ‘quality of care’ and ‘healthcare professionals’ attitudes. Solely looking at patients using a public provider, ‘geographical proximity’ was the most important factor guiding the decision (85% vs 11%, p 〈 0.001). For private provider’s patients, the ‘availability of diagnostic devices’ was the most important factor (69% vs 9%, p 〈 0.001). The odds of using public facilities were significantly higher among the patients who perceived their health as poor (OR 5.59; 95% CI 2.62 to 11.92), suffered from chronic conditions (OR 3.13; 95% CI 1.36 to 7.24) or were benefiting from a socioeconomic aid scheme (OR 3.52; 95% CI 1.64 to 7.56). Conclusion The use of primary healthcare is strongly influenced by geographical and financial access for public facility users and availability of equipment for private users. This study found that aspects of acceptability and adequacy of services are equally valued. Additional commitment to further develop primary care through engagement of local decision-makers and professional associations is needed.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-040398
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
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  • 9
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    Online Resource
    Updating Nursing Competencies in Primary Healthcare in Albania; Transforming Roles Through Tailored Education
    Frontiers Media SA ; 2021
    In:  International Journal of Public Health Vol. 66 ( 2021-9-17)
    Details
    In: International Journal of Public Health, Frontiers Media SA, Vol. 66 ( 2021-9-17)
    Type of Medium: Online Resource
    ISSN: 1661-8564
    URL: Article
    DOI: 10.3389/ijph.2021.1604085
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2276416-1
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  • 10
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    Online Resource
    The Organization of Outreach Work for Vulnerable Patients in General Practice during COVID-19: Results from the Cross-Sectional PRICOV-19 Study in 38 Countries
    MDPI AG ; 2023
    In:  International Journal of Environmental Research and Public Health Vol. 20, No. 4 ( 2023-02-10), p. 3165-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 20, No. 4 ( 2023-02-10), p. 3165-
    Abstract: The COVID-19 pandemic disproportionately affected vulnerable populations’ access to health care. By proactively reaching out to them, general practices attempted to prevent the underutilization of their services. This paper examined the association between practice and country characteristics and the organization of outreach work in general practices during COVID-19. Linear mixed model analyses with practices nested in countries were performed on the data of 4982 practices from 38 countries. A 4-item scale on outreach work was constructed as the outcome variable with a reliability of 0.77 and 0.97 at the practice and country level. The results showed that many practices set up outreach work, including extracting at least one list of patients with chronic conditions from their electronic medical record (30.1%); and performing telephone outreach to patients with chronic conditions (62.8%), a psychological vulnerability (35.6%), or possible situation of domestic violence or a child-rearing situation (17.2%). Outreach work was positively related to the availability of an administrative assistant or practice manager (p 〈 0.05) or paramedical support staff (p 〈 0.01). Other practice and country characteristics were not significantly associated with undertaking outreach work. Policy and financial interventions supporting general practices to organize outreach work should focus on the range of personnel available to support such practice activities.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph20043165
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2175195-X
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