The patient's experience of their own healthcare is an important aspect of care quality that has been shown to improve clinical and other outcomes. Very little is currently known about patient experience in the management of multimorbidity, although preliminary evidence suggests that it may be poor. Individuals with multimorbidity report better experiences of care when they are knowledgeable an...

With a focus on delivering low-cost, high-quality care, several organizations using the group employed model (GEM)-with physician groups whose primary and specialty care physicians are salaried or under contract-have been recognized for creating a culture of patient-centeredness and accountability, even in a toxic fee-for-service environment. The elements that leaders of such organizations iden...

OBJECTIVE Patients' experiences are often treated as health care quality indicators. Our aim was to identify the range of experiences of health care delivery that matter to patients and to produce a conceptual map to facilitate consideration of why they matter. METHODS Broad-based review and critical interpretive synthesis of research literature on patients' perspectives of health care delive...

In this thought paper, Professor Steven Spear argues that the way to achieve great operational performance and value has often been misunderstood. In order to ensure that good people and good science are facilitated, rather than overwhelmed, by systems, leaders have to expand their attention from ‘what individuals do’ to ‘how the pieces come together’. High quality care and great performance in...

Because the cost of institutional care for long-term patients has risen, home health has become a more visible and viable alternative to the growing elderly population. This article discusses problems found in the rapid expansion of home health services and presents two alternative health care delivery systems that address these problems: the Medicaid Waiver and the Social/Health Maintenance Or...

Measuring performance is critical to assess effectiveness of public health expenditure. Performance of health care delivery however relies on adequate accountability indicators as benchmark for efficiency. Individual programs sometimes track specific output but do not examine overall health care delivery system. This is difficult to measure but is critical if health care systems are to achieve ...

By putting together a comprehensive wellness strategy, employers are not only "doing the right thing" but also are able to see, believe and maintain the tangible return on investment (ROI) that wellness programs are capable of delivering. This article discusses employers' ROI from wellness initiatives, as well as innovations that support a culture of wellness and what enhanced opportunities for...

In South Africa the patient uses both the traditional healers and biomedical personnel's services out of need for the best healing therapy to fulfil his/ her health needs. Failure of one to yield the expected results leads to the use of the other. This shunting back and forth prompted the researcher to undertake research and formulated a model demonstrating how the traditional healers can be in...