Top PDF Experiences of Education, Health and Care plans: a multivariate analysis

Experiences of Education, Health and Care plans: a multivariate analysis

Experiences of Education, Health and Care plans: a multivariate analysis

Duration of the process: the duration of the EHC plan process was consistently significant across the models. Those whose process took less than 10 months reported more positive perceptions of outcomes, experiences and satisfaction overall, with this being particularly true for those whose process took the shortest time of less than 20 weeks. This variable recorded the second highest odds ratio from the analyses (the strongest being whether the plan actually led to the right support being received). Communication and personalisation: ‘a child’s wishes and opinions were included in the plan’ and ‘different services, such as health, care and education, worked together to make the plan’ showed odds ratios above 1 for each model and as such were associated with more positive experiences of the process for the child/young person, greater overall satisfaction and a stronger belief the plan would achieve its intended outcomes. This highlights the importance of co-production of the EHC plan with all stakeholders, and in particular with the child or young person and their family. The variable that identified that ‘their child’s and their family’s personal circumstances were taken into account in the process’ was also consistently reported with a higher than 1 odds ratio for each model, emphasising the need for personalisation of EHC plans.
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Experiences of Education, Health and Care plans: A survey of parents and young people

Experiences of Education, Health and Care plans: A survey of parents and young people

Analysis conducted in the preliminary stages of this study showed that some institutions had over time been re-classifying individuals flagged as having an EHC plan to another SEN marker again. Just under a third (29%) of EHC plans shown in the Autumn 2014 School Census were no longer marked as such in the Summer 2015 Census; while a significantly lower proportion of EHC plans shown in the Spring 2015 Census were no longer marked as such in the 2016 Spring Census (18%).

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Education, Health and Care plans: A qualitative investigation into service user experiences of the planning process

Education, Health and Care plans: A qualitative investigation into service user experiences of the planning process

The Code of Practice (DfE and DoH, 2015, para 9.69) notes that ‘Provision must be detailed and specific and should normally be quantified, for example, in terms of the type, hours and frequency of support and level of expertise, including where this support is secured through a Personal Budget.’ All the reviewed plans included some form of quantification though there were some variations in degrees of specificity. The best plans quantified provision through describing type, hours and frequency of provision in a clear way whilst emphasising the need for flexible deployment of the resource according to the child’s changing needs or circumstances. In the below example, clear accounts of school based provision were included in a section that mapped the outcomes sought with provisions:
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Experiences of Education, Health and Care plans: A survey of parents and young people

Experiences of Education, Health and Care plans: A survey of parents and young people

authority level, as the number of registered SEND Tribunal appeals in the 2015/16 academic year, per 10,000 of the population aged 0-18 in 2015. The data used is the most current available at the time of analysis. The population group has been taken as the best feasible proxy of the population of the potential total number of appeals per local authority area i.e. all those aged 0-18 who may be eligible for an EHC plan, and considers appeals as a result of refusal to carry out the EHC needs assessment. While the time periods used do not exactly match up – the 2015/16 academic year and 2015 calendar year – SEND Tribunal data is only available on an academic year basis, and given the potential lag between going through the EHC needs assessment and planning process it was felt that using this data was a sufficiently accurate proxy for the time period for the survey.
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Mapping user experiences of the education, health and care process: a qualitative study

Mapping user experiences of the education, health and care process: a qualitative study

40. The detailed parents’ experience of the EHC process in this sample revealed a number of areas where services were still working towards consistently delivering practice in line with the Code. These included examples of children and young people not having their needs identified early, a lack of appropriate Health and Care input, plans not being SMART (specific, measurable, attainable, relevant and timely) or outcome-focussed, panels overruling co-produced multi-agency needs assessment, and tensions around provision or placement issues. Also many parents had very little understanding of the new process and wider SEND reforms. 41. We now detail the key experiences parents reported on each step of the EHC
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Interprofessional education in the integrated medical education and health care system: A content analysis

Interprofessional education in the integrated medical education and health care system: A content analysis

The existence of factors such as close relationship between service provider milieus and educational environments in the integrated medical education and healthcare system, the possibility to run different types of inter- professional education programs (for example, shared workshops, joint training rounds, CME, etc.), and the opportunities of observing and practicing collaboration in the universities affiliated with educational hospitals may help to facilitate the implementation of such programs in the current conditions. Moreover, difficulties of adjusting the schedules among various professions, high workload of students in clinical settings, centralization of educational programs, and lack of attention to inter-professional skills and capabilities in the current curricula are all considered as barriers to implementing inter- professional education. There are similarities between these findings and those described by other researchers (18, 19). Accordingly, researchers believe that coordination of inter- professional experiences may require significant changes in the structure of curriculum in colleges. So, the deans, curriculum committees, and educational administrators must support these activities to reform the curriculum.
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Examining the teaching roles and experiences of non-physician health care providers in family medicine education: a qualitative study

Examining the teaching roles and experiences of non-physician health care providers in family medicine education: a qualitative study

Focus groups were conducted by two research team members (DT, MM), each with experience in focus group facilitation. Each focus group was observed by a second team member (SB, JP). The focus groups were 90 minutes in length. Focus groups were recorded, transcribed and anonymized. Data collection and analysis occurred iteratively, with discussions held after each focus group. Subtle modifications were made to the semi-structured guide based on team discussions. The first focus group transcript was coded by two independent researchers (SB, FW) and a coding framework was developed. The remaining three transcripts were coded based on this framework; NVivo software was used to manage the data. The initial codes were summarized and discussed across team meetings and a thematic analysis under- taken. The team also aimed to be reflexive by holding several meetings in which the analysis was discussed amongst the multi-disciplinary team (including phys- ician and nonphysician teachers, a quantitative expert, a sociologist). At these meetings multiple interpreta- tions were explored. The team determined that satur- ation of key themes was reached after 3 focus groups. One final focus group was conducted to confirm this assessment.
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Master's level in primary health care education - students' and preceptors' perceptions and experiences of the alteration in the clinical areas

Master's level in primary health care education - students' and preceptors' perceptions and experiences of the alteration in the clinical areas

Convenience sampling in both groups was found appro- priate to find variations of the phenomena. However, by using convenience sampling some important aspects of the phenomena may have been uncovered. In a small group the experiences are limited to the group. To assure credibility i.e. how well data and processes of analysis address the intended focus, interviews were chosen for the data collection. The interviews of the students were done by one of the researchers, a senior lecturer familiar with clinical practice, but not involved in the students' education. The preceptors were interviewed by a nurse manager, who had an administrative position in primary health care and not a manager of the preceptors. The interviewers' knowledge of the context facilitated the interview situation to a great extent, but could also be seen as a weakness of the study, since some information could have been taken for granted and not taken into consideration or not noticed. The extent of the data was limited to Swedish Master's level (one year) where the programme is usually two years of study.
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Exploring the professional identity of health and social care staff via experiences of interprofessional education and collaborative practice

Exploring the professional identity of health and social care staff via experiences of interprofessional education and collaborative practice

99 …suggests that it is possible to develop effective practice-based interprofessional learning opportunities, which meet the learning outcomes of the different professions drawing on resources within the community. (p237, emphasis added) It could be suggested that the potential to develop a learning opportunity for health professionals in a practice environment was self-evident, and that this was why the initiative the authors described was developed in the first instance, rather than being the study’s conclusion. For the evaluation to be anything other than a description of what occurred, it would have been useful for readers to be shown an analysis of the effects of the intervention. Unfortunately, this was not possible based on the use of only post-course questionnaires, focus groups with students and interviews with service users, which gathered only opinions about the course and its effects. This is not a criticism levelled specifically at Anderson et al. (2010), but rather at the number of IPE evaluations that exist in this format. At most, these reports are useful for establishing what sort of interprofessional curricula (or pilots) existed at certain times in certain institutions. While some papers, such as Peloquin et al. (2007), do make some recommendations for others wishing to set up similar IPE initiatives, the problems identified with RIPLS literature are also relevant here: that the most the reports can offer is contextualising information, in this instance, about what other IPE initiatives exist and what students thought about them. If anything, the volume of such reports offer more evidence of IPE as a dominant discourse regardless of the lack of a solid evidence-base or accepted theoretically grounded approach.
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Multivariate analysis of health data: General issues

Multivariate analysis of health data: General issues

The most popular empirical strategy is to estimate reduced form demand relations. That is, to regress health outcomes on (exogenous) determinants of health inputs, e.g. medical care prices. The resulting coefficients reflect both “technological” relationships between inputs and outcomes and household preferences for health relative to other “goods”. It is not possible to conclude anything from such a reduced form health function about the technological impact of a variable on health. For example, the relationship between female wage rates and child health reflects both the incentive effects of the wage on household time allocation and the effect of time use of child health. Nevertheless, for certain policy questions, reduced form estimation is appropriate. For example, say one wants to know how population health will respond to an increased availability of medical care facilities, taking account both of the technological impact of medical care on health and the behavioral response with respect to utilization. Then, estimation of the reduced form correlation of area variations in medical facilities with individual levels of health is adequate. If estimates of the health production technology are desired, then the problems of omitted variable bias and unobservable heterogeneity must be confronted. For example, regressing health on health care use, while omitting education, will give a biased estimate of the impact of health care in the (likely) instance that it is correlated with education. Resolution of the problem demands a sufficiently rich data set. The problem of heterogeneity bias arises from the unobservable health endowment, which induces correlation between the observable and unobservable arguments in a simple regression of health on its determinants. With cross- section data, correction of this bias requires the availability of instruments i.e. variables which affect the health input(s) but not health itself. Appropriate instruments vary with the specific inputs being considered. At a general level, instruments used in the estimation of health production functions commonly come from geographic variation in market prices, from family endowments e.g. land rights and from characteristics of public health programmes at the regional level [4].
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Capturing the voices of children in the education health and care plans : are we there yet?

Capturing the voices of children in the education health and care plans : are we there yet?

The need for a focus on the voice of children with special educational needs and disabilities (SEND) has received increased recognition internationally both in policy and research. In England, this was emphasized in the new special educational needs framework introduced in 2014. As part of this new policy, children with disabilities and/or additional needs can receive an Education Health and Care (EHC) plan. The EHC plan is a single document that should describe the children’s strengths and needs in a multi- disciplinary and holistic way. Section A of the EHC plan must include the child’s own perspective. In this context there is much need for evidence on the quality of these new plans and in particular on the quality of the depictions of children’s voices. The aim of this study was to address this knowledge gap by analyzing the depictions of children’s voices and the process by which these were gathered in 184 EHC plans of children with SEND attending mainstream and special schools in the Greater London area. The content analysis of the section concerning the children’s voices was conducted using the categories of a multi-dimensional classification system, which includes aspects relating to the child herself, but also to her environment and relationships—the International Classification of Functioning, Disability and Health (ICF). The findings revealed high levels of variability in the way the voices of children were captured, including the methods used to ascertain their views. Additionally, the type of school that the child was attending seemed to play a significant role on how his/her voice was captured, favoring mainstream schools. The findings of the present study provide the first set of evidence-based data concerning the quality of the content of the newly introduced EHC plans and are discussed in light of the implications they have for policy, practice and further research in the area.
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Association of Functional Limitation With Health Care Needs and Experiences of Children With Special Health Care Needs

Association of Functional Limitation With Health Care Needs and Experiences of Children With Special Health Care Needs

Functional Limitation and Health Care Needs of CSHCN In bivariate analyses, there were significant differences among the 3 functional limitation groups in their needs for all health care services examined, except for preven- tive care (Table 2). The proportions of CSHCN reporting needs for dental care in the no-limitation and some- limitation groups were similar and were greater than that in the severe-limitation group. Smaller proportions of CSHCN in the some-functional and severe-functional limitation categories reported needs for prescription medicine. The proportions of CSHCN reporting needs for all other health services were greater in the some-limi- tation group and greatest in the severe-limitation group. In multivariate analyses, the needs for preventive care and dental care did not differ among the 3 groups (Table 3). CSHCN with severe limitation were 7.5 times more likely and those with some limitation were 2.2 times more likely than those with no limitation to receive early intervention/special education services. The needs for specialty, mental health, and home health services, vision and hearing care, therapy (occupational, speech, or physical therapy), mobility aids, medical supplies, and medical equipment and receipt of physician visits were significantly greater for the severe-limitation group, compared with the no-limitation group. The needs of
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Experiences of leadership in health care in sub-Saharan Africa

Experiences of leadership in health care in sub-Saharan Africa

Despite these strengths, our findings should also be interpreted in light of several limitations. First, because we used qualitative methods to understand the complex experiences of leaders in sub-Saharan African health care through purposeful sampling, our findings are ex- ploratory and cannot be generalized to other leaders in sub-Saharan Africa. Second, our findings may have been influenced by social desirability bias, in which partici- pants provide socially desirable responses [37]; however, we encouraged them to share personal experiences in detail and with candour, emphasizing our interest in both positive and negative aspects of their experience. Third, our study was geographically circumscribed to four countries in sub-Saharan Africa. These reflected both East and West Africa; nevertheless, other geo- graphic regions may represent a substantially different environment for health-care leaders.
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Service Users’ Experiences of Liaison Mental Health Care

Service Users’ Experiences of Liaison Mental Health Care

Parsonage et al’s (2012) report was significant in making positive recommendations, drawing on both research evidence and anecdotal evidence, to recommend that all hospitals should have a liaison service with a first line approach that encompasses all ages and medical wards and the ED. The limitations of the work by Parsonage et al have already been identified (section 3.7.5). Notwithstanding this, their recommendations for direct patient contact that is high impact, i.e. complex cases and capacity building within non mental health staff through training and education is the key work stream for LMHS identified by Parsonage et al (2012). Brunero and Lamont (2010) and Patel et al (2009) set out examples of capacity building in the context of support for general hospital nurses to improve in assessment of suicide risk. Looking forward Parsonage et al (2012) suggested that liaison services will be required more in the community in the context of the government agenda to move care of chronic long term conditions (LTC) into the primary care sector and community provision.
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Care Plans 2.0. Consumer Principles for Health and Care Planning in an Electronic Environment. November 2013

Care Plans 2.0. Consumer Principles for Health and Care Planning in an Electronic Environment. November 2013

As the health care system moves toward a focus on wellness, these next-gen- eration care plans offer the opportunity for patients and their loved ones to play leading roles with their care team in identifying and pursuing the health and wellness goals most meaningful to them. Of course, early efforts to develop care plans will, and should, focus first on those with the greatest need — individuals needing more complex care, such as those with chronic conditions. However, our approach to care planning should evolve from episode- or illness-based care planning to proactive, all-encompassing
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THE ELDERLY S EXPERIENCES WITH HEALTH CARE IN FIVE NATIONS

THE ELDERLY S EXPERIENCES WITH HEALTH CARE IN FIVE NATIONS

#334 The Cost of Health System Change: Public Discontent in Five Nations (May/June 1999). Karen Donelan, Robert J. Blendon, Cathy Schoen, Karen Davis, and Katherine Binns. Health Affairs, vol. 18, no. 3. In this article, the authors find that amid widely divergent systems and cultural norms of health care, citizens express surprisingly similar concerns about the future. Different systems pose different problems: in those with universal coverage, dissatisfaction is with the level of funding and administration, including queues. In the U.S., the public is primarily concerned with financial access.
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Rural maternity care and health policy: parents’ experiences

Rural maternity care and health policy: parents’ experiences

Thirdly, accessing non-local maternity care, particularly removal for birthing, was associated with a range of family-related issues. Mothers discussed the emotional difficulty of leaving their families and the anxiety associated with being removed from social support networks at such a significant time. For some, the costs of relocation prohibited family members accompanying the pregnant woman, thus leaving her without the very important social and emotional support so valued around the time of birth (Box 3). This was exacerbated by practical considerations of preparing the family, such as organising children’s schooling and child care, and negotiating time off work for the woman’s partner to attend the birth where possible.
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What are the personal and health care experiences of women
with MS?

What are the personal and health care experiences of women with MS?

The focus of the study was rooted in a feminist methodological research perspective and brings together the current medical definition and understanding of MS drawing on some relevant me[r]

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Health Partners Plans Provider Manual Introduction to Health Partners Plans

Health Partners Plans Provider Manual Introduction to Health Partners Plans

Health Partners Plans is a not-for-profit Pennsylvania licensed managed care organization (MCO) that, since 1985, has provided comprehensive healthcare coverage to individuals and families living in the Philadelphia region. The organization was founded as Health Partners by four local teaching hospitals committed to offering residents of their surrounding communities coordinated quality healthcare services. With the endorsement of the Pennsylvania Department of Public Welfare (now the Department of Human Services) and a grant from the Robert Wood Johnson Foundation under its national program for prepaid managed health care, Health Partners and its member hospitals developed a viable managed care program for the Medical Assistance population. Health Partners was incorporated in 1987. In 2013 the organization formally changed its name to Health Partners Plans, reflecting its continued growth and diversification.
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Birth Defects: A Review on Global Action Plans on Maternal and Child Health Care

Birth Defects: A Review on Global Action Plans on Maternal and Child Health Care

A study to determine the epidemiology of major birth defects in live births during perinatal period has been carried out by Thong et al. [20]. This study was conducted in the district of Kinta, Perak over duration of 14 months, using a population-based birth defect register. The study reported that there were 253 infants born with major birth defects in 17,720 live births, giving an incidence per 1000 live birth recorded as 14.3 [20]. Recently, a study has been conducted on the birth defects that were registered in Pulau Pinang [21]. In this study, the data were taken from the International Classification of Diseases 10 (ICD10) database from the year 1999 to 2004. The state of Pulau Pinang was divided into five major districts, namely Seberang Perai Selatan, Seberang Perai Tengah, Seberang Perai Utara, Timur Laut and Barat Daya. Analysis on the incidence of congenital anomalies indicated a total of 3985 cases of birth defects from all of the five districts, with the average annual increase of 797 cases in the state [21].
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