Readmission is experienced as inevitable among older adults receiving homecare: A qualitative interview study.

BACKGROUND: Older adults receiving homecare have an increased risk of readmission. The transition from hospital to home can be experienced as unsafe, and older adults describe themselves as vulnerable during the post-discharge period. Thus, the objective was to explore the experiences of unplanned readmissions among older adults who receive homecare. METHODS: We conducted qualitative individual semi-structured interviews with older adults, 65 years or above, receiving homecare and being readmitted to an emergency department (ED) between August and October 2020. Data were analysed by systematic text condensation as described by Malterud. FINDINGS: We included 12 adults aged 67-95 years, seven were male, and eight lived alone. The analysis derived three themes: (1) Responsibility and security at home, (2) the role of family, friends and homecare and (3) the importance of trust. The older adults felt that the hospital strived for too-early discharge, as they still did not feel well. They worried about how to manage their daily life. Active involvement of their family increased their sense of security, but those living alone described feeling anxious being at home by themselves after discharge. Although older adults did not wish to go to the hospital, inadequate treatment at home and the feeling of responsibility for their illness made them feel insecure. They expressed that earlier negative experiences affected their trust in the system and their inclination to ask for help. CONCLUSIONS: The older adults were discharged from the hospital despite feeling ill. They described inadequate competencies from healthcare professionals in the home as a contributing factor to their readmission. The readmission increased a sense of security. Support from the family in the process was essential and provided a sense of security, whereas older adults living alone experienced feelings of insecurity in the home environment.

Human development index and innovation capabilities in the health sector of UAE.

Based on human capital theory, the goal of this study was to look into the role of innovation capabilities in the UAE healthcare sector's competitiveness. Following the qualitative research design, data were gathered through interviews with 90 experts and professionals working in the health industry in UAE. Furthermore, the study also analyzed the UAE's Human Development Index (HDI), innovation capacities, and human development competitiveness from 2014 to 2020 using the conceptual statistics of Key Performance Indicators (KPIs) obtained in the health sector. Results revealed that UAE achieved some positive indicator results from 2020 to 2021. In addition, there are significant areas of improvement through which the UAE can build a better rank in the global competitiveness index of the health sector. The study provided key policy insights for understanding the strengths and weaknesses of innovation capabilities and human development competitiveness in the healthcare sector. Avenues of growth policy and future research directions are suggested.

COVID-19: Public health issues and ethical dilemmas.

There are various ethical dilemmas faced by the healthcare sectors, especially at times of pandemics and health emergencies, which is more prominently visible in the case of public healthcare sectors. Keeping this into consideration, the concerned study had emphasized exploring the ethical dilemmas that are faced by the public health care sectors across the globe, in fighting the COVID-19 pandemic situations in the current period. The secondary and qualitative information collected for the concerned study has been analyzed and interpreted using the thematic analytical framework and following the inductive approach. Substantial evidence has revealed that the public health care system globally has been facing a scarcity of resources and allocation of responsibilities to the care provider. There has been disparity noted in the implementation of public health care ethics. The importance of ethics in the public healthcare system cannot be denied however, the issues noted during this pandemic situation have been associated with lack of accountability, issues in resource allocation, and loss of trustworthiness in the healthcare provisions. Hence, there is a need for changes to be made in the public policies and health policies so that the public health institutions are more prepared to deal with emergencies such as the one created by the COVID-19 pandemic.

Public and private sectors collective response to combat COVID-19 in Malaysia.

Over the last year, the dangerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly around the world. Malaysia has not been excluded from this COVID-19 pandemic. The resurgence of COVID-19 cases has overwhelmed the public healthcare system and overloaded the healthcare resources. Ministry of Health (MOH) Malaysia has adopted an Emergency Ordinance (EO) to instruct private hospitals to receive both COVID-19 and non-COVID-19 patients to reduce the strain on public facilities. The treatment of COVID-19 patients at private hospitals could help to boost the bed and critical care occupancy. However, with the absence of insurance coverage because COVID-19 is categorised as pandemic-related diseases, there are some challenges and opportunities posed by the treatment fees management. Another major issue in the collaboration between public and private hospitals is the willingness of private medical consultants to participate in the management of COVID-19 patients, because medical consultants in private hospitals in Malaysia are not hospital employees, but what are termed "private contractors" who provide patient care services to the hospitals. Other collaborative measures with private healthcare providers, e.g. tele-conferencing by private medical clinics to monitor COVID-19 patients and the rollout of national vaccination programme. The public and private healthcare partnership must be enhanced, and continue to find effective ways to collaborate further to combat the pandemic. The MOH, private healthcare sectors and insurance providers need to have a synergistic COVID-19 treatment plans to ensure public as well as insurance policy holders have equal opportunities for COVID-19 screening tests, vaccinations and treatment.