An exploratory assessment of willingness to pay for health care in Hong Kong

Key Messages: 1. Focus groups are useful in eliciting information on willingness to pay for health care. 2. Conjoint analysis is a valuable technique to evaluate health economic data. 3. Information derived from these techniques is useful to both policy makers and health service providers for reference and to researchers for future hypothesis generation studies.published_or_final_versio

Promotoras as Mental Health Practitioners in Primary Care: A Multi-Method Study of an Intervention to Address Contextual Sources of Depression

We assessed the role of promotoras—briefly trained community health workers—in depression care at community health centers. The intervention focused on four contextual sources of depression in underserved, low-income communities: underemployment, inadequate housing, food insecurity, and violence. A multi-method design included quantitative and ethnographic techniques to study predictors of depression and the intervention’s impact. After a structured training program, primary care practitioners (PCPs) and promotoras collaboratively followed a clinical algorithm in which PCPs prescribed medications and/or arranged consultations by mental health professionals and promotoras addressed the contextual sources of depression. Based on an intake interview with 464 randomly recruited patients, 120 patients with depression were randomized to enhanced care plus the promotora contextual intervention, or to enhanced care alone. All four contextual problems emerged as strong predictors of depression (chi square, p < .05); logistic regression revealed housing and food insecurity as the most important predictors (odds ratios both 2.40, p < .05). Unexpected challenges arose in the intervention’s implementation, involving infrastructure at the health centers, boundaries of the promotoras’ roles, and “turf” issues with medical assistants. In the quantitative assessment, the intervention did not lead to statistically significant improvements in depression (odds ratio 4.33, confidence interval overlapping 1). Ethnographic research demonstrated a predominantly positive response to the intervention among stakeholders, including patients, promotoras, PCPs, non-professional staff workers, administrators, and community advisory board members. Due to continuing unmet mental health needs, we favor further assessment of innovative roles for community health workers

A study on the validity and reliability of telephone interview and mail questionnaire in obtaining patient satisfaction levels in the accident and emergency department

Abstrac

A study on characteristics and levels of satisfaction for semi-urgent and non-urgent patients utilizing the accident and emergency service

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Imagery and creativity

imagery and creativit

The determination of cut-off point in receiver operating characteristic curve for the management of acute abdominal pain

Abstrac