No man is an island: disentangling multilevel effects in health services research

Ko, Michelle J; Bindman, Andrew B.

doi:10.1136/bmjqs-2013-002591

Cited by 3 publications

(1 citation statement)

References 11 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They recommended several approaches to addressing this ‘complexity gap’. Situational analysis for programming or policy decisions should include both individual and wider contextual factors and their relative contribution to welfare outcomes [ 3 , 12 , 13 ]. Situational analysis, intervention design and implementation should be undertaken by animal-owning communities and policy-makers themselves [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Improving working equine welfare in ‘hard-win’ situations, where gains are difficult, expensive or marginal

Pritchard¹,

Upjohn²,

Hirson³

2018

PLoS ONE

View full text Add to dashboard Cite

PurposeBrooke is a non-government organisation with working equine welfare programmes across Africa, Asia and Latin America. In 2014, staff from ten country programmes were asked to identify ‘no-win’ situations (subsequently reframed as ‘hard-wins’)—where improving equine welfare is proving difficult, expensive and/or marginal—in order to inform strategic decisions on how to approach, manage and mitigate for such situations.MethodsThe Delphi-type consultation process had three phases. Round 1 posed five questions in the form of a workshop, survey and semi-structured interviews. Round 2 re-presented key themes and sense-checked initial conclusions. Round 3 reviewed the nature and prevalence of hard-win situations at an international meeting of all participants.ResultsReasons given for hard-win situations included: no economic or social benefit from caring for working animals; poor resource availability; lack of empathy for working equids or their owners among wider stakeholders; deep-seated social issues, such as addiction or illegal working; areas with a high animal turnover or migratory human population; lack of community cooperation or cohesion; unsafe areas where welfare interventions cannot be adequately supported. Participants estimated the prevalence of hard-win situations as 40–70% of their work. They suggested some current ways of working that may be contributing to the problem, and opportunities to tackle hard-wins more effectively.Conclusion and animal welfare implicationsRespondents agreed that if equine welfare improvements are to span generations of animals, interventions cannot rely on relatively simple, technical knowledge-transfer strategies and quick-wins alone. Programmes need to be more flexible and iterative and less risk-averse in their approaches to embedding good equine welfare practices in all relevant actors. Consultation recommendations informed development of Brooke’s new global strategy, a revised organisational structure and redefinition of roles and responsibilities to streamline ways to approach hard-wins in the complex environments and socio-economic contexts in which working equids are found.

show abstract

Section: Discussionmentioning

confidence: 99%

Improving working equine welfare in ‘hard-win’ situations, where gains are difficult, expensive or marginal

Pritchard¹,

Upjohn²,

Hirson³

2018

PLoS ONE

View full text Add to dashboard Cite

show abstract

Income, education, and hospitalization in Canada: results from linked census and administrative data

Godley

Tang

2022

Discov Soc Sci Health

View full text Add to dashboard Cite

Background Addressing population health inequities begins with quantifying how social factors affect the health and health care utilization of individuals. Such quantification relies on the availability of detailed health and demographic data. Unfortunately, administrative health care data rarely includes detailed demographic information. Data linkage, which combines administrative health data with national-level census or survey data, enables researchers to examine socio-economic inequalities in health care utilization in greater detail. Data and methods With access to a unique Canadian dataset linking data from the Hospital Discharge Abstract Database (DAD) from 2006 to 2007 with detailed individual-level socio-demographic data from the 2006 Canadian Census, we are able to examine the patterning of hospitalization in Canada in the early 2000s across a variety of socio-demographic variables. We examine the association of education and income, controlling for immigration status, rural residence, marital status and ethnicity, with hospitalization rates for both ambulatory care sensitive conditions (ACSCs) and non-ambulatory care sensitive conditions (non-ACSCs) for children and youth, working-age adults, and older adults, in models stratified by sex. Results Age standardized hospitalization rates show that there is a clear socio-economic gradient in hospitalization in Canada in the 2000s. Education and income are independently, inversely associated with hospitalization for males and females across three broad age groups. These associations are stronger for ACSCs than non-ACSCs. The association of other socio-demographic variables, such as immigrant status, and rural residence is also stronger for hospitalization for ACSCs. The association of socio-economic status with hospitalization for ACSCs is strongest for working age women and men, and is somewhat attenuated for older adults. Conclusions Lower socio-economic status is associated with a higher likelihood of hospitalization for men and women in Canada across three broad age groups in the 2000s. These associations are stronger for ACSCs, suggesting that in addition to increased likelihood of disease, decreased access to preventative care may be driving up hospitalization rates for marginalized groups. We conclude with the recommendation that in order to track progress in reducing health inequities, health systems should either collect detailed individual-level socio-demographic data or link their administrative health data to existing demographic data sets.

show abstract

Macro and Micro Ergonomic Outcomes in Healthcare: Unraveling the Relationship Between Patient Handling Performance and Safety Climate

Fray

Waterson

Munro

2015

IIE Transactions on Occupational Ergonomics and Human Factors

View full text Add to dashboard Cite

No man is an island: disentangling multilevel effects in health services research

Cited by 3 publications

References 11 publications

Improving working equine welfare in ‘hard-win’ situations, where gains are difficult, expensive or marginal

Improving working equine welfare in ‘hard-win’ situations, where gains are difficult, expensive or marginal

Income, education, and hospitalization in Canada: results from linked census and administrative data

Macro and Micro Ergonomic Outcomes in Healthcare: Unraveling the Relationship Between Patient Handling Performance and Safety Climate

Contact Info

Product

Resources

About