Dataset Information

"It's easier in pharmacy": why some patients prefer to pay for flu jabs rather than use the National Health Service.

ABSTRACT: There is a need to increase flu vaccination rates in England particularly among those under 65 years of age and at risk because of other conditions and treatments. Patients in at risk groups are eligible for free vaccination on the National Health Service (NHS) in England, but despite this, some choose to pay privately. This paper explores how prevalent this is and why people choose to do it. There is moderate to good evidence from several countries that community pharmacies can safely provide a range of vaccinations, largely seasonal influenza Immunisation. Pharmacy-based services can extend the reach of immunisation programmes. User, doctor and pharmacist satisfaction with these services is high.Data were collected during the 2012-13 flu season as part of a community pharmacy private flu vaccination service to help identify whether patients were eligible to have their vaccination free of charge on the NHS. Additional data were collected from a sample of patients accessing the private service within 13 pharmacies to help identify the reasons patients paid when they were eligible for free vaccination.Data were captured from 89,011 privately paying patients across 479 pharmacies in England, of whom 6% were eligible to get the vaccination free. 921 patients completed a survey in the 13 pharmacies selected. Of these, 199 (22%) were eligible to get their flu vaccination for free. 131 (66%) were female. Average age was 54 years. Of the 199 patients who were eligible for free treatment, 100 (50%) had been contacted by their GP surgery to go for their vaccination, but had chosen not to go. Reasons given include accessibility, convenience and preference for pharmacy environment.While people at risk can access flu vaccinations free via the NHS, some choose to pay privately because they perceive that community pharmacy access is easier. There are opportunities for pharmacy to support the NHS in delivering free flu vaccinations to patients at risk by targeting people unlikely to access the service at GP surgeries.

SUBMITTER: Anderson C

PROVIDER: S-EPMC3902185 | biostudies-other | 2014 Jan

REPOSITORIES: biostudies-other

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"It's easier in pharmacy": why some patients prefer to pay for flu jabs rather than use the National Health Service.

Anderson Claire C Thornley Tracey T

BMC health services research 20140124

<h4>Background</h4>There is a need to increase flu vaccination rates in England particularly among those under 65 years of age and at risk because of other conditions and treatments. Patients in at risk groups are eligible for free vaccination on the National Health Service (NHS) in England, but despite this, some choose to pay privately. This paper explores how prevalent this is and why people choose to do it. There is moderate to good evidence from several countries that community pharmacies c ...[more]

PMID: 24456532

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Project description:BACKGROUND:The National Health Service (NHS) Long-Term Plan has set out a vision of enabling patients to access digital interactions with health care professionals within 5 years, including by video link. OBJECTIVE:This review aimed to examine the extent and nature of the use of patient-facing teleconsultations within a health care setting in the United Kingdom and what outcome measures have been assessed. METHODS:We conducted a systematic scoping review of teleconsultation studies following the Joanna Briggs Institute methodology. PubMed, Scopus, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched up to the end of December 2018 for publications that reported on the use of patient-facing teleconsultations in a UK health care setting. RESULTS:The search retrieved 3132 publications, of which 101 were included for a full review. Overall, the studies were heterogeneous in design, in the specialty assessed, and reported outcome measures. The technology used for teleconsultations changed over time with earlier studies employing bespoke, often expensive, solutions. Two-thirds of the studies, conducted between 1995 and 2005, used this method. Later studies transitioned to Web-based commercial solutions such as Skype. There were five outcome measures that were assessed: (1) technical feasibility, (2) user satisfaction, (3) clinical effectiveness, (4) cost, (5) logistical and operational considerations. Due to the changing nature of technology over time, there were differing technical issues across the studies. Generally, teleconsultations were acceptable to patients, but this was less consistent among health care professionals. However, among both groups, face-to-face consultations were still seen as the gold standard. A wide range of clinical scenarios found teleconsultations to be clinically useful but potentially limited to more straightforward clinical interactions. Due to the wide array of study types and changes in technology over time, it is difficult to draw definitive conclusions on the cost involved. However, cost savings for health care providers have been demonstrated by the goal-directed implementation of teleconsultations. The integration of technology into routine practice represents a complex problem with barriers identified in funding and hospital reimbursement, information technologies infrastructure, and integration into clinicians' workflow. CONCLUSIONS:Teleconsultations appear to be safe and effective in the correct clinical situations. Where offered, it is likely that patients will be keen to engage, although teleconsultations should only be offered as an option to support traditional care models rather than replace them outright. Health care staff should be encouraged and supported in using teleconsultations to diversify their practice. Health care organizations need to consider developing a digital technology strategy and implementation groups to assist health care staff to integrate digitally enabled care into routine practice. The introduction of new technologies should be assessed after a set period with service evaluations, including feedback from key stakeholders.

Project description:BackgroundCôte d'Ivoire's current health care financing system results from successive reforms undertaken with government funding and international support. The country is moving towards a national compulsory health insurance scheme. This context offered an opportunity to study additional features of health insurance's potential market in Sub-Sahara Africa developing economy. This study examined patients' willingness to pay in order to get access to health care when it is needed.MethodsA cross-sectional study was carried out in four tertiary level teaching hospitals from October to December 2017. These hospitals are located in Bouake (service of cardiology) and in Abidjan (two services of Endocrinology-Diabetology and Institute of Cardiology). Monthly willingness to pay was elicited using the contingent valuation method through a bidding game pre-tested interviewer-administered questionnaire. Multinomial logistic regression analysis was performed to predict participants' willingness to pay.ResultsOut of 450 participants included in the analysis, 22.2% were not willing to pay at least 4.5 euros per month while 7.6%, 26.9%, 29.6%, 5.3% and 8.4% stated to be willing to pay 4.5, 7.5, 15, 30, and 45 euros per month, respectively. Males were 2.3 and 2.5 times more likely to be willing to pay 4.5 or 7.5 and 30 or 45 euros, respectively. However, there was no statistically significant difference between males and females who stated being willing to pay a premium of 15 euros per month as compared to the participants in the reference modality, below 4.5 euros.ConclusionsThe findings indicated that the amount that participants were willing to pay is consistent with other previously elicited. The association of sex with the willingness to pay suggested what might influence the acceptability of and the contribution to the upcoming compulsory health insurance scheme. These pointed out that some market features have to be understood for a successful implementation of this social health insurance scheme.

Project description:Background:The Indian Health Service (IHS) has an agreement with the US Department of Veterans Affairs (VA) that allows IHS to use the VA Consolidated Mail Outpatient Pharmacy (CMOP) to send prescriptions to IHS patients. However, there is high variability among IHS facilities in the use of CMOP. Furthermore, there is no available resource that summarizes the relative positives/negatives, challenges/opportunities, and strengths/weaknesses of implementing CMOP. Methods:A 10-item questionnaire was developed to collect information on various aspects of prescription processing through CMOP. The questionnaire was distributed among the primary CMOP contacts of IHS facilities between December 2018 and January 2019. Results:The CMOP contacts at 44 of 94 (47%) IHS sites responded to the survey. Of the 347 respondents, 310 (89%) pharmacists were trained in CMOP prescription processing. To get information about CMOP rejections, 53% (185/347) of pharmacists check electronic messages. Twelve (27%) sites utilize technicians in some capacity in the CMOP process. Of the 16 facilities that require patients to request prescriptions to be mailed for each refill request, 8 (50%) do not use any method to designate a CMOP patient. Three sites (7%) have measured patient satisfaction with the CMOP program. Thirteen sites (31%) reported that they are losing insurance reimbursements by using CMOP. The decrease in insurance reimbursements, lengthy prescription processing time, and medication backorders are the most common challenges shared by respondents. Conclusions:CMOP presents unique challenges to pharmacy workflow but provides many benefits that local pharmacy mailout programs usually do not possess, such as the ability to mail refrigerated items. Furthermore, it is likely that local programs that utilize mail delivery will increase pharmacy workload. However, there is a lack of objective data to assess the net effect of CMOP on patients. Nevertheless, the successful implementation of CMOP can lead to reduced pharmacy workload while increasing access to care for patients with transportation issues.

Project description:BackgroundSmartphones and their associated technology have evolved to an extent where these devices can be used to provide digital health interventions. However, few studies have been conducted on the willingness to use (WTU) and willingness to pay (WTP) for digital health interventions.ObjectiveThe purpose of this study was to investigate how previous service experience, the content of the services, and individuals' health status affect WTU and WTP.MethodsWe conducted a nationwide web-based survey in 3 groups: nonusers (n=506), public service users (n=368), and private service users (n=266). Participants read scenarios about an imagined health status (such as having a chronic illness) and the use of digital health intervention models (self-management, expert management, and medical management). They were then asked to respond to questions on WTU and WTP.ResultsPublic service users had a greater intention to use digital health intervention services than nonusers and private service users: scenario A (health-risk situation and self-management), nonusers=odd ratio [OR] .239 (SE .076; P<.001) and private service users=OR .138 (SE .044; P<.001); scenario B (health-risk situation and expert management), nonusers=OR .175 (SE .040; P<.001) and private service users=OR .219 (SE .053; P<.001); scenario C (chronic disease situation and expert management), nonusers=OR .413 (SE .094; P<.001) and private service users=OR .401 (SE .098; P<.001); and scenario D (chronic disease situation and medical management), nonusers=OR .480 (SE .120; P=.003) and private service users=OR .345 (SE .089; P<.001). In terms of WTP, in scenarios A and B, those who used the public and private services had a higher WTP than those who did not (scenario A: β=-.397, SE .091; P<.001; scenario B: β=-.486, SE .098; P<.001). In scenario C, private service users had greater WTP than public service users (β=.264, SE .114; P=.02), whereas public service users had greater WTP than nonusers (β=-.336, SE .096; P<.001). In scenario D, private service users were more WTP for the service than nonusers (β=-.286, SE .092; P=.002).ConclusionsWe confirmed that the WTU and WTP for digital health interventions differed based on individuals' prior experience with health care services, health status, and demographics. Recently, many discussions have been made to expand digital health care beyond the early adapters and fully into people's daily lives. Thus, more understanding of people's awareness and acceptance of digital health care is needed.

Dataset Information

"It's easier in pharmacy": why some patients prefer to pay for flu jabs rather than use the National Health Service.

Publications

"It's easier in pharmacy": why some patients prefer to pay for flu jabs rather than use the National Health Service.

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