Carlued P Leon - Academia.edu (original) (raw)

Papers by Carlued P Leon

BMC Health Services Research, 2019

Background: Patient satisfaction is an important factor for both assessing the quality of healthc... more Background: Patient satisfaction is an important factor for both assessing the quality of healthcare and predicting positive health outcomes. This study assesses the influence of HIV/AIDS patients’ perception of the quality of health services on adherence to antiretroviral treatment using the decentralized care model in Manaus, Brazil.

Methods: We conducted a non-randomized, cross-sectional analysis to explore the relationship between patient satisfaction and adherence to antiretroviral treatment (ART) in Manaus, Amazonas, Brazil. We also compared patient satisfaction levels at the city’s main hospital with those at smaller health units established to decentralize HIV/AIDS healthcare. Using survey responses from 812 patients and health data from 713 patients, we conducted descriptive and regression analyses to identify health center characteristics associated with higher patient satisfaction and higher adherence to treatment.

Results: We found a clear and positive relationship between patient satisfaction with the quality of health services and adherence to ART. Patients who had better access to their health center and its services –mainly in the form of convenient location, shorter commute times, and shorter wait times— tended to rate the quality of services higher and were also more likely to adhere to ART. We also found higher levels of patient satisfaction and adherence to ART among patients served at decentralized health units than among patients served at the main hospital.

Conclusions: The study’s results emphasize the importance of patients’ experience at the health center for improved health outcomes. While many of the factors that play a role in whether a patient adheres to ART or not are beyond the control of the health center, our findings highlight that health centers can importantly contribute to increased ART adherence by improving such experience. The study also showcases the potential benefits of decentralizing HIV care to increase patient satisfaction and, with it, adherence to ART.

Most factory studies focus only on minimal safety and health at work or on “compliance audits wit... more Most factory studies focus only on minimal safety and health at work or on “compliance audits with minimal standards”. Compliance audits typically aim for achieving minimum standards versus striving for excellence. The audit criteria are set to tackle violations only rather than to understand process of improvement, efficiencies, and the effectiveness of corrective actions.
While the relationship between health and work is not new, the measurement of health and well-being as basic goals of work, in line with business outcomes, is a new bar for social impact and global health. We posit that a transparent evaluation of workforce well-being and factory conditions, which draws directly from the experience of representative sample of all workers instead of an external auditor, has the potential to revolutionize the current compliance audit procedures that commonly lack objectivity, a more representative view of work on the factory floor, and an understanding of the linkages between drivers and outcomes of worker well-being in factory operations.
We designed a comprehensive worker survey to monitor well-being in supply factories. Survey results provide buyers, suppliers and workers with a snapshot of the average worker experience of well-being and factory conditions (compared to simple auditor reports). Applying definitions of well-being at work that draw from decades of research on occupational health and safety, work stress and job strain, well-being and socially supportive communities, we aimed to conduct a comprehensive assessment of worker needs. Further, worker health and well-being were considered in relation to various business outcomes, such as turnover and job satisfaction. From this perspective, we explored the potential dependencies between worker needs and business needs at the factory level.
Our study shows that by setting out a metric for continuous process improvement that includes workers’ voice, buyers and suppliers all standing to gain – especially in the most vulnerable workforces and regions of the globe – business can choose to be a force for good by changing expectations on the factory floor.

BMC Health Services Research, 2019

Background: Patient satisfaction is an important factor for both assessing the quality of healthc... more Background: Patient satisfaction is an important factor for both assessing the quality of healthcare and predicting positive health outcomes. This study assesses the influence of HIV/AIDS patients’ perception of the quality of health services on adherence to antiretroviral treatment using the decentralized care model in Manaus, Brazil.

Methods: We conducted a non-randomized, cross-sectional analysis to explore the relationship between patient satisfaction and adherence to antiretroviral treatment (ART) in Manaus, Amazonas, Brazil. We also compared patient satisfaction levels at the city’s main hospital with those at smaller health units established to decentralize HIV/AIDS healthcare. Using survey responses from 812 patients and health data from 713 patients, we conducted descriptive and regression analyses to identify health center characteristics associated with higher patient satisfaction and higher adherence to treatment.

Results: We found a clear and positive relationship between patient satisfaction with the quality of health services and adherence to ART. Patients who had better access to their health center and its services –mainly in the form of convenient location, shorter commute times, and shorter wait times— tended to rate the quality of services higher and were also more likely to adhere to ART. We also found higher levels of patient satisfaction and adherence to ART among patients served at decentralized health units than among patients served at the main hospital.

Conclusions: The study’s results emphasize the importance of patients’ experience at the health center for improved health outcomes. While many of the factors that play a role in whether a patient adheres to ART or not are beyond the control of the health center, our findings highlight that health centers can importantly contribute to increased ART adherence by improving such experience. The study also showcases the potential benefits of decentralizing HIV care to increase patient satisfaction and, with it, adherence to ART.

Most factory studies focus only on minimal safety and health at work or on “compliance audits wit... more Most factory studies focus only on minimal safety and health at work or on “compliance audits with minimal standards”. Compliance audits typically aim for achieving minimum standards versus striving for excellence. The audit criteria are set to tackle violations only rather than to understand process of improvement, efficiencies, and the effectiveness of corrective actions.
While the relationship between health and work is not new, the measurement of health and well-being as basic goals of work, in line with business outcomes, is a new bar for social impact and global health. We posit that a transparent evaluation of workforce well-being and factory conditions, which draws directly from the experience of representative sample of all workers instead of an external auditor, has the potential to revolutionize the current compliance audit procedures that commonly lack objectivity, a more representative view of work on the factory floor, and an understanding of the linkages between drivers and outcomes of worker well-being in factory operations.
We designed a comprehensive worker survey to monitor well-being in supply factories. Survey results provide buyers, suppliers and workers with a snapshot of the average worker experience of well-being and factory conditions (compared to simple auditor reports). Applying definitions of well-being at work that draw from decades of research on occupational health and safety, work stress and job strain, well-being and socially supportive communities, we aimed to conduct a comprehensive assessment of worker needs. Further, worker health and well-being were considered in relation to various business outcomes, such as turnover and job satisfaction. From this perspective, we explored the potential dependencies between worker needs and business needs at the factory level.
Our study shows that by setting out a metric for continuous process improvement that includes workers’ voice, buyers and suppliers all standing to gain – especially in the most vulnerable workforces and regions of the globe – business can choose to be a force for good by changing expectations on the factory floor.