Evaluación de la Efectividad de las Medidas de Mitigación para Aplanar la Curva Epidémica de la COVID-19: Evidencia de Cinco Ciudades de México

The main objectives of this study were (1) to examine what has beenrecovered and what has not yet been recovered in Nishinomiya City five years after the GreatHanshin-Awaji Earthquake, and (2) to find current service needs for the earthquake survivors,especially for the disadvantaged populations. Disadvantaged populations are minorities in society, andtheir needs and opinions are often ignored and not reflected in the services or mitigation policy,despite the fact that they are the ones who are affected most by various hazards. At the same time, becauseof their unique characteristics and positions in society, their needs differ from the majorityof the society. Six hundred eighty-six opinion cards were collected in nine grassroots workshopsessions with various disadvantaged groups in Nishinomiya City, such as the physically challenged,the visually impaired, the elderly living in public housing, junior and senior high school students,mothers with small children, and those who lost their own homes because of the earthquake. Theseopinion cards were sorted out and analyzed by using a TQM(Total Quality Management)-basedassessment method. Since the TQM-based assessment method allows bottom-up integration ofopinions from each individual, it helps us identify unique needs of the disadvantaged groupsand reflect their opinions in mitigation plan and policies. The main findings of this study include (1)the city redevelopment cannot be achieved without integrating the viewpoints of thedisadvantaged; (2) the social support was a key resource for both mental health and community development;and (3) disaster experiences and adaptation produced civic mindedness among people in a community.

To examine the association between parental immigrant status and awareness of health and community resources to help address common family problems. Using the 1999 National Survey of America's Families, a survey of the health, economic, and social characteristics of children and adults, bivariate and multivariate analyses were conducted on 35,938 children to examine the relationship between parents' immigrant status (U.S.-born citizens, naturalized citizens, and noncitizens) and their responses to questions about their awareness of specific health and community resources. Compared to U.S.-born citizens, noncitizens were at the highest risk of not being aware of health and community resources for most outcomes, followed by naturalized citizens. The services of which noncitizens were most likely to be unaware were places to get help for family discord, child care issues, and family violence. Multivariate analyses indicate that parental race/ethnicity, education level, employment status, and child age were other significant independent risk factors. Immigrant parents are at particularly high risk of alienation from systems of health care and support services that are available to low-income and other vulnerable populations in the United States. These findings clearly document disparate awareness among parents of different immigrant status. Community and health resources should reach out to immigrant populations, in linguistically and culturally appropriate ways, to alert them to the availability of their services.

Challenges Facing Pediatric Nursing

Ensuring equitable access to healthcare services is fundamental to a robust healthcare system, especially during humanitarian crises. This study analyzes the availability and distribution of health resources across Afghanistan, aiming to provide a data-driven understanding of healthcare resource access and identify potential disparities, a critical aspect of effective humanitarian response planning. Principal investigators collated related data and literature from databases and data warehouses in a systematic approach using search strings and collection tools to query databases and available data warehouses to assess the availability and distribution of health services and resources across different regions in Afghanistan, with the principal database queried being the Afghanistan Health Resources Availability database (HeRAMS), an electronic and web-based system conceived by the World Health Organization. An Excel version was sourced. The sub-health center represents 31.1% of the health facilities, followed by the basic health center (22.5%) and the mobile health team (17.1%). More than 85% of these facilities are fully operational, with the highest percentage observed in the Southern and Northeastern regions at 96.8%, followed closely by the central highland and Southeastern regions. Outpatient services for primary care are notably prevalent in the Northeastern, Southeastern, Southern, Eastern, and Northern region, conversely, the Capital and Central Highland regions demonstrate the lowest provision of primary care services. Antenatal care services are accessible at a level exceeding 70% in nearly all regions, with the highest accessibility in the Northeastern region at 91.3%, the prevalence of non-communicable illness clinics was observed to be below 50%, with the highest availability in the Southern region at 49.4%, followed by the Southeastern region. In terms of sanitation facilities, availability surpasses 70% across Afghanistan, with the highest observed in the Northeastern region at 89.2%. The study highlights significant disparities in healthcare access across various regions, with notable challenges in the availability of critical services. Furthermore, the study underscores the significant impact of financial constraints and equipment shortages on the functionality of healthcare facilities, particularly in the Northeastern and Western regions. This analysis emphasises the need for targeted resource allocation and infrastructure improvements to address inequities in access to essential healthcare services, particularly for underserved populations, thereby facilitating the achievement of equitable health outcomes in Afghanistan.

COVID-19 has caused more than 500 million infections and 6 million deaths. Due to a continuous shortage of medical resources, COVID-19 has raised alarm about medical and health resource allocation in China. A balanced spatial distribution of medical and health resources is a key livelihood issue in promoting the equalization of health services. This paper explores the spatial allocation equilibrium of two-tier medical and health resources and its influencing factors in Taiyuan. Using extracted POIs of medical and health resources of AMAP, we evaluated the spatial quantitative characteristics through the Health Resources Density Index, researched the spatial distribution pattern by kernel density analysis, hot spot analysis, and service area analysis, and identified the influencing factors of the spatial distribution equilibrium by the Geodetector model. The findings are as follows. The overall allocation level of medical and health resources in Taiyuan is low. There are tiered and regional differences; the response degree of primary care facilities to external factors is greater than that of hospitals; and the comprehensive influence of economic and topographic systems is crucial compared with other factors. Therefore, in order to promote the rational spatial distribution of medical and health resources in Taiyuan and to improve the construction of basic medical services within a 15 min radius, it is important to continuously improve the tiered healthcare system, uniformly deploy municipal medical and health resources, and increase the resource allocation to surrounding counties and remote mountainous areas. Future research should focus on collecting complete data, refining the research scale, analyzing qualitative differences, and proposing more accurate resource allocation strategies.

Both health resources and access to these resources increased after China’s health care reform launched in 2009. However, it is not clear if the inequalities were reduced within rural China, which was one of the main targets in the reform. This study aims to examine the changes in inequalities in health resources and access following the reform. Data came from the routine report of rural counties in every other year from 2008 to 2014. Health professionals and hospital beds per 1000 population were used for measuring health resources, and the hospitalization rate was used for access. Descriptive analysis and the fixed effect model were used in this study. Health resources and access increased by about 50% between 2008 and 2014 in rural China. The counties in richer quintiles got more health resources and hospitalizations. As for health professionals, the absolute differences between the richer and the poorest quintile were significantly enlarging in 2014 when compared to 2008. Regarding the hospitalization rate, the differences between the richest and the poorest quintile showed no significant change after 2012. In sum, absolute inequalities of health resources were increased, while that of health utilization kept constant following China’s health care reform. The reform needs to continually recruit qualified health workers and appropriately allocate health infrastructures to strengthen the capacity of the health care system in the impoverished areas.

BackgroundThe primary health care (PHC) system plays an important role in China’s health care system, but there are challenges such as irrational allocation of health resources and inefficient operation, which need to be improved. The purpose of this study was to explore the impact of resource allocation on the efficiency of the PHC system in China.MethodsThe data in 31 provinces were collected from the China Statistical Yearbook 2017–2021 and the China Health Statistical Yearbook 2017–2021. The comprehensive health resource density index (CHRDI) was constructed based on the entropy method and the health resource density index (HRDI), which was used to analyze the allocation of primary health resources in each province. The adjusted efficiency of the PHC system in each province was calculated by the bootstrap data envelopment analysis (DEA). Finally, the spatial Dubin model was used to explore the effect of the CHRDI on efficiency.ResultsFrom 2016 to 2020, the allocation of primary health resources in 31 provinces showed an increasing trend, and the average efficiency after correction showed a decreasing state year by year. The spatial direct effect and spatial spillover effect coefficients of CHRDI were 0.820 and 1.471, which positively affect the efficiency. Per capita Gross Domestic Product (GDP), urbanization rate, and the proportion of the elderly were the factors affecting the efficiency of the PHC system.ConclusionsThe allocation of primary health resources in all provinces in China has improved each year, but there are still great differences, and efficiency must be further improved. Pay attention to the spatial spillover effect of the level of resource allocation and formulate differentiated measures for different regions. Attention should also be paid to the impact of population aging and economic development on the utilization of primary health resources by increasing health needs and choices.

BackgroundEquity and efficiency are two fundamental principles for the sound development of health systems, as advocated by the World Health Organization (WHO). Despite the notable progress made by the Association of Southeast Asian Nations (ASEAN) in advancing their health systems, gaps persist in achieving global health goals. This paper examines the efficiency of health system stages and the fairness of health resource distribution in ASEAN countries, analyzes the underlying causes of the existing gaps, and suggests potential solutions to bridge them.MethodsData spanning 2011 to 2019, sourced from the WHO Global Health Observatory and the World Bank Database, form the foundation of this study. This study employs an enhanced two-stage data envelopment analysis (DEA) to assess the efficiency of health system stages in ASEAN countries. Equity in health resource distribution is evaluated using health resource agglomeration degree and concentration curves across demographic, geographic, and economic aspects. Furthermore, the Entropy-Weighted TOPSIS method is utilized to integrate equity across these dimensions, measuring the overall fairness in health resource allocation across different countries. Finally, rankings of health system fairness and efficiency are compared to assess the overall development level of health systems.ResultsThe overall efficiency of the ASEAN health systems from 2011 to 2019 averaged 0.231, with an upward trend in the first stage efficiency at 0.559 and a downward trend in the second stage at 0.502. The health resource agglomeration degree indicated that Singapore, Brunei, and Malaysia had HRAD and HRPD values significantly greater than 1, and Cambodia, Myanmar, and Laos predominantly had indices significantly less than 1. The concentration curve for hospital beds was the closest to the line of absolute equity. During the study period, the health resource concentration curve increasingly approached absolute equity, shifting from above to below the concentration curve. Singapore, Brunei, and Malaysia consistently remained in the first quadrant of the quadrant plot, and Myanmar and Cambodia were consistently in the third quadrant.ConclusionASEAN countries face two key challenges in their healthcare systems: first, while many nations such as Indonesia, Thailand, and Vietnam have improved resource allocation efficiency, this hasn’t yet translated into better health services. To address this, establishing national health sector steering committees, focusing on workforce training and retention, and implementing centralized monitoring systems are crucial. Second, there is a growing disparity in healthcare development across ASEAN. Promoting balanced resource distribution and leveraging ASEAN’s economic integration for regional collaboration will help bridge these gaps and foster more equitable healthcare systems.

The Economic and Health Utilization Cost of Clinically Significant Cytomegalovirus Infection Following Allogeneic Hematopoietic Stem Cell Transplantation

The Economic and Health Utilization Cost of Clinically Significant Cytomegalovirus Infection Following Allogeneic Hematopoietic Cell Transplantation

Background: Children with complex chronic conditions have a high need for health and social care resources. Many parents explore parallel resources such as alternative therapies, associations, psychological support, private medical consultations, and other out-of-pocket expenses for healthcare. The use of these alternative health resources is sometimes unclear and may lead to health inequalities. To characterize the use made of alternative healthcare resources for children with complex chronic conditions. Additionally, we evaluate the influence of sociodemographic factors on the distribution of this utilization of resources; (2) Methods: Cross-sectional study. Children with complex chronic diseases were treated at a tertiary hospital in Granada, Spain in 2016. We analyzed their use of healthcare resources and socioeconomic variables. This research complies with STROBE guidelines for observational studies; (3) Results: In total, 265 children were analyzed (mean age 7.3 years, SD 4.63). A total of 105 children (39.6%) attended private consultations with specialists, and 12.1% (n = 32) of the children had additional private health insurance. One out three parents belonged to a mutual support association (n = 78), and 26% (n = 69) of the children used alternative therapies. Furthermore, 75.4% (n = 199) of the children received no psychological support. Children whose parents had a higher educational level and occupations status made greater use of parallel healthcare resources.; (4) Conclusions: A significant proportion of children used multiple health resources in addition to the public healthcare system depending on sociodemographic determinants. Studies are needed to determine whether the use of these alternative services achieves better levels of health.

The 2013 National Nursing Workforce Survey of Registered Nurses

Considerations in Retransplantation of the Failed Renal Allograft Recipient

Rural-Urban Differences in Health Care Access Among Women of Reproductive Age: A 10-Year Pooled Analysis.

Mexico's evolving HIV epidemic.