Health Care Systems In Countries Research Articles

Resilience and Vulnerability: Examining the Impact of COVID-19 Outbreaks on Indians

Even though the COVID-19 pandemic in India may have passed its height in 2023, it is still having a major effect on the country's population, economy, and healthcare system. After surviving the first wave, the public health system must now contend with the prospect of sustained pressure on its resources and workforce. Due to peak-time overcrowding, non-COVID illnesses may have gone undiagnosed or untreated. Because the pandemic hit low-income areas and informal labourers the hardest, socioeconomic gaps became wider. Many fell more into poverty as a result of lockdowns, company closures, and job losses. A possible fall in GDP and investment is one of the long-term effects that are just now becoming apparent. Anxieties about mental health also rose to the forefront. Anxiety, despair, and other mental health problems spiked during the lockdowns, social isolation, and virus dread. The road to complete recuperation will certainly be lengthy and need ongoing endeavours to fortify the healthcare system, tackle socioeconomic disparities, and offer mental health assistance to the populace; but, India has achieved progress in limiting the virus's spread. Keywords: COVID-19, India, Public Health, Long-Term Impact, Socioeconomic Disparity, Mental Health

HHS announces funding to support care transition for individuals leaving incarceration

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), took new policy action and announced the availability of $51 million for the first‐ever funding opportunity for HRSA‐supported health centers to implement innovative approaches to support transitions in care for people leaving incarceration, HHS officials announced last week. Aligned with the White House Second Chance Initiative, the action, for the first time, explicitly supports the provision of health services to individuals during the 90 days prior to their release to help them return to the community by expanding access to primary health care, including mental health and substance use disorder treatment, furthering public health and strengthening public safety. HRSA‐funded health centers provide primary care, regardless of ability to pay, and are a cornerstone of our country's health care system, especially for individuals and families who are uninsured; enrolled in Medicaid; living in rural, remote, or underserved areas; struggling to afford their health insurance co‐pays; experiencing homelessness; residing in public housing; or otherwise having difficulty finding a doctor or paying for the cost of care. The 1,400 HRSA‐funded health centers operate more than 15,000 service sites, providing care for more than 30 million patients.

The analysis of dynamics of physical accessibility of pharmaceutical aid in Ukraine

The level of development of the country's health care system can be assessed in different ways, in particular by the level of pharmaceutical aid provision to the population. The quality of pharmaceutical aid for the population depends on many factors, including physical accessibility and the number of pharmacies located in a certain area. The aim of the work was to study the dynamics of changes in the physical accessibility of pharmaceutical aid provision for the population and changes in the number of pharmacies in Ukraine during 2017–2022. Annual reports of the State Service of Ukraine for medicinal products and drug control, regarding licensees in the field of economic activity in the production of medicines, wholesale and retail trade of medicinal products, circulation of drugs have been used for the analysis of dynamics. It was established that the pandemic of the coronavirus disease, which was caused by the SARS-CoV-2 (COVID-19) coronavirus, and the full-scale invasion of the Russian Federation had a significant impact on the development of the pharmaceutical market in Ukraine according to the results of the study. There is a general tendency to decrease the number of economic entities conducting their activities in the retail trade of medicines, while simultaneous increasing the places of activity, which may indicate the globalization of the pharmaceutical market. However, it can also cause a reduction in the quality of the competitive environment and limit the choice of pharmaceutical aid providers by patients. Thus, in the studied period, the number of economic entities decreased by more than 1,400. The number of pharmaceutical establishments engaged in the compounding of medicinal products also decreased significantly, by 23.5%. The total number of economic entities engaged in activities related to the circulation of narcotic drugs, psychotropic substances and precursors also decreased significantly, which definitely worsened the physical availability of this group of drugs.

Globalization: Migrant nurses'acculturation and their healthcare encounters as consumers of healthcare.

Globally, one of every eight nurses is a migrant, but few studies have focused on the healthcare experiences of migrant nurses (MNs) as consumers or recipients of healthcare. We address this gap by examining MNs and their acculturation, barriers to healthcare access, and perceptions of healthcare encounters as consumers. For this mixed-methods study, a convenience sample of MNs working in Europe and Israel was recruited. The quantitative component's methods included testing the reliability of scales contained within the questionnaire and using Hayes Process Model #4 to test for mediation. The qualitative component's methods included analyzing interviews with iterative inductive thematic analysis. Quantitative findings on MNs (n = 73) indicated that the association between acculturation and perception of the healthcare encounter, which MNs experienced as healthcare consumers, was mediated by barriers to healthcare access, even after adjusting for age and gender (p = 0.03). Qualitative interviews with MNs (n = 13) provided possible explanations for the quantitative findings. Even after working in the host country's healthcare system for several years, MNs reported difficulties with their healthcare encounters as healthcare consumers, not only due to their limited knowledge about the culture and healthcare resources but also due to the biased responses they received.

Neurological Practice in the Time of War: Perspectives and Experiences from Ukraine.

The full-scale Russian invasion of Ukraine has significantly impacted the country's healthcare system. Insufficient infrastructure, destruction of medical facilities, and barriers to prevention and treatment efforts hinder the provision of timely, high-quality care to our patients. We aim to describe the impact of the war on neurological care across Ukraine. In this article, leading national experts in stroke, epilepsy, multiple sclerosis, and movement disorders describe their personal experience and efforts in organizing and providing care since the war started in February 2022. A neurologist who cared for patients in Mariupol recounts the first weeks of the war when the city was under constant attacks. An international stroke expert describes the role of Task Force for Ukraine, a European Stroke Organization initiative to support the Ukrainian stroke community. We discuss a series of critical challenges facing Ukraine's neurologists, patients, and healthcare delivery system, including shortages of personnel and medical supplies, disrupted logistics, and lack of funding. In addition, we highlight various interventions and strategies aimed at counteracting these challenges, including international support, collaborations within Ukraine, and initiatives enhancing the resilience of the Ukrainian neurology community. As the war is ongoing, this article emphasizes the pressing need for continuous support and investment in the Ukrainian healthcare system to preserve guaranteed access to high-quality healthcare for the Ukrainian people during the war and in its aftermath. Insights from the essays can inform the development and implementation of effective strategies and interventions tailored to such extraordinary circumstances.

An Analytic Hierarchy Process Contingency Analysis of Factors Affecting the Emigration Decision of Medical Doctors in Turkey.

While the importance of explicitly identifying and considering contingent factors such as decision content and context is widely accepted as a way to ensure the validity of the decision analysis for the specific task at hand, few studies include this. This research uses a contingency theoretical approach to study factors affecting the emigration decision of medical doctors (MDs) for the specific case of Turkey. The motivation for conducting this study arises from the observation that the growing trend in emigration among MDs from Turkey is having a significant impact on the country's healthcare system. Dealing with the emigration of MDs is crucial for ensuring an effective and sustainable healthcare system, especially in terms of the availability of services, satisfaction, and employment of the healthcare staff. Contextual factors were explicitly identified through consultation with experts, while the generic factors were retrieved from the specialized medical migration literature. The Analytic Hierarchy Process method was utilized to prioritize the factors. Seventy-three participants were surveyed about their intention to either study or work abroad. The findings reveal that low remuneration and anxiety about their future due to the political situation in the country constitute the two most important factors driving the decision to emigrate.

Ethical, legal, and information management aspects in the context of patient safety

Health systems around the world currently generate diverse health data related to their patients; their potential for use in the routine of health professionals is recognized; however, at the same time, patient safety is also widely discussed since, over the years, the patient's electronic medical record absorbs sensitive information, accumulated over time. In this sense, this study aimed to address ethical, legal, and information management aspects in the context of patient safety. This is a scoping review, conducted based on the methodological structure developed by the Joanna Briggs Institute and the checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, set in five stages: 1) identification of the research question, 2) bibliographic survey to search for relevant studies, 3) selection of studies, according to the criteria defined in this review, 4) data mapping and 5) presentation of results. The results showed that a) the articles, in general, pay much attention to patient safety, both in terms of data and also in terms of health; b) International patient safety goals were created to standardize care in private and public hospitals, c) The articles address patient safety by international patient safety goals and d) information leakage is becoming increasingly common, and actions are needed to minimize these situations. The conclusion shows that there is a lack of objective studies regarding the use of information technology in patient safety and that, due to the importance of these topics, both in public health and economic issues, more studies are necessary for an effective implementation that can generate practical results to patients and the country's healthcare system.

Traditional Medicine Offers Hope for Cancer Management

Traditional medicine practices play a vital role in health care systems in countries with developing economies like China, India, USA and few African countries like Nigeria, Ghana, Zimbabwe etc. The aim of this scientific article was to enlighten the public of the use of traditional medicine within local Nigerian communities for cancer management. In this article, we examine the ethnobotanical uses of selected plant species from the Nigerian flora and attempt to correlate the activities of the isolated bioactive principles with known uses of the plant species in African traditional medicine. Hundreds of plant species have been identified and about 100 out of the compounds identified with these plants matched with the ethnobotanical uses of the plants.

Dispositions of Health Facility In-charges Towards Decentralization and Integration of Mental Health Services into Primary Health Care: A Case of Lusaka District.

Introduction: Worldwide, the burden of mental illnesses poses serious public health challenges, with approximately 7.4% of the global burden attributed to mental disorders. However, many primary healthcare systems in countries around the world focus mainly on physical care and neglect to provide mental health care to their populations. In Zambia, the prevalence of mental disorders is approximately 20%, with common mental disorders including acute psychotic episodes, schizophrenia, alcohol-related problems, and organic brain syndromes. These are mainly seen in Chainama, the only mental institution in the country. The institution is highly stigmatized, and previous studies have shown that the general population does not access services at this facility as intended, leading to considerations of decentralizing these services to be integrated into primary health care. This study sought to understand the dispositions of primary health facility in-charges towards decentralization and the integration of mental health services into primary health care. Methods: This study was cross-sectional and employed both quantitative and qualitative techniques. A total of 76 primary health care facility in-charges from seven subdistricts of Lusaka district provided data through a questionnaire, and 56 participated in focus group discussions. Findings: The study found that in-charges had a positive disposition (52 in-charges: 68.3 percent) despite having inadequate knowledge (56 in-charges: 73.7 percent) of the subject matter and the decentralization process. While their current practices towards mental patients were found to be acceptable, the study also found that the majority (52.6 percent) of the in-charges foresaw more barriers to the integration of mental health, citing skilled staff, infrastructure, and drugs as main barriers. Conclusion: The study concludes that integration requires more investment and sensitization for its success.

Navigating Nigeria's Health Landscape: Population Growth and Its Health Implications.

This comprehensive analysis examines the multifaceted impacts of population growth on public health in Nigeria. Drawing parallels with Omran's epidemiological transition model (that focuses on the intricate means that patterns of health and illness are changing, as well as the relationships that exist between these patterns and the sociological, demographic, and economic factors that influence them) and referencing experiences from Chile and Ceylon. The study highlights a substantial rise in Nigeria's population causing a double burden of infectious and non-communicable diseases, leading to higher morbidity, and mortality rates, increased healthcare costs, decreased productivity, and health inequalities, posing significant challenges to the country's healthcare system. Furthermore, the correlation between low education levels and health outcomes underscores the importance of addressing systemic deficiencies in Nigeria's educational sector. The article emphasizes the urgent need for strategic interventions to mitigate the adverse effects of population growth on health. Recommendations include revitalizing primary healthcare centers, fostering public-private partnerships to enhance healthcare accessibility, leveraging technological advancements like telemedicine, and promoting initiatives to improve nutrition and environmental sustainability. Moreover, prioritizing education on reproductive health and family planning emerges as a crucial strategy to manage population growth sustainably. In conclusion, the article underscores the imperative for collaborative efforts across sectors to navigate Nigeria's evolving health landscape amidst increasing population growth. By implementing targeted policies and interventions, Nigeria can strive toward achieving universal health coverage, enhancing health outcomes, and ultimately raising the standard of living for its populace.

A Comparative Study of Healthcare User Satisfaction with Health Checkups in Thailand and Worldwide

This study aims to explore the potential influence of different factors on the respondents’ satisfaction with annual medical checkups. With 125 responses from other age groups and countries, the results explore other trends posed by other grouping criteria. The responses emphasize the importance of the guidelines, policies, and government benefits implied in various aspects of the healthcare system, namely equitability, efficiency, timeliness, and integration, and how they correspond with the respondents' satisfaction. Additionally, a significant portion of the responses are from Thailand. The extensive research on the country's healthcare system has highlighted its strengths and weaknesses that could be further improved.

Inhibitory effects against SARSCoV-2 main protease (Mpro) of biflavonoids and benzophenones from the fruit of Platonia insignis

The SARS-CoV-2 mutation and the limitation of the approved drug against COVID-19 are still a challenge in many country healthcare systems and need to be affronted despite the set of vaccines to prevent this viral infection. To contribute to the identification of new antiviral agents, the present study focused on natural products from an edible fruit with potential inhibitory effects against the SARS-CoV-2 main protease (Mpro). First, LC-ESIMS analysis of Platonia insignis fruits was performed and showed the presence of biflavonoids and benzophenones in the seed and pulp, respectively. Then, maceration and chromatographic purification led to the identification of two triglycerides (1 and 2) alongside chamaejasmine (3) and volkensiflavone (4) from the seed and isogarcinol (5) and cycloxanthochymol (6), from the pulp. Compounds 1–6 after evaluating their inhibitory against Mpro, displayed from no to significant activity. Compound 5 was the most potent with an IC50 value of 0.72 μM and was more active than the positive control, Ebselen (IC50 of 3.4 μM). It displayed weak and no cytotoxicity against THP-1 (CC50 of 116.2 μM) and Vero cell lines, respectively. Other active compounds showed no cytotoxicity against THP-1. and Vero cell lines. Molecular docking studies revealed interactions in the catalytic pocket between compound 5 and amino acid residues that composed the catalytic dyads (His 41 and Cyst 145).

Kennedy Forum receives grant to support MH movement

The Kennedy Forum, a national effort to transform the way mental health and substance use disorder are treated in this country's health care system, announced last week the receipt of a significant grant that will aid in its next steps to move its mental health movement forward.

The current state and potential evolution of carbon emissions in the healthcare sector: a narrative review article

Over 98% of the world's greenhouse gas emissions in 2014 came from carbon dioxide (CO2), methane, and nitrous oxide. Over one century, CO2 emissions increased from 3.09 to 37.12 billion metric tons. The healthcare sector is one of the major sources of greenhouse gas emissions. The carbon footprint of a country's healthcare system is influenced by its domestic economy, healthcare expenditure, and energy system. The aim of this study is to present a concise of the present status of carbon emissions within the healthcare sectors on a global scale, as well as the forthcoming endeavors to mitigate these emissions. A narrative review of studies on climate change, carbon emissions, and greenhouse gases in the healthcare sector was conducted using Medline PubMed, Web of Science, Scopus and Google Scholar databases from 2005 to April 2023. According to the data, several countries emit more carbon per capita than others. The Conference of the Parties on Climate Change (COP26) recently encompassed extensive efforts culminating in releasing initiatives toward zero-carbon healthcare sectors. Efforts in some medical practices, smart technology to save energy, digital health, artificial intelligence technology, and monitoring have contributed to reducing carbon emissions. In conclusion, the healthcare sector with zero carbon emissions must be sustainable, adaptable, and efficient while delivering safe, high-quality care. Addressing the sector's carbon footprint requires innovative strategies, a multisector approach, health professionals' participation, community engagement, and regular monitoring of emissions and performance indicators to ensure patient service quality and low carbon emissions in the healthcare sector.

THEORETICAL AND METHODOLOGICAL FOUNDATIONS OF THE HEALTHCARE SYSTEM OF UKRAINE

The aim of this article is to establish the theoretical and methodological basis for the operation of Ukraine's healthcare system through the definition of its objectives and functions, examination of its primary structural elements and performance indicators between 2010-2019, and identification of the key classification features that categorise the present healthcare system as belonging to a specific model of medical systems. Methodology. The study is based on theoretical research on the concepts of healthcare system functioning. Results. The article defines the "healthcare system" as a hierarchical formation of state, municipal, and private organizations that interact as subjects and objects of management. These organizations implement medical, financial, organizational, socio-economic, and other measures to maintain optimal human performance and social activity by restoring physiological and psychological functions. The main objectives of the healthcare system are highlighted. It is determined that the functions of the healthcare system are subordinated to its main goals and reflect its orderly, regular and organised behaviour in interaction with the external environment. It is emphasised that the functions of the healthcare system are an integrated result of the functioning of its constituent elements. Practical implications. The analysis and characterisation of the key performance indicators of the healthcare system for the period 2010-2019 showed that the existing infrastructure of the sector is still rather cumbersome, characterised by the dominance of specialised and inpatient medical care and irrational use of the potential of outpatient facilities. In terms of key criteria, such as ownership, financing methods, the role of the state in managing the sector, and incentives for healthcare professionals and consumers, the national healthcare system still has signs of the Semashko model, which does not meet modern requirements for the use of expensive medical technologies and is unable to provide high quality healthcare services. Value/originality. It is established that the primary means to reform the national healthcare system is through the formation of hospital trusts, which will guarantee improved medical services and significantly decrease the expense of maintaining medical infrastructure in Ukraine. Additionally, it is acknowledged that the key technology for forging a successful network of medical facilities should be strategical planning at all levels of the country's healthcare system.

Determinants of Consumers’ Willingness to Purchase Generic Medicines

In Malaysia healthcare costs have posed challenges to the sustainability of the country's dual healthcare system, it is crucial to learn about the factors influencing consumer preferences for generic medicines. The public healthcare system predominantly uses generic drugs, private healthcare providers often prescribe originator brands to their patients. This practice places financial burdens on patients who must fund their medication independently or through private medical insurance. Therefore, the main objective of this paper is to investigate the determinants affecting consumers' willingness to purchase generic medicine in Malaysia. Using convenience sampling, a total of 436 responses was obtained. Descriptive statistics and bivariate logistic regression analysis were employed to examine the influence of sociodemographic factors and individual knowledge on the willingness to purchase generic medicine. The results indicate that age, ethnicity, marital status, education level, household size and income significantly influence the consumers' willingness to purchase generic medicine. Notably, higher education levels and greater income were associated with a higher willingness to opt for generic medicine. Unexpectedly, variables measured by the Theory of Planned Behavior did not contribute substantially to the findings of this study. Nonetheless, individual knowledge was revealed as a significant determinant. To increase the uptake of generic medicines, this study recommends educational programs for both healthcare providers and patients, emphasizing the benefits and safety of generic medicine. This research contributes to the broader discussion on cost-effective healthcare solutions and informs policymakers and healthcare stakeholders in Malaysia.

Creation of registers as one of the mechanisms for improving medical care for patients with chronic heart failure. Problem state

The annual mortality of patients with clinically pronounced symptoms of chronic heart failure in the Russian Federation reaches 26-29%, i.e., from 880 to 986 thousand patients with heart failure die in the country in one year, which is comparable to the population of a large city. Providing care for patients with heart failure places a heavy burden on the country's health care system, making a significant contribution to mortality rates, hospitalization rates, including readmissions, which in turn requires considerable costs. The article presents an overview of registry studies that are devoted to assessing the effectiveness of diagnostics, the completeness of examinations, as well as the adequacy of ongoing drug treatment.

Secondary lesions of the mucous membrane of the oral cavity as a side effect of complex anticancer treatment: a literature review.

Today, both Ukraine and the world at large are faced with a significant number of oncological diseases with various localizations. The current state of diagnosis, prevention, early detection, and access to treatment leads to a substantial number of people in each country's healthcare system who require comprehensive cancer treatments. Modern medical and diagnosis protocols in oncology involve the usage of ionizing radiation and aggressive toxic chemotherapeutic agents which can significantly disrupt the physiology of the mucous membrane of the digestive tract during treatment, especially of the oral cavity. The most common complication of complex anticancer therapy is the development of various lesions of the oral cavity, including mucositis, which harms the patient's quality of life, limits the doses of chemotherapy and radiation therapy the patient can receive, and also negatively affects the effectiveness of complex therapy treatment. Acute oral mucositis is observed among almost 100% of treatment cases. This is a significant problem for clinical oncology as it may also reduce patient compliance with comprehensive anticancer treatment. The results indicate the presence of oral problems in 100% of patients receiving specialized antitumor chemotherapy and radiotherapy, as well as the presence of a high need for specialized dental treatment.

Physician practices and attitudes towards atopic dermatitis in Latin America: A cross-sectional study

BackgroundThe prevalence of atopic dermatitis (AD) is increasing in developing countries. Different worldwide guidelines have been proposed, but their applicability for AD specialists in Latin American (LA) countries is unknown. ObjectiveThe objective of this study was to explore the medical approach to treating AD in LA countries. MethodsThe study population comprised AD specialists (allergists and dermatologists). They completed an electronic survey containing questions about the health system, diagnostic criteria, and pharmacotherapy approach to treating AD. The survey was constructed and validated by the Atopic Dermatitis Committee of the Latin American Society of Allergy Asthma and Immunology (SLAAI) in Spanish and Portuguese. Each member was responsible for distributing the questionnaire through different networks in their respective countries. ResultsA total of 284 AD specialists from 13 LA countries completed the questionnaire; among them, 67% were allergists and 33% were dermatologists. Less than 50% of the AD specialists strictly followed guideline recommendations. Among the AD specialists, the European and North American guidelines were more frequently used, and only 16% followed LA guidelines. Dermatologists used the local guidelines less frequently than allergists. Most physicians did not routinely use AD assessment tools (55%). The frequency of the diagnostic tests depends on symptom severity. The availability of some systemic treatments, such as biologics and Janus Kinase (JAK) inhibitors, is not universal in all LA countries. ConclusionThere were marked differences between the specialists, and these differences seemed to be affected by their specialty and each country's healthcare system. New AD education strategies that consider the particularities of the region could allow patients to be more accurately managed. AD assessment tools may provide a way to enhance AD treatment and allow for shared decision-making, patient empowerment, and standardized care.

Roadmap for implementation of genomics in healthcare: towards equity in access to genomics

Abstract Issue Implementing genomic medicine in healthcare can bring us closer to making personalised medicine a reality, with notable socioeconomic benefits. Description of the problem The 1+Million Genomes Initiative is promoting a reflection in European countries regarding their national strategies for genomic medicine, and how these contribute to research and improve clinical practice. Implementation of genomic medicine is complex and requires investment and adjustments in the organisation and practices of healthcare services, including technical infrastructure for genomic data generation and management, a trained healthcare workforce, and appropriate ethical and legal frameworks. Methods To promote the implementation of genomic medicine in healthcare systems, and improve its societal impact, the Beyond 1+MG (B1MG) project organised three country exchange visits for capacity building, developed and validated in real world settings a comprehensive Maturity Level Model (B1MG MLM) for genomic medicine, and organized workshops on health economics models for genomics. Results The products resulting from these activities provide policy recommendations for adoption of genomic medicine, an innovative MLM Toolkit for health systems to self-assess their current maturity status regarding genomic medicine implementation, and plan the path for improvement, as well as several brief papers highlighting main challenges and key indicators for health economic evaluation of genomic tests. Overall, this set of B1MG products provide a Playbook to support the development of national or regional roadmaps for the implementation of genomic medicine in healthcare systems. Lessons Country healthcare systems have specific practices, barriers and constraints, so the actions needed for progress in genomic medicine implementation towards optimization are specific to the context of each healthcare system. Key messages • The B1MG Roadmap will support the definition of strategies for adoption of genomics in healthcare systems, towards equity in the access to genomic medicine for all European citizens. • Country healthcare systems actions needed for progress in genomic medicine implementation towards optimization are specific to the context of each healthcare system.