Decline In Health Care Research Articles

Risk factors for Burnout Syndrome in healthcare professionals on the front line against Covid-19

The Covid-19 pandemic, since its inception, has been causing serious damage and consequences to the health of the general population. The coronavirus has a high transmission rate and as a result, high rates of infection were obtained, as well as overcrowding in health services. WHO data indicate that most health professionals working on the front line in the fight against the Covid-19 virus, have high rates of anxiety, stress, depression, professional dissatisfaction and feelings of negativism, which negatively influences and causes a decline in health care. service performance. Thus, the objective of this study was to identify, through scientific evidence, which are the risk factors for Burnout Syndrome in health professionals on the front line against Covid-19. For this, an integrative review of the literature was carried out through a survey of data in the scientific bases: LILACS, SCIELO and BRISA. From the analysis of the selected studies, it was possible to identify some factors that emerge risks for the mental health of health professionals. Occupational stress triggered by a long period of exposure to negative emotional stimuli that are generated in the work environment. The findings in the literature indicate that psychic illness has increased in the services, since the Covid-19 virus contributes to this consequence, leaving health professionals exposed to vulnerabilities. Preexisting diseases such as comorbidity, depression, anxiety, mood disorder show as clinically significant indicators that can be a lever for the prevalence of Burnout.

TRENDS IN THE MIGRATION OF THE HEALTH LABOR FORCE IN THE SLOVAK REPUBLIC ABROAD

The current situation in the countries is monitored by various experts from various fields. Various factors are monitored in the countries, including demographic developments. The change in the structure of the population, which is reflected in the aging of the population, is an irreversible process in the European Union. It is important that Slovakia, as a member of the European Union, prepares the labor market for an aging population. The aging of the population is associated in the future with the additional need for labor in many areas, but especially in health care. Among the demographic factor, which has recently resonated more and more in the professional public, is the issue of labor migration. Labor migration is one of the issues that has recently received increasing attention from the professional public, mainly due to the current demographic situation in most countries of the world. Migration is generally perceived as a natural and in many respects positive phenomenon, but it is important to investigate and monitor it in order to maintain its positive impact on society and eliminate possible adverse effects. Globalization, greater economic integration of countries, the development of technology and transport infrastructure, or the removal of political barriers, but also other factors such as changes in demographic trends undoubtedly contribute to the expansion of migration in recent periods. Although it can be of potential benefit to migrants themselves and to both countries concerned, it is also necessary to examine its negative effects and look for ways to eliminate them. Migratory flows of the labor force, especially for work abroad, its intensity and extent are not negligible indicators that affect the labor force in the health sector. Therefore, the aim of the present study is to analyze trends in labor migration as a whole in the Slovak Republic, identify the share of medical staff emigrating from the Slovak Republic abroad and identify whether the migration of health workers will affect the decline in health care in the Slovak Republic

Trends in U.S. Burden of Clostridioides difficile Infection and Outcomes

BackgroundEfforts to prevent Clostridioides difficile infection continue to expand across the health care spectrum in the United States. Whether these efforts are reducing the national burden of C. difficile infection is unclear.MethodsThe Emerging Infections Program identified cases of C. difficile infection (stool specimens positive for C. difficile in a person ≥1 year of age with no positive test in the previous 8 weeks) in 10 U.S. sites. We used case and census sampling weights to estimate the national burden of C. difficile infection, first recurrences, hospitalizations, and in-hospital deaths from 2011 through 2017. Health care–associated infections were defined as those with onset in a health care facility or associated with recent admission to a health care facility; all others were classified as community-associated infections. For trend analyses, we used weighted random-intercept models with negative binomial distribution and logistic-regression models to adjust for the higher sensitivity of nucleic acid amplification tests (NAATs) as compared with other test types.ResultsThe number of cases of C. difficile infection in the 10 U.S. sites was 15,461 in 2011 (10,177 health care–associated and 5284 community-associated cases) and 15,512 in 2017 (7973 health care–associated and 7539 community-associated cases). The estimated national burden of C. difficile infection was 476,400 cases (95% confidence interval [CI], 419,900 to 532,900) in 2011 and 462,100 cases (95% CI, 428,600 to 495,600) in 2017. With accounting for NAAT use, the adjusted estimate of the total burden of C. difficile infection decreased by 24% (95% CI, 6 to 36) from 2011 through 2017; the adjusted estimate of the national burden of health care–associated C. difficile infection decreased by 36% (95% CI, 24 to 54), whereas the adjusted estimate of the national burden of community-associated C. difficile infection was unchanged. The adjusted estimate of the burden of hospitalizations for C. difficile infection decreased by 24% (95% CI, 0 to 48), whereas the adjusted estimates of the burden of first recurrences and in-hospital deaths did not change significantly.ConclusionsThe estimated national burden of C. difficile infection and associated hospitalizations decreased from 2011 through 2017, owing to a decline in health care–associated infections. (Funded by the Centers for Disease Control and Prevention.)

Who wants to live forever? Organizational decline in health care.

We tend to look upon any attempt at managed decline of health care organizations with suspicion bordering on hostility. Researchers rarely theorize on the topic, administrators typically have little or no experience of handling decline processes, and citizens invariably oppose proposals for closure that are put forward, irrespective of their merits. All of which means that health care organizations have an unusually long projected shelf life and in many cases can expect to survive indefinitely. In a context of economic growth and increases in public spending, we might think this to be reasonable, and this certainly seems to be the tacit position of much scholarship in health policy and management. However, in the context of public sector retrenchment, the assumption of resource fecundity has come under challenge, as is evident for example in the English health care system where local leaders are increasingly considering options for service reduction and closure. This is new territory for many of those involved and not surprisingly has proven to be both demanding and frustrating, with much of the ‘low hanging fruit’ already picked and the rest proving stubbornly hard to reach. Although some savings have been achieved, these have yet to be of the magnitude required, and some basic questions remain unaddressed such as: What management strategies are likely to be most effective in leading downsizing or closure? What happens to the patients and staff implicated in such changes? And, how should the politics be handled? Re-reading the work of the public management academic, Charles Levine reminds us that this is not the first period of retrenchment and constraint in history. Writing in the US in the 1970s and 1980s, Levine posed the question: ‘Without growth, how do we manage our public organizations?’ He proclaimed the influence of political and economic conditions on management in public organizations and sought to examine these effects and their appropriate responses. His understanding of ‘organizational change toward lower levels of resource consumption and organizational activity’ was longitudinal and highly sensitive to context, thereby anticipating much subsequent scholarly development whilst remaining relevant and accessible to managers of the day. The richness and scope of Levine’s work was in large part due to his simultaneous application of the wide-angle lens (e.g. what are the lifecycles of public organizations?) and the microscope (e.g. what is the impact of decline on work habits, incentive structures and relationships of compliance and control?). Although Levine noted that is ‘nearly impossible to get elected officials, public managers, citizens or management theorists to confront cutback and decremental planning situations’, a more sustained exploration of this inertia can be found in the policy termination literature. The impediments identified in this work remain stubbornly in place and include: institutional permanence; ‘dynamic conservatism’; coalitions of opposition and legal/financial obstacles. Of more interest to Levine were the dynamics played out in situations where organizational decline is either proposed or enacted, and the management strategies available to those involved. Underpinning this interest was a belief that public administrators have a legitimate and active role to play, and that decline should not be left entirely to other parties to determine: managers, Levine argued, should play an integral role in shaping and leading responses to the prospect of organizational downsizing or closure. Levine underlined the importance of understanding the causes of organizational decline which he grouped into four categories. The most common of these he considered to be ‘problem depletion’ resulting from factors such as changes in demography or shifts in the way population needs are understood – neatly exemplified by changing health needs and the

The impact of endoscopic sinus surgery on health care use in patients with respiratory comorbidities.

Analyze health care needs and outcomes-defined by changes in health care utilization-in cohorts of patients with respiratory comorbidities and requiring sinus surgery for the treatment of chronic rhinosinusitis (CRS). Retrospective database analysis. US-wide claims database (MarketScan). All patients with endoscopic sinus surgery (CPT 31254-31288) in 2008 and at least 2 years of continuous enrollment prior and post surgery were analyzed for concurrent comorbidities (asthma, polyps, aspirin sensitivity, and allergies). Inpatient and outpatient events as well as prescriptions related to the treatment of CRS were analyzed for frequency and cost, based on respiratory comorbidities. A total of 9105 patients were included and subdivided as following: no respiratory comorbidity (N = 4780), asthma only (N = 1167), polyps and asthma (N = 721), Samter's triad (N = 91), and additional subgroups based on various combinations of concurrent comorbidities. Before surgery, costs were flat, ranging from $296.4 (95% CI, $263.1-$329.8) per patient per year for patients in the no comorbidity group to $2189 (95% CI, $1449.2-$2930.1) for patients with Samter's triad. Surgery was preceded by at least 6 months of increased health care utilization (outpatient care and prescriptions). Following surgery, health care needs declined rapidly and reached baseline levels within 3 to 4 postoperative months. Patients with asthma received significantly more health care for CRS than patients without asthma through the entire study. Patients with CRS incur continuous costs and health care needs, due to the chronic nature of their disease. All patients, regardless of comorbidity, experienced significant decline in health care needs following sinus surgery from their preoperative state.

Fundamentals of infection prevention and control

At the beginning of the 21st century, the UK had one of the highest rates of healthcare–associated infection (HCAI) in Europe ( National Audit Office (NAO), 2000 ; 2004 ). Changes in healthcare practice, including an increased emphasis on handwashing, have led to a major decline in healthcare–associated infections, from 9.2% of patients in 1980 to between 6.7–6.4% in 2011 ( Walker et al, 2011:69 ; Health Protection Agency (HPA), 2012 ). Health Protection Agency data (2012) shows the rate of HCAI fell from 8.2% to 6.4% in five years. There has been a 69% reduction in MRSA bacteraemia rates and a 59% reduction in clostridium difficile infections over the past five years (Public Health England, 2013). Although much has been achieved, recent rising levels of antibiotic resistance mean ‘we could be close to reaching a point where we may not be able to prevent or treat everyday infections or diseases’ ( Department of Health (DH), 2013 ). Every healthcare worker has an important part to play in helping to prevent infection and to stem the tide of antibiotic (also known as antimicrobial) resistance. This article, the first in a series, aims to enable readers to understand the fundamentals of infection prevention and control. It explains how the body attempts to defend itself against infection, who is most vulnerable to infection and how infection affects older people and other vulnerable groups. The article explains how to assess and reduce risk and sets the scene for the series.

Radical Remedies:

As states weaken and public health care deteriorates throughout the developing world, new spaces are opening for civil society groups to fill the gaps of declining health systems. In Mexico, popular health groups have responded to health care decline by building community clinics, establishing health promoter training programs, and opening natural medicine pharmacies. Lower- and working-class women are the primary participants in these groups that use a self-help approach to find practical solutions to local health care problems. However, little is known about participants' circumstances, motivations, or the ideals they embrace. Drawing from women's narratives, I explore the "micropolitics" of women's participation in local health groups. I examine their efforts to reclaim control over the health process as a metaphor for claiming control over their lives. Highlighting the "instrumental effects" of participants' medical encounters and healing relationships, this case illuminates some unintended consequences of health care decline.