Secure Healthcare System Research Articles

Intense Seasonal A/H1N1 Influenza in Mexico, Winter 2013–2014

A recrudescent wave of pandemic influenza A/H1N1 affected Mexico during the winter of 2013-2014 following a mild 2012-2013 A/H3N2 influenza season. We compared the demographic and geographic characteristics of hospitalizations and inpatient deaths for severe acute respiratory infection (SARI) and laboratory-confirmed influenza during the 2013-2014 influenza season compared to previous influenza seasons, based on a large prospective surveillance system maintained by the Mexican Social Security health care system. A total of 14,236 SARI hospitalizations and 1,163 inpatient deaths (8.2%) were reported between October 1, 2013 and March 31, 2014. Rates of laboratory-confirmed A/H1N1 hospitalizations and deaths were significantly higher among individuals aged 30-59 years and lower among younger age groups for the 2013-2014 A/H1N1 season compared to the previous A/H1N1 season in 2011-2012 (χ(2) test, p <0.001). The reproduction number for the winter 2013-2014 influenza season in central Mexico was estimated at 1.3-1.4, in line with that reported for the 2011-2012 A/H1N1 season but lower than during the initial waves of pandemic A/H1N1 activity in 2009. We documented a substantial increase in the number of A/H1N1-related hospitalizations and deaths during the period from October 2013-March 2014 in Mexico and a proportionate shift of severe disease to middle-aged adults, relative to the preceding A/H1N1 2011-2012 season. In the absence of clear antigenic drift in globally circulating A/H1N1 viruses in the post-2009 pandemic period, the gradual change in the age distribution of A/H1N1 infections observed in Mexico suggests a slow build-up of immunity among younger populations, reminiscent of the age profile of past pandemics.

A Framework for Secure Healthcare Systems Based on Big Data Analytics in Mobile Cloud Computing Environments

A Framework for Secure Healthcare Systems Based on Big Data Analytics in Mobile Cloud Computing Environments

Comparative analysis of the social security healthcare system in Scandinavian countries and Ecuador

The main objective of this article is to compare the social security health system in Scandinavian countries and Ecuador. The research methodology which was followed vas the qualitative - descriptive type. As a tool for data recollection, semi-structured interviews viere used, and the samples chosen were several patients as well as administrative staff from two private clinics that have a written contract with the Ecuatorian Institute of Social Security (IESS). Its strategies, type of coverage and changes made were determined by answering the questions stated in this article. The research aims to determine the plans and changes applied in the Scandinavian countries and comparing them with the current Ecuatorian system changes. Among the most important findings is that the Ecuatorian system fails to standardize their services in all centers because of the lack of the key components for its operation purposes.

(A283) Hospital Security Planning for Patient Surge Incidents: A Comparison of Three National Systems in China, India, and Japan

IntroductionAs the number of disasters caused by natural and non-natural hazards increase, so does the emphasis placed on healthcare security planning for the influx of patients that often accompany such events. This presentation expands on a previously published examination of national healthcare security systems and emphasizes the role of security in the hospital environment during disasters in China, India, and Japan. National emergency preparedness planning systems and disaster type are examined. Elements of planning for a mass-casualty incident (MCI) that most directly impact security planning include mass-notification alert systems, patient routing processes to hospitals (from an MCI scene) and within hospitals (emergency department flow), staffing, disaster triage, patient identification, tracking and discharge, volunteer tracking, and the adaptability and flexibility of space and processes.MethodsResearchers conducted extensive literature reviews of country-specific health care and physical security elements of patient surge. The comparative analysis was augmented by communication with national healthcare security experts.ConclusionsPositive associations exist between increased disasters and the level of priority and funding given to healthcare security measures in disaster planning. National characteristics of governance, landmass, disaster history, and population influenced the development of healthcare security systems and planning for patient surge incidents. Planning for the mental health impact of terrorism victims, and its subsequent impact to patient surge into hospitals was more relevant in the literature for both India and Japan.

CALIDAD, SISTEMA DE SALUD Y GOBERNANZA: EL CASO ARGENTINO

Argentina had been a fertile ground for reform attempts, focusing in the quality of its health services and subsequently, improving the accessibility and equity to the system. Even though bioethics, as a tool for interdisciplinary reflection, should had been a participant for the foundations of health policies and the impact on its users, it seems that local bioethics had omitted the deleterious consequences created by the lack of governance and corruption on the Argentinean public and social security healthcare systems, choosing instead for focusing in blurry discussions about universal issues related to solidarity and justice, blaming for the failures to the imposition of foreign economical models.

Toward Productive Aging: SIRT1, Systemic NAD Biosynthesis, and the NAD World

In our current society, achieving "productive aging," which aims to keep people as productive as possible with good health and spirit for their private and social activities as they grow older, will be important to maximize the duration of high quality of life and to promote a stable economy and solvent social security in healthcare systems. To achieve this goal, we have been studying mechanisms of mammalian aging and longevity, focusing on the physiological importance of the mammalian nicotinamide adenine dinucleotide (NAD)--dependent protein deacetylase SIRT1 and systemic NAD biosynthesis mediated by nicotinamide phosphoribosyltransferase for the regulation of metabolism and aging. Through these studies, we have recently proposed a comprehensive concept of a novel systemic regulatory network for metabolism and aging, named "NAD World." This new concept of NAD World also conveys ideas of functional hierarchy and frailty for the induction of aging in mammals. Details of the NAD World and its implications to age-associated metabolic diseases such as type 2 diabetes will be discussed.

A SOA approach to the implementation of an electronic medical record

The development of technology and the internet has created a revolution in the healthcare domain, with regard to the implementation of electronic medical records using web-based applications, such as web services, to support interoperability between heterogeneous systems, and provide healthcare service. The need for web services has led to Service-Oriented Architecture (SOA), in order to protect patients' needs. On these grounds, this paper focuses on the implementation of electronic medical record systems using web services, SOA and Business Process Execution Language for Web Services (BPEL4WS); it also refers to SOA and BPEL4WS, discussing the reason for their use, and then assumes a process-oriented, service-oriented and web-based approach to integrate secure healthcare information systems.

Planning for Community Health Emergencies

Abstract After initially defining “community health-emergency planning,” this paper proposes research directions that would contribute to the security of healthcare systems, by mitigating disastrous emergencies and by preparing for them. The topics covered are: (1) Hazard-resistant healthcare facilities, (2) biodetection and syndrome surveillance, (3) diagnosis and investigation, (4) stockpiling, (5) disease containment, (6) patient movement, (7) mass decontamination and prophylaxis, (8) mass care, and (9) information and communication.

Linking Community Initiatives to National Institutions: Ghana

The ILO has developed an innovative concept of global solidarity for social security — the Global Social Trust — which supports the development of national social protection systems through international financing. The concept is ready to be tested nationally and the present paper proposes a pilot project for Ghana. The paper considers the virtues and weaknesses of developing‐country social security healthcare systems and community‐based voluntary insurance schemes, their lack of informal sector coverage on the one hand and their financial disequilibria on the other. It outlines the socio‐economic and macro‐policy context of Ghana and the current health policy environment. It argues for a fusion of the social health insurance and mutual health organization concepts in Ghana, thus linking community initiatives to national institutions, enhancing coverage and the quality of services for all. The paper outlines a basic model that could apply to Ghana, its organizational structure, practical functioning, financing arrangements and expected outputs. In particular it seeks to develop a model for the cross‐subsidization of insurance premiums for the poor. It describes a concept that would combine local ownership initiatives with national responsibility and financing, arguing for a truly interrelated network of social protection. The authors welcome feedback and comments from the wider social security audience.

Current initiatives in Germany for translating national guidelines into reality - a survey

The role of practice guidelines as a tool for quality management in health care is now widely accepted in Germany- not only by health professionals, but also in politics. The physicians' professional associations as well as health care authorities (physicians' self-governmental bodies) and parliament introduced several incentives and regulations, aiming at a regular use of guidelines in health care. Among these the German guideline clearinghouse with the systematic approach towards identification, dissemination, and implementation of best available evidence-based guidelines, as well as the country-wide implementation of disease management guidelines seem to be effective and efficient in quality management as well as in patient care management in the German health care system. The article gives an overview on background, procedures and barriers to country-wide implementation of clinical practice guidelines within a social security health care system.

A Preliminary Study of Security in Healthcare Systems on the Information Superhighway: The Malaysian Perspective

A Preliminary Study of Security in Healthcare Systems on the Information Superhighway: The Malaysian Perspective

Towards a National Health Service in Spain: the Search for Equity and Efficiency

All Southern European countries have enacted reform laws during the last decade with the in tention of turning their traditional social- security health-care systems into national health services. Spain was no exception to this reform thrust and the General Health Law of 1986 brought about a significant institutional change. The purpose of this article is twofold. First, it assesses the decision-making process that led to the approval of the 1986 reform law by contemplating the roles played by the main social and political actors. Moreover, the influence of policy legacies and the impact of regime change are considered. Second, the article evaluates the implementation process of the reform law as regards the coverage criteria and span, the financial sources and the services provided. The analysis of these indicators leads to the conclusion that the health-care system in Spain has been transformed into a national health service, although some minor characteristics of the previous model persist.