Status Of Health Care System Research Articles

A global spatial analysis of factors associated with case and mortality rates for coronavirus disease 2019 during the first year of the pandemic.

A increasing number of studies have revealed associations between country-level determinants and coronavirus disease 2019 (COVID-19) outcomes. This ecological study was conducted to analyze country-level parameters related to COVID-19 infections and deaths during the first year of the pandemic. The examined predictors comprised demographics, economic factors, disease prevalence and healthcare system status, and the relevant data were obtained from public databases. The index dates were set to 15 July 2020 (Time 1) and 15 December 2020 (Time 2). The adjusted spatial autoregression models used a first-order queen contiguity spatial weight for the main analysis and a second-order queen contiguity spatial weight for a sensitivity analysis to examine the predictors associated with COVID-19 case and mortality rates. Obesity was significantly and positively associated with COVID-19 case and mortality rates in both the main and sensitivity analyses. The sensitivity analysis revealed that a country's gross domestic product, population density, life expectancy and proportion of the population older than 65 y are positively associated with COVID-19 case and mortality rates. With the increasing global prevalence of obesity, the relationship between obesity and COVID-19 disease at the country level must be clarified and continually monitored.

Preserving Resilience for Prevention of Burnout in Anesthesiology Residents as Frontline Healthcare Workers During the COVID-19 Outbreak: A Report of Real-Life Experiences of Professionalism and Mentoring in Medical Education.

During the COVID-19 pandemic, burnout of healthcare workers, including anesthetists, has become a critical issue. This study aimed to provide a practical framework for decreasing and preventing burnout among anesthesiology residents through preserving their good mental health. Since the onset of the COVID-19 outbreak, anesthesiology residents have been members of medical teams with the attending staff, senior residents, and partner residents. Besides, the following measures were taken to reduce burnout: providing financial support for the attending staff to procure personal protective equipment (PPE), rearrangement of work schedules to reduce the workload, holding training sessions in virtual meetings, and improving the social network system for reducing burnout. The interventional program could help anesthesiology residents to adapt to or cope with the healthcare system status and also prevent burnout. Moreover, development of empathy, integrity, and cohesion in the healthcare system motivated the staff to comply with the principles of medical professionalism. During the current health crisis due to COVID-19, it is essential to implement specific interventional and training programs for decreasing or preventing burnout among healthcare workers.

Resource Oriented Decision Making for Treatment of Metastatic Colorectal Cancer (mCRC) in a Lower-Middle Income Country: Egyptian Foundation of Medical Sciences (EFMS) Consensus Recommendations 2020.

PurposeColorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide and the second cause of cancer related mortality. Treatment options for patients with metastatic CRC (mCRC) expanded during the last two decades, with introduction of new chemotherapeutic and targeted agents. Egypt is a lower middle-income country; Egyptian health care system is fragmented with wide diversity in drug availability and reimbursement policies across different health care providing facilities. We report the results of consensus recommendations for treatment of patients with metastatic colorectal cancer developed by Egyptian Foundation of Medical Sciences (EFMS), aiming to harmonize clinical practice through structured expert consensus-based recommendations consistent with the national status. EFMS recommendations could be utilized in other countries with similar economic status.MethodsEFMS recommendations were developed using a modified Delphi process, with three rounds of voting till the final recommendations were approved. A non-systematic review of literature was conducted before generating the provisional statements. Content experts were asked to vote on some recommendations in two different resource groups (restricted resources and non-restricted resources). External review board of experts from a low income and lower-middle countries voted on the applicability of EFMS recommendations in their countries.ResultsThe current recommendations highlighted the discrepancy in health care between restricted and non-restricted resources with expected survival loss and quality of life deterioration. Access to targeted agents in first line is very limited in governmental institutions, and no access to agents approved for third line in patients who failed oxaliplatin and irinotecan containing regimens for patients treated in restricted resource settings.ConclusionManagement of mCRC in developing countries is a challenge. The currently available resource-stratified guidelines developed by international cancer societies represent a valuable decision-making tool, adaptation to national status in each country based on healthcare system status is required.

Development of Health-RESPECT: An Integrated Service Model for Older Long-Term Care Hospital/Nursing Home Patients Using Information and Communication Technology.

BackgroundKorea, as one of the fastest-aging countries worldwide, requires an improved healthcare service model for older adults. We evaluated the current healthcare system and developed a service model based on information and communication technologies (ICT) for use in older patients in long-term care facilities (LTCF).MethodsWe conducted a qualitative literature review, focus group interviews (FGIs), and structured survey to identify the current technology use and status of healthcare systems. We then developed a web-based platform with necessary, high-priority, and usable content for the care of older patients in LTCF. ResultsWe reviewed 60 (23 hypertension, 18 diabetes, and 19 heart failure) articles on information and communication technologies (ICT)-based disease management for clinical effectiveness and improved patient satisfaction. FGIs and structured surveys were used to evaluate the inconvenience in patient and medical information transfer between hospitals and cost and time required for its process. Accordingly, we confirmed the unmet need for an ICT-based service model for management, monitoring, and consultation among older patients and developed the Health-RESPECT (integrated caRE Systems for elderly PatiEnts using iCT), a service platform for older patients residing in LTCF. The medical information exchange system was used to transfer medical information. Health-RESPECT includes an established algorithm for evidence-based comprehensive geriatric assessment and customized management; chronic disease management; management of potentially inappropriate medications; rehabilitation; and consultation and videoconferencing.ConclusionThis study identified the current status and unmet needs of healthcare systems for older adults. We developed an ICT-based system to manage older institutionalized patients. However, the Health-RESPECT service model requires further validation.

Managing the sequelae of urology medical tourism: A single center experience.

Medical tourism is a fast-growing business worldwide with almost every country involved as either a provider and/or consumer. The degree of participation may vary depending on the status of health-care system in that country. This study aims to present our experience in the management of patients who sought urologic care abroad or returned from medical tourism with urologic complications. The method of study was based on the documentation of interaction with patients, patients' relations and their agents in a questionnaire between January 2010 and December 2015. The data obtained included, their demographics, indications/motivations for seeking treatment abroad, procedures performed and complications. We also documented the secondary procedures that were performed and complications managed in our center. The data were entered into Microsoft Excel and analysed using descriptive statistics, tables and figures. A total of 113 have either indicated intention of going to seek for urological care abroad or had already had urologic procedures abroad but were attending our clinic for follow up or for management of complications. Only about 12% of these patients were found to have genuine indications for seeking care abroad. Most of the indications were not justifiably based on the current capabilities of our health facility but more due to a lack of trust in the system or at worst pretentious. Patients seek for treatment abroad for variable reasons but and most could not be justified based on available local options. India and some Middle-East countries were the favoured destinations, and the quality of care and relative lower cost are the major attractions. The rising trend in medical tourism is fuelled by the poor state of our health-care system, perceived dearth of expertise and a general apathy and lack of trust.

A study on the equality and benefit of China\u2019s national health care system

BackgroundThis study is designed to evaluate whether the benefit which the residents received from the national health care system is equal in China. The perceived equality and benefit are used to measure the personal status of health care system, health status. This study examines variations in perceived equality and benefit of the national health care system between urban and rural residents from five cities of China and assessed their determinants.MethodsOne thousand one hundred ninty eight residents were selected from a random survey among five nationally representative cities. The research characterizes perceptions into four population groupings based on a binary assessment of survey scores: high equality & high benefit; low equality & low benefit; high equality & low benefit; and low equality & high benefit.ResultsThe distribution of the four groups above is 30.4%, 43.0%, 4.6% and 22.0%, respectively. Meanwhile, the type of health insurance, educational background, occupation, geographic regions, changes in health status and other factors have significant impacts on perceived equality and benefit derived from the health care system.ConclusionThe findings demonstrate wide variations in perceptions of equality and benefit between urban and rural residents and across population characteristics, leading to a perceived lack of fairness in benefits and accessibility. Opportunities exist for policy interventions that are targeted to eliminate perceived differences and promote greater equality in access to health care.

Health systems and maternal and child survival in Central Asian Republics.

To describe the status of health care systems in five Central Asian Republics (CAR): Kyrgzstan, Kazakhstan, Uzbekistan, Turkmenistan, and Tajikistan, with particular attention to women's and children's health. Changing mortality profiles are investigated using the "protracted-polarized" model of epidemiologic transition. Empirical evidence was drawn from the World Health Organization (WHO) database for the region, along with additional evidence presented at a maternal-child health conference held in Bishkek, Kyrgyzstan, on November 11-14, 1998. The conference was sponsored by the Albert Schweitzer Institute and the Soros Foundation. This evidence is evaluated for completeness, validity, and reliability. Trends are identified using the 1998 and 1999 World Health Reports and 1999/2000 World Bank Development Report. Incomplete data prohibited comprehensive analysis. Available data indicated high but variable rates of maternal and child mortality and overall declines in health status and the health care infrastructure in the 1990s. Data collection and analysis from this part of the world are often incomplete and unreliable. Future research should focus on improving maternal and child health indicators by enhancing resource sharing and opportunities for international collaboration.

Good enough for Iganga?

Publisher Summary This chapter focuses on the status of health care system in Iganga Province of Uganda. Like many other places in Africa, Iganga benefits from drugs distributed through a 'kit' system. That system - periodically providing large boxes of drugs in a standard variety to each centre in a predesigned assortment - created a drug supply in a situation where there had previously been none. The contents of the kit are designed to meet the average need of a center. The kits thus provide only a rough-and-ready solution; in Iganga there is too little pentothal in them to meet local needs and often too little injectable penicillin, while the ergometrine which the kits contain may end up in centers, which have no obstetric patients to treat. In Namubngalwe, which attracts patients with sleeping sickness, there is a special supply of drugs for that purpose but nothing for the secondary ailments which often accompany it. Bugiri Hospital is supposed to conduct operations, yet there has been no pentothal for more than a year because of hold-ups at some central point. The risk in the present situation is that traditional medicine will increasingly become the backwater of health care, a means to which one has resort only where scientific medicine is topographically or financially out of reach. W.H.O. has done something to ensure that traditional healing is studied, but the field has received only a fraction of the attention which it deserves if the best elements in it are to be exploited and the weakest eliminated.