Variability of adverse events in the public health-care service of the Tuscany region

Abstract This paper deals with the period from 1881 to 1918, when the following Sanitary Laws were passed: Law on the Organization of the Sanitary Profession and Public Health Care (1881), which implemented measures for protection from venereal diseases, as well as restriction of prostitution; Public Sanitary Fund (1881), with independent budget for health care; Announcement on Free of Charge Treatment of Syphilis (1887). Dermatovenereological Departments were also founded: in the General Public Hospital in Belgrade (1881), and in the General Military Hospital (1909). The Hospital in Knjaževac for Syphilis was reopened (1881), as well as mobile and temporary hospitals for syphilis, and a network of County and Municipality hospitals. The first Serbian dermatovenereologist was Dr. Jevrem Žujović (1860 - 1944), and then Dr. Milorad Savićević (1877 - 1915). Skin and venereal diseases were treated by general practitioners, surgeons, internists and neurologists. Although Dr. Laza Lazarević (1851 - 1890) was not a dermatologist, but a physician and a writer, he published three papers on dermatovenereology, whereas Dr. Milorad Godjevac (1860 - 1933) wrote an important study on endemic syphilis. From 1885 to 1912, organization of dermatovenereology service has significantly improved. Considering the fact that archive documents are often missing, only approximate structure of diseases is specified: in certain monthly reports in Zaječar, out of all the diseased persons, 45% had skin or venereal diseases, while in Užice the number was 10.5%, which points to different distribution of these diseases. High percentage of dermatovenereology diseases was caused by high frequency of venereal diseases and syphilis. During the war: 1912 - 1918, the military medical service dominated, and in 1917 Prince Alexander Serbian Reserve Hospital was founded in Thessaloniki with a Department for Skin and Venereal Diseases. During this period, work of the Civilian Health Care Service was interrupted, consequently leading to a considerable aggravation of public health.

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Vascular dementia in a Brazilian public health care service specialized in cognitive disorders using NINDS-AIREN criteria

Journal of the Neurological Sciences ◽

10.1016/j.jns.2009.02.223 ◽

2009 ◽

Vol 283 (1-2) ◽

pp. 298-299

Author(s):

J.I. Siqueira-Neto ◽

O.M. Pontes-Neto ◽

J.D.V. Castro ◽

L. Wichert-Ana ◽

F.A.C. Vale ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Vascular Dementia ◽

Care Service ◽

Health Care Service ◽

Cognitive Disorders ◽

Public Health Care

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Teleconsultation Between Patients and Health Care Professionals in the Catalan Primary Care Service: Message Annotation Analysis in a Retrospective Cross-Sectional Study

Journal of Medical Internet Research ◽

10.2196/19149 ◽

2020 ◽

Vol 22 (9) ◽

pp. e19149 ◽

Cited By ~ 1

Author(s):

Francesc López Seguí ◽

Sandra Walsh ◽

Oscar Solans ◽

Cristina Adroher Mas ◽

Gabriela Ferraro ◽

...

Keyword(s):

Public Health ◽

Primary Care ◽

Health Care ◽

Random Sample ◽

General Practitioners ◽

Health Care Professionals ◽

Care Service ◽

Public Health Care ◽

Face To Face ◽

The Public

Background Over the last decade, telemedicine services have been introduced in the public health care systems of several industrialized countries. In Catalonia, the use of eConsulta, an asynchronous teleconsultation service between primary care professionals and citizens in the public health care system, has already reached 1 million cases. Before the COVID-19 pandemic, the use of eConsulta was growing at a monthly rate of 7%, and the growth has been exponential from March 15, 2020 to the present day. Despite its widespread usage, there is little qualitative evidence describing how this tool is used. Objective The aim of this study was to annotate a random sample of teleconsultations from eConsulta, and to evaluate the level of agreement between health care professionals with respect to the annotation. Methods Twenty general practitioners retrospectively annotated a random sample of 5382 cases managed by eConsulta according to three aspects: the type of interaction according to 6 author-proposed categories, whether the practitioners believed a face-to-face visit was avoided, and whether they believed the patient would have requested a face-to-face visit had eConsulta not been available. A total of 1217 cases were classified three times by three different professionals to assess the degree of consensus among them. Results The general practitioners considered that 79.60% (4284/5382) of the teleconsultations resulted in avoiding a face-to-face visit, and considered that 64.96% (3496/5382) of the time, the patient would have made a face-to-face visit in the absence of a service like eConsulta. The most frequent uses were for management of test results (26.77%, 1433/5354), management of repeat prescriptions (24.30%, 1301/5354), and medical enquiries (14.23%, 762/5354). The degree of agreement among professionals as to the annotations was mixed, with the highest consensus demonstrated for the question “Has the online consultation avoided a face-to-face visit?” (3/3 professionals agreed 67.95% of the time, 827/1217), and the lowest consensus for the type of use of the teleconsultation (3/3 professionals agreed 57.60% of the time, 701/1217). Conclusions This study shows the ability of eConsulta to reduce the number of face-to-face visits for 55% (79% × 65%) to 79% of cases. In comparison to previous research, these results are slightly more pessimistic, although the rates are still high and in line with administrative data proxies, showing that 84% of patients using teleconsultations do not make an in-person appointment in the following 3 months. With respect to the type of consultation performed, our results are similar to the existing literature, thus providing robust support for eConsulta’s usage. The mixed degree of consensus among professionals implies that results derived from artificial intelligence tools such as message classification algorithms should be interpreted in light of these shortcomings.

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Epidemiological effects in Amyotrophic Lateral Sclerosis from the application of a DTCP

10.21203/rs.3.rs-540129/v1 ◽

2021 ◽

Author(s):

Massimo Esposito ◽

Marcello Sartori ◽

Emilio Terlizzi ◽

Roberto Antenucci ◽

Elena Braghieri ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Care Pathway ◽

Care Service ◽

Health Care Service ◽

Public Health Care ◽

The Difference ◽

Als Patients ◽

Epidemiological Effects ◽

Lateral Sclerosis

Abstract This article introduces the report on the difference occurred in management of ALS patients by an italian Public Health Care Service through 15 years with-and without DTCP (Diagnostic and Therapeutic Care Pathway) during three timeframes. The article illustrates Demography, Provenance and Territorial context of the patients in charge. The formalization of the staging-based ALS DTCP appears to have increased and improved the possibility of clinical taking in charge of patients.

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Teleconsultation Between Patients and Health Care Professionals in the Catalan Primary Care Service: Message Annotation Analysis in a Retrospective Cross-Sectional Study (Preprint)

10.2196/preprints.19149 ◽

2020 ◽

Cited By ~ 1

Author(s):

Francesc López Seguí ◽

Sandra Walsh ◽

Oscar Solans ◽

Cristina Adroher Mas ◽

Gabriela Ferraro ◽

...

Keyword(s):

Public Health ◽

Primary Care ◽

Health Care ◽

Random Sample ◽

General Practitioners ◽

Health Care Professionals ◽

Care Service ◽

Public Health Care ◽

Face To Face ◽

The Public

BACKGROUND Over the last decade, telemedicine services have been introduced in the public health care systems of several industrialized countries. In Catalonia, the use of eConsulta, an asynchronous teleconsultation service between primary care professionals and citizens in the public health care system, has already reached 1 million cases. Before the COVID-19 pandemic, the use of eConsulta was growing at a monthly rate of 7%, and the growth has been exponential from March 15, 2020 to the present day. Despite its widespread usage, there is little qualitative evidence describing how this tool is used. OBJECTIVE The aim of this study was to annotate a random sample of teleconsultations from eConsulta, and to evaluate the level of agreement between health care professionals with respect to the annotation. METHODS Twenty general practitioners retrospectively annotated a random sample of 5382 cases managed by eConsulta according to three aspects: the type of interaction according to 6 author-proposed categories, whether the practitioners believed a face-to-face visit was avoided, and whether they believed the patient would have requested a face-to-face visit had eConsulta not been available. A total of 1217 cases were classified three times by three different professionals to assess the degree of consensus among them. RESULTS The general practitioners considered that 79.60% (4284/5382) of the teleconsultations resulted in avoiding a face-to-face visit, and considered that 64.96% (3496/5382) of the time, the patient would have made a face-to-face visit in the absence of a service like eConsulta. The most frequent uses were for management of test results (26.77%, 1433/5354), management of repeat prescriptions (24.30%, 1301/5354), and medical enquiries (14.23%, 762/5354). The degree of agreement among professionals as to the annotations was mixed, with the highest consensus demonstrated for the question “Has the online consultation avoided a face-to-face visit?” (3/3 professionals agreed 67.95% of the time, 827/1217), and the lowest consensus for the type of use of the teleconsultation (3/3 professionals agreed 57.60% of the time, 701/1217). CONCLUSIONS This study shows the ability of eConsulta to reduce the number of face-to-face visits for 55% (79% × 65%) to 79% of cases. In comparison to previous research, these results are slightly more pessimistic, although the rates are still high and in line with administrative data proxies, showing that 84% of patients using teleconsultations do not make an in-person appointment in the following 3 months. With respect to the type of consultation performed, our results are similar to the existing literature, thus providing robust support for eConsulta’s usage. The mixed degree of consensus among professionals implies that results derived from artificial intelligence tools such as message classification algorithms should be interpreted in light of these shortcomings.

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Demand for Competence-based Education for Worker of Public Health Care Service in Ulsan Metropolitan City

Public Health Affairs ◽

10.29339/pha.21.8 ◽

2021 ◽

Vol 5 (1) ◽

pp. e8

Author(s):

Hyrean Jeong ◽

Jeehee Pyo ◽

Minsu Ock

Keyword(s):

Public Health ◽

Health Care ◽

Work Ability ◽

Care Service ◽

Core Competencies ◽

Health Care Service ◽

Core Competency ◽

Public Health Care ◽

The Core ◽

Education Demand

Introduction: In order to strengthen the core competencies of workers, systematic education tailored to their needs is necessary. In this study, a survey was conducted on workers in public health care service in Ulsan Metropolitan City (Ulsan) to investigate the demand for education according to core competencies.Methods: A total of 70 workers who work for public health care service in Ulsan participated in this online survey. The questionnaire consisted of socio-demographic factors, work ability, education demand, and preference of education form.Results: The core competency with a high level of work ability is ‘Expertise on health and disease’ (41, 58.6%). On the other hand, the core competency with a low level of work ability was found to be the ‘Evaluation-related theories of public health care service’ (57, 81.4%). The core competencies with the highest demand for education were “Resident-centered service implementation” and “Public health care service strategy development” (64, 91.4%), followed by ‘Public health care service cases review’ and ‘knowledge of public health service plan’ (63, 90.0%). The preferred form of education is offline education (49, 40.8%). The most important factor in education was ‘work utilization’ (Offline: 57, 81.4%; Online: 48, 68.6%), both online and offline.Conclusions: Through the research results, it was possible to find out education demand according to core competencies and preference of education form. Based on these results, we will develop a core competency education program tailored to actual demand. In the future, it is necessary to continuously conduct research on such education demand.

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