Effectiveness of Prenatal Screening for Congenital Heart Disease: Assessment in a Jurisdiction With Universal Access to Health Care

2013 ◽  
Vol 29 (7) ◽  
pp. 879-885 ◽  
Author(s):  
Jean Trines ◽  
Deborah Fruitman ◽  
Kevin J. Zuo ◽  
Jeffrey F. Smallhorn ◽  
Lisa K. Hornberger ◽  
...  
Keyword(s):  
Health Care ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Access To Health Care ◽  
Congenital Heart ◽  
Prenatal Screening ◽  
Universal Access ◽  
Disease Assessment ◽  
Access To Health

scholarly journals Incidence of ESKD and Mortality among Children with Congenital Heart Disease after Cardiac Surgery

2019 ◽  
Vol 14 (10) ◽  
pp. 1450-1457 ◽  
Author(s):  
Chirag R. Parikh ◽  
Jason H. Greenberg ◽  
Eric McArthur ◽  
Heather Thiessen-Philbrook ◽  
Allen D. Everett ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
General Population ◽  
Access To Health Care ◽  
Health Care Services ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Universal Access ◽  
Population Based ◽  
Interquartile Range

Background and objectivesSurvival after surgical repair for congenital heart disease has markedly improved; however, there are limited data on long-term ESKD and mortality during childhood.Design, setting, participants, & measurementsWe conducted an observational, population-based cohort study of children who had their first surgery for congenital heart disease within 10 years of birth. The study was conducted in Ontario, Canada, where residents have universal access to health care services. Each child who underwent surgical repair was matched to ten children from the general population who were similar in age, sex, index date, rurality, and neighborhood income. Primary outcomes of all-cause mortality and ESKD were reported until March 2015.ResultsWe followed 3600 children with congenital heart disease for a median of 5.9 (interquartile range, 2.9–9.0) years after their surgical repair. Median age at first surgery was 150 (interquartile range, 40–252) days and 22% were low birth weight (<2500 g). During follow-up, 140 (4%) children who had surgery for congenital heart disease died and 52 (1%) reached ESKD. The cumulative incidence of death and ESKD at 1, 5, and 10 years was higher in children with surgical repair of congenital heart disease (death: 3%, 4%, and 5%, respectively; ESKD: 1%, 2%, and 2%, respectively) compared with the matched control population without any congenital heart disease (death: 0.06%, 0.10%, and 0.13%, respectively; ESKD: 0.00%, 0.02%, and 0.02%, respectively). The risk of ESKD and death increased with severity of congenital heart disease, with the highest risk in children with hypoplastic left heart syndrome and increased in children who had surgical repair of congenital heart disease compared with those without surgical repair.ConclusionsThe risk of mortality and ESKD is high in children who undergo surgical repair for congenital heart disease compared to the general population.

scholarly journals Estimating the local spatio‐temporal distribution of malaria from routine health information systems in areas of low health care access and reporting

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Elizabeth Hyde ◽  
Matthew H. Bonds ◽  
Felana A. Ihantamalala ◽  
Ann C. Miller ◽  
Laura F. Cordier ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Malaria Incidence ◽  
Universal Access ◽  
Surveillance Systems ◽  
Passive Surveillance ◽  
Transmission Season ◽  
Access To Health ◽  
Spatio Temporal ◽  
Geographic Access To Care

Abstract Background Reliable surveillance systems are essential for identifying disease outbreaks and allocating resources to ensure universal access to diagnostics and treatment for endemic diseases. Yet, most countries with high disease burdens rely entirely on facility-based passive surveillance systems, which miss the vast majority of cases in rural settings with low access to health care. This is especially true for malaria, for which the World Health Organization estimates that routine surveillance detects only 14% of global cases. The goal of this study was to develop a novel method to obtain accurate estimates of disease spatio-temporal incidence at very local scales from routine passive surveillance, less biased by populations' financial and geographic access to care. Methods We use a geographically explicit dataset with residences of the 73,022 malaria cases confirmed at health centers in the Ifanadiana District in Madagascar from 2014 to 2017. Malaria incidence was adjusted to account for underreporting due to stock-outs of rapid diagnostic tests and variable access to healthcare. A benchmark multiplier was combined with a health care utilization index obtained from statistical models of non-malaria patients. Variations to the multiplier and several strategies for pooling neighboring communities together were explored to allow for fine-tuning of the final estimates. Separate analyses were carried out for individuals of all ages and for children under five. Cross-validation criteria were developed based on overall incidence, trends in financial and geographical access to health care, and consistency with geographic distribution in a district-representative cohort. The most plausible sets of estimates were then identified based on these criteria. Results Passive surveillance was estimated to have missed about 4 in every 5 malaria cases among all individuals and 2 out of every 3 cases among children under five. Adjusted malaria estimates were less biased by differences in populations’ financial and geographic access to care. Average adjusted monthly malaria incidence was nearly four times higher during the high transmission season than during the low transmission season. By gathering patient-level data and removing systematic biases in the dataset, the spatial resolution of passive malaria surveillance was improved over ten-fold. Geographic distribution in the adjusted dataset revealed high transmission clusters in low elevation areas in the northeast and southeast of the district that were stable across seasons and transmission years. Conclusions Understanding local disease dynamics from routine passive surveillance data can be a key step towards achieving universal access to diagnostics and treatment. Methods presented here could be scaled-up thanks to the increasing availability of e-health disease surveillance platforms for malaria and other diseases across the developing world.

scholarly journals A systematic review examining the clinical and health-care outcomes for congenital heart disease patients using home monitoring programmes

2021 ◽  
pp. 1357633X2098405
Author(s):  
Rachel Crawford ◽  
Ciara Hughes ◽  
Sonyia McFadden ◽  
Jacqui Crawford
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Case Series ◽  
Home Monitoring ◽  
Risk Of Bias ◽  
Health Care Outcomes ◽  
Care Outcomes

Objectives This review aimed to present the clinical and health-care outcomes for patients with congenital heart disease (CHD) who use home monitoring technologies. Methods Five databases were systematically searched from inception to November 2020 for quantitative studies in this area. Data were extracted using a pre-formatted data-collection table which included information on participants, interventions, outcome measures and results. Risk of bias was determined using the Cochrane Risk of Bias 2 tool for randomised controlled trials (RCTs), the Newcastle–Ottawa Quality Assessment Scale for cohort studies and the Institute of Health Economics quality appraisal checklist for case-series studies. Data synthesis: Twenty-two studies were included in this systematic review, which included four RCTs, 12 cohort studies and six case-series studies. Seventeen studies reported on mortality rates, with 59% reporting that home monitoring programmes were associated with either a significant reduction or trend for lower mortality and 12% reporting that mortality trended higher. Fourteen studies reported on unplanned readmissions/health-care resource use, with 29% of studies reporting that this outcome was significantly decreased or trended lower with home monitoring and 21% reported an increase. Impact on treatment was reported in 15 studies, with 67% of studies finding that either treatment was undertaken significantly earlier or significantly more interventions were undertaken in the home monitoring groups. Conclusion The use of home monitoring programmes may be beneficial in reducing mortality, enabling earlier and more timely detection and treatment of CHD complication. However, currently, this evidence is limited due to weakness in study designs.

scholarly journals Struggling and Overcoming Daily Life Barriers Among Children With Congenital Heart Disease and Their Parents in the West Bank, Palestine

2018 ◽  
Vol 24 (4) ◽  
pp. 585-611 ◽  
Author(s):  
Kawther Elissa ◽  
Carina Sparud-Lundin ◽  
Åsa B. Axelsson ◽  
Salam Khatib ◽  
Ewa-Lena Bratt
Keyword(s):  
Health Care ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Health Care Providers ◽  
Congenital Heart ◽  
Daily Life ◽  
West Bank ◽  
Well Being ◽  
Negative Consequences ◽  
Care Providers

Advances in early diagnosis, treatment, and postoperative care have resulted in increased survival rates among children with congenital heart disease (CHD). Research focus has shifted from survival to long-term follow-up, well-being, daily life experiences, and psychosocial consequences. This study explored the everyday experiences of children with CHD and of their parents living in the Palestinian West Bank. Interviews with nine children aged 8 to 18 years with CHD and nine parents were analyzed using content analysis. The overall theme that emerged was facing and managing challenges, consisting of four themes: sociocultural burden and finding comfort, physical and external limitations, self-perception and concerns about not standing out, and limitations in access to health care due to the political situation. To provide optimum care for children with CHD and their parents, health care providers and policy makers must understand the negative consequences associated with sociocultural conditions and beliefs about chronic illness.

Health Care Resource Utilization in Adults With Congenital Heart Disease

2007 ◽  
Vol 99 (6) ◽  
pp. 839-843 ◽  
Author(s):  
Andrew S. Mackie ◽  
Louise Pilote ◽  
Raluca Ionescu-Ittu ◽  
Elham Rahme ◽  
Ariane J. Marelli
Keyword(s):  
Health Care ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Resource Utilization ◽  
Congenital Heart ◽  
Health Care Resource ◽  
Health Care Resource Utilization
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