scholarly journals Assessing the Capacity of the US Health Care System to Use Additional Mechanical Ventilators During a Large-Scale Public Health Emergency

2015 ◽  
Vol 9 (6) ◽  
pp. 634-641 ◽  
Author(s):  
Adebola Ajao ◽  
Scott V. Nystrom ◽  
Lisa M. Koonin ◽  
Anita Patel ◽  
David R. Howell ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care System ◽  
Large Scale ◽  
Health Care Systems ◽  
Influenza Pandemic ◽  
Public Health Emergency ◽  
Mechanical Ventilators ◽  
Study Results ◽  
Care System

AbstractObjectiveA large-scale public health emergency, such as a severe influenza pandemic, can generate large numbers of critically ill patients in a short time. We modeled the number of mechanical ventilators that could be used in addition to the number of hospital-based ventilators currently in use.MethodsWe identified key components of the health care system needed to deliver ventilation therapy, quantified the maximum number of additional ventilators that each key component could support at various capacity levels (ie, conventional, contingency, and crisis), and determined the constraining key component at each capacity level.ResultsOur study results showed that US hospitals could absorb between 26,200 and 56,300 additional ventilators at the peak of a national influenza pandemic outbreak with robust pre-pandemic planning.ConclusionsThe current US health care system may have limited capacity to use additional mechanical ventilators during a large-scale public health emergency. Emergency planners need to understand their health care systems’ capability to absorb additional resources and expand care. This methodology could be adapted by emergency planners to determine stockpiling goals for critical resources or to identify alternatives to manage overwhelming critical care need. (Disaster Med Public Health Preparedness. 2015;9:634–641)

scholarly journals Covid-19 Fault Lines: Palestinian Physicians in Israel

2020 ◽  
Vol 49 (4) ◽  
pp. 36-46
Author(s):  
Osama Tanous
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care System ◽  
Public Health Emergency ◽  
The Public ◽  
Fault Lines ◽  
Care System

This essay explores representations of Palestinian physicians in the Israeli health-care system during the Covid-19 pandemic and the dynamics that have played out in that system during the public health emergency from the perspective of a Palestinian physician. It argues that the health-care system, an essential pillar and infrastructural foundation of the settler-colonial project, is naively imagined as an apolitical, neutral sphere. As the site of a metaphorical battlefield against Covid-19, it has been window-dressed as an arena for brotherhood between Israeli Palestinians and Jews, and fantasized about as a gateway to political gain or equality for the Palestinian citizens of Israel (PCIs). Throughout the process, settler militarism, settler symbols, and settler domination have continued to be normalized.

scholarly journals Quantification of the resilience of primary care networks by stress testing the health care system

2019 ◽  
Vol 116 (48) ◽  
pp. 23930-23935 ◽  
Author(s):  
Donald Ruggiero Lo Sardo ◽  
Stefan Thurner ◽  
Johannes Sorger ◽  
Georg Duftschmid ◽  
Gottfried Endel ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care System ◽  
Large Scale ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Care Providers ◽  
Physician Density ◽  
Care Systems ◽  
Care System

There are practically no quantitative tools for understanding how much stress a health care system can absorb before it loses its ability to provide care. We propose to measure the resilience of health care systems with respect to changes in the density of primary care providers. We develop a computational model on a 1-to-1 scale for a countrywide primary care sector based on patient-sharing networks. Nodes represent all primary care providers in a country; links indicate patient flows between them. The removal of providers could cause a cascade of patient displacements, as patients have to find alternative providers. The model is calibrated with nationwide data from Austria that includes almost all primary care contacts over 2 y. We assign 2 properties to every provider: the “CareRank” measures the average number of displacements caused by a provider’s removal (systemic risk) as well as the fraction of patients a provider can absorb when others default (systemic benefit). Below a critical number of providers, large-scale cascades of patient displacements occur, and no more providers can be found in a given region. We quantify regional resilience as the maximum fraction of providers that can be removed before cascading events prevent coverage for all patients within a district. We find considerable regional heterogeneity in the critical transition point from resilient to nonresilient behavior. We demonstrate that health care resilience cannot be quantified by physician density alone but must take into account how networked systems respond and restructure in response to shocks. The approach can identify systemically relevant providers.

Does voluntary health insurance reduce the use of and the willingness to finance public health care in Sweden?

2021 ◽  
pp. 1-18
Author(s):  
Linn Kullberg ◽  
Paula Blomqvist ◽  
Ulrika Winblad
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Health Care Systems ◽  
Public Health Care ◽  
The Public ◽  
Voluntary Health Insurance ◽  
Care Systems ◽  
Care System

Abstract Voluntary private health insurance (VHI) has generally been of limited importance in national health service-type health care systems, especially in the Nordic countries. During the last decades however, an increase in VHI uptake has taken place in the region. Critics of this development argue that voluntary health insurance can undermine support for public health care, while proponents contend that increased private funding for health services could relieve strained public health care systems. Using data from Sweden, this study investigates empirically how voluntary health insurance affects the public health care system. The results of the study indicate that the public Swedish health care system is fairly resilient to the impact of voluntary health insurance with regards to support for the tax-based funding. No difference between insurance holders and non-holders was found in willingness to finance public health care through taxes. A slight unburdening effect on public health care use was observed as VHI holders appeared to use public health care to a lesser extent than those without an insurance. However, a majority of the insurance holders continued to use the public health care system, indicating only a modest substitution effect.

scholarly journals Public administration models and healthcare system regulation in foreign countries

2021 ◽  
pp. 11-16
Author(s):  
N. Hrazhevska ◽  
А. Tyngisheva
Keyword(s):  
Public Health ◽  
Health Care ◽  
Public Administration ◽  
Health Care System ◽  
Health Care Systems ◽  
Public Health Care ◽  
Individual Responsibility ◽  
Care Systems ◽  
Low Efficiency ◽  
Care System

The article examines main models of public administration and regulation of health care systems, assessed with an account for their organizational and financial characteristics: predominantly state, predominantly social and insurance, predominantly private models. The predominantly state model characterized by a significant role of the state is observed in the UK, Greece, Denmark, Norway, Portugal, Sweden, etc., the predominantly social and insurance model is found in Austria, Belgium, Netherlands, Germany, France, Switzerland, and Japan with the predominantly private model followed in the USA, South Korea, and other counties. The international ranking on the effectiveness of health systems is attained in terms of their response to challenges of the global COVID-19 pandemic. Based on the analysis, the critical issues for the health care systems were highlighted: insufficient funding of the public health care system, irrational distribution of health care costs, as well as the fact that health care systems were not designed for an emergency situations. The irrational distribution of public funds is a consequence of the low efficiency of health care management at all levels, which leads to concomitant problems in health care, such as staffing and material support. Based on the study of the main foreign models of public administration and regulation of the health care system, it was shown that for the Kazakh and Ukrainian models of the health-care system public administration, it is feasible to follow Germany and Singapore with their developed health insurance system based on a combination of the principles of individual responsibility and universal affordable medical care, as well as the well-coordinated systemic work of public health authorities in a state of emergency. Thus, further improving the efficiency of health care system management is one of the main tasks for social policy in Kazakhstan and Ukraine. Dealing with this task largely depends on the correct choice of the appropriate model of the health-care system public administration.

scholarly journals Reexamining Health Care Coalitions in Light of COVID-19

2020 ◽  
pp. 1-18
Author(s):  
Daniel J. Barnett ◽  
Lauren Knieser ◽  
Nicole A. Errett ◽  
Andrew J. Rosenblum ◽  
Meena Seshamani ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care System ◽  
Emergency Response ◽  
Emergency Preparedness ◽  
Swot Analysis ◽  
Geographical Area ◽  
Public Health Emergency ◽  
Hospital Preparedness ◽  
Care System

Abstract The national response to the COVID-19 pandemic has highlighted critical weaknesses in domestic health care and public health emergency preparedness despite nearly two decades of federal funding for multiple programs designed to encourage cross-cutting collaboration in emergency response. Health care coalitions (HCCs), which are funded through the Hospital Preparedness Program, were first piloted in 2007 and have been continuously funded nationwide since 2012 to support broad collaborations across public health, emergency management, emergency medical services, and the emergency response arms of the health care system within a geographical area. This commentary provides a SWOT analysis to summarize the strengths, weaknesses, opportunities, and threats related to the current HCC model against the backdrop of COVID-19. We close with concrete recommendations for better leveraging the HCC model for improved health care system readiness. These include better evaluating the role of HCCs and their members (including the responsibility of the HCC to better communicate and align with other sectors), reconsidering the existing framework for HCC administration, increasing incentives for meaningful community participation in HCC preparedness, and supporting next-generation development of health care preparedness systems for future pandemics.

scholarly journals Unmasking a health care system: the Dutch policy response to the Covid-19 crisis

2021 ◽  
pp. 1-10 ◽  
Author(s):  
Iris Wallenburg ◽  
Jan-Kees Helderman ◽  
Patrick Jeurissen ◽  
Roland Bal
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care System ◽  
Health Care Systems ◽  
Economic Policies ◽  
Hard Time ◽  
Dutch Health ◽  
Care Systems ◽  
Policy Systems ◽  
Care System

Abstract The Covid-19 pandemic has put policy systems to the test. In this paper, we unmask the institutionalized resilience of the Dutch health care system to pandemic crisis. Building on logics of crisis decision-making and on the notion of ‘tact’, we reveal how the Dutch government initially succeeded in orchestrating collective action through aligning public health purposes and installing socio-economic policies to soften societal impact. However, when the crisis evolved into a more enduring one, a more contested policy arena emerged in which decision-makers had a hard time composing and defending a united decision-making strategy. Measures have become increasingly debated on all policy levels as well as among experts, and conflicts are widely covered in the Dutch media. With the 2021 elections ahead, this means an additional test of the resilience of the Dutch socio-political and health care systems.

scholarly journals An Economic Evaluation of Disallowing Body Checking in 11- to 12-Year-Old Ice Hockey Leagues

2021 ◽  
pp. 194173812110215
Author(s):  
Gillian R. Currie ◽  
Raymond Lee ◽  
Amanda M. Black ◽  
Luz Palacios-Derflingher ◽  
Brent E. Hagel ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care System ◽  
Policy Change ◽  
National Policy ◽  
Ice Hockey ◽  
Public Health Care ◽  
Public Health Care System ◽  
Body Checking ◽  
Care System

Background: After a national policy change in 2013 disallowing body checking in Pee Wee ice hockey games, the rate of injury was reduced by 50% in Alberta. However, the effect on associated health care costs has not been examined previously. Hypothesis: A national policy removing body checking in Pee Wee (ages 11-12 years) ice hockey games will reduce injury rates, as well as costs. Study Design: Cost-effectiveness analysis alongside cohort study. Level of Evidence: Level 3. Methods: A cost-effectiveness analysis was conducted alongside a cohort study comparing rates of game injuries in Pee Wee hockey games in Alberta in a season when body checking was allowed (2011-2012) with a season when it was disallowed after a national policy change (2013-2014). The effectiveness measure was the rate of game injuries per 1000 player-hours. Costs were estimated based on associated health care use from both the publicly funded health care system and privately paid health care cost perspectives. Probabilistic sensitivity analysis was conducted using bootstrapping. Results: Disallowing body checking significantly reduced the rate of game injuries (−2.21; 95% CI [−3.12, −1.31] injuries per 1000 player-hours). We found no statistically significant difference in public health care system (−$83; 95% CI [−$386, $220]) or private health care costs (−$70; 95% CI [−$198, $57]) per 1000 player-hours. The probability that the policy of disallowing body checking was dominant (with both fewer injuries and lower costs) from the perspective of the public health care system and privately paid health care was 78% and 92%, respectively. Conclusion: Given the significant reduction in injuries, combined with lower public health care system and private costs in the large majority of iterations in the probabilistic sensitivity analysis, our findings support the policy change disallowing body checking in ice hockey in 11- and 12-year-old ice hockey leagues.

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