Prehospital Care of Tsunami Victims in Thailand: Description and Analysis

2006 ◽  
Vol 21 (3) ◽  
pp. 204-210 ◽  
Author(s):  
Dagan Schwartz ◽  
Avishay Goldberg ◽  
Issac Ashkenasi ◽  
Guy Nakash ◽  
Rami Pelts ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthcare System ◽  
Prehospital Care ◽  
Western Coast ◽  
Medical Department ◽  
Disaster Plan ◽  
Healthcare Facilities ◽  
Tsunami Disaster ◽  
Medical Response ◽  
Healthcare Needs

AbstractIntroduction:On 26 December 2004 at 09:00 h, an earthquake of 9.0 magnitude (Richter scale) struck the area off of the western coast of northern Sumatra, Indonesia, triggering a Tsunami. As of 25 January 2005, 5,388 fatalities were confirmed, 3,120 people were reported missing, and 8,457 people were wounded in Thailand alone. Little information is available in the medical literature regarding the response and restructuring of the prehospital healthcare system in dealing with major natural disasters.Objective:The objective of the study was to analyze the prehospital medical response to the Tsunami in Thailand, and to identify possible ways of improving future preparedness and response.Methods:The Israeli Defense Forces (IDF) Home Front Command Medical Department sent a research delegation to study the response of the Thai medical system to the 2004 earthquake and Tsunami disaster. The delegation met with Thai healthcare and military personnel, who provided medical care for and evacuated the Tsunami victims. The research instruments included questionnaires (open and closed questions), interviews, and a review of debriefing session reports held in the days following the Tsunami.Results:Beginning the day after the event, primary health care in the affected provinces was expanded and extended. This included: (1) strengthening existing primary care facilities with personnel and equipment; (2) enhancing communication and transportation capabilities; (3) erecting healthcare facilities in newly constructed evacuation centers; (4) deploying mobile, medical teams to make house calls to flood refugees in affected areas; and (5) deploying ambulance crews to the affected areas to search for survivors and provide primary care triage and transportation.Conclusion:The restructuring of the prehospital healthcare system was crucial for optimal management of the healthcare needs of Tsunami victims and for the reduction of the patient loads on secondary medical facilities. The disaster plan of a national healthcare system should include special consideration for the restructuring and reinforcement prehospital system.

Disaster Healthcare System Management and Crisis Intervention Leadership in Thailand–Lessons Learned from the 2004 Tsunami Disaster

2006 ◽  
Vol 21 (5) ◽  
pp. 299-302 ◽  
Author(s):  
Rami Peltz ◽  
Issac Ashkenazi ◽  
Dagan Schwartz ◽  
Ofer Shushan ◽  
Guy Nakash ◽  
...  
Keyword(s):  
Healthcare System ◽  
Disaster Management ◽  
Lessons Learned ◽  
Home Front ◽  
Medical Department ◽  
Tsunami Disaster ◽  
Group Interviews ◽  
Medical Teams ◽  
2004 Tsunami ◽  
Flow Of Information

AbstractIntroduction:Quarantelli established criteria for evaluating the effectiveness of disaster management.Objectives:The objectives of this study were to analyze the response of the healthcare system to the Tsunami disaster according to the Quarantelli principles, and to validate these principles in a scenario of a disaster due to natural hazards.Methods:The Israeli Defense Forces (IDF) Home Front Command Medical Department sent a research team to study the response of the Thai medical system to the disaster. The analysis of the disaster management was based on Quarantelli's 10 criteria for evaluating the management of community disasters. Data were collected through personal and group interviews.Results:The three most important elements for effective disaster management were: (1) the flow of information; (2) overall coordination; and (3) leadership. Although pre-event preparedness was for different and smaller scenarios, medical teams repeatedly reported a better performance in hospitals that recently conducted drills.Conclusions:In order to increase effectiveness, disaster management response should focus on: (1) the flow of information; (2) overall coordination; and (3) leadership.

scholarly journals How Can One Strengthen a Tiered Healthcare System through Health System Reform? Lessons Learnt from Beijing, China

2020 ◽  
Vol 17 (21) ◽  
pp. 8040
Author(s):  
Shuduo Zhou ◽  
Jin Xu ◽  
Xiaochen Ma ◽  
Beibei Yuan ◽  
Xiaoyun Liu ◽  
...  
Keyword(s):  
Primary Care ◽  
Ambulatory Care ◽  
Healthcare System ◽  
Primary Healthcare ◽  
Healthcare Facilities ◽  
Healthcare Seeking ◽  
Seeking Behavior ◽  
Tertiary Hospitals ◽  
Healthcare Seeking Behavior ◽  
The Impact

How one can reshape the current healthcare sector into a tiered healthcare system with clarified division of functions between primary care facilities and hospitals, and improve the utilization of primary care, is a worldwide problem, especially for the low and middle-income countries (LMICs). This paper aimed to evaluate the impact of the Beijing Reform on healthcare-seeking behavior and tried to explain the mechanism of the change of patient flow. In this before and after study, we evaluated the changes of outpatient visits and inpatient visits among different levels of health facilities. Using the monitored and statistical data of 373 healthcare institutions 1-year before and 1-year after the Beijing Reform, interrupted time series analysis was applied to evaluate the impact of the reform on healthcare-seeking behavior. Semi-structured interviews were used to further explore the mechanisms of the changes. One year after the reform, the flow of outpatients changed from tertiary hospitals to community health centers with an 11.90% decrease of outpatients in tertiary hospitals compared to a 15.01% increase in primary healthcare facilities. The number of ambulatory care visits in primary healthcare (PHC) showed a significant upward trend (P < 0.10), and the reform had a significant impact on the average number of ambulatory care visits per institution in Beijing’s tertiary hospitals (p < 0.10). We concluded that the Beijing Reform has attracted a substantial number of ambulatory care visits from hospitals to primary healthcare facilities in the short-term. Comprehensive reform policies were necessary to align incentives among relative stakeholders, which was a critical lesson for other provinces in China and other LMICs.

scholarly journals Accessing public healthcare in Oslo, Norway: the experiences of Thai immigrant masseuses

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Naomi Tschirhart ◽  
Esperanza Diaz ◽  
Trygve Ottersen
Keyword(s):  
Cultural Values ◽  
Healthcare System ◽  
Health Workers ◽  
Healthcare Access ◽  
Access To Healthcare ◽  
Public Healthcare ◽  
Health Coverage ◽  
Thai Women ◽  
Healthcare Facilities ◽  
Healthcare Needs

Abstract Background Thai massage is a highly gendered and culturally specific occupation. Many female Thai masseuses migrate to Norway as marriage migrants and as such are entitled to the same public healthcare as Norwegian citizens. Additionally, anyone who is not fluent in Norwegian is entitled to have an interpreter provided by the public healthcare system. Norway and most other countries aspire to universal health coverage, but certain immigrant populations continue to experience difficulties accessing appropriate healthcare. This study examined healthcare access among Thai migrant masseuses in Oslo. Methods Guided by access to healthcare theory, we conducted a qualitative exploratory study in 2018 with Thai women working as masseuses in Oslo, Norway. Through semi-structured in-depth interviews with 14 Thai women, we explored access to healthcare, health system navigation and care experiences. We analyzed the data using thematic analysis and grouped the information into themes relevant to healthcare access. Results Participants did not perceive that their occupation limited their access to healthcare. Most of the barriers participants experienced when accessing care were related to persistent language challenges. Women who presented at healthcare facilities with their Norwegian spouse were rarely offered interpreters, despite their husband’s limited capacity to translate effectively. Cultural values inhibit women from demanding the interpretation services to which they are entitled. In seeking healthcare, women sought information about health services from their Thai network and relied on family members, friends and contacts to act as informal interpreters. Some addressed their healthcare needs through self-treatment using imported medication or sought healthcare abroad. Conclusions Despite having the same entitlements to public healthcare as Norwegian citizens, Thai migrants experience difficulties accessing healthcare due to pervasive language barriers. A significant gap exists between the official policy that professional interpreters should be provided and the reality experienced by study participants. To improve communication and equitable access to healthcare for Thai immigrant women in Norway, health personnel should offer professional interpreters and not rely on Norwegian spouses to translate. Use of community health workers and outreach through Thai networks, may also improve Thai immigrants’ knowledge and ability to navigate the Norwegian healthcare system.

Response of Thai Hospitals to the Tsunami Disaster

2006 ◽  
Vol 21 (S1) ◽  
pp. S32-S37 ◽  
Author(s):  
Adi Leiba ◽  
Issac Ashkenasi ◽  
Guy Nakash ◽  
Rami Pelts ◽  
Dagan Schwartz ◽  
...  
Keyword(s):  
Disaster Management ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Home Front ◽  
Medical Systems ◽  
Medical Department ◽  
Tsunami Disaster ◽  
Medical Response ◽  
Secondary Transfer ◽  
Hospital Preparedness

AbstractThe disaster caused by the Tsunami of 26 December 2004 was one of the worst that medical systems have faced. The aim of this study was to learn about the medical response of the Thai hospitals to this disaster and to establish guidelines that will help hospitals prepare for future disasters.The Israeli Defense Forces (IDF) Home Front Command (HFC) Medical Department sent a research delegation to Thai hospitals to study: (1) pre-event hospital preparedness; (2) patient evacuation and triage; (3) personnel and equipment reinforcement; (4) modes used for alarm and recruitment of hospital personnel; (5) internal reorganization of hospitals; and (6) admission, discharge, and secondary transfer (forward management) of patients.Thai hospitals were prepared for and drilled for a general mass casualty incident (MCI) involving up to 50 casualties. However, a control system to measure the success of these drills was not identified, and Thai hospitals were not prepared to deal with the unique aspects of a tsunami or to receive thousands of victims.Modes of operation differed between provinces. In Phang Nga and Krabi, many patients were treated in the field. In Phuket, most patients were evacuated early to secondary (district) and tertiary (provincial) hospitals. Hospitals recalled staff rapidly and organized the emergency department for patient triage, treatment, and transfer if needed.Although preparedness was deficient, hospital systems performed well. Disaster management should focus on field-based first aid and triage, and rapid evacuation to secondary hospitals. Additionally, disaster management should reinforce and rely on the existing and well-trusted medical system.

Navigating being a young adult with cerebral palsy: a qualitative study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Gitte Normann ◽  
Kirsten Arntz Boisen ◽  
Peter Uldall ◽  
Anne Brødsgaard
Keyword(s):  
Young Adults ◽  
Cerebral Palsy ◽  
Young Adult ◽  
Qualitative Study ◽  
Healthcare System ◽  
Young Adulthood ◽  
Educational Background ◽  
Pediatric Care ◽  
Healthcare Needs ◽  
New Challenges

AbstractObjectivesYoung adults with cerebral palsy (CP) face potential challenges. The transition to young adulthood is characterized by significant changes in roles and responsibilities. Furthermore, young adults with chronic conditions face a transfer from pediatric care to adult healthcare. This study explores how living with CP affects young adults in general, and specifically which psychosocial, medical and healthcare needs are particularly important during this phase of life.MethodsA qualitative study with data from individual, semi-structured, in-depth interviews with six young adults with CP (ages 21–31 years) were transcribed verbatim and analyzed. The participants were selected to provide a maximum variation in age, gender, Gross Motor Function Classification System score and educational background. A descriptive thematic analysis was used to explore patterns and identify themes.ResultsThree themes were identified: “Being a Young Adult”, “Development in Physical Disability and New Challenges in Adulthood” and “Navigating the Healthcare System”. The three themes emerged from 15 sub-themes. Our findings emphasized that young adults with CP faced psychosocial challenges in social relationships, participation in education and work settings and striving towards independence. The transition to young adulthood led to a series of new challenges that the young adults were not prepared for. Medical challenges included managing CP-related physical and cognitive symptoms and navigating adult health care services, where new physicians with insufficient knowledge regarding CP were encountered.ConclusionThe young adults with CP were not prepared for the challenges and changes they faced during their transition into adulthood. They felt that they had been abandoned by the healthcare system and lacked a medical home. Better transitional care is urgently needed to prepare them for the challenges in young adulthood.

scholarly journals Analysis of Annual Costs of Mobile Clinics in the Southern United States

2020 ◽  
Vol 11 ◽  
pp. 215013272098062
Author(s):  
Sharon Attipoe-Dorcoo ◽  
Rigoberto Delgado ◽  
Dejian Lai ◽  
Aditi Gupta ◽  
Stephen Linder
Keyword(s):  
Primary Care ◽  
Healthcare Services ◽  
Medicare Beneficiaries ◽  
Mobile Clinic ◽  
Efficient Manner ◽  
Healthcare Facilities ◽  
Capital Costs ◽  
At Risk Populations ◽  
Mobile Clinics ◽  
The Cost

Introduction Mobile clinics provide an efficient manner for delivering healthcare services to at-risk populations, and there is a need to understand their economics. This study analyzes the costs of operating selected mobile clinic programs representing service categories in dental, dental/preventive, preventive care, primary care/preventive, and mammography/primary care/preventive. Methods The methodology included a self-reported survey of 96 mobile clinic programs operating in Texas, North Carolina, Georgia, and Florida; these states did not expand Medicaid and have a large proportion of uninsured individuals. Data were collected over an 8-month period from November 2016 to July 2017. The cost analyses were conducted in 2018, and were analyzed from the provider perspective. The average annual estimated costs; as well the costs per patient in each mobile clinic program within different service delivery types were assessed. Costs reported in the study survey were classified into recurrent direct costs and capital costs. Results Results indicate that mean operating costs range from about $300 000 to $2.5 million with costs increasing from mammography/primary care/preventive delivery to dental/preventive. The majority of mobile clinics provided dental care followed by dental/preventive. The cost per patient visit for all mobile clinic service types ranged from $65 to $529, and appears to be considerably less than those reported in the literature for fixed clinic services. Conclusion The overall costs of all delivery types in mobile clinics were lower than the costs of providing care to Medicare beneficiaries in federally funded health centers, making mobile clinics a sound economic complement to stationary healthcare facilities.

STATUS AND CHALLENGES OF COVID-19 WASTE MANAGEMENT IN THANE CITY, INDIA

2021 ◽  
pp. 36-41
Author(s):  
Lata Ghanshamnani ◽  
Ambily Adithyan ◽  
Shyamala K. Mani ◽  
Manisha Pradhan
Keyword(s):  
Waste Management ◽  
Management System ◽  
Waste Treatment ◽  
Treatment Facility ◽  
Healthcare Facilities ◽  
Biomedical Waste ◽  
Waste Management System ◽  
Healthcare Needs ◽  
The World ◽  
The City

Due to enhanced healthcare needs brought upon by the COVID-19 pandemic, the amount of biomedical waste generated has also increased manifold across the globe. With the world in global crisis due to the recent outbreak of the COVID-19 pandemic, it has put great pressure on the biomedical waste management system in India and around the world. To control the spread of the COVID-19 virus, proper disposal of the waste is essential to reduce any risk of secondary transmission. This paper investigates the situation of biomedical waste management in the city of Thane in Maharashtra due to the onset of COVID-19 and suggests some key recommendations to the policymakers to help handle biomedical waste from possible future pandemics. The study found that there was an 81% increase in the total biomedical waste (BMW) generation in 2020, when compared to 2019 and the yellow category waste from COVID-19 centres was the highest contributor to this waste. It was also found that though there was a slight increase in yellow category waste, the total biomedical waste from non- COVID healthcare facilities (HCFs) was comparable to that of the waste generated in HCFs during 2019, revealing that there was conscious reduction in the usage of single use PPEs at non- COVID HCFs. The city, despite owning a Central Biomedical Waste Treatment Facility (CBWTF), was dependent on another incinerator at the Hazardous Waste Management Treatment facility (HWTF) for treatment of the additional waste generated. Unforeseen situation like these, expose the vulnerability of our existing biomedical waste management system and reinforces the need for investing and improving them for strengthening preparedness in the future. The situation also demands periodic education on importance of source segregation and waste reduction through rational use, disinfection and disposal of PPEs.

Health Literacy in Primary Care: Reflections and Suggestions for Physicians, Researchers, and Administrators

2021 ◽  
pp. 155982762110412
Author(s):  
Anne Sprogell ◽  
Allison R. Casola ◽  
Amy Cunningham
Keyword(s):  
Primary Care ◽  
Health Literacy ◽  
Primary Care Physician ◽  
Healthcare System ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Health Records ◽  
The Past ◽  
Personal Bias ◽  
Concept Of Health

As the healthcare system evolves, it is becoming more complicated for physicians and patients. Patients might have had one doctor in the past, but now are likely to regularly see several specialists along with their primary care physician. Patients can access their health records online, which increases transparency and accountability, but adds more information they have to interpret. This is the concept of health literacy—the ability to obtain, process, and act upon information regarding one’s health. This article will characterize health literacy in primary care and provide three areas that primary care physicians and researchers can direct their focus in order to increase health literacy among patients: community engagement, trainee education, and examination of personal bias.

scholarly journals Addressing the quality and scope of paediatric primary care in South Africa: Evaluating contextual impacts of the introduction of the Practical Approach to Care Kit for children (PACK Child)

2020 ◽  
Author(s):  
Jamie Murdoch ◽  
Robyn Curran ◽  
Ruth Cornick ◽  
Sandy Picken ◽  
Max Bachmann ◽  
...  
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Primary Healthcare ◽  
Routine Care ◽  
Health Systems Strengthening ◽  
Psychosocial Issues ◽  
Healthcare Facilities ◽  
Contextual Features ◽  
Child Intervention

Abstract Background: Despite significant reductions in mortality, preventable and treatable conditions remain leading causes of death and illness in children in South Africa. The PACK Child intervention, comprising clinical decision support tool (guide), training strategy and health systems strengthening components, was developed to expand on WHO’s Integrated Management of Childhood Illness programme, extending care of children under 5 years to those aged 0-13 years, those with chronic conditions needing regular follow-up, integration of curative and preventive measures and routine care of the well child. In 2017-2018, PACK Child was piloted in 10 primary healthcare facilities in the Western Cape Province. Here we report findings from an investigation into the contextual features of South African primary care that shaped how clinicians delivered the PACK Child intervention within clinical consultations.Methods: Process evaluation using linguistic ethnographic methodology which provides analytical tools for investigating human behaviour, and the shifting meaning of talk and text within context. Methods included semi-structured interviews, focus groups, ethnographic observation, audio-recorded consultations and documentary analysis. Analysis focused on how mapped contextual features structured clinician-caregiver interactions. Results: Primary healthcare facilities demonstrated an institutionalised orientation to minimising risk upheld by provincial documentation, providing curative episodic care to children presenting with acute symptoms, and preventive care including immunisations, feeding and growth monitoring, all in children 5 years or younger. Children with chronic illnesses such as asthma rarely receive routine care. These contextual features constrained the ability of clinicians to use the PACK Child guide to facilitate diagnosis of long-term conditions, elicit and manage psychosocial issues, and navigate use of the guide alongside provincial documentation. Conclusion: Our findings provide evidence that PACK Child is catalysing a transition to an approach that strikes a balance between assessing and minimising risk on the day of acute presentation and a larger remit of care for children over time. However, optimising success of the intervention requires reviewing priorities for paediatric care which will facilitate enhanced skills, knowledge and deployment of clinical staff to better address acute illnesses and long-term health conditions of children of all ages, as well as complex psychosocial issues surrounding the child.

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