scholarly journals They have Arrived! How Dallas, Texas Provided Shelter-Based Onsite Medical Care to Evacuees from Hurricane Harvey

2019 ◽  
Vol 34 (s1) ◽  
pp. s44-s45
Author(s):  
Lindsay A. Flax ◽  
E. Liang Liu ◽  
Kelly R. Klein ◽  
Raymond L. Fowler ◽  
Raymond E. Swienton
Keyword(s):  
Medical Care ◽  
Care Delivery ◽  
Large Population ◽  
Standard Of Care ◽  
Medical Community ◽  
Medical Decision ◽  
Medical Services ◽  
Additional Patient ◽  
Adult Care ◽  
Epidemiologic Surveillance

Introduction:After Hurricane Harvey and the flooding that ensued, 3,829 displaced persons were transported from their homes and sheltered in the Dallas Convention Center. This large general population sheltering operation was medically supported by the onsite Mega-Shelter Medical Clinic (MMC). In an altered standard of care environment, a number of multi-disciplinary medical services were provided including emergent management, acute pediatric and adult care, psychiatric/behavioral services, onsite pharmaceutical, and durable medical equipment distribution, epidemiologic surveillance, and select laboratory services.Aim:To describe how onsite medical care in the adapted environment of a large population shelter can provide comparable services and limit the direct impact on the local medical community.Methods:A retrospective chart review of medical records was generated for all clinical encounters at the MMC. Data were sorted by daily census, disease surveillance, medical decision making, treatment, and transport destinations.Results:40.7% of registered evacuees utilized the MMC accounting for a total of 2,654 clinic visits by 1,560 unique patients representing all age groups. During the sustained MMC operations, 8% of patients required emergency transport and 500 additional patient transports were arranged for clinic appointments. No deaths occurred and no iatrogenic morbidity was reported.Discussion:Medical care was provided for a large number of evacuees which mitigated the potential impact on the local medical infrastructure. The provision of medical services in a large population shelter may necessitate adaptation to the standard of care. However, despite the nontraditional clinical setting, care delivery was not compromised.

From Health Services to Medical Markets: The Commodity Transformation of Medical Production and the Nonprofit Sector

1996 ◽  
Vol 26 (2) ◽  
pp. 221-238 ◽  
Author(s):  
Allen W. Imershein ◽  
Carroll L. Estes
Keyword(s):  
Health Services ◽  
Medical Care ◽  
Nonprofit Organizations ◽  
Hospital Care ◽  
Care Delivery ◽  
Nonprofit Sector ◽  
Medical Services ◽  
Product Lines ◽  
The Status ◽  
Medical Markets

In recent years the language and logic of medical care have moved from providing medical services to marketing product lines. Analysis in this article examines this task transformation and its implications for transformation of the nonprofit sector and of the state. The authors argue that these transformations are essential explanatory elements to account for the origins of medical services in the nonprofit sector, the early exclusion of capitalist organizations from hospital care, and the changes that fostered corporate entry. To wit, medical care tasks have undergone a two-stage transformation. The first transformation changed open-ended, ill-defined services with uncertain funding into more highly organized and codified services with stable funding, attracting both capitalist enterprises and capitalist logic into the nonprofit sector. The second transformation standardized medical care tasks into product lines, a process that also challenged the status of the nonprofit organizations performing these tasks. In an analysis of the second transformation, the authors argue that this challenge is in the process of turning back upon itself, undermining the conditions that fostered capitalist entry into medical care delivery in the first place.

Medical Care for Children with Cancer in the Donetsk People’s Republic: Results of an Ecological Study in 2014–2017

2018 ◽  
Vol 5 (3) ◽  
pp. 145-154
Author(s):  
M. Yu. Rykov ◽  
I. N. Inozemtsev ◽  
S. A. Kolomenskaya
Keyword(s):  
Medical Care ◽  
Pediatric Patient ◽  
Ecological Study ◽  
Medical Service ◽  
Care Delivery ◽  
Benign Tumors ◽  
High Tech ◽  
Malignant Neoplasms ◽  
Children With Cancer ◽  
Patient Capacity

Background.Analysis of medical care delivery for children with cancer in armed conflict is highly important because the high-tech treatment in this context is extraordinary difficult and challenging task. Objective. Our aim was to analyze the morbidity and mortality rates in children with malignant tumors, to assess the pediatric patient capacity and medical service density in the Donetsk People’s Republic.Methods.The ecological study was conducted where the units of analysis were represented by the aggregated data of the Republican Cancer Registry on the number of primary and secondary patients with malignant and benign tumors, the deceased patients in the DNR in 2014–2017, pediatric patient capacity, and medical service density.Results.The number of pediatric patient capacity for children with cancer was 10 (0.27 per 10,000 children aged 0–17), pediatric patient capacity for children with hematological disorders — 40 (1.37 per 10,000 children aged 0–17). The treatment of children with cancer was performed by 5 healthcare providers: 1 pediatric oncologist (0.02 per 10,000 children aged 0–17), 3 hematologists (0.08 per 10,000 pediatric population aged 0–17), and 1 practitioner who did not have a specialist certificate in oncology. Morbidity rate for malignant neoplasms from 2014 to 2017 decreased by 25% (in 2014 — 9.6 per 10,000 children aged 0–17; in 2017 — 7.2). In the morbidity structure, the incidence proportion of hemoblastoses was 68.4%, brain tumors — 2.6%, other solid tumors — 29%. The death rate due to malignant neoplasms decreased by 37% (in 2014 — 2.7; in 2017 — 1.7).Conclusion.Low levels of the incidence rate and pattern of morbidity indicate defects in the identification and recording of patients. This explains the performance of the bed: low average bed occupancy per year and low turnover. For a reliable analysis of mortality statistical data is not available: in 2014–2015 only the number of in-hospital deceased patients is presented. Limited data is due to the lack of reliable patient catamnesis which is explained by the high rate of population migration. 

Analysis of Current Practices of Organizing the Export of Medical Services in the United Kingdom, Italy, South Korea and China

2020 ◽  
pp. 30-42
Author(s):  
Arkady Nikolaevich Daykhes ◽  
Vladimir Anatolievich Reshetnikov ◽  
Olga Aleksandrovna Manerova ◽  
Ilya Aleksandrovich Mikhailov
Keyword(s):  
United Kingdom ◽  
South Korea ◽  
Medical Care ◽  
Medical Tourism ◽  
Value Added ◽  
External Factors ◽  
Medical Services ◽  
High Tech ◽  
Medical Organization ◽  
The United Kingdom

Aim of the study. Analysis of medical tourism’s organizational features based on the example of the large medical organizations in the United Kingdom, South Korea, Italy and China. Materials and methods. The data were collected by the authors by interviewing the heads of medical organizations and their deputies in the United Kingdom, South Korea, Italy and China (3–4 respondents per medical organization) using the developed questionnaire to identify the main mechanisms and tools for organizing the export of medical services. SWOT-analysis (Strengths; Weaknesses; Opportunities; Threats) was performed in order to comprehensively evaluate the received information. Results. Along with weaknesses and threats that slow down the development of medical services exports, strengths (internal factors) and opportunities ( external factors) that contribute to the development of medical tourism were also identified: the widespread popularity of the brand of medical organizations abroad which is associated with the provision of premium medical services; versatility and ability to conduct high-tech surgical operations; the presence of a separate premium class building and an international department for working with foreign patients and promoting a medical organization in the world market; well-established business relationships with assistance companies; foreign medical personnel who speak foreign languages and possess necessary skills to treat foreign patients; developed electronic medical care system; developed system of quality control of medical care; the presence of branches in other countries; the presence of a medical visa in the system of legislation; established cooperation with many countries at the embassy level; state licensing and accreditation for the provision of medical services to foreign citzens; the availability of a state website on the provision of medical assistance to foreign citizens; the possibility of the age of value added tax. Conclusion. We identified main patterns in the organization of export of medical services that can be applied to develop this direction in medical organizations of the Russian Federation during the analysis the strengths and weaknesses of four large medical organizations abroad, as well as external factors that affect the work of these medical organizations.

scholarly journals Transitioning Ambulatory Medicine from Pediatrics to Adult Care for Patients with Epilepsy and Intellectual Disability

2020 ◽  
Vol 09 (04) ◽  
pp. 172-176
Author(s):  
Derryl Miller ◽  
Marcia Felker ◽  
Mary Ciccarelli
Keyword(s):  
Young Adults ◽  
Intellectual Disability ◽  
Service Providers ◽  
Healthcare Services ◽  
Medical Decision ◽  
Small Subset ◽  
Adult Care ◽  
Consensus Statements ◽  
Youth And Young Adults ◽  
Ambulatory Medicine

AbstractConsensus statements and clinical reports exist to guide the transition of youth from pediatric to adult healthcare services. Across the range of youth with no chronic health conditions to those with the most complex disabilities, the standards of practice continue to vary broadly across the country and internationally. Youth and young adults with combined conditions of epilepsy with intellectual disability are a small subset of the total population of young adults who share common needs. These include a system of supports that supplement each person's limitations in autonomy and self-management. Caregivers play significant roles in their lives, whether they are family members or paid direct service providers. Medical decision making and treatment adherence require specific adaptations for patients whose independence due to disability is unlikely. Key issues related to tuberous sclerosis complex, neurofibromatosis, and Rett and Sturge–Weber syndromes will be highlighted.

Genetic Predispositions, Prophylactic Treatments and Private Health Insurance: Nothing is Better Than a Good Pair of Genes

1997 ◽  
Vol 23 (1) ◽  
pp. 45-68 ◽  
Author(s):  
Alexandra K. Glazier
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Genetic Predisposition ◽  
Genetic Linkage ◽  
Dna Analysis ◽  
Care Delivery ◽  
Medical Community ◽  
Care Providers ◽  
Linkage Studies ◽  
Prophylactic Measures

Discovering the genetic basis of a particular disease is not only of great interest to the medical community; private health insurers are also anxiously awaiting the results of genetic linkage studies. Apart from the scientific value of DNA studies, the results of genetic linkage research are relevant to health care delivery in two principal ways. First, identifying the genetic origin of a disease may allow doctors to detect the disease earlier. If doctors know that an individual is genetically predisposed to a particular disease, then health care providers can increase screening efforts and watch for early symptoms. Second, if an individual has a genetic predisposition to a particular disease, health care providers may employ preventive or “prophylactic" measures to reduce or eliminate the risk of developing the disease or condition to which the individual is genetically predisposed. Genetic linkage studies will soon allow more individuals to learn of their own genetic predispositions to certain diseases. Currently genetic predisposition tests (both pedigrees of family history and DNA analysis) can indicate that an individual is at high risk for developing a disease.

scholarly journals An Analysis of International Military Health Systems Using the Military Medical Corps Worldwide Almanac

2020 ◽  
Author(s):  
Ryan M Leone ◽  
Zenobia Homan ◽  
Antonin Lelong ◽  
Lutz Bandekow ◽  
Martin Bricknell
Keyword(s):  
Health Systems ◽  
Organizational Structures ◽  
Healthcare Systems ◽  
Medical Community ◽  
Medical Services ◽  
Medical Systems ◽  
Military Health ◽  
Military Healthcare ◽  
The Military

Abstract Introduction A number of organizations publish comparisons of civilian health systems between countries. However, the authors were unable to find a global, systematic, and contemporary analysis of military healthcare systems. Although many databases exist for comparing national healthcare systems, the only such compilation of information for military medical systems is the Military Medical Almanac. A thorough review of the Almanac was conducted to understand the quality of information provided in each country’s profile and to develop a framework for comparing between countries. This information is valuable because it can facilitate collaboration and lesson sharing between nations while providing a structured source of information about a nation’s military medical capabilities for internal use. Materials and Methods Each of the 142 profiles (submitted by 132 countries) published in the Almanac were reviewed. The information provided was extracted and aggregated into a spreadsheet that covered the broader categories of country background, force demographics, beneficiary populations, administration and oversight, physical structures and capabilities, research capabilities, and culture and artifacts. An initial sample of 20 countries was evaluated to test these categories and their subsections before the rest of the submissions were reviewed. Clear definitions were revised and established for each of the 69 subcategories. Qualitative and quantitative data were compiled in the spreadsheet to enable comparisons between entries. Results Significant variation was found in how information was presented in country profiles and to what extent this was comparable between submissions. The most consistently provided information was in the country background, where the categories ranged from 90.15% to 100% completion across submissions. There was inconsistency in reporting of the numbers and types of healthcare workers employed within military medical services. Nearly 25% of nations reported providing medical care to family members of service members, but retirees, veterans, reservists, and law enforcement personnel were also mentioned. Some countries described organizational structures, military medical education institutions, and humanitarian operations. A few reported military medical research capabilities, though each research domain was present in 25% or less of all submissions. Interestingly, cultural identities such as emblems were present in nearly 90% of profiles, with many countries also having badges, symbols, and mottos. Conclusions The Military Medical Almanac is potentially a highly valuable collection of publicly available baseline information on military medical services across the world. However, the quality of this collection is highly dependent on the submission provided by each country. It is recommended that the template for collecting information on each health system be refined, alongside an effort to increase awareness of the value of the Almanac as an opportunity to raise the international profile of each country’s military medical system. This will ensure that the Almanac can better serve the international military medical community.

THE ROAD AHEAD TO BETTER MEDICAL CARE FOR CHILDREN

PEDIATRICS ◽  
1950 ◽  
Vol 6 (3) ◽  
pp. 553-556
Keyword(s):  
Child Health ◽  
Medical Care ◽  
Medical Center ◽  
Point Of View ◽  
Medical Services ◽  
High Quality ◽  
The Road ◽  
Provide Child Care ◽  
Ultimate Objective ◽  
The Many

THE road to better child health has been discussed in relation to the doctor and his training, health services and their distribution. We have dealt with the unavoidable question of costs. Particular attention has been given to some of the advantages and dangers of decentralization of pediatric education and services. Each of the various subjects has been discussed from the point of view of its bearing on the ultimate objective of better health for all children and the steps necessary to attain this goal. Now, we may stand back from the many details of the picture, view the whole objectively and note its most outstanding features. First is the fact that the improvement of child health depends primarily upon better training for all doctors who provide child care, general practitioners as well as specialists. This is the foundation without which the rest of the structure cannot stand. The second dominant fact is the need for extending to outlying and isolated areas the high quality medical care of the medical centers, without at the same time diluting the service or training at the center. The road to better medical care, therefore, begins at the medical center and extends outward through a network of integrated community hospitals and health centers, finally reaching the remote and heretofore isolated areas. Inherent in all medical schools is a unique potential for rendering medical services as well as actually training physicians. The very nature of medical education—whereby doctors in training work under the tutelage of able specialists in the clinic, hospital ward, and out-patient department—provides medical services of high quality to people in the neighboring communities.

Challenges of Medical Care Delivery in Professional Sports

2018 ◽  
Vol 26 (24) ◽  
pp. 872-880 ◽  
Author(s):  
Xavier Duralde ◽  
Troy Jones ◽  
Timothy Griffith
Keyword(s):  
Medical Care ◽  
Care Delivery ◽  
Professional Sports

scholarly journals COVID-19 pandemic challenges for dermatology

2020 ◽  
Vol 1 (1) ◽  
pp. 14-17
Author(s):  
Evgenia Dvoryankova ◽  
Keyword(s):  
Medical Care ◽  
Personal Protective Equipment ◽  
Medical Community ◽  
Protective Equipment ◽  
Occupational Dermatitis ◽  
Medical Assistance ◽  
Coronavirus Infection ◽  
Quality Medical Care

COVID-19 pandemic posed a number of new formidable challenges to medical community. Dermatologists have not only to detect, define and reverse the new coronavirus infection cutaneus manifestations, but also to provide medical assistance to colleagues with occupational dermatitis due to personal protective equipment use. Moreover, it is necessary to provide quality medical care to patients with acute and chronic dermatosis given the limitations of present pandemic situation.

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