scholarly journals Spatial accessibility of general inpatient care in Germany: an analysis of surgery, internal medicine and neurology

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jan Bauer ◽  
Doris Klingelhöfer ◽  
Werner Maier ◽  
Lars Schwettmann ◽  
David A. Groneberg
Keyword(s):  
Internal Medicine ◽  
Inpatient Care ◽  
Health Care Systems ◽  
National Level ◽  
Spatial Accessibility ◽  
German Population ◽  
Geographic Variations ◽  
North East ◽  
Morbidity Data ◽  
Care Systems

Abstract Improving spatial accessibility to hospitals is a major task for health care systems which can be facilitated using recent methodological improvements of spatial accessibility measures. We used the integrated floating catchment area (iFCA) method to analyze spatial accessibility of general inpatient care (internal medicine, surgery and neurology) on national level in Germany determining an accessibility index (AI) by integrating distances, hospital beds and morbidity data. The analysis of 358 million distances between hospitals and population locations revealed clusters of lower accessibility indices in areas in north east Germany. There was a correlation of urbanity and accessibility up to r = 0.31 (p < 0.001). Furthermore, 10% of the population lived in areas with significant clusters of low spatial accessibility for internal medicine and surgery (neurology: 20%). The analysis revealed the highest accessibility for heart failure (AI = 7.33) and the lowest accessibility for stroke (AI = 0.69). The method applied proofed to reveal important aspects of spatial accessibility i.e. geographic variations that need to be addressed. However, for the majority of the German population, accessibility of general inpatient care was either high or at least not significantly low, which suggests rather adequate allocation of hospital resources for most parts of Germany.

Abstract 45: Global Impact of the Covid-19 Pandemic on Stroke Hospitalizations and Mechanical Thrombectomy Volumes: A Society of Vascular and Interventional Neurology Covid-19 International Collaboration

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Raul Nogueira ◽  
Mohamad AbdalKader ◽  
Muhammad Mustafa Qureshi ◽  
Michael R Frankel ◽  
Diogo Haussen ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Systems Of Care ◽  
Health Care Systems ◽  
Control Period ◽  
International Study ◽  
High Volume ◽  
Geographic Variations ◽  
Global Impact ◽  
Care Systems ◽  
Low Volume

Introduction: The COVID-19 pandemic led to profound changes in both the organization of health care systems and the psychosocial behavior of the population worldwide. The extent to which the COVID-19 outbreak disrupted stroke systems of care merits study from a global lens. Methods: We conducted a retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers. The study objectives were to measure the global impact of the pandemic on the volumes for mechanical thrombectomy (MT), stroke and intracranial hemorrhage (ICH) hospitalizations over a 3-month period at the height of the pandemic (March 1 to May 31, 2020) compared with two control 3-month periods prior (immediately preceding and one year prior). A secondary objective was to examine whether these changes in volume were impacted by COVID-19 and baseline hospital center stroke volumes. Third, we evaluated the relationships between stroke and COVID-19 diagnoses. Results: There were 26,699 stroke admissions in the 3 months immediately before compared to 21,576 admissions during the pandemic months, representing a 19.2% (95%CI,-19.7 to -18.7) decline. There were 5,191 MT procedures in the 3 months preceding compared to 4,533 procedures during the pandemic, representing a 12.7% (95%CI,-13.6 to -11.8) drop. Significant reductions were also seen in relation to the prior year control period. The decreases were noted across centers with high, intermediate, and low COVID-19 hospitalization burden, and also across high, intermediate, and low volume stroke centers. High-volume COVID-19 centers (-20.5%) had greater declines in MT volumes than mid- (-10.1%) and low-volume (-8.7%) centers. There was a 1.5% stroke rate across 54,366 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.9% (784/20,250) of all stroke admissions. Conclusions: The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, MT procedures, ischemic stroke/TIA and ICH admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke and MT volumes. Centers with higher COVID-19 inpatient volumes experienced steeper declines.

scholarly journals EXPRESS: Global Impact of the COVID-19 Pandemic on Stroke Hospitalizations and Mechanical Thrombectomy Volumes

2021 ◽  
pp. 174749302199165
Author(s):  
Raul Nogueira ◽  
Mohamad Abdalkader ◽  
Muhammed M Qureshi ◽  
MR Frankel ◽  
Ossama Yassin Mansour ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Health Care Systems ◽  
International Study ◽  
High Volume ◽  
Geographic Variations ◽  
Global Impact ◽  
Icd 10 ◽  
Care Systems ◽  
Low Volume ◽  
One Year

Background: The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide. Aims: We sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy (MT), stroke, and intracranial hemorrhage (ICH) hospitalizations over a 3-month period at the height of the pandemic (March 1 to May 31, 2020) compared with two control 3-month periods (immediately preceding and one year prior). Methods: Retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers. The diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases at participating centers. Results: The hospitalization volumes for any stroke, ICH, and MT were 26,699, 4,002, and 5,191 in the 3 months immediately before versus 21,576, 3,540, and 4,533 during the first 3 pandemic months, representing declines of 19.2% (95%CI,-19.7 to -18.7), 11.5% (95%CI,-12.6 to -10.6), and 12.7% (95%CI,-13.6 to -11.8), respectively. The decreases were noted across centers with high, mid, and low COVID-19 hospitalization burden, and also across high, mid, and low volume stroke/MT centers. High-volume COVID-19 centers (-20.5%) had greater declines in MT volumes than mid- (-10.1%) and low-volume (-8.7%) centers (p<0.0001). There was a 1.5% stroke rate across 54,366 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.9% (784/20,250) of all stroke admissions. Conclusion: The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, MT procedures, and ICH admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke/MT volumes.

scholarly journals Can innovative digital collaborations help overcome barriers to intersectoral collaboration?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Nordström ◽  
B Kumar
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Systems ◽  
Local Level ◽  
National Level ◽  
Migrant Health ◽  
Intersectoral Collaboration ◽  
Professional Networks ◽  
Care Systems

Abstract Issue Health in all policies is desirable, but moving from the silos approach is a challenge for health care systems. New health policies require more cooperation and broader collaboration between governmental, private and volunteer sector, as well as across professions. Though it is key to implementation of national policies and long-term public health work at the local level, intersectoral collaboration remains elusive. Professionals working with public health and migrant health across Norway often work independently of each other and other sectors. Description of the Problem Evaluation of the Norwegian network for migrant friendly hospitals showed that with the opportunity to meet and share experiences, participants used the new knowledge and network in developing their practice and organisation of services. They experienced greater support to challenge status quo in their institutions. However, fear of making the network “too big to handle” is a barrier to creating intersectoral network. In a recent survey (2017), health personnel ask for digital solutions for finding resources and support in their practice to give better health care to immigrant patients. Results The newly (2020) knowledge HUB part of JAHEE actions brings stakeholders together at the local, regional and national level, ensuring access to the same knowledge, increase evidence based decisions among stakeholders when choosing interventions on the local, regional and national level, including sharing of good practices and promising initiatives at a national level so that they can be replicated. Lessons Professional networks that are coordinated and collaborative are important for development of services and implementation of measures for migrant health. However, expanding them across sectors and fields may create challenges. Combining sectoral networks with a common digital platform may overcome some of these challenges. Key messages Exploiting the potential of collaborative digital solutions may help overcome some barriers to intersectoral approach to migrant health. Coordinated collaborative professional networks can support the participants in developing their practice and organisation of services for migrants.

scholarly journals ANALYSIS OF SUCCESS DRIVERS OF E-HEALTH INFRASTRUCTURE AND USE: A NATIONAL LEVEL STUDY

2013 ◽  
Vol 5 (2) ◽  
pp. 130-135
Author(s):  
KALLOL K. BAGCHI ◽  
Godwin J. Udo
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
National Level ◽  
Good Health ◽  
Common People ◽  
Health Infrastructure ◽  
Cost Of Health Care ◽  
Care Systems ◽  
Developed Nations ◽  
Perception Of Health

e-Health, in form of websites that contain information on health, is emerging as an important resource for common people in some developed nations. The purpose of the study is to explore the critical factors that drive the e-Health infrastructure of nations and its usage. Research data from a set of more than 40 developed and developing nations were gathered from 8,000 websites to allow analysis of factors driving the e-Health growth. The results suggest that at a national level, cost of health care per capita and perception of health are significant in e-Health infrastructure regression, explaining more than 32-41% of the variability in e-Health infrastructure. Confidence in health care systems, perception of good health, health care costs, and human development index and health infrastructure also explain over 69-78% of the variability in e-Health use.

Developing a hospital quality improvement initiative in Lesotho

2014 ◽  
Vol 27 (1) ◽  
pp. 15-24 ◽  
Author(s):  
Joshua Berman ◽  
Elizabeth Limakatso Nkabane ◽  
Sebaka Malope ◽  
Seta Machai ◽  
Brian Jack ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Care Systems ◽  
National Level ◽  
Hospital Staff ◽  
Steering Committee ◽  
Lessons Learned ◽  
Quality Improvement Initiative ◽  
Content Type ◽  
Skill Sets ◽  
Care Systems

Purpose – Hospital-based quality improvement (QI) programs are becoming increasingly common in developing countries as a sustainable method of strengthening health systems. The aim of this paper is to present the results and lessons learned from a QI program in a large, rural, district hospital in Lesotho, Southern Africa. Design/methodology/approach – Over a 15-month period, a locally-relevant, hospital-wide QI program was developed and implemented. The QI program consisted of: planning meetings with district and hospitals staff; creation of multi-disciplinary QI teams; establishment of a QI steering committee; design and implementation of a locally appropriate QI curriculum; and monthly consultation from technical advisers. Initial QI programming was developed in three distinct areas: maternity care, out-patient care, and referral systems. Findings – Partogram documentation in the maternity department increased by 78 percent, waiting time for critically ill patients in the out-patient department was reduced by 84 percent, and emergency referral times were reduced by 58 percent. Originality/value – The design and early implementation of QI programs should focus on easily achievable, locally-relevant improvement projects. It was found that early successes helped to fuel further QI gains and the authors believe that the work building sustainable QI skill sets within hospital staff could be useful in the future when attempting to tackle larger national-level quality of care indicators. The findings add to the existing evidence suggesting that an increased use of locally-relevant quality improvement programming could help strengthen health care systems in low resource settings.

scholarly journals National nodes: a tool to enable efficient work of Distributed Infrastructure on Population Health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Zaletel ◽  
P Bogaert ◽  
L A Abboud ◽  
L Palmieri ◽  
H Van Oyen ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Focal Point ◽  
Health Care Systems ◽  
National Level ◽  
Policy Research ◽  
Field Work ◽  
Health Data ◽  
Care Systems ◽  
Future Work

Abstract   The European framework of health information (HI) consists - besides the supra-national framework - of national frameworks of health infrastructures. It is therefore essential to strengthening capacities to provide HI and carry out research in countries. Nowadays, one can experience lack of coordination, communication and cooperation between stakeholders in a country, leading to overlap or duplication of research and field-work. InfAct proposes a tool to overcome a majority of these difficulties by encouraging MSs to establish national nodes (NN) as a national focal point for DIPoH. A NN is a building block of DIPoH often coordinated by a national institution or governmental unit that functions as a NN and brings together relevant national stakeholders in an organised way. Researchers from public health institutes and research groups constitute the NN to share expertise and updated knowledge on HI with each other. Currently, there are some active NN in the EU, with differences in scope, scale and initial purpose, due to different organisation of HI systems in countries. Such heterogeneity can also be found in national eHealth strategies. Diverse organizational arrangements exist which has proven to influence collaborative activities. At the same time new needs are arising, such as to better bridge the digital HI between research and health care, so that our health care systems can faster contribute to integrated data driven insights. This also relates to the debate on the Health Data Space, which creation is stated in the mission letter to the new European Commissioner for Health. For example, the eHealth Network has been discussing policy documents targeted at national level policy with regard to the organization of National eHealth Networks. In this pitch presentation, an overview of different practices will be presented with proposals for future work in this area, including the role of NN in DIPoH and proposals for their sustainability. Panelists: H Van Oyen Epidemiology and Public Health, Sciensano, Brussels, Belgium Department of Public Health, Ghent University, Ghent, Belgium Contact: [email protected] S Montante Brussels Liaison Office, National Institute of Health of Italy (ISS), Brussels, Belgium Contact: [email protected] E Bacry Health Data Hub, Santś publique France, Paris, France E Bernal-Delgado Health Services and Policy Research Group, Institute for Health Sciences in Aragon, Zaragoza, Spain Contact: [email protected] C Sousa Pinto Advanced Analytics and Intelligence, Shared Services In Ministry Of Health, Lisbon, Portugal Contact: [email protected]

scholarly journals Non-communicable diseases’ risk factors in India: a review of the current situation

2021 ◽  
Vol 8 (8) ◽  
pp. 4094
Author(s):  
Anjana Verma ◽  
Ashish Patyal ◽  
Medha Mathur ◽  
Navgeet Mathur ◽  
Shiv Virmani
Keyword(s):  
Risk Factors ◽  
Health Care Systems ◽  
National Level ◽  
Regular System ◽  
Communicable Diseases ◽  
Current Status ◽  
Non Communicable Diseases ◽  
Significant Burden ◽  
Care Systems ◽  
Considerable Morbidity

Non-communicable diseases (NCDs) are responsible for considerable morbidity and mortality, leading to a significant burden on the health care systems in developing countries like India. Despite heavy burden, there is no regular system of collection of good quality representative data on NCDs or their risk factors in India. The published review articles show the trends of risk factors, however only for one or few more risk factors, thereby rendering them non comprehensive. This paper examines the updated data and epidemiology of all the NCD risk factors, to provide the summary estimates of their prevalence at national level. A thorough knowledge on current status of risk factors is required to formulate the policies and programmes, so that the rising burden of NCDs can be tackled.

scholarly journals A view on medical care globalization and medical tourism

2018 ◽  
Vol 32 (1) ◽  
pp. 69-73
Author(s):  
Samlee Plianbangchang
Keyword(s):  
Health Care ◽  
Medical Care ◽  
National Health ◽  
Medical Tourism ◽  
Health Care Systems ◽  
National Level ◽  
Practical Experience ◽  
Content Type ◽  
National Health Care ◽  
Care Systems

Purpose The purpose of this paper is to disseminate among concerned professionals its certain operational aspects, including some possible implications on health and medical care practices. Design/methodology/approach It is written on the basis of the author’s special study of a diverse source of information, as well as on author’s practical experience and observation in this particular area. Findings Special attention is paid to possible public health impacts within a broad social and economic framework, as well as to its impacts on the existing national health care systems in countries, that would possibly lead to certain degree of inequity in health at national level as an important consequence of health development progress. Originality/value Knowledge and understanding gained from this paper might be useful in the efforts to develop and manage national health care systems to ensure a reasonable balance in health status of people of all groups.

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