The impact of COVID-19 pandemic on IBD endoscopic procedures in a high-volume IBD Center

Abstract Background and study aims The COVID-19 pandemic is having a major clinical and also organizational impact on national health care systems, particularly in high-volume hospitals that are utilized for several essential clinical needs. We aimed to analyze the short-term impact of the SARS-CoV-2 pandemic on management of endoscopic procedures in patients with inflammatory bowel disease (IBD). Patients and methods This was an observational prospective study exploring major clinical and organizational changes in endoscopic management at the IBD Center – CEMAD of the Fondazione Policlinico Gemelli IRCCS, Rome, Italy since the beginning of SARS-CoV-2 pandemic. Results Our IBD Unit, with up to 1,500 IBD patients receiving biotechnological or experimental therapy, represents a high-volume Italian and European IBD center. Since the beginning of the outbreak, our hospital has been extremely impacted by care related to COVID-19 cases, with a consequent need to dramatically reorganize management of endoscopic procedures for IBD. Conclusions Outbreak restrictions have significantly impacted the volume of endoscopic activities for IBD. Specific strategies have been designed to guarantee a high level of safety for both patients with IBD and healthcare personnel dedicated to their treatment.

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Characteristics of Critically Ill Patients with COVID-19 Compared to Patients with Influenza—A Single Center Experience

Journal of Clinical Medicine ◽

10.3390/jcm10102056 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2056

Author(s):

Frank Herbstreit ◽

Marvin Overbeck ◽

Marc Moritz Berger ◽

Annabell Skarabis ◽

Thorsten Brenner ◽

...

Keyword(s):

Influenza A ◽

Health Care Systems ◽

Severe Disease ◽

Tertiary Care ◽

Care Facility ◽

High Volume ◽

Single Center Experience ◽

Severe Influenza ◽

Tertiary Care Facility ◽

Care Systems

Infections with SARS-CoV-2 spread worldwide early in 2020. In previous winters, we had been treating patients with seasonal influenza. While creating a larger impact on the health care systems, comparisons regarding the intensive care unit (ICU) courses of both diseases are lacking. We compared patients with influenza and SARS-CoV-2 infections treated at a tertiary care facility offering treatment for acute respiratory distress syndrome (ARDS) and being a high-volume facility for extracorporeal membrane oxygenation (ECMO). Patients with COVID-19 during the first wave of the pandemic (n = 64) were compared to 64 patients with severe influenza from 2016 to 2020 at our ICU. All patients were treated using a standardized protocol. ECMO was used in cases of severe ARDS. Both groups had similar comorbidities. Time in ICU and mortality were not significantly different, yet mortality with ECMO was high amongst COVID-19 patients with approximately two-thirds not surviving. This is in contrast to a mortality of less than 40% in influenza patients with ECMO. Mortality was higher than estimated by SAPSII score on admission in both groups. Patients with COVID-19 were more likely to be male and non-smokers than those with influenza. The outcomes for patients with severe disease were similar. The study helps to understand similarities and differences between patients treated for severe influenza infections and COVID-19.

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The Impact and Implications of The COVID-19 Pandemic on Organ Procurement Outside of an Epicenter

Progress in Transplantation ◽

10.1177/15269248211002808 ◽

2021 ◽

pp. 152692482110028

Author(s):

Janice Jene Hudgins ◽

Allison Jo Boyer ◽

Kristen Danielle Orr ◽

Clint Allen Hostetler ◽

Jeffrey Paul Orlowski ◽

...

Keyword(s):

Health Care ◽

Initial Phase ◽

Organ Procurement ◽

Health Care Systems ◽

Health Data ◽

Organ Procurement Organization ◽

Care Systems ◽

The Impact ◽

Variable Impact ◽

Single Organ

The COVID-19 pandemic has been well-documented to have a variable impact on individual communities and health care systems. We describe the experience of a single organ procurement organization (OPO), located in an area without a large cluster of cases during the initial phase of the COVID-19 pandemic. A review of community health data describing the impact of COVID-19 nationally and in Oklahoma was conducted. Additionally, a retrospective review of available OPO data from March 2019-May 2020 was performed. While the amount of donor referrals received and organs recovered by the OPO remained stable in the initial months of the pandemic, the observed organs transplanted vs. expected organs transplanted (O:E) decreased to the lowest number in the 15-month period and organs transplanted decreased as well. Fewer organs from Oklahoma donors were accepted for transplant despite staff spending more time allocating organs.

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SARS-CoV-2 and Cytomegalovirus Co-Infections—A Case Series of Critically Ill Patients

Journal of Clinical Medicine ◽

10.3390/jcm10132792 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2792

Author(s):

Patrícia Moniz ◽

Sérgio Brito ◽

Pedro Póvoa

Keyword(s):

Intensive Care Unit ◽

Critically Ill ◽

Immune Suppression ◽

Clinical Course ◽

Health Care Systems ◽

Case Series ◽

Confounding Factors ◽

Care Systems ◽

The Impact ◽

Cmv Reactivation

The SARS-CoV-2 pandemic has placed great strain on the most developed of health care systems, especially in the context of critical care. Although co-infections with cytomegalovirus (CMV) are frequent in the critically ill due to underlying immune suppression of multiple causes, the impact on COVID-19 patients remains unclear. Furthermore, severe COVID-19 has recently been associated with significant immune suppression, and this may in turn impact CMV reactivation, possibly contributing to clinical course. Nevertheless, multiple confounding factors in these patients will certainly challenge upcoming research. The authors present a case series of five patients admitted to the intensive care unit (ICU) in the context of respiratory failure due to severe COVID-19. All patients evolved with CMV reactivation during ICU stay.

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Sustainability of Biosimilars in Europe: A Delphi Panel Consensus with Systematic Literature Review

Pharmaceuticals ◽

10.3390/ph13110400 ◽

2020 ◽

Vol 13 (11) ◽

pp. 400

Author(s):

Arnold G. Vulto ◽

Jackie Vanderpuye-Orgle ◽

Martin van der Graaff ◽

Steven R. A. Simoens ◽

Lorenzo Dagna ◽

...

Keyword(s):

Health Care ◽

Literature Review ◽

Systematic Literature Review ◽

Health Care Systems ◽

Delphi Panel ◽

The European Union ◽

Modified Delphi ◽

Care Systems ◽

Supply Risks ◽

The Impact

Introduction: Biosimilars have the potential to enhance the sustainability of evolving health care systems. A sustainable biosimilars market requires all stakeholders to balance competition and supply chain security. However, there is significant variation in the policies for pricing, procurement, and use of biosimilars in the European Union. A modified Delphi process was conducted to achieve expert consensus on biosimilar market sustainability in Europe. Methods: The priorities of 11 stakeholders were explored in three stages: a brainstorming stage supported by a systematic literature review (SLR) and key materials identified by the participants; development and review of statements derived during brainstorming; and a facilitated roundtable discussion. Results: Participants argued that a sustainable biosimilar market must deliver tangible and transparent benefits to the health care system, while meeting the needs of all stakeholders. Key drivers of biosimilar market sustainability included: (i) competition is more effective than regulation; (ii) there should be incentives to ensure industry investment in biosimilar development and innovation; (iii) procurement processes must avoid monopolies and minimize market disruption; and (iv) principles for procurement should be defined by all stakeholders. However, findings from the SLR were limited, with significant gaps on the impact of different tender models on supply risks, savings, and sustainability. Conclusions: A sustainable biosimilar market means that all stakeholders benefit from appropriate and reliable access to biological therapies. Failure to care for biosimilar market sustainability may impoverish biosimilar development and offerings, eventually leading to increased cost for health care systems and patients, with fewer resources for innovation.

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The impact of chronic disease and disability on the elderly

South African Journal of Physiotherapy ◽

10.4102/sajp.v55i3.567 ◽

1999 ◽

Vol 55 (3) ◽

pp. 9-14

Author(s):

C. J. Eales

Keyword(s):

Health Care ◽

Chronic Disease ◽

Chronic Diseases ◽

Health Care Systems ◽

The Elderly ◽

Therapeutic Interventions ◽

Elderly Persons ◽

Care Systems ◽

And Function ◽

The Impact

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.

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‘Untying the Knot’: Achieving Integrative and Collaborative Care within Trauma and Fear Saturated Systems – A Practice-Focused Discussion Paper

Children Australia ◽

10.1017/cha.2017.12 ◽

2017 ◽

Vol 42 (2) ◽

pp. 104-107 ◽

Cited By ~ 1

Author(s):

Dilip Balu

Keyword(s):

Child Protection ◽

Health Care Systems ◽

Traumatic Experience ◽

Ripple Effect ◽

Discussion Paper ◽

Care Systems ◽

Trauma Informed ◽

The Impact ◽

The Brain ◽

Mental Health Care Systems

The author's clinical experience with the Child Protection and Mental Health Care systems informs this brief practice-focused paper. The author posits that Secondary Traumatic Stress and Vicarious Trauma are central to understanding the impact of relationally traumatic material and the experience of individuals, families, team and the wider ecology of care systems. In particular, the author hypothesises that the tendency of systems to become fragmented in operation, with silos of sub-parts working parallel to each other, may be a natural adaptation to the ways in which traumatic experience ripples across system boundaries. This ‘ripple effect’ may lead to increasing emotional and relational reactivity, and survival-oriented inward focus of energies and efforts. The metaphor of the brain and nervous system is used to explore ideas of connection and integration in care systems. Trauma-informed leadership by individuals and teams is also touched upon in relation to reducing fear-driven clinical practice.

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The impact of the recession on health care expenditure — How does the Czech Republic, Hungary, Poland and Slovakia compare to other OECD countries?

Society and Economy ◽

10.1556/socec.37.2015.1.4 ◽

2015 ◽

Vol 37 (1) ◽

pp. 73-88

Author(s):

Petra Baji ◽

Márta Péntek ◽

Imre Boncz ◽

Valentin Brodszky ◽

Olga Loblova ◽

...

Keyword(s):

Health Care ◽

Czech Republic ◽

Economic Crisis ◽

Growth Rates ◽

Health Care Systems ◽

Oecd Countries ◽

The Czech Republic ◽

Relative Growth ◽

Care Systems ◽

The Impact

In the past few years, several papers have been published in the international literature on the impact of the economic crisis on health and health care. However, there is limited knowledge on this topic regarding the Central and Eastern European (CEE) countries. The main aims of this study are to examine the effect of the financial crisis on health care spending in four CEE countries (the Czech Republic, Hungary, Poland and Slovakia) in comparison with the OECD countries. In this paper we also revised the literature for economic crisis related impact on health and health care system in these countries. OECD data released in 2012 were used to examine the differences in growth rates before and after the financial crisis. We examined the ratio of the average yearly growth rates of health expenditure expressed in USD (PPP) between 2008–2010 and 2000–2008. The classification of the OECD countries regarding “development” and “relative growth” resulted in four clusters. A large diversity of “relative growth” was observed across the countries in austerity conditions, however the changes significantly correlate with the average drop of GDP from 2008 to 2010. To conclude, it is difficult to capture visible evidence regarding the impact of the recession on the health and health care systems in the CEE countries due to the absence of the necessary data. For the same reason, governments in this region might have a limited capability to minimize the possible negative effects of the recession on health and health care systems.

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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 ◽

10.1161/str.52.suppl_1.45 ◽

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.

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