scholarly journals How Would Medicare for All Affect Health System Capacity? Evidence from Medicare for Some

2021 ◽  
Vol 35 ◽  
pp. 225-262
Author(s):  
Jeffrey Clemens ◽  
Joshua D. Gottlieb ◽  
Jeffrey Hicks
Keyword(s):  
Health System ◽  
System Capacity

scholarly journals Prioritising surgical cases deferred by the COVID-19 pandemic: an ethics-inspired algorithmic framework for health leaders

BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000343
Author(s):  
Amit Jain ◽  
Tinglong Dai ◽  
Christopher G Myers ◽  
Punya Jain ◽  
Shruti Aggarwal
Keyword(s):  
Decision Analysis ◽  
Health System ◽  
System Capacity ◽  
Surgical Case ◽  
The World ◽  
The Face ◽  
Algorithmic Framework ◽  
Limited Health ◽  
Healthcare Leaders

Elective surgical suspension during the COVID-19 pandemic resulted in a sizeable surgical case backlog throughout the world. As we ramp back up, how do we decide which cases take priority? Potential future waves (or a future pandemic) may lead to additional surgical shutdown and subsequent reopening. Deciding which cases to prioritise in the face of limited health system capacity has emerged as a new challenge for healthcare leaders. Here we present an ethically grounded and operationally efficient surgical prioritisation framework for healthcare leaders and practitioners, drawing insights from decision analysis and organisational sciences.

scholarly journals Description of a Multi-faceted COVID-19 Pandemic Physician Workforce Plan at a Multi-site Academic Health System

2021 ◽  
Author(s):  
Sachin R. Pendharkar ◽  
Evan Minty ◽  
Caley B. Shukalek ◽  
Brendan Kerr ◽  
Paul MacMullan ◽  
...  
Keyword(s):  
Health System ◽  
Acute Care ◽  
Care Physician ◽  
System Capacity ◽  
Medical Emergency ◽  
Physician Workforce ◽  
Future Health ◽  
Academic Health ◽  
Response Planning ◽  
Implementation Period

Abstract Background The evolving COVID-19 pandemic has and continues to present a threat to health system capacity. Rapidly expanding an existing acute care physician workforce is critical to pandemic response planning in large urban academic health systems. Intervention The Medical Emergency-Pandemic Operations Command (MEOC)—a multi-specialty team of physicians, operational leaders, and support staff within an academic Department of Medicine in Calgary, Canada—partnered with its provincial health system to rapidly develop a comprehensive, scalable pandemic physician workforce plan for non-ventilated inpatients with COVID-19 across multiple hospitals. The MEOC Pandemic Plan comprised seven components, each with unique structure and processes. Methods In this manuscript, we describe MEOC’s Pandemic Plan that was designed and implemented from March to May 2020 and re-escalated in October 2020. We report on the plan’s structure and process, early implementation outcomes, and unforeseen challenges. Data sources included MEOC documents, health system, public health, and physician engagement implementation data. Key Results From March 5 to October 26, 2020, 427 patients were admitted to COVID-19 units in Calgary hospitals. In the initial implementation period (March–May 2020), MEOC communications reached over 2500 physicians, leading to 1446 physicians volunteering to provide care on COVID-19 units. Of these, 234 physicians signed up for hospital shifts, and 227 physicians received in-person personal protective equipment simulation training. Ninety-three physicians were deployed on COVID-19 units at four large acute care hospitals. The resurgence of cases in September 2020 has prompted re-escalation including re-activation of COVID-19 units. Conclusions MEOC leveraged an academic health system partnership to rapidly design, implement, and refine a comprehensive, scalable COVID-19 acute care physician workforce plan whose components are readily applicable across jurisdictions or healthcare crises. This description may guide other institutions responding to COVID-19 and future health emergencies.

scholarly journals HCFMUSP: Resilience in Response to the COVID-19 Pandemic

2021 ◽  
Vol 25 (spe) ◽  
Author(s):  
Marcelo Caldeira Pedroso ◽  
João Teixeira Pires ◽  
Ana Maria Malik ◽  
Antonio José Rodrigues Pereira
Keyword(s):  
Knowledge Management ◽  
Health System ◽  
Crisis Management ◽  
System Capacity ◽  
New Disease ◽  
Healthcare Operations ◽  
Teaching Case ◽  
Health System Governance ◽  
Emergency Actions ◽  
The Impact

ABSTRACT The teaching case describes a set of emergency actions taken by HCFMUSP to manage the needs brought by the COVID-19 pandemic in Brazil. The case objective considers the issues related to the impact of the pandemic mostly in healthcare operations, emphasizing how to: (a) adapt health system governance in response to a crisis (crisis management); (b) manage the health system capacity, which traditionally is not so resilient; (c) deal with a new disease (knowledge management). Thus, it should allow gathering elements for the management of future crises.

Who Counts Where? COVID-19 Surveillance in Federal Countries

2021 ◽  
Author(s):  
Philip Rocco ◽  
Jessica A. J. Rich ◽  
Katarzyna Klasa ◽  
Kenneth A. Dubin ◽  
Daniel Béland
Keyword(s):  
Public Health ◽  
Data Quality ◽  
Health System ◽  
Case Studies ◽  
Fiscal Decentralization ◽  
Public Health System ◽  
System Capacity ◽  
Democratic Institutions ◽  
Subnational Governments

Abstract Context: While the World Health Organization (WHO) has established guidance on COVID-19 surveillance, little is known about implementation of these guidelines in federations, which fragment authority across multiple levels of government. This study examines how subnational governments in federal democracies collect and report data on COVID-19 cases and mortality associated with COVID-19. Methods: We collected data from subnational government websites in 15 federal democracies to construct indices of COVID-19 data quality. Using bivariate and multivariate regression, we analyzed the relationship between these indices and indicators of state capacity, the decentralization of resources and authority, and the quality of democratic institutions. We supplement these quantitative analyses with qualitative case studies of subnational COVID-19 data in Brazil, Spain, and the United States. Findings: Subnational governments in federations vary in their collection of data on COVID-19 mortality, testing, hospitalization, and demographics. There are statistically significant associations (p<0.05) between subnational data quality and key indicators of public health system capacity, fiscal decentralization, and the quality of democratic institutions. Case studies illustrate the importance of both governmental and civil-society institutions that foster accountability. Conclusions: The quality of subnational COVID-19 surveillance data in federations depends in part on public health system capacity, fiscal decentralization, and the quality of democracy.

scholarly journals Health system capacity: maternal health policy implementation in the state of Gujarat, India

2013 ◽  
Vol 6 (1) ◽  
pp. 19629 ◽  
Author(s):  
Linda Sanneving ◽  
Asli Kulane ◽  
Aditi Iyer ◽  
Bengt Ahgren
Keyword(s):  
Health Policy ◽  
Maternal Health ◽  
Policy Implementation ◽  
Health System ◽  
The State ◽  
System Capacity ◽  
Maternal Health Policy ◽  
Health Policy Implementation

scholarly journals Coronavirus: Where Has All the Health Economics Gone?

2020 ◽  
Author(s):  
Cam Donaldson ◽  
Craig Mitton
Keyword(s):  
United Kingdom ◽  
Health Economics ◽  
Health System ◽  
Policy Making ◽  
System Capacity ◽  
The United Kingdom ◽  
Trade Offs ◽  
National Productivity ◽  
The Impact ◽  
Made In

As the coronavirus disease 2019 (COVID-19) pandemic continues to unfold there is an untold number of trade-offs being made in every country around the globe. The experience in the United Kingdom and Canada to date has not seen much uptake of health economics methods. We provide some thoughts on how this could take place, specifically in three areas. Firstly, this can involve understanding the impact of lockdown policies on national productivity. Secondly, there is great importance in studying trade-offs with respect to enhancing health system capacity and the impact of the mix of private-public financing. Finally, there are key trade-offs that will continue to be made both in terms of access to testing and ventilators which would benefit greatly from economic appraisal. In short, health economics could – and we would argue most certainly should – play a much more prominent role in policy-making as it relates to the current as well as future pandemics.

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