scholarly journals SP1.1.13Assessing quantitative FIT within the colorectal two-week wait pathway as a triage tool to focus endoscopy services

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
A Gendia ◽  
H Rottenburg ◽  
A Tam ◽  
W Faux
Keyword(s):  
Health Care Services ◽  
High Sensitivity ◽  
Cross Sectional ◽  
Care Services ◽  
Fit Testing ◽  
Risk Patients ◽  
Cross Sectional Imaging ◽  
Rectal Mass ◽  
Immunochemical Test ◽  
The Impact

Abstract Aims Quantitative Faecal Immunochemical test (qFIT) is highly specific for luminal colonic pathology. This study models the potential impact on health care services of its introduction as a tool of triage for the 2-week wait referrals pathway. The Model utilises the recently published NICEFIT tudy. Methods All symptoms and results for patients within the colorectal two-week wait pathway are prospectively collated into a relational database. We modelled the impact of introducing targeted FIT testing to those patients without anaemia, rectal mass or overt rectal bleeding. Based on the recent NICEFIT Study, we set a population positivity value of 37% at 2µg/g with sensitivity of identifying colorectal cancer of 97%. Results 4240 patients were referred in 12 months up to till July 2019. 1333 referrals met the modelled criteria. These 1333 patient events generated 1619 investigations in 1227 patients. Malignancy was found in 4.3% of the investigated referrals (2.8% colorectal, 1.5% extracolonic). By applying FIT to the selected demographics with a positive value of 37%, the number of colonoscopies would fall by 63% (from 815 to 303) with estimated cost saving of £192,000. The FIT negative group would be investigated by selective cross-sectional imaging, with selected use of endoscopy as needed. Conclusion The high sensitivity of FIT permits its application as a screening tool in selected symptomatic patients. This can reduce the number of colonoscopies performed by almost 63% within a defined patient group. This would reduce the waiting time for positive high-risk patients as well as cutting overall costs.

scholarly journals Impact of COVID-19 and mitigation plans on essential health services: institutional experience of a hospital in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Firaol Dandena ◽  
Berhanetsehay Teklewold ◽  
Dagmawi Anteneh
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
Vital Role ◽  
Treatment Center ◽  
Cross Sectional ◽  
Poor Countries ◽  
Care Services ◽  
The Impact

Abstract Background Health systems around the world are being challenged by an on-going COVID-19 pandemic. The COVID-19 pandemic and associated response can have a significant downstream effect on access to routine health care services, and indirectly cause morbidity and mortality from causes other than the disease itself, especially in resource-poor countries such as Ethiopia. This study aimed to explore the impact of the pandemic on these services and measures taken to combat the effect. Methods The study was conducted at St. Paul’s hospital millennium medical college (SPHMMC) from December 15, 2020 to January 15, 2021 using a comparative cross-sectional study design. We collected data on the number of clients getting different essential health care services from May to October 2019 (Pre COVID) and the same period in 2020 (during a COVID-19 pandemic) from the patient registry book. The analysis was done with SPSS version 24 software. Result Overall, the essential services of SPHMMC were affected by the COVID-19 pandemic. The most affected service is inpatient admission, which showed a 73.3% (2044 to 682) reduction from the pre-COVID period and the least affected is maternal service, which only decreased by 13% (3671 to 3177). During the 6 months after the COVID-19 pandemic, there was a progressive increment in the number of clients getting essential health services. Conclusion and recommendation The establishment of a triple setup for fighting against COVID-19, which encompasses non-COVID services, an isolation center and a COVID-19 treatment center, played a vital role in preserving essential health services.

The Impact of Community Based Health Insurance in Enhancing Better Accessibility and Lowering the Chance of Having Financial Catastrophe Due to Health Service Utilization

2015 ◽  
Vol 47 (3) ◽  
pp. 504-518 ◽  
Author(s):  
Somdeth Bodhisane ◽  
Sathirakorn Pongpanich
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Household Income ◽  
Health Care Services ◽  
Lower Probability ◽  
Community Based ◽  
Cross Sectional ◽  
Community Based Health Insurance ◽  
Care Services ◽  
The Impact

The Lao population mostly relies on out-of-pocket expenditures for health care services. This study aims to determine the role of community-based health insurance in making health care services accessible and in preventing financial catastrophe resulting from personal payment for inpatient services. A cross-sectional study design was applied. Data collection involved 126 insured and 126 uninsured households in identical study sites. Two logistic regression models were used to predict and compare the probability of hospitalization and financial catastrophe that occurred in both insured and uninsured households within the previous year. The findings show that insurance status does not significantly improve accessibility and financial protection against catastrophic expenditure. The reason is relatively simple, as catastrophic health expenditure refers to a total out-of-pocket payment equal to or more than 40% of household income minus subsistence. When household income declines as a result of inability to work due to illness, the 40% threshold is quickly reached. Despite this, results suggest that insured households are not significantly better off under community-based health insurance. However, compared to uninsured households, insured households do have better accessibility and a lower probability of reaching the financial catastrophe threshold.

scholarly journals Relationship between anxiety and insomnia in clinical clerkship students during COVID-19 pandemic

2021 ◽  
Vol 4 (1) ◽  
pp. 21
Author(s):  
Maria Sekartaji ◽  
Resty Puspita Sari ◽  
Muhammad Irsan ◽  
Muhammad Adnan ◽  
Labitta Pachira Aquaira ◽  
...  
Keyword(s):  
Health Care ◽  
Anxiety Disorder ◽  
Health Care Services ◽  
Online Survey ◽  
Mental Health Problems ◽  
Learning Performance ◽  
Clinical Clerkship ◽  
Cross Sectional ◽  
Care Services ◽  
The Impact

During the COVID-19 pandemic, there is an increase in anxiety disorder towards the general population, including those clinical clerkship students who are associated with health care services. There has been limited study conducted regarding to the topic, especially during the COVID-19 pandemic. This study was aimed to know the prevalence of anxiety and insomnia, as well as the correlation between them, in clinical clerkship students during COVID-19 pandemic. An online survey was conducted using a cross-sectional approach to 229 clinical clerkship students batch 2015 at the Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada. This study used the Insomnia Severity Index (ISI) and General Anxiety Disorder-7 (GAD-7), administered using Google Forms. Data were analysed using the Chi-Square test. We collected 101 responses. There were 41.6% of males and 58.4% of females with ages ranging from 21 to 26. The result shows 26.7% (95% CI: 8.1-35.4%) of students undergo anxiety and 44.6% (95% CI: 34.9-54.3%) of students experienced insomnia throughout the COVID-19 pandemic. There is a correlation between anxiety and insomnia on clinical clerkship students during the COVID-19 pandemic. Clinical clerkship students with an anxiety disorder have 2.62 times greater risk of experiencing insomnia (p<0.001). The correlation between insomnia and anxiety during COVID-19 pandemic is vital because clinical clerkship students are directly involved in health care services and could risk the safety of patients. Thus, it is important to conduct the course of actions to reduce the risk of mental health problems during pandemic conditions. Also, further research is needed to have a better understanding of the impact on learning performance.

scholarly journals Impact of SARS-CoV-2 Pandemic and Strategies for Resumption of Activities During the Second Wave of the Pandemic: A Report From Eight Paediatric Hospitals From the ECHO Network

2021 ◽  
Vol 9 ◽  
Author(s):  
Giuseppe Indolfi ◽  
Micol Stivala ◽  
Matteo Lenge ◽  
Ruben Diaz Naderi ◽  
Jennifer McIntosh ◽  
...  
Keyword(s):  
Health Care Services ◽  
Tertiary Care ◽  
Source Control ◽  
Children's Hospitals ◽  
Cross Sectional ◽  
Web Based ◽  
Care Services ◽  
Children’S Hospitals ◽  
Main Components ◽  
The Impact

The Severe Acute Respiratory Syndrome CoronaVirus type 2 (SARS-CoV-2) pandemic impacted the organization of paediatric hospitals. This study aimed to evaluate the preparedness for the pandemic among a European network of children's hospitals and to explore the strategies to restart health care services. A cross-sectional, web-based survey was distributed in May 2020 to the 13 children's tertiary care hospitals belonging to the European Children's Hospitals Organisation. Responses were obtained from eight hospitals (62%). Significant reductions were observed in accesses to the emergency departments (41.7%), outpatient visits (35.7%), intensive and non-intensive care unit inpatient admissions (16.4 and 13%, respectively) between February 1 and April 30, 2020 as compared with the same period of 2019. Overall, 93 children with SARS CoV-2 infection were admitted to inpatient wards. All the hospitals created SARS-CoV-2 preparedness plans for the diagnosis and management of infected patients. Routine activities were re-scheduled. Four hospitals shared their own staff with adult units, two designated bed spaces for adults and only one admitted adults to inpatient wards. The three main components for the resumption of clinical activities were testing, source control, and reorganization of spaces and flows. Telemedicine and telehealth services were used before the SARS-CoV-2 pandemic by three hospitals and by all the hospitals during it.Conclusion: The present study provides a perspective on preparedness to SARS-CoV-2 pandemic among eight large European children's hospitals, on the impact of the pandemic on the hospital activities and on the strategies adopted to restart clinical activities.

scholarly journals Impact of the COVID-19 Pandemic on Urology Practice in Indonesia: A Nationwide Survey

2020 ◽  
Author(s):  
Nur Rasyid ◽  
Ponco Birowo ◽  
Dyandra Parikesit ◽  
Fakhri Rahman
Keyword(s):  
Health Care Services ◽  
Elective Surgery ◽  
Nationwide Survey ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Short Supply ◽  
Care Services ◽  
Number Of Patients ◽  
Message Service ◽  
The Impact

Abstract Background.Coronavirus disease 2019 (COVID-19) has affected daily practices in health care services. This study aimed to investigate the impact of COVID-19 on urology practice in Indonesia.Methods.This was a cross-sectional study using web-based questionnaire (Survey Monkey), which was distributed and collected within a period of three weeks. All practicing urologists in Indonesia were sent an e-questionnaire link via E-mail, WhatsApp Messenger application, and/or short message service, and the chief of residents in each urology centre distributed the e-questionnaire to urology residents.ResultsThe response rate was 369/485 (76%) among urologists and 220/220 (100%) among urology residents. Less than 10 percent of the responses in each section were incomplete. There are 35/369 (9.5%) Nine percent of urologists and 59/220 (26.8%) of urology residents had been suspected as COVID-19 patients, of whom seven of them were confirmed to be COVID-19 positive. The majority of urologists (66%) preferred to continue face-to-face consultations with a limited number of patients, and more than 60% of urologists preferred to postpone the majority (66%) or all elective surgery. Most urologists also chose to postpone elective surgery in patient with COVID-19-related symptoms and patient who required post-operative ICU-care. Urologist and urology residents reported high rates of using personal protective equipment, except for medical gowns and N95 masks, which were in short supply. Several uro-oncology surgeries were considered to be the top priority for Indonesian urologist during COVID-19 epidemic period.Conclusion.The COVID-19 pandemic has had a major impact on urology practice in Indonesia.

Rural and Urban Canadians with Dementia: Use of Health Care Services

2006 ◽  
Vol 25 (3) ◽  
pp. 321-330 ◽  
Author(s):  
Dorothy A. Forbes ◽  
Debra Morgan ◽  
Bonnie L. Janzen
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Health Care Services ◽  
Canadian Community Health Survey ◽  
Health Services Use ◽  
Care Needs ◽  
Cross Sectional ◽  
Care Services ◽  
The Impact ◽  
Use Of Health Care

ABSTRACTThe purpose of this research was to examine the characteristics of older Canadians with dementia (compared to those without dementia), their use of health care services, and the impact of place (rural/urban) on use of services. Andersen and Newman's Behavioural Model of Health Services Use (1973) guided the study. A cross-sectional design used data from the Canadian Community Health Survey (CCHS) Cycle 1.1 (N=49,995 older Canadians; those with dementia =313). Results indicated that among Canadian females between the ages of 50 and 64, those with dementia were more likely than those without dementia to live in rural areas. Among females 80 years of age and over, those with dementia had higher levels of education and income than those without dementia. In addition, a higher proportion of white than of visible minority Canadians was afflicted with dementia. The results further suggest that Canadians with dementia primarily required support services and that they were more likely than persons without dementia to report that their health care needs were unmet. It is recommended that publicly funded national home care programs be expanded to ensure that the supportive services needed by this population are available.

The Impact of War on Population Health

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Turkan Ahmet
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health Care Services ◽  
Negative Effects ◽  
The Past ◽  
Care Services ◽  
Physical Environments ◽  
The Social ◽  
Personal Experiences ◽  
The Impact

The past few decades of ongoing war in Iraq has had a dramatic impact on the health of Iraq’s population. Wars are known to have negative effects on the social and physical environments of individuals, as well as limit their access to the available health care services. This paper explores the personal experiences of my family members, who were exposed to war, as well as includes information that has been reviewed form many academic sources. The data aided in providing recommendations and developing strategies, on both local and international levels, to improve the health status of the populations exposed to war.

A Study on the Impact of Demonetization on Utilisation of Private Health Care Services in a South Indian City

2020 ◽  
Vol 11 (2) ◽  
pp. 485
Author(s):  
Vijay K. Yalanchmanchili ◽  
N. Partha Sarathy ◽  
U. Vijaya Kumar ◽  
M. Ravi Kiran ◽  
Kalapala Abhilash
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Private Health Care ◽  
Care Services ◽  
South Indian ◽  
Indian City ◽  
The Impact

scholarly journals The impact of coronavirus outbreak on breastfeeding guidelines among Brazilian hospitals and maternity services: a cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Walusa Assad Gonçalves-Ferri ◽  
◽  
Fábia Martins Pereira-Cellini ◽  
Kelly Coca ◽  
Davi Casale Aragon ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
World Health ◽  
Breastfeeding Support ◽  
Cross Sectional ◽  
Maternity Services ◽  
Community Needs ◽  
Care Services ◽  
Skin Contact ◽  
Health Organization ◽  
The Impact

Abstract Background The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations. Results The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment’s health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. Conclusions In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.

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