scholarly journals Clinical philosophy in the context of pediatric care

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Ehrich ◽  
L Hirn ◽  
J Manemann
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Systems ◽  
Cost Benefit ◽  
Family Therapist ◽  
Pediatric Care ◽  
Root Cause ◽  
Care Systems ◽  
Pros And Cons ◽  
Rich Countries

Abstract Medical care may be better in many countries than it currently is. Developing countries are in the need to catch up with affluent countries, and rich countries have a need for answering the question of how quality of health care can be improved for their total population despite increasing high-technology-induced cost through comprehensive cost-benefit analyzes. Health is about 85% dependent on general health care and 15% on medical care. The current quality differences of health care not only have their roots in economic crises, but in the lack of application of the thought model of ‘root-cause-effect long-term consequences. The questions arise as to whether this lack of integration of philosophical perspectives and activities contributes to deficiencies in the health care system and how philosophy could lead to new pathways of thinking. Obviously, the health systems of many European countries are having major problems translating the necessary changes in care from the theory level to the policy executive at the practical level. Furthermore, in many health care systems, adequate socio-philosophical concepts for adapting to constantly changing social conditions are missing with regard to adequate, accessible and affordable health care. This presentation discusses the pros and cons of greater involvement of spiritual welfare, clinical philosophy and philosophical practices in medical care for adolescents in order to improve 1. adherence to therapy, 2. resilience and 3. resonance in the treatment triangle of ‘patient-family-therapist’.

scholarly journals Bottom-Up Approach to Establish Coordination Mechanisms for Disaster Preparedness Among Largely Private Health-Care Providers in Central Tokyo

2021 ◽  
pp. 1-9
Author(s):  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Disaster Preparedness ◽  
Health Care Systems ◽  
Health Care Personnel ◽  
Coordination Mechanisms ◽  
Care Providers ◽  
Bottom Up ◽  
Care Systems ◽  
The City

Abstract In Japan, despite its private-dominant and disjointed health-care system, national initiatives to coordinate various types of health-care facilities are lacking. Municipal governments manage this task with limited resources. This study describes a successful example of a bottom-up approach to create city-wide collaboration for disaster preparedness. In Minato City, located in central Tokyo, a group of physicians created a project involving a city-wide disaster medical care drill. The city Public Health Center, in charge of health-care systems including disaster medicine, helped the group to increase proponents of the project. The city-wide disaster drill started in November 2017; thereafter, the drills were held every year. Participation in drills by various health-care personnel helped establish a city-wide system for disaster medical care, coordination mechanisms among stakeholders, increased motivation among health-care personnel, and development of in-hospital systems. This approach is flexible and applicable to various forms of health-care systems in other areas.

scholarly journals PATIENT-CENTERED MEDICINE: BACKGROUND TO THE TRANSFORMATION AND COMPONENTS

2019 ◽  
Vol 23 (1) ◽  
pp. 104-114 ◽  
Author(s):  
R. A. Khalfin ◽  
V. V. Madyanova ◽  
O. E. Kachkova ◽  
I. D. Demina ◽  
T. I. Krishtaleva ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Systems ◽  
Developed Countries ◽  
The European Union ◽  
Patient Centered ◽  
Foreign Countries ◽  
Care Systems ◽  
Patient Centered Medicine ◽  
Quality Of Medical Care

Purpose of the study. To analyze the concept of creating patient-oriented medicine, the prerequisites for its emergence, the difficulties of introducing it into existing health systems based on foreign experience. Materials and methods. The main materials of the study were used sources of foreign literature, which presents the concept of patient-oriented medicine, analyzed the prerequisites for changing models of health care in the European Union, USA and Asia in accordance with the principles of patient-oriented medicine, as well as data on the components and levels of patient-oriented medicine in foreign countries Results. The analyzed literature quite fully describes the difficulties of introducing patient-oriented medicine into existing health care systems. Particular attention should be paid to a multidisciplinary approach, continuity at different levels of medical care and effective communication between the physician and the patient towards the integration of this model into clinical practice. The analysis of the availability of medical care in developed countries and its dependence on social status, ethnicity and disease of the patient. Conclusion. Patient-oriented medicine is a new model for planning, implementing and evaluating medical services, which is based on mutually beneficial partnerships between medical workers, patients and their families. Taking into account the current problems of domestic health care, the introduction of the patient-oriented model will significantly improve the quality of medical care provided to the population of our country. Globally, the implementation of the principles of this model is far from complete. In the Russian Federation, targeted work in this direction requires additional scientific research, systematization of available data, and development of new legal documents

Amendments to the Constitution of the Russian Federation: Dictated Necessity and Consequences in the Conditions of the Modern World

2021 ◽  
Author(s):  
V.V. Chuksina ◽  
◽  
K.A. Mirvoda ◽  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Local Governments ◽  
Health Care Systems ◽  
Modern World ◽  
Depth Analysis ◽  
Care Systems ◽  
The Russian Federation ◽  
The Impact

The subject of this article is Law of the Russian Federation on Amendments to the Constitution of the Russian Federation (14.03.2020 No. 1-Federal Constitutional Law) «On improving the regulation of certain issues of the public power organization and functioning», namely, aspects of «coordination of health care» and «protection of the family, motherhood and childhood». The authors analyzed the issues of the medical care provision centralization, the impact of these amendments on the legal capacity of citizens. For a more in-depth analysis, the experience of foreign countries (Canada and Germany) was used. Despite the fact that the health care systems of the countries cited as an example differ in their essence and organization, nevertheless, they influence the formation of the availability of medicine for the population. As a result of the study of this experience, it was concluded that the delegation of freedom in the provision of medical care to lower levels of government allows to provide to the population affordable and high-quality medical care. It is noted that at present it is necessary to review the degree of participation of local governments in ensuring the availability of medical care in accordance with the federal law.

Rethinking the Place of the Psychein Health: Toward the Integration of Health Care Systems

2005 ◽  
Vol 39 (9) ◽  
pp. 816-825 ◽  
Author(s):  
Roger G. Kathol ◽  
David Clarke
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Medical Care ◽  
Psychiatric Care ◽  
Health Care Systems ◽  
Medical Setting ◽  
General Medical Care ◽  
Behavioural Health ◽  
The World ◽  
Care Systems

Objective: To review the value provided when health care systems independently manage medical and psychiatric care. Method: The authors draw on data from the world literature, their own experiences and reflections (one author as an international consultant in the coordination of physical and behavioural health care), and input from colleagues throughout the world who face similar challenges to improve outcomes for complex, high cost patients in their own health care systems. Results: Most health care systems in the world approach the administration and delivery of mental health care separately from that of general medical care. This practice is no longer supported as effective, efficient or inexpensive. Rather accumulating data indicates that concurrent and coordinated medical and psychiatric care, which can only be accomplished by integrating physical and behavioural health through infrastructure change, should replace the present system of independently provided sequential care; that is, one which provides first medical and then psychiatric treatment, or vice versa, with little communication between clinicians in the two sectors. Conclusions: By making mental health treatment an integral part of general medical care through reorganization of the funding system, a higher percentage of those now untreated for their psychiatric disorders, both within and outside of the medical setting, can have their mental health needs addressed in coordination with their physical disorders. At the same time, the number of patients that can be treated within the same budget will be expanded.

Modifications of Medical Care of Chronic Liver Diseases during COVID19 Pandemic: Necessity or Novelty?

2021 ◽  
Vol 20 ◽  
Author(s):  
Hanan Hamed Soliman ◽  
Mohamed H. Emara ◽  
Mahmoud Elkadeem ◽  
Sherief Abd-Elsalam
Keyword(s):  
Health Care ◽  
Medical Care ◽  
21St Century ◽  
Liver Diseases ◽  
Health Care Systems ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
The World ◽  
Care Systems ◽  
The Impact

: In the late 2019, coronavirus-2 (SARS-COV 2) infection emerged in Wuhan, China and spread to all countries making the first pandemic in 21st century. It seems that this infection will continue period which is long enough to obligate modifications in both life style and health care systems. Because chronic liver diseases (CLD) are prevalent all over the world, it is expected to manage patients with CLD and COVID-19. The aim of this review was to shade the light on the impact of COVID-19 pandemic on the management of patients with CLD and how to give medical care to CLD patients during COVID-19 pandemic.

scholarly journals An ordinary life with chronic condition as a goal for medicine

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M s Gaille ◽  
M s Camus
Keyword(s):  
Social Sciences ◽  
Health Care ◽  
Medical Care ◽  
Chronic Condition ◽  
Health Care Systems ◽  
Health Care Organisation ◽  
Research Perspective ◽  
Ordinary Life ◽  
Normal Life ◽  
Care Systems

Abstract Background Social sciences and humanities have developed a significant interest about chronic condition since the 1960, examining the “biographical disruptions” it seems to entail and the coping capacities of individuals. The present study, funded by IreSP, aims at developing a new conceptual and normative perspective: to explore the idea of “normal” life with chronic condition. This perspective allows for taking into account the expression of the wish for a “normal life” actually expressed by persons with chronic condition. On the basis of this research perspective, the present study aims at assessing the possibility to live such a life with chronic condition as a goal for the health care systems. As it may have substantial implications in terms of health care organisation and orientation, this research is important to ground public health policies. Methods 1.Review of literature (philosophy of the forms of life and of ordinary life, social sciences’ critical assessment of the “injunction to normality”, ethnographic works on the expression of the whish for a normal life) 2.Analysis of the theoretical and ethical resources of the philosophical works by G. Canguilhem and K. Goldstein Results -Elaboration of a philosophical conceptual and normative frame based on the notion of “ordinary life” and of a “reinvented normality” -Attention paid to the “milieu” of life of the person and its adjustment to her capacities. -Identification of the technological tools and care practices contributing to such a reinvention. Conclusions The study presents the conceptual and normative results of a philosophical analysis careful of the challenge raised by the wish for a “normal life” expressed by people with chronic condition. It proposes some conceptual and normative tools to answer this challenge. It formulates this challenge as an issue for the health care systems and the organisation of medical care, its places (institutions of various types and/or home) and its goals. Key messages The wish for a “normal life”, “a life like everyone’s life expressed by persons with chronic condition should by taken into account by the health care system. Philosophy offers some conceptual and normative tools to medical care to answer this wish.

scholarly journals Humanism influencing the organization of the health care system and the ethics of medical relations in the society of Bosnia-Herzegovina

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Ante Kvesić ◽  
Kristina Galić ◽  
Mladenka Vukojević
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care System ◽  
Communication Systems ◽  
Health Care Systems ◽  
Organizational Models ◽  
Medical Care System ◽  
Care Systems ◽  
Political Economic ◽  
Care System

Abstract Every successful health care system should be based on some general humanistic ideals. However, the nationally organized health care systems of most European countries usually suffer from a deficiency in common ethical values based on universal human principles. When transitional societies, such as that of Bosnia-Herzegovina are concerned, health care organizational models are even more dysfunctional. The sources of a dysfunction in medical care system of Bosnia-Herzegovina are manifold and mutually controversial, including a lack of shared principles, an inappropriate involvement of politicians in medical care and practice, administrative difficulties arising from superficial communication systems, as well as economic limits concerned with the financing of health care. The deficiency of a moral culture of medicine, which is correlated to a general collapse of morality is also responsible for many problems affecting various aspects of life including medical care. Hence, medical ethics from a virtue perspective is becoming an important ingredient of any improvement deigned to provide better-quality medical care. The aim of this paper is to underline the influence of humanism on the organization of health care systems and the ethics of medical interrelations in the society of Bosnia-Herzegovina. It is not intended to diagnose or resolve the problems, but to analyze them. It is also a critique of specific socio-political-economic influences on this health care system, inquiring if well-educated individuals in the virtues, which are involved in medical practice and education, would counteract them. In conclusion, humanism creates a universal ethical structure, which is based on human values such as fidelity, trust, benevolence, intellectual honesty, courage, compassion and truthfulness. These values should represent the standard around which medical care is organized. Since the health care system in Bosnia-Herzegovina is not entirely founded upon humanistic ideals, addressing the socio-political-economic conditions that constantly undermine those values is a prerequisite for any much-needed improvements of the medical care.

Economic Class and Differential Access to Care: Comparisons among Health Care Systems

1975 ◽  
Vol 5 (3) ◽  
pp. 373-395 ◽  
Author(s):  
David S. Salkever
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Population Group ◽  
System Structure ◽  
Economic Class ◽  
Care Systems ◽  
Access To Medical Care ◽  
Care System

This paper presents a new technique for describing inequality of access to medical care. Access is described by the empirical relationship between need and the probability of entering the health care system for treatment. The need-entry probability relationship for one population group is compared with that for another population group to determine the extent of access differentials (differences in entry probabilities) at varying levels of need. As an illustrative application, the technique is employed to describe access differentials by economic class in six different geographic areas located in five different countries (Canada, England, Finland, Poland, United States) with differently structured health care systems. Although the findings for adults varied considerably from area to area, the access differentials among children were surprisingly consistent and unrelated to health care system structure. In particular, it appears that higher family income is associated with greater access to medical care among children at all levels of need. The paper concludes with suggestions for further applications of the proposed technique to problems of monitoring and evaluating the effectiveness of policies aimed at reducing the extent of access inequality.

The Mortality Crisis

2021 ◽  
pp. 74-85
Author(s):  
Kristen Ghodsee ◽  
Mitchell A. Orenstein
Keyword(s):  
Cardiovascular Disease ◽  
Health Care ◽  
Alcohol Consumption ◽  
Life Expectancy ◽  
Health Outcomes ◽  
Health Care Systems ◽  
Mortality Rates ◽  
Alcohol Dependency ◽  
Root Cause ◽  
Care Systems

Chapter 6 considers the roots of the mortality crisis that many postsocialist countries faced in the 1990s and the declining life expectancies that some countries continue to face, while others have increased dramatically. It shows how privatization dismantled socialist health care systems leading to significant deteriorations in health outcomes in some countries and how the privatization of previously state-run breweries and distilleries and deregulation of sales led to increased alcohol consumption. The chapter also evaluates rampant alcohol dependency and abuse as a significant factor in declining life expectancy and increasing mortality rates, and points to the psychosocial stress of transition as a major root cause for alcoholism, cardiovascular disease, and suicide.

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