Modeling Public Health and Healthcare Systems

2017 ◽  
Author(s):  
Sanjay Basu
Keyword(s):  
Public Health ◽  
Operations Research ◽  
Queuing Theory ◽  
Control Strategies ◽  
Waiting Times ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Systems Science ◽  
Screening Programs ◽  
Modeling Techniques

This book aims to empower readers to learn and apply engineering, operations research, and modeling techniques to improve public health programs and healthcare systems. Readers will engage in in-depth study of disease detection and control strategies from a “systems science” perspective, which involves the use of common engineering, operations research, and mathematical modeling techniques such as optimization, queuing theory, Markov and Kermack-McKendrick models, and microsimulation. Chapters focus on applying these techniques to classical public health dilemmas such as how to optimize screening programs, reduce waiting times for healthcare services, solve resource allocation problems, and compare macroscale disease control strategies that cannot be easily evaluated through standard public health methods such as randomized trials or cohort studies. The book is organized around solving real-world problems, typically derived from actual experiences by staff at nongovernmental organizations, departments of public health, and international health agencies. In addition to teaching the theory behind modeling methods, the book aims to confer practical skills to readers through practice in model implementation using the statistical software R.

Waiting Lines and Waiting Times

2017 ◽  
Author(s):  
Sanjay Basu
Keyword(s):  
Public Health ◽  
Operations Research ◽  
Healthcare Service ◽  
Research Method ◽  
Waiting Times ◽  
Drug Rehabilitation ◽  
Queuing Systems ◽  
Systems Of Equations ◽  
Strategic Decisions ◽  
Line P

This chapter seeks to determine if can we reduce the time it takes to deliver a public health or healthcare service, such as the long waiting times in emergency departments, long waiting lists for under-supported services such as drug rehabilitation, and vast periods of uncertainty for scarce commodities such as organ transplants. How can we minimize the time it takes to provide people with the services they need? Embedded in this question is the problem of making strategic decisions about distributing our resources. Should we invest in that new resource, or is our money better spent on something else? In this chapter, the reader will solve such problems using a common operations research method known as queuing systems, which are systems of equations that enable us to determine what factors influence the time that people wait in line.

INNOVATIVE MEDICINES INITIATIVE: THE SPRINTT PROJECT

2015 ◽  
pp. 1-2
Author(s):  
E. MARZETTI ◽  
R. CALVANI ◽  
F. LANDI1 ◽  
E. HOOGENDIJK ◽  
B. FOUGÈRE ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
European Population ◽  
Acute Illness ◽  
Geriatric Syndrome ◽  
Medical Needs ◽  
Significant Public Health ◽  
Chronic Disorders ◽  
Traditional Paradigm

The current healthcare systems are built around the traditional paradigm of patients suffering from a single acute illness. They are therefore largely unprepared to face the increasing demands for health services arising from the expansion of an older population with specific medical needs related to multiple chronic disorders. As a consequence, the medical conditions of a large and growing segment of the older European population are not efficiently managed by the available healthcare services (1). Among these conditions, the geriatric syndrome of frailty has emerged as a significant public health priority. It is defined as a multidimensional condition characterised by decreased reserve and diminished resistance to stressors (2).

scholarly journals Integrated Healthcare and the Dilemma of Public Health Emergencies

2021 ◽  
Vol 13 (8) ◽  
pp. 4517
Author(s):  
Krzysztof Goniewicz ◽  
Eric Carlström ◽  
Attila J. Hertelendy ◽  
Frederick M. Burkle ◽  
Mariusz Goniewicz ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Care ◽  
Chronically Ill ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Direct Patient Care ◽  
Global Public Health ◽  
Integrated Healthcare ◽  
Public Health Emergencies ◽  
The Individual

Traditional healthcare services have demonstrated structural shortcomings in the delivery of patient care and enforced numerous elements of integration in the delivery of healthcare services. Integrated healthcare aims at providing all healthcare that makes humans healthy. However, with mainly chronically ill people and seniors, typically suffering from numerous comorbidities and diseases, being recruited for care, there is a need for a change in the healthcare service structure beyond direct-patient care to be compatible in peacetime and during public health emergencies. This article’s objective is to discuss the opportunities and obstacles for increasing the effectiveness of healthcare through improved integration. A rapid evidence review approach was used by performing a systematic followed by a non-systematic literature review and content analysis. The results confirmed that integrated healthcare systems play an increasingly important role in healthcare system reforms undertaken in European Union countries. The essence of these changes is the transition from the episodic treatment of acute diseases to the provision of coordinated medical services, focused on chronic cases, prevention, and ensuring patient continuity. However, integrated healthcare, at a level not yet fully defined, will be necessary if we are to both define and attain the integrated practice of both global health and global public health emergencies. This paper attains the necessary global challenges to integrate healthcare effectively at every level of society. There is a need for more knowledge to effectively develop, support, and disseminate initiatives related to coordinated healthcare in the individual healthcare systems.

Corrupt Practices in the Public Health Sector: A Focus on Metropolitan Local Government Areas of Kano State, Nigeria

2020 ◽  
Vol 18 (2) ◽  
pp. 149
Author(s):  
Mohammed Mustapha Namadi
Keyword(s):  
Public Health ◽  
Local Government ◽  
Health Sector ◽  
Sampling Technique ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Healthcare Provision ◽  
The Public ◽  
Public Health Sector ◽  
The Government

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.

Funding models and expenditures with primary healthcare in Salvador, Bahia, Brazil metropolitan area

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Vivas ◽  
M Duarte ◽  
A Pitta ◽  
B Christovam
Keyword(s):  
Public Health ◽  
Metropolitan Area ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Ministry Of Health ◽  
Healthcare Budget ◽  
Health Budget ◽  
The Public ◽  
Before And After ◽  
The Government

Abstract Background The government investments in quality primary healthcare are the basis to strengthening the health systems and monitoring the public expenditure in this area is a way to assess the effectiveness and efficiency of the public health policies. The Brazil Ministry of Health changed, in 2017, the method of onlending federal resources to states and cities seeking to make the public funds management more flexible. This change, however, suppressed mandatory investments in primary healthcare. This research aims to determine the difference of expenditures on primary healthcare in Salvador, Bahia, Brazil metropolitan area before and after this funding reform, seeking to verify how it can impact the quality of primary healthcare services and programs. Methods This is an ecological time-series study that used data obtained in the Brazil Ministry of Health budget reports. The median and interquartile range of expenditures on primary healthcare (set as the percentage of total public health budget applied in primary care services and programs) of the 13 cities in the Salvador metropolitan area were compared two years before and after the reform. Results The median of expenditures on primary healthcare in Salvador metropolitan area was 25.5% (13,9% - 32,2%) of total public health budget before and 24.8% (20.8% - 30.0%) of total public health budget after the reform (-0.7% difference). Seven cities decreased the expenditures on primary healthcare after the reform, ranging from 1.2% to 10.8% reduction in the primary healthcare budget in five years. Conclusions Expenditures on primary healthcare in Salvador metropolitan area decreased after the 2017 funding reform. Seven of 13 cities reduced the government investments on primary healthcare services and programs in this scenario. Although the overall difference was -0.7%, the budget cuts ranged from 1.2% to 10.8% in the analyzed period and sample. More studies should assess these events in wide areas and with long time ranges. Key messages Public health funding models can impact the primary healthcare settings regardless of the health policy. Reforms in the funding models should consider the possible benefits before implementation. Funding models and methods that require mandatory investments in primary healthcare may be considered over more flexible ones.

scholarly journals A public health perspective on mental health: lessons for population health in the 21st century

2021 ◽  
pp. 1-4
Author(s):  
James V. Lucey
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Population Health ◽  
Royal College ◽  
Public Support ◽  
Healthcare Systems ◽  
Lessons Learned ◽  
Public Health Perspective ◽  
The World ◽  
Shared Commitment

In December 2019, clinicians and academics from the disciplines of public health and psychiatry met in Dublin at the Royal College of Surgeons in Ireland (RCSI), to restate their shared commitment to population health. The purpose of this review is to bring our discussion to a wider audience. The meeting could not have been more timely. Six weeks later, the COVID-19 emergency emerged in China and within 12 months it had swept the world. This paper, the contents of which were presented at that meeting in December recommended that future healthcare would be guided more by public health perspectives and informed by an understanding of health economics, population health and the lessons learned by psychiatry in the 20th century. Ultimately two issues are at stake in 21st century healthcare: the sustainability of our healthcare systems and the maintenance of public support for population health. We must plan for the next generation of healthcare. We need to do this now since it is clear that COVID-19 marks the beginning of 21st century medicine.

scholarly journals Diabetic Retinopathy Screening and Registration in Europe—Narrative Review

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 745
Author(s):  
Elitsa Hristova ◽  
Darina Koseva ◽  
Zornitsa Zlatarova ◽  
Klara Dokova
Keyword(s):  
Diabetic Retinopathy ◽  
Healthcare Services ◽  
The European Union ◽  
Specialist Care ◽  
Screening Programs ◽  
Diabetic Retinopathy Screening ◽  
Remote Assessment ◽  
Narrative Literature ◽  
Narrative Literature Review ◽  
Almost All

Diabetic retinopathy (DR) is a leading cause of preventable vision impairment and blindness in the European Region. Despite the fact that almost all European countries have some kind of prophylactic eye examination for people with diabetes, the examinations are not properly arranged and are not organized according to the principles of screening in medicine. In 2021, the current COVID-19 pandemic moved telemedicine to the forefront healthcare services. Due to that, a lot more patients could benefit from comfortable and faster access to ophthalmology specialist care. This study aimed to conduct a narrative literature review on current DR screening programs and registries in the European Union for the last 20 years. With the implementation of telemedicine in daily medical practice, performing screening programs became much more attainable. Remote assessment of retinal pictures simultaneously saves countries time, money, and other resources.

PP58 The Alliance Between Health Technology Assessment And Public Health In National Screening Policies

2019 ◽  
Vol 35 (S1) ◽  
pp. 48-48
Author(s):  
Leonor Varela-Lema ◽  
Janet Puñal-Riobóo ◽  
Paula Cantero-Muñoz ◽  
Maria José Faraldo-Vallés
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Newborn Screening ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
National Health System ◽  
Health Technology ◽  
Screening Tests ◽  
Special Focus ◽  
Screening Programs

IntroductionDecision making regarding national population-based prenatal and newborn screening policies is recognized to be highly challenging. This paper aims to describe the formalized collaboration that has been established between the Spanish National Public Health Screening Advisory Committee (PHSAC) and the Spanish Network of Health Technology Assessment (HTA) agencies to support the development of evidence- and consensus-based recommendations to support this process.MethodsIn-depth description and analysis of the strategic and methodological processes that have been implemented within the Spanish National Health System prenatal and newborn screening frameworks, with special emphasis on the role, actions, and responsibilities of HTA agencies.ResultsThe role of HTA agencies is threefold: (i) support the PHSAC by providing evidence on safety, effectiveness and cost/effectiveness of the screening tests/strategies, as well as contextualized information regarding costs, organizational, social, legal and ethical issues; (ii) collaborate with the PHSAC in the development of formal evidence- and consensus-based recommendations for defining population screening programs, when required; (iii) analyze real-world data that is generated by piloted programs. This paper will provide real-life examples of how these processes were implemented in practice, with a special focus on the development of the non-invasive prenatal testing (NIPT) policy. Recommendations for NIPT were developed by a multidisciplinary group based on the European network for Health Technology Assessment (EUnetHTA) rapid assessment report and the predictive models that were built using national statistics and other contextualized data.ConclusionsThe current work represents an innovative approach for prenatal and newborn screening policymaking, which are commonly difficult to evaluate due to the low quality of evidence and the confounding public health issues. The paper raises awareness regarding the importance of joint collaborations in areas where evidence is commonly insufficient for decision making.

scholarly journals Use of symptom checkers for COVID-19-related symptoms among university students: a qualitative study

2021 ◽  
pp. bmjinnov-2020-000498
Author(s):  
Stephanie Aboueid ◽  
Samantha B Meyer ◽  
James R Wallace ◽  
Shreya Mahajan ◽  
Teeyaa Nur ◽  
...  
Keyword(s):  
Young Adults ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Qualitative Interviews ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Positive Experience ◽  
Perceived Credibility ◽  
Inductive Thematic Analysis

ObjectiveSymptom checkers are potentially beneficial tools during pandemics. To increase the use of the platform, perspectives of end users must be gathered. Our objectives were to understand the perspectives and experiences of young adults related to the use of symptom checkers for assessing COVID-19-related symptoms and to identify areas for improvement.MethodsWe conducted semistructured qualitative interviews with 22 young adults (18–34 years of age) at a university in Ontario, Canada. Interviews were audio-recorded, transcribed, and analysed using inductive thematic analysis.ResultsWe identified six main themes related to the decision of using a symptom checker for COVID-19 symptoms: (1) presence of symptoms or a combination of symptoms, (2) knowledge about COVID-19 symptoms, (3) fear of seeking in-person healthcare services, (4) awareness about symptom checkers, (5) paranoia and (6) curiosity. Participants who used symptom checkers shared by governmental entities reported an overall positive experience. Individuals who used non-credible sources reported suboptimal experiences due to lack of perceived credibility. Five main areas for improvement were identified: (1) information about the creators of the platform, (2) explanation of symptoms, (3) personalised experience, (4) language options, and (5) option to get tested.ConclusionsThis study suggests an increased acceptance of symptom checkers due to the perceived risks of infection associated with seeking in-person healthcare services. Symptom checkers have the potential to reduce the burden on healthcare systems and health professionals, especially during pandemics; however, these platforms could be improved to increase use.

From epidemiology to public health decision making: analysis on IMD & vaccination strategy in Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Igidbashian ◽  
F Caracci ◽  
P Bonanni ◽  
P Castiglia ◽  
M Conversano ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Adult Population ◽  
Vaccination Strategy ◽  
Healthcare Services ◽  
Steady Increase ◽  
Vaccine Preventable Disease ◽  
Preventable Disease ◽  
Italian Regions ◽  
Age Range

Abstract Introduction Invasive Meningococcal Disease (IMD) is one of the most severe vaccine-preventable disease, with high fatality rate and severe sequelae in up to 20% of survivors. MenB, MenC and MenACWY vaccines are available in Italy, but recommendations vary among Italian regions in terms of type of vaccines and targeted age groups. The aim of the study is to describe epidemiology of IMDs in order to provide the best vaccination strategy. Methods IMDs surveillance data in the period 2011-2017 from the Italian National Health Institute were explored. Excel was used to present trend analysis, stratifying by age and serogroups. Results In Italy, during the period 2011-2017, IMDs overall incidence increased from 0.25 cases/100,000 inhabitants in 2011 to 0.33 in 2017. Most cases after 2013 were caused by non-B serogroups (52%, 52%, 66%, 64%, 59% from 2013 to 2017). Although incidence is highest in 1 years old children, the number of cases is highest in the age range 25-64. The number of cases in this age-range had a steady increase after 2013 (36 cases in 2011, 79 in 2017), with serogroups C, W and Y present in more than 65% of cases in 25+ age ranges after 2012. Conclusions IMD is a rare but severe vaccine-preventable disease. The key role of public health is to monitor disease serogroups, trends and outbreaks and strengthen methodological evidence-based tools for decision-making processes, public health policies, planning of healthcare services and intervention measures, including immunization. The increase in incidence shown in the period 2011-2017 in Italy, although probably due to better surveillance, highlighted the high circulation also of non-B serogroups and the importance of the disease in the adult population. Based on our analysis we believe that anti-meningococcal vaccination plan in Italy should include the highest number of preventable serogroups and be aimed to the whole population through a multicohort strategy, including boosters in children and in adults. Key messages Anti-meningococcal vaccination plan in Italy should include all the preventable serogroups and be aimed to the whole population with a multicohort strategy including boosters in children and in adults. The increase in incidence of IMD in the period 2011-2017 in Italy highlighted the high circulation also of non-B serogroups and the importance of the disease in the adult population.

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