AI in resource-poor health care systems

Science ◽  
2019 ◽  
Vol 366 (6468) ◽  
pp. 966.16-968
Author(s):  
Gemma Alderton
2019 ◽  
Vol 12 (2) ◽  
pp. 133-144 ◽  
Author(s):  
Ben Davies ◽  
Julian Savulescu

Abstract Some healthcare systems are said to be grounded in solidarity because healthcare is funded as a form of mutual support. This article argues that health care systems that are grounded in solidarity have the right to penalise some users who are responsible for their poor health. This derives from the fact that solidary systems involve both rights and obligations and, in some cases, those who avoidably incur health burdens violate obligations of solidarity. Penalties warranted include direct patient contribution to costs, and lower priority treatment, but not typically full exclusion from the healthcare system. We also note two important restrictions on this argument. First, failures of solidary obligations can only be assumed under conditions that are conducive to sufficiently autonomous choice, which occur when patients are given ‘Golden Opportunities’ to improve their health. Second, because poor health does not occur in a social vacuum, an insistence on solidarity as part of healthcare is legitimate only if all members of society are held to similar standards of solidarity. We cannot insist upon, and penalise failures of, solidarity only for those who are unwell, and who cannot afford to evade the terms of public health.


2017 ◽  
Author(s):  
Octavio Rivera-Romero ◽  
Alberto Olmo ◽  
Rocío Muñoz ◽  
Pablo Stiefel ◽  
María Luisa Miranda ◽  
...  

BACKGROUND Hypertensive disorders are the most common complications during pregnancy, occurring in 5% to 11% of pregnancies; gestational hypertension and preeclampsia are the leading causes of perinatal and maternal morbidity and mortality, especially in low- and middle-income countries (LMIC) where maternal and perinatal mortality ratios are still high. Pregnant women with hypertensive disorders could greatly benefit from mobile health (mHealth) solutions as a novel way to identify and control early symptoms, as shown in an increasing number of publications in the field. Such digital health solutions may overcome access limiting factors and the lack of skilled medical professionals and finances commonly presented in resource-poor environments. OBJECTIVE The aim of this study was to conduct a literature review of mHealth solutions used as support in hypertensive disorders during pregnancy, with the objective to identify the most relevant protocols and prototypes that could influence and improve current clinical practice. METHODS A methodological review following a scoping methodology was conducted. Manuscripts published in research journals reporting technical information of mHealth solutions for hypertensive disorders in pregnancy were included, categorizing articles in different groups: Diagnosis and Monitoring, mHealth Decision Support System, Education, and Health Promotion, and seven research questions were posed to study the manuscripts. RESULTS The search in electronic research databases yielded 327 articles. After removing duplicates, 230 articles were selected for screening. Finally, 11 articles met the inclusion criteria, and data were extracted from them. Very positive results in the improvement of maternal health and acceptability of solutions were found, although most of the studies involved a small number of participants, and none were complete clinical studies. Accordingly, none of the reported prototypes were integrated in the different health care systems. Only 4 studies used sensors for physiological measurements, and only 2 used blood pressure sensors despite the importance of this physiological parameter in the control of hypertension. The reported mHealth solutions have great potential to improve clinical practice in areas lacking skilled medical professionals or with a low health care budget, of special relevance in LMIC, although again, no extensive clinical validation has been carried out in these environments. CONCLUSIONS mHealth solutions hold enormous potential to support hypertensive disorders during pregnancy and improve current clinical practice. Although very positive results have been reported in terms of usability and the improvement of maternal health, rigorous complete clinical trials are still necessary to support integration in health care systems. There is a clear need for simple mHealth solutions specifically developed for resource-poor environments that meet the United Nations Sustainable Development Goal (SDG); of enormous interest in LMIC.


2004 ◽  
Vol 171 (4S) ◽  
pp. 42-43 ◽  
Author(s):  
Yair Latan ◽  
David M. Wilhelm ◽  
David A. Duchene ◽  
Margaret S. Pearle

2014 ◽  
Vol 1 (1) ◽  
pp. 41-46
Author(s):  
Nevin Altıntop

What is the perception of Turkish migrants in elderly care? The increasing number of elder migrants within the German and Austrian population is causing the challenge of including them in an adequate (culturally sensitive) way into the German/Austrian health care system. Here I introduce the perception of elder Turkish migrants within the predominant paradigm of intercultural opening of health care in Germany as well as within the concept of diversity management of health care in Vienna (Austria). The qualitative investigation follows a field research in different German and Austrian cities within the last four years and an analysis based on the Grounded Theory Methodology. The meaning of intercultural opening on the one hand, and diversity management on the other hand with respect to elderly care will be evaluated. Whereas the intercultural opening directly demands a reduction of barriers to access institutional elderly care the concept of diversity is hardly successful in the inclusion of migrants into elderly care assistance – concerning both, migrants as care-givers and migrants as care-receivers. Despite the similarities between the health care systems of Germany and Austria there are decisive differences in the perception and inclusion of migrants in elderly care that is largely based on an 'individual care' concept of the responsible institutions. Finally, this investigation demonstrates how elderly care in Germany and Austria prepares to encounter the demand of 'individual care' in a diverse society.


2015 ◽  
Vol 1 (2) ◽  
pp. 321-346 ◽  
Author(s):  
Shiri Noy ◽  
Patricia A. McManus

Are health care systems converging in developing nations? We use the case of health care financing in Latin America between 1995 and 2009 to assess the predictions of modernization theory, competing strands of globalization theory, and accounts of persistent cross-national differences. As predicted by modernization theory, we find convergence in overall health spending. The public share of health spending increased over this time period, with no convergence in the public-private mix. The findings indicate robust heterogeneity of national health care systems and suggest that globalization fosters human investment health policies rather than neoliberal, “race to the bottom” cutbacks in public health expenditures.


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