scholarly journals Self-Collected Gargle Lavage Allows Reliable Detection of SARS-CoV-2 in an Outpatient Setting

2021 ◽  
Author(s):  
Johannes Zander ◽  
Stephan Scholtes ◽  
Maximilian Ottinger ◽  
Marcel Kremer ◽  
Azadeh Kharazi ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Health Care ◽  
Health Care Systems ◽  
Outpatient Setting ◽  
Health Care Personnel ◽  
Reliable Detection ◽  
Care Systems ◽  
Outpatient Settings

The SARS-CoV-2 pandemic still strains health care systems worldwide. While COVID-19 testing is considered an essential pillar in combating this infectious disease, shortages in supplies and trained health care personnel often limit the procurement of patient samples, in particular in outpatient settings.

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 Outpatient Stereotactic Brain Biopsies

2021 ◽  
Author(s):  
Bertrand MATHON ◽  
Pauline MARIJON ◽  
Maximilien RICHE ◽  
Vincent DEGOS ◽  
Alexandre CARPENTIER
Keyword(s):  
Health Care ◽  
Medical Center ◽  
Health Care Systems ◽  
Cost Savings ◽  
Brain Biopsy ◽  
Outpatient Setting ◽  
Stereotactic Brain Biopsy ◽  
Same Day Discharge ◽  
Care Systems ◽  
Few Data

Abstract BackgroundOutpatient neurosurgery is rising popularity leading to patients’ satisfaction and cost-savings. Although several North-American teams have shown the safety of outpatient stereotactic brain biopsies, few data from other countries with different health care systems are available. ObjectiveWe therefore conducted a feasibility and safety study on the outpatient stereotactic brain biopsies. MethodsWe prospectively examined all the consecutive stereotactic brain biopsies performed in an outpatient setting at our tertiary medical center, between June 2018 and September 2020.ResultsAmong the 437 patients who underwent stereotactic brain biopsy during the study period, 40 (9.2%) patients were enrolled for an outpatient management. The sex ratio was 1 and the median age on biopsy day was 55 [41-66] years. The median distance from patients’ home to hospital was 17 kms [3-47]. 95% of patients had prebiopsy ASA score of 1 or 2 and mRs equal to 2 or less. The rate of same-day discharge was 100%. No patient experienced post-biopsy symptomatic complication necessitating readmission within the month following the biopsy. One patient (2.5%) resorted to an unplanned consultation. Histological findings obtained from brain biopsy led to a diagnosis in all patients; the most frequently found were neoplastic lesions (77.5%)ConclusionStereotactic brain biopsies can therefore be safely achieved on an outpatient setting in carefully selected patients. This process could be more widely adopted in other neurosurgical centers, without affecting the quality of patient’s health care and safety. In this article, we propose management guidelines and pre-biopsy checklist for performing ambulatory stereotactic brain biopsies.

Continuity Across Inpatient and Outpatient Mental Health Care or Specialisation of Teams? A Systematic Review

2015 ◽  
Vol 30 (2) ◽  
pp. 258-270 ◽  
Author(s):  
S. Omer ◽  
S. Priebe ◽  
D. Giacco
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Continuity Of Care ◽  
Health Care Systems ◽  
Cost Effective ◽  
Evidence Base ◽  
Outpatient Mental Health ◽  
Care Systems ◽  
Outpatient Settings

AbstractBackground:A central question for the organisation of mental health care is whether the same clinicians should be responsible for a patient's care across inpatient and outpatient settings (continuity of care) or if there should be separate teams (specialisation). Current reforms in Europe are inconsistent on which to favour, and are based on little research evidence. This review is the first systematic appraisal of the existing evidence comparing continuity of care and specialisation across inpatient and outpatient mental health care.Method:A systematic search for studies of any design comparing mental health care systems based on continuity or specialisation of care was performed. Differences in clinical, social and cost-effective outcomes, and the views and experiences of patients and staff were assessed using narrative synthesis.Results:Seventeen studies met the inclusion criteria. All studies had methodological shortcomings, but findings point towards reduced length and number of hospitalisations, and faster or more flexible transitions between services in continuity systems. Survey and qualitative findings suggest advantages of both systems, whilst patients and staff appear to prefer a continuity system.Conclusion:The evidence base suggests better outcomes and stakeholder preferences for continuity of care systems, but the quality of existing studies is insufficient to draw definitive conclusions. Higher quality comparative studies across various settings and population groups are urgently needed.

160: Cost-Effectiveness of Medical Management Strategies of Nephrolithiasis in Different Health Care Systems

2004 ◽  
Vol 171 (4S) ◽  
pp. 42-43 ◽  
Author(s):  
Yair Latan ◽  
David M. Wilhelm ◽  
David A. Duchene ◽  
Margaret S. Pearle
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Medical Management ◽  
Health Care Systems ◽  
Management Strategies ◽  
Care Systems

Barriers versus promotion: Culturally sensitive healthcare for elderly Turkish migrants in Austria and Germany

2014 ◽  
Vol 1 (1) ◽  
pp. 41-46
Author(s):  
Nevin Altıntop
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Elderly Care ◽  
Field Research ◽  
Diversity Management ◽  
Culturally Sensitive ◽  
Turkish Migrants ◽  
Care Givers ◽  
Individual Care ◽  
Care Systems

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.

Modernization, Globalization, Trends, and Convergence in Health Expenditure in Latin America and the Caribbean

2015 ◽  
Vol 1 (2) ◽  
pp. 321-346 ◽  
Author(s):  
Shiri Noy ◽  
Patricia A. McManus
Keyword(s):  
Health Care ◽  
Latin America ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Health Spending ◽  
Modernization Theory ◽  
The Public ◽  
National Differences ◽  
Care Systems ◽  
Public Private Mix

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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