scholarly journals The Challenges Confronting Public Hospitals in India, Their Origins, and Possible Solutions

2014 ◽  
Vol 2014 ◽  
pp. 1-27 ◽  
Author(s):  
Vikas Bajpai
Keyword(s):  
Public Health ◽  
Social Economic ◽  
Public Health System ◽  
Public Hospitals ◽  
Universal Health Care ◽  
The Public ◽  
The Social ◽  
Development Paradigm ◽  
Universal Health ◽  
Class Nature

Despite the implementation of National Rural Health Mission over a period of nine years since 2005, the public health system in the country continues to face formidable challenges. In the context of plans for rolling out “Universal Health Care” in the country, this paper analyzes the social, economic, and political origins of the major challenges facing public hospitals in India. The view taken therein holds the class nature of the ruling classes in the country and the development paradigm pursued by them as being at the root of the present problems being faced by public hospitals. The suggested solutions are in tune with these realities.

scholarly journals Path taken by morbidly obese people in search of bariatric surgery in the public health system

2020 ◽  
Vol 28 ◽  
Author(s):  
Claudete Aparecida Conz ◽  
Maria Cristina Pinto de Jesus ◽  
Estela Kortchmar ◽  
Vanessa Augusta Souza Braga ◽  
Renata Evangelista Tavares Machado ◽  
...  
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health System ◽  
Professional Training ◽  
Social Inequalities ◽  
Public Health System ◽  
Morbidly Obese ◽  
Obese People ◽  
The Public ◽  
The Social

Objective: to understand the path taken in the public health system by people with morbid obesity in the search for bariatric surgery. Method: qualitative research based on the social phenomenology of Alfred Schütz, with 17 hospitalized morbidly obese people, with a scheduled date for bariatric surgery. The phenomenological interview with open questions was used and the statements were analyzed in the light of the theoretical-methodological framework and literature related to the theme. Results: the participants were able to schedule bariatric surgery by referring friends, family and public people. The waiting list for the procedure generated anguish and anxiety due to fear of surgery, weight gain, risk of worsening health and physical limitations, but it helped prepare for its performance. The experience lived in the search for bariatric surgery led these people to want continuity of care in the Basic Health Unit, after the surgery, by professionals trained to meet their needs. Conclusion: the aspects inscribed in the path of people in search of bariatric surgery signal the need to strengthen the assistance-related flows of the public health system and to invest in professional training to reduce the social inequalities in access to bariatric surgery and increased quality of services.

Fostering healthcare innovation in public hospitals: the Queensland experience

2019 ◽  
Vol 43 (6) ◽  
pp. 672
Author(s):  
Linda Mundy ◽  
Sarah Howard ◽  
Liam McQueen ◽  
Jacqui Thomson ◽  
Kaye Hewson
Keyword(s):  
Public Health ◽  
Clinical Practice ◽  
Health System ◽  
Real World ◽  
Public Health System ◽  
Public Hospitals ◽  
Policy Makers ◽  
The Public ◽  
Health Technologies ◽  
Healthcare Technologies

Faced with scarce resources and a demand for health care that exceeds supply, health policy makers at all levels of government need to adopt some form of rationing when deciding which health services should be funded in the public health system. With a relatively small investment, programs such as Queensland Health’s New Technology Funding Evaluation Program (NTFEP) fosters innovation by providing funding and pilot studies for new and innovative healthcare technologies. The NTFEP assists policy makers to make informed decisions regarding investments in new safe and effective technologies based on available evidence gathered from real-world settings relevant to Queensland patients and clinicians. In addition, the NTFEP allows appropriate patient access, especially in rural and remote locations, to potentially beneficial technologies and acts a gatekeeper, protecting them from technologies that may be detrimental or harmful. What is known about the topic? Jurisdictions have struggled to identify ways to manage the introduction of new and innovative health technologies into clinical practice. The 2009 review of health technology in Australia recommended better assessment and appraisal by ensuring real-life practices in hospitals and community settings were considered, with a consumer and patient focus. What does this paper add? Queensland Health’s NTFEP provides a robust and transparent mechanism to manage the introduction of innovative healthcare technologies into clinical practice, providing an opportunity to collect real-world data outside of formal clinical trials. These data can not only be used to inform clinical, but also purchasing, decision-making within the public health system. This model of investment and innovation has the potential to be implemented in other jurisdictions and provide opportunities to share learnings. What are the implications for practitioners? Programs such as the NTFEP provide reassurance to practitioners and patients alike that innovative healthcare technologies are adopted in public hospitals using an evidence-based approach after demonstrating that they are not only safe and clinically effective, but represent value for money and improved patient outcomes in a public health system.

scholarly journals Outcomes of COVID-19 Admissions in the New York City Public Health System and Variations by Hospitals and Boroughs During the Initial Pandemic Response

2021 ◽  
Vol 9 ◽  
Author(s):  
Anant Dinesh ◽  
Taha Mallick ◽  
Tatiana M. Arreglado ◽  
Brian L. Altonen ◽  
Ryan Engdahl
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
Health System ◽  
York City ◽  
Public Health System ◽  
Public Hospitals ◽  
Mortality Trends ◽  
The Public ◽  
Pandemic Response

Introduction: In the initial pandemic regional differences may have existed in COVID-19 hospitalizations and patient outcomes in New York City. Whether these patterns were present in public hospitals is unknown. The aim of this brief study was to investigate COVID-19 hospitalizations and outcomes in the public health system during the initial pandemic response.Methods: A retrospective review was conducted on COVID-19 admissions in New York City public hospitals during the exponential phase of the pandemic. All data were collected from an integrated electronic medical records system (Epic Health Systems, Verona, WI). Overall, 5,422 patients with at least one admission each for COVID-19 were reviewed, with a study of demographic characteristics (including age, gender, race, BMI), pregnancy status, comorbidities, facility activity, and outcomes. Data related to hospitalization and mortality trends were also collected from City of New York website. These data often involved more than one facility and/or service line resulting in more location or treatment facility counts than patients due to utilization of services at more than one location and transfers between locations and facilities.Results: Higher mortality was associated with increasing age with the highest death rate (51.9%) noted in the age group >75 years (OR 7.88, 95%CI 6.32–10.08). Comorbidities with higher mortality included diabetes (OR 1.5, 95% CI 1.33–1.70), hypertension (OR 1.62, 95% CI 1.44–1.83), cardiovascular conditions (OR 1.66, 95% CI 1.47–1.87), COPD (OR 1.86, 95% CI 1.39–2.50). It was deduced that 20% of all New York City COVID-19 positive admissions were in public health system during this timeframe. A high proportion of admissions (21.26%) and deaths (19.93%) were at Elmhurst Hospital in Queens. Bellevue and Metropolitan Hospitals had the lowest number of deaths, both in borough of Manhattan. Mortality in public hospitals in Brooklyn was 29.9%, Queens 28.1%, Manhattan 20.4%.Conclusion: Significant variations existed in COVID-19 hospitalizations and outcomes in the public health system in New York City during the initial pandemic. Although outcomes are worse with older age and those with comorbidities, variations in hospitals and boroughs outside of Manhattan are targets to investigate and strategize efforts.

scholarly journals Can Cost-effective Reallocation of Inputs Increase the Efficiency of the Public Health System in Pakistan?

1997 ◽  
Vol 36 (4II) ◽  
pp. 669-693
Author(s):  
M. Aynulhasan ◽  
Hafiz A. Pasha ◽  
Ajazm M. Rasheed
Keyword(s):  
Public Health ◽  
Health System ◽  
Urban Areas ◽  
Public Health System ◽  
Cost Effective ◽  
Critical Issue ◽  
Public Health Department ◽  
Social Sector ◽  
The Public ◽  
The Social

Heavy investment in many developing countries in the social sector including health is based on the premise that human capital is vital to the growth and development of a nation. However, Pakistan's spending on this sector has been one of the lowest in the region. In the present environment of high budget deficits, one does not expect substantial public funds to be forthcoming and diverted towards the social sector in the intermediate- or medium-term future. The critical issue facing the public sector should then be to design health policies which must be cost-effective and efficient. This study examines these health policy issues within the context of an optimisation framework for public health system, forecasts future upto (2002-03) and discusses an efficient optimal mix of health inputs, outputs, expenditures, and wage policies under alternative scenarios. The study recommends that, first, growth of health infrastructure building in the urban areas be slowed down in the short-term (two to three years), and some of the resources reallocated towards the rural sector either in terms of building new Basic Health Units or upgrading the existing Rural Health Centres. Second, not only attractive wage policies be formulated for health personnel, but the status of nurses in the public health system be also elevated by giving them higher grades. Third, for every rupee of development expenditure incurred, Public Health Department must plan or keep provisions for recurring outlays. All this reallocation of resources is feasible within the projected actual budget and it will lead to efficiency gains in the order of 8 to 10 percent for the entire public health system.

scholarly journals NGOs, austerity, and universal health coverage in Mozambique

2019 ◽  
Vol 15 (S1) ◽  
Author(s):  
James Pfeiffer ◽  
Rachel R. Chapman
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Universal Health Coverage ◽  
Public Health System ◽  
Health Coverage ◽  
Donor Funding ◽  
The Public ◽  
Public Sector Health ◽  
Universal Health

AbstractIn many African countries, hundreds of health-related NGOs are fed by a chaotic tangle of donor funding streams. The case of Mozambique illustrates how this NGO model impedes Universal Health Coverage. In the 1990s, NGOs multiplied across post-war Mozambique: the country’s structural adjustment program constrained public and foreign aid expenditures on the public health system, while donors favored private contractors and NGOs. In the 2000s, funding for HIV/AIDS and other vertical aid from many donors increased dramatically. In 2004, the United States introduced PEPFAR in Mozambique at nearly 500 million USD per year, roughly equivalent to the entire budget of the Ministry of Health. To be sure, PEPFAR funding has helped thousands access antiretroviral treatment, but over 90% of resources flow “off-budget” to NGO “implementing partners,” with little left for the public health system. After a decade of this major donor funding to NGOs, public sector health system coverage had barely changed. In 2014, the workforce/ population ratio was still among the five worst in the world at 71/10000; the health facility/per capita ratio worsened since 2009 to only 1 per 16,795. Achieving UHC will require rejection of austerity constraints on public sector health systems, and rechanneling of aid to public systems building rather than to NGOs.

Aufgabenwahrnehmung zwischen Partikularinteressen und Gemeinwohl: Steuerung des Gesundheitswesens durch die Selbstverwaltung

2019 ◽  
Vol 68 (6-7) ◽  
pp. 537-545
Author(s):  
Markus Hofmann ◽  
Robert Spiller
Keyword(s):  
Public Health ◽  
Health System ◽  
Social Insurance ◽  
Public Health System ◽  
Management Style ◽  
Social Self ◽  
Self Administration ◽  
The Public ◽  
The Social ◽  
Administrative Structures

Zusammenfassung Die Kompetenzen der Institution der Sozialen Selbstverwaltung in der Steuerung des öffentlichen deutschen Gesundheitssystems sind geprägt von der historisch und gesetzlich begründeten Legitimation der Sozialpartner, Verantwortung sowohl für eine am Versichertenbedarf auszurichtende Gesundheitsversorgung zu übernehmen als auch deren Wirksamkeit durch demokratische Partizipation und nachhaltige Finanzierung sicherzustellen. Verschiedene politische Initiativen haben in den vergangenen Jahren sukzessive dazu beigetragen, diese Bedeutung zugunsten einer strukturellen Professionalisierung zurückzudrängen, wodurch auch das Verständnis der ehrenamtlichen Ebene der sozialen Selbstverwaltung unter Druck gesetzt wurde. Dies geschah im Kontext einer am Primat des Wettbewerbs und der Wirtschaftlichkeitsorientierung ausgerichteten Gesundheitspolitik. Um die Solidargemeinschaft GKV gegen diese Tendenzen zu stärken, ist auch eine Stärkung des Solidaritätsprinzips und damit eine Stärkung des Systems der ehrenamtlichen sozialen Selbstverwaltung notwendig. Abstract The social self-administration asserts control over the German public health system according to both a broad historical and social legitimation and a legal consensus on the role and competences of the social partners. Policy readjustments led to a subsequent shift of power within these administrative structures towards a professional, economy-oriented management style in accordance with a new, broad health policy perception based on competition and market influence. Thus, it is necessary to strengthen both the principle of solidarity and the voluntary dimension of the social self-administration in order to realign the public health system with a focus on public interest, needs of the social insured and sustainability of the social insurance systems.

Impact of COVID-19 in India, a disastrous pandemic outbreak

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 399-402
Author(s):  
Shrushti Jachak ◽  
Pratik Phansopkar ◽  
Waqar Naqvi M
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Developing Countries ◽  
Social Economic ◽  
Public Health Emergency ◽  
Health Impacts ◽  
The Public ◽  
The Social ◽  
Entire World

Coronavirus disease in 2019, also called COVID-19, which has been widely spread worldwide had given rise to a pandemic situation. The public health emergency of international concern declares the agent as the (SARS-CoV-2) the severe acute respiratory syndrome coronavirus 2. The COVID-19 pandemic has an unusual way of stroking the entire world. Crises have spread rapidly, disease load and casualties are still on the rise, and crisis influence is spreading across developing countries. Around the globe, the reactions, perceptions, and outcomes were distinct. The outbreak has reflected unfavourable mental health impacts and symptoms. This pandemic has also affected the healthcare department that is treating the patients suffering from diseases other than corona. The power and severity of slowdown varying from being temporary to a long-term recession, they are unanimous about the fact that the slowdown would have an intense impact amongst various sectors of the economy. Most importantly, some panic among consumers and firms has disfigured standard patterns of consumption and caused market inconsistency. This article would give the overall idea of how the social, economic, cultural, and psychological aspects influenced by the pandemic.

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