scholarly journals What can we learn from the SARS-COV-2 pandemic about the value of specific radiological examinations?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bjørn Hofmann ◽  
Eivind Richter Andersen ◽  
Elin Kjelle

Abstract Background The SARS-COV-2 pandemic provides a natural intervention to assess practical priority setting and internal evaluation of specific health services, such as radiological services. Norway makes an excellent case as it had a very low infection rate and very few cases of COVID-19. Accordingly, the objective of this study is to use the changes in performed outpatient radiological examinations during the first stages of the SARS-COV-2 pandemic to assess the practical evaluation of specific radiological examinations in Norway. Methods Data was collected retrospectively from the Norwegian Health Economics Administration (HELFO) in the years 2015–2020. Data included the number of performed outpatient imaging examinations at public hospitals and private imaging centers in Norway and was divided in to three periods based on the level of restrictions on elective health services. Results were analyzed with descriptive statistics. Results In the first period there was a 45% reduction in outpatient radiology compared to the same time period in 2015–2019 while in period 2 and 3 there was a 25 and 6% reduction respectively. The study identified a list of specific potential low-value radiological examinations. While some of these are covered by the Choosing Wisely campaign, others are not. Conclusion By studying the priority setting practice during the initial phases of the pandemic this study identifies a set of potential low value radiological examinations during the initial phases of the SARS-COV-2 pandemic. These examinations are candidates for closer assessments for health services quality improvement.

2021 ◽  
Vol 5 (1) ◽  
pp. e000862
Author(s):  
Irina Korotchikova ◽  
Sukainah Al Khalaf ◽  
Ewa Sheridan ◽  
Rory O'Brien ◽  
Colin P Bradley ◽  
...  

ObjectivesTo examine the characteristics of paediatric attendances to the emergency department (ED) in Cork University Hospital (CUH) before and after the expansion of free general practitioner (GP) care to children under the age of 6 years.DesignThis is a retrospective observational study that used a large administrative dataset.SettingThe study was conducted in major Irish tertiary referral centre that serves a total population of over 1.1 million. It is a public hospital, owned and managed by the health service executive.ParticipantsChildren aged 0–15 years who attended CUH ED during the study period of 6 years (2012–2018) were included in this study (n=76 831).InterventionsFree GP care was expanded to all children aged 0–5 years in July 2015.Main outcome measuresPaediatric attendances to CUH ED were examined before (Time Period 1: July 2012–June 2015) and after (Time Period 2: July 2015–June 2018) the expansion of free GP care to children under 6. Changes in GP referral rates and inpatient hospital admissions were investigated.ResultsPaediatric presentations to CUH ED increased from 35 819 during the Time Period 1 to 41 012 during the Time Period 2 (14.5%). The proportion of the CUH ED attendances through GP referrals by children under 6 increased by over 8% in the Time Period 2 (from 10 148 to 14 028). Although the number of all children who attended CUH ED and were admitted to hospital increased in Time Period 2 (from 8704 to 9320); the proportion of children in the 0–5 years group who attended the CUH ED through GP referral and were subsequently admitted to hospital, decreased by over 3%.ConclusionThe expansion of free GP care has upstream health service utilisation implications, such as increased attendances at ED, and should be considered and costed by policy-makers.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S17-S17
Author(s):  
Taylor Landay ◽  
Julie A Clennon ◽  
José A Ferreira ◽  
Lucia A Fraga ◽  
Maria Aparecida F Grossi ◽  
...  

Abstract Background Leprosy in children under 15 years of age, and in particular, the presence of leprosy grade 2 disability (G2D) in children, signifies ongoing transmission and the need for improved surveillance. Our objective was to describe the epidemiology of pediatric leprosy in Minas Gerais, Brazil and to explore associations with access to medical facilities. Methods A cross-sectional study was conducted using data from the Brazilian Notifiable Diseases Surveillance System (SINAN) from 2002–2017. Incident cases were included if they resided in a municipality with both adult and pediatric cases. Municipalities were divided by the number of medical facilities per municipality: < 5, 5–17, and 18 or higher. Analyses compared pediatric cases across two time periods (2002–2009 and 2010–2017) and number of medical facilities / municipality using chi-square, t-tests, and logistic regression. Results A total of 27,725 cases were reported with 1,611 under 15 years of age. Overall incidence declined from 34.8 per 100,000 to 13.6 per 100,000 during the study period with pediatric incidence declining from 2.6 per 100,000 to 0.8 per 100,000. Time period 2 (TP2) showed an increase in the proportion of pediatric G2D (2.58% vs 1.91%, p < 0.0001) when compared to time period 1 (TP1). Mean age of diagnosis in children was younger in TP2 then in TP1 (10.06 vs 10.43, p=0.02). In 2017, the pediatric incidence in municipalities with the fewest medical facilities was 0.95 per 100,000 compared to 0.23 per 100,000 in municipalities with > 5 facilities (p=0.009). There was significantly higher odds of disability at diagnosis (grades 1 and 2) in pediatric cases residing in municipalities with < 5 medical facilities (aOR 1.88; 95% CI 1.37–2.59), adjusted for age and sex. See map (Fig 1). Figure 1. Cases of Pediatric Disability By Number of Municipality Medical Facilities from 2002–2017 (White areas without reported pediatric leprosy) Conclusion The increasing proportion of G2D in children in the second half of the study period despite declining incidence suggest occult infections among children and adults alike in Minas Gerais. Furthermore, the average age of diagnosis in children should increase, not decrease, if M. leprae transmission was truly declining. Lastly, the association between fewer municipality health facilities and increased disability suggest barriers to timely diagnosis and a critical area of focus for research into access to healthcare and leprosy risk. Disclosures All Authors: No reported disclosures


2017 ◽  
Vol 95 (3) ◽  
pp. 63-71
Author(s):  
Manel Antelo ◽  
Francisco Reyes-Santiás ◽  
Carmen Cadarso-Suárez ◽  
María Xosé Rodríguez-Álvarez

2002 ◽  
Vol 20 (11) ◽  
pp. 1769-1781 ◽  
Author(s):  
J.-P. Villain ◽  
R. André ◽  
M. Pinnock ◽  
R. A. Greenwald ◽  
C. Hanuise

Abstract. The HF radars of the Super Dual Auroral Radar Network (SuperDARN) provide measurements of the E × B drift of ionospheric plasma over extended regions of the high-latitude ionosphere. We have conducted a statistical study of the associated Doppler spectral width of ionospheric F-region echoes. The study has been conducted with all available radars from the Northern Hemisphere for 2 specific periods of time. Period 1 corresponds to the winter months of 1994, while period 2 covers October 1996 to March 1997. The distributions of data points and average spectral width are presented as a function of Magnetic Latitude and Magnetic Local Time. The databases are very consistent and exhibit the same features. The most stringent features are: a region of very high spectral width, collocated with the ionospheric LLBL/cusp/mantle region; an oval shaped region of high spectral width, whose equator-ward boundary matches the poleward limit of the Holzworth and Meng auroral oval. A simulation has been conducted to evaluate the geometrical and instrumental effects on the spectral width. It shows that these effects cannot account for the observed spectral features. It is then concluded that these specific spectral width characteristics are the signature of ionospheric/magnetospheric coupling phenomena.Key words. Ionosphere (auroral ionosphere; ionosphere-magnetosphere interactions; ionospheric irregularities)


2006 ◽  
Vol 2 (1) ◽  
pp. 91-106
Author(s):  
Craig Mitton ◽  
Jennifer MacKenzie ◽  
Lynda Cranston ◽  
Flora Teng

Author(s):  
Amal Yassin

Abstract The study aimed to know the overall quality of the concept and its importance in providing high-quality health services and the availability of the key factors in the application and services and to take administrative factors, technical and human and financial, which may contribute to the raise if directed properly and have an adult in improving the quality of health services impact. Based on the nature of the study and the objectives it seeks, the analytical descriptive approach was used. It was based on the study of the phenomenon as it exists in reality and it is treated as a precise description and expressed in qualitative and quantitative terms. To analyze the analytical aspects of the research subject and then collect the initial data through the questionnaire as a main tool for research, designed specifically for this purpose, and distributed to government hospitals in Khartoum State, and included the study community department managers and patients in government hospitals in Khartoum state. A random sample was collected (300) department managers and patients from the Khartoum government hospitals. Each individual has the opportunity to be a member of the study sample during the year 2016. The study concluded with a number of results, the most important of which is that the hospital management has the material potential (furniture, equipment, ...) to use the Six Sigma curriculum with an intermediate degree. The hospital management is ready to use the Six Sigma curriculum to a high degree. Six Sigma In the middle level, the hospital management is keen to train the heads of departments to form teams for the process of continuous improvement to a high degree, the hospital administration is continuously improving the purpose of reducing the deviations and errors that occur, the hospital management is ready to provide an information system Its data continuously At, there is the management of the hospital readiness to provide direct contact with an intermediate degree of quality coaches tuning software system. The study presented a number of recommendations, the most important of which is linking the promotion system in the public hospitals in Khartoum state with the quality control program, paying attention to the overall quality and stressing the possibility of using it in hospitals in Khartoum State because of its scientific and practical importance and improving the quality of the services and the operations provided. Keywords: total quality management, health services, competitiveness, sigma six


2021 ◽  
Vol 8 (1) ◽  
pp. 130-137
Author(s):  
Suprajitno Suprajitno ◽  
Imam Zaenuri ◽  
Muliyadi Muliyadi

Introduction: SWOT analysis can be used to assess the position of an organization that has considered internal and external conditions. The objective of this systematic review is to find out the differences in SWOT analysis carried out by health service facilities outside Indonesia and the other country. Method: A systematic review used the PRISMA method. The search keywords used were strategic management, hospitals, health facilities, health services, and SWOT analysis obtained from Google Scholar, Science Direct, ProQuest, and PubMed. The articles analyzed were fully accessible and published in 2010-2020. Result: The main difference of analysis was that in Indonesia illustrates that the SWOT analysis was aimed at hospital organizations and few were oriented towards special services which has similar indicators on internal and external factors. Meanwhile, outside Indonesia, SWOT analysis was directed at specific health services so that it has different internal and external factors of indicator. Discussion: The difference analysis illustrates that the needs of an organization are different in strategic management development.


Author(s):  
Julie Sin

This chapter looks at the topic of health services quality from a commissioning and whole population perspective. Quality is noted to be a multidimensional concept and dimensions of quality are considered. The role of the commissioner in maintaining and improving quality of services is explored, and this is seen within a wider backdrop of a health system with commissioner and provider functions (if there are such distinctions in the system). Commissioners need to know whether they are securing quality care for their population for the money spent. They also need an understanding of how this dovetails with the provider perspective on this topic. Commissioners also need to be able to articulate what they wish to assess in practice under the guise of quality. Finally, at a system level there are also bearings on how to compile and interpret a picture of a population’s health if needed.


2017 ◽  
Vol 29 (4) ◽  
pp. 470-476 ◽  
Author(s):  
Aline C. Stolk-Vos ◽  
Joris J. van de Klundert ◽  
Niels Maijers ◽  
Bart L.M. Zijlmans ◽  
Jan J.V. Busschbach

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