scholarly journals Investigating opioid-related fatalities in southern Sweden: contact with care-providing authorities and comparison of substances

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Lisa Andersson ◽  
Anders Håkansson ◽  
Peter Krantz ◽  
Björn Johnson
Keyword(s):  
Health Care ◽  
Social Services ◽  
Health Care Services ◽  
Statistical Testing ◽  
Opioid Substitution Treatment ◽  
Exact Test ◽  
Regional Health Care ◽  
Opioid Intoxication ◽  
The Social ◽  
Probation Service

Abstract Background Opioid-related deaths have increased in Western countries over recent decades. Despite numerous studies investigating opioid-related mortality, only a few have focused on the lives of the deceased individuals prior to their deaths, specifically regarding contact with care-providing authorities such as health, social and correctional services. Furthermore, a change has been noted in the last two decades as to which opioids cause most deaths, from heroin to prescription opioids. However, studies comparing fatalities caused by different substances are rare. The aim of this study was to investigate contact with care-providing authorities during the year prior to death among individuals who died as a result of opioid intoxication and to analyse differences relating to which opioids caused their deaths. Methods The study is based on retrospective register data and includes 180 individuals with a history of illicit drug use, who died from opioid intoxication in Skåne, Sweden, between 1 January 2012 to 31 December 2013 and 1 July 2014 to 30 June 2016. Intoxications caused by heroin, methadone, buprenorphine and fentanyl were included. Data were collected from the National Board of Forensic Medicine, regional health care services, municipal social services and the Prison and Probation Service. Statistical testing was performed using Pearson’s chi-square test, Fisher’s exact test and the Mann-Whitney U test to analyse group differences. Results A total of 89% of the deceased individuals had been in contact with one or more of the care-providing authorities during the year prior to death; 75% had been in contact with health care, 69% with the social services, 28% with the Prison and Probation Service, and 23% had been enrolled in opioid substitution treatment at some point during their final year of life. Few differences appeared between the substance groups with regard to which opioid contributed to the death. In addition to opioids, sedatives were present in more than 80% of the cases. Individuals whose deaths were buprenorphine-related had been in contact with the social services to a significantly lesser extent during the year prior to death. Conclusions The studied population is characterised by extensive contact with care-providing authorities, thus providing numerous opportunities for authorities to reach this group with preventive and other interventions. Few differences emerged between groups with regard to which opioid had contributed to the death.

The Impact of War on Population Health

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Turkan Ahmet
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health Care Services ◽  
Negative Effects ◽  
The Past ◽  
Care Services ◽  
Physical Environments ◽  
The Social ◽  
Personal Experiences ◽  
The Impact

The past few decades of ongoing war in Iraq has had a dramatic impact on the health of Iraq’s population. Wars are known to have negative effects on the social and physical environments of individuals, as well as limit their access to the available health care services. This paper explores the personal experiences of my family members, who were exposed to war, as well as includes information that has been reviewed form many academic sources. The data aided in providing recommendations and developing strategies, on both local and international levels, to improve the health status of the populations exposed to war.

“PHONE-CONNECT” - A Pilot Program Prescribing Phones to Address Digital Health Equity Needs in the COVID-19 Era (Preprint)

2020 ◽  
Author(s):  
Gill Kazevman ◽  
Marck Mercado ◽  
Jennifer Hulme ◽  
Andrea Somers
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Point Of Care ◽  
Digital Health ◽  
Contact Tracing ◽  
Health Care Intervention ◽  
Care Intervention

UNSTRUCTURED Vulnerable populations have been identified as having higher infection rates and poorer COVID-19 related outcomes, likely due to their inability to readily access primary care, follow public health directives and adhere to self-isolation guidelines. As a response to the COVID-19 pandemic, many health care services have adopted new digital solutions, relying on phone and internet connectivity. Yet, persons who are digitally inaccessible, such as those struggling with poverty or homelessness, are often unable to utilize these services. In response to this newly highlighted social disparity known as “digital health inequity”, emergency physicians at the University Health Network, Toronto, initiated a program called “PHONE CONNECT”. This novel approach attempts to improve patients’ access to health care, information and social services, as well as improve their ability to adhere to public health directives (social isolation and contact tracing). While similar programs addressing the same emerging issues have been recently described in the media, this is the first time phones are provided as a health care intervention in an emergency department. This innovative ED point-of-care intervention may have a significant impact on improving the health outcomes for vulnerable people during the COVID-19 pandemic, and even beyond it.

scholarly journals Regional health care services and rates of lower extremity amputation related to diabetes and peripheral artery disease: an ecological study

CMAJ Open ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. E659-E666
Author(s):  
Charles de Mestral ◽  
Mohamad A. Hussain ◽  
Peter C. Austin ◽  
Thomas L. Forbes ◽  
Atul Sivaswamy ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Ecological Study ◽  
Lower Extremity Amputation ◽  
Peripheral Artery ◽  
Regional Health ◽  
Care Services ◽  
Regional Health Care ◽  
Artery Disease ◽  
Extremity Amputation

scholarly journals Equity, Efficiency, and Accessibility in Urban and Regional Health-Care Systems

1982 ◽  
Vol 14 (11) ◽  
pp. 1479-1507 ◽  
Author(s):  
L D Mayhew ◽  
G Leonardi
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
Health Care Services ◽  
Spatial Interaction ◽  
Health Care Systems ◽  
Interaction Model ◽  
Health Care Planning ◽  
Regional Health Care ◽  
Allocation Criteria ◽  
Care Systems

This paper explores four different criteria of health-care resource allocation at the urban and regional level. The criteria are linked by a common spatial-interaction model. This model is based on the hypothesis that the number of hospital patients generated in a residential zone i is proportional to the relative morbidity of i, and to the availability of resources in treatment zone j, but is in inverse proportion to the accessibility costs of getting from i to j. The resource-allocation criteria are based on objectives on which there is broad agreement among planners and other actors in a health-care system. These objectives are concerned with allocations that conform to notions of equity, efficiency, and two definitions of accessibility. The allocation criteria give mainly aggregate-level information, and are designed with the long-term regional planning of health-care services in mind. The paper starts by defining the criteria, and describes how they are intended to be employed in a planning context. The allocation rules are then formally derived and linked together mathematically. They are then applied to a region, London, England, which is known to have very complex health-care planning problems. As a result of this application, two of the criteria—equity and efficiency—are selected for further analysis. A new model is built and applied that specifically enables the user to trade off one of these criteria against the other.

La pianificazione socio-sanitaria: ruolo e funzioni del sociologo della salute

2009 ◽  
pp. 116-131
Author(s):  
Annamaria Perino
Keyword(s):  
Health Care ◽  
Key Words ◽  
Social Services ◽  
Empirical Research ◽  
Health Care Services ◽  
Care Services ◽  
Integration Planning ◽  
Sociology Of Health ◽  
Made In

- In the first part of the essay, after pointing out the need for an integrated work between social services and health-care services, the topic of planning and defining features, objectives and instruments is introduced. In the second part, referring to an empirical research recently made in Italy, Perino describes the role and functions of the sociologist of health in the processes of planning, with particular attention to critical and unsolved issues. Annamaria Perino suggests that in order to be innovative, the medical sociologist should redefine his/her identity.Key words: integration, planning, exploration, mediation, reflexivity, sociology of health.Parole chiave: integrazione, pianificazione, esplorazione, mediazione, riflessivitÀ, sociologia della salute.

Il "quadrilatero" di Ardigň: genealogia e sviluppo di un paradigma emergente

2009 ◽  
pp. 217-237
Author(s):  
Guido Giarelli
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Medical Sociology ◽  
Health Care Systems ◽  
New Paradigm ◽  
Scientific Debate ◽  
The Social ◽  
Care Systems ◽  
Sociology Of Health ◽  
Cultural Origins

- After describing the context in which the ‘quadrilateral'of Ardigň was conceived as an innovative gnoseological tool aimed to characterize the rising Italian Health Sociology in comparison with the much more well established tradition of the Northern American and British Medical Sociology, the essay tries to trace its cultural origins: which are found, at the level of scientific debate, in the ‘great coupure' or epistemological turning point of the Thirties, which Ardigň considers the framework from which to move; and, on the other side, in the micro-macro debate which characterized the sociological discipline during the Seventies and the Eighties with the opposition between the Sociologies of the subjective action versus the Sociologies of the social system, and the attempt to get over it by making a ‘paradigm of exit from the postmodern' which could deal in depth with the intrinsic double face and the ambivalence of the social stuff. In the last part, the developments of the ‘quadrilateral'are traced in the attempts of further elaboration by its critical application to different fields of the Sociology of Health (health care systems, health reforms, quality of health care services, health inequalities) which shape an emerging new paradigm of connectionist type.Keywords: "quadrilateral", Sociology of Health, Medical Sociology, ambivalence, connectionist paradigm, postmodern.Parole chiave: "quadrilatero", sociologia della salute, medical sociology, ambivalenza, paradigma connessionista, postmoderno.

Entrepreneurs ' perspective on public-private partnership in health care and social services

2016 ◽  
Vol 30 (1) ◽  
pp. 174-191 ◽  
Author(s):  
Janne Sinisammal ◽  
Pekka Leviäkangas ◽  
Tommi Autio ◽  
Elina Hyrkäs
Keyword(s):  
Health Care ◽  
Social Services ◽  
Care Service ◽  
Health Care Service ◽  
Public Private Partnership ◽  
Private Partnership ◽  
Content Type ◽  
Factors Affecting ◽  
The Social ◽  
Private Entrepreneurs

Purpose – The purpose of this paper is to probe experiences of entrepreneurs in the social and health care service provision. Design/methodology/approach – Information was collected regarding entrepreneurs’ views on the factors affecting the collaboration between public and private sectors. A sample of social and health care entrepreneurs was interviewed using open-ended questions. The interviews were transcribed and analysed using inductive content analysis. Findings – Three main categories of factors affecting the success of partnership were identified: the nature of partnership, business aspects and tension builders. Research limitations/implications – The research was undertaken in rural Finland and the sample consisted 13 entrepreneurs. The results must be considered as observations with more generalised conclusions. Practical implications – The results of this study support municipalities in their social and health care service strategy work and especially in consideration of how to also facilitate a fruitful public-private partnership (PPP)-framework, which will largely depend on mutual understanding and consensus. Originality/value – The reform of the social and health care system has raised intensive public debate throughout Europe. Key issues include the reorganising of social and health care processes as well as PPPs in provision of services. This study observes the views and experiences of private entrepreneurs and points out where some potential problems and solutions of social and health care PPPs are.

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