Implementation of care near home model (CNH) for cancer patients in response to COVID-19 pandemic.

32 Background: Cancer care is heavily centered in health care facilities due to the requirements of providing complex multidisciplinary care with multiple testing and interventions. We describe our experience in implementing a new model of care to minimize cancer patients visit to health care facilities and to reduce the risk of infections and to decrease the pressure on the health care system. Methods: In response to the COVID-19 pandemic, we reengineered the cancer care process to reduce patients visit to the hospital by the implementation of a Care Near Home (CNH) Model, which comprises of four components: virtual clinic, laboratory testing near home, shipping medications and supplies, and involving local health care facilities. The effectiveness and acceptance of this new model has been assessed by the delivery of timely care successfully and assessing the satisfaction patients and healthcare providers. Results: On March 18, 2020, we launched the virtual clinics followed by different components of the model. The number of virtual clinic visits has increased significantly from 399 visits in March to 1107 in April 2020. More the 90% of physicians and patients who responded to the survey expressed their acceptance and satisfaction with the virtual clinic services. Medications were shipped to total of 603 patients. Of those, 578 (96%) patients received their medications (378 patients outside city, 200 patients inside city of which, 95% received medications within 24 hours). Only 25 (4%) patients did not receive their medications and we arrange for alternative solutions. Laboratories in various regions were set up to perform the tests for our patients and to communicate the results through our electronic healthcare records system. The process of ordering and performing the test were piloted with success and now we are at the scaling up phase. Conclusions: Although the implementation of CNH Model was driven by COVID-19 pandemic, it will be integrated in our work process and utilized as a long term approach to manage many of our patients because it is more convenient to them and more cost effective to the health care system.

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Swedish health care system – some trends of its reforming

Oeconomia Copernicana ◽

10.12775/oec.2010.009 ◽

2010 ◽

Vol 1 (1) ◽

pp. 151-164 ◽

Cited By ~ 1

Author(s):

Marcin Moks

Keyword(s):

Health Care ◽

Health System ◽

Health Care System ◽

Service Providers ◽

Diagnosis Related Groups ◽

Health Care Facilities ◽

System Reform ◽

Swedish Health Care ◽

Care Facilities ◽

Care System

The constant increase in public health expenditure, which is being observed from the 60s, initiated research into way to optimize it. The aim the article is to show concepts of the health reforms which have been applied in the Swedish health service. In the article are presented main proposals of changes in the system financing and service provision. Article characterizes patient participation in costs of services, private health insurance, privatisation of health care facilities, purchase-provider split and providers reimbursement. The articles begins with the overview of concepts related to health care system reform. Next, the health system in Sweden is shortly presented. The main part of the article presents the reforms which has been implemented in the financing and services provision. Patients’ participation in financing of the health system has been extended by fees for service. The importance of private medical insurance is marginal. Purchaser-provider split has been introduced in most of counties. In general primary care facilities have been privatised. In regard to service providers reimbursement is generally used global budgeting, feed for service or diagnosis-related groups.

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NEED FOR DRUG PRICE CONTROL IN INDIA

International Journal of Drug Regulatory Affairs ◽

10.22270/ijdra.v1i4.118 ◽

2018 ◽

Vol 1 (4) ◽

pp. 12-18

Author(s):

Sachin K. R. Parasiya ◽

V. Balamuralidhara ◽

Pramod Kumar T.M ◽

A.J. Dave ◽

R. Gujarati ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Essential Medicine ◽

Care Facility ◽

Price Control ◽

Health Care Facilities ◽

Pharmaceutical Pricing ◽

Price Variation ◽

Care Facilities ◽

Care System

India is one of the developing countries. A substantial proportion of population of this country is largely exposed to the drug market whose purchasing power is extremely low. Around 42% population of this country lives under the National poverty line ($1.25 per day). Vital issue concerning them is to access the health care facility at an affordable cost. Medicine is a part of health care cost and it costs to around 70% to 80% of total cost. Thus, cost of medicine is a governing factor of health care system especially when it comes to price control of health care facilities. To bring down the cost of health care facilities, government spends money for health care facilities. A comparative expenditure made by state government is depicted in this article. NPPA (National Pharmaceutical Pricing Authority) is the Indian pharmaceutical pricing regulating authority and it achieves its objectives by implementing the DPCO (Drug Pricing control order). In spite of existence of the DPCO, drastic price variation is observed between the products of same API (Active Pharmaceutical Ingredient) and several factors are responsible for the same. To overcome the stated problem and monopolistic trade practice by patent holder/brand manufacturer, TRIPS (Trade Related Intellectual Properties Rights) provides Compulsory Licenses which has its unique role to play in affordability of medicines. Essential medicine is a basic requirement of health care system to serve their customers and hence an effective and overt price control on drugs is the need of present. This study will thus try to justify the need to bring NLEM (National List of Essential Medicine) under DPCO.

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Detection of imported COVID-19 cases worldwide: early assessment of airport entry screening, 24 January until 17 February 2020

Tropical Medicine and Health ◽

10.1186/s41182-020-00260-5 ◽

2020 ◽

Vol 48 (1) ◽

Author(s):

Varvara A. Mouchtouri ◽

Zacharoula Bogogiannidou ◽

Martin Dirksen-Fischer ◽

Sotirios Tsiodras ◽

Christos Hadjichristodoulou

Keyword(s):

Health Care ◽

Health Care System ◽

Health Care Facilities ◽

Early Assessment ◽

Point Of Entry ◽

Care Facilities ◽

Imported Cases ◽

Early Case ◽

Early Case Detection ◽

Care System

Abstract The purpose of this study was to provide an overview of entry screening measures applied at airports in response to the COVID-19 epidemic worldwide. Between 24 January and 17 February 2020, 5.2% (95% CI 3.1–8.5) of the 271 total imported COVID-19 cases worldwide (excluding imported cases arriving in China, Macao, and Hong Kong) with known detection location were captured through airport entry screening. The majority of imported COVID-19 cases (210) were identified by the health care system (77.5%). Efforts should focus on health care system preparedness for early case detection, since according to our and previous studies health care facilities are the actual point of entry of imported cases.

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COVID-19 in Italy: targeted testing as a proxy of limited health care facilities and a key to reducing hospitalization rate and the death toll

10.1101/2020.10.12.20211169 ◽

2020 ◽

Author(s):

Arnab Bandyopadhyay ◽

Marta Schips ◽

Tanmay Mitra ◽

Sahamoddin Khailaie ◽

Sebastian Binder ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Health Care Facilities ◽

Effective Control ◽

Death Toll ◽

Care Facilities ◽

Targeted Testing ◽

Limited Health ◽

The Impact ◽

Care System

AbstractThe novel Coronavirus SARS-CoV-2 (CoV) has induced a worldwide pandemic, notably in Italy, one of the worst-hit countries in Europe, which witnessed a death toll unseen in the recent past. There are potentially many factors, such as infections from undetected index cases, early vs late testing strategies, limited health care facilities etc., that might have aggravated the COVID-19 situation in Italy. We developed a COVID-19 specific infection epidemic model composed of susceptible (S), exposed (E), carrier (C), infected (I), recovery (R) and dead (D) (SECIRD), specifically parameterized for Italy to disentangle the impact of these factors and their implications on infection dynamics to help planning an effective control strategy for a possible second wave. Our model discriminates between detected infected and undetected individuals who played a crucial role in the disease spreading and is not well addressed by classical SEIR-like transmission models. We first estimated the number of undetected infections through a Bayesian Markov Chain Monte Carlo (MCMC) framework, which ranges from ∼ 7 to ∼ 22 fold higher than reported infections, depending upon regions. We exploited this information to evaluate the impact of the undetected component on the evolution of the pandemic and the benefits of an enhanced testing strategy. In high testing regions like Veneto, 18% of all infections resulted in hospitalization, while for Lombardia and Piemonte, it is 25% and 27%, respectively. We investigated the impact of an overwhelmed health care system upon death toll by applying hospital and intensive care unit (ICU) capacities in the SECIRD model, and we estimated a 10% reduction in death in Lombardia, the worst hit region, if a higher number of hospital facilities had been available since the beginning. Adopting a combined strategy of rapid early and targeted testing (∼ 10 fold) with increased hospital capacity would help in avoiding bottlenecks affecting the health care system. Our results demonstrate that the early testing would have a strong impact on the overall hospital accessibility and, hence, upon death toll (∼20% to 50% reduction) and could have mitigated the lack of facilities at the crucial middle stage of the epidemic.

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Tuberculosis in the veterans healthcare system: a six-year review and evaluation of programme effectiveness

Epidemiology and Infection ◽

10.1017/s0950268899004409 ◽

2000 ◽

Vol 125 (2) ◽

pp. 315-323 ◽

Cited By ~ 1

Author(s):

G. A. ROSELLE ◽

L. H. DANKO ◽

S. M. KRALOVIC ◽

L. A. SIMBARTL ◽

K. W. KIZER

Keyword(s):

Health Care ◽

Health Care System ◽

Hospital Setting ◽

Health Care Facilities ◽

Successful Outcome ◽

Multi Drug Resistance ◽

Veterans Health ◽

Free Standing ◽

Care Facilities ◽

Care System

The Department of Veterans Affairs operates a large, centrally administered health care system consisting of 173 hospitals and 4 free standing outpatient clinics nationwide with approximately 945115 hospital discharges, 24·2 million outpatient visits, and 2·86 million persons served annually over the time frame of the review. The purpose of the study was to define whether such a system could effect timely change in the incidence of tuberculosis (TB) using centralized programme planning and flexible field implementation. A retrospective review of the number of newly diagnosed cases of active TB treated at veterans health care facilities between 1 October 1990 and 30 September 1997 was determined by using a standardized annual case census.Intervention included implementation of the most current guidelines for the prevention of transmission of TB in the community and hospital setting, including administrative and engineering controls and a change in personal protective equipment. Centrally directed programme guidance, education, and funding were provided for field use in health care facilities of widely varying size and complexity.The numbers of total reported cases of TB decreased significantly (P < 0·001) throughout the veterans health care system (nationally and regionally), with the case rate decreasing at a rate significantly greater than that seen in the USA as a whole (P < 0·0001). TB associated with multi-drug resistance (isoniazid and rifampin) and HIV coinfection also significantly decreased over the study period. Therefore, a large, centrally administered health care system can effectively combat a re-emerging infectious disease and may also demonstrate a successful outcome greater than seen in other, perhaps less organized health care settings.

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Transformation of health care and the new model of care in Saudi Arabia: Kingdom’s Vision 2030

Journal of Medicine and Life ◽

10.25122/jml-2021-0070 ◽

2021 ◽

Vol 14 (3) ◽

pp. 347-354

Author(s):

◽

Sharfuddin Chowdhury ◽

...

Keyword(s):

Health Care ◽

Saudi Arabia ◽

Health Care System ◽

Systems Of Care ◽

Health Care Facilities ◽

Model Of Care ◽

New Model ◽

Vision 2030 ◽

Health Care Transformation ◽

Care System

The Kingdom of Saudi Arabia espoused “Vision 2030” as a strategy for economic development and national growth. The vision demonstrated the Kingdom’s objectives to become a pioneer nation globally by achieving three main goals: a vibrant society, a thriving economy, and an ambitious nation. To fulfill this, the Kingdom launched a national transformation program (NTP) as outlined in “vision 2030” in June 2016. The health care transformation is one of the eight themes of the NTP’s. The history of health care facilities in the Kingdom is almost a century. Although the Kingdom has made notable progress in improving its population’s health over recent decades, it needs to modernize the health care system to reach the “vision 2030” goal. This article aims to describe the new Model of Care (MOC) according to the recent Saudi health care transformation under the Kingdom’s vision 2030. The MOC concept started with understanding the current state and collecting learnings. It is based on the six systems of care (SOC)- keeping well, planned procedure, women & children, urgent problems, chronic conditions, and the last phase of life. The SOC is cut across different “service layers” to support people’s stay well and efficiently get them healthy again when they need care. The new MOC describes a total of forty-two interventions, of which twenty-seven split across the six SOC and the rest fifteen cut-across the multiple SOC. Implementation of all MOC interventions will streamline the Saudi health care system to embrace the Kingdom’s “vision 2030”.

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Spory co do statusu prawnego Samodzielnego Publicznego Zakładu Opieki Zdrowotnej

Studenckie Prace Prawnicze, Administratywistyczne i Ekonomiczne ◽

10.19195/1733-5779.19.13 ◽

2016 ◽

Vol 19 ◽

pp. 161-177

Author(s):

Artur Łysoń

Keyword(s):

Public Health ◽

Health Care ◽

Health Care System ◽

Legal Status ◽

Health Care Facilities ◽

Point Of View ◽

Public Health Care ◽

Scientific Controversy ◽

Care Facilities ◽

Care System

Disputes as to the Legal Status of Independent Public Health Care FacilitiesLife and health are values which are of fundamental importance both for individuals and for the proper functioning of society. Therefore, topics concerning health care in Poland have always aroused great controversy and numerous disputes. The functioning of the health care system is an important topic of public debate, scientific controversy, as well as private dispute amongst Poles. This article does not, however, focus on the sociological aspects of the operation of the health care system, but rather on the legal status of the primary legal-organizational unit of the system, namely independent public health care facilities. The analysis has been subjected to the genesis of the solutions functioning to date as well as the problems which have arisen in this respect. The legal conditions surrounding the activity of independent public health care facilities IPHF presented in this article, in particular the disputes as to whether or not these entities have alegal personality and entrepreneurial status, demonstrate alack of consistency on the part of the legislature, imprecision and inconsistency of regulations and anotable absence of aconception as to how the health care system should ultimately be shaped from the institutional point of view. Without denying the benefits of the introduction of modern methods of management in medical entities, it should be stressed that simply achange in the legal-organizational form is not comprehensive reform, but only afragment thereof.

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