- History of the U.S. Healthcare Delivery System

2017 ◽  
pp. 20-31
Keyword(s):  
Delivery System ◽  
Healthcare Delivery ◽  
Healthcare Delivery System ◽  
History Of ◽  
The U.S

scholarly journals Telehealth transformation: COVID-19 and the rise of virtual care

2020 ◽  
Vol 27 (6) ◽  
pp. 957-962 ◽  
Author(s):  
Jedrek Wosik ◽  
Marat Fudim ◽  
Blake Cameron ◽  
Ziad F Gellad ◽  
Alex Cho ◽  
...  
Keyword(s):  
Healthcare System ◽  
Delivery System ◽  
Outpatient Care ◽  
Healthcare Delivery ◽  
The Novel ◽  
Healthcare Organizations ◽  
Healthcare Delivery System ◽  
Virtual Care ◽  
Novel Coronavirus ◽  
The U.S

Abstract The novel coronavirus disease-19 (COVID-19) pandemic has altered our economy, society, and healthcare system. While this crisis has presented the U.S. healthcare delivery system with unprecedented challenges, the pandemic has catalyzed rapid adoption of telehealth, or the entire spectrum of activities used to deliver care at a distance. Using examples reported by U.S. healthcare organizations, including ours, we describe the role that telehealth has played in transforming healthcare delivery during the 3 phases of the U.S. COVID-19 pandemic: (1) stay-at-home outpatient care, (2) initial COVID-19 hospital surge, and (3) postpandemic recovery. Within each of these 3 phases, we examine how people, process, and technology work together to support a successful telehealth transformation. Whether healthcare enterprises are ready or not, the new reality is that virtual care has arrived.

scholarly journals HOW TELEMEDICINE HAS CHANGED SURGICAL PRACTICE IN COVID PANDEMIC

2020 ◽  
pp. 7-10
Author(s):  
Praveen Kumar ◽  
Farhanul Huda ◽  
Somprakas Basu
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Information And Communication Technologies ◽  
Delivery System ◽  
Healthcare Delivery ◽  
National Health System ◽  
Current Status ◽  
Free Text ◽  
Healthcare Delivery System ◽  
History Of

Background—The history of telemedicine parallels the history of communication and information technologies. With the advancement in information and communication technologies, telemedicine has also progressed. Still, it could not gain a respectable place in the healthcare delivery system due to lack of clear guidelines, lack of multidisciplinary approach to patient management, onerous privacy regulations, lack of reimbursement, lack of human touch in teleconsultations, and lack of integration with the national health system. There is a need to promote telemedicine services by looking into the current framework and bringing necessary changes to ease the delivery of services. Also, proper training of health care professionals about digital communication to improve patient outcome, and the introduction of telemedicine in medical education so that medical students do not suffer in the present scenario of COVID-19. Methods- We searched MEDLINE, Embase, PubMed, and PubMed Central. We used free-text terms and MeSH terms such as telemedicine, telemedicine, and COVID 19 pandemic, telemedicine and medical education, telemedicine pitfalls. Data regarding the guidelines of telemedicine and waivers during the pandemic, the current status of telemedicine in the healthcare delivery system, and its promotion during the epidemic were extracted. Finally,43 articles were found suitable to be considered for writing this evidence-based review. Results—Telemedicine has proven to be an important tool to reduce the risk of transmission of COVID 19 without hampering patient care,medical education and research. With relaxation of existing guidelines in most of the countries and training of healthcare professionals to introduce digital empathy it can be closer to a usual patient-provider encounter. Conclusion—Telemedicine cannot replace regular face to face patient-provider encounters, but it can be helpful, especially during the times of pandemics as happening during current circumstances. It should be included in the health care delivery infrastructure with all guidelines and legality to help the existing system during normal conditions and take over in need of time.

The healthcare delivery system: an overview

2017 ◽  
Author(s):  
Jan Abel Olsen
Keyword(s):  
Delivery System ◽  
Chronic Care ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Healthcare Delivery System ◽  
Care Level ◽  
Primary Care Level ◽  
Internal Markets ◽  
System A ◽  
Policy Challenge

This chapter provides an overview of the healthcare delivery system. A figure illustrates how six different parts of the system relate to each other. The primary care level plays a key role in many countries by representing the gate, in which referrals to secondary care are being made. Tertiary care is principally of two types depending on patients’ prognosis: chronic care or rehabilitation. In addition to the three care levels, there are two parts with quite different roles: pharmacies provide pharmaceuticals, and sickness benefit schemes compensate the sick for their income losses. A recurrent policy challenge is to make each provider level take into account the resource implications of their isolated decisions outside of their own budgets. A brief discussion is included on the scope for ‘internal markets’.

scholarly journals Seroprevalence of antibodies to SARS-CoV-2 in healthcare workers: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043584 ◽  
Author(s):  
Joseph E Ebinger ◽  
Gregory J Botwin ◽  
Christine M Albert ◽  
Mona Alotaibi ◽  
Moshe Arditi ◽  
...  
Keyword(s):  
African American ◽  
Los Angeles ◽  
Delivery System ◽  
Healthcare Workers ◽  
Los Angeles County ◽  
Healthcare Delivery ◽  
Healthcare Delivery System ◽  
Hispanic Ethnicity ◽  
Factors Associated ◽  
African American Race

ObjectiveWe sought to determine the extent of SARS-CoV-2 seroprevalence and the factors associated with seroprevalence across a diverse cohort of healthcare workers.DesignObservational cohort study of healthcare workers, including SARS-CoV-2 serology testing and participant questionnaires.SettingsA multisite healthcare delivery system located in Los Angeles County.ParticipantsA diverse and unselected population of adults (n=6062) employed in a multisite healthcare delivery system located in Los Angeles County, including individuals with direct patient contact and others with non-patient-oriented work functions.Main outcomesUsing Bayesian and multivariate analyses, we estimated seroprevalence and factors associated with seropositivity and antibody levels, including pre-existing demographic and clinical characteristics; potential COVID-19 illness-related exposures; and symptoms consistent with COVID-19 infection.ResultsWe observed a seroprevalence rate of 4.1%, with anosmia as the most prominently associated self-reported symptom (OR 11.04, p<0.001) in addition to fever (OR 2.02, p=0.002) and myalgias (OR 1.65, p=0.035). After adjusting for potential confounders, seroprevalence was also associated with Hispanic ethnicity (OR 1.98, p=0.001) and African-American race (OR 2.02, p=0.027) as well as contact with a COVID-19-diagnosed individual in the household (OR 5.73, p<0.001) or clinical work setting (OR 1.76, p=0.002). Importantly, African-American race and Hispanic ethnicity were associated with antibody positivity even after adjusting for personal COVID-19 diagnosis status, suggesting the contribution of unmeasured structural or societal factors.Conclusion and relevanceThe demographic factors associated with SARS-CoV-2 seroprevalence among our healthcare workers underscore the importance of exposure sources beyond the workplace. The size and diversity of our study population, combined with robust survey and modelling techniques, provide a vibrant picture of the demographic factors, exposures and symptoms that can identify individuals with susceptibility as well as potential to mount an immune response to COVID-19.

scholarly journals The characteristics of patients with possible familial hypercholesterolemia—screening a large payer/provider healthcare delivery system

QJM ◽  
2019 ◽  
Vol 113 (6) ◽  
pp. 411-417 ◽  
Author(s):  
A Elis ◽  
M Leventer-Roberts ◽  
A Bachrach ◽  
N Lieberman ◽  
R Durst ◽  
...  
Keyword(s):  
General Population ◽  
Health Services ◽  
Familial Hypercholesterolemia ◽  
Chronic Kidney Disease Stage ◽  
Healthcare Delivery ◽  
Disease Stage ◽  
Study Cohort ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
History Of

Abstract Background Familial hypercholesterolemia (FH) is an under-diagnosed condition. Aim We applied standard laboratory criteria across a large longitudinal electronic medical record database to describe cross-sectional population with possible FH. Methods A cross-sectional study of Clalit Health Services members. Subjects who met the General Population MED-PED laboratory criteria, excluding: age &lt;10 years, documentation of thyroid, liver, biliary or autoimmune diseases, a history of chronic kidney disease stage 3 or greater, the presence of urine protein &gt;300 mg/l, HDL-C&gt;80 mg/dl, active malignancy or pregnancy at the time of testing were considered possible FH. Demographic and clinical characteristics are described at time of diagnosis and at a single index date following diagnosis to estimate the burden on the healthcare system. The patient population is also compared to the general population. Results The study cohort included 12 494 subjects with out of over 4.5 million members of Clalit Health Services. The estimated prevalence of FH in Israel was found to be 1:285. These patients are notably positive for, and have a family history of, cardiovascular disease and risk factors. For most of them the LDL-C levels are not controlled, and only a quarter of them are medically treated. Conclusions By using the modified MED-PED criteria in a large electronic database, patients with possible FH can be identified enabling early intervention and treatment.

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