scholarly journals Tracking aspects of healthcare activity during the first nine months of COVID-19 in Ireland: a secondary analysis of publicly available data

2021 ◽  
Vol 4 ◽  
pp. 98
Author(s):  
Domhnall McGlacken-Byrne ◽  
Sarah Parker ◽  
Sara Burke
Keyword(s):  
Healthcare System ◽  
Healthcare Access ◽  
Healthcare Delivery ◽  
Secondary Analysis ◽  
Public Healthcare ◽  
Language Therapy ◽  
Care Community ◽  
Universal Healthcare ◽  
Allied Healthcare ◽  
The Impact

Background: Sláintecare aims to introduce universal healthcare in Ireland. The COVID-19 pandemic poses both challenges and opportunities to this process. This study explored the impact of COVID-19 on aspects of Irish healthcare during the first nine months of the pandemic and considers the implications for Sláintecare implementation. Methods: Secondary analysis was undertaken on publicly available data on three key domains of the Irish healthcare system: primary care, community-based allied healthcare, and hospitals. Descriptive statistics were computed using Microsoft Excel 2016. Results: Up to March 2021, 3.76 million COVID-19 tests were performed by Ireland’s public healthcare system, 2.48 million (66.0%) of which were referred from the community. General practitioners delivered 2.31 million telephone triages of COVID-19 symptoms, peaking in December 2020 when 416,607 consultations occurred. Patient numbers across eight allied healthcare specialties fell by 35.1% versus previous years, with the greatest reductions seen in speech and language therapy (49.0%) and audiology (46.1%). Hospital waiting lists increased from 729,937 to 869,676 (or by 19.1%) from January 2019 to January 2021. In January 2021, 629,919 patients awaited a first outpatient clinic appointment, with 170,983 (27.1%) waiting longer than 18 months. The largest outpatient lists were observed in orthopaedic surgery (n=77,257); ear, nose and throat surgery (n=68,073); and ophthalmology (n=47,075). The proportion of patients waiting more than 12 months for a day-case gastrointestinal endoscopy rose from 6.0% in January 2020 to 19.0% in January 2021. Conclusions: Healthcare activity has been significantly disrupted by COVID-19, leading to increased wait times and greater barriers to healthcare access during the pandemic. Yet, Ireland’s health system responses also revealed strong willingness and ability to adapt and to implement novel solutions for healthcare delivery, rapidly and at scale. This has demonstrated what is achievable under Sláintecare and provides a unique opportunity to ‘build back better’ towards sustainable recovery.

scholarly journals The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

2022 ◽  
Vol 14 (1) ◽  
pp. e2022012
Author(s):  
Annarita Botta ◽  
Gianmarco Lugli ◽  
Matteo Maria Ottaviani ◽  
Guido Ascione ◽  
Alessandro Bruschi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Healthcare System ◽  
Public Healthcare ◽  
Healthcare Provision ◽  
Hub And Spoke ◽  
Medical Specialties ◽  
Health Crisis ◽  
Outbreak Period ◽  
Long Term Impact ◽  
The Impact

Background Italy has been one of the countries most affected by the SARS-CoV-2 pandemic and the regional healthcare system has had to quickly adapt its organization to meet the needs of infected patients. This has led to a drastic change in the routine management of non-communicable diseases with a potential long-term impact on patient health care. We investigated the management of non-COVID-19 patients across all medical specialties in Italy. Methods A PRISMA guideline-based systematic review of the literature was performed using PubMed, Embase, and Scopus, restricting the search to the main outbreak period in Italy (from 20 February to 22 June, 2020). We selected articles in English or Italian that detailed changes in the Italian hospital care for non-COVID-19 patients due to the pandemic. Our keywords included all medical specialties in combination with our geographical focus (Italy) and COVID-19. Results Of the 4643 potentially eligible studies identified by the search, 247 studies were included. A decrease in the management of emergencies in non-COVID patients was found together with an increase in mortality. Similarly, non-deferrable conditions met a tendency toward decreased diagnosis. All specialties have been affected by the reorganization of healthcare provision in the hub-and-spoke system and have benefited from telemedicine.   Conclusions Our work highlights the changes taking place in the Italian public healthcare system to tackle the developing health crisis due to the COVID-19 pandemic. The findings of our review may be useful to analyze future directions for the healthcare system in the case of new pandemic scenarios.  

Framework of Indian Healthcare System and its Challenges

2017 ◽  
pp. 247-271 ◽  
Author(s):  
Prashant Mehta
Keyword(s):  
Healthcare System ◽  
Healthcare Delivery ◽  
Policy Framework ◽  
Public Healthcare ◽  
System State ◽  
Service Delivery System ◽  
Law And Policy ◽  
Healthcare Reforms ◽  
Lifestyle Diseases ◽  
Populous Country

India, one of the oldest civilizations and second most populous country is ethnically, linguistically, geographically, religious, and demographically diverse is poorly ranked due to complex public healthcare system, which suffers from insufficient funding, poor management. Poor health intertwined with poverty, affordability, accessibility, burden of infectious and non-communicable affecting lives of most Indians. Healthcare ecosystems are complex and still evolving, investments in service delivery system, infrastructure, and technology, are still being experimented and explored. India's booming population; increasing purchasing power; rising awareness of personal health and hygiene; and significant growth in infectious, chronic degenerative, and lifestyle diseases are driving the growing market. In this chapter we will explore accessible and affordable healthcare system, state of public healthcare, healthcare reforms, governance (Constitutional Provisions, Law, and Policy framework) in healthcare delivery, and Opportunity offered by market drivers.

Health of a Democracy

2021 ◽  
pp. 41-60
Author(s):  
Debasish Roy Chowdhury ◽  
John Keane
Keyword(s):  
Health System ◽  
Healthcare System ◽  
Good Health ◽  
Caste System ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Universal Healthcare ◽  
The Rich ◽  
The Government ◽  
The Right

This chapter discusses India’s health system. The Indian Constitution upholds the right of its citizens to enjoy human dignity. The country’s Supreme Court has ruled that this means the right to health is integral to the right to life and the government has a constitutional obligation to provide health facilities. But healthcare is not a fundamental right in India. There is no universal healthcare system. Instead, it has a three-tiered health system, in which the poorest go to the notionally free and suitably ramshackle public hospitals; the rich and upper middle classes access super-specialty private hospitals with hotel-like lobbies and air-conditioned suites, respectful doctors, and state-of the-art equipment; and the rest resort to low-to-middle-end private nursing homes that are a scaled-down version of the five-star corporate hospitals. The Covid-19 outbreak laid bare the denial of decent medical attention to the poor by this long-tolerated caste system of public healthcare. The chapter then looks at the relationship between democracy and healthcare. The commonplace belief that representative democracy forces competition for popular support that in turn makes contenders for power more responsive to citizens’ healthcare needs is shown not to apply to India. India’s pathetic public healthcare system and its mercenary private healthcare sector present a troubling anomaly to statistical conclusions that democracy is the nurse of good health. The murderous inequity of its healthcare system speaks of a democracy that celebrates the equality of its people and their votes, even while treating their bodies as unequal.

Finland

2021 ◽  
pp. 226-246
Author(s):  
Liina-Kaisa Tynkkynen ◽  
Meri Koivusalo ◽  
Ilmo Keskimäki
Keyword(s):  
Health Services ◽  
Healthcare System ◽  
Large Scale ◽  
Universal Access ◽  
Healthcare Delivery ◽  
Healthcare Provision ◽  
Political Debate ◽  
Municipal Governments ◽  
Universal Healthcare ◽  
Sharing Responsibility

This chapter offers an in-depth look at health politics and the health system in Finland, which combines universal tax-financed health services provided by municipalities, national health insurance coverage for private provision, and an occupational healthcare system for those in employment. The chapter traces the development of the Finnish healthcare system, characterized by a long history of state and municipal governments sharing responsibility for organizing health services and multichannel healthcare delivery. The need to control costs, maintain financial sustainability, and ensure equitable access has underpinned political debate, but large-scale structural reform has been impeded. As the chapter shows, reform priorities have been advanced under the guise of more technical issues, such as public sector and administrative reform or, increasingly, choice, competition, and engagement with the private sector as means for change. Furthermore, via local measures such as cooperation among municipalities the system is gradually moving towards a more centralized organization without major reform. Widespread support for universal healthcare provision means that politics have focused to a large extent on how universal access is to be achieved, rather than whether the system should be universal.

Healthcare of Vulnerable Populations: Through the Lens of Halldorsdottir’s Theory

2010 ◽  
Vol 14 (3) ◽  
pp. 53-59 ◽  
Author(s):  
Denise Nagle Bailey
Keyword(s):  
Delivery System ◽  
Vulnerable Populations ◽  
Healthcare Access ◽  
Healthcare Delivery ◽  
Poor Health ◽  
System Implementation ◽  
Healthcare Delivery System ◽  
Patient’S Perspective ◽  
Healthcare Coverage ◽  
The Impact

This paper explores caring within the context of healthcare access in vulnerable populations. Specifically, it connects how underserved status heightens an individual’s vulnerability to poor health. With the increase of disparities and inequalities that exist in the healthcare delivery system, implementation of caring and caring theory are examined as a plausible means to ameliorate the impact of inadequate healthcare coverage. Halldorsdottir’s (1996) theory of caring and uncaring encounters, within nursing and healthcare, from the patient’s perspective frames the discussion.

scholarly journals Estimated hospitalizations attributable to Diabetes Mellitus within the public healthcare system in Brazil from 2008 to 2010: study DIAPS 79

2014 ◽  
Vol 60 (3) ◽  
pp. 222-230 ◽  
Author(s):  
Roger Rosa ◽  
Marcelo Eidi Nita ◽  
Roberto Rached ◽  
Bonnie Donato ◽  
Elaine Rahal
Keyword(s):  
Diabetes Mellitus ◽  
Healthcare System ◽  
Primary Diagnosis ◽  
Public Healthcare ◽  
Public Healthcare System ◽  
The Public ◽  
Unified Health System ◽  
The Mean ◽  
Mean Cost ◽  
The Impact

Objective: to estimate the number of hospitalizations attributable to diabetes mellitus (DM) and its complications within the public healthcare system in Brazil (SUS) and the mean cost paid per hospitalization. Methods: the official database from the Hospital Information System of the Unified Health System (SIH/SUS) was consulted from 2008 to 2010. The proportion of hospitalizations attributable to DM was estimated using attributable risk methodology. The mean cost per hospitalization corresponds to direct medical costs in nursing and intensive care, from the perspective of the SUS. Results: the proportion of hospitalizations attributable to DM accounted for 8.1% to 12.2% of total admissions in the period, varying according to use of maximum (self-reported with correction factor) or minimal (self-reported) DM prevalence. The hospitalization rate was 47 to 70.8 per 10.000 inhabitants per year. The mean cost per hospitalization varied from 1.302 Brazilian Reais (BRL) to 1,315 BRL. Assuming the maximum prevalence, hospitalizations were distributed as 10.3% as DM itself, 36.6% as chronic DM-associated complications and 53.1% as general medical conditions. Advancing age was accompanied by an increase in hospitalization rates and corresponding costs, and more pronounced in male patients. Conclusion: the results express the importance of DM in terms of the use of health care resources and demonstrate that studies of hospitalizations with DM as a primary diagnosis are not sufficient to assess the magnitude of the impact of this disease.

scholarly journals Universal Healthcare and Access for Undocumented Immigrants

2011 ◽  
Vol 5 ◽  
Author(s):  
Samuel Wolbert
Keyword(s):  
Healthcare System ◽  
Affordable Care Act ◽  
Political Discourse ◽  
Undocumented Immigrants ◽  
Financial Burden ◽  
Public Healthcare ◽  
Universal Healthcare ◽  
Healthcare Plan ◽  
Patient Protection ◽  
Run Up

Nothing can rouse fury in even the most apathetic voter or stir the vitriol of American political discourse like the healthcare debate. From the run-up to the 2008 Presidential Election—when then-Senator Barack Obama made the creation of a revamped healthcare system the crux of his platform—through the present, the President’s Patient Protection and Affordable Care Act (“PPACA”) has been under siege. Obstreperous members of Congress on both sides of the debate levied traditional lines of criticism, concerning themselves with the law’s perceived socialist leaning 1 or the associated financial burden.2 Still other critics believe the healthcare plan will grant undocumented immigrants unmerited access to the benefits of a public healthcare system. Collectively, the narrative surrounding the healthcare debate has been so overly contentious and hostile as to obviate any remaining comity within the political discourse surrounding the problem. 3 But, behind all this white noise and livid rhetoric there still remains the central issue: without an adequate proposal that addresses the undocumented immigrant ‘problem,’ President Obama’s healthcare plan is incomplete.

scholarly journals The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

2020 ◽  
Author(s):  
Lugli Gianmarco ◽  
Ottaviani Matteo Maria ◽  
Botta Annarita ◽  
Ascione Guido ◽  
Bruschi Alessandro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Healthcare System ◽  
Public Healthcare ◽  
Healthcare Provision ◽  
Hub And Spoke ◽  
Medical Specialties ◽  
Health Crisis ◽  
Outbreak Period ◽  
Long Term Impact ◽  
The Impact

AbstractBackgroundItaly has been one of the countries most affected by the SARS-CoV-2 pandemic and the regional healthcare system has had to quickly adapt its organization to meet the needs of infected patients. This has led to a drastic change in the routine management of non-communicable diseases with a potential long-term impact on patient health care. We investigated the management of non-COVID-19 patients across all medical specialties during the pandemic in Italy.MethodsA PRISMA guideline-based systematic review of the available literature was performed using PubMed, Embase, and Scopus, restricting the search to the main outbreak period in Italy (from 20 February to 22 June, 2020). We selected articles in English or Italian that detailed changes in the Italian hospital care for non-COVID-19 patients due to the pandemic. Our keywords included all medical specialties in combination with our geographical focus (Italy) and COVID-19.FindingsOf the 4643 potentially eligible studies identified by the search, 247 studies were included in the systematic review. A decrease in the management of emergencies in non-COVID patients was found together with an increase in mortality. Similarly, non-deferrable conditions met a tendency toward decreased diagnosis. All specialties have been affected by the reorganization of healthcare provision in the hub-and-spoke system and have benefited from telemedicine during the pandemic.InterpretationOur work highlights the changes taking place in the Italian public healthcare system in order to tackle the developing health crisis due to the COVID-19 pandemic. The findings of our review may be useful to analyze future directions for the healthcare system in the case of new pandemic scenarios.

scholarly journals Examining ‘institutional entrepreneurship’ in healthcare redesign and improvement through comparative case study research: a study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e020807 ◽  
Author(s):  
Angela Melder ◽  
Prue Burns ◽  
Ian Mcloughlin ◽  
Helena Teede
Keyword(s):  
Health Service ◽  
Study Protocol ◽  
Healthcare Service ◽  
Healthcare Delivery ◽  
Comparative Case Study ◽  
Public Healthcare ◽  
Service Improvement ◽  
Institutional Entrepreneurship ◽  
Doctoral Research ◽  
The Impact

IntroductionHealthcare service redesign and improvement has become an important activity that health system leaders and clinicians realise must be nurtured and mastered, if the capacity issues that constrain healthcare delivery are to be solved. However, little is known about the critical success factors that are essential for sustaining and scaling up improvement initiatives. This situation limits the impact of these initiatives and undermines the general standing of redesign and improvement activity within healthcare systems. The conduct of the doctoral research detailed in this study protocol will be nested within a broader parent study that seeks to address this problem by drawing on the theory of ‘institutional entrepreneurship’. The doctoral research will apply this idea to understanding the capacities and capabilities required at the organisation level to bring about transformational change in healthcare services.Methods and analysisThe parent study is predominantly qualitative, is multilevel in nature and has been codesigned with five partner healthcare organisations. The focus is a sector-wide attempt in an Australian state jurisdiction to transfer new redesign and improvement knowledge into the public healthcare system. The doctoral research will focus on the implementation of the sector-wide approach in one healthcare service in the jurisdiction. This research involves interviews with project team members and stakeholders involved in two improvement initiatives undertaken by the health service. It will involve interviews with redesign and improvement leaders and senior managers responsible for the overall health service improvement approach. The methods will also include immersive fieldwork, interviews and focus groups. Appropriate methods for coding and thematic extraction will be applied to the qualitative data.Ethics and disseminationEthical approval has been granted by the health service and Monash University Human Research Ethics Committee. Dissemination will be facilitated via academic publication, industry reports and workshops and dissemination events as part of the broader project.

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