How many medical beds does a country need? An international perspective

2020 ◽  
Vol 26 (9) ◽  
pp. 248-259 ◽  
Author(s):  
Rodney P Jones
Keyword(s):  
International Comparisons ◽  
Current Method ◽  
International Perspective ◽  
Important Variable ◽  
World Health ◽  
Data Sets ◽  
Similar Data ◽  
Crude Mortality Rate ◽  
Health Organization ◽  
Bed Numbers

Background/Aims While many methods exist for calculating bed numbers, the current method for making international comparisons is inadequate, as it makes no adjustment for population age or the nearness to death effect. This study investigated the number of acute medical beds in various countries using a new method to compare bed numbers within and between countries. Methods The number of available medical beds in various (mainly European) countries were obtained from the World Health Organization. These were divided by the number of deaths in each country to give the ratio of beds per 1000 deaths and this was plotted against the ratio of deaths per 1000 population (the crude mortality rate) in each country. This was compared to similar data, but for occupied rather than available beds, for England over the period 2000/01 to 2018/19. Results In England, the medical group of specialties accounts for over 60% of all occupied acute beds. Since 2011 this proportion has risen to over 64%. For two decades England has had around 165±5 occupied medical beds per 1000 deaths (at an assumed 95% average occupancy), and England therefore has a similar number of medical beds to 11 of the 37 other countries. The relatively low slope of the relationship between beds per 1000 deaths and deaths per 1000 population indicates that the nearness to death effect is the major driving force for medical bed requirements. Conclusions Both data sets indicate that the nearness to death effect is the most important variable in forecasting occupied and available medical bed numbers. Based on the forecasted increase in deaths, demanf of medical beds in England is likely to increase by 39% over the next 40 years.

Evaluating Percentage-Based Reporting of Glucose-6-Phosphate Dehydrogenase (G6PD) Enzymatic Activity in a National Reference Laboratory: Assessment of Patient Eligibility for Plasmodium vivax Radical Cure Therapy

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S82-S82
Author(s):  
Emilia Calvaresi ◽  
Jonathan Genzen
Keyword(s):  
Normal Activity ◽  
Population Based ◽  
G6pd Activity ◽  
World Health ◽  
Reference Laboratory ◽  
Data Sets ◽  
Radical Cure ◽  
Laboratory Assessment ◽  
Data Set ◽  
Health Organization

Abstract Objectives The World Health Organization recommends measurement of G6PD activity prior to initiation of 8-aminoquinolones for the treatment of P vivax malaria. An estimated 400 million people worldwide have G6PD deficiency, making them susceptible to hemolysis under oxidative stress. A new single-dose therapy (radical cure) for malaria with tafenoquine is contraindicated in patients with <70% normal G6PD activity due to its prolonged circulating half-life. However, most clinical laboratories report G6PD activity in units g/Hb or units/1012 RBC and do not provide percentage of normal activity, making potential eligibility determination challenging. Methods Using an IRB-exempt protocol, a limited data set of consecutive G6PD quantitative results was retrieved from the clinical laboratory’s enterprise data warehouse. Laboratory testing of these specimens was previously performed at 37°C using an automated enzymatic assay (Pointe Scientific) configured on a cobas c501 chemistry analyzer (Roche Diagnostics). Data were assembled to include adults age 18 to 89 years and excluded repeat results from the same patients as well as outliers. Conclusion The final data set included 52,216 results (female, 55.9%, n = 29,173; male, 44.1%, n = 23,043) from 47 US states. An adjusted male median (100% G6PD activity) was derived using an approach proposed by the Bangkok Workshop guidelines (Domingo et al., Malaria Journal, 2013), modified to more accurately differentiate bimodal peaks in population G6PD histograms. The laboratory-specific, adjusted male median was 12.7 U g/Hb and was similar to peak values derived from alternative curve-fitting approaches. Applying this median to gender-specific data sets, 5.4% of males and 3.8% of females were found to have <70% of normal activity (<8.9 U g/Hb). This study demonstrates the feasibility of percentage-based G6PD result reporting in adults; further studies will query percentage-based reporting in pediatric populations. Population-based medians will vary based on G6PD assay type and temperature and should be established by laboratories prior to percentage-based reporting.

Management of RBC-Transfusion Dependence

Hematology ◽  
2007 ◽  
Vol 2007 (1) ◽  
pp. 398-404 ◽  
Author(s):  
Magda Melchert ◽  
Alan F. List
Keyword(s):  
Natural History ◽  
Important Variable ◽  
World Health ◽  
Primary Therapy ◽  
Endogenous Erythropoietin ◽  
Fda Approval ◽  
Increased Risk ◽  
History Of ◽  
Health Organization ◽  
Rbc Transfusion

Abstract Strategies for the management of anemia in patients with myelodysplastic syndrome (MDS) have evolved following the U.S. Food and Drug Administration (FDA) approval of three new therapeutics from one of symptom amelioration with red blood cell (RBC) transfusions to one of active treatment. Most patients develop transfusion-dependent anemia over the course of their disease, however, and its adverse consequence on the natural history of disease has only recently been appreciated. Although severe anemia contributes to symptoms of fatigue and reduced quality of life, transfusion dependence increases the risk of organ complications from iron overload coupled with an increased risk of leukemia transformation. Among World Health Organization categories without elevation in bone marrow myeloblasts, an incremental rise in RBC transfusion burden is associated with a proportionate reduction in both overall survival and leukemia-free survival, implying that anemia severity is an important variable limiting the otherwise favorable natural history of patients with lower risk disease. Moreover, therapeutic strategies that successfully restore effective erythropoiesis, such as erythropoetic stimulating agents, immunomodulatory agents, immunosuppressive therapies, or hypomethylating agents, may favorably affect the natural history of this disease, creating perhaps a new urgency for the initiation of erythropoietic promoters that have durable clinical benefit. Selection of primary therapy for the management of anemia should consider four response determinants: age, RBC transfusion burden and duration, endogenous erythropoietin production, and karyotype.

scholarly journals A comparison of hepatitis B seroepidemiology in ten European countries

2008 ◽  
Vol 137 (7) ◽  
pp. 961-969 ◽  
Author(s):  
A. NARDONE ◽  
C. G. ANASTASSOPOULOU ◽  
H. THEETEN ◽  
B. KRIZ ◽  
I. DAVIDKIN ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Vaccine Coverage ◽  
International Comparisons ◽  
European Countries ◽  
World Health ◽  
Core Antigen ◽  
Hbv Vaccination ◽  
B Virus ◽  
Health Organization ◽  
Testing Algorithm

SUMMARYTo inform current and future vaccination strategies, we describe the seroepidemiology of hepatitis B virus (HBV) infection in ten representative European countries using standardized serology that allowed international comparisons. Between 1996 and 2003, national serum banks were compiled by collecting residual sera or by community sampling; sera were then tested by each country using its preferred enzyme immunoassays and testing algorithm, and assay results were standardized. Information on current and past HBV vaccination programmes in each country was also collected. Of the ten countries, six reported low levels (<3%) of antibodies against HBV core antigen (anti-HBc). Of the eight countries testing for HBV surface antigen (HBsAg), the highest prevalence was reported in Romania (5·6%) and in the remaining seven countries prevalence was <1%. Universal HBV vaccination programmes had been established in seven countries as recommended by the World Health Organization, but the seroprevalence of antibodies against HBsAg (anti-HBs) was lower than the reported vaccine coverage in three countries. Regular serological surveys to ascertain HBV status within a population, such as reported here, provide important data to assess the need for and to evaluate universal HBV vaccination programmes.

scholarly journals Preventing Suicide in Prisons, Part I

Crisis ◽  
2007 ◽  
Vol 28 (3) ◽  
pp. 113-121 ◽  
Author(s):  
Norbert Konrad ◽  
Marc S. Daigle ◽  
Anasseril E. Daniel ◽  
Greg E. Dear ◽  
Patrick Frottier ◽  
...  
Keyword(s):  
Suicide Prevention ◽  
Task Force ◽  
International Association ◽  
International Comparisons ◽  
Epidemiological Data ◽  
World Health ◽  
Correctional Facilities ◽  
Prevention Services ◽  
Correctional Settings ◽  
Health Organization

Abstract. In 2000 the Department of Mental Health of the World Health Organization (WHO) published a guide named Preventing Suicide. A Resource for Prison Officers as part of the WHO worldwide initiative for the prevention of suicide. In 2007 there are new epidemiological data on prison suicide, a more detailed discussion of risk factors accounting for the generally higher rate of suicide in correctional settings in comparison to the general population, and several strategies for developing screening instruments. As a first step, this paper presents an update of the WHO guide by the Task Force on Suicide in Prisons, created by the International Association for Suicide Prevention. A second paper, by the same Task Force, will present some international comparisons of suicide prevention services in correctional facilities.

scholarly journals Reporting progress on the human right to water and sanitation through JMP and GLAAS

2015 ◽  
Vol 5 (2) ◽  
pp. 310-321 ◽  
Author(s):  
Óscar Flores Baquero ◽  
Alejandro Jiménez ◽  
Agustí Pérez-Foguet
Keyword(s):  
International Institutions ◽  
Global Analysis ◽  
World Health ◽  
Data Sets ◽  
Human Right ◽  
Water And Sanitation ◽  
Outcome Indicators ◽  
Joint Monitoring ◽  
Health Organization ◽  
The Right

International institutions have the authority to monitor States' compliance with the Human Right to Water and Sanitation (HRWS) but the necessary tools for this task are not yet ready. The human development sector has a wider experience of using information about progress, which provides a perfect opportunity to develop this further. The World Health Organization (WHO)/United Nations Children's Fund (UNICEF) Joint Monitoring programme (JMP) and the UN Water Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS) data sets could be used for those with a mandate to monitor the right, contributing to this challenge. Consequently, the information they offer has been analysed through a human rights lens. A matrix has been constructed to specifically identify to what extent their data sets could be combined to monitor HRWS in a broad sense. The JMP-led post-2015 proposal makes a considerable contribution to outcome indicators for measuring right-holders’ enjoyment of the right, and GLAAS adds structural and process outcome indicators to measure duty-bearers’ conduct. However, there are still some critical gaps if both UN Water platforms are to be used to report progress on HRWS. Finally, the article suggests some ideas concerning the way these shortcomings could be addressed.

scholarly journals ICD-data collection features: an international survey

2019 ◽  
Vol 2 (3) ◽  
pp. 2
Author(s):  
Lucia Otero Varela ◽  
Chelsea Doktorchik ◽  
Natalie Wiebe ◽  
Catherine Eastwood ◽  
Hude Quan
Keyword(s):  
Data Collection ◽  
Online Survey ◽  
International Comparisons ◽  
International Classification Of Diseases ◽  
World Health ◽  
Hospital Data ◽  
Discharge Disposition ◽  
Classification Of Diseases ◽  
Hospital Morbidity ◽  
Health Organization

Background:  The International Classification of Diseases (ICD) is globally used for coding morbidity and mortality statistics, however, its use, as well as the data collection features vary greatly across countries. Objective: To characterize hospital ICD-coded data collection worldwide. Methods: After an in-depth grey and academic literature review, an online survey was created to poll the 194 World Health Organization (WHO) member countries. Questions focused on hospital data collection systems and ICD-coded data features. The survey was distributed, using different methods, to potential participants that met the specific criteria, as well as organizations specialized in the topic, such as WHO Collaborating Centers (WHO-CC) or International Federation of Health Information Management Association (IFHIMA), to be forwarded to their representatives. Answers were analyzed using descriptive statistics. Results: Data from 48 respondents from 26 different countries has been collected. Results reveal worldwide use of ICD, with variations in the maximum allowable coding fields for diagnoses and interventions. For instance, in some countries there is an unlimited number of coding fields (Netherlands, Thailand and Iran), as opposed to others with only 1-6 available (Guatemala or Mauritius). Disparities also exist in the definition of a main condition, as 60% of the countries use “reason for admission” and 40% utilize “resource use”. Additionally, the mandatory type of data fields in the hospital morbidity database (e.g. patient demographics, admission type, discharge disposition, diagnoses, …) differ among countries, with diagnosis timing and physician information being the least frequently required. Conclusion: These survey data will establish the current state of ICD use internationally, which will ultimately be valuable to the WHO for the promotion of ICD and the rollout of ICD-11. Additionally, it will improve international comparisons of health data, and encourage further research on how to improve ICD coding.

scholarly journals Malaria in Haiti: A Descriptive and Temporal Study from 2009 to 2018.

2021 ◽  
Author(s):  
Jean Ricardo Jules ◽  
Jeronimo Alencar ◽  
Ernst Jn Baptiste ◽  
Martha Cecília Suárez-Mutis ◽  
Hermano Gomes Albuquerque ◽  
...  
Keyword(s):  
Urban Areas ◽  
Malaria Incidence ◽  
World Health ◽  
Epidemiological Surveillance ◽  
Data Sets ◽  
Rural And Urban Areas ◽  
Temporal Study ◽  
Rural And Urban ◽  
Epidemiological Profile ◽  
Health Organization

Abstract Background Haiti is one of the Caribbean countries where malaria still persists. Malaria occurs throughout the country at altitudes below 600 meters. More than 99% of the malaria cases are caused by Plasmodium falciparum and the main vector is Anopheles albimanus. This paper aims to describe the epidemiological profile of malaria in Haiti between 2009 and 2018. Methods We analyzed information on malaria cases reported by both the Health Ministry of Haiti (Ministère de la Santé Publique et de la Population-MSPP) and the World Health Organization (WHO) during the study period. Results Between 2009 and 2018, a total of 232,479 malaria cases were reported by the MSPP. There was an increase in the incidence of malaria in the country in 2010 followed by a decrease in 2011. Due to efforts made by Haiti over the past decade to reduce malaria by 2020, malaria incidence has declined from 60,130 cases in 2010 to 8,978 cases in 2018. We verified that the MSPP and the WHO data are conflicting in relation to the number of cases reported. However, the results from both data sets presented the same malaria trend in Haiti from 2009 to 2018. The results also show the endemicity of the disease throughout Haiti, both in rural and urban areas, especially along the coast. Conclusion This work emphasizes the need to promote official data collection and analyses and the application of epidemiological surveillance of malaria for a better knowledge about the real impact of malaria on the Haitian population aiming more appropriate interventions.

scholarly journals Environment, Lifestyle and Health Status: a European Perspective

2021 ◽  
Author(s):  
Kristina Seke ◽  
Ljiljana Marković-Denić ◽  
Velimir Štavljanin ◽  
Zoran Radojičić ◽  
Nataša Petrović
Keyword(s):  
Health Status ◽  
World Health Organization ◽  
Statistical Data ◽  
World Health ◽  
Data Sets ◽  
European Perspective ◽  
Joint Influence ◽  
The World ◽  
Health Organization ◽  
The Impact

Although population health cannot be measured in exact measurable form, a large number of concepts have been developed, and measurements have been framed through the presence of many different indicators. The impact of the environment on human health is well known. However, attention should be paid that no significant number of papers focused on the co-occurrence of environmental and lifestyle determinants on health status. This paper aims to emphasize the joint influence of environmental and lifestyle determinants on the European population's health status. The study was based on the World Health Organization statistical data, and 50 European countries were included. Three data sets were observed: Health status, Environmental, and Lifestyle indicators. Taking into account a large number of data, multivariate analyzes were applied. Results indicate that co-occurrence of environmental and lifestyle determinants have a significant impact on the health status in Europe.

scholarly journals Hospitalized Psychiatric Morbidity in Ireland: A Suggested Approach

1967 ◽  
Vol 113 (499) ◽  
pp. 675-676 ◽  
Author(s):  
Dermot Walsh ◽  
Brendan Walsh
Keyword(s):  
Mental Illness ◽  
Psychiatric Morbidity ◽  
International Comparisons ◽  
World Health ◽  
Suggested Approach ◽  
Admission Rates ◽  
Hospitalization Rates ◽  
Coefficients Of Variation ◽  
Health Organization ◽  
First Admission

Ireland has the highest rate of hospitalized mental illness on record. This is borne out both by the World Health Organization figures for treated mental illness (W.H.O., 1961), by international comparisons of point prevalence rates (Arentsen and Strdmgren, 1959) and by consideration of first admission rates (Hammer and Lcacock, 1961). The Irish national figures for each of these measures were respectively 7·12, 10·81 and 1·45 per 1,000 population in 1959. The rates exhibit a distinct geographical pattern within Ireland: they are highest on the coastal areas furthest from Dublin, while in the Dublin area they are as low as those of most western European countries. All three measures have risen over time, and the intercounty variation has also increased since 1900. In 1959 the coefficients of variation for both first admission and hospitalization rates were equal to 25·1 per cent.

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