scholarly journals Forecasting the Future of Healthcare Democratization

2021 ◽  
Vol 7 (2) ◽  
pp. 155-158
Author(s):  
Beatrice Barbazzeni ◽  
Holger Fritzsche ◽  
Michael Friebe
Keyword(s):  
Healthy Lifestyle ◽  
Care Delivery ◽  
Economic Status ◽  
Global Teams ◽  
Healthcare Provision ◽  
Organization And Management ◽  
Care Services ◽  
The Future ◽  
Holistic Vision ◽  
Care Costs

Abstract Health longevity, cost reduction, prevention-based healthcare, personalized medicine, predictive diagnostic, transformed care delivery, de-aging, healthy lifestyle trends, and implementation of intelligent technologies should lead to a more democratized (availability for everyone on this planet) healthcare provision. Forecasting the future of healthcare and health policy certainly is imperfect but nevertheless a precious scientific approach that can lead to novel innovative approaches. In the last decade, the healthcare system faced several challenges, including the significant increase of care costs, demographic changes towards the older population, inability to prevent and overcome pandemics, increased chronic and non-communicable diseases, or resistance to adopting emerging technologies. The need to shift the focus from sickness to health becomes a critical mission. We developed a lecture titled "Healthtech Innovation Design" for graduate students from medicine, biomedical engineering, neuroscience and software engineering. The lecture's goal is to teach innovation methodologies, exponential technologies and methods to achieve healthcare democratization. A critical component is to promote initiatives with global teams focused on the future of health. The educational and initiative programs were impactful in growing interest toward innovation, focusing on disruption and healthcare democratization. Participants awareness towards the main issues and challenges was raised. Interdisciplinary participation was qualitatively processed to generate a holistic vision toward innovation. Through embracing digitalization to a patient-centric approach, affordable care services, and the expansion of precision medicine, the entire healthcare organization and management will likely undergo a worldwide change. Notably, digital technologies, the leverage of artificial intelligence and empathy would satisfy unmet clinical needs. With a future-oriented statement, the forecast of healthcare becomes more imaginable, in which democratization will allow the affordability of services in different countries and economic status.

Can Home Palliative Care services reduce Emergency Department visits? Piedmont Experience, 2013-2018

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Scacchi ◽  
P Berchialla ◽  
M Dalmasso ◽  
M M Gianino
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Medical Care ◽  
Care Delivery ◽  
Emergency Department Visits ◽  
Care Services ◽  
Medical Care Costs ◽  
Home Based ◽  
Ed Visits ◽  
Care Costs

Abstract Background Home-based Palliative Care (HPC) ensures multi-disciplinary medical, nursing, rehabilitation and psychological assistance for people with severe disabilities or with progressive end-stage disorders like cancer, promoting the continuity of care in home setting. Emergency Department (ED) visits in palliative care patients are considered an indicator of poor quality in home care services, since ED visits in these patients are not essential and potentially avoidable. There is still no agreement in literature about the efficacy of HPC in reducing the use of ED. However, recent studies demonstrated that HPC increases patient satisfaction while reducing use of medical services like ED, symptom burden and medical costs. The objective of this study was to evaluate if patients assisted by HPC have a reduction of ED visits compared to the 90-day period before HPC admission. Methods A retrospective study using the administrative regional database of Piedmont (Italy) was conducted on the cohort of 4433 patients admitted to HPC from 2013 to 2018. ED visits during period A (90-days before HPC) and period B (during HPC) were compared for each patient, taking into account avoidable or unavoidable visits based on triage examination. Results During period A, patients had 2880 ED visits, 1934 were considered avoidable (67%). During period B, 2050 ED visits were recorded, 994 were considered avoidable (48%). Patients receiving HPC had a reduction of overall ED visits (IRR 0.87, IC 95% 0.82-0.92) as well as avoidable ED visits (IRR 0.63, IC 95% 0.58-0.67). Unavoidable ED visits increased during HPC (IRR 1.36, IC 95% 1.24-1.49), as a consequence of disease progression. Conclusions Home-based Palliative Care is associated with a significant reduction of the use of overall Emergency Department visits (-13%) and ED avoidable visits (-37%). Since it reduces medical care costs and burden of patients and caregivers at the end of life, Home-based Palliative Care delivery should be increased. Key messages Home-based Palliative Care is associated with a reduction of the use of overall Emergency Department visits and avoidable ED visits, reducing medical care costs and burden of patients and caregivers. Home-based Palliative Care delivery should be encouraged and increased, aiming to an early enrolment as well as an increase of the patients.

scholarly journals Study of attitudes to own health patients of multiprofile institution: instruments and main results

2019 ◽  
Vol 2 (8) ◽  
pp. 28-35
Author(s):  
V.А. Gandzyuk
Keyword(s):  
Chronic Diseases ◽  
System Analysis ◽  
Clinical Medicine ◽  
Healthy Lifestyle ◽  
Care Delivery ◽  
Economic Status ◽  
Science Research ◽  
State Institution ◽  
Holistic View ◽  
Medical Checkup

Among the main determinants that form a holistic view of the health of the population are the following: lifestyle, influence of genetic factors, state of health care delivery system and socio-economic status of the country. In the article, we proposed a self-administered questionnaire on self-assessment of self-esteem, the importance of prevention and risk-taking behavior at primary level, and analyzed the main results that help characterize patients' perceptions of healthy lifestyles and health. Purpose – to study attitudes towards one's own health, to undergo periodic preventive examinations, to be responsible for one's own health among the contingent assigned to the service of the SIS “RPC PCM” SAD, and to identify the main factors of influence. Material and methods. Analysis of literary sources, sociological and system analysis. The survey was conducted at the pre-doctoral counseling stage on equal terms for all patients by way of active interviewing by the same interviewer. Results of the study and their discussion. 349 patients participated in the survey, including 159 (45.6%) men and 190 (54.4%) women. The average age of the respondents is 40.8±9.8 year (min 19 years, max 83 years). The survey questionnaires have 7 main blocks of questions, which are designed to determine the patient's level of awareness and identify him or her as accurately as possible. Conclusions. Analyzing the results of a sociological survey conducted among a contingent attached to the service of the State Institution of Science "Research and Practical Centre of Preventive and Clinical Medicine" State Administration Department, it was found that more than 95% of the respondents are aware of the concepts of "healthy lifestyle", "risk factors for chronic diseases", "foul" preventive medical checkup», etc. With regard to the assessment of one's own health, it should be noted that more than half (62.8%) of the respondents consider it satisfactory, while noting that they have one or more chronic diseases (mainly in the stage of persistent remission). The prospects for further research are to analyze the results of the questionnaire and to correlate it with the data of the objective study, which will allow to determine, besides the attitude to the medical prophylaxis and psychological type of person, the level of patient's commitment to the doctor's appointments.

scholarly journals Bibliometric Review of the Knowledge Base on Healthcare Management for Sustainability, 1994–2018

2019 ◽  
Vol 12 (1) ◽  
pp. 205 ◽  
Author(s):  
Prattana Punnakitikashem ◽  
Philip Hallinger
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Healthcare Management ◽  
Intellectual Structure ◽  
Organization And Management ◽  
Care Services ◽  
Body Of Knowledge ◽  
Bibliometric Review ◽  
Development Goals

In response to the United Nations’ (UN) Sustainable Development Goals (SDGs), health care organizations throughout the world have adopted management initiatives designed to increase their sustainability. This review of research used bibliometric methods to analyze a dataset comprised of 477 documents extracted from the Scopus database. The review sought to document research on sustainable healthcare management (SHM) that has accumulated over the past 25 years. Results indicated that the intellectual structure of this body of knowledge is comprised of three schools of thought: (1) sustainable change in health care services, (2) innovations in managing health care operations, and (3) prioritizing and allocating resources for sustainability. The review also highlighted the recent topical focus of research in this literature. Key topics were linked to organization and management of health care services, quality of patient care, and sustainability of health care delivery.

scholarly journals Analysis of Facilitators and Barriers to the Delivery of Routine Care during the COVID-19 Global Pandemic: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Cristian Lieneck ◽  
Brooke Herzog ◽  
Raven Krips
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Routine Care ◽  
Future Research ◽  
Healthcare Organizations ◽  
Care Services ◽  
Global Pandemic ◽  
Facilitators And Barriers

The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues.

scholarly journals Structure and Distribution of Health Care Costs across Age Groups of Patients with Multimorbidity in Lithuania

2021 ◽  
Vol 18 (5) ◽  
pp. 2767
Author(s):  
Laura Nedzinskienė ◽  
Elena Jurevičienė ◽  
Žydrūnė Visockienė ◽  
Agnė Ulytė ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Chronic Disease ◽  
National Health Insurance ◽  
Health Care Services ◽  
Age Groups ◽  
Age Group ◽  
Resource Usage ◽  
Care Services ◽  
Care Costs

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.

scholarly journals Effectiveness of a Care Delivery Model for High-Need Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 279-279
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu
Keyword(s):  
Older Adults ◽  
Comparison Group ◽  
Care Delivery ◽  
Care Service ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Care Services ◽  
Care Delivery Model ◽  
Community Dwelling Older Adults

Abstract The effectiveness of sufficient care coordination for high-need community-dwelling older adults has not been discussed. This study aimed to examine the effectiveness of a newly-developed care delivery model for high-need community-dwelling older adults. A cluster randomized controlled trial with repeated measures design was employed. A total of 145 high-need older adults participated in the study and were randomly assigned to either the intervention group or comparison group. A categorized list of care services based on the types of high-need older adults as the intervention allowed care coordinators to make adequate care service linkages. The intervention period ranged over 6 months with regulated home visits and assesssments. Functional ability, quality of life, depressive symptoms, and healthcare and social service utilizations were measured at baseline, and at 3 and 6 months into the intervention. The participants’ satisfaction with care delivery was measured at the end of 6-month intervention. Results showed that the intervention group had a better functional ability, a higher quality of life, reduced depressive symptoms, and more efficient healthcare and social service utilizations than the comparison group at both the 3-month and 6-month intervals (all p < .05). By the end of the 6-month study, the intervention group were more satisfied with the care service linkages than the comparison group (p < .05). The positive effects of providing a categorized list of care services for care coordinators to make service linkages have been evidenced by the outcomes. The promising findings supported a further longer-term implementation of the care delivery model.

scholarly journals Rapid implementation of virtual neurology in response to the COVID-19 pandemic

Neurology ◽  
2020 ◽  
Vol 94 (24) ◽  
pp. 1077-1087 ◽  
Author(s):  
Scott N. Grossman ◽  
Steve C. Han ◽  
Laura J. Balcer ◽  
Arielle Kurzweil ◽  
Harold Weinberg ◽  
...  
Keyword(s):  
Care Delivery ◽  
Mitigation Strategies ◽  
Urgent Care ◽  
Technology Infrastructure ◽  
Information Technology Infrastructure ◽  
Care Services ◽  
Global Pandemic ◽  
Specific Practice ◽  
Government Rules ◽  
Rapid Deployment

The COVID-19 pandemic is causing world-wide social dislocation, operational and economic dysfunction, and high rates of morbidity and mortality. Medical practices are responding by developing, disseminating, and implementing unprecedented changes in health care delivery. Telemedicine has rapidly moved to the frontline of clinical practice due to the need for prevention and mitigation strategies; these have been encouraged, facilitated, and enabled by changes in government rules and regulations and payer-driven reimbursement policies. We describe our neurology department's situational transformation from in-person outpatient visits to a largely virtual neurology practice in response to the COVID-19 pandemic. Two key factors enabled our rapid deployment of virtual encounters in neurology and its subspecialties. The first was a well-established robust information technology infrastructure supporting virtual urgent care services at our institution; this connected physicians directly to patients using both the physician's and the patient's own mobile devices. The second is the concept of one patient, one chart, facilitated by a suite of interconnected electronic medical record (EMR) applications on several different device types. We present our experience with conducting general teleneurology encounters using secure synchronous audio and video connections integrated with an EMR. This report also details how we perform virtual neurologic examinations that are clinically meaningful and how we document, code, and bill for these virtual services. Many of these processes can be used by other neurology providers, regardless of their specific practice model. We then discuss potential roles for teleneurology after the COVID-19 global pandemic has been contained.

Les Nouveaux Miserables: Modem Victims of Social Asphyxia

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 851-857
Author(s):  
David R. Smith
Keyword(s):  
Health Care ◽  
Health Status ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Services ◽  
Preventive Services ◽  
Medical Care System ◽  
Care Services ◽  
Care Costs ◽  
Care System

During the past 30 years, social and economic barriers to health care services have increased for many Americans, especially for the nation's most vulnerable populations. Health status actually has declined for certain populations during this time. Meanwhile, national attention has been focused primarily on containing health care costs and on devising strategies for reforming the financing of health care rather than strategies for achieving improvements in the health status of the population. Existing methods of financing health care services, health research priorities, the increasing centralization and compartmentalization of health care services, and the recent failure of national health reform all serve to hinder this nation's progress towards developing a comprehensive and accountable health care system focused on promoting and achieving improved health as well as treating sickness. Recent changes in the health care marketplace, however, including a growing movement toward measuring the outcomes of medical treatments and an emphasis on improving the quality of services, have increased interest among payers and providers of health care services in investing in preventive services. Health maintenance organizations and other integrated health care delivery systems are beginning to devise incentives for increasing preventive care as well as for containing costs. The transformation of the nation's current medical care system into a true health care system will require innovative strategies designed to merge the existing fragmented array of services into coordinated and comprehensive systems for delivering primary and preventive health care services in community settings. The community-Oriented Primary Care concept successfully blends these functions and has achieved measurable results in reducing health care costs and improving access to preventive services for identified populations. There is flexibility in existing funding sources to promote preventive services in various public and private health care settings and to assist in the transformation from a disease-oriented medical care system to one focused on health.

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