Changing Infant Mortality: The Need to Spend More While Getting Less

PEDIATRICS ◽  
1984 ◽  
Vol 73 (6) ◽  
pp. 862-866
Author(s):  
Bernard S. Bloom
Keyword(s):  
Infant Mortality ◽  
Medical Care ◽  
Medical Technology ◽  
Social Economic ◽  
High Technology ◽  
Live Births ◽  
Potential Benefits ◽  
Expectant Mothers ◽  
Unlimited Access ◽  
Low Levels

A steady decline of infant and maternal mortality has been recorded for as long as these statistics have been collected. Much of the improvement has been due to reductions in infectious diseases and to social, economic, and public health improvements over the years. The major portion of mortality reductions took place before there were any important effects of medical care. However, there is increasing evidence suggesting that important benefits, can still be gained from medical technology. But, with infant mortality at low levels (between 7 and 12/1,000 live births in high-income countries) the wide use of high technology to effect further reductions guarantees escalating medical care expenditures. With pressures mounting to control costs, what will society be willing to give up in order to make this care available? From where will funds come to utilize costly existing and new medical technology so that all expectant mothers and newborns needing it may have essentially unlimited access in order to reap potential benefits?

The Turn to the Local: The Possibility of Returning Health Care to the Community

2002 ◽  
Vol 12 (4) ◽  
pp. 505-526
Author(s):  
Lisa H. Newton
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Medical Technology ◽  
Private Insurance ◽  
High Technology ◽  
Public School System ◽  
Medical Interventions ◽  
The Core ◽  
Single Payer ◽  
The U.S

Abstract:It is not too early to suggest that the attempts to place medical care in private hands (through group insurance arrangements) has not fulfilled its promise—or better, the promises that were made for it. Yet history has not been kind to plans to make government the single payer, and the laudable progress in medical technology has placed high-technology medical care beyond the reach of most private budgets. In this paper I suggest that the major problem of the U.S. health care system as presently conceived is a failure of legitimacy, and I put forward a proposal that purports to solve that problem. The proposal is to localize health care, on the model of a public school system, on the argument that such localization will answer most of the questions of legitimacy at the core of the private insurance imbroglio, provide a brake for medical costs, while preserving our ability to take advantage of the most advanced medical interventions. I present some initial arguments for the proposal, but await its proof in the dialogue emerging as the present insurance system collapses.

scholarly journals The theory and practice of indicative planning in health care

2019 ◽  
Vol 60 (2) ◽  
pp. 60-65
Author(s):  
V. G. Kudrina ◽  
Dzeynap O. Sapralieva
Keyword(s):  
Health Care ◽  
Infant Mortality ◽  
Medical Care ◽  
Health Care System ◽  
Russian Federation ◽  
Social Economic ◽  
Ministry Of Health ◽  
The Russian Federation ◽  
The Republic ◽  
Care System

The planning as a key function of management in health care system is focused on target indicators of population health and development of health care sector. The focusing on social economic values of target indicators and setting them as indicators of appropriateness and effectiveness of implementing activities is actual standard ofplanning. For all that, the technique of indicative planning in health care still requires to be putted to level of its theoretical substantiation (prerequisites of becoming, conceptual foundations, terms, requirements to evaluation) and implementation in practice. The example of the Republic of Ingushetia, one of the regions of the Russian Federation, was used to demonstrate becoming of indicative planning and its development with the purpose of effective management. The emphasis is made on terms system, approaches of choosing and monitoring of target indicators for indicative planning. To present the technique of indicative planning scientifically the monograph method (analysis of reports, statistical data of Rosstat, Ministry of Health of the Russian Federation and Ministry of Health of the Republic of Ingushetia) was applied. The SWOT analysis of the situation in health care of the region was applied. The infant mortality indicator became the reference point of evaluation of effectiveness of functioning of health care system and social economic reforming in the region. The level and dynamics of infant mortality indicator reflects shortcomings of medical care organization in the region and first of all absence of the three-level system of its rendering, routing according standards of medical care support of patients on main pathology profiles, including pregnant women, women in labor, newborns and children. According to situation, the investment decisions were made on the federal level. To what extent they will be effective i.e. what will be the reaction of values of target indicators of social economic development of the region, primarily indicators of infant mortality, the «road map» should demonstrate.

scholarly journals Correction to: Geographic distribution of live births and infant mortality from congenital anomalies in Brazil, 2012–2017

2021 ◽  
Author(s):  
Luzivan Costa Reis ◽  
Wesley Luciano Kaizer ◽  
Juliano André Boquett
Keyword(s):  
Infant Mortality ◽  
Geographic Distribution ◽  
Congenital Anomalies ◽  
Live Births

Social Dimensions of Genetic Disorders

1992 ◽  
Vol 14 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Joan Ablon
Keyword(s):  
Health Education ◽  
Infant Mortality ◽  
Genetic Disease ◽  
Genetic Factors ◽  
Genetic Disorders ◽  
Genetic Defects ◽  
Social Dimensions ◽  
Live Births ◽  
Department Of Health ◽  
Recessive Genes

Each of us carries between 4-8 recessive genes for serious genetic defects, and, hence, stands a statistical chance of passing on a serious or lethal condition to each child… 12 million Americans carry true genetic disease due wholly or partly to defective genes or chromosomes…40 percent or more of all infant mortality results from genetic factors…4.8 to 5 percent of all live births have genetic defects. (U.S. Department of Health, Education, and Welfare. "What are the Facts About Genetic Disease?" National Inst. of Gen. Med. Scs., P.H.S., N.I.H. DHEW Pub. No. (NIH), 75-370, 1975.)

Adolescent pregnancy, infant mortality, and source of payment for birth: Alabama residential live births, 1991–1994

2001 ◽  
Vol 29 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Anita J Cowden ◽  
Ellen Funkhouser
Keyword(s):  
Infant Mortality ◽  
Adolescent Pregnancy ◽  
Live Births

scholarly journals Geographic distribution of live births and infant mortality from congenital anomalies in Brazil, 2012–2017

2021 ◽  
Author(s):  
Luzivan Costa Reis ◽  
Wesley Luciano Kaizer ◽  
Juliano André Boquett
Keyword(s):  
Infant Mortality ◽  
Geographic Distribution ◽  
Congenital Anomalies ◽  
Live Births

How Much does Improved Medical Service Affect Infant Mortality?

PEDIATRICS ◽  
1972 ◽  
Vol 49 (4) ◽  
pp. 638-638
Author(s):  
Arnold Gilbert
Keyword(s):  
Infant Mortality ◽  
Medical Care ◽  
Community Health ◽  
Medical Service ◽  
Health Programs ◽  
Community Health Programs ◽  
Delivery Of Medical Care

The meaning of the article by Dr. Chabot in Pediatrics, June 1971 concerning improved infant mortality between 1964 and 1968 in Denver puzzled me. I wonder whether there is any relation between the improved community health programs described and the happy results presented. Surely, many factors other than medical care affect infant mortality. For example, I wonder whether the author would suggest that the startling (to me) rise in infant mortality noted in Table II for Boston, Buffalo, Phoenix, Pittsburgh and Seattle, resulted from poorer delivery of medical care.

Risk of Neonatal and Infant Mortality in Twins and Singletons by Gestational Age

2018 ◽  
Vol 36 (08) ◽  
pp. 798-805 ◽  
Author(s):  
Han-Yang Chen ◽  
Suneet P. Chauhan
Keyword(s):  
Infant Mortality ◽  
Gestational Age ◽  
Regression Models ◽  
Causes Of Death ◽  
Error Variance ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Adjusted Risk ◽  
Live Births ◽  
Risk Ratios

Objective To compare neonatal and infant mortality rates stratified by gestational age (GA) between singletons and twins and examine the three leading causes of death among them. Study Design This was a retrospective cohort study using the U.S. vital statistics datasets. The study was restricted to nonanomalous live births at 24 to 40 weeks delivered in 2005 to 2014. We used multivariable Poisson regression models with robust error variance to examine the association between birth plurality (singleton vs. twin) and mortality outcomes within each GA, while adjusting for confounders. The results were presented as adjusted risk ratios (aRRs) with 95% confidence intervals (CIs). Results Of 26,292,747 live births, 96.6% were singletons and 3.4% were twins. At 29 to 36 weeks of GA, compared with singletons, twins had a lower risk of neonatal mortality (aRR: 0.37–0.78) and infant mortality (aRR: 0.54–0.86). When examined by GA, the three leading causes of neonatal and infant mortality varied between singletons and twins. Conclusion When stratified by GA, the risk of neonatal and infant mortality was lower at 29 to 36 weeks in twins than in singletons, though the cause of death varied.

scholarly journals Infant mortality: comparison between two birth cohorts from Southeast and Northeast, Brazil

2004 ◽  
Vol 38 (6) ◽  
pp. 773-779 ◽  
Author(s):  
Valdinar S Ribeiro ◽  
Antônio A M Silva ◽  
Marco A Barbieri ◽  
Heloisa Bettiol ◽  
Vânia M F Aragão ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Protective Factor ◽  
Infant Mortality Rate ◽  
Northeast Brazil ◽  
Birth Cohorts ◽  
Neonatal Mortality Rate ◽  
Live Births

OBJECTIVE: To obtain population estimates and profile risk factors for infant mortality in two birth cohorts and compare them among cities of different regions in Brazil. METHODS: In Ribeirão Preto, southeast Brazil, infant mortality was determined in a third of hospital live births (2,846 singleton deliveries) in 1994. In São Luís, northeast Brazil, data were obtained using systematic sampling of births stratified by maternity unit (2,443 singleton deliveries) in 1997-1998. Mothers answered standardized questionnaires shortly after delivery and information on infant deaths was retrieved from hospitals, registries and the States Health Secretarys' Office. The relative risk (RR) was estimated by Poisson regression. RESULTS: In São Luís, the infant mortality rate was 26.6/1,000 live births, the neonatal mortality rate was 18.4/1,000 and the post-neonatal mortality rate was 8.2/1,000, all higher than those observed in Ribeirão Preto (16.9, 10.9 and 6.0 per 1,000, respectively). Adjusted analysis revealed that previous stillbirths (RR=3.67 vs 4.13) and maternal age <18 years (RR=2.62 vs 2.59) were risk factors for infant mortality in the two cities. Inadequate prenatal care (RR=2.00) and male sex (RR=1.79) were risk factors in São Luís only, and a dwelling with 5 or more residents was a protective factor (RR=0.53). In Ribeirão Preto, maternal smoking was associated with infant mortality (RR=2.64). CONCLUSIONS: In addition to socioeconomic inequalities, differences in access to and quality of medical care between cities had an impact on infant mortality rates.

scholarly journals PANSONOSCOPY IN POLYTRAUMA (NEW MEDICAL TECHNOLOGY)

2014 ◽  
Vol 2 (1) ◽  
pp. 46-56 ◽  
Author(s):  
Alexandr Sergeevich Iova ◽  
Irina Alexandrovna Krukova ◽  
Dmitriy Alexandrovich Iova
Keyword(s):  
Medical Care ◽  
Medical Technology ◽  
Ultrasound Examination ◽  
New Technology ◽  
Whole Body ◽  
Actual Problem ◽  
Portable Ultrasound ◽  
Traumatic Injuries ◽  
Medical Consultations ◽  
Large Sections

This article deals with the actual problem of present-day traumotology - improvement of rendering of medical care for patients with polytrauma. The new technology “Pansonoscopy” is presented, which is the minimally invasive and widely available method of fast imaging of the “whole body” of the patient in any medical situations. It permits to detect the most frequent and dangerous traumatic injuries (cranial, thoracal, abdominal, skeletal, etc.) applying portable ultrasound scanners in real-time mode. The guarantee of imaging of the intracranial injuries, pos sibility realization of ultrasound examination by clinician on his own, and possibility of online medical consultations to experts (sonologist) - are fundamently new. This technology is destined for the large sections of practitioners, what render medical care for patients with polytrauma.

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