Adattudományi innováció az egészségügy környezeti kihívásainak kezelésében: a nagy adatállományok hasznosításának jelentősége és lehetőségei a járványkezelésben

Összefoglaló. A COVID-19 járvány rámutatott arra, hogy az egészségügy kiemelt nemzetbiztonsági terület. Az egészségbiztonsági kockázati tényezőkkel szemben ellenálló egészségügyi rendszerek adattudományi innováció nélkül nem képzelhetők el. A közlemény két esettanulmányon keresztül mutatja be, hogy a nagy, működés során generálódó adatbázisok elemzése hogyan segítheti a járványokkal szembeni védekezést. A mobilcella információk elemzése a leghatékonyabb eszköz a tömeges népességmozgások nyomon követésére, így a vesztegzár intézkedések hatásának döntéstámogatási célú vizsgálatára, az oltásellenes közösségimédia-aktivitás hálózatelemzése pedig segíti az immunizációs kampányok tervezését és megvalósítását. Tanulmányunkban amellett érvelünk, hogy az egészségügy információ- és kommunikációtechnológia fejlődésére építő digitalizációja a kulcsa egy környezeti változásokkal megbirkózni képes egészségügy kialakításának. Summary. The COVID-19 pandemic has shown that health and health care should be considered a top priority area of national security. Health security risks can only be addressed with resilient health systems, which are not possible to be established without innovation in health data science. This publication introduces two examples to illustrate this point, both in the field of the management of epidemics. The first case provides a summary of our previous publication about how mobile phone Call Detail Records can be used to trace population movement to evaluate the effectiveness of movement restriction measures, such as the lock down, which was implemented in Hungary during the first phase of the COVID-19 pandemic. Our analysis shows that the collation and processing of Call Detail Records is an effective and inexpensive method to monitor mass population movement, and complements well the GPS-based smartphone method, which is more suitable for contact tracing and controlling of home quarantine of individuals. Our CDR-based method could be used by other countries, as well as to monitor movement between countries at the European level or internationally, with minimal adaptation effort. The second case introduces a study to gain insight into and better understanding of the potential impact of antivaccination social media activism on the Human Papilloma Virus vaccination campaign in Hungary in 2014. The network analysis of Facebook antivaccination posts and comments showed that during this period, the activists in this network were unable to reach a wider population and were not able to disturb the implementation of the expansion of the well functioning Hungarian public vaccination programme. Unfortunately, this is not the case regarding the COVID-19 vaccination campaign in progress, which suggests that the antivaccination activism is a real and serious security threat to be dealt with. In conclusion, we argue in this paper that the digital transformation of health care, based on the explosive development of information and communication technologies, is of key importance to the establishment of resilient health systems, which are able to cope efficiently with the challenges posed by the rapid environmental changes generated by societal transformation of the 21st century.

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Cost estimates of COVID-19 clinical management in Myanmar

BMC Health Services Research ◽

10.1186/s12913-021-07394-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Phyu Win Thant ◽

Khin Thu Htet ◽

Wit Ye Win ◽

Ye Min Htwe ◽

Thant Sin Htoo

Keyword(s):

Health Care ◽

Critically Ill ◽

Health Systems ◽

Clinical Management ◽

Treatment Guidelines ◽

Unit Cost ◽

Economic Evaluations ◽

First Case ◽

Asymptomatic Patients ◽

Standard Treatment Guidelines

Abstract Objective This study aims to estimate the cost of clinical management of COVID-19 infected patients based on their severity by exploring the resources used in health care provision in Myanmar. Methods A multicenter retrospective cost analysis of COVID-19 patients was performed using the micro-costing approach from the perspective of the health system. It covered two cost components, namely direct and indirect cost of treating a patient. Input data and their quantities were obtained from COVID-19 Standard Treatment Guidelines of Ministry of Health and Sports, and administrative and financial records of resource utilization of three designated health facilities in Yangon Region. Valuation of these resources was based on the price list from the Procurement Section of the Ministry. Results This study estimated the unit cost of clinical management of COVID-19 infected patients with no symptom to be 953,552 MMK(717 USD), with mild-moderate symptoms to be 1,155,222 MMK(869 USD) and with severe-critically ill conditions to be 5,705,052 MMK(4290 USD). Average cost for a patient par day was 86,687 MMK(65 USD) for asymptomatic patients, 105,020 MMK(79 USD) for mild-moderate patients and 283,252 MMK(214 USD) for severe-critically ill patients. Since the first case detected till December 31, 2020, COVID-19 clinical management cost was accounted for 139 Billion MMK (104 Million USD) for total 124,630 confirmed cases. Conclusions COVID-19 pandemic has caused health systems to incur the significant health care expenses. Timely implementation of the sustainable, affordable and efficient policy for COVID-19 responses is of utmost important for every nation especially in the face of a pandemic. This study provides the fundamental inputs for strategic planning, for future economic evaluations of different policy interventions, and policy recommendations for health systems to remain resilient during and after the COVID-19 pandemic in Myanmar.

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20.F. Workshop: Dental care – coverage and access across countries

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.984 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

◽

Keyword(s):

Public Health ◽

Health Care ◽

Oral Health ◽

North America ◽

Health Systems ◽

Universal Health Coverage ◽

Dental Care ◽

Financial Protection ◽

Health Coverage ◽

Universal Health

Abstract Oral health is a central element of general health with significant impact in terms of pain, suffering, impairment of function and reduced quality of life. Although most oral disease can be prevented by health promotion strategies and routine access to primary oral health care, the GBD study 2017 estimated that oral diseases affect over 3.5 billion people worldwide (Watt et al, 2019). Given the importance of oral health and its potential contribution to achieving universal health coverage (UHC), it has received increased attention in public health debates in recent years. However, little is known about the large variations across countries in terms of service delivery, coverage and financing of oral health. There is a lack of international comparison and understanding of who delivers oral health services, how much is devoted to oral health care and who funds the costs for which type of treatment (Eaton et al., 2019). Yet, these aspects are central for understanding the scope for improvement regarding financial protection against costs of dental care and equal access to services in each country. This workshop aims to present the comparative research on dental care coverage in Europe, North America and Australia led by the European Observatory on Health Systems and Policies. Three presentations will look at dental care coverage using different methods and approaches. They will compare how well the population is covered for dental care especially within Europe and North America considering the health systems design and expenditure level on dental care, using the WHO coverage cube as analytical framework. The first presentation shows results of a cross-country Health Systems in Transition (HiT) review on dental care. It provides a comparative review and analysis of financing, coverage and access in 31 European countries, describing the main trends also in the provision of dental care. The second presentation compares dental care coverage in eight jurisdictions (Australia (New South Wales), Canada (Alberta), England, France, Germany, Italy, Sweden, and the United States) with a particular focus on older adults. The third presentation uses a vignette approach to map the extent of coverage of dental services offered by statutory systems (social insurance, compulsory insurance, NHS) in selected countries in Europe and North America. This workshop provides the opportunity of a focussed discussion on coverage of dental care, which is often neglected in the discussion on access to health services and universal health coverage. The objectives of the workshop are to discuss the oral health systems in an international comparative setting and to draw lessons on best practices and coverage design. The World Conference on Public Health is hence a good opportunity for this workshop that contributes to frame the discussion on oral health systems in a global perspective. Key messages There is large degree of variation in the extent to which the costs of dental care are covered by the statutory systems worldwide with implications for oral health outcomes and financial protection. There is a need for a more systematic collection of oral health indicators to make analysis of reliable and comparable oral health data possible.

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How Public Trust in Health Care Can Shape Patient Overconsumption in Health Systems? The Missing Links

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083860 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3860

Author(s):

Katarzyna Krot ◽

Iga Rudawska

Keyword(s):

Health Care ◽

Patient Satisfaction ◽

Health System ◽

Health Systems ◽

Quantitative Research ◽

Public Trust ◽

Complex Problem ◽

Health Care Consumption ◽

Mediating Role ◽

Countries In Transition

Overconsumption of health care is an ever-present and complex problem in health systems. It is especially significant in countries in transition that assign relatively small budgets to health care. In these circumstances, trust in the health system and its institutions is of utmost importance. Many researchers have studied interpersonal trust. Relatively less attention, however, has been paid to public trust in health systems and its impact on overconsumption. Therefore, this paper seeks to identify and examine the link between public trust and the moral hazard experienced by the patient with regard to health care consumption. Moreover, it explores the mediating role of patient satisfaction and patient non-adherence. For these purposes, quantitative research was conducted based on a representative sample of patients in Poland. Interesting findings were made on the issues examined. Patients were shown not to overconsume health care if they trusted the system and were satisfied with their doctor-patient relationship. On the other hand, nonadherence to medical recommendations was shown to increase overuse of medical services. The present study contributes to the existing knowledge by identifying phenomena on the macro (public trust in health care) and micro (patient satisfaction and non-adherence) scales that modify patient behavior with regard to health care consumption. Our results also provide valuable knowledge for health system policymakers. They can be of benefit in developing communication plans at different levels of local government.

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Depression among health care students in the time of COVID-19: the mediating role of resilience in the hopelessness–depression relationship

South African Journal of Psychology ◽

10.1177/0081246321994452 ◽

2021 ◽

pp. 008124632199445

Author(s):

Tammy-lee Pretorius

Keyword(s):

Health Care ◽

Traumatic Event ◽

National Level ◽

Depression Scale ◽

Health Care Students ◽

Mediating Role ◽

First Case ◽

Hopelessness Depression ◽

The World

COVID-19 spread rapidly across the world, and by March 2020, the first case of COVID-19 was identified in South Africa. Lockdown-related measures such as restricted movement and isolation were implemented to contain the virus. Combined with these measures, factors such as economic decline, job losses, and food shortages can cause numerous mental health sequelae such as depression. Feelings of hopelessness and helplessness as well as cases of suicide have been reported around the world due to the pandemic and the associated feelings of anxiety and depression. The aims of this study were to investigate levels of hopelessness and depression in a sample of health care students. A random sample of students ( N = 174) enrolled in a health sciences programme at the University of the Western Cape completed the Beck Hopelessness Scale, the Center for Epidemiological Studies Depression Scale, and a three-item Resilience Scale. The results revealed high levels of hopelessness and depression compared to previously reported normative data for these scales. In addition, the indirect effects of hopelessness on depression were significant, demonstrating the mediating role of resilience in the hopelessness–depression relationship. These results highlight a call for universities to take proactive measures in providing students with free and easily accessible resources to help them cope and manage stress during a traumatic event. More importantly, at a national level, preventive measures should be implemented to strengthen resilience in young adults.

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Person-Centered Health Care: An Approach That Integrates Acute and Long-Term Care

Innovation in Aging ◽

10.1093/geroni/igaa057.2474 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 704-704

Author(s):

Yuchi Young ◽

Barbara Resnick

Keyword(s):

Older Adults ◽

Health Care ◽

Health Systems ◽

Long Term Care ◽

The United States ◽

World Population ◽

Term Care ◽

The Usa ◽

Aged Society

Abstract The world population is aging. The proportion of the population over 60 will nearly double from 12% in 2015 to 22% in 2050. Global life expectancy has more than doubled from 31 years in 1900 to 72.6 years in 2019. The need for long-term care (LTC) services is expanding with the same rapidity. A comprehensive response is needed to address the needs of older adults. Learning from health systems in other countries enables health systems to incorporate best long-term care practices to fit each country and its culture. This symposium aims to compare long-term care policies and services in Taiwan, Singapore, and the USA where significant growth in aging populations is evidenced. In 2025, the aging population will be 20% in Taiwan, 20% in Singapore and 18 % in the USA. In the case of Taiwan, it has moved from aging society status to aged society, and to super-aged society in 27 years. Such accelerated rate of aging in Taiwan is unparalleled when compared to European countries and the United States. In response to this dramatic change, Taiwan has passed long-term care legislation that expands services to care for older adults, and developed person-centered health care that integrates acute and long-term care services. Some preliminary results related to access, care and patterns of utilization will be shared in the symposium. International Comparisons of Healthy Aging Interest Group Sponsored Symposium.

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Nationwide Seroprevalence of SARS-CoV-2 IgG Antibodies among Four Groups of Primary Health-Care Workers and Their Household Contacts 6 Months after the Initiation of the COVID-19 Vaccination Campaign in France: SeroPRIM Study Protocol

Pathogens ◽

10.3390/pathogens10070911 ◽

2021 ◽

Vol 10 (7) ◽

pp. 911

Author(s):

Marie Pouquet ◽

Dorine Decarreaux ◽

Pol Prévot-Monsacré ◽

Corentin Hervé ◽

Andréas Werner ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care Workers ◽

Phase 1 ◽

Vaccination Campaign ◽

Igg Antibodies ◽

Household Contacts ◽

Primary Health ◽

Care Workers ◽

Natural Protection

Background: The protocol study will focus on the seroprevalence of IgG antibodies to SARS-CoV-2 achieved by vaccination and/or natural protection as well as the history, symptoms, and risk factors for SARS-CoV-2 in four primary health-care workers (PHCWs) and their household contacts in metropolitan France. Methods: Here, we propose a protocol for a nationwide survey to determine the seroprevalence of IgG antibodies to SARS-CoV-2 achieved by vaccination and/or natural protection in four PHCW populations (general practitioners, pediatricians, pharmacists and assistants, and dentists and assistants) and their household contacts. Participants will be included from June to July 2021 (Phase 1) among PHCW populations located throughout metropolitan France. They will be asked to provide a range of demographic and behavioral information since the first SARS-CoV-2 wave and a self-sampled dried blood spot. Phase 1 will involve also a questionnaire and serological study of PHCWs’ household contacts. Seroprevalence will be estimated using two ELISAs designed to detect specific IgG antibodies to SARS-CoV-2 in humoral fluid, and these results will be confirmed using a virus neutralization test. This study will be repeated from November to December 2021 (Phase 2) to evaluate the evolution of immune status achieved by vaccination and/or natural protection of PHCWs and to describe the history of exposure to SARS-CoV-2.

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Southern social world-regionalisms: The place of health in nine African regional economic communities

Global Social Policy ◽

10.1177/1468018120961850 ◽

2020 ◽

pp. 146801812096185

Author(s):

Nicola Yeates ◽

Rebecca Surender

Keyword(s):

Health Care ◽

Public Policy ◽

Social Policy ◽

Health Systems ◽

Regional Integration ◽

Regional Cooperation ◽

Health Sector ◽

World Health ◽

Regional Health ◽

Regional Economic

This article presents key results from a comparative qualitative Social Policy study of nine African regional economic communities’ (RECs) regional health policies. The article asks to what extent has health been incorporated into RECs’ public policy functions and actions, and what similarities and differences are evident among the RECs. Utilising a World Health Organization (WHO) framework for conceptualising health systems, the research evidence routes the article’s arguments towards the following principal conclusions. First, the health sector is a key component of the public policy functions of most of the RECs. In these RECs, innovations in health sector organisation are notable; there is considerable regulatory, organisational, resourcing and programmatic diversity among the RECs alongside under-resourcing and fragmentation within each of them. Second, there are indications of important tangible benefits of regional cooperation and coordination in health, and growing interest by international donors in regional mechanisms through which to disburse health and -related Official Development Assistance (ODA). Third, content analysis of RECs’ regional health strategies suggests fairly minimal strategic ambitions as well as significant limitations of current approaches to advancing effective and progressive health reform. The lack of emphasis on universal health care and reliance on piecemeal donor funding are out of step with approaches and recommendations increasingly emphasising health systems development, sector-wide approaches (SWAPs) and primary health care as the bedrock of health services expansion. Overall, the health component of RECs’ development priorities is consistent with an instrumentalist social policy approach. The development of a more comprehensive sustainable world-regional health policy is unlikely to come from the African Continental Free-Trade Area, which lacks requisite social and health clauses to underpin ‘positive’ forms of regional integration.

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Maintaining fair and efficient health care during the COVID-19 pandemic: Theoretical context and practical implications

International Journal of Care Coordination ◽

10.1177/2053434521999959 ◽

2021 ◽

Vol 24 (1) ◽

pp. 5-9 ◽

Cited By ~ 1

Author(s):

Charalampos Milionis ◽

Maria Ntzigani ◽

Stella Olga Milioni ◽

Ioannis Ilias

Keyword(s):

Health Care ◽

Health Services ◽

Health Systems ◽

Human Life ◽

Health Coverage ◽

Maximum Benefit ◽

Community Health Systems ◽

Health Care Efficiency ◽

Universal Health ◽

Practical Implications

Coronavirus disease 2019 is a respiratory infection that has evolved to a pandemic with an enormous burden both on human life and health care. States throughout the world have pursued strategies to restrict the transmission of the virus in the community. Health systems have a crucial dual role as they are at the frontline of the fight against the pathogen and at the same time they must continue to offer emergency and routine health services. The provision of health care in the context of the COVID-19 pandemic finds certain barriers. The simultaneous protection of both universal health coverage and health care efficiency is a difficult task due to conflicting challenges of these two goals. Key actions need to be decided and implemented in the fields of health policy, operation of health services, and clinical interaction between health personnel and patients, so that health care continues to perform its mission in a sustainable manner. As the scientific community prepares for the widespread production and application of effective protective and therapeutic agents against COVID-19, it is vital for the general population to remain safe and for the health systems to survive. Allocation of resources and priority setting need to be applied fairly and efficiently for the achievement of the maximum benefit.

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