Gender Disparity in the Medical Speciality of Obstetrics and Gynecology

2020 ◽  
Vol 16 ◽  
Author(s):  
Vitalii B. Kaliberdenko ◽  
Shanmugaraj Kulanthaivel ◽  
Elena V. Popova-Petrosyan ◽  
Natalya V. Kosolapova ◽  
Keerthanaa Balasundaram
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Health Care System ◽  
Gender Disparity ◽  
Male Students ◽  
Obstetrics And Gynecology ◽  
Medical Speciality ◽  
Significant Difference ◽  
Demographic Indices ◽  
Care System

Background:: The actual question on the health care system all over the world is gender inequity in some specialties. In spite of different influencing factors for choosing their specialty by medical students and residents, the recent research studies show that gender is significantly influencing on their specialty. Especially gender disparity or inequity is mostly seen in the field of Obstetrics and gynecology. Aim of the Research:: The purpose of our study is to understand the actual problems for male specialists in the field of obstetrics and gynecology in health care system and to understand how it affects the nation’s health care system and to analyze the possible solutions. Materials and Methods:: The research consists of 815 respondents, which includes medical students, obstetricians and gynecologists and ObsGyn patients. Average age of the respondents were 20 - 50 years. They were divided into three groups. Questionnaire consists of 15 different questions for each group of people in different languages. Results:: The significant difference about the future plan towards choosing of specialty of ObsGyn were less among male respondents with 4%, whereas female respondents accounts for 69% (P<0.001). The main reason for women to choose ObsGyn specialty were comfortability on field with 43%. On the other hand, male respondents didn’t choose ObsGyn specialty because of its less scope for male specialists in this field with 37% and they weren’t sure about the availability of patients with 51%. There is a direct proportion between patients age and wish to visit the male consultants. And indirect proportion between patients age and wish to visit the female consultants. Conclusion:: Less number of male specialists in the obstetrics and gynecology field, doesn’t mean that the male students and residents have no interests on obstetrics and gynecology, but they are thinking and doubting on employment, patient’s availability and scope in the field. By including male and female specialists equally in this field we can improve the quality in preservation of reproductive health, women’s health and significant changes in crude and specific demographic indices. Making proper awareness and explaining about the current reality could be the best possible solution for this issue. The interpersonal style and communication skills should be the most important traits in physicians rather than gender.

scholarly journals Value-Added Roles of Medical Students During COVID-19 Pandemic: Assessment of Medical Students’ Perception and Willingness in Sri Lanka

2020 ◽  
Author(s):  
Nuwan Wickramasinghe ◽  
Shamalee Jayarathne ◽  
Senaka Pilapitiya
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Sri Lanka ◽  
Health Care System ◽  
Patient Management ◽  
Clinical Skills ◽  
Health Sector ◽  
Value Added ◽  
Significant Difference ◽  
Care System

Abstract BackgroundCOVID-19 pandemic is an opportune time to identify the value-added roles of medical students to utilize the services of this potential workforce effectively in the health-care system. Hence, this study assessed medical students’ perception and willingness to assist in COVID-19 health sector preparedness and response via value-added roles in Sri Lanka. MethodsA cross-sectional online survey was conducted among all medical students studying in six batches of the Faculty of Medicine and Allied Sciences (FMAS), Rajarata University of Sri Lanka (RUSL). A Google form prepared in English with statements about individual perception of medical students’ role and their willingness to assist in the COVID-19 health sector response via value-added roles was used to collect data. ResultsOut of 856 (79.6%) study participants, the majority was females (n=601, 70.2%). The majority (n=804, 93.9%) reported that they have a responsibility to contribute to the COVID-19 health sector response in the country. There was a statistically significant difference in medical students’ perceived level of clinical knowledge and clinical skills to assist in COVID-19 health sector response with advancing academic year (p<0.001). The commonly identified value-added roles were developing (n=770, 89.9%) and disseminating (n=744, 86.9%) health education messages, and field contact tracing activities (n=653, 76.3%). Other value-added roles were assisting the curative health sector in COVID-19 patient management (n=380, 44.4%) and other non-COVID-19 patient management (n=463, 54.1%). ConclusionsMedical students are mostly willing to be engaged in the preventive health sector value-added roles and to a lesser extent in the curative health sector value-added roles during the COVID-19 outbreak. However, the medical educators need to clearly define the value-added roles and provide adequate training and supervision for medical students, from the first year to the final year, to combine learning with meaningful contributions to patient care and health-care system during the COVID-19 pandemic.

Preparing Future Physicians to Adapt to the Changing Health Care System

2017 ◽  
pp. 106-125
Author(s):  
Joanna Lauren Drowos ◽  
Sarah K Wood
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Medical Students ◽  
Health Care System ◽  
Clinical Settings ◽  
Patient Relationship ◽  
Learning Models ◽  
Clinical Clerkships ◽  
Over Time ◽  
Care System

One vital goal of medical education is to promote the development of desirable professional qualities among future physicians, such as compassion, empathy, and humanism. Future physicians must finish their training prepared to meet the changing health needs of society, yet in reality many students graduate from medical school more cynical and less empathetic than when they began. During clinical clerkships, many students experience an “ethical erosion” as they transition in to real world clinical settings. Through innovative longitudinal integrated curricular designs focusing on continuity, medical students participate in the comprehensive care of patients over time and have continuous ongoing learning relationships with the responsible clinicians. As patients place increasing importance on the doctor-patient relationship, learning models that foster stronger connections between medical students and their patients, as well as with their teachers and communities, are needed in order to better prepare the next generation of physicians to serve a changing health care system.

Impact of Contaminated Blood Cultures on Children, Families, and the Health Care System

2020 ◽  
Vol 10 (10) ◽  
pp. 836-843
Author(s):  
Megan Farrell ◽  
Sarah Bram ◽  
Hongjie Gu ◽  
Shakila Mathew ◽  
Elizabeth Messer ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Health Care System ◽  
Peripheral Blood ◽  
Blood Cultures ◽  
Hospital Charges ◽  
Significant Difference ◽  
Contaminated Blood ◽  
The Impact ◽  
Care System

BACKGROUND: Contaminated blood cultures pose a significant burden. We sought to determine the impact of contaminated peripheral blood cultures on patients, families, and the health care system. METHODS: In this retrospective case-control study from January 1, 2014, to December 31, 2017, we compared the hospital course, return visits and/or admissions, charges, and length of stay of patients with contaminated peripheral blood cultures (case patients) with those of patients with negative cultures (controls). Patients were categorized into those evaluated and discharged from the emergency department (ED) (ED patients) and those who were hospitalized (inpatients). RESULTS: A total of 104 ED case patients were matched with 208 ED control patients. A total of 343 case inpatients were matched with 686 inpatient controls. There was no significant difference between case and control patient demographics, ED, or hospital course at presentation. Fifty-five percent of discharged ED patients returned to the hospital for evaluation and/or admission versus 4% of controls. There was a significant (P &lt; .0001) increase in repeat blood cultures (43% vs 1%), consultations obtained (21% vs 2%), cerebrospinal fluid studies (10% vs 0%), and antibiotic administration (27% vs 1%) in ED patients compared with controls. Each ED patient requiring revisit to the hospital incurred, on average, $4660 in additional charges. There was a significant (P &lt; .04) increase in repeat blood cultures (57% vs 7%), consultations obtained (35% vs 28%), broadening of antibiotic coverage (18% vs 11%), median length of stay (75 vs 64 hours), and median laboratory charges ($3723 vs $3296) in case inpatients compared with controls. CONCLUSIONS: Contaminated blood cultures result in increased readmissions, testing and/or procedures, length of stay, and hospital charges in children.

scholarly journals A brief instrument to measure attitudes of medical students toward changes in the health care system

1999 ◽  
Vol 74 (10) ◽  
pp. S78-80 ◽  
Author(s):  
M Hojat ◽  
J J Veloski ◽  
J S Gonnella ◽  
J B Erdmann ◽  
S Rattner
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Health Care System ◽  
Care System

scholarly journals Stories of institutional and local policy change from Harvard’s Cambridge Health Alliance

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Debra Ann Dawson
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Health Care System ◽  
Policy Change ◽  
Local Population ◽  
Cultural Exchange ◽  
Academic Community ◽  
Local Policy ◽  
Health Alliance ◽  
Care System

In May of 2017, myself and five other first and second year McGill Medical students embarked on a cultural exchange with Harvard medical students.  This is an annual program run by Dr. Semaan, professor at Harvard Medical School, and McGill Medicine graduate. During the exchange, we had the opportunity to attend some pointed lectures which had the goal of illustrating some of the realities of the health care system in the Cambridge-Boston area.  This article is a reflection on the talk given by Dr. David Bor of the Cambridge Health Alliance titled “Cambridge Health Alliance: A Public, Academic Community-Responsive Health Care System”, wherein he provided inspiring personal stories of institutional and policy change pursuits he was involved in in response to needs of the local population.

Abstract P863: Did Covid 19 Highlight Disparities in Stroke Care: A Real-World Study of Telehealth Utilization Between Urban and Suburban Populations in a Health Care System

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Maryika I Gibson ◽  
Ruchi Wanchoo
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Care Delivery ◽  
Small Sample Size ◽  
National Level ◽  
Stroke Care ◽  
Small Sample ◽  
Acute Stroke Care ◽  
Significant Difference ◽  
Care System

A viable alternative to in person assessments, telemedicine offered providers cost effective and safe alternative to patient care delivery during COVID19. Resource limitations, state and organizational safety precautions accelerated our system adoption of video visits for stroke post hospitalization assessments. Utilizing mixed methods we aimed to investigate an association between patients characteristics (age, gender, race, Modified Rankin Score-mRS, residence) and their choice for post-acute care during a five-month period. The subset selecting in-person visits was further interviewed regarding perceptions of barriers to telehealth. We analyzed data from 85 patients’ records (45 in the urban telehealth and 40 in the suburban clinic visit groups) according to ICD10 codes. While total volume of televisits increased during COVID 19, stroke accounted for <1% of them. There was no significant difference in the mean age between the two groups-68.5 years in the clinic and 64.4 in the tele. The clinic subset had 42% of patients age greater than 75 years. Significant difference was detected in disabilities (t=3.5, p<.001) with one-point higher mean mRS (1.7 vs .7) and stronger positive correlation of age to disabilities in the suburban group (r2=.26 vs r2=.16). Patients selecting in-person care outlined as barriers to telehealth a lack of technology, poor connectivity, no caregiver availability for tele exam, inability to communicate or other major co-morbidities, family’s perception of complexity of patient’s condition, fragmentation of care during the period. Patients selecting video assessment were more connected with a health care system and from the urban center. Strengths of the study are the application of mix methods and investigation of suburban patients’ perceptions of barriers to telehealth. Limitations consist of small sample size and 90% Caucasian population. Current technology advancements, software applications, and the goal of Healthy People 2030 of removing disparities in heart and stroke disease will require a new multipronged approach to improving stroke telehealth at population level. Further studies at national level including social determinates of health need to examine barriers to telemedicine in post-acute stroke care.

scholarly journals Impact of the SARS-CoV-2 pandemic on the course and treatment of appendicitis in the pediatric population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alicja Pawelczyk ◽  
Malgorzata Kowalska ◽  
Marzena Tylicka ◽  
Olga Martyna Koper-Lenkiewicz ◽  
Marta Diana Komarowska ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Abdominal Cavity ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
World Health ◽  
Major Influence ◽  
Significant Difference ◽  
Purulent Peritonitis ◽  
Care System

AbstractSARS-CoV-2 is a highly contagious virus causing mainly respiratory track disease called COVID-19, which dissemination in the whole world in the 2020 has resulted in World Health Organisation (WHO) announcing the pandemic. As a consequence Polish Government made a decision to go into a lockdown in order to secure the population against SARS-CoV-2 outbreak what had its major influence on the Polish Health Care System. All of the social and medical factors caused by the pandemic might influence children’s health care, including urgent cases. The aim of this survey was the analysis of medical charts with focus on the course and results of surgical treatment of children who underwent appendectomy before and during the COVID-19 pandemic. Material and methods: We performed analysis of charts of 365 subjects hospitalized in the Pediatric Surgery Department from 1st January 2019 to 31st December 2020 because of acute appendicitis. Patients were divided into two groups—those treated in 2019—before pandemic outbreak, and those treated in 2020 in the course of pandemic. Results: the most common type of appendicitis was phlegmonous (61% of cases in 2019 and 51% of cases in 2020). Followed by diffuse purulent peritonitis (18% of cases in 2019 vs 31% of cases in 2020), gangrenous (19% of cases in 2019 vs 15% of cases in 2020) and simple superficial appendicitis (1% of cases in 2019 vs 3% of cases in 2020). There was statistically significant difference in the length of hospitalization: in 2019 the mean length of hospi-talization was 4.761 vs 5.634 in 2020. Laparoscopic appendectomy was performed more frequently before the COVID period (63% of cases treated in 2019 vs 61% of cases treated in 2020). In the pandemic year 2020, there was double increase in the number of conversion from the laparoscopic approach to the classic open surgery. In the year 2019 drainage of abdominal cavity was necessary in 22% of patients treated with appendectomy, in 2020 the amount of cases threated with appendectomy and drainage increased to 32%. Conclusions: fear of being infected, the limited availability of appointments at General Practitioners and the new organisation of the medical health care system during pandemic, delay proper diagnosis of appendicitis. Forementioned delay leads to higher number of complicated cases treated with open appendectomy and drainage of abdominal cavity, higher number of conversions from the laparoscopic to classic open technique, and longer hospitalization of children treated with appendectomy in the year of pandemic.

scholarly journals Universal Health Care and Reform of the Health Care System: Views of Medical Students in the United States

2006 ◽  
Vol 81 (8) ◽  
pp. 721-727 ◽  
Author(s):  
Jeffrey Huebner ◽  
Jaya R. Agrawal ◽  
Ashwini R. Sehgal ◽  
Paul Jung ◽  
Joan Hedgecock ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Students ◽  
Health Care System ◽  
The United States ◽  
Universal Health Care ◽  
Universal Health ◽  
Care System

scholarly journals Patients’ Satisfaction of Health Care System Reform Plan in Educational-Medical Centers of Rasht City in North of Iran, 2018

2020 ◽  
Vol 30 (4) ◽  
pp. 191-199
Author(s):  
Samid Bahari Jokandan ◽  
Ataollah Asadi Louyeh ◽  
Zahra Majd Teimoori ◽  
Ehsan Kazem Nezhad Leili
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Care Quality ◽  
System Reform ◽  
Patients Satisfaction ◽  
Medical Centers ◽  
Reform Plan ◽  
Significant Difference ◽  
The Mean ◽  
Care System

Introduction: One of the goals of the health system is to ensure that people are healthy. Reaching this goal is only possible through the provision of the proper services. The satisfaction of patients with the quality of health care services is used as a questionare to investigate the effectiveness of hospital services concerning consumption management and patient care quality. It assists managers and the decision-making network to identify the strengths and weaknesses of the system. Objective: This study aimed to investigate the satisfaction of hospitalized patients in educational and medical centers of Rasht City, Iran with the “Health Care System Reform Plan” in 2019. Materials and Methods: The present study is an analytical cross-sectional study. A total of 395 patients hospitalized in educational and medical centers of Rasht City were selected based on the stratified random sampling method and according to the inclusion criteria. The study data were collected by a questionnaire examining patients' satisfaction with the “Health Care System Reform Plan” developed by the Treatment Deputy of Guilan University of Medical Sciences. The questionnaire has 37 questions in 5 areas of patient’s satisfaction with hoteling, hospital bills reduction program, resident physician program, notification program, the program for the promotion of normal childbirth. Data analysis performed using descriptive statistics indicators and Mann-Whitney U, Kruskal Wallis, and logistic regression model. Results: The results showed the mean±SD of samples' age was 43.51±18 years. The majority (23.8%) of the samples were less than 30 years old. Moreover, there was a significant difference between satisfaction score of the Plan (P = 0.009) in terms of gender, hospital bills (P = 0.001), resident physicians (P = 0.009), and notification program (P = 0.032). Also, men had a higher overall score than women. The findings of this study showed that the mean ± SD satisfaction was equal to 82.8 9.1 with a minimum score of 39.71. In the logistics model, only two variables of the hospital (P = 0.017) and job (P = 0.001) were considered as the most important factors related to the overall satisfaction with the “Health Care System Reform Plan.” Conclusion: Based on the results of the study, patients' satisfaction with the implementation of the “Health Care System Reform Plan” was at the acceptable level and various factors have contributed to this level of satisfaction.  

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