Central COVID-19 Coordination Centers in Germany: Description, economic evaluation and systematic review (Preprint)

2021 ◽  
Author(s):  
Nikolas Schopow ◽  
Georg Osterhoff ◽  
Nikolaus von Dercks ◽  
Felix Girrbach ◽  
Christoph Josten ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health System ◽  
University Hospital ◽  
Local Health ◽  
The Public ◽  
Important Benefit ◽  
Economic Analyses ◽  
Management Institutions ◽  
Local Health System ◽  
Regional Hospitals

BACKGROUND During the COVID-19 pandemic, Central COVID-19 Coordination Centers (CCCC) have been established at several hospitals across Germany with the intention to assist local healthcare professionals in efficiently referring patients with suspected or confirmed SARS-CoV-2 infection to regional hospitals, and therefore to prevent the collapse of local health system structures. In addition, they coordinate interhospital transfers of COVID-19 patients and provide or arrange specialized telemedical consultations. OBJECTIVE This study describes the establishment and management of a CCCC at a German university hospital. METHODS We perform economic analyses (cost, cost-effectiveness, use and utility) according to the CHEERS criteria. Additionally, a systematic review was conducted to identify publications on similar institutions worldwide. RESULTS The two months with the highest local incidence (12/2020 and 01/2021) of COVID-19 cases were considered. During this time, 17.3 requests per day were made to CCCC regarding admission or transfer of COVID-19 patients. The majority of requests was made by emergency medical services (56.3%), patients with an average age of 71.8 years were involved and 69.0% of cases had already positive PCR detection. In 59.8% of the concerning patients, further treatment by the general practitioner or outpatient presentation in a hospital could be initiated after appropriate advice, 27.2% of patients were admitted to normal wards and 12.9% were directly transmitted to an intensive care unit. The operating costs of the CCCC amounted to more than €52,000 per month. 90.4% of all patients presented to the hospital were triaged and announced in advance by the CCCC. No other published economic analysis of COVID-19 coordination or management institutions at hospitals could be found. CONCLUSIONS Despite the high cost of the CCCC, we were able to show that it is a beneficial concept to both the providing hospital and the public health system. However, the most important benefit of the CCCC is that it prevents hospitals from being overrun by patients and that it avoids situations in which doctors have to weigh up one patient’s life against another´s.

scholarly journals Systematic review of experiences and perceptions of key actors and organisations at multiple levels within health systems internationally in responding to COVID-19

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Simon Turner ◽  
Natalia Botero-Tovar ◽  
Maria Alejandra Herrera ◽  
Juan Pablo Borda Kuhlmann ◽  
Francisco Ortiz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Qualitative Studies ◽  
System Level ◽  
Local Health ◽  
Multiple Levels ◽  
Local Health System ◽  
Organisational Level

Abstract Background COVID-19 has presented challenges to healthcare systems and healthcare professionals internationally. After one year of the pandemic, the initial evidence on health system responses begins to consolidate, and there is a need to identify and synthesise experiences of responding to COVID-19 among healthcare professionals and other health system stakeholders. This systematic review of primary qualitative studies depicts the experiences and perceptions of organisations and actors at multiple levels of health systems internationally in responding to COVID-19. Methods Six main databases of biomedical information, public health and health administration research were searched over the period October 1, 2019, to October 21, 2020. Information extracted from included studies was analysed thematically. Results Thirty-four studies were eligible for data extraction. Nine of those studies, of lower methodological quality, were removed from the thematic analysis of study results. Considering the professional level experiences, predominant themes of the studies consisted of the new roles and responsibilities of healthcare workers, burnout and distress, recognition of ´unseen´ healthcare workers, and positive changes and emergent solutions amid the crisis. Organisational level findings of the studies included provision of psychological support, COVID-19 as "catalyst" for change, and exercise of more "open" leadership by managers and health authorities. Continuous training, regulation of working conditions, providing supportive resources, coordinating a diversity of actors, and reviewing and updating regulations were roles identified  at the local health system level. Conclusions The experiences of frontline healthcare workers have been the focus of attention of the majority of primary qualitative studies as of October 2020. However, organisational and wider system level studies indicate that some responses to COVID-19 have been characterised by increased emphasis on coordination activities by local health system actors, making service adaptations at pace, and reliance on expanded roles of front-line workers. The need for theory-informed qualitative studies was identified at the organisational level. Trial registration CRD42020202875

PD61 HTA Regional Network In The Central Region Of Brazil: Survey In 2016

2018 ◽  
Vol 34 (S1) ◽  
pp. 152-152
Author(s):  
Flavia Tavares Silva Elias ◽  
Juliana da Motta Girardi ◽  
Rafael Moraes ◽  
Fabio Amorim ◽  
Ana Carolina Pereira ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Federal District ◽  
Decision Makers ◽  
University Hospital ◽  
Online Questionnaire ◽  
Questionnaire Response ◽  
Medical Specialties ◽  
The Public

Introduction:The Federal District in Brazil has about 2.9 million inhabitants and the public health system is focused on medical specialties, with one university hospital and twenty regional hospitals. This ecosystem is favorable for fostering health technology assessment (HTA) to improve the efficiency and effectiveness of health care. The objective was to identify institutions that could form a HTA network to support decision-oriented evidence in the public health system.Methods:Stakeholders from the hospitals and training/research institutions in the Federal District were surveyed. An online questionnaire (Google Docs) was developed to identify the potential and capacity of institutions to analyze or produce clinical and economic evidence. Two HTA seminars were held to spread knowledge about HTA and to encourage stakeholders to complete the survey.Results:The questionnaire response rate was thirty-five percent (25/70). Fifteen institutions were cited by the respondents as having the potential to build a HTA network. Twelve of the institutions produced rapid reviews and clinical guidelines, but only three of these had an organized priority setting process or produced assessments at the request of the hospital manager. The challenges identified were training and willingness of decision makers to organize HTA units in the hospitals.Conclusions:An executive group was created which defined a strategy to support the implementation of HTA units as part of the HTA National Network (REBRATS). A regulation proposal was also created to encourage decision makers to activate a HTA network in the Federal District.

scholarly journals Costs of bariatric surgery in a teaching hospital and the financing provided by the Public Unified Health System

2010 ◽  
Vol 25 (2) ◽  
pp. 201-205 ◽  
Author(s):  
Wilson Salgado Júnior ◽  
Karoline Calfa Pitanga ◽  
José Sebastião dos Santos ◽  
Ajith Kumar Sankarankutty ◽  
Orlando de Castro e Silva Jr ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health System ◽  
Perioperative Period ◽  
University Hospital ◽  
Retrospective Evaluation ◽  
The Public ◽  
Unified Health System ◽  
The Government ◽  
The Cost ◽  
The University

PURPOSE: Analyze the effect of some measures on the costs of bariatric surgery, adopting as reference the remuneration of the procedure provided by the Unified Health System (SUS). METHODS: A retrospective evaluation conducted in the Costs Section of the University Hospital of Ribeirão Preto, of the costs involved in the perioperative period for patients submitted to bariatric surgery from 2004 to 2007. Changes in the routines and protocols of the service aiming at the reduction of these costs during the study period were also analyzed. RESULTS: Nine patients in 2004 and seven in 2007 submitted to conventional vertical banded "Roux-en-Y" gastric bypass were studied. All patients presented good postoperative evolution. The average cost with these patients was R$ 6,845.17 in 2004. Even though an effort was made to contain expenditures, the cost in 2007 was of R$ 7,525.64 because of the increase in the price of materials and medicines. The Government remuneration of the procedure in the two years was R$ 3,259.72. CONCLUSION: Despite the adoption of diverse measures to reduce the expenditures of bariatric surgery, in fact there was an increase in the costs, a fact supporting the necessity of permanent evaluation of the financing of public health.

scholarly journals The Case of Brazil

2021 ◽  
Vol 11 (1-2) ◽  
pp. 111-142
Keyword(s):  
Health System ◽  
The State ◽  
Local Health ◽  
Life Domains ◽  
Social Quality ◽  
The Social ◽  
Urban Rural ◽  
Local Health System ◽  
Quality Approach

This article analyzes the impacts of the COVID-19 pandemic on the lives of the Amazonian populations of Brazil. Following the social quality approach, it inquires into how COVID-19 intertwined with and reinforced underlying trends and inequalities in different life domains expressed in long-term societal complexities, urban–rural dynamics, and environmental transformations. The article finds that the pandemic, following coloniality of power patterns, has been instrumentalized as a necropolitical tool, and has disproportionately impacted certain peoples and territories based on ethnoracial bias. The collapse of the local health system in the State of Amazonas is a systemic burden, not serendipity. A dialogue is proposed between decolonial and social quality approaches to analyze, unveil, and denounce the interplay between the coloniality of power patterns in non-Western contexts.

Indian Plural Health System and Resilience: Lessons from COVID-19

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Unnikrishnan Payyappallimana
Keyword(s):  
Health System ◽  
Health Systems ◽  
Local Health ◽  
Potential Core ◽  
The Public ◽  
Integrative Health ◽  
Indian Health ◽  
Indian Context ◽  
Rigorous Research ◽  
History Of

Beginning with a brief recent history of plural health systems in the Indian context, this is a commentary on the idea of resilience from the perspectives of AYUSH and local health traditions (LHTs) as witnessed historically and during the COVID pandemic. By narrating the AYUSH systems’ experiences during COVID-19, in providing health care and in attempts at building rigorous research and evidence, it examines their potential future engagement in the public health scenario in the country. The article contextualizes the potential core functions of plural and integrative health systems for the resilience of the Indian health system.

scholarly journals Perceptions of the quality of generic medicines: implications for trust in public services within the local health system in Tumkur, India

2018 ◽  
Vol 2 (Suppl 3) ◽  
pp. e000644 ◽  
Author(s):  
Praveen Kumar Aivalli ◽  
Maya Annie Elias ◽  
Manoj Kumar Pati ◽  
Srinath Bhanuprakash ◽  
Chikkagollahalli Munegowda ◽  
...  
Keyword(s):  
Health System ◽  
Public Services ◽  
Local Health ◽  
Generic Medicines ◽  
Local Health System
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