scholarly journals A RIPPLE EFFECT OF COVID-19 PANDEMIC ON SHORTAGE OF MEDICINAL PRODUCTS AND ITS IMPACT ON PATIENT CARE

2021 ◽  
pp. 364-370
Author(s):  
BIPLAB KUMAR DEY ◽  
EFFICIENCY MYRSING ◽  
RUHUL AMIN ◽  
FARUK ALAM ◽  
MIZANUR RAHMAN ◽  
...  
Keyword(s):  
Health Care ◽  
Medicinal Product ◽  
Antimicrobial Agents ◽  
The United States ◽  
Public Health Issue ◽  
European Medicines Agency ◽  
Ripple Effect ◽  
Medicinal Products ◽  
Short Supply ◽  
The Impact

Objective: Shortages of medicinal products are complex global problems. Drug shortages remain a significant public health issue. Global shortages of medical products have a potential effect on patient health and total healthcare costs. Countries worldwide, especially those affected by Coronavirus disease 2019 (COVID-19), is experiencing a rapid increase in drug shortage, which causes several complications for physicians, health care provider, patients, health institutes and health regulatory bodies. Methods: To carry out the study of shortages, several efforts have been taken by the regulators and industries. Prominent amongst these include FDA's research the needs and the reforms made in the regulations about shortages. We also searched for electronic databases (PubMed, Science direct, Web of Science) using the terms (COVID-19 and shortage) or (medicine and COVID-19) for articles in periods of 2019 to 2021. Results: On assessment based on the report, the number of shortage drugs in 2020 is 835; Anesthesia drugs are highest during the COVID-19 outbreak data indicate the number of shortages is 143 in USA. It was found that generic products were mostly in short supply, with antimicrobial agents (63%) topping the list of therapeutic categories of medicines with interrupted supply, followed by oncology medicines (47%) and then anesthetic agents (38%) during COVID-19 pandemic. Conclusion: Many steps have been taken to reduce the impact of a shortage of health care. Agencies like the United States Food and Drug Administration (US FDA) and European Medicines Agency (EMA) has established guidelines and works with manufacturers and other partners to help prevent shortages. This article aims to the analysis the root cause of medicinal product shortages, their effects on the patient outcome, medication error, which occurs due to the substitution safe and effective therapies with alternative treatments, identify possible solutions and policies established to manage medicinal product shortages.

Health Care, Health Insurance, and the Distribution of American Incomes

2010 ◽  
Vol 13 (1) ◽  
Author(s):  
Gary Burtless ◽  
Pavel Svaton
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Panel Study ◽  
The United States ◽  
Medical Expenditure ◽  
Cash Income ◽  
Health Coverage ◽  
Money Income ◽  
Health Care Consumption ◽  
The Impact

Cash income offers an incomplete picture of the resources available to finance household consumption. Most American families are covered by an insurance plan that pays for some or all of the health care they consume. Only a comparatively small percentage of families pays for the full cost of this insurance out of their cash incomes. As health care has claimed a growing share of consumption, the percentage of care that is financed out of household incomes has declined. Because health care consumption is more important for some groups in the population than others, the growth in spending and changes in the payment system for medical care have reduced the value of standard income measures for assessing relative incomes of the rich and poor and the young and old. More than a seventh of total personal consumption now consists of health care that is purchased with government insurance and employer contributions to employee health plans. This paper combines health care spending and insurance reimbursement data in the Medical Expenditure Panel Study and money income and health coverage data in the Current Population Survey to assess the impact of health insurance on the distribution of income. Our estimates imply that gross money income significantly understates the resources available to finance household purchases. The estimates imply that a more complete measure of resources would show less inequality than the income measures that are currently used. The addition of estimates of the value of health insurance to countable incomes reduces measured inequality in the population and the income gap between young and old. If the analysis were extended over a longer period, it would show a sizeable impact of insurance on inequality trends in the United States.

Impact of Health Plan Deductibles and Health Insurance Marketplace Enrollment on Health Care Experiences

2018 ◽  
Vol 77 (5) ◽  
pp. 483-497
Author(s):  
Weiwei Chen ◽  
Timothy F. Page
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
The United States ◽  
Health Plans ◽  
Medical Needs ◽  
Care Access ◽  
Health Care Experiences ◽  
Monitoring Survey ◽  
Using Data ◽  
The Impact

High-deductible health plans (HDHPs) have become increasingly prevalent among employer-sponsored health plans and plans offered through the Health Insurance Marketplace in the United States. This study examined the impact of deductible levels on health care experiences in terms of care access, affordability, routine checkup, out-of-pocket cost, and satisfaction using data from the Health Reform Monitoring Survey. The study also tested whether the experiences of Marketplace enrollees differed from off-Marketplace individuals, controlling for deductible levels. Results from multivariable and propensity score weighted regression models showed that many of the outcomes were adversely affected by deductible levels and Marketplace enrollment. These results highlight the importance of efforts to help individuals choose the plan that fits both their medical needs and their budgets. The study also calls for more attention to improving provider acceptance of HDHPs and Marketplace plans as these plans become increasingly common over time.

Book Reviews: Coddington et al. - The Crisis in Health Care: Costs, Choices, and StrategiesDean C. Coddington, David J. Keen, Keith D. Moore, and Richard L. Clarke San Francisco: Jossey-Bass, 1991, 303 pp. US$30.95 cloth. ISBN 1-55542-273-X. Jossey-Bass Publishers, 350 Sansome St., San Francisco, CA 94104, USA.

1992 ◽  
Vol 11 (2) ◽  
pp. 274-275
Author(s):  
Andrea L. Bonnicksen
Keyword(s):  
Health Care ◽  
San Francisco ◽  
Health Care System ◽  
The United States ◽  
Economic Research ◽  
Present System ◽  
Cost Shifting ◽  
Hospital Administrators ◽  
The Impact ◽  
Care System

PrécisThe authors assume that costs can no longer be contained in the United States health care system and that the present system cannot be sustained beyond the near future. Three of the authors are affiliated with an applied economic research and consulting firm, and the fourth is president of the Healthcare Financial Management Association. They are trained in business and city planning. The bibliography lists articles from such journals as Hospitals, Business & Health, Business Insurance, and Medical Economics.The book is directed to members of hospital governing boards and other hospital administrators, but it will be of interest to students of health policy. Part I highlights tensions between what the authors call the worlds of doctors and hospital administrators struggling to survive, on the one hand, and health care planners worried about spiraling costs on the other. Part II contains five chapters that suggest reasons for growing costs and that criticize cost shifting as a remedy.In Part III the authors evaluate alternative health care systems by presenting four future scenarios: incremental change, universal access, consumer choice model, and single payer system. In these chapters they also approach the fundamental purpose of the book—to “help physicians, hospitals, and health plans take the next steps to position themselves for the future.” While not highly analytical, the book is a readable and thoughtful supplement to more abstract critiques of the impact of today's health care system on distributive justice.

scholarly journals Machine learning analysis of lifeguard flag decisions and recorded rescues

2019 ◽  
Vol 19 (11) ◽  
pp. 2541-2549
Author(s):  
Chris Houser ◽  
Jacob Lehner ◽  
Nathan Cherry ◽  
Phil Wernette
Keyword(s):  
Machine Learning ◽  
The United States ◽  
Machine Learning Techniques ◽  
Public Health Issue ◽  
Rip Currents ◽  
Effective Strategies ◽  
Wave Forcing ◽  
Learning Techniques ◽  
Yellow Flag ◽  
The Impact

Abstract. Rip currents and other surf hazards are an emerging public health issue globally. Lifeguards, warning flags, and signs are important, and to varying degrees they are effective strategies to minimize risk to beach users. In the United States and other jurisdictions around the world, lifeguards use coloured flags (green, yellow, and red) to indicate whether the danger posed by the surf and rip hazard is low, moderate, or high respectively. The choice of flag depends on the lifeguard(s) monitoring the changing surf conditions along the beach and over the course of the day using both regional surf forecasts and careful observation. There is a potential that the chosen flag is not consistent with the beach user perception of the risk, which may increase the potential for rescues or drownings. In this study, machine learning is used to determine the potential for error in the flags used at Pensacola Beach and the impact of that error on the number of rescues. Results of a decision tree analysis indicate that the colour flag chosen by the lifeguards was different from what the model predicted for 35 % of days between 2004 and 2008 (n=396/1125). Days when there is a difference between the predicted and posted flag colour represent only 17 % of all rescue days, but those days are associated with ∼60 % of all rescues between 2004 and 2008. Further analysis reveals that the largest number of rescue days and total number of rescues are associated with days where the flag deployed over-estimated the surf and hazard risk, such as a red or yellow flag flying when the model predicted a green flag would be more appropriate based on the wind and wave forcing alone. While it is possible that the lifeguards were overly cautious, it is argued that they most likely identified a rip forced by a transverse-bar and rip morphology common at the study site. Regardless, the results suggest that beach users may be discounting lifeguard warnings if the flag colour is not consistent with how they perceive the surf hazard or the regional forecast. Results suggest that machine learning techniques have the potential to support lifeguards and thereby reduce the number of rescues and drownings.

scholarly journals Culturally Congruent Health Care of COVID-19 in Minorities in the United States: A Clinical Practice Paper From the National Coalition of Ethnic Minority Nurse Associations

2020 ◽  
Vol 31 (5) ◽  
pp. 434-443
Author(s):  
Norma G. Cuellar ◽  
Elizabeth Aquino ◽  
Martha A. Dawson ◽  
Mary Joy Garcia-Dia ◽  
Eun-Ok Im ◽  
...  
Keyword(s):  
Health Care ◽  
Ethnic Minority ◽  
Ethnic Groups ◽  
Epidemiological Data ◽  
The United States ◽  
Clinical Paper ◽  
Culturally Congruent ◽  
National Coalition ◽  
The Impact ◽  
Racial Ethnic

Introduction: Race and ethnicity along with social determinants of health have been identified as risk factors for COVID-19. The purpose of this clinical paper is to provide an overview of the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), present COVID-19 epidemiological data on five racial–ethnic groups, identify culturally congruent health care strategies for each group, and provide directions for practice and research. Method: NCEMNA collaborated to provide a clinical paper that addresses information about COVID-19 and culturally congruent health care in five racial–ethnic groups. Results: Every organization presented common themes across the different groups and unique perspectives that each group is faced with during this challenge. Discussion: This article provides an introduction to the issues that minority groups are facing. It is imperative that data are collected to determine the extent of the impact of COVID-19 in diverse communities in the country.

Immigration and Contract Problems Experienced by Foreign-Educated Nurses

2012 ◽  
Vol 69 (3) ◽  
pp. 351-365 ◽  
Author(s):  
Patricia Pittman ◽  
Carolina Herrera ◽  
Joanne Spetz ◽  
Catherine R. Davis
Keyword(s):  
United States ◽  
Health Care ◽  
Low Income ◽  
The United States ◽  
Low Income Countries ◽  
Labor Rights ◽  
Care Practice ◽  
Quality Health Care ◽  
International Recruitment ◽  
The Impact

More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.

scholarly journals The Role of Streptococcus pneumoniae in Community-Acquired Pneumonia

2020 ◽  
Vol 41 (04) ◽  
pp. 455-469 ◽  
Author(s):  
Charles Feldman ◽  
Ronald Anderson
Keyword(s):  
Antibiotic Resistance ◽  
Streptococcus Pneumoniae ◽  
Antimicrobial Agents ◽  
Bacterial Pathogen ◽  
Epidemiological Data ◽  
The United States ◽  
Invasive Infection ◽  
Geographic Variations ◽  
The Impact

AbstractWith the notable exceptions of the United States and Canada in particular, the global burden of disease in adults due to invasive infection with the dangerous respiratory, bacterial pathogen, Streptococcus pneumoniae (pneumococcus) remains. This situation prevails despite the major successes of inclusion of polysaccharide conjugate vaccines (PCVs) in many national childhood immunization programs and associated herd protection in adults, as well as the availability of effective antimicrobial agents. Accurate assessment of the geographic variations in the prevalence of invasive pneumococcal disease (IPD) has, however, been somewhat impeded by the limitations imposed on the acquisition of reliable epidemiological data due to reliance on often insensitive, laboratory-based, pathogen identification procedures. This, in turn, may result in underestimation of the true burden of IPD and represents a primary focus of this review. Other priority topics include the role of PCVs in the changing epidemiology of IPD in adults worldwide, smoking as a risk factor not only in respect of increasing susceptibility for development of IPD, but also in promoting pneumococcal antibiotic resistance. The theme of pneumococcal antibiotic resistance has been expanded to include mechanisms of resistance to commonly used classes of antibiotics, specifically β-lactams, macrolides and fluoroquinolones, and, perhaps somewhat contentiously, the impact of resistance on treatment outcome. Finally, but no less importantly, the role of persistent antigenemia as a driver of a chronic, subclinical, systemic proinflammatory/procoagulant phenotype that may underpin the long-term sequelae and premature mortality of those adults who have recovered from an episode of IPD, is considered.

The future of Indian Health Services for native Americans in the United States: an analysis of policy options and recommendations

2016 ◽  
Vol 11 (4) ◽  
pp. 397-414
Author(s):  
Tiffany Henley ◽  
Maureen Boshier
Keyword(s):  
United States ◽  
Health Care ◽  
Native Americans ◽  
American Indians ◽  
Health Care Services ◽  
The United States ◽  
Policy Options ◽  
Care Services ◽  
Policy Window ◽  
The Impact

AbstractThe passage of the Affordable Care Act in the United States has opened a policy window for the establishment of an independent Medicaid agency for the Navajo Nation. This article explores several policy options to improve health care services for Native Americans. Although there is a lack of scholarly research on the impact of healthcare reform and the effectiveness of current health care programs for American Indians, policymakers should utilize evidence-based research to inform policy decisions.

The European Network of Centres for Pharmacoepidemiology and Pharmacovigilance: application to diabetes and vascular disease

2011 ◽  
Vol 11 (6) ◽  
pp. 304-307 ◽  
Author(s):  
Kevin V Blake ◽  
Camilla Smeraldi ◽  
Xavier Kurz ◽  
Peter Arlett ◽  
Stella Blackburn ◽  
...  
Keyword(s):  
Drug Utilisation ◽  
Real Life ◽  
European Medicines Agency ◽  
The European Union ◽  
Medicinal Products ◽  
European Network ◽  
Study Protocols ◽  
Real Life Setting ◽  
The Impact ◽  
Support Decision Making

The European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) is an initiative led by the European Medicines Agency (EMA) aimed at further strengthening the post-authorisation monitoring of medicinal products in Europe by facilitating the undertaking of multi-centre, independent, studies focusing on safety and on benefit/risk. A key objective of ENCePP is to provide a unique point of access for all involved stakeholders, including industry or regulatory authorities, who are seeking collaboration for the commissioning or the performance of post-authorisation studies. The 2010 EMA regulatory action relating to rosiglitazone included a pharmacoepidemiological drug utilisation study to evaluate the benefit–risk profile in a real-life setting and has also led to the commissioning of an ENCePP study to evaluate the impact of risk-minimisation activities. ENCePP seeks to improve the European Union capacity to conduct such studies and thus support decision making. Application of the ENCePP study concept will result in an increase in trust in medicines and their use. In addition, the ENCePP register of studies will serve as a resource to allow for ready access to study protocols and results, thereby ensuring transparency.

A Framework for Assessing the Performance of Integrated Health Delivery Systems

1997 ◽  
Vol 10 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Sandra G. Leggat ◽  
Peggy Leatt
Keyword(s):  
Health Care ◽  
Health Care System ◽  
The United States ◽  
Delivery Systems ◽  
Health Delivery ◽  
Integrated Health ◽  
Integrated Delivery ◽  
The Impact ◽  
Care System ◽  
Health Delivery Systems

Competing demands for resources within the health care system require health care providers to ensure the most effective and efficient use of resources. The evidence from the United States, the United Kingdom and other jurisdictions suggests that integrated health delivery systems (IDS) may be a cost-effective way to meet the health care needs of a population. This article introduces a framework for use in monitoring and evaluating the performance of an integrated delivery system. The establishment of a consistently used evaluation framework for integrated delivery systems will provide the government, governing bodies and other evaluators with an effective assessment tool that will enable greater understanding of the impact of the IDS on the health care system. It will also provide information to enable ongoing performance improvements within the system.

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