scholarly journals Socioeconomic characteristics and costs of rare and orphan diseases in Peru, 2019

2021 ◽  
Vol 21 (4) ◽  
pp. 710-718
Author(s):  
Grecia Claussen Portocarrero ◽  
Alfonso Gutierrez Aguado
Keyword(s):  
Age Groups ◽  
Orphan Diseases ◽  
Access To Health Services ◽  
Administrative Records ◽  
The Public ◽  
Socioeconomic Characteristics ◽  
Access To Health ◽  
Observational Design ◽  
Delay Of Diagnosis ◽  
A Current

Introduction: The rare and orphan diseases (ROD) constitute a current challenge due to the lack of investigation. Objective: Describe the socioeconomic characteristics of rare and orphan diseases (ROD) in Peru, 2019. Methods: Descriptive observational design. The information was obtained from FISSAL administrative records, and an intentional sample of 20 patients was taken to carry out the questionnaire on ROD. For the economic records, a review of the public budget of the MEF was made. The data analysis was descriptive and inferential. Results: There were 454 patients with a total of 49 ROD; of these, the most representative age groups were schoolchildren and young adults (18% each), and the most frequent diagnosis was Tetralogy of Fallot (22%). The questionnaire on ROD reports a median of 7 months in the delay of diagnosis and between 3 and 5 doctors were visited. Likewise, 30% considered that it generated a high to very high expense. It was calculated that the ROD budget constitutes 2.25% of the total budget for high-cost diseases. Likewise, the ROD budget was different between 2014 and 2019. Conclusions: The population with ROD in Peru is not large; however, it requires greater attention to access to health services and a greater budget allocation.

scholarly journals Analysis of Hospital Lethality of COVID-19 in Mexico

2021 ◽  
Vol 14 (4) ◽  
pp. 2157-2164
Author(s):  
Carolina Muñoz- Corona ◽  
Elia Lara-Lona ◽  
Christian Andrés Díaz- Chávez ◽  
Gilberto Flores- Vargas ◽  
Daniel Alberto Díaz- Martínez ◽  
...  
Keyword(s):  
Social Dynamics ◽  
Age Groups ◽  
Hospitalized Patients ◽  
Social Changes ◽  
Access To Health Services ◽  
Ministry Of Health ◽  
Cross Sectional ◽  
Access To Health ◽  
Quantitative Descriptive ◽  
General Mortality

Background. COVID-19 has caused 244,830 deaths in Mexico. Evaluating the severity of this contingency is possible if the hospital fatality rate of COVID-19 is described because hospitalized patients present more severe conditions. Objective. To analyze the fatality of COVID-19 in hospitalized patients. Methods. A quantitative, descriptive, analytical, cross-sectional, and retrospective study was conducted using open database from Ministry of Health in Mexico. Results. The analysis included 71,189 discharges from patients diagnosed with COVID-19 in the Mexican Ministry of Health Hospitals during 2020. Of them, 27,403 were due to death, predominantly in men and age groups from 50 to 69 years. The general hospital fatality due to COVID-19 was 38.49%, a hospital fatality of 40.75% in men and 35.03% in women. The 55-to-99-year-old age groups, Baja California, Puebla, and Coahuila had a higher hospital fatality than the general fatality. Conclusion. Besides the deaths caused directly by COVID-19 (those that occurred due to respiratory failures), many deaths were indirect in persons with comorbidities exacerbated by this disease. Access to health services, social changes derived from job loss, home protection, and changes in social dynamics, facts expressed in the general mortality excess, cannot be quantified in our study. There are similar patterns with other persons infected worldwide: this disease is more severe for males and older age subjects.

scholarly journals Exploring Accessibility of Community Pharmacy Services

2015 ◽  
Vol 6 (3) ◽  
Author(s):  
Sarah E. Kelling
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Pharmacy ◽  
Health Care Professionals ◽  
Community Pharmacists ◽  
Access To Health Services ◽  
The Public ◽  
Access To Health ◽  
Accessibility Of Health Services ◽  
System Access

Objective: To use selected literature to describe strengths and opportunities for improvement related to accessibility of health services in the community pharmacy setting. Summary: Pharmacists have been described as one of the most accessible health care professionals, particularly as nearly 90% of Americans live within 5 miles of a community pharmacy. However, geography alone does not provide access to health services. Individuals must be able to gain entry into the health care system, access a health care location where needed services are provided, and find a health care provider with whom the patient can communicate and trust. Current and potential opportunities for community pharmacists to increase access via each step are described. Conclusion: Community pharmacists are highly accessible health care professionals who are trusted by patients. Opportunities exist to further increase access to dispensing and non-dispensing services in order to better meet the needs of the public.   Type: Commentary

scholarly journals Reforming Medicaid and Vulnerable People

2016 ◽  
Vol 20 (1) ◽  
pp. 33
Author(s):  
Arnold Birenbaum
Keyword(s):  
People With Disabilities ◽  
Federal State ◽  
Access To Health Services ◽  
The Public ◽  
Insurance Program ◽  
Political Clout ◽  
Access To Health ◽  
Vulnerable People ◽  
Almost All ◽  
Gain Access

Medicaid, the federal-state financed program that assists people to gain access to health services when they cannot afford them, has been inthe news of late. Unfortunately the news is disquieting for people who count on this program for health care and rehabilitation services. Change is not always the friend of vulnerable people, and in this instance, it can be downright disruptive when it comes to accessing services. Because they are not well organized, people with Medicaid coverage do not have political clout, even though more people are covered by Medicaid than Medicare (e.g., the public insurance program for almost all people over the age of 65 and some people with disabilities). New Bush administration proposals and ongoing practices could be particularly harsh for people with disabilities.

scholarly journals Epidemiological and socio-economic characteristics of the COVID-19 spring outbreak in Quebec, Canada: A population-based study

2020 ◽  
Author(s):  
Rodolphe Jantzen ◽  
Nolwenn Noisel ◽  
Sophie Camilleri-Broet ◽  
Catherine Labbe ◽  
Thibault de Malliard ◽  
...  
Keyword(s):  
Online Survey ◽  
Population Based ◽  
Health Condition ◽  
Positive Test ◽  
Access To Health Services ◽  
The Public ◽  
Health Authorities ◽  
Access To Health ◽  
The Status ◽  
Public Health Authorities

Background: By mid-July 2020, more than 108,000 COVID-19 cases had been diagnosed in Canada with more than half in the province of Quebec. To be prepared for a potential second wave of COVID-19 in the fall, it seems of utmost importance to analyze the epidemiological and socio-economic characteristics of the spring outbreak in the population. Method: We conducted an online survey of the participants of the CARTaGENE population-based cohort, composed of middle-aged and older adults. We collected information on socio-demographic, lifestyle, health condition, COVID-related symptoms and COVID-19 testing. We studied the association between these factors and two outcomes: the status of having been tested for SARS-CoV-2 and the status of having received a positive test when having been tested. These associations were evaluated with univariate and multivariate analyzes using a hybrid tree-based regression model. Results: Among the 8,129 respondents from the CARTaGENE cohort, 649 were tested for COVID-19 and 41 were positive. Medical workers and individuals having a contact with a COVID-19 patient had the highest probabilities of being tested (32% and 42.4%, respectively) and of being positive (17.2% and 13.0%, respectively) among those tested. 7.6% of the participants declared that they have experienced at least one of the four COVID-related symptoms chosen by the Public Health authorities (fever, cough, dyspnea, anosmia) but were not tested. Results from the tree-based model analyzes adjusted on exposure factors show that the combination of dyspnea, dry cough and fever was highly associated with being tested whereas anosmia, fever, and headache were the most discriminant factors for having a positive test among those tested. During the spring outbreak, more than one third of the participants have experienced a decrease in access to health services. There were sex and age differences in the socio-economic and emotional impacts of the pandemic. Conclusion: We have shown some discrepancies between the symptoms associated with being tested and being positive. In particular, the anosmia is a major discriminant symptom for positivity whereas ear-nose-throat symptoms seem not to be COVID-related. The results also emphasize the need of increasing the accessibility of testing for the general population.

scholarly journals Epidemiological profile of home deaths due to stroke during the COVID-19 pandemic

2021 ◽  
Author(s):  
Gyovanna Rodrigues Cardoso ◽  
Gabriel David Camargo ◽  
Nikolas Lisboa Coda Dias ◽  
Priscila Anice Fernandes ◽  
Stefan Vilges de Oliveira
Keyword(s):  
Age Groups ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Medical Support ◽  
Cross Sectional ◽  
Access To Health ◽  
Excessive Alcohol ◽  
Epidemiological Profile

Background: Stroke is one of the main causes of death, disability and hospitalization. Although more prevalent in adults and the elderly, it has increased in young people for stress, poor diet, excessive alcohol and sedentary lifestyle. This study is justified because the restrictions in the pandemic, such as social isolation, reduced access to health services, have changed people’s behavior in relation to health care. This can cause the delay in medical care, leading to negative outcomes. Objectives: Analysis of home deaths for stroke, in Brazil, in the pandemic by age intervals. Design and Setting: Cross-sectional study in Federal University of Uberlândia. Methods: Study of home deaths from stroke, based on the Portal de Transparência do Registro Civil (ARPEN). Analyzing a previous context and during the pandemic, the percentage variations by age group between 2019 and 2020 were compared. Results: In 2020, 15,777 home deaths were recorded, while 2019 there were 12,349, representing an increase of 27.76%. In 2020, all age groups analyzed, there were increases in relation to 2019, the most expressive were: 0-9 years (76%), 10-19 (32.14%), 60-69 (28.12%), 70-79 (36.35%) and 80-89 (29.97%). Conclusions: Medical support in the first hours of symptoms is essential. The delay in care can delay the diagnosis, make the use of medications unfeasible, due to the door-to-needle times, as well as increasing home deaths. Thus, it is important to guide the population in the identification of signs and symptoms, to knowledge about the need for immediate hospital care, even in the pandemic.

scholarly journals An Interview Study of Consequences of Early-Career Unemployment in Bulgaria

2019 ◽  
Vol 10 (2) ◽  
Author(s):  
Veneta Krasteva
Keyword(s):  
Personal Development ◽  
Age Groups ◽  
Early Career ◽  
Point Of View ◽  
Negative Consequences ◽  
Access To Health Services ◽  
Family Ties ◽  
Access To Health ◽  
In The Beginning ◽  
Depth Interviews

The article examines the consequences of prolonged unemployment experienced in the beginning of the career in Bulgaria from a subjective point of view. The analysis is based on information obtained from in-depth interviews with people from three age groups who have entered the labor market in periods with high levels of unemployment. The negative consequences pointed out by the interviewed people include material deprivation, limited access to health services, low self-esteem, interruption of social contacts, postponement of creating a family and living in a home of one’s own, loss of hope for a better future. Along with the negative consequences, some positive ones were also identified, such as strengthening family ties, people’s enhanced motivation to deal with the arising difficulties and their striving for personal development.

scholarly journals The prevention of teenage pregnancy in adolescent's view

2015 ◽  
Vol 24 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Milla Wildemberg Fiedler ◽  
Alisson Araújo ◽  
Márcia Christina Caetano de Souza
Keyword(s):  
Health Care ◽  
Teenage Pregnancy ◽  
Access To Health Services ◽  
Contraceptive Methods ◽  
Public Power ◽  
The Public ◽  
Barriers To Access ◽  
Access To Health ◽  
Semistructured Interviews

The objective of the research is to understand the vision of adolescents on the prevention of adolescent pregnancy in a school in the municipality of Divinópolis, Minas Gerais. This is a descriptive study, exploratory, with a qualitative approach, with 14 adolescents. Semistructured interviews. Data were analyzed and interpreted by discourse analysis. The analysis of the reports of the subjects interviewed originated four empirical categories: perception about the importance of preventing teenage pregnancy, knowledge about the use of contraception methods, use of contraceptives methods, barriers to access to health services for the prevention of pregnancy. It is concluded that the adolescents consider the prevention of teenage pregnancy as something positive, express their Knowledge about contraceptive methods demonstrate that practicing, safe sex and unsafe and point out flaws in the quality of health care. Efforts of public power are required for the realization of the public policies in health care of adolescents.

scholarly journals Improving the usefulness of mortality data: reclassification of ill-defined causes based on medical records and home interviews in Brazil

2019 ◽  
Vol 22 (suppl 3) ◽  
Author(s):  
Elisabeth Barboza França ◽  
Lenice Harumi Ishitani ◽  
Renato Azeredo Teixeira ◽  
Carolina Cândida da Cunha ◽  
Maria Fatima Marinho
Keyword(s):  
Age Groups ◽  
Family Health ◽  
Mortality Data ◽  
Access To Health Services ◽  
Access To Health ◽  
Underlying Causes ◽  
Quality Of Medical Care ◽  
Training Physicians ◽  
Over Time

ABSTRACT Introduction: Brazil presented a high proportion of ill-defined causes of death (IDCD) in 2000, compromising accurate cause-of-death analysis. Objective: To analyze specific underlying causes for deaths originally assigned as IDCD in the Mortality Information System (SIM - Sistema de Informação sobre Mortalidade), after investigation activities implemented in country between 2006 and 2017. Method: For all IDCD identified in the SIM, municipal health professionals collected information about the final disease obtained from hospital records, autopsies, forms of family health teams, and home investigation. Specific causes among reclassified IDCD after investigation were evaluated according to age groups and four calendar periods. Results: Proportions of IDCD reassigned to other causes after review increased over time, reaching 30.1% in 2017. From a total of 257,367 IDCD reclassified in 2006-2017, neonatal-related conditions, injury, ischemic heart disease and stroke were the leading causes detected in the age groups 0-9 years, 10-29 years, 30-69 years, 70 years and over, respectively. Discussion: The similarity and plausibility of cause-specific proportions derived from the reclassification of IDCD by age group over time indicate the accuracy of the investigation data. Conclusion: High proportions of IDCD reassigned to more informative causes after review indicate the success of this approach to correct misclassification in the SIM, an initiative that should be maintained. Training physicians on death certification along with better quality of medical care and access to health services would lead to further improvement.

scholarly journals A health impact assessment (HIA) on a new motorway bypass in Strasbourg, France

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Christie ◽  
G Dardier ◽  
F Jabot ◽  
A Roué-LeGall ◽  
N Cantoreggi ◽  
...  
Keyword(s):  
Air Pollution ◽  
Health Services ◽  
Rural Area ◽  
Road Safety ◽  
Living Environment ◽  
City Centre ◽  
Health Determinants ◽  
Access To Health Services ◽  
The Public ◽  
Access To Health

Abstract Issue In 2018-2019, HIA was carried out on a projected 24-km north-south motorway bypass in a rural area west of Strasbourg, intended to alleviate pressure on a pre-existing motorway that cuts through the city centre. Although transport is a major source of impacts on health, HIA is rarely performed on new road construction projects, globally. Description The HIA included the screening, scoping, assessment and recommendations phases. Assessed health determinants were outdoor air quality, noise, mobility/access to health services, road safety, urban planning and the living environment. Methods included a literature review, the AirQ+ air pollution model, cartography and an NVivo analysis of answers to a public enquiry. Results Noise was set to increase for 1-4% of the population in the study area, but impacts related to air pollution appeared to be negligible and road safety did not change substantially. Mobility and access to health services were to improve, with strong local differences (inequalities): some areas benefitted from access to the new motorway without being affected by noise or traffic, while for others it was the opposite. Stakeholders who participated in the public enquiry were concerned about the loss of agriculturally and environmentally valuable land, viewed as a collective cultural asset. Those living in the vicinity of the bypass expressed anger at the reduction of the quantity and quality of green areas, which was experienced as an injustice given their choice to live in a rural area. Our recommendations related mainly to the pre-existing urban motorway, where reducing traffic volumes and speeds, as well as diverting trucks onto the new bypass, had the most promising effects on health. Lessons Due to its rural localization, the new road had limited health effects through air pollution, which is the focus of many transport-related HIAs. Through the analysis of the public enquiry, the HIA showed that the project generated anger and distress. Key messages The substantial investment represented by the new bypass did not solve pre-existing problems related to environmental health but generated new ones linked to social and mental health issues. Many HIAs miss out on valuable qualitative information because interviews or focus groups cannot be carried out with local stakeholders. Secondary analysis of public consultations can fill this gap.

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