scholarly journals Theme C: AGEING AND HEALTH SYSTEM SUSTAINABILITY Session C1: Demographic Challenges in the European Ageing Societies Session C2: Bioethics and Ageing Session C3: Epidemiological Trends on Prevention of Age Related Frailty Syndrome and Diseases Session C4: Community Based Approaches and Medical Wellness for Healthy Ageing Session C5: Healthcare System Organization in the Advent of Chronic Diseases Caused by Ageing

2020 ◽  
Vol 142 (supp 1) ◽  
Keyword(s):  
Health System ◽  
Chronic Diseases ◽  
Healthcare System ◽  
System Organization ◽  
Frailty Syndrome ◽  
Community Based ◽  
Demographic Challenges ◽  
Age Related ◽  
System Sustainability ◽  
Epidemiological Trends

scholarly journals Prioritizing Community-Based Intervention Programs for Improving Treatment Compliance of Patients with Chronic Diseases: Applying an Analytic Hierarchy Process

2021 ◽  
Vol 18 (2) ◽  
pp. 455
Author(s):  
Do Hwa Byun ◽  
Rho Soon Chang ◽  
Myung-Bae Park ◽  
Hyo-Rim Son ◽  
Chun-Bae Kim
Keyword(s):  
Analytic Hierarchy Process ◽  
Chronic Diseases ◽  
Healthcare System ◽  
Primary Care Physicians ◽  
Treatment Compliance ◽  
Intervention Programs ◽  
Community Based ◽  
Analytic Hierarchy ◽  
Ahp Model ◽  
Hierarchy Process

The purpose of this study was to apply multicriteria decision making and an analytic hierarchy process (AHP) model for assessing sustainable management of hypertension and diabetes. Perception of two alternative health care priorities was also investigated. One priority was improving treatment compliance of patients with hypertension and diabetes. The other priority was strengthening the healthcare system for continuous care. Our study design to evaluate community-based intervention programs for hypertension and diabetes was developed using brainstorming, Delphi techniques, and content analysis along with literature review. We finally proposed a hierarchical structure of the AHP model with 50 third sub-criteria in six levels. By surveying this AHP questionnaire to a total of 185 community health practitioners in Korea, we found that improving treatment compliance of patients with chronic diseases should be relatively more important than strengthening the healthcare system. Further research is needed to expand survey subjects to primary care physicians and even policymakers of central government for the appropriate application of this AHP model.

scholarly journals A Wearable Tele-Health System towards Monitoring COVID-19 and Chronic Diseases

2021 ◽  
pp. 1-1
Author(s):  
Wei Jiang ◽  
Sumit Majumder ◽  
Sophini Subramaniam ◽  
Xiaohe Li ◽  
Ridha Khedri ◽  
...  
Keyword(s):  
Health System ◽  
Chronic Diseases

scholarly journals Age-Related Chronic Diseases and Alzheimer’s Disease in Texas: A Hispanic Focused Study

2021 ◽  
Vol 5 (1) ◽  
pp. 121-133
Author(s):  
Shyam Sheladia ◽  
P. Hemachandra Reddy
Keyword(s):  
United States ◽  
Risk Factors ◽  
Chronic Diseases ◽  
Hispanic Americans ◽  
The United States ◽  
Modifiable Risk Factors ◽  
American Population ◽  
Hispanic American ◽  
West Texas ◽  
Age Related

The emergence of age-related chronic diseases within the United States has led to the direct increase of Alzheimer’s disease (AD) as well as other neurological diseases which ultimately contribute to the development of dementia within the general population. To be specific, age-related chronic diseases such as cardiovascular disease, high cholesterol, diabetes, and kidney disease contribute greatly to the advancement and rapid progression of dementia. Furthermore, unmodifiable risk factors such as advancing age and genetics as well as modifiable risk factors such as socioeconomic status, educational attainment, exercise, and diet further contribute to the development of dementia. Current statistics and research show that minority populations such as Hispanic Americans in the United States face the greatest burden of dementia due to the increase in the prevalence of overall population age, predisposing genetics, age-related chronic diseases, low socioeconomic status, as well as poor lifestyle choices and habits. Additionally, Hispanic Americans living within Texas and the rural areas of West Texas face the added challenge of finding appropriate healthcare services. This article will focus upon the research associated with AD as well as the prevalence of AD within the Hispanic American population of Texas and rural West Texas. Furthermore, this article will also discuss the prevalence of age-related chronic diseases, unmodifiable risk factors, and modifiable risk factors which lead to the progression and development of AD within the Hispanic American population of the United States, Texas, and rural West Texas.

Looking to the horizon: the role of bilirubin in the development and prevention of age-related chronic diseases

2015 ◽  
Vol 129 (1) ◽  
pp. 1-25 ◽  
Author(s):  
Karl-Heinz Wagner ◽  
Marlies Wallner ◽  
Christine Mölzer ◽  
Silvia Gazzin ◽  
Andrew Cameron Bulmer ◽  
...  
Keyword(s):  
Disease Resistance ◽  
Chronic Diseases ◽  
Elevated Serum ◽  
Future Research ◽  
Bile Pigment ◽  
Therapeutic Modalities ◽  
Age Related ◽  
All Cause Mortality ◽  
Novel Biomarkers ◽  
Future Research Directions

Bilirubin, the principal tetrapyrrole, bile pigment and catabolite of haem, is an emerging biomarker of disease resistance, which may be related to several recently documented biological functions. Initially believed to be toxic in infants, the perception of bilirubin has undergone a transformation: it is now considered to be a molecule that may promote health in adults. Data from the last decade demonstrate that mildly elevated serum bilirubin levels are strongly associated with reduced prevalence of chronic diseases, particularly cardiovascular diseases (CVDs), as well as CVD-related mortality and risk factors. Recent data also link bilirubin to other chronic diseases, including cancer and Type 2 diabetes mellitus, and to all-cause mortality. Therefore, there is evidence to suggest that bilirubin is a biomarker for reduced chronic disease prevalence and a predictor of all-cause mortality, which is of important clinical significance. In the present review, detailed information on the association between bilirubin and all-cause mortality, as well as the pathological conditions of CVD, cancer, diabetes and neurodegenerative diseases, is provided. The mechanistic background concerning how bilirubin and its metabolism may influence disease prevention and its clinical relevance is also discussed. Given that the search for novel biomarkers of these diseases, as well as for novel therapeutic modalities, is a key research objective for the near future, bilirubin represents a promising candidate, meeting the criteria of a biomarker, and should be considered more carefully in clinical practice as a molecule that might provide insights into disease resistance. Clearly, however, greater molecular insight is warranted to support and strengthen the conclusion that bilirubin can prevent disease, with future research directions also proposed.

scholarly journals Innovative Partnership Between Primary Care, AAA, and Academia Connects 4Ms and Social Determinants of Health

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 107-107
Author(s):  
Suzanne Leahy ◽  
Katie Ehlman ◽  
Lisa Maish ◽  
Brad Conrad ◽  
Jillian Hall ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health System ◽  
Preliminary Evaluation ◽  
Language And Literacy ◽  
Community Based ◽  
Primary Care Clinics ◽  
College Of Nursing ◽  
Value Based Care ◽  
The University

Abstract Nationally, there is a growing focus on addressing geriatric care in primary care settings. HRSA’s Geriatric Workforce Enhancement Program (GWEP) has called for academic and health system partners to develop a reciprocal, innovative, cross-sector partnership that includes primary care sites and community-based agencies serving older adults. Through the University of Southern Indiana’s GWEP, the College of Nursing and Health Professions, the Deaconess Health System, three primary care clinics, and two Area Agencies on Aging (AAA) have joined to transform the healthcare of older adults regionally, including rural residents in the 12-county area. Core to the project is a value-based care model that “embeds” AAA care managers in primary care clinics. Preliminary evaluation indicates early success in improving the healthcare of older adults at one primary clinic, where clinical teams have referred 64 older adult patients to the AAA care manager. Among these 64 patients, 80% were connected to supplemental, community-based health services; 22% to programs addressing housing and transportation; and, nearly 10% to a range of other services (e.g., job training; language and literacy; and technology). In addition to presenting limited data on referred patients and referral outcomes, the presentation will share copies of the AAA referral log, to illustrate how resources were categorized by SDOH and added to support integration of the 4Ms.

scholarly journals 1655. Extrapulmonary Tuberculosis in a Large Healthcare System

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S816-S816
Author(s):  
Travis Denmeade ◽  
William Smith ◽  
Banks Kooken ◽  
Michael Leonard
Keyword(s):  
Health System ◽  
Healthcare System ◽  
Extrapulmonary Tuberculosis ◽  
Retrospective Chart Review ◽  
The United States ◽  
Primary Objective ◽  
Hiv Positive ◽  
Hiv Status ◽  
Southeastern Us ◽  
Race Ethnicity

Abstract Background The US has seen a rise in the proportion of patients with extrapulmonary tuberculosis (TB) even though the yearly incidence of new TB cases has been in decline. The purpose of this study was to analyze incidence of extrapulmonary TB at Atrium Health, a large non-profit health system in the Southeastern US. Methods Retrospective chart review of 94 adult patients with culture confirmed extrapulmonary TB between 2008-2019. Individuals younger than 18 years were excluded from analysis. The primary objective was to examine incidence of extrapulmonary TB and compare it to that reported in the literature. Secondary objectives included determination of sites of extrapulmonary disease and associated patient characteristics including HIV status, race, ethnicity, and birthplace. Results 237 patients were identified as having confirmed TB infection from 2008-2019 in a retrospective analysis within the Atrium Health System. 94 (40%) were found to have extrapulmonary disease; 42 (45%) with concomitant pulmonary disease. The patients were 55% male, 40% African American, 21% Hispanic or Latino, and 51% US-born. Median age was 44 years (range 20-62). The most common sites of extrapulmonary TB were lymphatic (35%), pleural (24%), GI/Peritoneal (12%), CNS (10%), and Bone/Joint (10%). Lymphatic involvement was 40% cervical, 19% intrathoracic, and 16% axillary. 66% of skeletal disease was vertebral. Other sites included GU, pericardial, skin, and disseminated disease (5%). 37% were HIV positive, 18% with unknown HIV status as they were never tested. Information regarding patient’s race, ethnicity, and birthplace were unknown for 2 patients. The percentage of extrapulmonary cases were 29% in 2008, 39% in 2012, 38% in 2016, and 49% in 2019. Conclusion Lymphatic and pleural involvement were the most common extrapulmonary sites. Of those tested, 37% were HIV positive but there was a significant portion never tested showing a need for increased testing. The proportion of extrapulmonary TB cases since 2008 is higher at 40% compared to the 31% reported in the United States. There has been a rise in the proportion of extrapulmonary TB within our healthcare system and deserves further analysis. Disclosures All Authors: No reported disclosures

scholarly journals Empowering families facing end-stage nonmalignant chronic diseases with a holistic, transdisciplinary, community-based intervention: 3 months outcome of the Life Rainbow Program

2020 ◽  
pp. 1-10
Author(s):  
Man-Chi Law ◽  
Bobo Hi-Po Lau ◽  
Anna Y. Y. Kwok ◽  
Judy S. H. Lee ◽  
Rain N. Y. Lui ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Information Needs ◽  
Well Being ◽  
Caregiver Strain ◽  
Spiritual Support ◽  
Community Based ◽  
Average Hospital ◽  
Hospital Bed ◽  
Bed Days ◽  
End Stage

Abstract Objectives Families facing end-stage nonmalignant chronic diseases (NMCDs) are presented with similar symptom burdens and need for psycho-social–spiritual support as their counterparts with advanced cancers. However, NMCD patients tend to face more variable disease trajectories, and thus may require different anticipatory supports, delivered in familiar environments. The Life Rainbow Programme (LRP) provides holistic, transdisciplinary, community-based end-of-life care for patients with NMCDs and their caregivers. This paper reports on the 3-month outcomes using a single-group, pre–post comparison. Method Patients with end-stage NMCDs were screened for eligibility by a medical team before being referred to the LRP. Patients were assessed at baseline (T0), 1 month (T1), and 3 months (T2) using the Integrated Palliative Outcome Scale (IPOS). Their hospital use in the previous month was also measured by presentations at accident and emergency services, admissions to intensive care units, and number of hospital bed-days. Caregivers were assessed at T0 and T2 using the Chinese version of the Modified Caregiver Strain Index, and self-reported health, psychological, spiritual, and overall well-being. Over-time changes in outcomes for patients, and caregivers, were tested using paired-sample t-tests, Wilcoxon-signed rank tests, and chi-square tests. Results Seventy-four patients and 36 caregivers participated in this research study. Patients reported significant improvements in all IPOS domains at both 1 and 3 months [ranging from Cohen's d = 0.495 (nausea) to 1.793 (depression and information needs fulfilled)]. Average hospital bed-days in the previous month fell from 3.50 to 1.68, comparing baseline and 1 month (p < 0.05). At 3 months, caregiver strain was significantly reduced (r = 0.332), while spiritual well-being was enhanced (r = 0.333). Significance After receiving 3 month's LRP services, patients with end-stage NMCDs and their caregivers experienced significant improvements in the quality of life and well-being, and their hospital bed-days were reduced.

Responsible innovation in health and health system sustainability: Insights from health innovators’ views and practices

2021 ◽  
pp. 095148482110486
Author(s):  
Pascale Lehoux ◽  
Hudson P Silva ◽  
Robson Rocha de Oliveira ◽  
Renata P Sabio ◽  
Kathy Malas
Keyword(s):  
Health System ◽  
System Level ◽  
Responsible Innovation ◽  
Inclusive Design ◽  
Specific System ◽  
Design Processes ◽  
Health Innovations ◽  
Intensity Of Care ◽  
Context Specific ◽  
System Sustainability

Although healthcare managers make increasingly difficult decisions about health innovations, the way they may interact with innovators to foster health system sustainability remains underexplored. Drawing on the Responsible Innovation in Health (RIH) framework, this paper analyses interviews ( n=37) with Canadian and Brazilian innovators to identify: how they operationalize inclusive design processes; what influences the responsiveness of their innovation to system-level challenges; and how they consider the level and intensity of care required by their innovation. Our qualitative findings indicate that innovators seek to: 1) engage stakeholders at an early ideation stage through context-specific methods combining both formal and informal strategies; 2) address specific system-level benefits but often struggle with the positioning of their solution within the health system; and 3) mitigate staff shortages in specialized care, increase general practitioners’ capacity or patients and informal caregivers’ autonomy. These findings provide empirical insights on how healthcare managers can promote and organize collaborative processes that harness innovation towards more sustainable health systems. By adopting a RIH-oriented managerial role, they can set in place more inclusive design processes, articulate key system-level challenges, and help innovators adjust the level and intensity of care required by their innovation.

Health System Organization

2008 ◽  
pp. 273-289
Author(s):  
Patricia L. Dobkin ◽  
Lucy J. Boothroyd
Keyword(s):  
Health System ◽  
System Organization
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