scholarly journals Prospects for Planning Development of a Reception and Diagnostic Department of a Children’s Hospital

2020 ◽  
Vol 3 (38) ◽  
pp. 60-64
Author(s):  
Nurlan Mussirov ◽  
◽  
Galiya Sultanbekova ◽  
Keyword(s):  
Health Care ◽  
Government Programs ◽  
Children's Hospital ◽  
Current State ◽  
Medical Institutions ◽  
Diagnostic Center ◽  
Children’S Hospital ◽  
Planning Development ◽  
Key Indicators ◽  
The City

Abstract This article discusses the current state of children’s medical organizations on the example of the reception and diagnostic center of the city children’s hospital in Nur-Sultan. The main goals and objectives of planning the development of children’s medical institutions are also presented. In addition, measures are shown to improve the work of the children’s clinic. Improving the efficiency of health care in Kazakhstan is carried out within the framework of government programs developed to improve the key indicators of the country’s health care. Key words: healthcare, medical institutions, children’s hospital, Kazakhstan.

scholarly journals A113 COST SAVINGS OF SEROLOGIC VERSUS BIOPSY PROVEN DIAGNOSIS OF PEDIATRIC CELIAC DISEASE

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 131-132
Author(s):  
M Wiepjes ◽  
H Q Huynh ◽  
J Wu ◽  
M Chen ◽  
L Shirton ◽  
...  
Keyword(s):  
Health Care ◽  
Celiac Disease ◽  
North America ◽  
Cost Saving ◽  
Health Care System ◽  
Cost Savings ◽  
Serologic Diagnosis ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Care System

Abstract Background Celiac disease (CD) affects approximately one percent of the population in Canada and the United States. At present, endoscopic diagnosis (ED) of CD remains the gold standard in North America, despite mounting evidence and validated European guidelines for serologic diagnosis (SD). Within publicly funded healthcare systems there is pressure to ensure optimal resource utilization and cost efficiency, including for endoscopic services. At Stollery Children’s Hospital, Edmonton, Canada, we have adopted serologic diagnosis as routine practice since 2016. Aims The aim of this study is to estimate cost savings, i.e. hard dollar savings and capacity improvements, to the health care system as well as impacts on families in regard to reduced work days lost and missing child school days for SD versus ED. Initial cost saving data is presented. Methods Micro-costing methods were used to determine health care resource use in patients undergoing ED or SD from 2017–2018. SD testing included anti-tissue glutaminase antibody (aTTG) ≥200IU/mL (on two occasions), human leukocyte antigen (HLA) DQA5/DQ2, blood sampling, transport and laboratory costs. ED diagnosis included gastroenterologist, anesthetist, OR equipment, staff, overhead and histopathology. Cost of each unit of resource was obtained from the schedule of medical benefits (Alberta) and reported average ambulatory cost for day hospital endoscopy for Stollery Children’s Hospital determined in 2016; reported in CAN$. Results Between March 2017-December 2018, 473 patients were referred for diagnosis of CD; 233 had ED and 127 SD. Estimated cost for ED was $1240 per patient; for SD was $85 per patient (6.8% of ED cost). Based on 127 patients not requiring endoscopy and a cost saving of $1155 per patient there was a total cost savings of $146,685 over 22 months. Conclusions A SD approach presents a significant cost savings to the public health care system. It also frees up valuable endoscopic resources, and limits exposure of children to the immediate and long-term risks associated with anesthesia and biopsy. SD also decreases time to diagnosis and the cost of the process to families (lost days of school/work, travel costs etc.). Our costing data can be used in combination with mounting evidence on the test performance of SD versus ED to determine cost-effectiveness of serological diagnosis for pediatric CD. Given the potential for cost saving and more efficient operating room utilization, SD for pediatric CD warrants further investigation in North America. Funding Agencies None

scholarly journals Modern approaches to improving the quality of medical care for premature children in Moscow health care

2020 ◽  
Vol 65 (1) ◽  
pp. 5-10 ◽  
Author(s):  
I. M. Osmanov ◽  
A. K. Mironova ◽  
A. L. Zaplatnikov
Keyword(s):  
Health Care ◽  
Body Weight ◽  
Medical Care ◽  
Rehabilitation Center ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Quality Of Medical Care ◽  
Premature Children

This article is devoted to the issue of nursing and further monitoring of children born with very low and extremely low body weight. The article presents the data of international statistics and seven-year experience of the Rehabilitation Center for children born with very low and extremely low body weight, based on a large multidisciplinary children’s hospital. The authors pay particular attention to improvement of medical care of children born with very low and extremely low body weight.

scholarly journals Trends in Nosocomial Bloodstream Infections following Health Care Restructuring in Alberta between 1999 and 2005

2010 ◽  
Vol 21 (1) ◽  
pp. e1-e5 ◽  
Author(s):  
Mao-Cheng Lee ◽  
Lynora Saxinger ◽  
Sarah E Forgie ◽  
Geoffrey Taylor
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Alberta Hospital ◽  
University Of Alberta ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The University

OBJECTIVE: A previous study at the University of Alberta Hospital/Stollery Children’s Hospital in Edmonton, Alberta, revealed an increase in hospital-acquired bloodstream infection (BSI) rates associated with an increase in patient acuity during a period of public health care delivery restructuring between 1993 and 1996. The present study assessed trends in BSIs since the end of the restructuring.DESIGN: Prospective surveillance for BSIs was performed using Centers for Disease Control and Prevention (USA) criteria for infection. BSI cases between January 1, 1999, and December 31, 2005, were reviewed. Available measures of patient volumes, acuity and BSI risk factors between 1999 and 2005 were also reviewed from hospital records.SETTING: The University of Alberta Hospital/Stollery Children’s Hospital (617 adult and 139 pediatric beds, respectively).PATIENTS: All pediatric and adult patients admitted during the above-specified period with one or more episodes of BSIs.RESULTS: There was a significant overall decline in the BSI number and rate over the study period between 1999 and 2005. The downward trend was widespread, involving both adult and pediatric populations, as well as primary and secondary BSIs. During this period, the number of hospital-wide and intensive care unit admissions, intensive care unit central venous catheter-days, total parenteral nutrition days and number of solid-organ transplants were either unchanged or increased. Gram-positive bacterial causes of BSIs showed significant downward trends, but Gram-negative bacterial and fungal etiologies were unchanged.CONCLUSIONS: These data imply that, over time, hospitals can gradually adjust to changing patient care circumstances and, in this example, control infectious complications of health care delivery.

scholarly journals TERRITORIAL DEVELOPMENT OF KYIV HOSPITAL NETWORK

2021 ◽  
pp. 57-64
Author(s):  
Irina Bulakh
Keyword(s):  
Construction Projects ◽  
State Funding ◽  
Actual State ◽  
Territorial Development ◽  
Industrial Construction ◽  
Current State ◽  
Medical Standards ◽  
Medical Institutions ◽  
The One ◽  
The City

The article examines the actual state of the hospital network in Kyiv, offers proposals for its further territorial development, which are based on the current and future needs and capabilities of residents and managers of the city, nearby settlements. The study is part of a comprehensive study of the problem of urban planning foundations of the territorial and spatial development of the system of healthcare institutions and is aimed at finding the optimization of the existing material fund of medical institutions. The city of Kyiv is the capital of our state and, at the same time, its largest city, which historically has the largest number of hospitals among Ukrainian cities. There are historical architectural monuments among Kyiv’s hospitals, but most of the facilities were built during the Soviet era in Ukraine according to typical industrial construction projects. The current state of the network of hospitals in Kyiv does not correspond to either the world indicators for the provision of beds per 100 thousand of the population (significantly exceeds), or the quality of medical care, or the comfortable conditions for the implementation of treatment. Unfortunately, Ukraine is not able (and it is not necessary) to maintain the functioning of all hospitals that were built before and during Soviet times - the number of the population has significantly decreased, medical standards have changed, and most importantly, it is necessary to develop a network of prehospital institutions. So, the article contains proposals for optimizing the hospital network of the city of Kyiv, which, on the one hand, are aimed at removing individual hospitals from mono-state funding, and on the other, expanding the possibilities of treating children in a larger number of city hospitals. 

Who Should Provide Primary Health Care to Children: Pediatricians or Family Medicine Physicians?

PEDIATRICS ◽  
1984 ◽  
Vol 74 (4) ◽  
pp. 460-477 ◽  
Author(s):  
Robert A. Hoekelman ◽  
Michael Klein ◽  
James E. Strain
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Albert Einstein ◽  
Assistant Professor ◽  
Senior Resident ◽  
Children's Hospital ◽  
Practice Experience ◽  
Primary Health ◽  
Children’S Hospital

INTRODUCTION —Robert A. Hoekelman, MD This debate is one of a series entitled "Controversies in Child Health and Pediatric Practice." In 1978 and 1979, the Department of Pediatrics at the University of Rochester conducted 12 such debates, which were published in book form in 1981.1 It is interesting that of these 12 controversies, not one has been resolved. That may prove to be the case for the controversy presented in this debate, "Who should provide primary health care to children: pediatricians or family medicine physicians?" Our guest speakers are Dr Michael Klein and Dr James E. Strain. Dr Klein is Professor of Family Medicine and Assistant Professor of Pediatrics at McGill University School of Medicine. He is also Director of the Department of Family Medicine and of the Herzl Family Practice Center at the Sir Mortimer B. Davis Jewish General Hospital in Montreal. Dr Klein received his medical degree at Stanford University in 1966, and he was his class's recipient of the pediatric Harold K. Kaiser Award. Dr Klein served his internship at Bronx Municipal Hospital Center at Albert Einstein University and his pediatric residency at Montreal Children's Hospital. During his last year, he served as Senior Resident in Neonatology under Robert Usher at the Royal Victoria Hospital. He then became a fellow in biochemical genetics under Charles Scriver and the Chief Medical Resident at Montreal Children's Hospital under Mary Ellen Avery. In 1970, he came to Rochester as a Fellow in Ambulatory Pediatrics. Dr Klein's practice experience is extensive. He was the pediatric coordinator of the St Jacques Clinic in Montreal during the late 1960s and the medical director of the Westside Health Services in Rochester from 1971 to 1975, after which he assumed his current position.

Neonatal Hospice Program

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 502-503
Author(s):  
Jonathan M. Whitfield ◽  
Anita Glicken ◽  
Robert Harmon ◽  
Roberta Siegel ◽  
L. Joseph Butterfield
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Health Care Professionals ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Staff Members ◽  
Children's Hospital ◽  
Children’S Hospital

We wish to comment on the editorial by Silverman (A hospice setting for humane neonatal death, Pediatrics 69:239, 1982), which we find both insightful and timely. We feel we must take issue with some of Silverman's statements. Over the last 3½ years we have actively incorporated hospice concepts into our neonatal program at Denver Children's Hospital, creating a so-called Neonatal Hospice Program. 1. We agree that health care professionals involved in neonatal intensive care tend to be oriented to "rescue" care; however, in our own experience we have found that with adequate training not only are the staff members open, but often they are very willing to switch from a rescue to palliative mode of treatment in the appropriate circumstances.

scholarly journals Spatial Organization of Hierarchical Medical Services within the City Proper of Tianjin, China: Towards Efficient Medical Alliances

2019 ◽  
Vol 11 (1) ◽  
pp. 229 ◽  
Author(s):  
Xuan Sun ◽  
Tao Sun ◽  
Yushan Jin ◽  
Ya Ping Wang
Keyword(s):  
Health Care ◽  
First Grade ◽  
Health Care Facilities ◽  
Third Grade ◽  
Medical Services ◽  
Chinese Government ◽  
Medical Institutions ◽  
Service Efficiency ◽  
The City ◽  
Different Levels

To address the low performance of health care service delivery in the half-market system, the Chinese government has begun to advocate the medical alliance (MA) recently. Instead of strict regulations on the procedure of diagnosis and treatment, flexible resource sharing among medical institutions of different grades inside each MA is encouraged. By now, many attempts have been made for MA establishment from different perspectives, but there is no effective model maturely developed. For the promotion of the spatial accessibility to medical services at different levels, it is important to organize the hierarchial medial services according to the distributions of different grades of health care facilities in a city. With the city proper of Tianjin as the study case, we explored the optimal establishment of MAs using the geographic information system (GIS). By means of the Voronoi Diagrams, the service regions of different medical institutions were precisely defined and the organizational structure of hierarchical medical services in MAs was determined. Through interpolation analysis, accessibility to different levels of medical services was measured, and on this basis, discussions were conducted on the service efficiency of the MAs. According to the results from Tianjin, (1) under the proposed organizational model for MAs, the fit of the service regions of the first grade and the other two higher grades of medical institutions was good. but the fit of the second and the third grade medical institutions was insufficient. (2) Although the overall service efficiency was excellent, there were still deficiencies in a number of the MAs. (3) Increasing the number of second and third grade medical institutions in specific regions near the city’s edge, as well as the number of first grade institutions, could further improve the performance of hierarchical medical services.

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