scholarly journals Institutional Clashes Beyond the Judicialization of Health: Overlapping Powers in the Case of the Cancer Pill

2021 ◽  
Vol 7 (1) ◽  
pp. 313-331
Author(s):  
Luciana Godri ◽  
◽  
Carolina Marcelino ◽  
Keyword(s):  
National Health ◽  
Access To Health Care ◽  
National Health System ◽  
Organizational Studies ◽  
Federal Drug Administration ◽  
Federal Constitution ◽  
Institutional Void ◽  
Production And Consumption ◽  
Popular Pressure ◽  
Judicialization Of Health

The 1988 Brazilian Federal Constitution institutes the promotion of “universal and equal access” to health care for Brazilian citizens. In this article, we will focus on the use and distribution of medicines as one of the national health system components. The organization responsible for standardizing and regulating the production and consumption of products and services is ANVISA – National Health Surveillance Agency, which works like the FDA (Federal Drug Administration). A unique episode took place in 2015 when a “popular uprising” began to take shape in Brazil around an issue regulated by ANVISA. Cancer patients had started to file lawsuits calling for access and permission to use a drug not authorized by this agency and which, according to the askers, supposedly would cure their disease. This drug is named phosphoethanolamine (popular name, cancer pill). Apart from the efficacy or otherwise of the drug in question, it might be interesting to organizational studies why a government organization may miss legitimation to exercise its legal role due to popular pressure, which strongly diverges from court decisions, especially involving power and legal interpretation. We approach theoretical possibilities about judicialization of health discussing triggers of institutional and social conflicts (a) by surveying studies that deal with judicialization calling for supply or release of medication (b) possible connections already established in the academy with the so-called cancer pill and, finally, (c) relating such situations to the concept of institutional void.

An automated model for forecasting non-elective hospital bed demand in the entire English National Health System: retrospective process assessment study (Preprint)

2020 ◽  
Author(s):  
Kanan Shah ◽  
Akarsh Sharma ◽  
Chris Moulton ◽  
Simon Swift ◽  
Clifford Mann ◽  
...  
Keyword(s):  
National Health ◽  
Mean Squared Error ◽  
Winter Season ◽  
National Health System ◽  
Forecast Accuracy ◽  
Occupancy Models ◽  
Bed Occupancy ◽  
Median Error ◽  
Hospital Bed ◽  
Forecasting Techniques

BACKGROUND From 2006/2007 to 2017/2018, there was a 26% increase in emergency department (ED) attendances and 32% increase in total admissions in the National Health Service in England (NHS). Growing demand puts severe strain on hospitals, resulting in bed, nursing, clinical and equipment shortages. Nevertheless, scheduling issues can still result in significant under-utilization of beds. It is imperative to optimize the allocation of existing healthcare resources, including hospital beds. More accurate and reliable long-term hospital bed occupancy rate prediction would help managers plan ahead for their population’s hospital requirements, ultimately resulting in greater efficiencies and better patient care. OBJECTIVE This study aimed to compare widely used automated time series forecasting techniques to predict short-term daily non-elective bed occupancy at all trusts in the NHS. METHODS Bed occupancy models that accounted for patterns in occupancy were created for each trust in the NHS. Daily non-elective midnight trust occupancy data from April 2011 to March 2017 for 121 NHS trusts were utilized to generate these models. Forecasts were generated using the three most widely used automated forecasting techniques: Exponential Smoothing (ES); Seasonal Autoregressive Integrated Moving Average (SARIMA); Trigonometric, Box-Cox transform, ARMA errors, Trend and Seasonal components (TBATS). The NHS Modernization Agency’s recommended forecasting method prior to 2020, was also replicated. A comparative analysis of forecast accuracy was conducted by comparing forecasted daily non-elective occupancy with actual non-elective occupancy in the out-of-sample dataset for each week forecasted. Percentage root mean squared error (RMSE) was reported. RESULTS The accuracy of the models varied based on the season during which occupancy was forecasted. For the summer season, percent RMSE values for each model remained relatively stable across six forecasted weeks. However, only the TBATS model (median error 2.45% for six weeks) outperformed the NHS Modernization Agency’s recommended method (median error 2.63% for six weeks). In contrast, during the winter season, percent RMSE values increased as we forecasted further into the future. ES generated the most accurate forecasts (median error 4.91% over four weeks), but all models outperformed the NHS Modernization Agency’s recommended method prior to 2020 (median 8.5% error over four weeks). CONCLUSIONS It is possible to create automated models, similar to those recently published by the NHS, that can be used at a hospital level for a large, national healthcare system in order to predict non-elective bed admissions and thus schedule elective procedures. CLINICALTRIAL N/A

scholarly journals Cardiovascular diseases burden in Italy, 1990–2017: the Global Burden of Disease Study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Fornari ◽  
P A Cortesi ◽  
F Madotto ◽  
S Conti ◽  
G Crotti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
National Health ◽  
Population Aging ◽  
National Health System ◽  
Total Mortality ◽  
Premature Death ◽  
Global Burden ◽  
High Systolic Blood Pressure ◽  
Life Years

Abstract Background Cardiovascular diseases (CVDs) are still the leading cause of mortality, morbidity and disability in Europe. Consequently, an exhaustive estimation of CVDs burden and cardiovascular risk factors impact is crucial for healthcare planning and resource allocation. In Italy, data on CVDs burden are sparse. This study aims to assess the global Italian CVDs burden and to analyze time changes from 1990 to 2017 within the country and in comparison to other European states. Methods We used data from the 2017 Global Burden of Diseases (GBD) study to estimate CVDs prevalence, mortality and disability-adjusted life-years (DALYs) in Italy from 1990 to 2017. We also analyzed burden attributable to CVDs-related risk factors. Finally, Italian estimations were compared to those of the other 28 European Union countries. Results CVDs were still the first cause of death (34.8% of total mortality) in Italy in 2017. A significant decrease in CVDs burden was observed since 1990: age-standardized prevalence (-12.7%), mortality rate (-53.75%), and DALYs rate (-55.54%) all decreased. Similar patterns were observed also in the majority of European countries. Despite these trends, all-ages CVDs prevalent cases increased from 5.75 million to 7.49 million. More than 80% of CVDs burden could be attributed to known modifiable risk factors such as high systolic blood pressure, dietary risks, high LDL cholesterol, and impaired kidney function. Conclusions Data showed a decline in cardiovascular mortality and DALYs, which reflects the success in terms of reducing disability, premature death and early incidence of CVDs. However, the burden of CVDs is still high, as population aging and the increased prevalent cases require more access to care and generate more years lived with disability, which in turn leads to higher costs for the National Health Service and society. More efficient prevention strategies at community and individual level are needed. Key messages Despite decreasing trends in CVDs mortality and DALYs, the burden of CVDs is still high in Italy. A joined approach of the National Health System stakeholders is needed to keep reducing the CVDs burden.

Experience in applying the effectiveness audit methodology in order to save budget funds for the purchase of medicines in the UK

2020 ◽  
pp. 82-87
Author(s):  
S. S. Budarin ◽  
N. V. Yurgel
Keyword(s):  
United Kingdom ◽  
Health System ◽  
National Health ◽  
Sharp Increase ◽  
National Health System ◽  
Pharmaceutical Market ◽  
National Audit ◽  
Drug Pricing ◽  
The United Kingdom ◽  
The Uk

The article examines the experience of the national audit office of the United Kingdom in conducting an audit of the effectiveness of budget funds aimed at providing medicines to English citizens. The reasons for the sharp increase in budget expenditures for providing the population with reproduced medicines in 2017—2018 are described in detail.The article analyzes the shortcomings of the system of regulation of drug pricing procedures and the resulting risks to the budget of the national health system in United Kingdom.It is concluded that the effectiveness audit has allowed us to identify not only the reasons for significant overspending of the NHS budget to provide the population with medicines, but also to assess the actions of organizations authorized by the UK Government to address issues of regulation of the pharmaceutical market.

I limiti del tempo in un tempo di limiti

2009 ◽  
pp. 55-62
Author(s):  
Fabrizio Rizzi
Keyword(s):  
Health System ◽  
Key Words ◽  
Community Service ◽  
National Health ◽  
National Health System ◽  
Short Term ◽  
Intellectual Honesty ◽  
Life Itself ◽  
Environmental Limits

- This article recounts the doubts and fears of an experienced analyst who is now an apprentice acrobat. He is forced to keep himself tiredly balanced between psychological and physical limits imposed by age, restrictions introduced by the National Health System and categories of patients who have precedence over others. He cannot receive all of the patients who ask for him and even those who he does receive will have to be discharged in the short term. Explaining to them, with intellectual honesty, that the community service has rules that limit his wishes as well. What can this be if not acrobatics? In the end it means combining the contradictory but perhaps also the most real aspects of life itself. [KEY WORDS: desires, personal and environmental limits, truth of the therapist]

A view from abroad: a New Zealand perspective on the English NHS health reforms

2016 ◽  
Author(s):  
Robin Gauld
Keyword(s):  
Health Policy ◽  
New Zealand ◽  
Health System ◽  
Access To Care ◽  
Healthcare System ◽  
National Health ◽  
Universal Access ◽  
National Health System ◽  
High Income ◽  
Coalition Government

The English NHS is of significance among health policy observers around the globe for various reasons. The NHS is particularly noteworthy for the fact that, for many, it represents the high-income world’s best attempt to have built and maintained a ‘national’ health system with a focus on universal access to care that is free at point of service. The NHS has been in transition for several years. Many commentators have highlighted the role and influence of US market ideals in this transition, with various UK governments clearly pushing this agenda. However, is often useful to look to countries more closely comparable to England, such as New Zealand, for comparison with a view to improvement. This chapter takes such an approach in looking at the NHS from abroad. It draws upon the case of NZ which, in many ways, is very similar to England when it comes to health policy and the healthcare system. In doing so, it aims to provide a critique of the NHS reforms and demonstrate that there are alternatives to the policies and structures being pursued for the English NHS by the Coalition government.

scholarly journals Time trends in physical activity of adult users of the Brazilian National Health System: 2010-2014. Longitudinal study

2017 ◽  
Vol 135 (4) ◽  
pp. 369-375 ◽  
Author(s):  
Bruna Camilo Turi ◽  
Jamile Sanches Codogno ◽  
Rômulo Araújo Fernandes ◽  
Kyle Robinson Lynch ◽  
Eduardo Kokubun ◽  
...  
Keyword(s):  
Physical Activity ◽  
Longitudinal Study ◽  
Health System ◽  
National Health ◽  
Time Trends ◽  
Economic Status ◽  
National Health System ◽  
Sports Participation ◽  
Male Sex

ABSTRACT CONTEXT AND OBJECTIVE: In this longitudinal study, we aimed to describe time trends of physical activity (PA) in different domains from 2010 to 2014 among users of the Brazilian National Health System, taking into account the effects of sex, age and economic status (ES). DESIGN AND SETTING: Longitudinal study conducted in five primary care units in Bauru (SP), Brazil. METHODS: The sample was composed of 620 men and women who were interviewed in 2010, 2012 and 2014. The same group of researchers conducted the interviews, using the questionnaire developed by Baecke et al. Scores for occupational, exercise/sport, leisure-time/transportation and overall PA were considered in this longitudinal survey. Time trends of PA over the four years of follow-up were assessed according to sex, age and ES. RESULTS: We found that after four years of follow-up, the reduction in overall PA (-13.6%; 95% confidence interval, CI = -11.9 to -15.3) was statistically significant. Additionally, declines in the occupational domain and exercise/sports participation were affected by age, while the reduction in overall PA was affected by sex, age and ES. CONCLUSIONS: Overall PA decreased significantly from 2010 to 2014 among these outpatients of the Brazilian National Health System, and age and male sex were important determinants of PA in its different domains.

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