scholarly journals An Analysis of Medical Care Services for Children With Rare Diseases in the Russian Federation

2021 ◽  
Vol 12 ◽  
Author(s):  
Svetlana Ya. Volgina ◽  
Alexey A. Sokolov
Keyword(s):  
Medical Care ◽  
Rare Diseases ◽  
Population Level ◽  
Cost Effective ◽  
Healthcare Systems ◽  
Screening Programs ◽  
Care Services ◽  
Patient Organizations ◽  
Effective Interventions ◽  
Access To Medical Care

Rare diseases continue to present numerous challenges for the medical field worldwide. Understanding innovative mechanisms of service provision for patients with rare conditions through shared communication across different healthcare systems should be encouraged. This study presents the organization of medical care for people with rare diseases in Russia, while also exploring the epidemiology of both life-threatening and chronic, progressive, rare diseases. Further, the regulation of medical care provision is examined, including the preferential provision of medicines in different Russian regions and potential role of compulsory medical insurance. The principles guiding patient referrals to appropriate specialist centres for rare diseases are outlined, including considering the increased role that public-patient organizations have in developing healthcare systems. In reviewing the specialized resources available for patients with rare diseases, medical genetics services offering diagnostics and counselling are discussed. Additionally, population-level preventive care necessitates significant investment, principally in diagnostic technology and screening programs. As seen elsewhere, these initiatives involve forming reference centres and tertiary-level pediatric departments staffed by multidisciplinary specialists in rare diseases. Numerous challenges are highlighted relating to Russian healthcare systems, including the financing of expensive treatments and ensuring equitable access to medical care for those patients with rare diseases outside of State-subsidized programs. Recommendations are made on creating international registries for knowledge sharing, quality appraisal, newborn screening, diagnostic challenges, available treatments and rehabilitation services. Given the high cost of rare diseases, cost-effective interventions are advisable, particularly developing preventive programs and targeting the most common and severe mutations in patients planning pregnancies.

scholarly journals Community level barriers for cervical cancer screening in marginalized population

2020 ◽  
Vol 9 (12) ◽  
pp. 5006
Author(s):  
Kranti Vora ◽  
Shahin Saiyed ◽  
Rajendra Joshi ◽  
Senthil Natesan
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Large Population ◽  
Population Level ◽  
Cost Effective ◽  
Reproductive Age ◽  
Hpv Testing ◽  
Screening Programs

Background: In India, cervical cancer is the second common cause of cancer deaths among women of reproductive age, with 469 million Indian women at risk. High risk human papillomavirus genotypes mainly 16 and 18 account of cervical cancer. The burden of cervical cancer can be reduced by regular screening of human papillomavirus (HPV). There is no specific national program for cervical cancer screening. Eligible women have limited knowledge of screening and also limited access to preventive screenings.Methods: The study was conducted in the slum areas of Ahmedabad city in Gujarat. 1088 women between 30-45 years of age were recruited in the study and 536 women consented to give cervical samples for DNA based HPV testing. We collected information regarding knowledge and practice for cervical cancer and HPV along with demographic data.Results: Lack of knowledge and practices around cervical cancer and screening among community women was found. There is a lack of awareness about the importance of preventive healthcare and near absence of evidence-based practices. Sociodemographic characteristics are important predictors of participation in the screening program.Conclusions: In the Indian context, HPV testing is a cost-effective option to prevent cervical cancer. The burden of cervical cancer is incredibly high. With increased ability to accurately detect, population level HPV testing would reduce the burden of cervical cancer and the ultimate cost per person would be minimal, due to the country’s large population. There is a need to develop policy to ensure participation of women in the HPV based cervical cancer screening programs.

Influence of provider mix and regulation on primary care services supplied to US patients

2015 ◽  
Vol 11 (2) ◽  
pp. 193-213 ◽  
Author(s):  
Michael R. Richards ◽  
Daniel Polsky
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Care Physician ◽  
Financial Strain ◽  
Large Field ◽  
Office Visits ◽  
Physician Practices ◽  
Care Services ◽  
Appointment Availability ◽  
Access To Medical Care

AbstractAccess to medical care and how it differs for various patients remain key policy issues. While existing work has examined clinic structure’s influence on productivity, less research has explored the link between provider mix and access for different patient types – which also correspond to different service prices. We exploit experimental data from a large field study spanning 10 US states where trained audit callers were randomly assigned an insurance status and then contacted primary care physician practices seeking new patient appointments. We find clinics with more non-physician clinicians are associated with better access for Medicaid patients and lower prices for office visits; however, these relationships are only found in states granting full practice autonomy to these providers. Substituting more non-physician labor in primary care settings may facilitate greater appointment availability for Medicaid patients, but this likely rests on a favorable policy environment. Relaxing regulations for non-physicians may be an important initiative as US health reforms continue and also relevant to other countries coping with greater demands for medical care and related financial strain.

scholarly journals Telemedicine in Assistance to Healthcare in the COVID-19 Pandemic

2020 ◽  
Vol 47 (4) ◽  
pp. 63-68
Author(s):  
K. Kilova ◽  
S. Uzunova
Keyword(s):  
Medical Care ◽  
Healthcare Systems ◽  
Current Situation ◽  
Effective Solution ◽  
Public Authorities ◽  
Pubmed Database ◽  
Prevention And Treatment ◽  
Coronavirus Infection ◽  
Access To Medical Care

AbstractGlobal pandemics pose unprecedented challenges to healthcare. In the current situation, telemedicine appears to be a sustainable and effective solution in the implementation of precautions, prevention and treatment in order to discontinue the spreading of the coronavirus infection (COVID-19).The aim of this paper was to research and analyze the role of telemedicine in assistance to healthcare in the COVID-19 pandemic.Methods: The PubMed Database, Google Scholar, SpringerLink, ScienceDirect (Elsevier) and sites of public authorities have been accessed and reviewed.Results: Advantages, restrictions, policy and application of telemedicine in the conditions of COVID-19 pandemic have been studied and analyzed.Conclusion: Healthcare systems are put under an extreme test during global pandemics. Telemedicine is crucial during the COVID-19 pandemic because it guarantees that patients have access to medical care.

Assessment of Kangaroo Mother Care Services and identifying its Implementation Bottlenecks: Situational Analysis of Special New Born Care Units in Gujarat State of India

Healthline ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 7-13
Author(s):  
Shashi Vani ◽  
Narayan Gaonkar ◽  
N.B. Dholakia ◽  
Uday Shankar Singh ◽  
Rajanikant Solanki
Keyword(s):  
Birth Weight ◽  
Newborn Care ◽  
Cost Effective ◽  
General Information ◽  
Kangaroo Mother Care ◽  
Situational Analysis ◽  
Gujarat State ◽  
Care Services ◽  
Effective Interventions ◽  
Validated Questionnaire

Introduction: Kangaroo Mother Care (KMC) and optimal feeding in Low Birth Weight (LBW) infants are evidence based cost effective interventions which if properly implemented across all facilities can help to save millions of newborn. The study, focussing on status of KMC services in Gujarat State, has not been conducted so far. Objectives: The intent of present study was to ascertain the infrastructure, facilities, policies and practices related to Kangaroo Mother Care at special newborn care units (SNCUs) of various regions of Gujarat and to suggest strategies for effective delivery of KMC services. Methods: A pre tested, semi structured and validated questionnaire including general information about SNCU, baseline data about KMC protocols and practices of each SNCU etc. was developed. The information was collected from all 40 Special Newborn Care Units (SNCUs) of Gujarat State of India.The data analysis was performed using EpiInfo 7 Statistical Software developed by Centres for Disease Control and Prevention (CDC), Atlanta. Simple frequency tables were used for analysis. Results: About 81% of the facilities reported that newborns with birth weight less than 2000 grams, either stable or with non-serious medical conditions were eligible for receiving KMC. None of the facilities were providing continuous KMC more than 12 hours. Thirty (81.08%) SNCUs had an earmarked space for performing KMC either in the form of separate ward or identified corner in the ward. Conclusion: The present study revealed inadequate Kangaroo Mother Care services in selected newborn care units of Gujarat State of India. The services, especially basic facilities like drinking water, food, toilet and hand washing was not available in some of the facility.

scholarly journals Linking Food and Resource Access to Medical Care Access in Maputo, Mozambique

2021 ◽  
Vol 13 (15) ◽  
pp. 8174
Author(s):  
Cameron McCordic ◽  
Bruce Frayne ◽  
Naomi Sunu
Keyword(s):  
Medical Care ◽  
Household Survey ◽  
Healthcare Systems ◽  
Cash Income ◽  
Rapid Urbanization ◽  
Socioeconomic Resources ◽  
Care Access ◽  
Development Goals ◽  
Access To Medical Care

Background: Rapid urbanization coupled with evolving threats from both communicable and non-communicable diseases underscore the vulnerability of urban healthcare systems. Building resilient healthcare systems and increasing access to socioeconomic resources is key for achieving sustainable development goals (SDGs). The city of Maputo (Mozambique) provides a helpful case study for the analysis of this situation. Methods: This investigation analyzes household survey data to determine the predictors of consistent household medical care access (SDG 3) in Maputo. Using those identified predictors, the study identifies key segments of households in Maputo that are vulnerable to disease given their inconsistent access to medical care. Results: The results indicate that households with inconsistent medical care access (SDG 3) also suffer from severe food insecurity (SDG 2) and inconsistent access to a cash income (SDG 8), water (SDG 6), and electricity (SDG 7). Conclusions: This study identifies challenges to the achievement of SDG 3 in Maputo, where households that are likely to need medical care under the strain of impoverished living conditions are also the least likely to have consistent access to needed medical care.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

Rare diseases and their patient organization: the Hungarian Federation of People with Rare and Congenital Diseases

2014 ◽  
Vol 155 (9) ◽  
pp. 329-333
Author(s):  
Gábor Pogány
Keyword(s):  
Social Services ◽  
Rare Diseases ◽  
Poor Quality ◽  
Congenital Diseases ◽  
Governmental Organization ◽  
Patient Organizations ◽  
Long Duration ◽  
Care And Support ◽  
Educational Professionals ◽  
Duration Of Hospitalization

The aim of the author is to discuss special issues of rare diseases, with emphasis on circumstances present in Hungary, including those leading to the foundation of the non-governmental organization, the Hungarian Federation of People with Rare and Congenital Diseases. The author briefly reviews the most important findings of current international surveys which have been performed with or without the involvement of member associations of the Hungarian Federation of People with Rare and Congenital Diseases. At the level of medical and social services in Hungary, it is still “incidental” to get to the appropriate expert or centre providing the diagnosis or treatment. It is difficult to find the still very few existing services due to the lack of suitable “pathways” and referrals. There are long delays in obtaining the first appointment, resulting in vulnerability and inequality along the regions. The overall consequence is the insufficiency or lack of access to medical and social services. There are also difficulties related to the supply of orphan medication and the long duration of hospitalization. At the level of patient organizations financial scarcity and uncertainty are typical, combined with inappropriate infrastructural background and human resources. The poor quality of organization of patient bodies along with insufficient cooperation among them are characteristic as well. The author concludes that a National Plan or Strategy is needed to improve the current fragmentation of services which would enable patients and health, social and educational professionals to provide and use the best care in the practice. This would ensure all patients with rare diseases to be diagnosed within a possible shortest time allowing access to the care and support needed in time resulting in a decrease in burden of families and society. Orv. Hetil., 2014, 155(9), 329–333.

Diagnosis, assessment, and treatment of depression in advanced disease

2018 ◽  
Author(s):  
Matthew Hotopf
Keyword(s):  
Palliative Care ◽  
Advanced Disease ◽  
Antidepressant Treatment ◽  
Population Level ◽  
Care Staff ◽  
Care Services ◽  
Treatment Of Depression ◽  
Assessment And Treatment ◽  
Palliative Care Services ◽  
Key Issues

Depression in palliative care is common, under-recognised and has significant impacts for sufferers. There are effective treatments but often a shortage of staff to provide them. This chapter sets out a number of key issues to consider when assessing and treating individual patients and considers the way in which palliative care services can innovate to provide a population level response to depression. Palliative care staff can be trained to deliver basic depression care and follow simple protocols to initiate, monitor and adjust antidepressant treatment. These approaches have been tested in trials in cancer care but the challenge is to take these approaches from research trials conducted in centres of excellence with good resources, to other settings.

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