scholarly journals Outcomes of COVID-19 Admissions in the New York City Public Health System and Variations by Hospitals and Boroughs During the Initial Pandemic Response

2021 ◽  
Vol 9 ◽  
Author(s):  
Anant Dinesh ◽  
Taha Mallick ◽  
Tatiana M. Arreglado ◽  
Brian L. Altonen ◽  
Ryan Engdahl
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
Health System ◽  
York City ◽  
Public Health System ◽  
Public Hospitals ◽  
Mortality Trends ◽  
The Public ◽  
Pandemic Response

Introduction: In the initial pandemic regional differences may have existed in COVID-19 hospitalizations and patient outcomes in New York City. Whether these patterns were present in public hospitals is unknown. The aim of this brief study was to investigate COVID-19 hospitalizations and outcomes in the public health system during the initial pandemic response.Methods: A retrospective review was conducted on COVID-19 admissions in New York City public hospitals during the exponential phase of the pandemic. All data were collected from an integrated electronic medical records system (Epic Health Systems, Verona, WI). Overall, 5,422 patients with at least one admission each for COVID-19 were reviewed, with a study of demographic characteristics (including age, gender, race, BMI), pregnancy status, comorbidities, facility activity, and outcomes. Data related to hospitalization and mortality trends were also collected from City of New York website. These data often involved more than one facility and/or service line resulting in more location or treatment facility counts than patients due to utilization of services at more than one location and transfers between locations and facilities.Results: Higher mortality was associated with increasing age with the highest death rate (51.9%) noted in the age group >75 years (OR 7.88, 95%CI 6.32–10.08). Comorbidities with higher mortality included diabetes (OR 1.5, 95% CI 1.33–1.70), hypertension (OR 1.62, 95% CI 1.44–1.83), cardiovascular conditions (OR 1.66, 95% CI 1.47–1.87), COPD (OR 1.86, 95% CI 1.39–2.50). It was deduced that 20% of all New York City COVID-19 positive admissions were in public health system during this timeframe. A high proportion of admissions (21.26%) and deaths (19.93%) were at Elmhurst Hospital in Queens. Bellevue and Metropolitan Hospitals had the lowest number of deaths, both in borough of Manhattan. Mortality in public hospitals in Brooklyn was 29.9%, Queens 28.1%, Manhattan 20.4%.Conclusion: Significant variations existed in COVID-19 hospitalizations and outcomes in the public health system in New York City during the initial pandemic. Although outcomes are worse with older age and those with comorbidities, variations in hospitals and boroughs outside of Manhattan are targets to investigate and strategize efforts.

scholarly journals Reform of the New York’s public health system in the context of rapid urban development (turn of the XIX – XX centuries)

2020 ◽  
pp. 1-10
Author(s):  
Evgeniya Vladimirovna Zhilina
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
Health System ◽  
York City ◽  
Preventive Measures ◽  
Public Health System ◽  
The United States ◽  
Administrative Reforms ◽  
The City

This article explores the factors for conducting administrative reforms in the United States in the area of public health. For detailed consideration, the author selected New York City as an example the largest metropolitan area that faced aggravation of social problems due to the shortcomings in the existing public health system. Rapid increase in the number of resident in the conditions of significant growth of population density led to proliferation of the dangerous infectious diseases, for elimination of which local authorities had to take prompt actions of state regulation, including creation of the new administrative branches. Special attention is given to the treatment of tuberculosis and preventive measures thereof, namely the importance of tracking all new cases. In studying public health system of New York City, the author applied interdisciplinary approach that ensured comprehensive and objective outlook upon the problems of poorest population groups of the city. Comparative-historical method was used juxtapose the situation in New York and typologically similar US metropolises. Chronological method allowed tracing the patterns in evolution of administrative innovations, and assessing them in a single historical perspective. The main conclusion consists in the statement that private medicine appeared to be insufficient due to the drastic changes of social conditions in the densely populated metropolises, as the constantly growing population of poor immigrant neighborhoods was capable of paying for medical services. At the same time, namely the residents of such ghettos were most vulnerable category of population from the standpoint of epidemiology. Taking preventive measures by the municipal authorities, which included mass vaccination and clearing New York streets from dirt and trash, became an effective way to alleviate the situation. The administrative reforms in the city significantly improved the situation, which laid the foundation for sweeping changes in the future.

scholarly journals Challenges of Conducting Point-Of-Care Testing Operations During The COVID-19 Pandemic In The Municipal Public Health System Based Ambulatory Care And School Health Clinics In New York City

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S115-S115
Author(s):  
T Sherpa ◽  
T Choesang ◽  
S Ahmad ◽  
F M Huq Ronny
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
Health System ◽  
Ambulatory Care ◽  
York City ◽  
Public Health System ◽  
Point Of Care ◽  
Ambulatory Care Clinics

Abstract Introduction/Objective Our New York City Municipal Public Health System based multisite ambulatory clinics and school-based clinics, offer various waived POCT (point of care tests) and provider performed microscopy (PPM). To ensure standardization and quality of POC testing across our health system, our laboratory service conducts system wide centralized implementation, monitoring and oversight of the POCT operations in regard to regulatory compliance, test performance, quality control and training. With the emergence of the COVID-19 infection in the New York City, like all other clinical laboratories, our ambulatory care clinics encountered numerous hurdles and challenges. Here we elaborated the issues that we encountered and how we managed to overcome during the COVID-19 Pandemic. Methods/Case Report We categorized the challenges that affected our managers as well as field level laboratory operations and have devised a plane to deal with COVID-19 related predicaments. Results (if a Case Study enter NA) Among the staffing issues, staff relocation to the acute care hospital laboratories during the peak of the pandemic caused massive delay or cessation of POCT operations in our ambulatory care clinics. Manual result entry, for COVID-19 testing, at the patient portals due to lack of interface with the reference testing labs, staff shortages and frequent absences due to illness and fatigue were primary issues noted at technical level. Furthermore, there were notable delays in the processing of paper works and new staff recruitments. The lack of and significant delays in the critical laboratory supplies was another major management issue. Conclusion Given the vastness and complexity of our multisite ambulatory care network, the COVID -19 pandemic impacted our ambulatory care clinic POCT operation in a very challenging way. However, our timeliness, coordinated interventions, close communications and initiatives handled the obstacles that arose very effectively to the ensure quality of POC testing, patient safety and quality care across our health system.

Successful, Easy to Access, Online Publication of COVID-19 Data During the Pandemic, New York City, 2020

2021 ◽  
Vol 111 (S3) ◽  
pp. S193-S196
Author(s):  
Matthew Peter Mannix Montesano ◽  
Kimberly Johnson ◽  
Andrew Tang ◽  
Jennifer Sanderson Slutsker ◽  
Pui Ying Chan ◽  
...  
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
York City ◽  
Data Communication ◽  
Web Based ◽  
The Public ◽  
Department Of Health ◽  
Public Health Data ◽  
Pandemic Response

Making public health data easier to access, understand, and use makes it more likely that the data will be influential. Throughout the COVID-19 pandemic, the New York City (NYC) Department of Health and Mental Hygiene’s Web-based data communication became a cornerstone of NYC’s response and allowed the public, journalists, and researchers to access and understand the data in a way that supported the pandemic response and brought attention to the deeply unequal patterns of COVID-19’s morbidity and mortality in NYC. (Am J Public Health. 2021;111(S3):S193–S196. https://doi.org/10.2105/AJPH.2021.306446 )

Hospitals: N.Y. Appellate Court Denies Move to Privatize Public Hospital

1999 ◽  
Vol 27 (2) ◽  
pp. 202-203
Author(s):  
Robert Chatham
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Public Health System ◽  
Municipal Hospital ◽  
The Public ◽  
Public Benefit ◽  
For Profit ◽  
Benefit Corporation ◽  
The City

The Court of Appeals of New York held, in Council of the City of New York u. Giuliani, slip op. 02634, 1999 WL 179257 (N.Y. Mar. 30, 1999), that New York City may not privatize a public city hospital without state statutory authorization. The court found invalid a sublease of a municipal hospital operated by a public benefit corporation to a private, for-profit entity. The court reasoned that the controlling statute prescribed the operation of a municipal hospital as a government function that must be fulfilled by the public benefit corporation as long as it exists, and nothing short of legislative action could put an end to the corporation's existence.In 1969, the New York State legislature enacted the Health and Hospitals Corporation Act (HHCA), establishing the New York City Health and Hospitals Corporation (HHC) as an attempt to improve the New York City public health system. Thirty years later, on a renewed perception that the public health system was once again lacking, the city administration approved a sublease of Coney Island Hospital from HHC to PHS New York, Inc. (PHS), a private, for-profit entity.

scholarly journals Ideologies of Black churches in New York City and the public health crisis of HIV among Black men who have sex with men

2011 ◽  
Vol 6 (sup2) ◽  
pp. S227-S242 ◽  
Author(s):  
Patrick A. Wilson ◽  
Natalie M. Wittlin ◽  
Miguel Muñoz-Laboy ◽  
Richard Parker
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
Black Men ◽  
York City ◽  
Black Churches ◽  
Health Crisis ◽  
The Public ◽  
Public Health Crisis ◽  
Sex With Men

Fostering healthcare innovation in public hospitals: the Queensland experience

2019 ◽  
Vol 43 (6) ◽  
pp. 672
Author(s):  
Linda Mundy ◽  
Sarah Howard ◽  
Liam McQueen ◽  
Jacqui Thomson ◽  
Kaye Hewson
Keyword(s):  
Public Health ◽  
Clinical Practice ◽  
Health System ◽  
Real World ◽  
Public Health System ◽  
Public Hospitals ◽  
Policy Makers ◽  
The Public ◽  
Health Technologies ◽  
Healthcare Technologies

Faced with scarce resources and a demand for health care that exceeds supply, health policy makers at all levels of government need to adopt some form of rationing when deciding which health services should be funded in the public health system. With a relatively small investment, programs such as Queensland Health’s New Technology Funding Evaluation Program (NTFEP) fosters innovation by providing funding and pilot studies for new and innovative healthcare technologies. The NTFEP assists policy makers to make informed decisions regarding investments in new safe and effective technologies based on available evidence gathered from real-world settings relevant to Queensland patients and clinicians. In addition, the NTFEP allows appropriate patient access, especially in rural and remote locations, to potentially beneficial technologies and acts a gatekeeper, protecting them from technologies that may be detrimental or harmful. What is known about the topic? Jurisdictions have struggled to identify ways to manage the introduction of new and innovative health technologies into clinical practice. The 2009 review of health technology in Australia recommended better assessment and appraisal by ensuring real-life practices in hospitals and community settings were considered, with a consumer and patient focus. What does this paper add? Queensland Health’s NTFEP provides a robust and transparent mechanism to manage the introduction of innovative healthcare technologies into clinical practice, providing an opportunity to collect real-world data outside of formal clinical trials. These data can not only be used to inform clinical, but also purchasing, decision-making within the public health system. This model of investment and innovation has the potential to be implemented in other jurisdictions and provide opportunities to share learnings. What are the implications for practitioners? Programs such as the NTFEP provide reassurance to practitioners and patients alike that innovative healthcare technologies are adopted in public hospitals using an evidence-based approach after demonstrating that they are not only safe and clinically effective, but represent value for money and improved patient outcomes in a public health system.

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