scholarly journals The Capacity of the Indonesian Healthcare System to Respond to COVID-19

2021 ◽  
Vol 9 ◽  
Author(s):  
Yodi Mahendradhata ◽  
Ni Luh Putu Eka Andayani ◽  
Eva Tirtabayu Hasri ◽  
Mohammad Dzulfikar Arifi ◽  
Renova Glorya Montesori Siahaan ◽  
...  
Keyword(s):  
Healthcare System ◽  
Essential Elements ◽  
Limited Capacity ◽  
Surge Capacity ◽  
Indonesian Government ◽  
Medical Supplies ◽  
Number Of Patients ◽  
Wide Range ◽  
Response Equation ◽  
Pandemic Response

The Indonesian Government has issued various policies to fight Coronavirus Disease (COVID-19). However, cases have continued to fluctuate over a year into the pandemic. There is a need to assess the country's healthcare system's capacity to absorb and accommodate the varying healthcare demands. We reviewed the current capacity of Indonesia's healthcare system to respond to COVID-19 based on the four essential elements of surge capacity: staff, stuff, structure, and system. Currently available medical staffs are insufficient to deal with potentially increasing demands as the pandemic highlighted the human resources challenges the healthcare system has been struggling with. The pandemic has exposed the fragility of medical supply chains. Surges in the number of patients requiring hospitalization have led to depleted medical supplies. The existing healthcare infrastructure is still inadequate to deal with the rise of COVID-19 cases, which has also exposed the limited capacity of the healthcare infrastructure to manage medical waste. The COVID-19 pandemic has further exposed the weakness of the patient referral system and the limited capacity of the healthcare system to deliver essential health services under prolonged emergencies. The Indonesian Government needs to ramp up the country's healthcare capacity. A wide range of strategies has been proposed to address those mounting challenges. Notwithstanding, the challenges of increasing healthcare capacity highlight that such efforts could represent only one part of the pandemic response equation. Effective pandemic response ultimately requires governments' commitment to increase healthcare capacity and flatten the curve concurrently.

scholarly journals Coordination of care for multimorbid patients from the perspective of general practitioners – a qualitative study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Judith Stumm ◽  
Cornelia Thierbach ◽  
Lisa Peter ◽  
Susanne Schnitzer ◽  
Lorena Dini ◽  
...  
Keyword(s):  
General Practice ◽  
Healthcare System ◽  
General Practitioners ◽  
Health Care Professionals ◽  
Healthcare Providers ◽  
Care Process ◽  
Framework Analysis ◽  
Number Of Patients ◽  
Wide Range ◽  
Multimorbid Patients

Abstract Background In Germany, a decreasing number of general practitioners (GPs) face a growing number of patients with multimorbidity. Whilst care for patients with multimorbidity involves various healthcare providers, the coordination of this care is one of the many responsibilities of GPs. The aims of this study are to identify the barriers to the successful coordination of multimorbid patient care and these patients’ complex needs, and to explore the support needed by GPs in the care of multimorbid patients. Interviewees were asked for their opinion on concepts which involve the support by additional employees within the practice or, alternatively, external health care professionals, providing patient navigation. Methods Thirty-two semi-structured, qualitative interviews were conducted with 16 GPs and 16 medical practice assistants (MPAs) from 16 different practices in Berlin. A MPA is a qualified non-physician practice employee. He or she undergoes a three years vocational training which qualifies him or her to provide administrative and clinical support. The interviews were digitally recorded, transcribed and analysed using the framework analysis methodology. Results The results of this paper predominantly focus on GPs’ perspectives of coordination within and external to general practice. Coordination in the context of care for multimorbid patients consists of a wide range of different tasks. Organisational and administrative obstacles under the regulatory framework of the German healthcare system, and insufficient communication with other healthcare providers constitute barriers described by the interviewed GPs and MPAs. In order to ensure optimal care for patients with multimorbidity, GPs may have to delegate responsibilities associated with coordinating tasks. GPs consider the deployment of an additional specifically qualified employee inside the general practice to take on coordinative and social and legal duties to be a viable option. Conclusions The cross-sectoral cooperation between all involved key players working within the healthcare system, as well as the coordination of the whole care process, is seemingly challenging for GPs within the complex care system of multimorbid patients. GPs are generally open to the assignment of a person to support them in coordination tasks, preferably situated within the practice team.

Age- and sex-related bone uptake of Tc-99m-HDP measured by whole-body bone scanning

2000 ◽  
Vol 39 (05) ◽  
pp. 127-132 ◽  
Author(s):  
Nicole Sieweke ◽  
K. H. Bohuslavizki ◽  
W. U. Kampen ◽  
M. Zuhayra ◽  
M. Clausen ◽  
...  
Keyword(s):  
Whole Body ◽  
Bone Lesions ◽  
Men And Women ◽  
Bone Uptake ◽  
Normal Bone ◽  
Age Related ◽  
Number Of Patients ◽  
Wide Range ◽  
Bone Scans ◽  
Body Bone

Summary Aim of this study was to validate a recently introduced new and easy-to-perform method for quantifying bone uptake of Tc-99m-labelled diphosphonate in a routine clinical setting and to establish a normal data base for bone uptake depending on age and gender. Methods: In 49 women (14-79 years) and 47 men (6-89 years) with normal bone scans as well as in 49 women (33-81 years) and 37 men (27-88 years) with metastatic bone disease whole-body bone scans were acquired at 3 min and 3-4 hours p.i. to calculate bone uptake after correction for both urinary excretion and soft tissue retention. Results: Bone uptake values of various age-related subgroups showed no significant differences between men and women (p >0.05 ). Furthermore, no differences could be proven between age-matched subgroups of normals and patients with less than 10 metastatic bone lesions, while patients with wide-spread bone metastases revealed significantly increased uptake values. In both men and women highest bone uptake was obtained (p <0.05 ) in subjects younger than 20 years with active epiphyseal growth plates. In men, bone uptake slowly decreased with age up to 60 years and then showed a tendency towards increasing uptake values. In women, the mean uptake reached a minimun in the decade 20-29 years and then slowly increased with a positive linear correlation of age and uptake in subjects older than 55 years (r = 0.57). Conclusion: Since the results proposed in this study are in good agreement with data from literature, the new method used for quantification could be validated in a large number of patients. Furthermore, age- and sexrelated normal bone uptake values of Tc-99m-HDP covering a wide range of age could be presented for this method as a basis for further studies on bone uptake.

Cerebellotrigeminal Dermal Dysplasia (Gómez-López-Hernández Syndrome)

2018 ◽  
Vol 16 (05) ◽  
pp. 362-368 ◽  
Author(s):  
Federica Sullo ◽  
Agata Polizzi ◽  
Stefano Catanzaro ◽  
Selene Mantegna ◽  
Francesco Lacarrubba ◽  
...  
Keyword(s):  
De Novo ◽  
Chromosomal Rearrangements ◽  
Number Of Patients ◽  
Wide Range ◽  
Visual Problems ◽  
Neurodevelopmental Abnormalities ◽  
Clinical Triad ◽  
High Degree ◽  
Motor Handicap

Cerebellotrigeminal dermal (CTD) dysplasia is a rare neurocutaneous disorder characterized by a triad of symptoms: bilateral parieto-occipital alopecia, facial anesthesia in the trigeminal area, and rhombencephalosynapsis (RES), confirmed by cranial magnetic resonance imaging. CTD dysplasia is also known as Gómez-López-Hernández syndrome. So far, only 35 cases have been described with varying symptomatology. The etiology remains unknown. Either spontaneous dominant mutations or de novo chromosomal rearrangements have been proposed as possible explanations. In addition to its clinical triad of RES, parietal alopecia, and trigeminal anesthesia, CTD dysplasia is associated with a wide range of phenotypic and neurodevelopmental abnormalities.Treatment is symptomatic and includes physical rehabilitation, special education, dental care, and ocular protection against self-induced corneal trauma that causes ulcers and, later, corneal opacification. The prognosis is correlated to the mental development, motor handicap, corneal–facial anesthesia, and visual problems. Follow-up on a large number of patients with CTD dysplasia has never been reported and experience is limited to few cases to date. High degree of suspicion in a child presenting with characteristic alopecia and RES has a great importance in diagnosis of this syndrome.

scholarly journals Current status of vascular access in Japan—from Dialysis Access Symposium 2017

2019 ◽  
Vol 20 (1_suppl) ◽  
pp. 38-44
Author(s):  
Mizuya Fukasawa
Keyword(s):  
Vascular Access ◽  
Current Status ◽  
Good Survival ◽  
Chronic Glomerulonephritis ◽  
Dialysis Access ◽  
Dialysis Patients ◽  
Survival Prognosis ◽  
Access Methods ◽  
Number Of Patients ◽  
Wide Range

At the second Dialysis Access Symposium held in Nagoya, Japan, a proposal was made to investigate the differences in vascular access methods used in different countries. In this article, we describe the management of vascular access in Japan. The Japanese population is rapidly aging, and the proportion of elderly patients on dialysis is also increasing. There were 325,000 dialysis patients in Japan at the end of 2015, of whom 65.1% were aged 65 years or above. The number of patients with diabetic nephropathy or nephrosclerosis as the underlying condition is also increasing, whereas the number with chronic glomerulonephritis is steadily decreasing. The Japanese health insurance system enables patients to undergo medical treatment at almost no out-of-pocket cost. Percutaneous transluminal angioplasty suffers from a severe device lag compared with other countries, but although there are limitations on permitted devices, the use of those that have been authorized is covered by medical insurance. One important point that is unique to Japan is that vascular access is performed and managed by doctors involved in dialysis across a wide range of disciplines, including nephrologists, surgeons, and urologists. This may be one factor contributing to the good survival prognosis of Japanese dialysis patients.

scholarly journals A Cross-sectional Survey of the North American Skull Base Society: Current Practice Patterns of Vestibular Schwannoma Evaluation and Management in North America

2017 ◽  
Vol 79 (03) ◽  
pp. 289-296 ◽  
Author(s):  
Jamie Van Gompel ◽  
R. Wiet ◽  
Nicole Tombers ◽  
Anand Devaiah ◽  
Devyani Lal ◽  
...  
Keyword(s):  
North America ◽  
Skull Base ◽  
Vestibular Schwannoma ◽  
North American ◽  
Management Practices ◽  
Current Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Wide Range

Background Very few studies have examined vestibular schwannoma (VS) management trends across centers and between providers. The objective of this study is to examine current practice trends, variance in treatment philosophies, and nuanced or controversial aspects of VS care across North America. Methods This is a cross-sectional survey of North American Skull Base Society (NASBS) members who report regular involvement in VS care. Results A total of 57 completed surveys were returned. Most respondents claimed to have over 20 years of experience and the majority reported working in an academic practice with an affiliated otolaryngology and/or neurosurgery residency program. Sixty-three percent of respondents claimed to evaluate VS patients in clinic with both an otolaryngologist and neurosurgeon involved. Eighty-six percent of respondents claimed to operate on VS with both an otolaryngologist and neurosurgeon involved, while only 18% of neurosurgeons and 9% of otolaryngologists performed surgery alone. There was a wide range in the number of cases evaluated at each center annually. Similarly, there was wide variation in the number of patients treated with microsurgery and radiation at each center. Additional details regarding management preferences for microsurgery, stereotactic radiosurgery, stereotactic radiotherapy, and conservative observation are presented. Conclusion VS management practices vary between providers and centers. Overall, most centers employ a multidisciplinary approach to management with collaboration between otolaryngology and neurosurgery. Overall, survey responses concur with previous studies suggesting a shift toward conservatism in management.

scholarly journals Reported Diabetes Mellitus Prevalence Rates in the Colombia Healthcare System from 2009 to 2012: Analysis by Regions Using Data of the Official Information Sources

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Noël C. Barengo ◽  
Diana Carolina Tamayo
Keyword(s):  
Diabetes Mellitus ◽  
Healthcare System ◽  
Social Protection ◽  
Prevalence Rates ◽  
Annual Increase ◽  
Number Of Patients ◽  
High Expenditure ◽  
System Information ◽  
Using Data ◽  
Official Information

The objective of this study was to describe the reported diabetes mellitus (DM) prevalence rates of the 20–79-year-old population in Colombia from 2009 to 2012 reported by the healthcare system. Information on number of patients treated for DM was obtained by the Integral Information System of Social Protection (SISPRO), the registry of the Ministry of Health and Social Protection, and the High Cost Account (CAC), an organization to trace high expenditure diseases. From both sources age-standardized reported DM prevalence rates per 100.000 inhabitants from 2009 to 2012 were calculated. Whereas the reported DM prevalence rates of SISPRO revealed an increase from 964/100.000 inhabitants (2009) to 1398/100.000 inhabitants in 2012 (mean annual increase 141/100.000;pvalue: 0.001), the respective rates in the CAC register were 1082/100.000 (2009) and 1593/100.000 in 2012 (mean annual increase 165/100.000;pvalue: 0.026). The number of provinces reporting not less than 19% of the highest national reported DM prevalence rates (1593/100.000) increased from two in 2009 to ten in 2012. Apparently, the registries and the information retrieving system have been improved during 2009 and 2012, resulting in a greater capacity to identify and report DM cases by the healthcare system.

scholarly journals 47 COVID-19 Impact on Burn Care- A Summary of Weekly Bed Counts and Surge Capacity

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S35-S35
Author(s):  
Jeffrey E Carter ◽  
Herbert Phelan ◽  
Colleen M Ryan ◽  
James C Jeng ◽  
Kathryn Mai ◽  
...  
Keyword(s):  
Substantial Reduction ◽  
Surge Capacity ◽  
Burn Centers ◽  
Resource Limitations ◽  
Burn Care ◽  
Regional Trends ◽  
Number Of Patients ◽  
Bed Capacity ◽  
Initial Survey ◽  
The Impact

Abstract Introduction The COVID-19 pandemic has raised global awareness of healthcare resource limitations. Specifically, the pandemic has demonstrated that burn disaster planning should involve non-burn disasters that threaten staff, supplies, or space. The ABA facilitated bed counts with the assistance of regional disaster coordinators from April through August of 2020. Our analysis examines the impact of the pandemic on burn surge and bed capacity in the U.S. Methods Bed availability was obtained by the ABA regional disaster coordinators through an initiative by the Organization and Delivery of Burn Care Committee. Bed availability was defined as immediately available burn beds and categorized as adult, pediatric, or flexible. Surge capacity was defined as the maximum number of patients that a burn center could admit in a surge situation. Data was deidentified by the central office with descriptive statistics to determine bed availability and surge capacity trends regionally and nationally. Results Bed counts were performed 6 times from 04/17/2020 through 08/14/2020. Response rates from the 137 North American burn centers varied from 86–96%. At least 6 burn centers (5%) were either closed or converted for COVID patients during the initial two bed counts. The total number of adult or pediatric burn beds was 2,082. Total bed availability decreased from 845 at the first survey down to 572 beds at the last survey. Surge capacity baseline was 1,668 beds and decreased from 1,132 beds in the initial survey down to 833 beds in the final survey. Conclusions Our study demonstrates a significant impact on burn bed availability due to the COVID-19 pandemic with a 37% reduction in available burn beds from April to August and a 26% reduction in surge capacity. This study demonstrates a substantial reduction in bed availability during the pandemic with additional analysis in process to examine regional trends.

Surge capacity and capability of intensive care units across a large healthcare system: An operational blueprint for regional integration

2021 ◽  
Vol 16 (3) ◽  
pp. 179-192
Author(s):  
Abhijit Duggal, MD, MPH, MSc ◽  
Erica Orsini, MD ◽  
Eduardo Mireles-Cabodevila, MD ◽  
Sudhir Krishnan, MD ◽  
Prabalini Rajendram, MD ◽  
...  
Keyword(s):  
Resource Allocation ◽  
Intensive Care ◽  
Healthcare System ◽  
Regional Integration ◽  
Medical Center ◽  
Academic Medical Center ◽  
Healthcare Services ◽  
Surge Capacity ◽  
Hospital System ◽  
The Individual

Objective: Many hospitals were unprepared for the surge of patients associated with the spread of coronavirus disease 2019 (COVID-19) pandemic. We describe the processes to develop and implement a surge plan framework for resource allocation, staffing, and standardized management in response to the COVID-19 pandemic across a large integrated regional healthcare system.Setting: A large academic medical center in the Cleveland metropolitan area, with a network of 10 regional hospitals throughout Northeastern Ohio with a daily capacity of more than 500 intensive care unit (ICU) beds.Results: At the beginning of the pandemic, an equitable delivery of healthcare services across the healthcare system was developed. This distribution of resources was implemented with the potential needs and resources of the individual ICUs in mind, and epidemiologic predictions of virus transmissibility. We describe the processes to develop and implement a surge plan framework for resource allocation, staffing, and standardized management in response to the COVID-19 pandemic across a large integrated regional healthcare system. We also describe an additional level of surge capacity, which is available to well-integrated institutions called “extension of capacity.” This refers to the ability to immediately have access to the beds and resources within a hospital system with minimal administrative burden.Conclusions: Large integrated hospital systems may have an advantage over individual hospitals because they can shift supplies among regional partners, which may lead to faster mobilization of resources, rather than depending on local and national governments. The pandemic response of our healthcare system highlights these benefits.

scholarly journals Mental health services for war-affected children

2003 ◽  
Vol 183 (6) ◽  
pp. 540-546
Author(s):  
Lynne Jones ◽  
Alban Rrustemi ◽  
Mimoza Shahini ◽  
Aferdita Uka
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Learning Disability ◽  
Stress Reactions ◽  
Educational Role ◽  
Number Of Patients ◽  
Wide Range ◽  
Adolescent Mental Health Service ◽  
Local Actors

BackgroundIn war-affected societies it is assumed that the major mental health problem facing the population will be stress reactions.AimsTo describe the creation of a child and adolescent mental health service (CAMHS) in Kosovo after the military conflict ended in 1999, and to establish the range of problems and diagnoses that presented.MethodData were collected on 559 patients over 2 years, including their referring problems and diagnoses.ResultsStress-related disorders constituted only a fifth of the case-load in year 1. A substantial number of patients were symptom-free but attended because they had been exposed to atraumatic event, and believed it might make them ill. Non-organic enuresis and learning disability were the most common diagnoses in year 2. Many patients had a complex mix of social and psychological difficulties that did not fit conventional diagnostic categories.ConclusionsMental health services that only address traumatic stress may fail to meet the needs of war-affected children. A comprehensive, culturally appropriate CAMHS is needed to address a wide range of problems including learning disability. It should be developed through local actors, and build on existing local infrastructure. Services can also have an educational role in ‘depathologising’ normative responses.

scholarly journals Culinary and Medicinal Mushrooms: Insight into Growing Technologies

2021 ◽  
Vol 55 (2) ◽  
Author(s):  
Piotr Zięba ◽  
Agnieszka Sękara ◽  
Katarzyna Sułkowska-Ziaja ◽  
Bożena Muszyńska
Keyword(s):  
Rapid Development ◽  
Essential Elements ◽  
Market Demand ◽  
Fruiting Bodies ◽  
Mushroom Species ◽  
Medicinal Mushrooms ◽  
Wide Range ◽  
Growing Conditions ◽  
Natural Medicines ◽  
Modern Technologies

Humans have used mushrooms from the beginning of their history. However, during the last few decades, the market demand for these fruiting bodies has increased significantly owing to the spread in the capabilities of culinary and pharmacological exploitation. Natural mushroom resources have become insufficient to meet the support needs. Therefore, traditional methods of extensive cultivation as well as modern technologies have been exploited to develop effective growing recommendations for dozens of economically important mushroom species. Mushrooms can decompose a wide range of organic materials, including organic waste. They play a fundamental role in nutrient cycling and exchange in the environment. The challenge is a proper substrate composition, including bio-fortified essential elements, and the application of growing conditions to enable a continuous supply of fruiting bodies of market quality and stabilized chemical composition. Many mushroom species are used for food preparation. Moreover, they are treated as functional foods, because they have health benefits beyond their nutritional value, and are used as natural medicines in many countries. Owing to the rapid development of mushroom farming, we reviewed the growing technologies used worldwide for mushroom species developed for food, processing, and pharmacological industries.

Sign in / Sign up

Export Citation Format

Share Document