scholarly journals Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions

2021 ◽  
Vol 18 (8) ◽  
pp. 4051
Author(s):  
Javier Cerezo-Espinosa de los Monteros ◽  
Antonio Castro-Torres ◽  
Juan Gómez-Salgado ◽  
Javier Fagundo-Rivera ◽  
Carlos Gómez-Salgado ◽  
...  
Keyword(s):  
Mergers And Acquisitions ◽  
Health System ◽  
Public Health System ◽  
Complex Structure ◽  
Public Hospitals ◽  
Hospital Mergers ◽  
The Public ◽  
Merger Process ◽  
High Benefit ◽  
Regional Variance

Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.

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.

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.

Research as the gatekeeper: introduction ofrobotic-assisted surgery into the public sector

2019 ◽  
Vol 43 (6) ◽  
pp. 676
Author(s):  
Kate E. McBride ◽  
Daniel Steffens ◽  
Michael J. Solomon ◽  
Teresa Anderson ◽  
Jane Young ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Research Training ◽  
New Technology ◽  
Public Hospitals ◽  
Tertiary Referral Hospital ◽  
Governance Framework ◽  
Surgical Technology ◽  
The Public

Objective Within Australia, robotic-assisted surgery (RAS) has largely been undertaken within the private sector, and predominately based within urology. This is rapidly developing, with RAS becoming increasingly prevalent across surgical specialties and within public hospitals. At this point in time there is a need to consider how this generation of the technology can be appropriately and safely introduced into the public health system given its prohibitive costs and lack of high-level long-term evidence. Methods This paper describes a unique approach used to govern the establishment of a new RAS program within a large public tertiary referral hospital in Australia. This included the creation of a comprehensive governance framework that covered research, training and operational components, with research being the ultimate gatekeeper to accessing the technology. Results Taking this novel approach, both benefits and challenges were encountered. Although initially there was a trade-off of activity to enable time for the research program to be developed, it was found the model strengthened patient safety in introducing the technology, fostered a breadth of surgical speciality involvement, ensured uniformity of data collection and, in the longer term, will enable a significant contribution to be made to the evidence regarding the appropriateness of RAS being used across several surgical specialties. Conclusions There is potential for this comprehensive governance framework to be transferred to other public hospitals commencing or with existing RAS programs and to be applied to the introduction of other new and expensive surgical technology. What is known about the topic? RAS is rapidly evolving and becoming increasingly prevalent across surgical specialities in major public hospitals. Consequently, it is important that this new technology is safely and appropriately implemented into the public health system. What does this paper add? This article describes the benefits and implementation challenges of a novel RAS approach, including a comprehensive governance framework that covered research, training and operational components, with research being the ultimate gatekeeper to accessing the technology. What are the implications for practitioners? This comprehensive governance framework can be transferred to other public hospitals introducing, or already using, new and expensive surgical technology.

scholarly journals The high cost patients on waiting list for the Liver Transplantation. main burdens and consequences for the Public Health System

2015 ◽  
Vol 18 (3) ◽  
pp. A224
Author(s):  
J.A. Turri ◽  
L.B. Haddad ◽  
W. Andrauss ◽  
L.A. D’Albuquerque ◽  
M.A. Diniz
Keyword(s):  
Public Health ◽  
Liver Transplantation ◽  
Health System ◽  
Public Health System ◽  
Waiting List ◽  
The Public

Development of a probabilistic model for quantitative risk assessment of COVID-19 in Brazil

2021 ◽  
pp. 2150069
Author(s):  
Paulo Gabriel Santos Campos de Siqueira ◽  
Alexandre Calumbi Antunes de Oliveira ◽  
Heitor Oliveira Duarte ◽  
Márcio das Chagas Moura
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Health System ◽  
Probabilistic Model ◽  
Public Health System ◽  
The Other ◽  
Quantitative Risk Assessment ◽  
The Public ◽  
Business As Usual ◽  
Excessive Number

We have developed a probabilistic model to quantify the risks of COVID-19 explosion in Brazil, the epicenter of COVID-19 in Latin America. By explosion, we mean an excessive number of new infections that would overload the public health system. We made predictions from July 12th to Oct 10th, 2020 for various containment strategies, including business as usual, stay at home (SAH) for young and elderly, flight restrictions among regions, gradual resumption of business and the compulsory wearing of masks. They indicate that: if a SAH strategy were sustained, there would be a negligible risk of explosion and the public health system would not be overloaded. For the other containment strategies, the scenario that combines the gradual resumption of business with the mandatory wearing of masks would be the most effective, reducing risk to considerable category. Should this strategy is applied together with the investment in more Intensive Care Unit beds, risk could be reduced to negligible levels. A sensitivity analysis sustained that risks would be negligible if SAH measures were adopted thoroughly.

scholarly journals Neutralization of B.1.1.28 P2 variant with sera of natural SARS-CoV-2 infection and recipients of BBV152 vaccine

2021 ◽  
Author(s):  
Gajanan Sapkal ◽  
Pragya Yadav ◽  
Raches Ella ◽  
Priya Abraham ◽  
Deepak Patil ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Natural Infection ◽  
Vaccination Program ◽  
Vaccine Regimen ◽  
The Public ◽  
Neutralizing Potential ◽  
Dose Vaccine

The emergence of new SARS-CoV-2 variants has been a serious threat to the public health system and vaccination program. The variant of concerns have been the under investigation for their neutralizing potential against the currently available COVID-19 vaccines. Here, we have determined the neutralization efficacy of B.1.1.28.2 variant with the convalescent sera of individuals with natural infection and BBV152 vaccination. The two-dose vaccine regimen significantly boosted the IgG titer and neutralizing efficacy against both B.1.1.28.2 and D614G variants compared to that seen with natural infection. The study demonstrated 1.92 and 1.09 fold reductions in the neutralizing titer against B.1.1.28.2 variant in comparison with prototype D614G variant with sera of vaccine recipients and natural infection respectively.

scholarly journals Amalgam versus resin composite for the restoration of posterior teeth: disparities between public clinical practice and dental education in southern Brazil

2011 ◽  
Vol 52 (1/3) ◽  
pp. 33-37
Author(s):  
Clarissa Fatturi Parolo ◽  
Aline Macarevich ◽  
Juliana Jobim Jardim ◽  
Marisa Maltz
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Resin Composite ◽  
Dental Students ◽  
Restorative Material ◽  
Chi Square ◽  
Posterior Teeth ◽  
The Public ◽  
Dental Schools

Purpose: To compare the restorative material used in the treatment of posterior teeth taught and performed in two Dental Schools (UFRGS and ULBRA) and in 8 basic health units (BHU) from the Public Health System in Porto Alegre, Brazil. Materials and methods: Data referring the teaching of restorative procedures using amalgam (AM) or resin (R) were obtained through the analysis of patient’s files and questionnaires applied to final year dental students. Information regarding restorative procedures at BHU was obtained through patient’s records and a questionnaire applied to the dentists. The type of restorative material used in both BHU and Dental Schools were compared by chi-square test. Results: At UFRGS, 327 restorations were performed, 78.28% R and 21.72% AM, and at ULBRA 366 restorations, 92.63% R and 7.37% AM. At BHU, 1664 restorations were performed (35.93% R and 64.07% AM). A major proportion of AM restorations was performed in the Public Health Service in comparison to both Dental Schools, in which resin restorations prevailed (p=0.000). Conclusion: The change from AM to R in the dental material choice for posterior teeth at Dental Schools was not followed by the Public Health System, where the AM is still widely used in posterior teeth.

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