DISASTER-RESILIENT HOSPITALS: THE NOAH’S ARK

Health services are important lifelines of a community any time and this role is more pronounced during times of disasters. Evidence from various parts of the world presents examples of disaster-induced damage to hospitals and failure of health services at times of need. The impact of disasters-induced damage to health care is three-dimensional: health, social and economic. Damage to health care facilities apart from delaying and complicating relief measures also compromise the achievement of planned national and global health and related goals. The indirect and long-term costs of damage to health sector are greater than direct and immediate costs, compounding the disastrous consequences on the economy. The increasing invasion of nature spaces, climate change and urbanisation are bound to aggravate more natural hazards in future. So a resilient health care system is an immediate necessity for all global states. This paper discusses the international and national endeavours towards a resilient health-care system and analyses the strategies to promote safe hospitals in future.

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COVID-19 in Italy: targeted testing as a proxy of limited health care facilities and a key to reducing hospitalization rate and the death toll

10.1101/2020.10.12.20211169 ◽

2020 ◽

Author(s):

Arnab Bandyopadhyay ◽

Marta Schips ◽

Tanmay Mitra ◽

Sahamoddin Khailaie ◽

Sebastian Binder ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Health Care Facilities ◽

Effective Control ◽

Death Toll ◽

Care Facilities ◽

Targeted Testing ◽

Limited Health ◽

The Impact ◽

Care System

AbstractThe novel Coronavirus SARS-CoV-2 (CoV) has induced a worldwide pandemic, notably in Italy, one of the worst-hit countries in Europe, which witnessed a death toll unseen in the recent past. There are potentially many factors, such as infections from undetected index cases, early vs late testing strategies, limited health care facilities etc., that might have aggravated the COVID-19 situation in Italy. We developed a COVID-19 specific infection epidemic model composed of susceptible (S), exposed (E), carrier (C), infected (I), recovery (R) and dead (D) (SECIRD), specifically parameterized for Italy to disentangle the impact of these factors and their implications on infection dynamics to help planning an effective control strategy for a possible second wave. Our model discriminates between detected infected and undetected individuals who played a crucial role in the disease spreading and is not well addressed by classical SEIR-like transmission models. We first estimated the number of undetected infections through a Bayesian Markov Chain Monte Carlo (MCMC) framework, which ranges from ∼ 7 to ∼ 22 fold higher than reported infections, depending upon regions. We exploited this information to evaluate the impact of the undetected component on the evolution of the pandemic and the benefits of an enhanced testing strategy. In high testing regions like Veneto, 18% of all infections resulted in hospitalization, while for Lombardia and Piemonte, it is 25% and 27%, respectively. We investigated the impact of an overwhelmed health care system upon death toll by applying hospital and intensive care unit (ICU) capacities in the SECIRD model, and we estimated a 10% reduction in death in Lombardia, the worst hit region, if a higher number of hospital facilities had been available since the beginning. Adopting a combined strategy of rapid early and targeted testing (∼ 10 fold) with increased hospital capacity would help in avoiding bottlenecks affecting the health care system. Our results demonstrate that the early testing would have a strong impact on the overall hospital accessibility and, hence, upon death toll (∼20% to 50% reduction) and could have mitigated the lack of facilities at the crucial middle stage of the epidemic.

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Performing Analysis of Quality of Service Parameters of 4G Long Term Evolution in Health Care System

Journal of Computational and Theoretical Nanoscience ◽

10.1166/jctn.2019.8556 ◽

2019 ◽

Vol 16 (12) ◽

pp. 5008-5013

Author(s):

Suresh B. Rangankar ◽

Nitiket Mhala

Keyword(s):

Health Care ◽

Health Services ◽

Health Care System ◽

Long Term Evolution ◽

Term Evolution ◽

Wide Range ◽

4G Lte ◽

The Right ◽

Care System

Long Term Evolution (LTE) is a leading 4G wireless broadband technology developed by the Third Generation Partnership Project (3GPP) Release 8. LTE is expected to provide very fast, highly responsive and cost effective data services and appears itself to be the right technology at the right time. LTE is becoming an ultimate choice for 4G services around the world due to its higher data rates and lower latency objectives. E-Health services comprise a wide range of healthcare services delivered by utilizing information and communication technology. In order to help existing and emerging e-Health services over converged next generation network (NGN) architectures, there is a need for network QoS control mechanisms that meet the often stringent requirements of such services. The mobile Health (m-health) is currently uniting major academic research worldwide to achieve innovative arrangements in the areas of healthcare. However, there are several challenges and issues that need to be addressed. In this paper we have proposed m-health care system based on 4G LTE network communication instead of existing 3G communication system. We will be monitoring QoS parameters like Delay, Throughput, Jitter, Energy Efficiency and Packet Data Rate for comparing 3G and 4G LTE usage over health care applications. We will further experiment the parameters with graph based analysis.

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The impact of Hurricane Maria on Puerto Rico’s health system: post-disaster perceptions and experiences of health care providers and administrators

Global Health Research and Policy ◽

10.1186/s41256-021-00228-w ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Sheilla L. Rodríguez-Madera ◽

Nelson Varas-Díaz ◽

Mark Padilla ◽

Kevin Grove ◽

Kariela Rivera-Bustelo ◽

...

Keyword(s):

Health Care ◽

Puerto Rico ◽

Health Care System ◽

Health Care Providers ◽

Health Care Facilities ◽

Health Needs ◽

Care Providers ◽

The Impact ◽

Post Disaster ◽

Care System

Abstract Background After its landfall in Puerto Rico in 2017, Hurricane Maria caused the longest blackout in United States history, producing cascading effects on a health care system that had already been weakened by decades of public sector austerity and neoliberal health reforms. This article addresses how health care professionals and administrators experienced the health care system’s collapse and the strategies used by them to meet their communities' health needs. Methods Data were collected between September 2018 and February 2020. Ethnographic observations in health care facilities and semi-structured qualitative interviews with representatives of the health care system were conducted. This paper focuses on data from interviews with health care providers (n = 10) and administrators (n = 10), and an ethnographic visit to a pop-up community clinic. The analysis consisted of systematic thematic coding of the interview transcripts and ethnographic field notes. Results Results provide insight on how participants, who witnessed first-hand the collapse of Puerto Rico’s health care system, responded to the crisis after Maria. The prolonged power outage and lack of a disaster management plan were partly responsible for the death of 3,052 individuals who experienced extended interruptions in access to medical care. Participants reported a sense of abandonment by the government and feelings of mistrust. They also described the health sector as chaotic and lacking clear guidelines on how to provide services or cope with personal crises while working under extreme conditions. In such circumstances, they developed resilient responses to meet communities’ health needs (e.g., itinerant acupuncture services, re-locating physicians to local pharmacies). Conclusions Participants’ narratives emphasize that the management of Hurricane Maria was fraught with political and economic constraints affecting Puerto Rico. Ineffective planning and post-Maria responses of the local and federal governments were determinants of the disaster’s impact. The findings contribute to a growing scientific literature indicating that Hurricane Maria revealed ‘the collapse before the collapse,’ alluding to the structural deficiencies that presaged the catastrophic event. In the context of governmental abandonment, the authors argue for the importance of developing alternative strategies in post-disaster health care provision among health professionals and administrators who work at the front lines of recovery.

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How to govern the digital transformation of health services

European Journal of Public Health ◽

10.1093/eurpub/ckz165 ◽

2019 ◽

Vol 29 (Supplement_3) ◽

pp. 7-12 ◽

Cited By ~ 4

Author(s):

Walter Ricciardi ◽

Pedro Pita Barros ◽

Aleš Bourek ◽

Werner Brouwer ◽

Tim Kelsey ◽

...

Keyword(s):

Health Care ◽

Health Services ◽

Health System ◽

Health Care System ◽

Digital Health ◽

Digital Transformation ◽

Broad Perspective ◽

Health Technologies ◽

The Impact ◽

Care System

Abstract The impact of digitalization of health services has been profound and is expected to be even more profound in the future. It is important to evaluate whether digital health services contribute to health system goals in an optimal way. This should be done at the level of the service, not the ‘digital transformation’. Decisions to adopt new digital health services, at different levels of the health care system, are ideally based on evidence regarding their performance in light of health system goals. In order to evaluate this, a broad perspective should be taken in evaluations of digital health services. Attainment of the broad health system goals, including quality, efficiency and equity, are objectives against which to judge new digital health services. These goals in a broad sense are unaltered by the process of digitalization. Governance should be designed and tailored in such a way to capture all relevant changes in an adequate way. When evaluating digital health services many specific aspects need to be considered. Like for other innovations and (new) technologies, such promises may or may not materialize and potential benefits may also be accompanied by unintended and/or negative (side) effects in the short or long term. Hence, the introduction, implementation, use and funding of digital health technologies should be carefully evaluated and monitored. Governments should play a more active role in the further optimization both of the process of decision making (both at the central and decentral level) and the related outcomes. They need to find a balance between centralized and decentralized activity. Moreover, the broader preparation of the health care system to be able to deal with digitalization, from education, through financial and regulatory preconditions, to implementation of monitoring systems to monitor its effects on health system performance remains important.

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Skin diseases in children in rural Kenya: long-term results of a dermatology project within the primary health care system

British Journal of Dermatology ◽

10.1046/j.1365-2133.2001.03962.x ◽

2001 ◽

Vol 144 (1) ◽

pp. 118 ◽

Cited By ~ 6

Author(s):

W. Schmeller

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care System ◽

Skin Diseases ◽

Long Term Results ◽

Primary Health Care System ◽

Primary Health ◽

Rural Kenya ◽

Care System

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The Impact of Increased Hydrocodone Regulation on Opioid Prescribing in an Urban Safety-Net Health Care System

The Journal of the American Board of Family Medicine ◽

10.3122/jabfm.2019.03.180356 ◽

2019 ◽

Vol 32 (3) ◽

pp. 362-374 ◽

Cited By ~ 2

Author(s):

Thomas F. Northrup ◽

Kelley Carroll ◽

Robert Suchting ◽

Yolanda R. Villarreal ◽

Mohammad Zare ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Safety Net ◽

Opioid Prescribing ◽

Urban Safety ◽

The Impact ◽

Care System

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Analysing the impact of health-care system change in the EU member states - Germany

Health Economics ◽

10.1002/hec.1032 ◽

2005 ◽

Vol 14 (S1) ◽

pp. S133-S149 ◽

Cited By ~ 47

Author(s):

Markus Wörz ◽

Reinhard Busse

Keyword(s):

Health Care ◽

Health Care System ◽

System Change ◽

Member States ◽

Eu Member States ◽

The Impact ◽

The Eu ◽

Care System

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The impact of the 2006 Massachusetts health care reform law on spine surgery patient payer-mix status and age

Journal of Neurosurgery Spine ◽

10.3171/2017.4.spine161141 ◽

2017 ◽

Vol 27 (6) ◽

pp. 694-699 ◽

Cited By ~ 2

Author(s):

Nicolas W. Villelli ◽

Hong Yan ◽

Jian Zou ◽

Nicholas M. Barbaro

Keyword(s):

Health Care ◽

New York ◽

Health Care Reform ◽

Health Care System ◽

Spine Surgery ◽

Private Insurance ◽

New York State ◽

Before And After ◽

The Impact ◽

Care System

OBJECTIVESeveral similarities exist between the Massachusetts health care reform law of 2006 and the Affordable Care Act (ACA). The authors’ prior neurosurgical research showed a decrease in uninsured surgeries without a significant change in surgical volume after the Massachusetts reform. An analysis of the payer-mix status and the age of spine surgery patients, before and after the policy, should provide insight into the future impact of the ACA on spine surgery in the US.METHODSUsing the Massachusetts State Inpatient Database and spine ICD-9-CM procedure codes, the authors obtained demographic information on patients undergoing spine surgery between 2001 and 2012. Payer-mix status was assigned as Medicare, Medicaid, private insurance, uninsured, or other, which included government-funded programs and workers’ compensation. A comparison of the payer-mix status and patient age, both before and after the policy, was performed. The New York State data were used as a control.RESULTSThe authors analyzed 81,821 spine surgeries performed in Massachusetts and 248,757 in New York. After 2008, there was a decrease in uninsured and private insurance spine surgeries, with a subsequent increase in the Medicare and “other” categories for Massachusetts. Medicaid case numbers did not change. This correlated to an increase in surgeries performed in the age group of patients 65–84 years old, with a decrease in surgeries for those 18–44 years old. New York showed an increase in all insurance categories and all adult age groups.CONCLUSIONSAfter the Massachusetts reform, spine surgery decreased in private insurance and uninsured categories, with the majority of these surgeries transitioning to Medicare. Moreover, individuals who were younger than 65 years did not show an increase in spine surgeries, despite having greater access to health insurance. In a health care system that requires insurance, the decrease in private insurance is primarily due to an increasing elderly population. The Massachusetts model continues to show that this type of policy is not causing extreme shifts in the payer mix, and suggests that spine surgery will continue to thrive in the current US health care system.

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