scholarly journals The concept of public health. Types of health systems. Parallel between the Romanian and the Australian health system

2021 ◽  
Vol 68 (1) ◽  
pp. 17-21
Author(s):  
Dorel Dulău ◽  
◽  
Simona Bungău ◽  
Lucia Daina ◽  
Camelia Buhaş ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Systems ◽  
Medical Management ◽  
Local Authority ◽  
Public Health System ◽  
Point Of View ◽  
The Public ◽  
Australian Health ◽  
Centralization And Decentralization

Medical management is a field that combines, both in theory and in practice, two somewhat different domains, administration and the medical domain, creating a third area of activity, namely that of medical management. This review is part of a study of health services management, which seeks to find solutions to improve the efficiency of the the management and administration of the medical system, both locally and nationally. In order to be able to study and evaluate, from a scientific point of view, the concepts of centralization and decentralization of the public health system in Romania, it is absolutely pertinent, but also mandatory, to focus on defining the notion of health system. Only later can we approach and research the process of decentralization of health, the political and economic context in which it can be initiated, as well as how to activate and carry it out. Decentralization, as a phenomenon of the transfer of rights and obligations, from the level of the central authority to the level of the local authority, can take various forms. From a theoretical and practical point of view, the forms of decentralization can be studied, evaluated and concluded by emphasizing the strengths and weaknesses. Also important to study are the ways of putting health systems into practice, which from the point of view of the source of funding are divided into state-funded health systems (Semashko, Beveridge and Bismarck) and privately funded health systems.

scholarly journals Population estimates and characteristics of Australians potentially eligible for bariatric surgery: findings from the 2011–13 Australian Health Survey

2018 ◽  
Vol 42 (4) ◽  
pp. 429 ◽  
Author(s):  
Melanie J. Sharman ◽  
Monique C. Breslin ◽  
Alexandr Kuzminov ◽  
Andrew J. Palmer ◽  
Leigh Blizzard ◽  
...  
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health System ◽  
Public Health System ◽  
Population Estimates ◽  
Eligibility Criteria ◽  
The Public ◽  
Australian Health ◽  
Potential Demand ◽  
Patient Prioritisation

Objective The aim of the present study was to determine the potential demand for publicly and privately funded bariatric surgery in Australia. Methods Nationally representative data from the 2011–13 Australian Health Survey were used to estimate the numbers and characteristics of Australians meeting specific eligibility criteria as recommended in National Health and Medical Research Council guidelines for the management of overweight and obesity. Results Of the 3 352 037 adult Australians (aged 18–65 years) estimated to be obese in 2011–13, 882 441 (26.3%; 95% confidence interval (CI) 23.0–29.6) were potentially eligible for bariatric surgery (accounting for 6.2% (95% CI 5.4–7.1) of the adult population aged 18–65 years (n = 14 122 020)). Of these, 396 856 (45.0%; 95% CI 40.4–49.5) had Class 3 obesity (body mass index (BMI) ≥40 kg m–2), 470945 (53.4%; 95% CI 49.0–57.7) had Class 2 obesity (BMI 35–39.9 kg m–2) with obesity-related comorbidities or risk factors and 14 640 (1.7%; 95% CI 0.6–2.7) had Class 1 obesity (BMI 30–34.9 kg m–2) with poorly controlled type 2 diabetes and increased cardiovascular risk; 458 869 (52.0%; 95% CI 46.4–57.6) were female, 404 594 (45.8%; 95% CI 37.3–54.4) had no private health insurance and 309 983 (35.1%; 95% CI 28.8–41.4) resided outside a major city. Conclusion Even if only 5% of Australian adults estimated to be eligible for bariatric surgery sought this intervention, the demand, particularly in the public health system and outside major cities, would far outstrip current capacity. Better guidance on patient prioritisation and greater resourcing of public surgery are needed. What is known about this topic? In the period 2011–13, 4 million Australian adults were estimated to be obese, with obesity disproportionately more prevalent in areas of socioeconomic disadvantage. Bariatric surgery is considered to be cost-effective and the most effective treatment for adults with obesity, but is mainly privately funded in Australia (>90%), with 16 650 primary privately funded procedures performed in 2015. The extent to which the supply of bariatric surgery is falling short of demand in Australia is unknown. What does this paper add? The present study provides important information for health service planners. For the first time, population estimates and characteristics of those potentially eligible for bariatric surgery in Australia have been described based on the best available evidence, using categories that best approximate the national recommended eligibility criteria. What are the implications for practitioners? Even if only 5% of those estimated to be potentially eligible for bariatric surgery in Australia sought a surgical pathway (44 122 of 882 441), the potential demand, particularly in the public health system and outside major cities, would still far outstrip current capacity, underscoring the immediate need for better guidance on patient prioritisation. The findings of the present study provide a strong signal that more funding of public surgery and other effective interventions to assist this population group are necessary.

scholarly journals Staying afloat: community perspectives on health system resilience in the management of pregnancy and childbirth care during floods in Cambodia

2020 ◽  
Vol 5 (4) ◽  
pp. e002272 ◽  
Author(s):  
Dell D Saulnier ◽  
Hom Hean ◽  
Dawin Thol ◽  
Por Ir ◽  
Claudia Hanson ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Health System ◽  
Health Systems ◽  
Public Health System ◽  
Health Needs ◽  
Structured Interviews ◽  
The Public ◽  
Pregnancy And Childbirth ◽  
Childbirth Care

IntroductionResilient health systems have the capacity to continue providing health services to meet the community’s diverse health needs following floods. This capacity is related to how the community manages its own health needs and the community and health system’s joined capacities for resilience. Yet little is known about how community participation influences health systems resilience. The purpose of this study was to understand how community management of pregnancy and childbirth care during floods is contributing to the system’s capacity to absorb, adapt or transform as viewed through a framework on health systems resilience.MethodsEight focus group discussions and 17 semi-structured interviews were conducted with community members and leaders who experienced pregnancy or childbirth during recent flooding in rural Cambodia. The data were analysed by thematic analysis and discussed in relation to the resilience framework.ResultsThe theme ‘Responsible for the status quo’ reflected the community’s responsibility to find ways to manage pregnancy and childbirth care, when neither the expectations of the health system nor the available benefits changed during floods. The theme was informed by notions on: i) developmental changes, the unpredictable nature of floods and limited support for managing care, ii) how information promoted by the public health system led to a limited decision-making space for pregnancy and childbirth care, iii) a desire for security during floods that outweighed mistrust in the public health system and iv) the limits to the coping strategies that the community prepared in case of flooding.ConclusionsThe community mainly employed absorptive strategies to manage their care during floods, relieving the burden on the health system, yet restricted support and decision-making may risk their capacity. Further involvement in decision-making for care could help improve the health system’s resilience by creating room for the community to adapt and transform when experiencing floods.

scholarly journals Implementing laparoscopy in Brazil´s National Public Health System: the bariatric surgeons´ point of view

2014 ◽  
Vol 27 (suppl 1) ◽  
pp. 39-42 ◽  
Author(s):  
Samanta SUSSENBACH ◽  
Everton N SILVA ◽  
Milene Amarante PUFAL ◽  
Carina ROSSONI ◽  
Daniela Schaan CASAGRANDE ◽  
...  
Keyword(s):  
Public Health ◽  
Laparoscopic Surgery ◽  
Health System ◽  
Public Health System ◽  
Current Model ◽  
Point Of View ◽  
Average Increase ◽  
Public System ◽  
The Public ◽  
National Public Health

BACKGROUND: Although Brazilian National Public Health System (BNPHS) has presented advances regarding the treatment for obesity in the last years, there is a repressed demand for bariatric surgeries in the country. Despite favorable evidences to laparoscopy, the BNPHS only performs this procedure via laparotomy. AIM: 1) Estimate whether bariatric surgeons would support the idea of incorporating laparoscopic surgery in the BNPHS; 2) If there would be an increase in the total number of surgeries performed; 3) As well as how BNPHS would redistribute both procedures. METHODS: A panel of bariatric surgeons was built. Two rounds to answer the structured Delphi questionnaire were performed. RESULTS: From the 45 bariatric surgeons recruited, 30 (66.7%) participated in the first round. For the second (the last) round, from the 30 surgeons who answered the first round, 22 (48.9%) answered the questionnaire. Considering the possibility that BNPHS incorporated laparoscopic surgery, 95% of surgeons were interested in performing it. Therefore, in case laparoscopic surgery was incorporated by the BNPHS there would be an average increase of 25% in the number of surgeries and they would be distributed as follows: 62.5% via laparoscopy and 37.5% via laparotomy. CONCLUSION: 1) There was a preference by laparoscopy; 2) would increase the number of operations compared to the current model in which only the laparotomy is available to users of the public system; and 3) the distribution in relation to the type of procedure would be 62.5% and 37.5% for laparoscopy laparotomy.

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.

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