scholarly journals The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

2022 ◽  
Vol 14 (1) ◽  
pp. e2022012
Author(s):  
Annarita Botta ◽  
Gianmarco Lugli ◽  
Matteo Maria Ottaviani ◽  
Guido Ascione ◽  
Alessandro Bruschi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Healthcare System ◽  
Public Healthcare ◽  
Healthcare Provision ◽  
Hub And Spoke ◽  
Medical Specialties ◽  
Health Crisis ◽  
Outbreak Period ◽  
Long Term Impact ◽  
The Impact

Background Italy has been one of the countries most affected by the SARS-CoV-2 pandemic and the regional healthcare system has had to quickly adapt its organization to meet the needs of infected patients. This has led to a drastic change in the routine management of non-communicable diseases with a potential long-term impact on patient health care. We investigated the management of non-COVID-19 patients across all medical specialties in Italy. Methods A PRISMA guideline-based systematic review of the literature was performed using PubMed, Embase, and Scopus, restricting the search to the main outbreak period in Italy (from 20 February to 22 June, 2020). We selected articles in English or Italian that detailed changes in the Italian hospital care for non-COVID-19 patients due to the pandemic. Our keywords included all medical specialties in combination with our geographical focus (Italy) and COVID-19. Results Of the 4643 potentially eligible studies identified by the search, 247 studies were included. A decrease in the management of emergencies in non-COVID patients was found together with an increase in mortality. Similarly, non-deferrable conditions met a tendency toward decreased diagnosis. All specialties have been affected by the reorganization of healthcare provision in the hub-and-spoke system and have benefited from telemedicine.   Conclusions Our work highlights the changes taking place in the Italian public healthcare system to tackle the developing health crisis due to the COVID-19 pandemic. The findings of our review may be useful to analyze future directions for the healthcare system in the case of new pandemic scenarios.  

scholarly journals The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

2020 ◽  
Author(s):  
Lugli Gianmarco ◽  
Ottaviani Matteo Maria ◽  
Botta Annarita ◽  
Ascione Guido ◽  
Bruschi Alessandro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Healthcare System ◽  
Public Healthcare ◽  
Healthcare Provision ◽  
Hub And Spoke ◽  
Medical Specialties ◽  
Health Crisis ◽  
Outbreak Period ◽  
Long Term Impact ◽  
The Impact

AbstractBackgroundItaly has been one of the countries most affected by the SARS-CoV-2 pandemic and the regional healthcare system has had to quickly adapt its organization to meet the needs of infected patients. This has led to a drastic change in the routine management of non-communicable diseases with a potential long-term impact on patient health care. We investigated the management of non-COVID-19 patients across all medical specialties during the pandemic in Italy.MethodsA PRISMA guideline-based systematic review of the available literature was performed using PubMed, Embase, and Scopus, restricting the search to the main outbreak period in Italy (from 20 February to 22 June, 2020). We selected articles in English or Italian that detailed changes in the Italian hospital care for non-COVID-19 patients due to the pandemic. Our keywords included all medical specialties in combination with our geographical focus (Italy) and COVID-19.FindingsOf the 4643 potentially eligible studies identified by the search, 247 studies were included in the systematic review. A decrease in the management of emergencies in non-COVID patients was found together with an increase in mortality. Similarly, non-deferrable conditions met a tendency toward decreased diagnosis. All specialties have been affected by the reorganization of healthcare provision in the hub-and-spoke system and have benefited from telemedicine during the pandemic.InterpretationOur work highlights the changes taking place in the Italian public healthcare system in order to tackle the developing health crisis due to the COVID-19 pandemic. The findings of our review may be useful to analyze future directions for the healthcare system in the case of new pandemic scenarios.

scholarly journals Ageing, limb-loss and military veterans: a systematic review of the literature

2018 ◽  
Vol 39 (8) ◽  
pp. 1582-1610 ◽  
Author(s):  
NICK CADDICK ◽  
HELEN CULLEN ◽  
AMANDA CLARKE ◽  
MATT FOSSEY ◽  
MICHAEL HILL ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Military Service ◽  
Military Veterans ◽  
Limb Loss ◽  
Cochrane Library ◽  
Term Care ◽  
Long Term Impact ◽  
The Impact

ABSTRACTThe impact of losing a limb in military service extends well beyond initial recovery and rehabilitation, with long-term consequences and challenges requiring health-care commitments across the lifecourse. This paper presents a systematic review of the current state of knowledge regarding the long-term impact of ageing and limb-loss in military veterans. Key databases were systematically searched including: ASSIA, CINAHL, Cochrane Library, Medline, Web of Science, PsycArticles/PsychInfo, ProQuest Psychology and ProQuest Sociology Journals, and SPORTSDiscus. Empirical studies which focused on the long-term impact of limb-loss and/or health-care requirements in veterans were included. The search process revealed 30 papers relevant for inclusion. These papers focused broadly on four themes: (a) long-term health outcomes, prosthetics use and quality of life; (b) long-term psycho-social adaptation and coping with limb-loss; (c) disability and identity; and (d) estimating the long-term costs of care and prosthetic provision. Findings present a compelling case for ensuring the long-term care needs and costs of rehabilitation for older limbless veterans are met. A dearth of information on the lived experience of limb-loss and the needs of veterans’ families calls for further research to address these important issues.

scholarly journals A Systematic Review of Recommendations of Long-Term Strategies for Researchers Using Data Science Techniques

Computers ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 35
Author(s):  
Gilberto Ayala-Bastidas ◽  
Hector G. Ceballos ◽  
Francisco J. Cantu-Ortiz
Keyword(s):  
Systematic Review ◽  
Data Science ◽  
Process Mining ◽  
Research Strategies ◽  
Scientific Content ◽  
Open Research ◽  
Using Data ◽  
Long Term Impact ◽  
The Impact

The impact of the strategies that researchers follow to publish or produce scientific content can have a long-term impact. Identifying which strategies are most influential in the future has been attracting increasing attention in the literature. In this study, we present a systematic review of recommendations of long-term strategies in research analytics and their implementation methodologies. The objective is to present an overview from 2002 to 2018 on the development of this topic, including trends, and addressed contexts. The central objective is to identify data-oriented approaches to learn long-term research strategies, especially in process mining. We followed a protocol for systematic reviews for the engineering area in a structured and respectful manner. The results show the need for studies that generate more specific recommendations based on data mining. This outcome leaves open research opportunities from two particular perspectives—applying methodologies involving process mining for the context of research analytics and the feasibility study on long-term strategies using data science techniques.

scholarly journals Estimated hospitalizations attributable to Diabetes Mellitus within the public healthcare system in Brazil from 2008 to 2010: study DIAPS 79

2014 ◽  
Vol 60 (3) ◽  
pp. 222-230 ◽  
Author(s):  
Roger Rosa ◽  
Marcelo Eidi Nita ◽  
Roberto Rached ◽  
Bonnie Donato ◽  
Elaine Rahal
Keyword(s):  
Diabetes Mellitus ◽  
Healthcare System ◽  
Primary Diagnosis ◽  
Public Healthcare ◽  
Public Healthcare System ◽  
The Public ◽  
Unified Health System ◽  
The Mean ◽  
Mean Cost ◽  
The Impact

Objective: to estimate the number of hospitalizations attributable to diabetes mellitus (DM) and its complications within the public healthcare system in Brazil (SUS) and the mean cost paid per hospitalization. Methods: the official database from the Hospital Information System of the Unified Health System (SIH/SUS) was consulted from 2008 to 2010. The proportion of hospitalizations attributable to DM was estimated using attributable risk methodology. The mean cost per hospitalization corresponds to direct medical costs in nursing and intensive care, from the perspective of the SUS. Results: the proportion of hospitalizations attributable to DM accounted for 8.1% to 12.2% of total admissions in the period, varying according to use of maximum (self-reported with correction factor) or minimal (self-reported) DM prevalence. The hospitalization rate was 47 to 70.8 per 10.000 inhabitants per year. The mean cost per hospitalization varied from 1.302 Brazilian Reais (BRL) to 1,315 BRL. Assuming the maximum prevalence, hospitalizations were distributed as 10.3% as DM itself, 36.6% as chronic DM-associated complications and 53.1% as general medical conditions. Advancing age was accompanied by an increase in hospitalization rates and corresponding costs, and more pronounced in male patients. Conclusion: the results express the importance of DM in terms of the use of health care resources and demonstrate that studies of hospitalizations with DM as a primary diagnosis are not sufficient to assess the magnitude of the impact of this disease.

scholarly journals Tracking aspects of healthcare activity during the first nine months of COVID-19 in Ireland: a secondary analysis of publicly available data

2021 ◽  
Vol 4 ◽  
pp. 98
Author(s):  
Domhnall McGlacken-Byrne ◽  
Sarah Parker ◽  
Sara Burke
Keyword(s):  
Healthcare System ◽  
Healthcare Access ◽  
Healthcare Delivery ◽  
Secondary Analysis ◽  
Public Healthcare ◽  
Language Therapy ◽  
Care Community ◽  
Universal Healthcare ◽  
Allied Healthcare ◽  
The Impact

Background: Sláintecare aims to introduce universal healthcare in Ireland. The COVID-19 pandemic poses both challenges and opportunities to this process. This study explored the impact of COVID-19 on aspects of Irish healthcare during the first nine months of the pandemic and considers the implications for Sláintecare implementation. Methods: Secondary analysis was undertaken on publicly available data on three key domains of the Irish healthcare system: primary care, community-based allied healthcare, and hospitals. Descriptive statistics were computed using Microsoft Excel 2016. Results: Up to March 2021, 3.76 million COVID-19 tests were performed by Ireland’s public healthcare system, 2.48 million (66.0%) of which were referred from the community. General practitioners delivered 2.31 million telephone triages of COVID-19 symptoms, peaking in December 2020 when 416,607 consultations occurred. Patient numbers across eight allied healthcare specialties fell by 35.1% versus previous years, with the greatest reductions seen in speech and language therapy (49.0%) and audiology (46.1%). Hospital waiting lists increased from 729,937 to 869,676 (or by 19.1%) from January 2019 to January 2021. In January 2021, 629,919 patients awaited a first outpatient clinic appointment, with 170,983 (27.1%) waiting longer than 18 months. The largest outpatient lists were observed in orthopaedic surgery (n=77,257); ear, nose and throat surgery (n=68,073); and ophthalmology (n=47,075). The proportion of patients waiting more than 12 months for a day-case gastrointestinal endoscopy rose from 6.0% in January 2020 to 19.0% in January 2021. Conclusions: Healthcare activity has been significantly disrupted by COVID-19, leading to increased wait times and greater barriers to healthcare access during the pandemic. Yet, Ireland’s health system responses also revealed strong willingness and ability to adapt and to implement novel solutions for healthcare delivery, rapidly and at scale. This has demonstrated what is achievable under Sláintecare and provides a unique opportunity to ‘build back better’ towards sustainable recovery.

Analysis of the operational risk factors in public hospitals in an Indian state

2019 ◽  
Vol 33 (1) ◽  
pp. 67-88 ◽  
Author(s):  
C.R. Vishnu ◽  
R. Sridharan ◽  
P.N. Ram Kumar ◽  
V. Regi Kumar
Keyword(s):  
Risk Factors ◽  
Healthcare System ◽  
Significant Risk ◽  
Public Hospitals ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Content Type ◽  
Indian State ◽  
The Government ◽  
The Impact

Purpose Risk management in the healthcare sector is a highly relevant sub-domain and a crucial research area from the humanitarian perspective. The purpose of this paper is to focus on the managerial/supply chain risk factors experienced by the government hospitals in an Indian state. The present paper analyzes the inter-relationships among the significant risk factors and ranks those risk factors based on their criticality. Design/methodology/approach The current research focuses on 125 public hospitals in an Indian state. Questionnaire-based survey and personal interviews were conducted in the healthcare sector among the inpatients and hospital staff to identify the significant risk factors. An integrated DEMATEL–ISM–PROMETHEE method is adopted to analyze the impact potential and dependence behavior of the risk factors. Findings The analysis asserts the absence of critical risk factors that have a direct impact on patient safety in the present healthcare system under investigation. However, the results illustrate the remarkable impact potential attributed to the risk factor, namely, staff shortage in inducing other risk factors such as employee attitudinal issues, employee health issues and absenteeism altogether resulting in community mistrust/misbeliefs. Maintenance mismanagement, monsoon time epidemics, physical infrastructure limitations are also found to be significant risk factors that compromise patient satisfaction levels. Practical implications Multiple options are illustrated to mitigate significant risk factors and operational constraints experienced by public hospitals in the state. The study warrants urgent attention from government officials to fill staff vacancies and to improve the infrastructural facilities to match with the increasing demand from the society. Furthermore, this research recommends the hospital authorities to start conducting induction and training programs for the hospital employees to instill the fundamental code of conduct while working in hectic, challenging and even in conditions with limited resources. Originality/value Only limited papers are visible that address the identification and mitigation of risk factors associated with hospitals. The present paper proposes a novel DEMATEL–ISM–PROMETHEE integrated approach to map the inter-relationships among the significant risk factors and to rank those risk factors based on their criticality. Furthermore, the present study discloses the unique setting of the public healthcare system in a developing nation.

scholarly journals Non-medical prescribing policy in the United Kingdom National Health Service: systematic review and narrative synthesis

2019 ◽  
Author(s):  
Emma Graham-Clarke ◽  
Alison Rushton ◽  
Timothy Noblet ◽  
John Marriott
Keyword(s):  
Systematic Review ◽  
United Kingdom ◽  
Health Service ◽  
Narrative Analysis ◽  
Improve Patient Care ◽  
Policy Position ◽  
Healthcare Provision ◽  
Policy Documents ◽  
The United Kingdom ◽  
The Impact

AbstractNon-medical prescribing was introduced into the United Kingdom (UK) to improve patient care, through extending healthcare professionals’ roles. More recent government health service policy focuses on the increased demand and the need for efficiency. This systematic review aimed to describe any changes in government policy position and the role that non-medical prescribing plays in healthcare provision.The systematic review and narrative analysis included policy and consultation documents that describe independent non-medical prescribing. A pre-defined protocol was registered with PROSPERO (CRD42015019786). Professional body websites, other relevant websites and the following databases were searched to identify relevant papers: HMIC, Lexis Nexis, UK Government Web Archive, UKOP, UK Parliamentary Papers and Web of Science. Papers published between 2006 and February 2018 were included.Following exclusions, 45 papers were selected for review; 23 relating to policy or strategy and 22 to consultations. Of the former, 13/23 were published 2006-2010 and the remainder since 2013. Two main themes are identified: chronological aspects and healthcare provision. The impact of government change and associated major healthcare service reorganisation resulted in the publication gap for policy documents. The role of non-medical prescribing has evolved to support efficient service delivery, and cost reduction. For many professions, prescribing appears embedded into practice; however, pharmacy continues to produce policy documents, suggesting that prescribing is not yet perceived as normal practice.Prescribing appears to be more easily adopted into practice where it can form part of the overall care of the patient. Where new roles are required to be established, then prescribing takes longer to be universally adopted. While this research concerns policy and practice in the UK, this aspect of role adoption has wider potential implications.

scholarly journals O Direito à Saúde no Brasil em Tempos de Crise Econômica, Ajuste Fiscal e Reforma Implícita do Estado

2016 ◽  
Vol 10 (3) ◽  
pp. 28 ◽  
Author(s):  
Fabiola Sulpino Vieira ◽  
Rodrigo Pucci De Sá E Benevides
Keyword(s):  
Healthcare System ◽  
Latin American ◽  
Health Spending ◽  
Right To Health ◽  
Constitutional Amendment ◽  
Public Healthcare ◽  
Public Healthcare System ◽  
America Latina ◽  
The Right ◽  
The Impact

ResumoO objetivo deste artigo é discutir as mudanças recentes no modelo de financiamento da proteção social brasileira e seus impactos na garantia do direito à saúde no Brasil, a partir da promulgação Emenda Constitucional nº 95 de 2016, que institui o chamado “Novo Regime Fiscal”, que limita por 20 anos o crescimento das despesas primárias à taxa de inflação. Para dar suporte à discussão, apresentam-se, inicialmente, os contornos do direito à saúde no Brasil, bem como dados sobre o gasto com saúde do País, comparando-o ao de países da América Latina. São abordados, ainda, os esforços empreendidos para o aumento dos recursos alocados no sistema público de saúde e para a estabilidade do seu financiamento ao longo das últimas décadas. Em seguida, avalia-se o impacto das novas regras fiscais sobre os recursos federais para a saúde em comparação com a regra vigente em 2016, chegando-se à conclusão de que maiores dificuldades serão enfrentadas para a efetivação do direito à saúde no Brasil. Haverá diminuição da participação das despesas primárias do governo federal no Produto Interno Bruto, e da despesa federal com saúde, em particular, revelando o objetivo implícito de redução do tamanho do Estado na recente reforma fiscal.Palavras-chave: Sistema Único de Saúde. Sistema público de saúde. Direito à saúde. Reforma do Estado. Financiamento da saúde. Emenda Constitucional nº 95. ***Derecho a la Salud en Tiempos de Crisis Económica, Austeridad Fiscal y Reforma Implícita del Estado en BrasilResumenEl propósito de este artículo es discutir los recientes cambios en el modelo de financiación de la protección social de Brasil y su impacto en la garantía del derecho a la salud desde la promulgación de la Enmienda Constitucional nº 95, de 2016. Esta Enmienda establece el llamado "Nuevo Régimen Fiscal", que limita durante 20 años el crecimiento del gasto general a la tasa de inflación, excepto de los gastos financieros. Para apoyar la discusión, se presienta, inicialmente, el derecho a la salud en Brasil, así como datos sobre el gasto en salud del país, comparándolo con los gastos de países de América Latina. Los esfuerzos para aumentar los recursos asignados en el sistema de salud pública y para garantizar la estabilidad de su financiación a lo largo de las últimas décadas también son abordados. A continuación, se evalúa el impacto de las nuevas normas fiscales de fondos federales para la salud en comparación con la regla actual, concluyéndose que mayores dificultades son esperadas para la garantía del derecho a la salud en Brasil. Disminuirá la proporción del gasto primario del gobierno federal en el producto interno bruto, y el gasto federal en salud, en particular, revelando el objetivo implícito de reducción del tamaño del Estado en la reciente reforma fiscal.Palabras clave: Sistema Único de Salud. Sistema público de salud. Derecho a la salud. Reforma del estado. Financiación de la atención de la salud. Enmienda Constitucional nº 95.  ***The Right to Health in Times of Economic Crisis, Fiscal Austerity and State Implicit Reform in BrazilAbstractThe objective of this article is to discuss the recent changes in the Brazilian social protection financing model and its impacts on the guarantee of the right to health in Brazil, after the enactment of Constitutional Amendment No. 95 of 2016. This Amendment establishes the so-called "New Fiscal Regime" for 20 years, which links the growth of the government expenditure to the inflation rate. To support the discussion, we first present the contours of the right to health in Brazil, as well as data on health spending in the country, comparing it to that of Latin American countries. We also discuss the efforts made to increase the resources allocated to the public healthcare system and to stabilize the spending over the last decades. Next, the impact of the new fiscal rules on the federal resources for health is evaluated in comparison with the current rule, and we conclude that greater difficulties will be faced for the right to health guarantee in Brazil. There will be a decline in the share of federal government expenditures on Gross Domestic Product, and in federal health spending in particular, revealing that the implicit goal of the recent reform is to reduce the State size.Key-words: Unified Health System. Public healthcare system. Right to health. State reform. Healthcare financing. Constitutional Amendment No. 95. 

scholarly journals Heroin on trial: Systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addiction

2015 ◽  
Vol 207 (1) ◽  
pp. 5-14 ◽  
Author(s):  
John Strang ◽  
Teodora Groshkova ◽  
Ambros Uchtenhagen ◽  
Wim van den Brink ◽  
Christian Haasen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Methadone Maintenance ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Heroin Dependence ◽  
Heroin Addiction ◽  
Healthcare Provision ◽  
Safety Issues ◽  
Randomised Controlled ◽  
The Impact

BackgroundSupervised injectable heroin (SIH) treatment has emerged over the past 15 years as an intensive treatment for entrenched heroin users who have not responded to standard treatments such as oral methadone maintenance treatment (MMT) or residential rehabilitation.AimsTo synthesise published findings for treatment with SIH for refractory heroin-dependence through systematic review and meta-analysis, and to examine the political and scientific response to these findings.MethodRandomised controlled trials (RCTs) of SIH treatment were identified through database searching, and random effects pooled efficacy was estimated for SIH treatment. Methodological quality was assessed according to criteria set out by the Cochrane Collaboration.ResultsSix RCTs met the inclusion criteria for analysis. Across the trials, SIH treatment improved treatment outcome, i.e. greater reduction in the use of illicit ‘street’ heroin in patients receiving SIH treatment compared with control groups (most often receiving MMT).ConclusionsSIH is found to be an effective way of treating heroin dependence refractory to standard treatment. SIH may be less safe than MMT and therefore requires more clinical attention to manage greater safety issues. This intensive intervention is for a patient population previously considered unresponsive to treatment. Inclusion of this low-volume, high-intensity treatment can now improve the impact of comprehensive healthcare provision.

scholarly journals Impact of austerity on prison health in England: a qualitative study involving national policymakers

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Ismail
Keyword(s):  
Political Ideology ◽  
Constructivist Grounded Theory ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Narrative Texts ◽  
Female Prisoners ◽  
Prison Health ◽  
Long Term Impact ◽  
The Uk ◽  
The Impact

Abstract Prisons offer states access to a population that is at high risk of morbidity. The UK austerity policy adopted in 2010 led to a 22% reduction (-£2.71bn) in prison spending by 2017. Whilst the number of prison officers dropped by 30%, the long-term impact of austerity on prison health in England has not been systematically contextualised. This research seeks to articulate the impact of austerity on prison health in England from the perspective of national policymakers. Semi-structured interviews (X: 66 min) were conducted with 30 key prison policymakers. Constructivist grounded theory was used to assess the impact of austerity on prisoner health in England. Transcripts of 195,680 narrative texts were analysed using NVivo 11 until data saturation was achieved. As a stealthy political ideology, austerity has caused societal disruption, which disproportionately affects prisons. The lack of access to services offered by the welfare state, including health-related provisions, precipitates societal unrest, increases prisoner numbers, and encourages harsher and longer sentences. The prolonged constrained funding and the burgeoning population widen health inequalities in prisons. Healthcare provisions become increasingly limited, which unduly affects older and female prisoners who require more complex support. The degrading living conditions and lack of purposeful activities contribute to the increasing violence, self-harm and suicides in prisons, and reorient the healthcare provision from planned services to health emergencies. The excessive focus on Brexit and the perpetual changing political direction imposed on prisons reinforce the system’s instability. Despite having the fifth largest economy in the world, England’s poorest population continues to bear the brunt of austerity. Initiating a more informed economic recovery policy and considering alternatives to imprisonment would help to ensure that England lives up to its view of itself as a progressive society.

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