Analysis of out-of-pocket health expenditure using the WHO Global Health Expenditure Database (GHED): A systematic review

2020 ◽  
Vol 128 (4) ◽  
pp. 474-479
Author(s):  
Marino J González R
Keyword(s):  
Systematic Review ◽  
Global Health ◽  
Health Expenditure ◽  
Health Financing ◽  
World Health ◽  
Health Coverage ◽  
Sources Of Information ◽  
Health Organization ◽  
Meta Analyses ◽  
Country Specific

Introduction: Tracking out-of-pocket (OOP) health expenditure is a very useful reference for knowing the progress of countries in the goal of universal health coverage (UHC) in 2030. The World Health Organization (WHO) has developed the Global Health Expenditure Database (GHED) to facilitate analysis of health financing in countries or regions. The paper explores the use of GHED in the analysis of OOP health expenditure in the specialized literature. Objective: To perform a systematic review of the studies in which GHED is used to analyze OOP health expenditure in countries or groups of countries. Methods: The systematic review followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). The database used was PubMed. All publications that were available on PubMed by July 30, 2020, were identified. Results: Twenty-five papers were identified. The use of the GHED to analyze OOP health expenditure was reported in five studies, one country study, and four studies with regional comparisons. The included studies cover the period 1995-2016. Discussion: The use of the GHED for the analysis of the evolution of OOP health expenditure in countries or regions is not very widespread in the specialized literature. The GHED has proven to be a very useful instrument for international comparison, although the fact that there are differences with national reports (public expenditure reviews) makes it advisable to combine both sources of information in the analysis of country- specific health policies. Conclusion: The systematic use of the GHED can be useful to improve the quality of information and estimates, such as country-specific expenditure analyses. To this end, it is particularly important to characterize the levels of OOP health expenditure and to incorporate policy monitoring into the analyses.

scholarly journals Ketamine for Adults with Severe Asthma Exacerbation: A Systematic Review and Meta-analysis

2022 ◽  
Vol 2 (1) ◽  
pp. 91-97
Author(s):  
Fatimah AlShehri ◽  
Heetaf Aloqaily ◽  
Joud Enabi ◽  
Sharafaldeen Bin Nafisah
Keyword(s):  
Systematic Review ◽  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Meta Analysis ◽  
World Health ◽  
Severe Asthma Exacerbation ◽  
Number Of Patients ◽  
Acute Asthma Exacerbation ◽  
Health Organization ◽  
Meta Analyses

BACKGROUND: Severe asthma mandates careful attention and timely management, and the benefit of ketamine in severe asthma exacerbations in adult patients require further exploration. METHODS: We conducted a systematic review and meta-analysis of the use of ketamine in cases of acute asthma exacerbation in adults. We searched PubMed, Google Scholar, Cochrane databases, and gray literature (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform); we also searched the reference lists of included articles and any systematic reviews and meta-analyses identified therein. Our search covered the period from 1963 to August 20, 2021. Search terms were “ketamine” AND “asthma”. RESULTS: Of 25 540 articles, two studies were included in the analysis. The total number of patients included in the studies was 136 (68 in the ketamine groups and 68 in the placebo group). The pooled effect size was 0.30 (95% CI: -0.04, 0.63) favouring ketamine over placebo, p=0.08, (I2=0%, p=0.39). A paired t-test revealed that ketamine improved the mean peak expiratory flow rate (PEFR) from 242.4 (SD=146.23) to 286.95 (SD=182.22), p=0.33, representing an 18.38% improvement. CONCLUSION: Ketamine can induce a 30% improvement in PEFR, representing a small positive effect in the treatment of acute severe asthma exacerbation in the emergency department (ED). The improvement was not statistically significant; nonetheless, since the improvement could be as great as 63% versus only a 4% possibility of no benefit/harm, the benefit appears to considerably outweigh any harm.

scholarly journals Dynamics of sputum conversion during effective tuberculosis treatment: A systematic review and meta-analysis

PLoS Medicine ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. e1003566
Author(s):  
Claire J. Calderwood ◽  
James P. Wilson ◽  
Katherine L. Fielding ◽  
Rebecca C. Harris ◽  
Aaron S. Karat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
World Health ◽  
Significant Heterogeneity ◽  
Tb Treatment ◽  
Health Organization ◽  
Reported Data ◽  
Meta Analyses ◽  
Culture Conversion

Background Two weeks’ isolation is widely recommended for people commencing treatment for pulmonary tuberculosis (TB). The evidence that this corresponds to clearance of potentially infectious tuberculous mycobacteria in sputum is not well established. This World Health Organization–commissioned review investigated sputum sterilisation dynamics during TB treatment. Methods and findings For the main analysis, 2 systematic literature searches of OvidSP MEDLINE, Embase, and Global Health, and EBSCO CINAHL Plus were conducted to identify studies with data on TB infectiousness (all studies to search date, 1 December 2017) and all randomised controlled trials (RCTs) for drug-susceptible TB (from 1 January 1990 to search date, 20 February 2018). Included articles reported on patients receiving effective treatment for culture-confirmed drug-susceptible pulmonary TB. The outcome of interest was sputum bacteriological conversion: the proportion of patients having converted by a defined time point or a summary measure of time to conversion, assessed by smear or culture. Any study design where more than 10 participants were included was considered. Record sifting and data extraction were performed in duplicate. Random effects meta-analyses were performed. A narrative summary additionally describes the results of a systematic search for data evaluating infectiousness from humans to experimental animals (PubMed, all studies to 27 March 2018). Other evidence on duration of infectiousness—including studies reporting on cough dynamics, human tuberculin skin test conversion, or early bactericidal activity of TB treatments—was outside the scope of this review. The literature search was repeated on 22 November 2020, at the request of the editors, to identify studies published after the previous censor date. Four small studies reporting 3 different outcome measures were identified, which included no data that would alter the findings of the review; they are not included in the meta-analyses. Of 5,290 identified records, 44 were included. Twenty-seven (61%) were RCTs and 17 (39%) were cohort studies. Thirteen studies (30%) reported data from Africa, 12 (27%) from Asia, 6 (14%) from South America, 5 (11%) from North America, and 4 (9%) from Europe. Four studies reported data from multiple continents. Summary estimates suggested smear conversion in 9% of patients at 2 weeks (95% CI 3%–24%, 1 single study [N = 1]), and 82% of patients at 2 months of treatment (95% CI 78%–86%, N = 10). Among baseline smear-positive patients, solid culture conversion occurred by 2 weeks in 5% (95% CI 0%–14%, N = 2), increasing to 88% at 2 months (95% CI 84%–92%, N = 20). At equivalent time points, liquid culture conversion was achieved in 3% (95% CI 1%–16%, N = 1) and 59% (95% CI 47%–70%, N = 8). Significant heterogeneity was observed. Further interrogation of the data to explain this heterogeneity was limited by the lack of disaggregation of results, including by factors such as HIV status, baseline smear status, and the presence or absence of lung cavitation. Conclusions This systematic review found that most patients remained culture positive at 2 weeks of TB treatment, challenging the view that individuals are not infectious after this interval. Culture positivity is, however, only 1 component of infectiousness, with reduced cough frequency and aerosol generation after TB treatment initiation likely to also be important. Studies that integrate our findings with data on cough dynamics could provide a more complete perspective on potential transmission of Mycobacterium tuberculosis by individuals on treatment. Trial registration Systematic review registration: PROSPERO 85226.

Links Between Perceptions and Practices in Patient Education: A Systematic Review

2019 ◽  
Vol 46 (6) ◽  
pp. 1001-1011 ◽  
Author(s):  
Sandrine Roussel ◽  
Mariane Frenay
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Education ◽  
Health Care Professionals ◽  
Quality Criteria ◽  
World Health ◽  
Health Organization ◽  
The Individual ◽  
Meta Analyses

Background. Two decades after “patient education” was defined by the World Health Organization, its integration in health care practices remains a challenge. Perceptions might shed light on these implementation difficulties. This systematic review aims to investigate links between perceptions and patient education practices among health care professionals, paying particular attention to the quality of practices in order to highlight any associated perception. Method. PubMed, PsycINFO, and Scopus were searched using the following search terms: “perceptions,” “patient education,” “health care professionals,” and “professional practices.” PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used. Results. Twenty studies were included. Overall findings supported the existence of links between some perceptions and practices. Links were either correlational or “causal” (generally in a single direction: perceptions affecting practices). Four types of perceptions (perceptions of the task including patient education, perceptions about the patient, perceptions of oneself as a health care professional, and perceptions of the context) were identified as being linked with educational practices. Links can although be mediated by other factors. Results concerning links should, however, be considered with caution as practices were mostly assessed by prevalence measurements, were self-reported and concerned exclusively individual education. When analyzing the quality of practices, the two retained studies highlighted their changing nature and the central role of perceptions with respect to the individual patient. Conclusions. This literature review led us to specify the quality criteria for further research: covering the entire spectrum of patient education, operationalizing variables, exploring specific practices, measuring the quality of practices, developing designs that facilitate causation findings, and considering a bidirectional perspective.

Zika Virus, Global Health Communication, and Dataveillance

2020 ◽  
Author(s):  
Kirsten Ostherr
Keyword(s):  
Global Health ◽  
Communication Networks ◽  
Zika Virus ◽  
Disease Outbreaks ◽  
Social Contexts ◽  
World Health ◽  
Digital Networks ◽  
Sources Of Information ◽  
Filter Bubbles ◽  
Health Organization

Through analysis of media produced by the World Health Organization (WHO) in response to the Zika virus outbreak of 2016, this chapter demonstrates how distributed digital communication networks such as social media platforms have created significant challenges for the WHO’s top-down model of information management. Unlike disease outbreaks of the past, Zika virus media circulated through mobile, social digital networks shaped by invisible algorithms and filter bubbles that helped generate counter narratives opposing the communications of official health organizations. This chapter examines Zika virus media through the analytical frames of datafication, dataveillance, and data-making to explain how diverse sources of information and social contexts of interpretation pose new challenges for global health communications.

scholarly journals Health financing for universal health coverage in Sub-Saharan Africa: a systematic review

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Susan C. Ifeagwu ◽  
Justin C. Yang ◽  
Rosalind Parkes-Ratanshi ◽  
Carol Brayne
Keyword(s):  
Systematic Review ◽  
Health Services ◽  
Universal Health Coverage ◽  
Health Financing ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cochrane Library ◽  
Health Coverage ◽  
Sub Saharan ◽  
Universal Health

Abstract Background Universal health coverage (UHC) embedded within the United Nations Sustainable Development Goals, is defined by the World Health Organization as all individuals having access to required health services, of sufficient quality, without suffering financial hardship. Effective strategies for financing healthcare are critical in achieving this goal yet remain a challenge in Sub-Saharan Africa (SSA). This systematic review aims to determine reported health financing mechanisms in SSA within the published literature and summarize potential learnings. Methods A systematic review was conducted aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. On 19 to 30 July 2019, MEDLINE, EMBASE, Web of Science, Global Health Database, the Cochrane Library, Scopus and JSTOR were searched for literature published from 2005. Studies describing health financing approaches for UHC in SSA were included. Evidence was synthesised in form of a table and thematic analysis. Results Of all records, 39 papers were selected for inclusion. Among the included studies, most studies were conducted in Kenya (n = 7), followed by SSA as a whole (n = 6) and Nigeria (n = 5). More than two thirds of the selected studies reported the importance of equitable national health insurance schemes for UHC. The results indicate that a majority of health care revenue in SSA is from direct out-of-pocket payments. Another common financing mechanism was donor funding, which was reported by most of the studies. The average quality score of all studies was 81.6%, indicating a high appraisal score. The interrater reliability Cohen’s kappa score, κ=0.43 (p = 0.002), which showed a moderate level of agreement. Conclusions Appropriate health financing strategies that safeguard financial risk protection underpin sustainable health services and the attainment of UHC. It is evident from the review that innovative health financing strategies in SSA are needed. Some limitations of this review include potentially skewed interpretations due to publication bias and a higher frequency of publications included from two countries in SSA. Establishing evidence-based and multi-sectoral strategies tailored to country contexts remains imperative.

scholarly journals Protocol of a Systematic Review on Telemedicine Solutions in COVID-19 Pandemic

2021 ◽  
Vol 10 (1) ◽  
pp. 96
Author(s):  
Saeid Eslami ◽  
Raheleh Ganjali
Keyword(s):  
Systematic Review ◽  
Decision Makers ◽  
World Health ◽  
Future Health ◽  
Screening Process ◽  
Review Study ◽  
Health Organization ◽  
Meta Analyses ◽  
Abstract Screening ◽  
Respiratory Droplets

Introduction: On March 20, 2020, the World Health Organization (WHO) announced the spread of SARS-CoV-2 infection in most countries worldwide as a pandemic. COVID-19 is mainly disseminated through human-to-human transmission route via direct contact and respiratory droplets. Telehealth and/or telemedicine technologies are beneficial methods that could be employed to deal with pandemic situation of communicable infections. The purpose of this proposed systematic review study is to sum up the functionalities, applications, and technologies of telemedicine during COVID-19 outbreak.Material and Methods: This review will be carried out in accordance with the Cochrane Handbook and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines. PubMed and Scopus databases were searched for related articles. Randomized and non-randomized controlled trials published in English in scientific journals were identified to be evaluated for eligibility. Articles conducted on telemedicine services (TMS) during COVID-19 outbreak (2019-2020) were identified to be evaluated.Results: The literature search for related articles in PubMed and Scopus databases led to the identification and retrieval of a total of 1118 and 485 articles, respectively. After eliminating duplicate articles, title and abstract screening process was performed for the remaining 1440 articles. The current study findings are anticipated to be used as a guide by researchers, decision makers, and managers to design, implement, and assess TMS during COVID-19 crisis.Conclusion: As far as we know, this systematic review is conducted to comprehensively evaluate TM methods and technologies developed with the aim of controlling and managing COVID-19 pandemic. This study highlights important applications of telemedicine in pandemic conditions, which could be employed by future health systems in controlling and managing communicable infections when an outbreak occurs.

Building a better global health security early-warning system post-COVID: The view from Canada

2021 ◽  
pp. 002070202098522
Author(s):  
Wesley Wark
Keyword(s):  
Global Health ◽  
Early Warning ◽  
Disease Outbreaks ◽  
Warning System ◽  
World Health ◽  
Global Public Health ◽  
Sources Of Information ◽  
Health Security ◽  
Leading Role ◽  
Health Organization

In the years following the Severe Acute Respiratory Syndrome (SARS) outbreak in 2002–2003, the World Health Organization (WHO) created a new system for global disease outbreak surveillance. The system relied on timely reporting by nation-states and gave the WHO a leading role in the global response. It also recognized the value of a multiplicity of sources of information, including from open-source media scanning. The post-SARS system faced its most significant task with the outbreak of the COVID-19 pandemic in the People’s Republic of China and its rapid spread in 2020. The WHO architecture for early warning of disease outbreaks arguably failed and gives rise to questions about how the international community can better respond to pandemic threats in future. This article explores the inter-connectedness of Canada’s system for global health surveillance, featuring the work of the Global Public Health Intelligence Network and that of the WHO, and argues that, while Canada has positioned itself as a global leader, much work needs to be done in Canada, and globally, if the concept of collective health security and shared early warning is to be maintained in the future.

scholarly journals Health systems in the SDG era: consolidating and building on the gains

2017 ◽  
Vol 4 (12) ◽  
pp. 4377
Author(s):  
Gunjan Taneja ◽  
Rajeev Gera ◽  
Dinesh Agarwal ◽  
Michael Favin ◽  
Satish Saroshe ◽  
...  
Keyword(s):  
Global Health ◽  
Health Systems ◽  
Care Delivery ◽  
Health Financing ◽  
Well Being ◽  
Global Strategy ◽  
World Health ◽  
Health Coverage ◽  
The Sustainable Development ◽  
Equity And Efficiency

Global health today stands at cross-roads, with unanticipated problems challenging the unprecedented progress achieved over the last two decades. To achieve the targets established for the sustainable development goal 3 of “ensuring healthy lives and promote well-being for all at all ages”, significant resources and comprehensive health systems must play a critical and integral role. World Health Organization’s (WHO) framework for action on “Strengthening Health Systems to Improve Health Outcomes” has well identified the challenges of global health.  The Global Strategy for Women's, Children's and Adolescents' Health 2015-2030 states that for women’s and children’s health investments in high-impact health interventions for RMNCH at a cost of US$5 per person per year up to 2035 in 74 high-burden countries, could yield up to nine times that value in economic and social benefits. As global health marches towards achieving universal health coverage (UHC), innovative health financing schemes and health system design will be the major determinants of equity and efficiency in resource allocation and health care delivery. Because we are now in a critical phase, it is imperative that the initial years of the SDGs receive utmost thrust from all relevant stakeholders across countries to initiate and maintain a sustained momentum for achieving the targets. The primary priority for the health-related targets’ therefore’ necessitates the need for formulation of robust, responsive and resilient health systems strategies by all the major policy makers and concerned stakeholders.

Global Health and the Global Burden of Disease

2021 ◽  
pp. 85-99
Author(s):  
Joia S. Mukherjee
Keyword(s):  
Global Health ◽  
Burden Of Disease ◽  
Disease Burden ◽  
World Health ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Health Coverage ◽  
New Era ◽  
Health Organization ◽  
Key Terms

In this new era of global health in which delivering care has become a reality, it is important to understand the terms used to describe the health of populations, such as incidence, prevalence, morbidity, and mortality. As well as to be able to describe the concepts such as the burden of disease in a population, the quantity and impact of diseases that affect the health of populations, and the epidemiologic shifts within a society. This chapter reviews these key terms and concepts as well as the creation of the Global Burden of Disease (GBD) project, launched in 1990 at the World Health Organization. The GBD project measures and estimates the disease burden in countries on a regular basis. These data are critical to built health systems with sufficient inputs to address the entirety of the disease burden and achieve universal health coverage.

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