Sâkipakâwin: Assessing Indigenous Cancer Supports in Saskatchewan Using a Strength-Based Approach

Given that the health care system for Indigenous people tends to be complex, fragmented, and multi-jurisdictional, their cancer experiences may be especially difficult. This needs assessment study examined system-level barriers and community strengths regarding cancer care experiences of Indigenous people in Saskatchewan. Guided by an advisory committee including Indigenous patient and family partners, we conducted key informant interviews with senior Saskatchewan health care administrators and Indigenous leaders to identify supports and barriers. A sharing circle with patients, survivors, and family members was used to gather cancer journey experiences from Indigenous communities from northern Saskatchewan. Analyses were presented to the committee for recommendations. Key informants identified cancer support barriers including access to care, coordination of care, a lack of culturally relevant health care provision, and education. Sharing circle participants discussed strengths and protective factors such as kinship, connection to culture, and spirituality. Indigenous patient navigation, inter-organization collaboration, and community relationship building were recommended to ameliorate barriers and bolster strengths. Recognizing barriers to access, coordination, culturally relevant health care provision, and education can further champion community strengths and protective factors and frame effective cancer care strategies and equitable cancer care for Indigenous people in Saskatchewan.

Artificial inteligence and its use in the process of providing health care

In the article, the author discusses the issue of electronic health care with a focus on telemedicine. The first part of the paper provides an overview and explanation of the basic related concepts, which are electronic healthcare and e-health, telemedicine and health care. In this part, the author also summarizes the relevant legislation. The author also presents the performance of telemedicine in the conditions of the Slovak Republic. Above all, the author asks which legal institutes are affected by another way of providing health care, which is distance medicine? The author gradually analyzes selected issues, namely instruction and informed consent, making audio or video-audio recording, recording telemedicine performance in medical documentation and payment for such performance. The conclusion of the article is devoted to summarizing and pointing out the threats and challenges of telemedicine, which the author considers the use of private communication platforms, the related violation of cyber security and the use of artificial intelligence. Key words: electronic healthcare, e-health, telemedicine, remote medicine, remote health care provision.

Authoritarian Regime Legitimacy and Health Care Provision: Survey Evidence from Contemporary China

Context: Over the last two decades a growing body of research has shown authoritarian regimes trying to increase their legitimacy by providing public goods. But there has so far been very little research on whether or not these regimes are successful. Methods: This article analyzes data from a 2012–2013 nationally representative survey in China to examine whether health care provision bolsters the communist regime’s legitimacy. Using multivariate ordinal logistic regression, we test whether having public health insurance and being satisfied with the health care system are associated with separate measures of the People’s Republic of China’s regime legitimacy: support for “our form of government” (which we call “system support”) and political trust. Findings: Having public health insurance is positively associated with trust in the Chinese central government. Health care system satisfaction is positively associated with system support and trust in local government. Conclusions: Health care provision may bolster the legitimacy of authoritarian regimes, with the clearest evidence showing that concrete benefits may translate into trust in the central government. Further research is needed to understand the relationship between trends in provision and legitimacy over time and in other types of authoritarian regime.

Has healthcare rationalisation been rationale? Hospital beds and Covid-19 in Italy

The outbreak of Covid-19 pandemic highlighted the existence of a hospital bed shortage in Italy, as a result of a longstanding trend. The article analyses this process by an international comparison with other Western European countries, highlighting the intensity of hospital bed reduction in Italy, as a fundamental component of NHS rationalisation. Although it was based on solid grounds, international data suggest that hospital bed reduction was probably excessive, depriving the NHS of organisational slack. Moreover, de-hospitalisation would have been matched with a stronger development of primary and community care. The relative shortage of these services, along with the lack of integrated networks between hospital and non-hospital care, explains many difficulties experienced by hospitals in tackling Covid patients. Beyond investments in health care, these elements call to re-think the organisation of health care provision at local level, questioning the purchaser-provider split.

Public opinion on the eligibility of health care for migrants and refugees

Background: Worldwide, more than 200 million people have left their home country, and international migration from the Middle East to Europe is increasing. The journey and the poor living conditions cause numerous health problems. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with native populations and this can impact access to health systems and participation in prevention programmes. Aim: Our aim was to measure the attitude of survey participants to migrants and to define up to what level migrants are entitled to health care from the viewpoint of Slovenian citizens. Methods: This survey was carried out in January 2019 and included 311 respondents. We applied a quantitative, nonexperimental sampling method. We used a structured survey questionnaire based on an overview, a national survey on the experiences of patients in hospitals and user satisfaction with medical services of basic health care at the primary level. Results: A large proportion of the respondents agreed that migrants should receive emergency or full health care provision, that there is no need to limit their health rights and that they do not feel that their own rights are compromised by the rights of migrants. Over 80% agreed with health protection for women and for children. Conclusion: The findings offer a basis for supplementing the existing, or designing a new, model of health care provision for migrants in Slovenia, focusing on the provision of health protection and care as a fundamental human right.

11. Free movement of services: the freedom to provide and receive services

This chapter examines the law on the free movement of services in the European Union. It discusses the service economy and the law on services; non-discrimination and the direct effect of Article 56 TFEU; the meaning of services; remuneration; economic services and other activities; services and cross-border activity; the freedom to provide a service; the freedom to receive services; health care provision; services that move where the provider and recipient do not; limitations on services freedom; public interest grounds limiting the freedom of Article 56 TFEU; proportionality; illegal services; the focus on market access and the Services Directive.

Medicine in Unplanned Mass Gatherings: A Qualitative Study of Health-Care Providers’ Response and Recommendations to Beirut’s Protests

Objective: This study aims at exploring the dynamics of health-care provision during recent unplanned public mass gatherings in Beirut, and how the health-care system adapts to mass movements in protests. Methods: A qualitative study was conducted using semi-structured interviews with 12 health-care providers who volunteered at medical tents set during protests in Beirut, Lebanon. Responses were transcribed and coded. Results: Three themes were noted: preparedness and logistics, encountered cases, and participants’ proposed recommendations. In terms of preparedness and logistics, participants lacked knowledge of field medicine protocols and an organizational structure. They faced difficulties in securing equipment and advertising their services. Most encountered cases were physical injuries rather than mental health problems. The participants proposed both short-term recommendations, including advice on how to boost care provided, and long-term recommendations on structuring the health-care system to be better prepared. Conclusions: On-site health-care provision during unplanned mass gatherings is a vital need. We recommend forming a task force of health-care workers from various fields led by the Ministry of Public Health in every respective country to plan protocols, train personnel, and secure resources beforehand.