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Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 107
Author(s):  
László Lorenzovici ◽  
Andrea Bârzan-Székely ◽  
Szabolcs Farkas-Ráduly ◽  
Bogdan C. Pană ◽  
Marcell Csanádi ◽  
...  

Chronic heart failure (CHF) affects millions of people across the world, with increasing trends in prevalence, putting ever increasing pressure on the healthcare system. The aim of this study was to assess the financial burden of CHF hospital care on the public healthcare sector in Romania by estimating the number of inpatient episodes and the associated costs. Additionally, societal costs associated with missed work and premature death of CHF patients were also estimated. The national claims database was analyzed to estimate the number of CHF patients. Cost data was extracted from a pool of nine public hospitals in Romania. In 2019, 375,037 CHF patient episodes were identified on specific wards at the national level. The average cost calculated for the selected nine hospitals was EUR 996. The calculated weighted national average cost per patient episode was EUR 1002, resulting in a total cost of EUR 376 million at the national level. The cost of workdays missed summed up to EUR 122 million, while the annual costs associated with the premature death of CHF patients was EUR 230 million. In conclusion, the prevalence of CHF in Romania is high, accounting for a large proportion of hospitalizations, which translates into large costs for the national payer.


2022 ◽  
pp. 114-134
Author(s):  
Ngoako Solomon Marutha

This chapter reflects on the lesson learnt from the application of multi-methods in a quantitative study that was conducted to study patient record management in the public healthcare sector. In this study, a questionnaire was the main data collection tool, which was supported by interviews, observations, and document/system analysis data. In conducting the study, triangulation of multi-methods data was performed at different stages of the study. Currently there is no clear framework in social science research about the application of multi-method, mono-method, and mixed method research, which the study intends to clear. The study revealed that quantitative data need to be augmented with some narrative/qualitative data to make an empirical conclusion and recommendations because alone, it may not be completely reliable. Triangulation of multi-methods eliminates bias and closes some gaps where data leave some questions unanswered. The study provides a framework to guide on research method based on methods ingredients.


2021 ◽  
Vol 9 ◽  
Author(s):  
Adrian V. Horodnic

Background: A new institutional approach toward informal payments in healthcare views informal payments as arising when there is a misalignment between values/norms (informal institutions) and the formal rules (formal institutions) of patients. However, less knowledge is available on the effectiveness of this approach in tackling informal payments in healthcare. This study aimed to fill this gap by evaluating the trends in the effect of institutional misalignment on informal payments made by patients.Methods: A quantitative study design with data extracted from the last three waves of special Eurobarometer surveys on corruption was used to model the propensity of European patients in 27 European Union countries and the United Kingdom to make informal payments. Multilevel logistic regression analysis was employed in order to test the relationship between the formal–informal institution misalignment and the likelihood to make informal payments. Sensitivity analyses were also performed to test the robustness of the findings.Results: The finding is that there is a strong association between the formal–informal institution misalignment and the likelihood to make informal payments for public healthcare services. Similarly, social norms play a pivotal role. When patients perceive that informal practices are widespread in the public healthcare sector they are more likely to make informal payments themselves.Conclusion: The outcome is a call for complementing deterrence measures toward informal payments in healthcare with measures aiming to reduce the formal–informal institution misalignment and to change the social norms. This can be achieved by improving the structural conditions at country level and by changing values/norms and beliefs of patients.


2021 ◽  
Vol 13 (21) ◽  
pp. 11988
Author(s):  
Munyaradzi Bvuchete ◽  
Sara Saartjie Grobbelaar ◽  
Joubert van Eeden

The healthcare supply chain is a complex adaptive ecosystem that facilitates the delivery of health products to the end patient in a cost-effective way. However, low forecast accuracy and high demand volatility in healthcare supply chains have resulted in an increase in stockouts, operational inefficiencies, poor health outcomes, and a significant increase in supply chain costs. To cope with these challenges, organisations are trying to adopt demand-driven supply chain management (DDSCM) operating practices which have been established in other sectors such as the telecommunications, fruit, and flower industries. However, previous studies have not considered these practices in the healthcare industry, and hence no methodologies exist that support the implementation of these practices in this context. Moreover, current studies present cases where the focus has been on improving and expanding individual organisational performance, but no supply chain network-level studies exist on the healthcare industry. Therefore, this paper provides a network-level analysis when addressing DDSCM in the healthcare industry. A grounded theory-based approach coupled with a conceptual framework analysis process was used to leverage a systematized literature review methodology with the development of a network maturity mapping tool for DDSCM which was validated in the public healthcare sector.


2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Devanshi R. Shah ◽  
Abimbola Leslie ◽  
Kristen Destigter ◽  
Eline van de Broek-Altenburg ◽  
Susan Horton ◽  
...  

Purpose: Radiology global outreach programs have increased in recent years but progressed more slowly than other specialties. Establishing radiology services is increasingly recognized as a priority in resource-limited settings. Myanmar has a tremendous disease burden that is treatable with interventional radiology (IR) techniques, and aims to grow and effectively integrate this service into its public healthcare sector. Through collaborations between Asia Pacific Society of Cardiovascular and Interventional Radiology (APSCVIR) and Myanmar Radiological Society (MRS), the field of IR has grown exponentially over recent years. This study aims to provide a Myanmar national IR report on the current trends and future challenges. Methods and materials: Descriptive variables across five domains (facility and equipment, workforce, supplies, infrastructure, and casemix) from the four public sector hospitals with IR capability were obtained between 2016-2019. The four hospitals were Yangon General Hospital (YGH), Yangon Specialty Hospital (YSH), Mandalay General Hospital (MGH), and Defense Services General Hospital (DSGH). Data were analyzed to demonstrate progress in IR and the differing casemix. Results: There are currently four IR-capable hospitals and nine interventional radiologists across Myanmar’s public healthcare sector. IR case volumes tripled from 514 cases in 2016 to more than 1,500 cases in 2019. The three most common procedures performed were trans-arterial chemoembolization (TACE, 63%), bronchial arterial embolization (BAE, 7.7%), and drainages (7.7%). Significant challenges to the growth and adoption of IR services span the domains of infrastructure, equipment and supplies, workforce, and IR awareness, among other clinical specialties. Conclusion: Myanmar’s healthcare priorities, coupled with international radiological outreach programs, have led to rapid growth of IR. The exponential growth in case volumes is promising for Myanmar and other developing countries. But to widen the scope of practice and integrate the service within local clinical workflows, a holistic effort that addresses multiple domains is needed in the future.


Author(s):  
Stephen Cantarutti ◽  
Emmanuel M. Pothos

Abstract Background According to recent polling, public trust in the healthcare sector remains low relative to other industries globally. The implications of low healthcare trust permeate throughout the industry in a number of ways, most visibly by discouraging therapy compliance. Methods This study investigated four putative determinants of trust in healthcare-related scenarios: individuals vs. collective groups as communicators of healthcare advice; expert vs. laypeople as providers of healthcare communication; public vs. private healthcare sector; and positive vs. negative information. Two hundred seventy-four participants were recruited via Prolific Academic and were presented with four statements in random order, related to a positive reflection of the public healthcare sector, a negative reflection of the public healthcare sector, a positive reflection of the private healthcare sector and a negative reflection of the private healthcare sector. According to these reflection, participants were repeatedly asked to rate the system on its trustworthiness. Trust outcomes were constructed using a four-dimension framework, consisting of benevolence, reliability, competence and predictability. Results Claims relating to the public sector had a significantly stronger impact on benevolence and reliability than claims relating to the private sector; claims from individuals had a significantly stronger impact on all trust variables than claims from collectives; and claims from laypeople had a significantly greater impact on reliability and competence ratings than claims from experts. Conclusions The findings in this study offer insight into the patterns with which trust decisions are made in healthcare contexts. More importantly, this research offers a novel perspective of how different factors interact to affect the various facets of trust. These results provide a foundation for future study in this evolving area, and offer insights into designing effective communication strategies that cultivate greater levels of individual trust in the healthcare sector.


2021 ◽  
pp. 127-145
Author(s):  
Elisabetta Gola ◽  
Fabrizio Meloni ◽  
Andrea Volterrani

In the mediated construction of social reality, public institutions need to in-crease digital communication and build trust through proximity and relationality. During the crisis generated by Covid-19 this has become even more evident. In this paper we will explore some case study of social media communication in ten Italian Health Public Hospitals and Authorities, exploring them in the light of some key perspectives related to four dimensions related to space, time, relational-ity, digital communities and two objectives of public institutions: inclusion and popularity.


PLoS Medicine ◽  
2021 ◽  
Vol 18 (7) ◽  
pp. e1003682
Author(s):  
Giorgia Sulis ◽  
Brice Batomen ◽  
Anita Kotwani ◽  
Madhukar Pai ◽  
Sumanth Gandra

Background We assessed the impact of the coronavirus disease 2019 (COVID-19) epidemic in India on the consumption of antibiotics and hydroxychloroquine (HCQ) in the private sector in 2020 compared to the expected level of use had the epidemic not occurred. Methods and findings We performed interrupted time series (ITS) analyses of sales volumes reported in standard units (i.e., doses), collected at regular monthly intervals from January 2018 to December 2020 and obtained from IQVIA, India. As children are less prone to develop symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we hypothesized a predominant increase in non-child-appropriate formulation (non-CAF) sales. COVID-19-attributable changes in the level and trend of monthly sales of total antibiotics, azithromycin, and HCQ were estimated, accounting for seasonality and lockdown period where appropriate. A total of 16,290 million doses of antibiotics were sold in India in 2020, which is slightly less than the amount in 2018 and 2019. However, the proportion of non-CAF antibiotics increased from 72.5% (95% CI: 71.8% to 73.1%) in 2019 to 76.8% (95% CI: 76.2% to 77.5%) in 2020. Our ITS analyses estimated that COVID-19 likely contributed to 216.4 million (95% CI: 68.0 to 364.8 million; P = 0.008) excess doses of non-CAF antibiotics and 38.0 million (95% CI: 26.4 to 49.2 million; P < 0.001) excess doses of non-CAF azithromycin (equivalent to a minimum of 6.2 million azithromycin treatment courses) between June and September 2020, i.e., until the peak of the first epidemic wave, after which a negative change in trend was identified. In March 2020, we estimated a COVID-19-attributable change in level of +11.1 million doses (95% CI: 9.2 to 13.0 million; P < 0.001) for HCQ sales, whereas a weak negative change in monthly trend was found for this drug. Study limitations include the lack of coverage of the public healthcare sector, the inability to distinguish antibiotic and HCQ sales in inpatient versus outpatient care, and the suboptimal number of pre- and post-epidemic data points, which could have prevented an accurate adjustment for seasonal trends despite the robustness of our statistical approaches. Conclusions A significant increase in non-CAF antibiotic sales, and particularly azithromycin, occurred during the peak phase of the first COVID-19 epidemic wave in India, indicating the need for urgent antibiotic stewardship measures.


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