Do COVID-19 patients needing extended care in an intensive care unit fall under the 'emergency medical treatment' provisions of the South African Constitution?

Whether COVID-19 patients in need of extended care in an intensive care unit qualify for 'emergency medical treatment' is answered by considering the Constitution, the meaning of emergency medical treatment, and whether such patients are in an incurable chronic condition. Considering ethical guidelines for the withholding and withdrawal of treatment may assist a court in determining whether a healthcare practitioner has acted with the degree of skill and care required of a reasonably competent practitioner in his or her branch of the profession.

Doença Crônica Brasil: aplicativo para os direitos aos portadores de agravos crônicos à saúde / Chronic Disease Brazil: application for the rights of patients with chronic health problems

Introdução: A sociedade brasileira vive um período no qual as facilidades e avanços tecnológicos, que surgiram com o advento do computador são irreversíveis. Atualmente esses avanços se transportaram para as mãos dos cidadãos através dos smartphones. Sabemos que a utilização de ferramentas computacionais na área da saúde está em crescente expansão, pois esse tipo de suporte tecnológico pode proporcionar aos seus usuários alcançar com mais precisão e agilidade as informações desejadas. Objetivos: O presente estudo tem por objetivo criar um aplicativo para aparelhos celulares do sistema operacional Android® para pacientes e profissionais de saúde sintetizando as legislações, os direitos para pessoas acometidas por doenças crônicas e as formas de obtenção desses direitos de entes públicos e privados. Método: O método utilizado contou com a operacionalização do estudo para o cumprimento do objetivo através de 3 etapas, a saber: 1) revisão de literatura; 2) apresentação técnica do aplicativo e; 3) funcionamento do aplicativo para uso dos interessados. Resultados: Como resultados esperados houve a produção do aplicativo e a verificação/validação de sua operabilidade, bem como se dará visibilidade a este nas redes sociais, apresentações em eventos científicos e acompanhar a utilidade do aplicativo. Este último não irá fazer parte da investigação, mas sim como desdobramento do cumprimento do objetivo apresentado. Conclusão: A conclusão final é a de que o aplicativo disponibilizado, após obter classificação de "Usabilidade muito alta" conforme teste MATCH® do GQS/UFSC (Grupo de Qualidade em Software da Universidade Federal de Santa Catarina) revelouse pertinente e atualizado ao cenário pandêmico e pós pandêmico, contribuindo de forma eficiente aos seus usuários no sentido de terem garantidos seus direitos de forma célere. As 2 (duas) marcas (subprodutos) que acompanham o produto são consideradas como ativos de propriedade intelectual e possuem avaliação T1 conforme classificação CAPES e o comercial/propaganda para divulgação do produto em redes sociais também possui avaliação T1 por ser considerado um material didático/instrucional

Introduction: Brazilian society is going through a period in which the technological facilities and advances that emerged with the advent of the computer are irreversible. Currently these advances have been carried into the hands of citizens through smartphones. We know that the use of computational tools in the health area is growing, as this type of technological support can provide its users with more accurate and agile access to the desired information. Objective: The present study aims to create an application for mobile devices of the Android® operating system for patients and health professionals summarizing the legislation, the rights for people affected by chronic diseases and the ways of obtaining these rights from public and private entities. Methods: The method used relied on the operationalization of the study to fulfill the objective through 3 stages, namely: 1) literature review; 2) technical presentation of the application and; 3) operation of the application for use by interested parties. Results: As expected results there was the production of the application and the verification / validation of its operability, as well as visibility to it on social networks, presentations at scientific events and monitoring the utility of the application. The latter will not be part of the investigation, but as an outcome of the fulfillment of the objective presented. Conclusion: The final conclusion is that the application made available, after obtaining a "Very high usability" rating according to the MATCH® test of the GQS / UFSC (Software Quality Group at the Federal University of Santa Catarina) proved to be relevant and updated to the pandemic scenario and post pandemic, contributing efficiently to its users in order to have their rights guaranteed in a quick way. The 2 (two) brands (by-products) that accompany the product are considered as intellectual property assets and have a T1 rating according to CAPES classification and the commercial / advertisement for product promotion on social networks also has a T1 rating because it is considered didactic material / instructional

Perspectives on Opportunities and Challenges for Medicare Advantage Plans to Address Social Determinants of Health via the CHRONIC Care Act.

There is increasing recognition of the role of social determinants of health (SDOH) in the ability of Medicare Advantage (MA) enrollees to obtain needed care. The 2018 CHRONIC Care Act established Special Supplemental Benefits for the Chronically Ill (SSBCI), which for the first time gives MA plans the flexibility to provide supplemental benefits to enrollees to address SDOH. Given the role of SDOH in chronic disease, this represents an opportunity for MA plans to address underlying issues not strictly health care related with which MA enrollees struggle and that affect their overall health. MA plans have experimented with different approaches to address SDOH but have been limited by the lack of ability to offer services as part of covered benefits and reliance on partnerships, grants, and other funding sources to support the provision of these services. The effect of this policy and how it may evolve before implementation begins in 2020 remains uncertain as we wait to see how MA plans will interpret eligibility criteria and services offered without any additional allotted funding.

The Association between Socioeconomic Status, Smoking, and Chronic Disease in Inner Mongolia in Northern China.

The interactive associations of socioeconomic status (SES) and smoking with chronic disease were investigated with a view to expanding the evidence to inform tobacco policies and interventions in Northern China. The fifth NHSS (National Health Service Survey) 2013 in Inner Mongolia was a population-based survey of national residents, aged 15 years and older, in which multi-stage stratified cluster sampling methods were used to survey 13,554 residents. The SES was measured by scores derived from levels of education level and household annual income. Multivariate logistic regression models were performed to determine the association between SES, smoking, and chronic disease adjusted by confounders. Three thousand nine hundred and thirty-seven residents (32.29%) were identified as current smokers and 3520 residents (26.01%) had been diagnosed with chronic diseases. In the males, former smoking with low SES had the highest risk of one chronic disease, with an odds ratio (OR) of 2.505 (95% confidence interval [95% CI] (OR = 2.505, 95% CI: 1.635⁻3.837) or multiple chronic diseases (OR = 2.631, 95% CI: 1.321⁻5.243). In the females, current smoking with low SES had the highest risk of one chronic disease (OR = 3.044, 95% CI: 2.158⁻4.292). The conclusion of this study was that residents with combined ever-smoking and low SES deserved more attention in the prevention and control of chronic disease.

Protecting Rights of Children With Medical Complexity in an Era of Spending Reduction.

Children with medical complexity (CMC) often require multiple services across the continuum of care, such as therapies and home nursing. However, sufficient access to needed services is not assured and varies considerably by payer, many of whom who face pressures to control health spending. In this article, we review the rights of CMC in Medicaid, the Children's Health Insurance Program, and various forms of private health insurance to receive services that are necessary to promote optimal health, development, and family functioning. Controlling laws such as the Americans with Disabilities Act and the Early and Periodic Screening, Diagnostic, and Treatment provisions of the Medicaid Act are discussed, and precedential court decisions affecting CMC are reviewed. Implications for policy, advocacy, and payment model design are explored in the context of current emphasis on spending reduction.

A comparison of policies and guidelines related to multimorbidity in the UK, Australia and Sri Lanka

DISCUSSION: Increased rates of multimorbidity, evident in developed and developing countries, should be addressed by health policy. The aim of this study was to compare policies and guidelines related to multimorbidity in primary healthcare in countries with different health systems, to identify initiatives, gaps and opportunities for further improvement. We conducted a content analysis of UK, Australian and Sri Lankan policy documents and guidelines published between 2006 and 2017, in electronic databases, references and government repositories, tabulating data extracted for content, implementation plans, gaps and opportunities for development. Overall, 38 of the 56 identified documents explicitly or implicitly addressed multimorbidity or its prevention. The UK had four policy documents and guidelines specifically on multimorbidity. Australia and Sri Lanka lacked specific policies on multimorbidity, but policies did address chronic conditions and non-communicable diseases. Important differences exist in how national policies seek to address multimorbidity. Policy implementation, how this affects quality of care and outcomes, and the role of primary care should be examined.