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1.
Clin Obstet Gynecol ; 64(2): 392-397, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-33904844

RESUMEN

While telemedicine had been utilized in varying ways over the last several years, it has dramatically accelerated in the era of the COVID-19 pandemic. In this article we describe the privacy issues, in relation to the barriers to care for health care providers and barriers to the obstetric patient, licensing and payments for telehealth services, technological issues and language barriers. While there may be barriers to the use of telehealth services this type of care is feasible and the barriers are surmountable.


Asunto(s)
Barreras de Comunicación , Accesibilidad a los Servicios de Salud , Obstetricia , Privacidad , Telemedicina , Femenino , Health Insurance Portability and Accountability Act , Accesibilidad a los Servicios de Salud/ética , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Internet , Concesión de Licencias , Obstetricia/ética , Obstetricia/legislación & jurisprudencia , Obstetricia/métodos , Obstetricia/organización & administración , Embarazo , Privacidad/legislación & jurisprudencia , Tecnología , Telemedicina/ética , Telemedicina/legislación & jurisprudencia , Telemedicina/métodos , Telemedicina/organización & administración , Estados Unidos
2.
BMC Fam Pract ; 22(1): 69, 2021 04 08.
Artículo en Inglés | MEDLINE | ID: mdl-33832422

RESUMEN

BACKGROUND: The emergence of the COVID-19 pandemic has raised concerns about the potential decrease in access and utilisation of general practice services and its impact on patient care. In March 2020, the Australian Government introduced telehealth services to ensure that people more vulnerable to COVID-19 do not delay routine care from their general practitioners. Evidence about patients' experience of telehealth and its impact on patient care is scarce. This study aimed to investigate the experience with telehealth by Australian general practice patients at high risk of poor health outcomes during the COVID-19 pandemic. METHODS: Semi-structured telephone interviews were conducted with 30 patients from nine general practices in metropolitan Adelaide (May-June 2020). Participants were identified by their regular doctor as being at high risk of poor health outcomes. Interviews sought participants' perspectives and experiences about telehealth services in the general practice setting during COVID-19, and the value of offering continued telehealth services post pandemic. Interviews were recorded and transcribed verbatim. Data were analysed using a coding structure developed based on deductive codes derived from the research questions and any additional concepts that emerged inductively from interviews. RESULTS: Participants expressed satisfaction with telehealth including convenient and timely access to general practice services. Yet, participants identified challenges including difficulties in expressing themselves and accessing physical exams. Prescription renewal, discussing test results and simple follow-ups were the most common reasons that telehealth was used. Telehealth was mainly via phone that better suited those with low digital literacy. Participants indicated that an existing doctor-patient relationship was important for telehealth services to be effective. Subjects believed that telehealth services should be continued but needed to be combined with opportunities for face-to-face consultations after the COVID-19 pandemic was over. CONCLUSIONS: The expansion of telehealth supported access to general practice including chronic disease management during the COVID-19 pandemic. In the future, telehealth in Australia is likely to have a stronger place in primary healthcare policy and practice and an increased acceptance amongst patients.


Asunto(s)
Enfermedad Crónica , Medicina General , Relaciones Médico-Paciente , Medición de Riesgo/métodos , Telemedicina , Australia/epidemiología , /prevención & control , Enfermedad Crónica/epidemiología , Enfermedad Crónica/terapia , Control de Enfermedades Transmisibles/métodos , Femenino , Medicina General/métodos , Medicina General/tendencias , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Investigación Cualitativa , Telemedicina/métodos , Telemedicina/organización & administración
3.
Addict Sci Clin Pract ; 16(1): 24, 2021 04 20.
Artículo en Inglés | MEDLINE | ID: mdl-33879260

RESUMEN

Telemedicine (TM) enabled by digital health technologies to provide medical services has been considered a key solution to increasing health care access in rural communities. With the immediate need for remote care due to the COVID-19 pandemic, many health care systems have rapidly incorporated digital technologies to support the delivery of remote care options, including medication treatment for individuals with opioid use disorder (OUD). In responding to the opioid crisis and the COVID-19 pandemic, public health officials and scientific communities strongly support and advocate for greater use of TM-based medication treatment for opioid use disorder (MOUD) to improve access to care and have suggested that broad use of TM during the pandemic should be sustained. Nevertheless, research on the implementation and effectiveness of TM-based MOUD has been limited. To address this knowledge gap, the National Drug Abuse Treatment Clinical Trials Network (CTN) funded (via the NIH HEAL Initiative) a study on Rural Expansion of Medication Treatment for Opioid Use Disorder (Rural MOUD; CTN-0102) to investigate the implementation and effectiveness of adding TM-based MOUD to rural primary care for expanding access to MOUD. In preparation for this large-scale, randomized controlled trial incorporating TM in rural primary care, a feasibility study is being conducted to develop and pilot test implementation procedures. In this commentary, we share some of our experiences, which include several challenges, during the initial two-month period of the feasibility study phase. While these challenges could be due, at least in part, to adjusting to the COVID-19 pandemic and new workflows to accommodate the study, they are notable and could have a substantial impact on the larger, planned pragmatic trial and on TM-based MOUD more broadly. Challenges include low rates of identification of risk for OUD from screening, low rates of referral to TM, digital device and internet access issues, workflow and capacity barriers, and insurance coverage. These challenges also highlight the lack of empirical guidance for best TM practice and quality remote care models. With TM expanding rapidly, understanding implementation and demonstrating what TM approaches are effective are critical for ensuring the best care for persons with OUD.


Asunto(s)
/epidemiología , Accesibilidad a los Servicios de Salud/organización & administración , Tratamiento de Sustitución de Opiáceos/estadística & datos numéricos , Trastornos Relacionados con Opioides/terapia , Población Rural/estadística & datos numéricos , Telemedicina/organización & administración , Estudios de Factibilidad , Humanos
4.
G Ital Nefrol ; 38(2)2021 Apr 14.
Artículo en Italiano | MEDLINE | ID: mdl-33852221

RESUMEN

The public emergency caused by Covid-19 has forced health services to reorganize in order to separate positive patients from negative ones. In nephrology, this reorganization involves several levels of assistance concerning hospitalizations, ambulatory care and haemodialysis. Within the Complex Unit of Nephrology in Ragusa, the distribution of nephro-dialytic resources has involved four different hospitals, hence ensuring haemodialysis services for asymptomatic and pauci-symptomatic Covid-19 patients as well as for patients in Covid-Unit, Sub-Intensive Therapy and Intensive Care Unit. In this complex context, we had to create a common protocol involving all the professionals who provide assistance in our Unit, across the different structures. We also report some encouraging data that seem to indicate the effectiveness of the protocols put in place.


Asunto(s)
/epidemiología , Nefrología/organización & administración , Pandemias , Asignación de Recursos/organización & administración , Atención Ambulatoria/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Control de Infecciones/métodos , Unidades de Cuidados Intensivos/organización & administración , Italia/epidemiología , Diálisis Renal
5.
Prev Chronic Dis ; 18: E30, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33793392

RESUMEN

Cultural mistrust of government with regard to health issues has pressed the need to engage trusted community leaders with influence and reach in disproportionately affected communities to ensure that essential public health activities related to COVID-19 occur among populations experiencing disproportionate impact from the pandemic. In April of 2020, a Georgia-based integrated academic health care system created a Community Outreach and Health Disparities Collaborative to unite trusted community leaders from faith-based, civic, and health-sector organizations to work with the health system and Emory University to develop tailored approaches and mobilize support within the context of the communities' cultural and individual needs to reduce the burden of COVID-19. We describe the framework used to join health care and academic collaborators with community partners to mobilize efforts to address the disproportionate impact of COVID-19 on racial, ethnic, and socioeconomic minority groups. The framework outlines a series of steps taken that led to a community-driven collaboration designed to engage local influential community leaders as partners in improving access to care for disproportionately affected communities, collaborations that could be replicated by other large health care systems. This framework can also be applied to other chronic diseases or future public health emergencies to improve communication, education, and health care access for communities experiencing disproportionate impact.


Asunto(s)
/prevención & control , Servicios de Salud Comunitaria/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Administración en Salud Pública , Disparidades en el Estado de Salud , Disparidades en Atención de Salud , Humanos
7.
Clin Obstet Gynecol ; 64(2): 333-344, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-33882522

RESUMEN

Telehealth has expanded its reach significantly since its inception due to the advances in technology over the last few decades. Social determinants of health (SDOH) negatively impact the health of pregnant and postpartum women and need to be considered when deploying telehealth strategies. In this article, we describe telehealth modalities and their application to improve the SDOH that impact pregnancy and postpartum outcomes. Physicians and patients alike report satisfaction with telehealth as it improves access to education, disease monitoring, specialty care, prenatal and postpartum care. Ten years ago, we developed a program, Moms2B, to eliminate disparities in pregnancy outcomes for underserved women. Using a case study, we describe how Moms2B, devoted to improve the SDOH for pregnant women, transitioned from an in-person to a virtual format. Telehealth benefited women before the recent coronavirus disease 2019 pandemic and increasingly after emergency authorizations has allowed telehealth to flourish.


Asunto(s)
Accesibilidad a los Servicios de Salud/organización & administración , Disparidades en el Estado de Salud , Disparidades en Atención de Salud , Atención Perinatal/métodos , Atención Prenatal/métodos , Determinantes Sociales de la Salud , Telemedicina/métodos , Femenino , Humanos , Aplicaciones Móviles , Ohio , Evaluación de Resultado en la Atención de Salud , Atención Perinatal/organización & administración , Pobreza , Embarazo , Resultado del Embarazo , Atención Prenatal/organización & administración , Telemedicina/organización & administración
10.
Ann Transplant ; 26: e929946, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33888674

RESUMEN

BACKGROUND This single-center study analyzed distinctions between lung transplants performed in the Department of Cardiac and Vascular surgery of the University Clinical Center in Gdansk, Poland before and during the COVID-19 pandemic. MATERIAL AND METHODS There were 189 patients who underwent the qualification procedure to lung transplantation in the Department of Cardiac and Vascular Surgery of the University Clinical Center in Gdansk, Poland in the years 2019 and 2020. The control group consisted of 12 patients transplanted in 2019, and the study group consisted of 16 patients transplanted in 2020. RESULTS During 2019, the qualification process was performed in 102 patients with pulmonary end-stage diseases. In 2020, despite the 3-month lockdown related to organizational changes in the hospital, 87 qualification processes were performed. The mortality rate of patients on the waiting list in 2020 was 14.3% (6 patients died), and during 2019 the rate was also 14.3% (4 patients died). Donor qualifications were according to ISHLT criteria. The distribution of donors in both years was similar. There was no relationship between the geographic area of residence and source of donors. In 2019, all 12 patients had double-lung transplant. In 2020, 11 patients had double-lung transplant and 5 patients had single-lung transplant. There was no difference in ventilation time and PGD aside from a shorter ICU stay in 2020. CONCLUSIONS Lung transplants were relatively well-conducted despite the continued obstacles of the COVID-19 pandemic.


Asunto(s)
Accesibilidad a los Servicios de Salud/tendencias , Trasplante de Pulmón/tendencias , Obtención de Tejidos y Órganos/tendencias , Listas de Espera/mortalidad , Adulto , Anciano , /prevención & control , Femenino , Estudios de Seguimiento , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Trasplante de Pulmón/mortalidad , Masculino , Persona de Mediana Edad , Evaluación de Procesos y Resultados en Atención de Salud , Pandemias , Polonia/epidemiología , Obtención de Tejidos y Órganos/organización & administración
11.
Rheumatol Int ; 41(5): 843-850, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33710419

RESUMEN

Depression is a common co-morbidity among rheumatoid arthritis (RA) patients, which may translate into difficulty performing activities of daily living. COVID-19 is an unprecedented disaster that has disrupted lives worldwide and led to a rise in the incidence of mental health disorders. Given the widespread economic devastation due to COVID-19, many RA patients, already susceptible to mental illness, maybe at an increased risk of inaccessibility to medical care, accentuated stress, and consequent worsening of existent mental health disorders, or the onset of new mental health disorders such as anxiety, post-traumatic stress disorder, or depression. The objective of this review is to assess if there is an increased risk of mental health disorders in patients with RA during the COVID-19 pandemic. Telemedicine has bridged the transition to remote chronic care in the pandemic period, though certain accessibility and technological challenges are to be addressed. Decreased access to care amid lockdowns and a proposed triggering of disease activity in patients with autoimmune disorders may potentially herald a massive spike in incidence or flares of patients diagnosed with RA in the coming months. Such a deluge of cases may be potentially devastating to an overburdened healthcare system. Rheumatologists may need to prepare for this eventuality and explore techniques to provide adequate care during these challenging times. The authors found that there is a significant association between the adverse impact on the mental health of RA patients and the COVID-19 pandemic. However, more research is needed to highlight individual risk factors.


Asunto(s)
Artritis Reumatoide/psicología , Depresión/epidemiología , Accesibilidad a los Servicios de Salud/organización & administración , Artritis Reumatoide/complicaciones , Artritis Reumatoide/terapia , Depresión/etiología , Depresión/psicología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Pandemias , Calidad de Vida , Medición de Riesgo
13.
Lancet Gastroenterol Hepatol ; 6(5): 371-380, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33743883

RESUMEN

BACKGROUND: Direct-acting antiviral treatment for hepatitis C virus (HCV) has provided the opportunity for simplified models of care delivered in decentralised settings by non-specialist clinical personnel. However, in low-income and middle-income countries, increasing overall access to HCV care remains an ongoing issue, particularly for populations outside of urban centres. We therefore aimed to implement a simplified model of HCV care via decentralised health services within a rural health operational district in Battambang province, Cambodia. METHODS: The study cohort included adult residents (≥18 years) of the health operational district of Moung Russei who were voluntarily screened at 13 local health centres. Serology testing was done by a rapid diagnostic test using SD Bioline HCV (SD Bioline HCV, Standard Diagnostics, South Korea) with capillary blood. HCV viral load testing was done by GeneXpert (Cepheid, Sunnyvale, CA, USA). Viraemic patients (HCV viral load ≥10 IU/mL) received pretreatment assessment by a general physician and minimal treatment evaluation tests at the health operational district referral hospital. Viraemic patients who did not have additional complications received all HCV care follow-up at the local health centres, provided by nursing staff, and patients who had decompensated cirrhosis, previously treated with a direct-acting antiviral, HBV co-infection, or other comorbidities requiring observation continued receiving care at the referral hospital with a general physician. Patients deemed eligible for treatment were prescribed oral sofosbuvir (400 mg) and daclatasvir (60 mg) once a day for 12 weeks, or 24 weeks for patients with decompensated cirrhosis or those previously treated with a direct-acting antiviral. HCV cure was defined as sustained virological response at 12 weeks after treatment (HCV viral load <10 IU/mL). Patients were assessed for serious and non-serious adverse events at any time between treatment initiation and 12 weeks post-treatment testing. FINDINGS: Between March 12, 2018, and Jan 18, 2019, 10 425 residents (ie, 7·6% of the estimated 136 571 adults in the health operational district of Moung Russei) were screened. Of those patients screened, the median age was 44 years (IQR 31-55) and 778 (7·5%) were HCV-antibody positive. 761 (97·8%) of 778 antibody-positive patients received HCV viral load testing, and 540 (71·0%) of those tested were HCV viraemic. Among these 540 patients, linkage to treatment and follow-up care was high, with 533 (98·7%) attending a baseline consultation at the HCV clinic, of whom 530 (99·4%) initiated treatment. 485 (91·5%) of 530 patients who initiated treatment received follow-up at a health centre and 45 (8·5%) were followed up at the referral hospital. Of the 530 patients who initiated direct-acting antiviral therapy, 515 (97·2%) completed treatment. Subsequently, 466 (90·5%) of 515 patients completed follow-up, and 459 (98·5%) of 466 achieved a sustained virological response at 12 weeks after treatment. Two (0·4%) adverse events (fatigue [n=1] and stomach upset [n=1]) and five (0·9%) serious adverse events (infection [n=2], cardiovascular disease [n=1], and panic attack [n=1], with data missing for one of the causes of serious adverse events) were reported among patients who initiated treatment. All serious adverse events were deemed to be unrelated to therapy. INTERPRETATION: This pilot project showed that a highly simplified, decentralised model of HCV care can be integrated within a rural public health system in a low-income or middle-income country, while maintaining high patient retention, treatment efficacy, and safety. The project delivered care via accessible, decentralised primary health centres, using non-specialist clinical staff, thereby enhancing the efficient use of limited resources and maximising the potential to test and treat individuals living with HCV infection. FUNDING: Médecins Sans Frontières.


Asunto(s)
Antivirales/uso terapéutico , Carbamatos/uso terapéutico , Accesibilidad a los Servicios de Salud/organización & administración , Hepatitis C/diagnóstico , Hepatitis C/tratamiento farmacológico , Imidazoles/uso terapéutico , Pirrolidinas/uso terapéutico , Servicios de Salud Rural/organización & administración , Sofosbuvir/uso terapéutico , Valina/análogos & derivados , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cambodia , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Masculino , Tamizaje Masivo/organización & administración , Persona de Mediana Edad , Proyectos Piloto , Evaluación de Programas y Proyectos de Salud , Salud Pública , Respuesta Virológica Sostenida , Resultado del Tratamiento , Valina/uso terapéutico , Adulto Joven
14.
Inquiry ; 58: 46958021997337, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33682514

RESUMEN

The coronavirus disease pandemic has created a crisis for patients with chronic kidney disease, as far as getting treatment facilities are concerned. The crisis is more intense in developing countries where the health system is more vulnerable due to poor infrastructures and insufficient health professionals. Bangladesh, being a developing nation, is also facing similar challenges to provide sufficient services to patients with chronic kidney disease. In this short report, we have discussed the challenges and barriers non-COVID chronic kidney disease patients are facing in terms of healthcare access along with getting proper medical interventions and suggested probable strategies to minimize the suffering.


Asunto(s)
/epidemiología , Accesibilidad a los Servicios de Salud/organización & administración , Necesidades y Demandas de Servicios de Salud/organización & administración , Insuficiencia Renal Crónica/terapia , Telemedicina/organización & administración , Bangladesh , Países en Desarrollo , Humanos , Servicios Preventivos de Salud/organización & administración , Índice de Severidad de la Enfermedad
15.
Med J (Ft Sam Houst Tex) ; (PB 8-21-01/02/03): 122-127, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33666924

RESUMEN

The United States declared a national emergency on March 13, 2020, in response to the rapidly spreading COVID-19 pandemic after all 50 states reported laboratory-confirmed cases.1 The demand for ambulatory medical care in the US fell by almost 60% and immunization encounters at Walter Reed National Military Medical Center decreased by 76% as patients became concerned about the risk of coronavirus exposure within a clinic or hospital setting.2 Our vaccination initiatives aimed to increase our pediatric and adult immunization rates through offering two alternative immunization platforms aimed to reduce patient concerns about COVID exposure.


Asunto(s)
Instituciones de Atención Ambulatoria , Accesibilidad a los Servicios de Salud/organización & administración , Vacunación Masiva/organización & administración , /epidemiología , Humanos , Aceptación de la Atención de Salud , Estados Unidos
16.
Pediatr Transplant ; 25(3): e13991, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33704869

RESUMEN

Coronavirus disease 2019 is a global pandemic, and to deal with the unexpected, enormous burden on healthcare system, liver transplantation (LT) services have been suspended in many centers. Development of robust and successful protocols in preventing the disease among the recipients, donors and healthcare workers would help in re-starting the LT programs. We adapted a protocol at our center, which is predominantly a living donor liver transplant center based in north India, and continued the service as the pandemic unfolded and peaked in India with good results and shared the experience of the same. Between March 24 and June 7, 2020, during the government-enforced public curfew-"lockdown"-7 children received LT. The protocols of infection control were drafted in our team by local customization of published guidelines. The number of pediatric LT done during the lockdown period in 2020 was similar to that done in corresponding pre-COVID period in 2019. The outcomes were of 100% survival, and none of recipients developed COVID. One potential donor was asymptomatic positive for COVID, responded well to conservative treatment, and was later accepted as a donor. LT program during the COVID pandemic can successfully function after putting in place standard protocols for infection control. These can be implemented with minimal extra involvement of healthcare infrastructure, hence without diversion of resources from COVID management. In conclusion, pediatric liver transplantation services can be continued amid COVID-19 pandemic after establishing a properly observed protocol with minimum additional resources.


Asunto(s)
/prevención & control , Accesibilidad a los Servicios de Salud/organización & administración , Control de Infecciones/normas , Trasplante de Hígado/normas , Adolescente , Niño , Preescolar , Protocolos Clínicos , Femenino , Política de Salud , Humanos , India/epidemiología , Lactante , Control de Infecciones/métodos , Trasplante de Hígado/métodos , Masculino , Evaluación de Resultado en la Atención de Salud , Pandemias , Estudios Retrospectivos
17.
BMC Cancer ; 21(1): 307, 2021 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-33761907

RESUMEN

BACKGROUND: Hepatocellular carcinoma (HCC) is the most frequent primary invasive cancer of the liver. During the last decade, the epidemiology of HCC has been continuously changing in developed countries, due to more effective primary prevention and to successful treatment of virus-related liver diseases. The study aims to examine survival by level of access to care in patients with HCC, for all patients combined and by age. METHODS: We included 2018 adult patients (15-99 years) diagnosed with a primary liver tumour, registered in the Palermo Province Cancer Registry during 2006-2015, and followed-up to 30 October 2019. We obtained a proxy measure of access to care by linking each record to the Hospital Discharge Records and the Ambulatory Discharge Records. We estimated net survival up to 5 years after diagnosis by access to care ("easy access to care" versus "poor access to care"), using the Pohar-Perme estimator. Estimates were age-standardised using International Cancer Survival Standard (ICSS) weights. We also examined survival by access to care and age (15-64, 65-74 and ≥ 75 years). RESULTS: Among the 2018 patients, 62.4% were morphologically verified and 37.6% clinically diagnosed. Morphologically verified tumours were more frequent in patients aged 65-74 years (41.6%), while tumours diagnosed clinically were more frequent in patients aged 75 years or over (50.2%). During 2006-2015, age-standardised net survival was higher among HCC patients with "easy access to care" than in those with "poor access to care" (68% vs. 48% at 1 year, 29% vs. 11% at 5 years; p < 0.0001). Net survival up to 5 years was higher for patients with "easy access to care" in each age group (p < 0.0001). Moreover, survival increased slightly for patients with easier access to care, while it remained relatively stable for patients with poor access to care. CONCLUSIONS: During 2006-2015, 5-year survival was higher for HCC patients with easier access to care, probably reflecting progressive improvement in the effectiveness of health care services offered to these patients. Our linkage algorithm could provide valuable evidence to support healthcare decision-making in the context of the evolving epidemiology of hepatocellular carcinoma.


Asunto(s)
Carcinoma Hepatocelular/mortalidad , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Neoplasias Hepáticas/mortalidad , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/terapia , Toma de Decisiones en la Organización , Técnicas de Apoyo para la Decisión , Femenino , Estudios de Seguimiento , Accesibilidad a los Servicios de Salud/organización & administración , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Humanos , Italia/epidemiología , Neoplasias Hepáticas/terapia , Masculino , Persona de Mediana Edad , Sistema de Registros/estadística & datos numéricos , Análisis de Supervivencia , Adulto Joven
19.
Indian J Public Health ; 65(1): 82-84, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33753697

RESUMEN

Addressing oxygen requirements of rural India should aim at using a safe, low-cost, easily available, and replenishable source of oxygen of moderate purity. This may be possible with the provision of a self-sustaining oxygen concentrator (pressure swing adsorption with multiple molecular sieve technology) capable of delivering oxygen at high-flow rates, through a centralized distribution system to 100 or more bedded rural hospitals, with back up from an oxygen bank of 10 × 10 cylinders. This will provide a 24 × 7 supply of oxygen of acceptable purity (~93%) for the treatment of hypoxemic conditions and will enable hospitals to specifically provide for high-flow oxygen in at least 15% of the beds. It may also serve as a facility for a local refill of oxygen cylinders for emergency use within the hospital as well as to subsidiary primary health centers, subcenters, and ambulances, thereby nudging our health-care system toward self-sufficiency in oxygen generation and utilization.


Asunto(s)
Accesibilidad a los Servicios de Salud/organización & administración , Hospitales Rurales/organización & administración , Oxígeno/provisión & distribución , Servicios de Salud Rural/organización & administración , Necesidades y Demandas de Servicios de Salud/organización & administración , Capacidad de Camas en Hospitales , Humanos , India , Unidades de Cuidados Intensivos/organización & administración
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