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1.
J Health Care Poor Underserved ; 32(3): 1320-1338, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34421034

RESUMO

To describe the dynamics and forecast the main parameters of the COVID-19 pandemic, the time series of daily cases in the World Health Organization African Region (WHOAR) from February 26th to December 29th, 2020 was analyzed. Estimates for expected values of parameters characterizing an epidemic (size of the epidemic, turning point, maximum value of daily cases, and basic reproductive number) were provided for both the first and the second wave, and for the entire ongoing pandemic in WHOAR. To this aim, the classical SIR (Susceptible-Infected-Removed) model and its approximations were applied to each identified wave. Our results suggest that the turning point of the COVID-19 first wave took place around July 20th, 2020. The first wave was expected to disappear by mid-December 2020, with a total of 1,200,000 expected cases. The second wave apparently started around August 19th, with an expected turning point by January 12th, 2021. The second wave is expected to end by August 9th, 2021, with 1,800,000 cumulative cases, and mounting up to 3,000,000 total cases between February 2020 and August 2021. Estimated basic reproduction numbers (R0) were 1.27 (first wave) and 1.15 (second wave); the expected total number of deaths is around 66,000 victims.


Assuntos
COVID-19/epidemiologia , África ao Sul do Saara/epidemiologia , Número Básico de Reprodução , Humanos , Modelos Biológicos , Pandemias , SARS-CoV-2 , Organização Mundial da Saúde
2.
Stud Health Technol Inform ; 264: 969-973, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438068

RESUMO

Since the eighties, case mix evaluation methods based on diagnosis-related groups (DRG) were gradually introduced in developed countries. These methods of assessing the costs of diseases to measure the productivity of the hospital have been introduced in management softwares that are not accessible to low-income countries. In this study, the authors applied these methods to an open source hospital management information system (HMIS) implemented in three university hospitals in Great Lakes Africa. A comparative study of the financial burden of five major diseases, monitored as part of a universal health coverage (UHC) analysis, was carried out. The level of coverage of patients in the hospitals was evaluated and the impact of UHC policies demonstrated. Although the financial protection of patients treated in the three hospitals had improved, HIV and tuberculosis treatments that ought to be free, remained a considerable financial burden for the patient.


Assuntos
Sistemas de Informação Hospitalar , África , Efeitos Psicossociais da Doença , Hospitais Universitários , Humanos , Cobertura Universal do Seguro de Saúde
3.
Stud Health Technol Inform ; 245: 738-742, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29295196

RESUMO

The Universal Health Coverage (UHC) is at the center of the 2030 Sustainable Development Goals agenda. In this study, the authors made an evaluation of the patient health coverage indicators in eight Burundian hospitals from 2011 to 2016. The relevant UHC indicators were calculated on the basis of patient administrative and health insurance data, collected via OpenClinic GA, an information and communication technology (ICT) supported health management information system (HMIS). The results show that the patient health services coverage rate was 70.8% for inpatients and 46.0% for outpatients. The patient health services payment rate as the proportion of total health service costs was above the 25% threshold recommended by WHO for inpatients (30.2%) and for outpatients (43.1%). The patient out-of-pocket payment was below the threshold of 180USD per patient per year for public hospitals. This study demonstrated the possibility to assess the degree of UHC in developing countries, by using routine data extracted automatically from the electronic HMIS.


Assuntos
Gastos em Saúde , Sistemas de Informação Hospitalar , Cobertura Universal do Seguro de Saúde , Serviços de Saúde , Humanos , Seguro Saúde
4.
Stud Health Technol Inform ; 245: 965-967, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29295243

RESUMO

Clinical coding is a requirement to provide valuable data for billing, epidemiology and health care resource allocation. In sub-Saharan Africa, we observe a growing awareness of the need for coding of clinical data, not only in health insurances, but also in governments and the hospitals. Presently, coding systems in sub-Saharan Africa are often used for billing purposes. In this paper we consider the use of a nomenclature to also have a clinical impact. Often coding systems are assumed to be complex and too extensive to be used in daily practice. Here, we present a method for constructing a new nomenclature based on existing coding systems by considering a minimal subset in the sub-Saharan region. Evaluation of completeness will be done nationally using the requirements of national registries. The nomenclature requires an extension character for dealing with codes that have to be used for multiple registries. Hospitals will benefit most by using this extension character.


Assuntos
Codificação Clínica , Atenção à Saúde , África ao Sul do Saara , Humanos , Vocabulário Controlado
5.
Stud Health Technol Inform ; 216: 193-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26262037

RESUMO

In this retrospective study, the authors monitored the patient health coverage in 6 Rwandan hospitals in the period between 2011 and 2014. Among the 6 hospitals, 2 are third level hospitals, 2 district hospitals and 2 private hospitals. Patient insurance and financial data were extracted and analyzed from OpenClinic GA, an open source hospital information system (HIS) used in those 6 hospitals. The percentage of patients who had no health insurer globally decreased from 35% in 2011 to 15% in 2014. The rate of health insurance coverage in hospitals varied between 75% in private hospitals and 84% in public hospitals. The amounts paid by the patients for health services decreased in private hospitals to 25% of the total costs in 2014 (-7.4%) and vary between 14% and 19% in public hospitals. Although the number of insured patients has increased and the patient share decreased over the four years of study, the patients' out-of-pocket payments increased especially for in-patients. This study emphasizes the value of integrated hospital information systems for this kind of health economics research in developing countries.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/economia , Sistemas de Informação Hospitalar/economia , Cobertura Universal do Seguro de Saúde/economia , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos , Análise Custo-Benefício/economia , Custos de Cuidados de Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Sistemas de Informação Hospitalar/estatística & dados numéricos , Ruanda
6.
Stud Health Technol Inform ; 216: 482-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26262097

RESUMO

From 2007 through 2014, the authors participated in the implementation of open source hospital information systems (HIS) in 19 hospitals in Rwanda, Burundi, DR Congo, Congo-Brazzaville, Gabon, and Mali. Most of these implementations were successful, but some failed. At the end of a seven-year implementation effort, a number of risk factors, facilitators, and pragmatic approaches related to the deployment of HIS in Sub-Saharan health facilities have been identified. Many of the problems encountered during the HIS implementation process were not related to technical issues but human, cultural, and environmental factors. This study retrospectively evaluates the predictive value of 14 project failure factors and 15 success factors in HIS implementation in the Sub-Saharan region. Nine of the failure factors were strongly correlated with project failure, three were moderately correlated, and one weakly correlated. Regression analysis also confirms that eight factors were strongly correlated with project success, four moderately correlated, and two weakly correlated. The study results may help estimate the expedience of future HIS projects.


Assuntos
Atitude do Pessoal de Saúde , Alfabetização Digital/estatística & dados numéricos , Comportamento do Consumidor/estatística & dados numéricos , Sistemas de Informação Hospitalar/estatística & dados numéricos , Cultura Organizacional , Revisão da Utilização de Recursos de Saúde , África ao Sul do Saara , Atitude Frente aos Computadores
7.
Stud Health Technol Inform ; 216: 525-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26262106

RESUMO

Since 2011, the Regional e-Health Center of Excellence in Rwanda (REHCE) has run an MSc in Health Informatics programme (MSc HI). A programme review was commissioned in February 2014 after 2 cohorts of students completed the post-graduate certificate and diploma courses and most students had started preparatory activity for their master dissertation. The review developed a method for mapping course content on health informatics competences and knowledge units. Also the review identified and measured knowledge gaps and content redundancy. Using this method, we analyzed regulatory and programme documents combined with stakeholder interviews, and demonstrated that the existing MSc HI curriculum did not completely address the needs of the Rwandan health sector. Teaching strategies did not always match students' expectations. Based on a detailed Rwandan health informatics needs assessment, International Medical Informatics Association (IMIA)'s Recommendations on Education in Biomedical and Health Informatics and the IMIA Health Informatics Knowledge Base, a new curriculum was developed and provided a better competences match for the specifics of healthcare in the Central African region. The new approved curriculum will be implemented in the 2014/2015 academic year and options for regional extension of the programme to Eastern DRC (Bukavu) and Burundi (Bujumbura) are being investigated.


Assuntos
Currículo/normas , Educação de Pós-Graduação/normas , Avaliação Educacional/normas , Bases de Conhecimento , Informática Médica/educação , Internacionalidade , Ruanda
8.
Stud Health Technol Inform ; 192: 520-3, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23920609

RESUMO

This research explores to what extent Information and Communication Technology (ICT)-based information management methods can help to improve efficiency and effectiveness of health services in sub-Saharan hospitals and how clinical information can be made available for secondary use enabling non-redundant reporting of health- and care performance indicators. In the course of a 6 years research effort between 2006 and 2012, it was demonstrated that patient identification, financial management and structured reporting improved dramatically after implementation of well adapted ICT-tools in a set of 19 African health facilities. Real-time financial management metrics helped hospitals to quickly identify fraudulent practices and defective invoicing procedures. Out-patient case load significantly increased compared to the national average, average length of stay has been shortened in 15 of 19 health facilities and global hospital mortality decreased. Hospital workforce-evaluated impact of hospital information system implementation on local working conditions and quality of care was very positive. It was demonstrated that local sub-Saharan health professionals strongly believe in the importance of health information systems.


Assuntos
Atitude do Pessoal de Saúde , Atenção à Saúde/estatística & dados numéricos , Eficiência Organizacional/estatística & dados numéricos , Sistemas de Comunicação no Hospital/estatística & dados numéricos , Informática Médica/estatística & dados numéricos , Sistemas Computadorizados de Registros Médicos/estatística & dados numéricos , Software , Burundi , Ruanda , Validação de Programas de Computador , Avaliação da Tecnologia Biomédica , Carga de Trabalho/estatística & dados numéricos
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