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1.
Infectio ; 25(4): 212-240, oct.-dic. 2021. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1286716

RESUMO

Abstract Intra-abdominal infections are frequent at all levels of health care, therefore, it is necessary to maintain a high level of clinical suspicion, performing the fastest and most cost-effective measures to confirm the diagnosis and offer a precise and targeted multidisciplinary therapy, this being the only way to have an impact on the morbidity of this infection, reducing mortality and minimizing the complications and costs of health care. Intra-abdominal infections are linked to the appearance and selection of resistant mutants in both bacteria and fungi, becoming currently a major public health problem. Increasing bacterial resistance when associated with a greater possibility of difficulties in antimicrobial treatment increases mortality. This evidence-based consensus brings together the recommendations for the diagnosis and treatment of intra-abdominal infections in the pediatric and adult population. With strict monitoring of bacterial resistance and stimulating the control of the risk factors that have the greatest impact on the appearance of this phenomenon, this consensus is intended to be a practical guide that is easy to implement, and with periodic updates it will favor and facilitate multidisciplinary and the adequacy of the therapeutic management of intra-abdominal infections.


Resumen Las infecciones intrabdominales son frecuentes en todos los niveles de atención en salud, por ende, es necesario mantener un alto nivel de sospecha clínica, realizando las medidas más rápidas y costoefectivas para confirmar el diagnóstico y así ofrecer de una forma precisa y dirigida la terapéutica multidisciplinaria, siendo esta la única manera de tener impacto en la morbilidad de esta infección, disminuyendo la mortalidad y minimizando las complicaciones y los costos de la atención en salud. Las infecciones intrabdominales se encuentran ligadas a la aparición y selección de las mutantes resistentes tanto en las bacterias como en los hongos, convirtiéndose en la actualidad en una gran problemática en la salud pública. La creciente resistencia bacteriana al asociarse a mayor posibilidad de dificultades en el tratamiento antimicrobiano incrementa la mortalidad. Este consenso basado en la evidencia, reúne las recomendaciones en el diagnóstico y en el tratamiento de las infecciones intrabdominales en la población pediátrica y de adultos. Con un estricto seguimiento de la resistencia bacteriana y estimulando el control de los factores de riesgo que tienen mas impacto en la aparición de este fenómeno, este consenso pretende ser una practica guía de fácil implementación, y con periódicas actualizaciones favorecerá y facilitará el manejo multidisciplinario y la adecuación del manejo terapéutico de las infecciones intrabdominales.


Assuntos
Humanos , Criança , Adulto , Infecções Intra-Abdominais , Peritonite , Bactérias , Fatores de Risco , Mortalidade , Colômbia , Sepse , Atenção à Saúde , Infecções , Antibacterianos
2.
Estima (Online) ; 19(1): e0921, jan.-dez. 2021.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1280948

RESUMO

Objetivo:descrever o processo de implementação da Rede de Atenção à Saúde em Lesões Cutâneas no município de Divinópolis − MG. Método: trata-se de um relato de experiência sobre a implementação de uma Rede de Atenção à Saúde em Lesões Cutâneas a partir do Programa de Educação Pelo Trabalho para Saúde (PET-Saúde/GraduaSUS), no período de maio de 2016 a abril de 2018. Participaram das ações professores e alunos de uma universidade pública e profissionais enfermeiros vinculados à Secretaria Municipal de Saúde do município. Resultados: foi possível implementar a Rede de Atenção à Saúde para prevenção e tratamento de lesões cutâneas de maneira estruturada e sistematizada. Foi estabelecido um fluxo de atendimento, supervisão de casos e acompanhamento clínico por meio da construção de um protocolo assistencial. Conclusão: a habilidade prática e o conhecimento científico de alunos e profissionais de saúde para o tratamento e manejo de lesões cutâneas foram desenvolvidos fortalecendo, assim, a tríade ensino-serviço-comunidade.


Objective: describe the process of implementing the Rede de Atenção à Saúde em Lesões Cutâneas (Health Care Network for Skin Injuries) in the municipality of Divinópolis - MG. Method: it is an experience report on the implementation of a Health Care Network for Skin Injuries from the Programa de Educação Pelo Trabalho para Saúde (PET-Saúde/GraduaSUS) (Education Through Work for Health Program), from May 2016 to April 2018. Teachers and students from a public university and professional nurses linked to the Municipal Health Secretariat of the municipality participated in the actions. Results: it was possible to implement the Health Care Network for the prevention and treatment of skin lesions in a structured and systematic way. A flow of care, case supervision and clinical follow-up was established through the construction of an assistance protocol. Conclusion: the practical skill and scientific knowledge of students and health professionals for the treatment and management of skin lesions were developed, thus strengthening the teaching-service-community triad.


Assuntos
Ferimentos e Lesões , Relações Comunidade-Instituição , Atenção à Saúde , Acesso aos Serviços de Saúde
3.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48435

RESUMO

O Ministério da Saúde, por meio da Secretaria de Vigilância em Saúde (SVS), deu início à Semana das Doenças Crônicas não Transmissíveis. O evento, que ocorre até amanhã (16), tem apresentado o atual cenário das doenças e agravos não transmissíveis no país


Assuntos
Doenças não Transmissíveis/prevenção & controle , Brasil , Doença Crônica/prevenção & controle , Atenção à Saúde/métodos
4.
BMJ Open ; 11(9): e049878, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475176

RESUMO

INTRODUCTION: Given the complex causal origins of many non-communicable diseases (NCDs), and the complex landscapes in which policies designed to tackle them are made and unfold, the need for systems thinking and complexity science (STCS) in developing effective policy solutions has been emphasised. While numerous methods informed by STCS have been applied to the policy process in NCD prevention, these applications have not been systematically catalogued. The aim of this scoping review is to identify existing applications of methods informed by STCS to the policy process for NCD prevention, documenting which domains of the policy process they have been applied to. METHODS AND ANALYSIS: A systematic scoping review methodology will be used. IDENTIFICATION: We will search Medline, SCOPUS, Embase and Web of Science using search terms combining STCS, NCD prevention and the policy process. All records published in English will be eligible for inclusion, regardless of study design. SELECTION: We will screen titles and abstracts and extract data according to published guidelines for scoping reviews. In order to determine the quality of the included studies, we will use the approach developed by Dixon-Woods et al, excluding studies identified as fatally flawed, and determining the credibility and contribution of included studies. SYNTHESIS: We will identify relevant studies, summarising key data from each study and mapping applications of methods informed by STCS to different parts of the policy process. Review findings will provide a useful reference for policy-makers, outlining which domains of the policy process different methods have been applied to. ETHICS AND DISSEMINATION: Formal ethical approval is not required, as the study does not involve primary data collection. The findings of this study will be disseminated through a peer-reviewed publication, presentations and summaries for key stakeholders.


Assuntos
Doenças não Transmissíveis , Atenção à Saúde , Humanos , Doenças não Transmissíveis/prevenção & controle , Políticas , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Análise de Sistemas
5.
BMJ Open ; 11(9): e050054, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34489287

RESUMO

OBJECTIVES: The healthcare system is characterised by a high degree of complexity and involves various actors at different institutional levels and in different care contexts. To implement patient-centred care (PCC) successfully, a multidimensional consideration of influencing factors is required. Our qualitative study aims to identify system-level determinants of PCC implementation from the perspective of different health and social care organisations (HSCOs). DESIGN: A qualitative study using n=20 semistructured face-to-face interviews with n=24 participants was carried out between August 2017 and May 2018. Interview data were analysed based on concepts of qualitative content analysis using an inductive and deductive approach. SETTING AND PARTICIPANTS: Interviews were conducted with clinical and managerial decision makers from multiple HSCOs in the model region of Cologne, Germany. Participants were recruited via networks of practice partners and cold calling. RESULTS: This study identified various determinants on the system level that are associated with PCC implementation. Decision makers described external regulations as generating an economically controlled alignment of the healthcare system. The availability and qualification of staff resources and patient-related incentives of financial resources were identified as an eminent requirement for providers to deliver PCC. Participants considered the strict separation of financing and delivery of healthcare into inpatient and outpatient sectors to be a barrier to PCC. Interorganisational collaboration and information exchange were identified as facilitators of PCC, as they enable continuous patient care cycles. CONCLUSION: The results showed the necessity of enforcing paradigm changes at the system level from disease-centredness to patient-centredness while aligning policy and reimbursement decisions directly with patient needs and values. A systematic, long-term planned strategy that extends across all organisations is lacking, rather each organisation seeks its own possibilities to implement PCC activities under external restrictions.Trial registration numberDRKS00011925.


Assuntos
Atenção à Saúde , Assistência Centrada no Paciente , Tomada de Decisões , Humanos , Pesquisa Qualitativa , Apoio Social
6.
RMD Open ; 7(3)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34475248

RESUMO

OBJECTIVES: We engaged patients with systemic sclerosis (SSc) and healthcare professionals to assess electronic health (eHealth) literacy and needs relating to web-based support using internet-based information and communication technologies (ICT). METHODS: We employed an explanatory sequential mixed methods design. First, we conducted a cross-sectional survey in patients (n=101) and professionals (n=47). Next, we conducted three focus groups with patients, family members and professionals (n=17). RESULTS: Of patients, 89.1% used ICT at least weekly for private communication. Patients reported relatively high comprehension of eHealth information ([Formula: see text] =6.7, 95% CI: 6.2 to 7.3, range 1-10), yet were less confident evaluating information reliability ([Formula: see text] =5.8, 95% CI: 5.1 to 6.4) and finding eHealth apps ([Formula: see text] =4.8, 95% CI: 4.2 to 5.4). Patients and professionals reported little experience with web-based self-management support. Focus groups revealed 'considering non-ICT-accessible groups' and 'fitting patients' and professionals' technology' as crucial for acceptability. In relation to understanding/appraising eHealth, participants highlighted that general SSc information is not tailored to individual's disease course. Recommendations included 'providing timely, understandable and safe information' and 'empowering end-users in ICT and health decision-making skills'. Professionals expressed concerns about lacking resources. Patients were concerned about data security and person-centredness. Key eHealth drivers included 'addressing end-user perceptions' and 'putting people at the centre of technology'. CONCLUSIONS: Patients and professionals need education/training to support uptake of eHealth resources. Key elements include guiding patients to timely/reliable information and using eHealth to optimise patient-provider communication. Design that is responsive to end-users' needs and considers individuals with limited eHealth literacy and/or ICT access appears to be critical for acceptability.


Assuntos
Escleroderma Sistêmico , Telemedicina , Estudos Transversais , Atenção à Saúde , Eletrônica , Humanos , Reprodutibilidade dos Testes , Escleroderma Sistêmico/terapia
7.
Lancet Oncol ; 22(9): e410-e418, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34478677

RESUMO

Cancer mortality rates in low-income and middle-income countries (LMICs) are unacceptably high, requiring both collaborative global effort and in-country solutions. Experience has shown that working together in policy, clinical practice, education, training, and research leads to bidirectional benefit for LMICs and high-income countries. For over 60 years, the UK National Health Service has benefited from recruitment from LMICs, providing the UK with a rich diaspora of trained health-care professionals with links to LMICs. A grassroots drive to engage with partners in LMICs within the UK has grown from the National Health Service, UK academia, and other organisations. This drive has generated a model that rests on two structures: London Global Cancer Week and the UK Global Cancer Network, providing a high-value foundation for international discussion and collaboration. Starting with a historical perspective, this Series paper describes the UK landscape and offers a potential plan for the future UK's contribution to global cancer control. We also discuss the opportunities and challenges facing UK partnerships with LMICs in cancer control. The UK should harness the skills, insights, and political will from all partners to make real progress.


Assuntos
Países em Desenvolvimento , Cooperação Internacional , Neoplasias/prevenção & controle , Pesquisa Biomédica , Atenção à Saúde , Países em Desenvolvimento/estatística & dados numéricos , Saúde Global , Pessoal de Saúde/educação , Humanos , Oncologia/organização & administração , Neoplasias/epidemiologia , Reino Unido
8.
Best Pract Res Clin Anaesthesiol ; 35(3): 293-306, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34511220

RESUMO

International hospitals and healthcare facilities are facing catastrophic financial challenges related to the COVID-19 pandemic. The American Hospital Association estimates a financial impact of $202.6 billion in lost revenue for America's hospitals and healthcare systems, or an average of $50.7 billion per month. Furthermore, it could cost low- and middle-income countries ~ US$52 billion (equivalent to US$8.60 per person) each four weeks to provide an effective healthcare response to COVID-19. In the setting of the largest daily COVID-19 new cases in the US, this burden will influence patient care, surgeries, and surgical outcomes. From a global economic standpoint, The World Bank projects that global growth is projected to shrink by almost 8% with poorer countries feeling most of the impact, and the United Nations projects that it will cost the global economy around 2 trillion dollars this year. Overall, a lack of preparedness was a major contributor to the struggles experienced by healthcare facilities around the world. Items such as personal protective equipment (PPE) for healthcare workers, hospital equipment, sanitizing supplies, toilet paper, and water were in short supply. These deficiencies were exposed by COVID-19 and have prompted healthcare organizations around the world to invent new essential plans for pandemic preparedness. In this paper, we will discuss the economic impact of COVID-19 on US and international hospitals, healthcare facilities, surgery, and surgical outcomes. In the future, the US and countries around the world will benefit from preparing a plan of action to use as a guide in the event of a disaster or pandemic.


Assuntos
COVID-19/economia , COVID-19/epidemiologia , Efeitos Psicossociais da Doença , Atenção à Saúde/economia , Saúde Global/economia , COVID-19/terapia , Atenção à Saúde/tendências , Saúde Global/tendências , Pessoal de Saúde/economia , Pessoal de Saúde/tendências , Humanos , Pandemias , Equipamento de Proteção Individual/economia , Equipamento de Proteção Individual/tendências , Estados Unidos/epidemiologia
9.
Best Pract Res Clin Anaesthesiol ; 35(3): 405-414, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34511228

RESUMO

The current COVID-19 pandemic is testing political leaders and healthcare systems worldwide, exposing deficits in crisis communication, leadership, preparedness and flexibility. Extraordinary situations abound, with global supply chains suddenly failing, media communicating contradictory information, and politics playing an increasingly bigger role in shaping each country's response to the crisis. The pandemic threatens not just our health but also our economy, liberty, and privacy. It challenges the speed at which we work, the quality of our research, and the effectiveness of communication within the scientific community. It can impose ethical dilemmas and emotional stress on healthcare workers. Nevertheless, the pandemic also provides an opportunity for healthcare organizations, leaders, and researchers to learn from their mistakes and to place their countries and institutions in a better position to face future challenges.


Assuntos
COVID-19/epidemiologia , Gestão de Recursos da Equipe de Assistência à Saúde/normas , Pessoal de Saúde/normas , Liderança , COVID-19/terapia , Comunicação , Gestão de Recursos da Equipe de Assistência à Saúde/métodos , Atenção à Saúde/métodos , Atenção à Saúde/normas , Humanos , Pandemias
10.
Best Pract Res Clin Anaesthesiol ; 35(3): 437-448, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34511231

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, emerged in late 2019 in Wuhan, China. The World Health Organization declared the virus a pandemic on March 11, 2020. Disease progression from COVID-19 infection has shown significant symptom manifestations within organ systems beyond the respiratory system. The literature has shown increasing evidence of cardiovascular involvement during disease course and an associated increase in mortality among infected patients. Although the understanding of this novel virus is continually evolving, it is currently proposed that the mechanism by which the SARS-CoV-2 virus contributes to cardiovascular manifestations involves the ACE2 transmembrane protein. The protein ACE2 is highly expressed in blood vessel pericytes, and infection can result in microvascular dysfunction and subsequent acute coronary syndromes. Complications involving the cardiovascular system include myocardial infarction, arrhythmias, shock, and heart failure. In this evidence-based review, we discuss risk factors of cardiovascular involvement in COVID-19 infection, pathophysiology of COVID-19-related cardiovascular infection, and injury, COVID-19 effects on the cardiovascular system and corresponding treatments, and hematologic effects of COVID-19 and COVID-19 in heart transplant patients. Clinicians managing COVID-19 patients should appreciate the potential cardiovascular effects related to the disease process.


Assuntos
COVID-19/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/virologia , Sistema Cardiovascular/virologia , Prática Clínica Baseada em Evidências/métodos , COVID-19/terapia , Doenças Cardiovasculares/terapia , Atenção à Saúde/métodos , Atenção à Saúde/normas , Prática Clínica Baseada em Evidências/normas , Humanos , Fatores de Risco
11.
J Infect Dev Ctries ; 15(8): 1048-1053, 2021 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-34516409

RESUMO

INTRODUCTION: In Africa, the first case of COVID-19 was reported in February 2020. Mauritania's first case was confirmed in March 2020. METHODOLOGY: We provide an update of the COVID-19 epidemic in Mauritania as of December 2020, and describe the country's Health System Response. RESULTS: In total, 133,749 diagnostic tests were performed, 14,364 (10.7%) were positive (309 cases/100,000 inhabitants). Case fatality rate was 2.4%. The 20-39 year-olds (41%) and males (59.1%) were most commonly affected. Comorbidities among fatal cases included cardiovascular diseases (44.8%) and diabetes (37.1%). Clinical symptoms included fever (57%), cough (52%), running nose (47%) and headache (26%). After the first case, prevention measures were progressively tightened, and quarantine implemented for all suspected cases. Schools and universities were closed, and flights to Mauritania suspended. Restaurants and cafeterias were closed, and night curfews installed. Friday prayers were suspended nationwide, and movements between regions restricted. These measures helped to contain the spread of SARS-CoV-2 during the first pandemic wave, which peaked in June 2020 with low rates. However, the number of daily cases reached high levels in December 2020, during the second wave (40.1% of all cases and 48.9% of deaths). During the first wave, there were 38 ICU beds nationwide, but the ICU's capacity increased in short time. CONCLUSIONS: Mauritania has passed through the first pandemic wave with relatively low case fatality rates, currently being at the end of the second wave. As the country's health system is very vulnerable, there is a need for strict public health measures during epidemics.


Assuntos
COVID-19/epidemiologia , Atenção à Saúde/estatística & dados numéricos , Atenção à Saúde/normas , Adolescente , Adulto , Idoso , COVID-19/mortalidade , COVID-19/prevenção & controle , Criança , Pré-Escolar , Planejamento em Saúde Comunitária , Atenção à Saúde/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Mauritânia/epidemiologia , Pessoa de Meia-Idade , Saúde Pública , Adulto Jovem
12.
PLoS One ; 16(9): e0257423, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34520505

RESUMO

Health Care Leaders (HCLs) faced unprecedented challenges during the initial phases of the COVID-19 pandemic. Leaders played an important role in shaping the experiences of Health Care Workers (HCWs) during this time. However, research is needed on how HCWs experienced and characterized HCLs' response and support. The aim of our study was to examine HCWs' experiences with leadership and to identify aspects of HCLs' response that were effective in supporting HCWs in their roles during the early phases of the pandemic. This was a qualitative study based on open-ended semi-structured interviews conducted (June 1- July 18, 2020) with frontline HCWs during the first wave of the COVID-19 pandemic in Connecticut, USA. Participants (N = 45) included physicians, nurses, respiratory therapists and patient care assistants who worked in inpatient and outpatient settings in various specialties, roles and 3 health systems across Connecticut, USA during the COVID-19 pandemic. Participants were offered a $25 gift card as an incentive for participation. We used inductive techniques derived from grounded theory to develop themes. We identified 6 main themes related to leadership response and support of HCWs during the pandemic namely: 1) Effective communication and transparency; 2) Prioritizing their health and safety; 3) Employee scheduling considerations: autonomy, assignment support and respite; 4) Appreciation- financial and nonfinancial; 5) Showing up and listening and 6) Stepping up with resources. Our findings can inform leadership responses to future pandemics and other unanticipated crises leading to strengthening of the health care system as a whole.


Assuntos
COVID-19 , Atenção à Saúde , Pessoal de Saúde , Liderança , Pandemias , Comunicação , Connecticut/epidemiologia , Atenção à Saúde/economia , Atenção à Saúde/organização & administração , Humanos
13.
Rev Med Chil ; 149(2): 263-267, 2021 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-34479272

RESUMO

This paper deals with the relevance of bioethical guidelines for the prioritization of patient care. These guidelines should guide health professionals' triage procedures in exceptional situations of resource shortage. Also, they would contribute to evaluate the legal liability of professionals in these situations.


Assuntos
Pessoal de Saúde , Pandemias , Atenção à Saúde , Humanos , Responsabilidade Legal , Triagem
14.
Rev Med Chil ; 149(2): 268-273, 2021 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-34479273

RESUMO

BACKGROUND: A central aspect of professional identity is occupational commitment, which has a significant relationship with motivation and positive mental states in healthcare environments. However, it is not clear how occupational commitment is related to teaching practices in universities. AIM: To apply the Occupational Commitment Questionnaire (OCQ) to university teachers and relate its results with the Teaching Practices Questionnaire. MATERIAL AND METHODS: OCQ and Teaching Practices Questionnaire were answered by 319 university teachers from 13 Chilean regions, who were selected through a non-probabilistic volunteer sampling. Data collection was done after informed consent. An exploratory factor analysis was performed for OCQ. The internal consistency of each factor was calculated with Cronbach's Alpha. Spearman correlations were used to explore the relationship between the two questionnaires. RESULTS: Two factors were identified in OCQ, namely Teacher Commitment and Ethical-Professional Commitment. Cronbach's Alpha was 0.85 for both factors. A moderate direct relationship between teacher commitment, ethical-professional commitment, and the Teaching Practices Questionnaire was found. CONCLUSIONS: OCQ showed an adequate internal consistency, and it was directly related with teaching practices. Committed teachers had better teaching practices. This confirms the importance of teachers' values and perceptions on their professional performance.


Assuntos
Docentes , Motivação , Atenção à Saúde , Humanos , Inquéritos e Questionários , Ensino , Universidades
15.
Rev Med Chil ; 149(3): 458-463, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-34479325

RESUMO

BACKGROUND: The recognition of ethical problems in medical practice and the potential harmful effects that they may have on patients, underscores the importance of the ethical training of professionals as well as the development of Ethics Committees in Healthcare institutions. However, there is a paucity of national studies about the type of problems faced by professionals and the role of Ethics Committees in hospitals. AIM: To explore the perception about ethical problems in clinical practice of Chilean physicians of different specialties of two public teaching hospitals. MATERIAL AND METHODS: Physicians of both sexes and different specialties working in two teaching hospitals of Metropolitan Santiago, were invited to participate in focus groups of seven to eight participants. They discussed the ethical problems faced during their clinical practice. A content analysis based on the Grounded Theory was performed with the obtained information. RESULTS: Different types of ethical problems could be distinguished according to their content and the actors involved. The data obtained shows that the ethical dimension is present in the daily work of physicians. The evolution of the narrative throughout the interviews corroborated the importance of installing ethical issues and culture in the working routine of health care professionals. CONCLUSIONS: Human resources and an adequate institutional environment are required to promote the discussion about ethical issues such as the relationship between physicians and patient, the role of teaching in health care and institutional decisions.


Assuntos
Médicos , Atenção à Saúde , Feminino , Pessoal de Saúde , Hospitais Públicos , Humanos , Masculino , Princípios Morais
16.
East Mediterr Health J ; 27(8): 806-817, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34486717

RESUMO

Background: To measure progress towards universal health coverage (UHC) in the context of ageing, it is necessary to develop suitable monitoring frameworks. The global UHC monitoring framework is focused on priorities for younger populations and does not adequately address issues relevant to ageing populations. Aims: This study aims to propose a framework to measure UHC in a way that is relevant to health systems responding to population ageing. Methods: Based on a search strategy focusing on measures of UHC in relation to older people's care, we searched electronic databases and screened the records to qualitatively analyse the data. We also conducted 2 rounds of expert panel consultations to discuss the findings and examine the feasibility of the recommended indicators using the case of the Islamic Republic of Iran as an example. Results: We identified main themes and classified core indicators under each theme. Besides 25 indicators for quality of care, there were 22 indicators for financial protection. Ten indicators were retrieved measuring coverage and access to long-term care. Some indicators were excluded owing to limited data availability or absence of related programmes and some alternate indicators were proposed. Conclusions: We identified several indicators which could be used to measure progress toward UHC in the context of population ageing. However, not all of these indicators are feasible in context of low- and middle-income countries. This study could offer useful general guidance on how to define the exact set of measures in a specific country context.


Assuntos
Atenção à Saúde , Cobertura Universal do Seguro de Saúde , Idoso , Saúde Global , Humanos , Irã (Geográfico)
17.
East Mediterr Health J ; 27(8): 826-849, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34486719

RESUMO

Background: The increasing trend in unnecessary caesarean sections has caused maternal and neonatal health concerns worldwide. Various medical and non-medical interventions have been designed and implemented to reduce caesarian section overuse. However, their efficacy is questionable. Aims: This study aimed to identify and classify effective interventions to reduce unnecessary caesarian sections. Methods: We searched EMBASE, MEDLINE, Web of Knowledge and Scopus databases for articles, using appropriate search strategies, up to 2 June 2020. Overall, 7951 identified articles were screened and assessed using a valid quality assessment checklist. Finally, 109 eligible studies were included in this review. Thematic content analysis was used to identify and classify the effective interventions. Results: Overall, 188 effective caesarian section reduction measures were identified. They were categorized into 45 actions, 16 intervention groups and 6 WHO building blocks, including "governance and leadership", "financing", "health workforce", "medical products and technologies", "information" and "service delivery". Using qualified and competent staff, intra-partum services, and oversight were the most commonly applied interventions to reduce unnecessary caesarian sections. Conclusions: A taxonomy of effective strategies to reduce unnecessary caesarian sections was developed in this study. A holistic approach is crucial to addressing the new epidemic of unnecessary caesarian section. Multiple interventions based on the underlying causes of caesarian section overuse should be designed and implemented at local and global levels.


Assuntos
Cesárea , Parto , Atenção à Saúde , Feminino , Humanos , Recém-Nascido , Gravidez
18.
Artigo em Russo | MEDLINE | ID: mdl-34486847

RESUMO

The article presents analysis of legal regulation of medical technologies in Russia. The proper development of medicine and health care is impossible without permanent improvement and implementation of new medical technologies. The upcoming decades will be an era of development of bio-technologies, cellular and gene technologies included. The proposed analysis is focused on conceptual set, analysis of actual normative legal base regulating mentioned relationships and identification of perspectives of development of medical technologies. The adequate and competent legal regulation creates enabling environment developing new technological capabilities. The legislation should avoid inhibiting retributive mode and apply particularly permitting and regulating approach determining framework not to be violated. Undoubtedly, these activities should be carried out in conjunction with professional medical community to develop legislation ensuring the highest possible level of development of health care practice.


Assuntos
Atenção à Saúde , Federação Russa
19.
Artigo em Russo | MEDLINE | ID: mdl-34486848

RESUMO

The analysis of international data established that the national indicator of population health quality in the Russian Federation is significantly lower than in the EU, the USA and Canada. In this regard, the urgency of enhancement of state policy concerning updating and promoting development of national health care system,involving available resources of the public and private health sectors is obvious. The development of entrepreneurship in health care should be considered as a mean of improving social and economic efficiency of health care system in Russia. The purpose of study was to analyze perspective directions of development of entrepreneurial initiatives in national health care. On the basis of analysis of corresponding normative legal acts and publications, it is demonstrated that in national health care system prerequisites are establishing to implement new opportunities for patient-oriented entrepreneurial activities associated with development of digital technologies, e-Health, new forms of public-private partnership focused primarily on prevention and rehabilitation of patients.


Assuntos
Atenção à Saúde , Empreendedorismo , Humanos , Setor Privado , Estudos Prospectivos , Federação Russa
20.
Artigo em Russo | MEDLINE | ID: mdl-34486866

RESUMO

The enhancement of organization of palliative medical care to increase life quality of terminally ill patients is one of directions of development of health care system. To elaborate measures of improving accessibility and quality of palliative medical care, it is necessary to apply single unified methodology of calculating indices and criteria. One of them is provision of bed capacity. The purpose of the study is to elaborate methodology of calculating control indices of provision population with beds to render palliative medical care. The indices are calculated on the basis of statistical processing of monitoring corresponding data in the subjects of the Russian Federation.


Assuntos
Atenção à Saúde , Cuidados Paliativos , Humanos , Qualidade de Vida , Federação Russa
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