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1.
Rev. enferm. UERJ ; 28: 49570, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1094832

RESUMO

Objetivo: discutir as experiências e contradições no controle da pandemia de Covid-19 sob a perspectiva da epidemiologia e das políticas públicas brasileiras. Conteúdo: o debate apresentado divide-se em duas seções: a primeira traça a reflexão dos parâmetros epidemiológicos sobre a curva epidêmica do SARS-CoV-2, bem como as experiências internacionais para o controle deste fenômeno. A segunda, ancorada nas políticas públicas brasileiras, apresenta uma análise comparada das experiências nacionais e internacionais, discutindo os potenciais reflexos sobre a pandemia, considerando algumas especificidades sociais. Conclusão: frente à impossibilidade de redução de pessoas susceptíveis por meio de estratégias vacinais, a redução da velocidade da curva epidêmica precisa ocorrer por meio de ações de isolamento físico social. Ademais, a construção de políticas públicas que visem a proteção ao trabalhador e a ampliação do investimento no setor saúde são medidas urgentes.


Objective: to discuss experiences and contradictions in the control of the Covid-19 pandemic from the perspective of epidemiology and Brazilian public policies. Content: the discussion presented is divided into two sections: the first one present epidemiological parameters on the epidemic curve of SARS-CoV-2, as well as the international experiences for the control of this phenomenon. The second, anchored in the Brazilian public policies, presents a comparative analysis of national and international experiences, discussing the potential impacts on the pandemic, considering some specific social issues. Conclusion: in the face of impossibility of reducing susceptible people through vaccination strategies, the reduction of the speed of the epidemic curve needs to occur through actions of social distance. In addition, the construction of public policies aimed at protecting workers and expanding investment in the health sector are urgent measures.


Objetivo: discutir las experiencias y contradicciones en el control de la pandemia Covid-19 desde la perspectiva de la epidemiología brasileña y las políticas públicas. Contenido: el debate presentado se divide en dos secciones. El primero traza la reflexión de los parámetros epidemiológicos en la curva epidémica del SARS-CoV-2, así como las experiencias internacionales para el control de este fenómeno. El segunda seccione, anclada en las políticas públicas brasileñas, presenta un análisis comparativo de las experiencias nacionales e internacionales, discutiendo los posibles impactos en la pandemia, considerando algunas especificidades sociales brasileñas. Conclusión: dada la imposibilidad de reducir a las personas susceptibles a través de estrategias de vacunación, la reducción de la velocidad de la curva epidémica debe ocurrir a través de acciones de aislamiento social y físico. Además, la construcción de políticas públicas destinadas a proteger a los trabajadores y ampliar la inversión en el sector de la salud son medidas urgentes.


Assuntos
Humanos , Pneumonia Viral , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Políticas Públicas de Saúde , Pandemias , Política Pública , Betacoronavirus
2.
Infect Dis Poverty ; 9(1): 78, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600426

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is now a global public threat. Given the pandemic of COVID-19, the economic impact of COVID-19 is essential to add value to the policy-making process. We retrospectively conducted a cost and affordability analysis to determine the medical costs of COVID-19 patients in China, and also assess the factors affecting their costs. METHODS: This analysis was retrospectively conducted in Shandong Provincial Chest Hospital between 24 January and 16 March 2020. The total direct medical expenditures were analyzed by cost factors. We also assessed affordability by comparing the simulated out-of-pocket expenditure of COVID-19 cases relative to the per capita disposable income. Differences between groups were tested by student t test and Mann-Whitney test when appropriate. A multiple logistic regression model was built to determine the risk factors associated with high cost. RESULTS: A total of 70 COVID-19 patients were included in the analysis. The overall mean cost was USD 6827 per treated episode. The highest mean cost was observed in drug acquisition, accounting for 45.1% of the overall cost. Total mean cost was significantly higher in patients with pre-existing diseases compared to those without pre-existing diseases. Pre-existing diseases and the advanced disease severity were strongly associated with higher cost. Around USD 0.49 billion were expected for clinical manage of COVID-19 in China. Among rural households, the proportions of health insurance coverage should be increased to 70% for severe cases, and 80% for critically ill cases to avoid catastrophic health expenditure. CONCLUSIONS: Our data demonstrate that clinical management of COVID-19 patients incurs a great financial burden to national health insurance. The cost for drug acquisition is the major contributor to the medical cost, whereas the risk factors for higher cost are pre-existing diseases and severity of COVID-19. Improvement of insurance coverage will need to address the barriers of rural patients to avoid the occurrence of catastrophic health expenditure.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Pandemias , Pneumonia Viral , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Modelos Econômicos , Programas Nacionais de Saúde/economia , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Estudos Retrospectivos , População Rural , Adulto Jovem
3.
Rev Lat Am Enfermagem ; 28: e3344, 2020.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-32609281

RESUMO

OBJECTIVE: to analyze the relationship between per capita income and the cumulative incidence of COVID-19 in the neighborhoods of the city of Rio de Janeiro, RJ, Brazil. METHOD: an ecological study using neighborhoods as units of analysis. The cumulative incidence rate per 100,000 inhabitants and the median of potential confounding variables (sex, race, and age) were calculated. Multiple analysis included quantile regression, estimating the regression coefficients of the variable income for every five percentiles from the 10th to 90th percentiles to verify the relationship between income and incidence. RESULTS: the city's rate was 36.58 new cases per 100,000 inhabitants. In general, the highest rates were observed in the wealthiest regions. Multiple analysis was consistent with this observation since the per capita income affected all percentiles analyzed, with a median regression coefficient of 0.02 (p-value <0.001; R2 32.93). That is, there is an increase of R$ 0.02 in the neighborhood's per capita income for every unit of incidence. CONCLUSION: cumulative incident rates of COVID-19 are influenced by one's neighborhood of residency, suggesting that access to testing is uneven.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Renda , Pandemias , Pneumonia Viral/epidemiologia , Características de Residência/estatística & dados numéricos , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Distribuição por Idade , Brasil/epidemiologia , Cidades/epidemiologia , Infecções por Coronavirus/economia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pandemias/economia , Pandemias/estatística & dados numéricos , Pneumonia Viral/economia , Distribuição por Sexo , Fatores Socioeconômicos
4.
Sr Care Pharm ; 35(7): 331, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32600512

RESUMO

The Centers for Medicare & Medicaid Services (CMS) and other federal agencies are busy churning out regulations and guidance documents in response to the COVID-19 crisis. CMS now requires plans to waive cost sharing for COVID-19-related immunizations, testing, and treatment and suspend utilization review requirements related to drug-supply limits unless these limits are related to patient safety.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Medicaid/organização & administração , Medicare/organização & administração , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Betacoronavirus , Infecções por Coronavirus/economia , Infecções por Coronavirus/prevenção & controle , Uso de Medicamentos , Humanos , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/economia , Pneumonia Viral/prevenção & controle , Estados Unidos
7.
In Vivo ; 34(3 Suppl): 1695-1699, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32503831

RESUMO

BACKGROUND/AIM: Coronavirus is an ongoing pandemic challenging health systems worldwide. The aim of this report was to evaluate the effectiveness of lockdown in different countries, highlighting the performance of Greek society and authorities. METHODS: We analyzed publicly available data from the "Worldometer". We evaluated the efficacy of lockdown at one month after implementation. Delta Days (DD) referred to the difference in the days of reaching 1 case/million people to the adoption of lockdown. RESULTS: Higher healthcare expenditure as % of the national GDP was not correlated with better 30-day mortality outcomes. DD index was significantly correlated to the incidence of COVID-19 per million people at 30 days (p-value=0.001). The correlation between DD and 30-day mortality was not statistically significant (p-value=0.087). CONCLUSION: Early lockdown was proven to be the appropriate policy to limit the spread of COVID-19. Greece was a success story in preventing spread despite limited resources.


Assuntos
Infecções por Coronavirus/prevenção & controle , Política de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/economia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/transmissão , Saúde Global , Grécia/epidemiologia , Gastos em Saúde/estatística & dados numéricos , Recursos em Saúde/economia , Humanos , Incidência , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/mortalidade , Pneumonia Viral/transmissão , Utilização de Procedimentos e Técnicas/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Quarentena/estatística & dados numéricos , Alocação de Recursos
8.
Rev Med Suisse ; 16(698): 1262-1264, 2020 Jun 17.
Artigo em Francês | MEDLINE | ID: mdl-32558456

RESUMO

The current new coronavirus pandemic has highlighted the importance of taking into consideration population groups particularly at risk of contracting Covid-19 disease or developing severe forms of the disease. The medical literature, the press and the authorities have thus stepped up the use of the expression «â€…vulnerable populations ¼ in recent weeks to refer to it. However, behind this general expression there are diverse but often interdependent realities whose specific consideration and understanding seem essential for the effective management of the epidemic and its health and socio-economic consequences.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Populações Vulneráveis/estatística & dados numéricos , Betacoronavirus/patogenicidade , Infecções por Coronavirus/economia , Humanos , Pandemias/economia , Pneumonia Viral/economia
14.
Indian J Public Health ; 64(Supplement): S108-S111, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32496238

RESUMO

The whole globe is reeling under the COVID-19 pandemic now. With the scale and severity of infection, number of deaths and lack of any definite therapeutic armamentarium, the vaccine development has been accelerated at a never-before pace. A wide variety of vaccine technologies and platforms are being attempted. Out of the over 108 efforts, 100 are in preclinical and eight in Phase 1 or 2 trial stage. While the availability of newer technologies has facilitated development, there are several challenges on the way including limited understanding of the pathophysiology, targeting humoral or mucosal immunity, lack of suitable animal model, poor success of human severe acute respiratory syndrome/Middle East Respiratory Syndrome vaccines, limited efficacy of influenza vaccines, and immune exaggeration with animal coronavirus vaccines. With the current scenario with political, funding, research, and regulatory supports, if everything sails through smoothly, the successful vaccine is expected in 12-18 months. Modestly efficacious vaccine may be also a good achievement.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vacinas Virais/administração & dosagem , Vacinas Virais/imunologia , Antivirais/uso terapêutico , Betacoronavirus , Pesquisa Biomédica/organização & administração , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Humanos , Índia/epidemiologia , Mediadores da Inflamação/metabolismo , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Fatores de Tempo , Vacinas Virais/economia , Vacinas Virais/provisão & distribução
15.
Indian J Public Health ; 64(Supplement): S231-S233, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32496262

RESUMO

The emergence of novel coronavirus disease 2019 (COVID-19) pandemic provides unique challenges for health system. While on the one hand, the government has to struggle with the strategies for control of COVID-19, on the other hand, other routine health services also need to be managed. Second, the infrastructure needs to be augmented to meet the potential epidemic surge of cases. Third, economic welfare and household income need to be guaranteed. All of these have complicated the routine ways in which the governments have dealt with various trade-offs to determine the health and public policies. In this paper, we outline key economic principles for the government to consider for policymaking, during, and after the COVID-19 pandemic. The pandemic rightfully places long due attention of policymakers for investing in health sector. The policy entrepreneurs and public health community should not miss this once-in-a-lifetime "policy window" to raise the level of advocacy for appropriate investment in health sector.


Assuntos
Infecções por Coronavirus/economia , Setor de Assistência à Saúde/organização & administração , Pandemias/economia , Pneumonia Viral/economia , Política Pública , Betacoronavirus , Fortalecimento Institucional , Alocação de Recursos para a Atenção à Saúde/organização & administração , Setor de Assistência à Saúde/economia , Setor de Assistência à Saúde/estatística & dados numéricos , Nível de Saúde , Humanos , Índia , Setor Privado/organização & administração , Setor Público/organização & administração
16.
Cien Saude Colet ; 25(suppl 1): 2411-2421, 2020 Jun.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32520286

RESUMO

This paper presents the results of an opinion poll conducted in Brazil on the perception of social isolation during the COVID-19 pandemic. The questionnaire was prepared on Google Forms, disseminated through social networks, with questions about the socioeconomic profile and factors associated with isolation. A non-probabilistic sample was obtained with 16,440 respondents. Data were analyzed using the Stata 13 software. Social interaction was the most affected aspect among people with higher education and income (45.8%), and financial problems caused a more significant impact (35%) among people with low income and education. Those who practice some physical activity showed lower levels of stress 13%, as well as greater normality in sleep 50.3%. People who reported living in worse habitability conditions reported willingness to remain isolated for less time, 73.9%. Among non-isolated people (10.7% of the total sample), 75.8% believe that social isolation will reduce the number of victims of COVID-19. We conclude, based on this sample, that the perception about social isolation as a pandemic mitigation action varies by income, education, age, and gender. However, most believe that it is the most appropriate control measure and are willing to wait as long as necessary to contribute to the fight against COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pandemias , Espaço Pessoal , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Isolamento Social/psicologia , Adulto , Fatores Etários , Brasil/epidemiologia , Infecções por Coronavirus/economia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Escolaridade , Exercício Físico/psicologia , Feminino , Humanos , Renda , Relações Interpessoais , Masculino , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/economia , Pneumonia Viral/prevenção & controle , Opinião Pública , Fatores Sexuais , Fatores Socioeconômicos , Estresse Psicológico/epidemiologia , Inquéritos e Questionários/estatística & dados numéricos , Fatores de Tempo
17.
Cien Saude Colet ; 25(suppl 1): 2469-2477, 2020 Jun.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32520291

RESUMO

This paper aims to perform a theoretical reflection on the historical-social foundations of the COVID-19 pandemic. The "capital worldization", "capital-imperialism", "space-time compression", and "structural crisis of capital" categories are conjured from the historical materialistic-theoretical matrix, outlining a course that transcends the limits of Health Sciences to understand global health, of which the COVID-19 pandemic is an expression. We then return to the field of health, when the category of "social determination of health" allows elucidating the bases of the pandemic studied. We show that, other elements typical of the current phase of contemporary capitalism have become universal besides the SARS-CoV-2 characteristics or the dynamics of the rapid movement of people and objects around the world, unifying the health social determination process.


Assuntos
Betacoronavirus , Capitalismo , Infecções por Coronavirus , Saúde Global , Pandemias , Pneumonia Viral , Determinantes Sociais da Saúde , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etiologia , Saúde Global/economia , Saúde Global/estatística & dados numéricos , Humanos , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Saúde Pública , Determinantes Sociais da Saúde/economia , Fatores de Tempo
18.
Artigo em Inglês | MEDLINE | ID: mdl-32512826

RESUMO

We read with interest several manuscripts recently published in the International Journal of Environmental Research and Public Health (IJERPH) on the ongoing coronavirus pandemic. While these articles provide a well-rounded overview on the risk and current status of this virus, we herein add some relevant information on its etiology, prevention and management, especially for resource-limited healthcare systems. The use of protective actions is both complex and expensive. Affordable options are essential to respond to this and future viral outbreaks.


Assuntos
Betacoronavirus/patogenicidade , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Técnicas de Laboratório Clínico/economia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/economia , Infecções por Coronavirus/terapia , Análise Custo-Benefício , Assistência à Saúde/economia , Alocação de Recursos para a Atenção à Saúde , Humanos , Pneumonia Viral/terapia , Administração em Saúde Pública , Quarentena , Fatores de Tempo
20.
J Korean Med Sci ; 35(24): e224, 2020 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-32567260

RESUMO

Coronavirus disease 2019 (COVID-19) has resulted in an ongoing pandemic; however, the socioeconomic burden of COVID-19 treatment in the pediatric population remains unclear. Thus, the aim of this study was to determine the hospitalization periods and medical costs among children with COVID-19. In total, 145 billing statements for pediatric patients receiving healthcare services because of COVID-19 from February 1, 2020 to March 31, 2020 were used. The study showed that individual treatment costs for children with COVID-19 are approximately USD 2,192 under the Korean National Health Insurance Service System. This study revealed the differences in cost among age groups, determined by the type of hospital wherein admission occurred, as a trend of increasing age, increasing hospitalization time, and increasing cost was observed. Tailored COVID-19 treatment strategies by age group may lower costs and increase the effectiveness of resource allocation.


Assuntos
Infecções por Coronavirus/economia , Hospitalização/economia , Pandemias/economia , Pneumonia Viral/economia , Adolescente , Betacoronavirus , Criança , Pré-Escolar , Infecções por Coronavirus/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Tempo de Internação/economia , Programas Nacionais de Saúde/economia , Pneumonia Viral/tratamento farmacológico , República da Coreia/epidemiologia , Adulto Jovem
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