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1.
Int J Med Sci ; 17(16): 2449-2453, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029087

RESUMO

The COVID-19 pandemic is a novel infectious disease pandemic with the agent SARS-CoV-2 virus which is currently affecting and causing damage globally. The outbreak has been crossing over 200 countries in the world. In the situation of the outbreak of COVID-19, Vietnam has first sixteen typical cases confirmed positive updated to Feb 28th, 2020. After completely applying the medical prevention and active control, Vietnam has the ability to take control of the outbreak of COVID-19 as a recent of WHO assessment. Vietnam has been reported as an effective country for prevention and control the outbreak of COVID-19. We retroactive reviewed our experience with 16 positive cases isolation. This article aims to present the first cohort of COVID-19 patients updated to Feb 28th, 2020 in Vietnam and sharing the national response to the pandemic.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/prevenção & controle , Betacoronavirus/genética , Estudos de Coortes , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/etiologia , Infecções por Coronavirus/transmissão , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Programas Nacionais de Saúde , Pneumonia Viral/etiologia , Pneumonia Viral/transmissão , Vietnã/epidemiologia
2.
Biomed Res Int ; 2020: 8397053, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029526

RESUMO

Introduction: The Portuguese healthcare system had to adapt at short notice to the COVID-19 pandemic. We implemented workflow changes to our molecular pathology laboratory, a national reference center, to maximize safety and productivity. We assess the impact this situation had on our caseload and what conclusions can be drawn about the wider impact of the pandemic in oncological therapy in Portugal. Material and Methods. We reviewed our database for all oncological molecular tests requested between March and April of 2019 and 2020. For each case, we recorded age, sex, region of the country, requesting institution, sample type, testing method, and turnaround time (TAT). A comparison between years was made. Results: The total number of tests decreased from 421 in 2019 to 319 in 2020 (p = 0.0027). The greatest reduction was in clinical trial-related cases. Routine cases were similar between years (267 vs. 256). TAT was higher in 2019 (mean 15 days vs. 12.3 days; p = 0.0003). Medium- to large-sized public hospitals in the north of the country were mostly responsible for the reduction in cases (p = 0.0153). Conclusions: Case reduction was observed at hospitals that have mostly been involved in the treatment of COVID-19 and in the north of the country, the region worst-hit by the pandemic. Similar to other studies, our TAT decreased, even with a similar number of routine cases. Thus, we conclude that it is possible to successfully adapt the workflow of a molecular pathology laboratory to new safety standards without losing efficiency.


Assuntos
Infecções por Coronavirus/epidemiologia , Oncologia , Técnicas de Diagnóstico Molecular , Patologia Molecular , Pneumonia Viral/epidemiologia , Betacoronavirus , Humanos , Laboratórios , Pessoal de Laboratório , Técnicas de Diagnóstico Molecular/estatística & dados numéricos , Programas Nacionais de Saúde , Pandemias , Portugal/epidemiologia , Fluxo de Trabalho
3.
Rev Esp Salud Publica ; 942020 Oct 14.
Artigo em Espanhol | MEDLINE | ID: mdl-33056957

RESUMO

Between March and May 2020, the Spanish Ministry of Health and the Spanish Psychological Association created the Psychological First Care Service (Servicio de Primera Ayuda Psicológica-SPAP), a national helpline designed to provide early psychological intervention to those people affected by COVID-19. This service attended more than 15,000 calls and carried out more than 11,000 interventions and 9,500 follow-ups with the general population, healthcare and other essential professionals and the patients and relatives of the sick or deceased. Results show that the majority of calls (45.7%) came from the Autonomous Community of Madrid, that women significantly used this service in a higher proportion than men (73.5%) and that the commonest age range among users was 40-59. 75.9% of consultations were related to psychological problems linked to anxiety and depressive symptoms. However, grief symptoms also stood out among the patients or relatives of the sick and deceased and, to a lesser extent, stress symptoms were prevalent in the group of professionals. These data show the usefulness of this early psychological care service and the need for similar resources to be implemented in coordination with or within the National Health System.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Intervenção na Crise/métodos , Utilização de Instalações e Serviços/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Pneumonia Viral/psicologia , Telemedicina/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/etiologia , Ansiedade/terapia , Criança , Infecções por Coronavirus/terapia , Intervenção na Crise/organização & administração , Intervenção na Crise/estatística & dados numéricos , Depressão/epidemiologia , Depressão/etiologia , Depressão/terapia , Feminino , Pesar , Humanos , Masculino , Serviços de Saúde Mental/organização & administração , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Pandemias , Pneumonia Viral/terapia , Prevalência , Espanha/epidemiologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Telemedicina/organização & administração , Telemedicina/estatística & dados numéricos , Telefone , Adulto Jovem
7.
Cien Saude Colet ; 25(9): 3465-3474, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876270

RESUMO

This work aims to systematize a set of scientific evidence presented in international papers that identify the main problems affecting health professionals directly involved in coping with the COVID-19 pandemic and point out actions and strategies for the protection and healthcare of these professionals. The risk of infection is the main issue and has led to absence from work, illness, death, and intense psychological distress, expressed in generalized anxiety and sleep disorders, fear of becoming ill and infecting colleagues and relatives. In the Brazilian reality, this work revives the analysis of the chronic problems affecting health workers, resulting from the underfinancing of the Brazilian Unified Health System (SUS), the sector's spending freeze, the deterioration of services and workforce's insecurity, and points out the acute challenges of work management and staff training, given the expanded hospital bed infrastructure and reorganization of the work process in primary care to face the pandemic, emphasizing the necessary measures for the protection and promotion of the physical and mental health of health professionals and workers.


Assuntos
Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/psicologia , Transtornos Mentais/epidemiologia , Pneumonia Viral/epidemiologia , Adaptação Psicológica , Brasil/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Humanos , Saúde Mental , Programas Nacionais de Saúde/organização & administração , Pandemias , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Estresse Psicológico/epidemiologia
8.
S Afr Med J ; 110(8): 747-750, 2020 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-32880299

RESUMO

Broader policy research and debate on the issues related to the planning of National Health Insurance (NHI) in South Africa (SA) need to be complemented by case studies to examine and understand the issues that will have to be dealt with at micro and macro levels. The objective of this article is to use caesarean section (CS) as a case study to examine the health systems challenges that NHI would need to address in order to ensure sustainability. The specific objectives are to: (i) provide an overview of the key clinical considerations related to CS; (ii) assess the CS rates in the SA public and private sectors; and (iii) use a health systems framework to examine the drivers of the differences between the public and private sectors and to identify the challenges that the proposed NHI would need to address on the road to implementation.


Assuntos
Cesárea/estatística & dados numéricos , Programas Nacionais de Saúde , Feminino , Planejamento em Saúde , Humanos , Gravidez , Setor Privado/estatística & dados numéricos , Setor Público/estatística & dados numéricos , África do Sul
10.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(4): 414-418, 2020 Jun 11.
Artigo em Chinês | MEDLINE | ID: mdl-32935520

RESUMO

OBJECTIVE: To analyze the advantages, disadvantages, opportunities and challenges for schistosomiasis elimination in Laos, so as to propose the corresponding healthy policies and suggestions. METHODS: A SWOT analysis was performed to analyze the strength, weakness, opportunity and threat for the schistosomiasis elimination program in Laos, and the corresponding policy suggestions were proposed. RESULTS: The national schistosomiasis elimination program of Laos receives governmental emphases and great supports. A strategy based on mass drug administration was proposed and a sentinel site-bases surveillance system has been built for schistosomiasis elimination in Laos; however, there are several challenges for the national schistosomiasis elimination program in Laos, including insufficient financial supports, inadequate professional capability, weak schistosomiasis control awareness in community populations and difficulty in vector control. CONCLUSIONS: Persistent governmental leadership, increasing financial supports, strengthening professional team building and improving schistosomiasis control awareness in community populations are required to facilitate the progress towards schistosomiasis elimination in Laos.


Assuntos
Erradicação de Doenças , Programas Nacionais de Saúde , Esquistossomose , Erradicação de Doenças/normas , Humanos , Laos , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/normas , Controle de Pragas , Esquistossomose/prevenção & controle
11.
Artigo em Alemão | MEDLINE | ID: mdl-32897408

RESUMO

BACKGROUND: Estimating the number of persons tested for HIV in Germany is challenging. HIV testing can be reimbursed by statutory health insurance (SHI) under certain circumstances. This study aimed to use SHI physician claims data to determine the number of persons tested in the outpatient sector. METHODS: The Central Research Institute for Ambulatory Health Care in Germany (Zi) aggregated a dataset of persons tested for HIV among all SHI insurees. Descriptive analysis differentiated between screening and confirmatory HIV tests. Time trends were explored using linear regression. Insurees with confirmatory tests were compared to newly diagnosed HIV (ndHIV) cases. RESULTS: Between 2010 and 2015, 1.7% of insurees were annually screened by SHI physicians. Screening tests increased significantly between 2010 and 2015. Among persons screened, 82.5% were women and of those 81.2% had a screening test during pregnancy. Confirmatory tests were performed on 16,034 insurees (0.3% with screening test; 51.2% men). A total of 18,446 (82.8% men) ndHIV cases were notified between 2010 and 2015. CONCLUSIONS: For the first time, the number of persons with HIV tests in the SHI sector was estimated. The high number of screened women is due to tests during pregnancy. The higher number of ndHIV cases indicates an unknown number of persons tested at other testing sites.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Pacientes Ambulatoriais , Assistência à Saúde , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Programas Nacionais de Saúde
13.
Medicine (Baltimore) ; 99(32): e21495, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769885

RESUMO

The aim of this study was to clarify the relationship between doctor-shopping behavior and clinical conditions, and to clearly outline the effects of both the number of clinic visits and the number of doctor changes on patients' health conditions. Data from January 1, 2000 to December 31, 2004 was collected from the National Health Insurance Research Database in Taiwan. After randomly selecting one million people, we extracted 5-year longitudinal data, about the number of clinic visits, number of doctor changes, and changes in self-health status for each patient with diabetes over the age of 18. We developed a relationship among the variables by using the generalized estimating equation. The results revealed that the number of clinic visits on the change of health status is a U curve, suggesting that health condition could be optimal with an appropriate number of clinic visits. The effect of the number of doctor changes is linearly correlated with health deterioration. The results suggest that disease conditions can only be controlled with an adequate number of clinic visits. Excessively frequent clinic visits are not only unfavorable to patients' health status but are also wasteful of limited medical resources. For diabetic mellitus patients, the more they change doctors, the worse their health status. All of these results are important for patients to stay healthy and to save medical resources.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Diabetes Mellitus/terapia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Médicos/estatística & dados numéricos , Adulto , Assistência Ambulatorial/psicologia , Bases de Dados Factuais , Diabetes Mellitus/psicologia , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Estudos Retrospectivos , Taiwan
14.
Lancet Diabetes Endocrinol ; 8(10): 823-833, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32798471

RESUMO

BACKGROUND: Diabetes has been associated with increased COVID-19-related mortality, but the association between modifiable risk factors, including hyperglycaemia and obesity, and COVID-19-related mortality among people with diabetes is unclear. We assessed associations between risk factors and COVID-19-related mortality in people with type 1 and type 2 diabetes. METHODS: We did a population-based cohort study of people with diagnosed diabetes who were registered with a general practice in England. National population data on people with type 1 and type 2 diabetes collated by the National Diabetes Audit were linked to mortality records collated by the Office for National Statistics from Jan 2, 2017, to May 11, 2020. We identified the weekly number of deaths in people with type 1 and type 2 diabetes during the first 19 weeks of 2020 and calculated the percentage change from the mean number of deaths for the corresponding weeks in 2017, 2018, and 2019. The associations between risk factors (including sex, age, ethnicity, socioeconomic deprivation, HbA1c, renal impairment [from estimated glomerular filtration rate (eGFR)], BMI, tobacco smoking status, and cardiovascular comorbidities) and COVID-19-related mortality (defined as International Classification of Diseases, version 10, code U07.1 or U07.2 as a primary or secondary cause of death) between Feb 16 and May 11, 2020, were investigated by use of Cox proportional hazards models. FINDINGS: Weekly death registrations in the first 19 weeks of 2020 exceeded the corresponding 3-year weekly averages for 2017-19 by 672 (50·9%) in people with type 1 diabetes and 16 071 (64·3%) in people with type 2 diabetes. Between Feb 16 and May 11, 2020, among 264 390 people with type 1 diabetes and 2 874 020 people with type 2 diabetes, 1604 people with type 1 diabetes and 36 291 people with type 2 diabetes died from all causes. Of these total deaths, 464 in people with type 1 diabetes and 10 525 in people with type 2 diabetes were defined as COVID-19 related, of which 289 (62·3%) and 5833 (55·4%), respectively, occurred in people with a history of cardiovascular disease or with renal impairment (eGFR <60 mL/min per 1·73 m2). Male sex, older age, renal impairment, non-white ethnicity, socioeconomic deprivation, and previous stroke and heart failure were associated with increased COVID-19-related mortality in both type 1 and type 2 diabetes. Compared with people with an HbA1c of 48-53 mmol/mol (6·5-7·0%), people with an HbA1c of 86 mmol/mol (10·0%) or higher had increased COVID-19-related mortality (hazard ratio [HR] 2·23 [95% CI 1·50-3·30, p<0·0001] in type 1 diabetes and 1·61 [1·47-1·77, p<0·0001] in type 2 diabetes). In addition, in people with type 2 diabetes, COVID-19-related mortality was significantly higher in those with an HbA1c of 59 mmol/mol (7·6%) or higher than in those with an HbA1c of 48-53 mmol/mol (HR 1·22 [95% CI 1·15-1·30, p<0·0001] for 59-74 mmol/mol [7·6-8·9%] and 1·36 [1·24-1·50, p<0·0001] for 75-85 mmol/mol [9·0-9·9%]). The association between BMI and COVID-19-related mortality was U-shaped: in type 1 diabetes, compared with a BMI of 25·0-29·9 kg/m2, a BMI of less than 20·0 kg/m2 had an HR of 2·45 (95% CI 1·60-3·75, p<0·0001) and a BMI of 40·0 kg/m2 or higher had an HR of 2·33 (1·53-3·56, p<0·0001); the corresponding HRs for type 2 diabetes were 2·33 (2·11-2·56, p<0·0001) and 1·60 (1·47-1·75, p<0·0001). INTERPRETATION: Deaths in people with type 1 and type 2 diabetes rose sharply during the initial COVID-19 pandemic in England. Increased COVID-19-related mortality was associated not only with cardiovascular and renal complications of diabetes but, independently, also with glycaemic control and BMI. FUNDING: None.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Diabetes Mellitus Tipo 1/mortalidade , Diabetes Mellitus Tipo 2/mortalidade , Pneumonia Viral/mortalidade , Vigilância da População , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Infecções por Coronavirus/diagnóstico , Bases de Dados Factuais/tendências , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Programas Nacionais de Saúde/tendências , Pandemias , Pneumonia Viral/diagnóstico , Vigilância da População/métodos , Fatores de Risco , Adulto Jovem
15.
PLoS One ; 15(8): e0237320, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32780775

RESUMO

Ghana Health Service (GHS) has strengthened community-based surveillance (CBS) to facilitate early detection and rapid reporting of health events of all origins. Since June 2017, GHS has employed an event-based surveillance approach at the community level in a phased manner. CBS coverage has broadened from 2 to 30 districts across Ghana. Through this effort, capacity was built across all administrative levels in these districts to detect, report, triage, and verify signals, and to perform risk assessment and investigate events. Data were collected and analyzed during an evaluation of initial 2-district implementation in March 2018 and during expanded 30-district implementation in March 2019. Between September 2018 and March 2019, 317 health events were detected through CBS. These events included vaccine-preventable disease cases, acute hemorrhagic conjunctivitis outbreaks, clusters of unexpected animal deaths, and foodborne illness clusters. Eighty-nine percent of the 317 events were reported to district-level public health staff within 24 hours of detection at the community level, and 87% of all detected events were responded to within 48 hours of detection. CBS detected 26% of all suspected vaccine-preventable disease cases that were reported from implementing districts through routine disease surveillance. GHS strengthened CBS in Ghana to function as an early warning system for health events of all origins, advancing the Global Health Security Agenda.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Participação da Comunidade , Saúde Global , Implementação de Plano de Saúde/organização & administração , Programas Nacionais de Saúde/organização & administração , Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis/epidemiologia , Conjuntivite Hemorrágica Aguda/epidemiologia , Conjuntivite Hemorrágica Aguda/prevenção & controle , Surtos de Doenças/prevenção & controle , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/prevenção & controle , Gana , Humanos , Governo Local , Medição de Risco/métodos
16.
PLoS One ; 15(8): e0236984, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790677

RESUMO

BACKGROUND: Understanding of the facilitators and challenges to female condom (FC) uptake has been limited due to lack of evaluation of national FC programmes. SETTING: The FC has been an integral component of South Africa's (SA) HIV prevention programme for 20 years and is the largest government-funded FC programme worldwide. METHODS: The national FC evaluation used a mixed-methods approach and consisted of key informant interviews and a telephone survey in a national sample of public and non-public sites. A sub-sample of sites participated in client and provider interviews, and a self-administered client survey. A review of distribution statistics from South Africa's District Health Information System was also conducted. RESULTS: All 256 public-sector and 28 non-public-sector facilities reported having ever distributed FCs. Less than 5% of these facilities reported stock-outs and less than 3% reported they had a supply of expired female condoms. Systems for male condom (MC) and FC distribution were complementary, with similar ordering, delivery and reporting processes. FC promotion by providers (n = 278) varied with regard to FC training, whether attitudes about FCs influenced providers offer of FCs, and how they counselled clients about FCs. Of the 4442 self-administered client surveys in 133 facilities, similar proportions of women (15.4%) and men (15.2%) had ever used FCs. Although FCs were available at almost all sites surveyed, only two-thirds of clients were aware of their availability. CONCLUSION: Data highlight the role of providers as gatekeepers to FC access in public and non-public sectors and provide support for further FC programme expansion in SA and globally.


Assuntos
Preservativos Femininos , Adolescente , Adulto , Preservativos/estatística & dados numéricos , Preservativos/provisão & distribução , Preservativos Femininos/estatística & dados numéricos , Preservativos Femininos/provisão & distribução , Feminino , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Política de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Setor Privado , Setor Público , África do Sul , Inquéritos e Questionários , Adulto Jovem
18.
Gan To Kagaku Ryoho ; 47(8): 1158-1163, 2020 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-32829347

RESUMO

From June 2019, 2 different comprehensive genomic profiling(CGP)test panels were covered by National Health Insurance System in Japan. However, the indication of CGP was solid cancer patients refractory to standard chemotherapy or those without standard of care, while other countries indicate CGP to chemotherapy naIve advanced cancer patients. To be covered by National Health Insurance System, certified core hospital for genomic medicine should hold expert panel with affiliated hospitals. We develop a unique system for expert panel collaborated with SYSMEX Corporation to streamline medical staffs' effort. To provide precision medicine to cancer patients, we have to maximize the merit of CGP and solve several issues.


Assuntos
Neoplasias , Medicina de Precisão , Genômica , Humanos , Seguro Saúde , Japão , Programas Nacionais de Saúde
19.
Z Evid Fortbild Qual Gesundhwes ; 155: 1-10, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32861615

RESUMO

INTRODUCTION: Within the statutory health insurance system of the Federal Republic of Germany, a system of quality assurance has been implemented and operationalised through the measurement of quality indicators. For breast surgery, these quality indicators are mainly based on recommendations of the German clinical guideline for screening, diagnosis, therapy and follow-up of breast cancer. The 2018 update of this guideline includes a new chapter on breast cancer in men. The aim of this analysis is to examine whether male and female patients with breast cancer are treated equally where appropriate and recommended by the clinical guideline, as measured by the quality indicators. METHOD: Data of ten quality assurance indicators were analysed, for each indicator separately, stratified by sex and pooled over a 5-year period to gain statistical power. This dataset constitutes the largest data pool of men with surgical interventions for breast neoplasm in Germany. Indicator results were then compared between male and female cases. Additional subgroup analyses were carried out for two quality indicators with substantial outcome difference between male and female cases in order to detect possible differences in the treatment of breast cancer between different medical departments. RESULTS: The database of the ten quality assurance indicators comprised 551,221 patients (546,324 females and 4,897 males) between 2014 and 2018. Pooled data of nine quality indicators (QIs) showed statistically significant outcome differences between male and female cases. In spite of pooling, the male sample size of four QIs was too small to allow for statistically reliable comparisons between male and female patients. Outcome differences in the remaining five QIs may, on the one hand, be explained by anatomical differences and different extent of the surgery, and on the other hand they confirm international data for lower HER2-positivity rates in male breast cancer patients. However, two process indicators, aiming at pretherapeutic biopsy and sentinel lymph node biopsy in invasive breast cancer recommended by the clinical guideline, show substantial differences of more than 6 percentage points between the sexes: although recommended by the clinical guideline, both procedures are carried out less often in male cases. Further analysis regarding the medical departments that recorded the treatment revealed that risk for non-adherence to guideline recommendation was high if treatment took place in non-gynaecological departments. Compared to gynaecological departments, procedures such as pretherapeutic biopsy and sentinel lymph node biopsy were carried out less frequently if cases were documented to be handled by surgery or plastic surgery departments. DISCUSSION AND CONCLUSION: Analysis of breast surgery quality indicators reveals a lower level of adherence to guideline recommendations for men with breast cancer compared to women in some aspects of the guideline, as measured by statutory quality indicators in breast surgery. Male breast cancer might be a rare disease, but nevertheless, awareness-rising is needed in diagnostics, treatment and interdisciplinarity in order to avoid inequality between the sexes.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/terapia , Bases de Dados Factuais , Feminino , Alemanha , Humanos , Masculino , Programas Nacionais de Saúde
20.
Can J Public Health ; 111(4): 473-476, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32767269

RESUMO

The fear, grief, social isolation, and financial and occupational losses from COVID-19 have created a mental health crisis. Ontario's response highlights the shortcomings of its physician-only public healthcare system that limits public access to appropriate and sustainable mental healthcare. Specifically, Ontario's attempt to rapidly expand mental healthcare access in response to COVID-19 includes new Ontario Health Insurance Program (OHIP) billing codes that enable physicians to provide telephonic trauma counselling and patient self-serve online tools while psychologist and other registered mental health provider services have been largely left out of the provincial response. Why? Non-physician mental health providers operate outside of the provincial healthcare infrastructure, including the provincial payer (i.e., OHIP) that facilitated the provincial physician response. A physician-centric mental healthcare system limits public access to quality, sustainable, evidence-based mental health services because most physicians do not have the capacity, training, or desire to provide mental health services. To improve public access to needed mental health services, provinces should integrate psychologists and other registered mental health providers directly into their public health insurance systems. Integrated providers can be strategically and sustainably mobilized to respond to COVID-19 and future mental health crises.


Assuntos
Infecções por Coronavirus/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Programas Nacionais de Saúde/organização & administração , Pneumonia Viral/psicologia , Infecções por Coronavirus/epidemiologia , Humanos , Ontário/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia
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