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1.
Texto & contexto enferm ; 29: e20180104, Jan.-Dec. 2020. graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1101981

RESUMO

ABSTRACT Objective: To identify work aspects that generate satisfaction for the professionals who work in the Family Health Strategy. Method: This was a qualitative, descriptive study that involved five geographical regions of Brazil, and 27 Family Health Teams from six municipalities. The data were collected from 76 health professionals using semi-structured interviews, and were analyzed articulating the three phases of content analysis using Atlas.ti software resources. Results: The findings showed 129 statement excerpts, with 14 codes, grouped into three categories related to satisfaction. The category, Job Identification and Family Health Strategy Principles, represented 40.3%, with the codes: team work, job affinity, health model, completeness of care, and longitudinality of care. The category, Relationship with Family Health Strategy patients, represented 32.6%, with the following codes: bonding with patient, resoluteness of care, patient satisfaction, and patient care. Finally, the category, Professional and Working Aspects related to the Family Health Strategy, represented 27.1%, with the following codes: relationship with professionals, work recognition, enjoying the profession, team organization, and employment relationship. Conclusion: Professional satisfaction is associated with the work principles of the Family Health Strategy, and with the relationships that are established between patients, professionals and health management. It also has a subjective dimension, with a strong relationship with characteristics of the work process, how it is organized, and under what conditions and relationships this work occurs.


RESUMEN Objetivo: Identificar los aspectos del trabajo, que generan satisfacción en los profesionales de salud que actúan en la estrategia de salud familiar. Método: Estudio cualitativo que incluye 5 regiones geográficas del Brasil, 27 equipos de salud familiar de 6 municipios. Los datos fueron obtenidos, a través de 76 profesionales de salud por medio de entrevistas semi estructuradas y analizados, articulando las tres frases de Análisis del Contenido y los recursos del software Atlas ti. Resultados: Seleccionaron 129 extractos de conversaciones, 14 códigos agrupados en 3 categorías relacionadas a la satisfacción. La categoría Identificación con el trabajo y principios de la Estrategia salud de la familia, representó 40,3%; tuvo los códigos: trabajo en equipo, afinidad con el trabajo, modelo de salud, integralidad de la asistencia, longitudinalidad del cuidado. La categoría, Relación con los Usuarios en la Estrategia salud de la familia, representó el 32,6% con los siguientes códigos: vinculo con el usuario, resolutividad de la asistencia, satisfacción del usuario y asistencia al usuario. Finalmente, la categoría Aspectos Profesionales y de Trabajo, relacionados con la estrategia salud de la familia, representó 27,1% con los siguientes códigos: Relación con los profesionales, reconocimiento del trabajo, gusto por la profesión, organización del equipo, vinculo del trabajo. Conclusión: La satisfacción del profesional está asociada a los principios del trabajo en la Estrategia Salud de la Familia, a las relaciones que se establecen entre usuarios, profesionales y gestión de la salud. También posee una dimensión subjetiva, fuertemente relacionada con las características del proceso de trabajo, como se encuentra organizado, sus condiciones y relaciones.


RESUMO Objetivo: Identificar os aspectos do trabalho que são geradores de satisfação para os profissionais que atuam na Estratégia Saúde da Família. Método: Estudo qualitativo do tipo descritivo que envolveu 5 regiões geográficas do Brasil, 27 equipes de Saúde da Família de 6 municípios. Os dados foram coletados com 76 profissionais de saúde por meio de entrevistas semiestruturadas e analisados articulando as três fases da Análise de Conteúdo e dos recursos do software Atlas.ti. Resultados: Indicaram 129 trechos de falas e 14 códigos agrupados em 3 categorias relacionadas à satisfação. A categoria Identificação com o trabalho e princípios da Estratégia Saúde da Família representou 40,3% e teve os códigos: trabalho em equipe, afinidade com o trabalho, modelo de saúde, integralidade da assistência, longitudinalidade do cuidado. A categoria relações com os usuários na Estratégia Saúde da Família representou 32,6% com os seguintes códigos: vínculo com o usuário, resolutividade da assistência, satisfação do usuário, assistência ao usuário. Por fim, a categoria aspectos profissionais e trabalhistas relacionados à Estratégia Saúde da Família, representou 27,1% com os seguintes códigos: relação com os profissionais, reconhecimento do trabalho, gostar da profissão, organização da equipe, vínculo de trabalho. Conclusão: A satisfação profissional está associada aos princípios do trabalho na Estratégia Saúde da Família, as conexões que se estabelecem entre usuários, profissionais e gestão em saúde. Possui ainda uma dimensão subjetiva, possuindo forte vínculo com características do processo de trabalho, como esse é organizado e sob que condições e relações o trabalho acontece


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Atenção Primária à Saúde , Condições de Trabalho , Estratégia Saúde da Família , Pesquisa Qualitativa , Satisfação no Emprego , Equipe de Assistência ao Paciente , Trabalho , Sistema Único de Saúde , Saúde da Família , Pessoal de Saúde , Continuidade da Assistência ao Paciente , Gestão em Saúde , Assistência ao Paciente , Recursos em Saúde
2.
PLoS One ; 15(11): e0240651, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33147213

RESUMO

The general public is subject to triage policies that allocate scarce lifesaving resources during the COVID-19 pandemic, one of the worst public health emergencies in the past 100 years. However, public attitudes toward ethical principles underlying triage policies used during this pandemic are not well understood. Three experiments (preregistered; online samples; N = 1,868; U.S. residents) assessed attitudes toward ethical principles underlying triage policies. The experiments evaluated assessments of utilitarian, egalitarian, prioritizing the worst-off, and social usefulness principles in conditions arising during the COVID-19 pandemic, involving resource scarcity, resource reallocation, and bias in resource allocation toward at-risk groups, such as the elderly or people of color. We found that participants agreed with allocation motivated by utilitarian principles and prioritizing the worst-off during initial distribution of resources and disagreed with allocation motivated by egalitarian and social usefulness principles. At reallocation, participants agreed with giving priority to those patients who received the resources first. Lastly, support for utilitarian allocation varied when saving the greatest number of lives resulted in disadvantage for at-risk or historically marginalized groups. Specifically, participants expressed higher levels of agreement with policies that shifted away from maximizing benefits to one that assigned the same priority to members of different groups if this mitigated disadvantage for people of color. Understanding these attitudes can contribute to developing triage policies, increase trust in health systems, and assist physicians in achieving their goals of patient care during the COVID-19 pandemic.


Assuntos
Atitude , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Recursos em Saúde/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Adolescente , Adulto , Idoso , Emergências/psicologia , Feminino , Alocação de Recursos para a Atenção à Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública/estatística & dados numéricos , Opinião Pública , Triagem/estatística & dados numéricos , Adulto Jovem
3.
Med. U.P.B ; 39(2): 11-16, 21/10/2020. tab, mapas
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1123559

RESUMO

Objetivo: Caracterizar la atención de accidentes de tránsito en la ciudad de Medellín para obtener una imagen general de la situación de salud en este contexto. Metodología: Estudio descriptivo observacional, con intención analítica, de fuentes secundarias de información, en pacientes con edad mayor o igual a 16 años, atendidos por el personal 123, módulo salud, víctimas de accidentes de tránsito en Medellín. Resultados: Un total de 3 829 individuos sufrieron accidente de tránsito entre octubre y diciembre del 2018 según los criterios del estudio. De estos, el 63.1% de sexo masculino, con edad media de 34 años. La zona con mayor demanda de atención prehospitalaria fue la comuna 10 de la ciudad (La Candelaria) y la mayoría de los afectados por los accidentes lo fueron en calidad de conductor, 64%, y en un 75% de los casos, el vehículo involucrado fue una motocicleta. Solo el 26.5% de los pacientes fueron dados de alta en la escena. Las extremidades fueron las zonas corporales de mayor compromiso, en un 78.2% de los episodios, seguidas por el cráneo y la cara, con un 26.8%. Conclusiones: Es evidente la necesidad de la ciudad de implementar y evaluar el impacto de estrategias dinámicas que permitan un manejo eficiente de los recursos, que priorice las zonas y grupos demográficos de mayor riesgo y la articulación de la disposición de pacientes dentro de la cadena de atención, según los tipos más frecuentes de lesiones.


Objective: To characterize the traffic accident attention in the city of Medellín in order to obtain a general image of the health situation in this context. Methodology: Observational descriptive study, with analytic intent, of secondary information sources in patients with age higher or equal to 16 years of age, served by the 123 personnel, health module, who were victims of traffic accidents in Medellín. Results: A total of 3 829 individuals suffered traffic accidents between October and December of 2018 according to the study criteria. Of these, 63.1% were males, with an average age of 34 years old. The zone with the highest demand of pre-hospital attention was the Comuna 10 of the city (known as La Candelaria) and most of the affected by the accidents were as drivers, 64%, and 75% of the cases, the vehicle involved was a motorcycle. Only 26.5% of the patients were discharged on the scene. The extremities were the body zones with the highest compromise in 78.2% of the episodes, followed by the cranium and the face, with 26.8%. Conclusions: It is evident that the city needs to implement and evaluate the impact of dynamic strategies that enable an efficient management of the resources that prioritizes the zones and demographic groups with the highest risk and the articulation of the disposition of patients within the attention chain, according to the most frequent types of injuries.


Objetivo: Caracterizar a atenção de acidentes de trânsito na cidade de Medellín para obter uma imagem geral da situação de saúde neste contexto. Metodologia: Estudo descritivo observacional, com intenção analítica, de fontes secundárias de informação, em pacientes com idade maior ou igual a 16 anos, atendidos pelo pessoal 123, módulo saúde, vítimas de acidentes de trânsito em Medellín. Resultados: Um total de 3 829 indivíduos sofreram acidente de trânsito entre outubro e dezembro de 2018 segundo os critérios do estudo. Destes, 63.1% de sexo masculino, com idade média de 34 anos. A região com maior demanda de atenção pré-hospitalar foi a comuna 10 da cidade (La Candelaria) e a maioria dos afetados pelos acidentes foram em qualidade de condutor, 64%, e num 75% dos casos, o veículo envolvido foi uma motocicleta. Só 26.5% dos pacientes foram dados de alta na cena. As extremidades foram as zonas corporais de maior compromisso, em 78.2% dos episódios, seguidas pelo crâneo e a cara, com um 26.8%. Conclusões: É evidente a necessidade da cidade de implementar e avaliar o impacto de estratégias dinâmicas que permitam um manejo eficiente dos recursos, que priorize as zonas e grupos demográficos de maior risco e a articulação da disposição de pacientes dentro da cadeia de atenção, segundo os tipos mais frequentes de lesões.


Assuntos
Humanos , Acidentes de Trânsito , Assistência Pré-Hospitalar , Extremidades , Traumatismos Craniocerebrais , Recursos em Saúde
4.
Emergencias ; 32(5): 320-331, 2020 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33006832

RESUMO

OBJECTIVES: To estimate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the organization of Spanish hospital emergency departments (EDs). To explore differences between Spanish autonomous communities or according to hospital size and disease incidence in the area. MATERIAL AND METHODS: Survey of the heads of 283 EDs in hospitals belonging to or affiliated with Spain's public health service. Respondents evaluated the pandemic's impact on organization, resources, and staff absence from work in March and April 2020. Assessments were for 15-day periods. Results were analyzed overall and by autonomous community, hospital size, and local population incidence rates. RESULTS: A total of 246 (87%) responses were received. The majority of the EDs organized a triage system, first aid, and observation wards; areas specifically for patients suspected of having COVID-19 were newly set apart. The nursing staff was increased in 83% of the EDs (with no subgroup differences), and 59% increased the number of physicians (especially in large hospitals and locations where the COVID-19 incidence was high). Diagnostic tests for the severe acute respiratory syndrome coronavirus 2 were the resource the EDs missed most: 55% reported that tests were scarce often or very often. Other resources reported to be scarce were FPP2 and FPP3 masks (38% of the EDs), waterproof protective gowns (34%), and space (32%). More than 5% of the physicians, nurses, or other emergency staff were on sick leave 20%, 19%, and 16% of the time. These deficiencies were greatest during the last half of March, except for tests, which were most scarce in the first 15 days. Large hospital EDs less often reported that diagnostic tests were unavailable. In areas where the COVID-19 incidence was higher, the EDs reported higher rates of staff on sick leave. Resource scarcity differed markedly by autonomous community and was not always associated with the incidence of COVID-19 in the population. CONCLUSION: The COVID-19 pandemic led to organizational changes in EDs. Certain resources became scarce, and marked differences between autonomous communities were detected.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde , Pandemias , Pneumonia Viral/epidemiologia , Absenteísmo , Adulto , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Surtos de Doenças , Serviço Hospitalar de Emergência/organização & administração , Recursos em Saúde/provisão & distribução , Necessidades e Demandas de Serviços de Saúde , Mão de Obra em Saúde/estatística & dados numéricos , Número de Leitos em Hospital , Hospitais Públicos/organização & administração , Hospitais Públicos/estatística & dados numéricos , Humanos , Incidência , Recursos Humanos em Hospital/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Alocação de Recursos , Síndrome do Desconforto Respiratório do Adulto/diagnóstico , Síndrome do Desconforto Respiratório do Adulto/etiologia , Espanha/epidemiologia , Triagem/organização & administração
5.
Pan Afr Med J ; 37: 28, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33062129

RESUMO

COVID-19 is a rapidly growing pandemic that has grown from a few cases in Wuhan, China to millions of infections and hundreds of thousands of deaths worldwide within a few months. Sub-Saharan Africa is not spared. Radiology has a key role to play in the diagnosis and management of COVID-19 as literature from Wuhan and Italy demonstrates. We therefore share some critical knowledge and practice areas for radiological suspicion and diagnosis. In addition, emphasis on how guarding against healthcare acquired infections (HAIs) by applying "red" and "green" principle is addressed. Given that pandemics such as COVID-19 can worsen the strain on the scantily available radiological resources in this region, we share some practical points that can be applied to manage these precious resources also needed for other essential services. We have noted that radiology does not feature in many main COVID-19 guidelines, regionally and internationally. This paper therefore suggests areas of collaboration for radiology with other clinical and management teams. We note from our local experience that radiology can play a role in COVID-19 surveillance.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Área de Atuação Profissional/tendências , Radiologia/organização & administração , África ao Sul do Saara/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Surtos de Doenças/ética , Surtos de Doenças/prevenção & controle , Recursos em Saúde , Humanos , Conhecimento , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia
6.
Am Surg ; 86(9): 1057-1061, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33049163

RESUMO

BACKGROUND: Timely access to emergency general surgery services, including trauma, is a critical aspect of patient care. This study looks to identify resource availability at small rural hospitals in order to improve the quality of surgical care. METHODS: Forty-five nonteaching hospitals in West Virginia were divided into large community hospitals with multiple specialties (LCHs), small community hospitals with fewer specialties (SCHs), and critical access hospitals (CAHs). A 58-question survey on optimal resources for surgery was completed by 1 representative surgeon at each hospital. There were 8 LCHs, 18 SCHs, and 19 CAHs with survey response rates of 100%, 83%, and 89%, respectively. RESULTS: One hundred percent of hospitals surveyed had respiratory therapy and ventilator support, computerized tomography (CT) scanner and ultrasound, certified operating rooms, lab support, packed red blood cells (PRBC), and FFP accessible 24/7. Availability of cryoprecipitate, platelets, tranexamic acid (TXA), and prothrombin complex concentrate (PCC) decreased from LCHs to CAHs. The majority had board-certified general surgeons; however, only 86% LCHs, 53% SCHs, and 50% CAHs had advanced trauma life support (ATLS) certification. One hundred percent of LCHs had operating room (OR) crew on call within 30 minutes, emergency cardiovascular equipment, critical care nursing, on-site pathologist, and biologic/synthetic mesh, whereas fewer SCHs and CAHs had these resources. One hundred percent of LCHs and SCHs had anesthesia availability 24/7 compared to 78% of CAHs. DISCUSSION: Improving access to the aforementioned resources is of utmost importance to patient outcomes. This will enhance rural surgical care and decrease emergency surgical transfers. Further education and research are necessary to support and improve rural trauma systems.


Assuntos
Recursos em Saúde/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Hospitais Rurais/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Humanos , Inquéritos e Questionários , Estados Unidos , West Virginia
7.
Rev Sci Tech ; 39(2): 373-384, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33046938

RESUMO

Preparedness for an animal emergency event reduces a country's economic and production losses and decreases animal disease threats to neighbouring countries. Investing in animal disease preparedness reduces economic expenditures during an emergency as well as in recovery. An essential component of animal disease preparedness is a national contingency plan that is fit for purpose. This useful document should be frequently updated and can be modified with new information from self-assessments and after-action reports, which should identify resource needs and improvements to be made. National contingency plans are recommended in global international guidance and by animal health and veterinary organisations. Despite this, some countries lack national contingency plans that are fit for purpose, or the resources to implement them. This review concentrates on trends in national contingency planning around the world. In 2018 and 2019, the authors surveyed existing global animal disease contingency plans. Of the 181 Members of the World Organisation for Animal Health (OIE), 163 were reported to have some form of national contingency plan. (Over the course of the review from 2018 to 2019, the 182nd Member joined the OIE. This review examines only the 181 that were Members when the survey began.) The authors review current global animal emergency preparedness and discuss the gaps that have been identified. They discuss global trends, examining developing concepts and novel approaches that may aid improvements in global national contingency planning and enhance the global capacity to prepare for animal disease where gaps exist.


Assuntos
Doenças dos Animais , Recursos em Saúde , Doenças dos Animais/prevenção & controle , Animais , Saúde Global
8.
Hastings Cent Rep ; 50(5): 17-19, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33095490

RESUMO

The Covid-19 pandemic has brought about renewed conversation about equality and equity in the distribution of medical resources. Much of the recent conversation has focused on creating and implementing policies in times of crisis when resources are exhausted. Depending on how the pandemic develops, some communities may implement crisis measures, but many health care facilities are currently experiencing shortages of staff and materials even if the facilities have not implemented crisis standards. There is a need for shared conversation about equality and equity in these times of contingency between conventional and crisis medicine. To respond well to these challenges, I recommend that institutions rely on policy, professional education, and ethics consultation. As is the case with crisis policies, creating contingency policies requires that health care professionals decide on how, specifically, to achieve equity. A policy is only as effective as its implementation; therefore, institutions should invest in context-specific education on contingency policies. Finally, ethics consultation should be available for questions that contingency policies cannot address.


Assuntos
Infecções por Coronavirus , Medicina de Desastres , Alocação de Recursos para a Atenção à Saúde , Equidade em Saúde , Recursos em Saúde/provisão & distribução , Disparidades em Assistência à Saúde , Pandemias , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Medicina de Desastres/ética , Medicina de Desastres/normas , Consultoria Ética , Alocação de Recursos para a Atenção à Saúde/ética , Alocação de Recursos para a Atenção à Saúde/métodos , Política de Saúde , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Alocação de Recursos
10.
PLoS One ; 15(10): e0238842, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33091015

RESUMO

BACKGROUND: Under the pandemic conditions created by the novel coronavirus of 2019 (COVID-19), physicians have faced difficult choices allocating scarce resources, including but not limited to critical care beds and ventilators. Past experiences with severe acute respiratory syndrome (SARS) and current reports suggest that making these decisions carries a heavy emotional toll for physicians around the world. We sought to explore Canadian physicians' preparedness and attitudes regarding resource allocation decisions. METHODS: From April 3 to April 13, 2020, we conducted an 8-question online survey of physicians practicing in the region of Ottawa, Ontario, Canada, organized around 4 themes: physician preparedness for resource rationing, physician preparedness to offer palliative care, attitudes towards resource allocation policy, and approaches to resource allocation decision-making. RESULTS: We collected 219 responses, of which 165 were used for analysis. The majority (78%) of respondents felt "somewhat" or "a little prepared" to make resource allocation decisions, and 13% felt "not at all prepared." A majority of respondents (63%) expected the provision of palliative care to be "very" or "somewhat difficult." Most respondents (83%) either strongly or somewhat agreed that there should be policy to guide resource allocation. Physicians overwhelmingly agreed on certain factors that would be important in resource allocation, including whether patients were likely to survive, and whether they had dementia and other significant comorbidities. Respondents generally did not feel confident that they would have the social support they needed at the time of making resource allocation decisions. INTERPRETATION: This rapidly implemented survey suggests that a sample of Canadian physicians feel underprepared to make resource allocation decisions, and desire both more emotional support and clear, transparent, evidence-based policy.


Assuntos
Atitude do Pessoal de Saúde , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Tomada de Decisões , Alocação de Recursos para a Atenção à Saúde , Médicos/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Adulto , Idoso , Infecções por Coronavirus/virologia , Estudos Transversais , Feminino , Recursos em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Cuidados Paliativos , Pandemias , Pneumonia Viral/virologia , Angústia Psicológica , Inquéritos e Questionários
11.
PLoS One ; 15(10): e0240348, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33052956

RESUMO

Coronavirus disease 2019 (COVID-19) was first identified in December 2019 in Wuhan, China as an infectious disease, and has quickly resulted in an ongoing pandemic. A data-driven approach was developed to estimate medical resource deficiencies due to medical burdens at county level during the COVID-19 pandemic. The study duration was mainly from February 15, 2020 to May 1, 2020 in the U.S. Multiple data sources were used to extract local population, hospital beds, critical care staff, COVID-19 confirmed case numbers, and hospitalization data at county level. We estimated the average length of stay from hospitalization data at state level, and calculated the hospitalized rate at both state and county level. Then, we developed two medical resource deficiency indices that measured the local medical burden based on the number of accumulated active confirmed cases normalized by local maximum potential medical resources, and the number of hospitalized patients that can be supported per ICU bed per critical care staff, respectively. Data on medical resources, and the two medical resource deficiency indices are illustrated in a dynamic spatiotemporal visualization platform based on ArcGIS Pro Dashboards. Our results provided new insights into the U.S. pandemic preparedness and local dynamics relating to medical burdens in response to the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Alocação de Recursos para a Atenção à Saúde/estatística & dados numéricos , Recursos em Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Análise Espaço-Temporal , Infecções por Coronavirus/economia , Efeitos Psicossociais da Doença , Humanos , Pandemias/economia , Pneumonia Viral/economia , Estados Unidos
13.
Unfallchirurg ; 123(11): 856-861, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33079219

RESUMO

INTRODUCTION: In addition to the advantages for patients and physicians, the progression of digitalization will also have economic implications for healthcare systems in toto worldwide. The integration of digital innovations enables healthcare institutions to transform their current activities and processes and to create a new form of patient care. IMPORTANT ECONOMIC TOPICS OF DIGITALIZATION: Using digital applications process optimization can be achieved by increased efficiency and therefore a reduction in costs in the healthcare system. Improved processes can in turn achieve an increase in quality in the treatment of patients. Simultaneously, a duplication of investigations can be avoided through digital interfaces and the communication among the healthcare professions involved can be improved, which would result in a conservation of resources. Finally, these influences can lead to more precision in medicine, acceleration of healing processes and represent an advantage for all parties involved. PERSPECTIVES: Economic redistribution due to digitalization of medicine will become increasingly apparent in the future. Ethical considerations as well as data protection will be important topics. At the same time investments and digital innovations must be sponsored by the government and industry. Scientific studies are necessary to secure the evidence of new methods for practice in orthopedics and trauma surgery.


Assuntos
Procedimentos Ortopédicos , Ortopedia , Assistência à Saúde , Recursos em Saúde , Humanos , Ortopedia/economia , Assistência ao Paciente
14.
PLoS One ; 15(10): e0241027, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33085729

RESUMO

As the number of cases of COVID-19 continues to grow, local health services are at risk of being overwhelmed with patients requiring intensive care. We develop and implement an algorithm to provide optimal re-routing strategies to either transfer patients requiring Intensive Care Units (ICU) or ventilators, constrained by feasibility of transfer. We validate our approach with realistic data from the United Kingdom and Spain. In the UK, we consider the National Health Service at the level of trusts and define a 4-regular geometric graph which indicates the four nearest neighbours of any given trust. In Spain we coarse-grain the healthcare system at the level of autonomous communities, and extract similar contact networks. Through random search optimisation we identify the best load sharing strategy, where the cost function to minimise is based on the total number of ICU units above capacity. Our framework is general and flexible allowing for additional criteria, alternative cost functions, and can be extended to other resources beyond ICU units or ventilators. Assuming a uniform ICU demand, we show that it is possible to enable access to ICU for up to 1000 additional cases in the UK in a single step of the algorithm. Under a more realistic and heterogeneous demand, our method is able to balance about 600 beds per step in the Spanish system only using local sharing, and over 1300 using countrywide sharing, potentially saving a large percentage of these lives that would otherwise not have access to ICU.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Recursos em Saúde/provisão & distribução , Modelos Teóricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Algoritmos , Infecções por Coronavirus/virologia , Cuidados Críticos , Número de Leitos em Hospital , Humanos , Unidades de Terapia Intensiva/provisão & distribução , Pandemias , Transferência de Pacientes , Pneumonia Viral/virologia , Espanha/epidemiologia , Reino Unido/epidemiologia , Ventiladores Mecânicos/provisão & distribução
18.
Rev Epidemiol Sante Publique ; 68(5): 302-305, 2020 Sep.
Artigo em Francês | MEDLINE | ID: mdl-32948360

RESUMO

Following the onset of the global COVID-19 pandemic and the alerts issued by the World Health Organization, for several months attention has been focused on Africa as a potentially severely endangered continent. A sizable number of African countries, mainly low and middle income, suffer from limited available resources, especially in critical care, and COVID-19 is liable to overwhelm their already fragile health systems. To effectively manage what is shaping up as a multidimensional crisis, the challenge unquestionably goes beyond the necessary upgrading of public health infrastructures. It is also a matter of anticipating and taking timely action with regard to factors that may mitigate the propagation of SARS-CoV2 and thereby cushion the shock of the pandemic on the African continent. While some of these factors are largely unmanageable (climate, geography…), several others (socio-cultural, religious, audio-visual, and potentially political…) could be more or less effectively dealt with by African governments and populations.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , África/epidemiologia , Vacina BCG/uso terapêutico , Betacoronavirus/fisiologia , Clima , Infecções por Coronavirus/economia , Infecções por Coronavirus/terapia , Recursos em Saúde/organização & administração , Recursos em Saúde/estatística & dados numéricos , Recursos em Saúde/provisão & distribução , História do Século XX , História do Século XXI , Humanos , Controle de Infecções/economia , Controle de Infecções/história , Controle de Infecções/organização & administração , Controle de Infecções/normas , Pandemias/economia , Pandemias/estatística & dados numéricos , Pneumonia Viral/economia , Pneumonia Viral/terapia , Áreas de Pobreza , Papel Profissional , Saúde Pública/economia , Saúde Pública/história , Saúde Pública/estatística & dados numéricos , Mídias Sociais , Responsabilidade Social , Fatores Socioeconômicos , Organização Mundial da Saúde
19.
Respir Care ; 65(9): 1378-1381, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32879035

RESUMO

COVID-19 is devastating health systems globally and causing severe ventilator shortages. Since the beginning of the outbreak, the provision and use of ventilators has been a key focus of public discourse. Scientists and engineers from leading universities and companies have rushed to develop low-cost ventilators in hopes of supporting critically ill patients in developing countries. Philanthropists have invested millions in shipping ventilators to low-resource settings, and agencies such as the World Health Organization and the World Bank are prioritizing the purchase of ventilators. While we recognize the humanitarian nature of these efforts, merely shipping ventilators to low-resource environments may not improve outcomes of patients and could potentially cause harm. An ecosystem of considerable technological and human resources is required to support the usage of ventilators within intensive care settings. Medical-grade oxygen supplies, reliable electricity, bioengineering support, and consumables are all needed for ventilators to save lives. However, most ICUs in resource-poor settings do not have access to these resources. Patients on ventilators require continuous monitoring from physicians, nurses, and respiratory therapists skilled in critical care. Health care workers in many low-resource settings are already exceedingly overburdened, and pulling these essential human resources away from other critical patient needs could reduce the overall quality of patient care. When deploying medical devices, it is vital to align the technological intervention with the clinical reality. Low-income settings often will not benefit from resource-intensive equipment, but rather from contextually appropriate devices that meet the unique needs of their health systems.


Assuntos
Infecções por Coronavirus/epidemiologia , Disparidades em Assistência à Saúde/economia , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pobreza/estatística & dados numéricos , Ventiladores Mecânicos/estatística & dados numéricos , Infecções por Coronavirus/terapia , Cuidados Críticos/organização & administração , Países em Desenvolvimento , Feminino , Recursos em Saúde/economia , Humanos , Unidades de Terapia Intensiva/organização & administração , Masculino , Nigéria , Pneumonia Viral/terapia , Nações Unidas , Ventiladores Mecânicos/economia , Organização Mundial da Saúde
20.
J Infect Dev Ctries ; 14(8): 838-843, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32903226

RESUMO

The novel coronavirus, SARS-CoV-2, which causes COVID-19, is seen world-wide. In developing countries, adequate health facilities and staff numbers are a concern. Ghana recorded its first 2 cases of COVID-19 on 12 March 2020. On 30 March 2020, a partial lockdown for 14 days was imposed and later extended along with other measures. By the end of the initial lockdown, 19 April 2020, an estimated 86,000 people had been traced and 68,591 tests performed. Of the 68,591 tests, there were 1,042 (1.5%) positive cases, 9 deaths, and 99 recoveries, with Ghana ranked number one among African countries in administering tests per million people. Ghana's effective track and trace system, as well as lockdown and other measures, have helped limit mortality with only 85 recorded deaths by 23 June 2020. Scientists from three facilities of the University of Ghana have also successfully sequenced the genomes of COVID-19 from 15 confirmed cases, and the Food and Drugs Authority in Ghana have also helped address shortages by fast-tracking certification of hand sanitizers and local production of 3.6 million standardized personal protective equipment. There has also been the development of prototypes of locally-manufactured mechanical ventilators to meet local need at intensive care units. Most people have also resorted to changing diets and the use of supplements to boost their immune system. Although initial results are encouraging, further research is needed to understand the dynamics of COVID-19 in Ghana and provide additional guidance.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/prevenção & controle , Gana/epidemiologia , Recursos em Saúde , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
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