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1.
Rev Med Liege ; 75(2): 125-129, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32030939

RESUMO

Cybersecurity is a real threat in almost all human activity domains. The health sector is a particular vulnerable target for cybercriminals. The first reason is obviously the financial incentive: the value of the content of a personal electronic health record, sold on the darknet, easily exceeds 1000 US dollars. The second reason is the aging Information Technology (IT) infrastructure we are dealing with, both in the hospital sector as well as in the vast majority of private medical practices. There is also an astonishing lack of environmental consciousness and an absence of a real safety culture in the medical profession. Very often there is neither an institutional basic training, nor a continuous and mandatory education in institutional cybersecurity. There is no single magic bullet to solve the problem, but various mechanisms can be put in place to mitigate the risks and limit the hazards as much as possible.


Assuntos
Segurança Computacional , Setor de Assistência à Saúde , Registros Eletrônicos de Saúde , Hospitais , Humanos
2.
Psychiatr Prax ; 47(1): 16-21, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31671469

RESUMO

OBJECTIVE: In Germany, the number of patients with dementia is expected to increase from 1.7 (2017) to more than 3 million people (2050). Preventive and therapeutic measures target at early stages of dementia such as mild cognitive impairment (MCI). Aim of the study is to compare prevalence rates of MCI and dementia over time. METHODS: The study was based on the complete nation-wide outpatient claims data of the panel doctors services according to §â€Š295 SGB V. We identified prevalent patients with MCI (PwMCI) and with dementia (PwD) in the years 2009 to 2016 treated by general practitioners or neuropsychiatric specialists. RESULTS: The number of prevalent PwMCI/PwD increased from 50,760/1,014,381 (2009) to 166,919/1,416,319 (2016) and the corresponding prevalence rates from 0.13 % to 0.42 % (MCI) and from 2.52 % to 3.55 % (dementia), resp. CONCLUSION: Despite the significant prevalence gain, the number of PwMCI identified in outpatient health claims data is much lower than the expected number of 2,8 to 3,7 million people at the population level. Therefore, we anticipate a further increase in the number of PwMCI being treated in the outpatient sector over the coming years.


Assuntos
Disfunção Cognitiva , Demência , Idoso , Disfunção Cognitiva/epidemiologia , Demência/epidemiologia , Feminino , Alemanha/epidemiologia , Setor de Assistência à Saúde , Humanos , Masculino , Testes Neuropsicológicos , Pacientes Ambulatoriais , Prevalência
3.
Gen Dent ; 68(1): 56-60, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31859664

RESUMO

The purpose of this retrospective, observational study was to characterize the amounts and types of healthcare industry payments made to dental care providers in 2017. Data were collected from the Open Payments database of the US Centers for Medicare & Medicaid Services. Dentists were classified as providing general services or services in 1 of 9 specialties recognized by the American Dental Association (prior to the recognition of dental anesthesiology). The value and nature of each payment made to providers were recorded, and descriptive statistics were calculated. Distributions across dental specialties were compared with analyses of variance. In 2017, US dentists received a total of 321,627 industry payments totaling $110,750,601. The most money was spent on service fees ($37,333,870; 33.7%), followed by consulting fees ($12,983,013; 11.7%) and royalties and licenses ($11,426,776; 10.3%). Each provider received a median payment of $63.27 (range, $0.21-$22,931,027.12) spread over 2 payments (range, 1-285). Participation rates among dental specialists ranged from 19% to 62%, and the highest rates were found among orthodontists (61.8%), oral and maxillofacial surgeons (55.7%), and periodontists (54.6%). The greatest median payments per provider were made to specialists in oral and maxillofacial radiology ($187.52), periodontics ($127.31), and oral and maxillofacial surgery ($123.39). The mean number (P < 0.01) and amount of payments (P < 0.01) per provider differed significantly across all specialties. The majority of dentists in this study received less than $200; however, the distribution of payments was positively skewed by a few top earners. The effect of these payments on clinical practice remains to be determined.


Assuntos
Conflito de Interesses , Economia em Odontologia , Indústrias/economia , Idoso , Odontologia , Honorários e Preços , Setor de Assistência à Saúde , Humanos , Indústrias/ética , Medicare , Padrões de Prática Médica/economia , Estudos Retrospectivos , Estados Unidos
4.
Lancet ; 394(10214): 2119-2124, 2019 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-31785827

RESUMO

Corruption is embedded in health systems. Throughout my life-as a researcher, public health worker, and a Minister of Health-I have been able to see entrenched dishonesty and fraud. But despite being one of the most important barriers to implementing universal health coverage around the world, corruption is rarely openly discussed. In this Lecture, I outline the magnitude of the problem of corruption, how it started, and what is happening now. I also outline people's fears around the topic, what is needed to address corruption, and the responsibilities of the academic and research communities in all countries, irrespective of their level of economic development. Policy makers, researchers, and funders need to think about corruption as an important area of research in the same way we think about diseases. If we are really aiming to achieve the Sustainable Development Goals and ensure healthy lives for all, corruption in global health must no longer be an open secret.


Assuntos
Fraude , Saúde Global , Setor de Assistência à Saúde , Má Conduta Profissional , Pesquisa Biomédica , Crime , Humanos , Cooperação Internacional , Responsabilidade Social
5.
Semin Vasc Surg ; 32(1-2): 30-32, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540654

RESUMO

Vascular surgery is a specialty discipline highlighted by a lifelong learning process from which new endovascular devices and techniques will continue to emerge. Industry partnerships can provide a safe learning environment for trainees, with a focus on maximizing learning opportunities during fellowship or residency. Unlike other surgical specialties, vascular surgery empowers its trainees to become competent in both open and image-guided endovascular interventions, requiring two unique skill sets to become a contemporary vascular surgeon. Due to the rapid growth of technology and innovations, industry partnerships enhance and maximize the learning experience of the trainee by often providing the products, education, research support, and financial assistance. This can come in the form of innovative and educational activities, including simulation, exposure to thought leaders, attendance at conferences and workshops, and one-on-one assistance with cases. In this article, we review the role that industry can serve in vascular education to support budding vascular surgeons through exposure and repetition as they lay down the fundamentals of their careers.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Setor de Assistência à Saúde , Relações Interinstitucionais , Parcerias Público-Privadas , Cirurgiões/educação , Procedimentos Cirúrgicos Vasculares/educação , Comportamento Cooperativo , Currículo , Educação de Pós-Graduação em Medicina/economia , Setor de Assistência à Saúde/economia , Humanos , Parcerias Público-Privadas/economia , Apoio à Pesquisa como Assunto , Cirurgiões/economia , Procedimentos Cirúrgicos Vasculares/economia
8.
BMC Infect Dis ; 19(1): 714, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409289

RESUMO

BACKGROUND: Despite rapid scale up of antiretroviral therapy (ART), Tuberculosis (TB) remains the commonest opportunistic infection and cause of death among HIV infected individuals in resource limited settings like India. Incidence of TB in individuals on ART in private healthcare sector in India is infrequently studied. METHODS: This retrospective cohort study conducted between 1st March 2009 and 1st March 2017 aimed to evaluate rate of incident TB in individuals initiated on ART at 3 private sector ART clinics in Pune, India. Individuals more than 12 years of age with ART duration of atleast 6 months were included. Patients were classified as having prevalent TB if they had a TB episode within the year prior to ART initiation or if they developed TB within 6 months of starting ART. Individuals who were diagnosed with TB after 6 months of starting ART were classified as incident TB cases. A recurrent episode of TB after treatment completion or cure of prevalent TB was also regarded as incident TB. Patients were classified as definitive TB if Mycobacterium tuberculosis was grown in culture from a biological sample or a positive rapid molecular test. Patients were classified as probable TB if there was radiologic evidence of TB in absence of confirmatory culture or PCR. RESULTS: 1904 patients with a median duration of follow up on ART of 57 (IQR = 32.0, 84.0) months were included. Of these, 182 developed incident TB (22% definitive TB, 38% recurrent cases). TB incidence at 6-12 months, 13-24 months, 25-60 months and > 60 months of ART was 24.32, 5.46, 2.54 and 0.75 cases per 100 person years respectively. Current time updated CD4 count < 500 cells/mm3 (p < 0.0001), virologic failure on ART (adjusted Hazard Ratio (aHR): 3.05 (95% CI: 2.094, 4.454), p < 0.0001) and receipt of ART without IPT (aHR: 8.24 (95% CI, 3.358, 20.204), p < 0.0001) were associated with higher risk of incident TB. CONCLUSION: Starting ART early in treatment naïve individuals, prompt detection of virologic failure on ART and providing IPT along with ART will be useful in reducing incident TB. Efforts from private sector are crucial in achieving Sustainable Development Goals set by Government of India and attaining the vision of a TB free India.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Infecções por HIV/tratamento farmacológico , Tuberculose/epidemiologia , Adulto , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Estudos de Coortes , Feminino , Setor de Assistência à Saúde/estatística & dados numéricos , Humanos , Incidência , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Setor Privado/estatística & dados numéricos , Modelos de Riscos Proporcionais , Estudos Retrospectivos
9.
Georgian Med News ; (291): 126-130, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31418745

RESUMO

The article examines the issue of public procurement in the healthcare sector through the prism of the Association Agreement with the EU. The emphasis is on the ensuring mutual access to the markets of public procurement of the EU and Ukraine on the basis of planned and consistent approximation of Ukrainian legislation in the field of public procurement to the EU acquis in the field of public procurement. The purpose of this article is to identify the peculiarities of the reform in the field of public procurement in Ukraine, to search for drawbacks in the administrative legislation of Ukraine, which is governing public procurement in the healthcare sector in the context of Ukraine's implementation of the Association Agreement with the EU, and to justify its improvement. The subject of research is the social relations that arise in the implementation of public procurement in the field of health. The methodological basis of the conducted research is the general methods of scientific cognitivism as well as concerning those used in legal science: methods of analysis and synthesis, formal logic, comparative law, statistical methods etc The following main directions of reforming the system of public procurement were established. It has been proved that CPO functioning on the national level of government in the form of a state-owned enterprise under the control of one of the relevant ministries is non-feasibility. The advantages of the ProZorro electronic procurement system and the state of implementation of the provisions of the EU Directives on 2014/23/ EU, 2014/24/ EU, 2014/25/EU, 2014/55/EU into the administrative legislation of Ukraine have been identified. It has been found that in March, 2015 centralized procurement system for medicines and medical products was changed in Ukraine to use the funds of the State Budget of Ukraine for the purchase of medicines and medical products with the involvement of international specialized organizations. On December 21, 2018 the Verkhovna Rada (Supreme Council) of Ukraine put amendments into the Law of Ukraine "On Public Procurement". The attention is paid to the novelties of this Law. It has been found that the legislation of Ukraine has such shortcomings: 1) in Ukraine the issue of clear distribution of functions of the authorities authorized to carry out control in the field of public procurements remains unresolved; 2) the norms of the Law contradict each other; 3) the problems of creating effective mechanisms for the formation of the nomenclature of medicines still remain, as well as their supplies to healthcare institutions.


Assuntos
Assistência à Saúde/legislação & jurisprudência , União Europeia , Setor de Assistência à Saúde/legislação & jurisprudência , Assistência à Saúde/economia , Setor de Assistência à Saúde/economia , Humanos , Ucrânia
12.
Yakugaku Zasshi ; 139(8): 1093-1095, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31366844

RESUMO

Currently, the role of medical representative (MR) is responsible for providing information to medical doctors from pharmaceutical/medical equipment companies. In recent years, however, the newer role of medical science liaison (MSL) has been established to construct evidence and provide advanced medical and scientific information to health care professionals. This position, independent from the sales division of a pharmaceutical or medical equipment company, has already been established in Europe and the U.S. The MSL helps to combat concerns of conflicts of interest (COI) concerning the sophistication of expert information, and in support of clinical research. I will introduce the role of the MSL in Japan.


Assuntos
Protocolos Clínicos , Indústria Farmacêutica , Equipamentos Médicos Duráveis , Setor de Assistência à Saúde , Pessoal de Saúde , Papel Profissional , Humanos , Japão
15.
Int J Clin Pharm ; 41(4): 859-863, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31313002

RESUMO

Background Globally Attention-Deficit/Hyperactivity Disorder (ADHD) has been in the spotlight. Despite some controversies, treatment of ADHD remains the cornerstone of patient care. Objective To describe the consumption of methylphenidate and atomoxetine in the private healthcare sector in South Africa over a four-year period (2013-2016). Method Data were extracted from the Intercontinental Marketing Service (IMS) database for the drug utilisation study. Consumption patterns were expressed as number of Defined Daily Doses (DDDs)/1000 inhabitants/day and number of DDDs/1000 inhabitants/month. Results Methylphenidate (95.85%) was the medication of choice when compared to atomoxetine (4.15%) in 2013. The corresponding figures for 2016 were 96.40% and 3.60%. Consumption of ADHD medication showed slight changes over the 4-year period. If only the private healthcare sector population is considered, consumption of methylphenidate was 6.010 DDDs/1000 inhabitants/day in 2013, and 7.827 DDDs/1000 inhabitants/day in 2016. A previous study (1994-1996) reported 0.12 DDDs/1000 inhabitants/day for methylphenidate. Consumption of atomoxetine was 0.044 DDDs/1000 inhabitants/day in 2013 and 0.050 DDDs/1000 inhabitants/day in 2016. Conclusion Consumption showed an increase in use of methylphenidate in South Africa, with small changes observed over the study period. Further studies are required.


Assuntos
Cloridrato de Atomoxetina/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Uso de Medicamentos/estatística & dados numéricos , Metilfenidato/uso terapêutico , Setor Privado/estatística & dados numéricos , Adolescente , Estimulantes do Sistema Nervoso Central/uso terapêutico , Criança , Bases de Dados Factuais , Uso de Medicamentos/tendências , Feminino , Setor de Assistência à Saúde , Humanos , Estudos Longitudinais , Masculino , Padrões de Prática Médica/estatística & dados numéricos , África do Sul
16.
N C Med J ; 80(4): 214-218, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31278180

RESUMO

The health care industry collects ever-increasing volumes of patient data. Currently, this largely untapped "big data" primarily documents encounters and facilitates billing. This issue of the North Carolina Medical Journal explores the promise and the perils of big data as we seek to transform our health care system into one that is more proactive, equitable, and value based.


Assuntos
Ciência de Dados , Assistência à Saúde , Setor de Assistência à Saúde , Humanos , North Carolina
17.
N C Med J ; 80(4): 237-239, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31278187

RESUMO

In today's ever-changing health care market, the need for more agile data to support population health, value-based revenue models, and market consolidation is only increasing. To leverage emerging advanced analytics technologies, you must have a clear picture of the who, what, where and why of your data. This commentary explores how to utilize governance capabilities and technologies to ensure you derive value from your analytics investments.


Assuntos
Análise de Dados , Setor de Assistência à Saúde , Humanos
18.
Artigo em Inglês | MEDLINE | ID: mdl-31277331

RESUMO

(1) Background: Collaboration between the health care sector and the sports sector to increase physical activity (PA) behaviour among inactive adults is still rare. The objective of the study was to evaluate the short- and long-term effectiveness of a mixed PA intervention on the PA behaviour in an adult population. (2) Methods: In a quasi-experimental study with two follow-up measurements (four and 12 months), adults were contacted by post before their stay in a health resort. During the health resort stay, the intervention group (IG) received PA counselling and a coupon for 12 standardised free-of-charge sessions in a sports club. The participants in the comparator group (CG) received PA counselling and written material. PA was measured with an accelerometer (GENEActive). Linear mixed-effects models were applied to examine the change in PA behaviour, both within and between groups in moderate- to vigorous-intensity PA over time. (3) Results: We obtained at least one follow-up measurement from 217 participants (IG = 167, CG = 50), who were 50% female, with an average age of 53 (±6) years. PA significantly increased from the baseline to the four-month measurement by 58 min./wk (95% CI 36, 80) and to the 12-month measurement by 24 min./wk (95% CI 2, 46) within the IG. No change in PA occurred in the CG. We also found a short-term between-group (IG vs. CG) difference in change over time, but not a long-term difference. (4) Conclusions: The study confirms that a collaboration between the health care sector and local sports clubs is a feasible method of recruiting people into a standardised PA programme and to increase their PA over the long term.


Assuntos
Exercício , Estâncias para Tratamento de Saúde , Instalações Esportivas e Recreacionais , Áustria , Feminino , Comportamentos Relacionados com a Saúde , Setor de Assistência à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sedentário , Esportes
20.
Int J Occup Environ Med ; 10(3): 99-110, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31325293

RESUMO

BACKGROUND: Workplace violence (WPV) in the health care sector remains a prominent, under-reported global occupational hazard and public health issue. OBJECTIVE: To determine the types and prevalence of WPV among doctors. METHODS: Primary papers on WPV in medicine were identified through a literature search in 4 health databases (Ovid Medline, EMBASE, PsychoINFO and CINAHL). The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for the mapping and identification of records. To assess the studies included in our review, we used the Critical Appraisal Skills Programme cohort review checklist and the Risk of Bias Assessment. RESULTS: 13 out of 2154 articles retrieved were reviewed. Factors outlining physician WPV included (1) working in remote health care areas, (2) understaffing, (3) mental/emotional stress of patients/visitors, (4) insufficient security, and (5) lacking preventative measures. The results of 6 studies were combined in a meta-analysis. The overall prevalence of WPV was 69% (95% CI 58% to 78%). CONCLUSION: The impact of WPV on health care institutions is profound and far-reaching; it is quite common among physicians. Therefore, steps must be taken to promote an organizational culture where there are measures to protect and promote the well-being of doctors.


Assuntos
Médicos/estatística & dados numéricos , Violência no Trabalho/estatística & dados numéricos , Setor de Assistência à Saúde/estatística & dados numéricos , Humanos , Prevalência , Estresse Psicológico/epidemiologia
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