Can social firms contribute to alleviating the economic burden of psychiatric disabilities for the public healthcare system?

Abstract Background: Delays in starting physical therapy after hospital discharge worsen deconditioning in older adults. Intervening quickly can minimize the negative effects of deconditioning. Telerehabilitation is a strategy that increases access to rehabilitation, improves clinical outcomes, and reduces costs. This paper presents the protocol for a pragmatic clinical trial that aims to determine the effectiveness and cost-effectiveness of a multi-component intervention offered by telerehabilitation for discharged older adults awaiting physical therapy for any specific medical condition.Methods: This is a pragmatic randomized controlled clinical trial with two groups: telerehabilitation and control. Participants (n=230) will be recruited among individuals discharged from hospitals who are in the public healthcare system physical therapy waiting lists. The telerehabilitation group will receive a smartphone app with a personalized program (based on individual’s functional ability) of resistance, balance, and daily activity training exercises. The intervention will be implemented at the individuals’ homes. This group will be monitored weekly by phone and monthly through a face-to-face meeting until they start physical therapy. The control group will adhere to the public healthcare system usual flow and will be monitored weekly by telephone until they start physical therapy. The primary outcome will be physical function (Timed Up and Go and 30-second Chair Stand Test). The measurements will take place in baseline, start, and discharge of outpatient physical therapy. The economic evaluations will be performed from the perspective of society and the Brazilian public healthcare system.Discussion: The study will produce evidence on the effectiveness and cost-effectiveness of multi-component telerehabilitation intervention for discharged older adult patients awaiting physical therapy, providing input that can aid implementation of similar proposals in other patient groups. Trial registration: Brazilian Clinical Trials Registry, RBR-9243v7. Registered on 24 August 2020.

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Singapore SPICE: sedation practices in intensive care evaluation in Singapore – a prospective cohort study of the public healthcare system

Singapore Medical Journal ◽

10.11622/smedj.2019055 ◽

2020 ◽

Vol 61 (1) ◽

pp. 19-23 ◽

Cited By ~ 2

Author(s):

SY Ng ◽

J Phua ◽

YL Wong ◽

G Kalyanasundaram ◽

A Mukhopadhyay ◽

...

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Healthcare System ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Public Healthcare ◽

Public Healthcare System ◽

The Public ◽

Care Evaluation

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Factors Behind Gaps in Public Familiarity with the Public Healthcare System

Iryo To Shakai ◽

10.4091/iken.22.41 ◽

2012 ◽

Vol 22 (1) ◽

pp. 41-55

Author(s):

Kunio Urakawa

Keyword(s):

Healthcare System ◽

Public Healthcare ◽

Public Healthcare System ◽

The Public

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Implications for Poor Public Healthcare System of South Korea Revealed in MERS Outbreak

International Journal of E-Health and Medical Communications ◽

10.4018/ijehmc.2018100103 ◽

2018 ◽

Vol 9 (4) ◽

pp. 20-28

Author(s):

MyungHee Kim

Keyword(s):

Public Health ◽

Infectious Disease ◽

Health System ◽

Healthcare System ◽

Community Health Centers ◽

Public Health System ◽

Health Centers ◽

Public Healthcare ◽

Public Healthcare System ◽

The Public

This article aims to prevent the possible recurrence of the Middle East Respiratory Syndrome (MERS) by understanding the status of South Korea's public healthcare system through a literature review. In addition, it presents measures to reinforce the public health system by analyzing the roles and limitations of the health authority, which plays a key role in preventing the spread of this infectious disease, through their response to the recent MERS outbreak in the country. Based on the analysis, the results showed the following implications: (1) Community health centers need to expand and reinforce their functions. It is important to publish response manuals at the national level and regularly educate and train medical service providers on infectious disease control, especially against diseases such as MERS. Accordingly, manpower and facilities must be developed. (2) Public hospitals located in regional hubs must expand to establish a public healthcare system. Public healthcare and emergency healthcare systems should be established by connecting community health centers, regional hub hospitals, and national university hospitals. The improvements in the facility must to be supported to help increase the efficiency of public health system. (3) Awareness among people must increase with respect to the prevention of infectious diseases and managing direct contact with infected patients. Most importantly, education and training on infectious disease prevention must be regularly provided to the public, and social support systems and programs must be organized for the infected people who are in self-isolation.

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