Health Care Equity and COVID-19: Assessing the Relative Effectiveness of Egalitarian Governance and Health System Capacity on the COVID-19 Pandemic

2020 ◽  
Author(s):  
Krishna Chaitanya Vadlamannati ◽  
Arusha V. Cooray ◽  
Indra De Soysa
Keyword(s):  
Health Care ◽  
Health System ◽  
Relative Effectiveness ◽  
System Capacity ◽  
Health Care Equity

scholarly journals Health system capacity and readiness for delivery of integrated non-communicable disease services in primary health care: A qualitative analysis of the Ethiopian experience

2021 ◽  
Vol 1 (10) ◽  
pp. e0000026
Author(s):  
Azeb Gebresilassie Tesema ◽  
Seye Abimbola ◽  
Afework Mulugeta ◽  
Whenayon S. Ajisegiri ◽  
Padmanesan Narasimhan ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Communicable Disease ◽  
Addis Ababa ◽  
System Capacity ◽  
World Health ◽  
Political Commitment ◽  
District Health ◽  
Primary Health

Background Non-communicable diseases (NCDs) now account for about 71% and 32% of all the deaths globally and in Ethiopia. Primary health care (PHC) is a vital instrument to address the ever-increasing burden of NCDs and is the best strategy for delivering integrated and equitable NCD care. We explored the capacity and readiness of Ethiopia’s PHC system to deliver integrated, people-centred NCD services. Methods A qualitative study was conducted in two regions and Federal Ministry of Health, Addis Ababa, Ethiopia. We carried out twenty-two key informant interviews with national and regional policymakers, officials from a partner organisation, woreda/district health office managers and coordinators, and PHC workers. Data were coded and thematically analysed using the World Health Organization (WHO) Operational Framework for PHC. Results Although the rising NCD burden is well recognised in Ethiopia, and the country has NCD-specific strategies and some interventions in place, we identified critical gaps in several levers of the WHO Operational Framework. Many compared the under-investment in NCDs contrasted with Ethiopia’s successful PHC models established for maternal and child health and communicable disease programs. Insufficient political commitment and leadership required to integrate NCD services at the PHC level and weaknesses in governance structures, inter-sectoral coordination, and funding for NCDs were identified as significant barriers to strengthening PHC capacity to address NCDs. Among the operational-focussed levers, fragmented information management systems and inadequate equipment and medicines were identified as critical bottlenecks. The PHC workforce was also considered insufficiently skilled and supported to provide NCD services in PHC facilities. Conclusion Strengthening NCD prevention and control through PHC in Ethiopia requires greater political commitment and investment at all health system levels. Prior success strategies with other PHC programs could be adapted and applied to NCD policies and practice, giving due consideration for the unique nature of the NCD program.

It Matters How We Define Health Care Equity

2013 ◽  
Vol 3 (1) ◽  
Author(s):  
Allan Goldberg ◽  
Keyword(s):  
Health Care ◽  
Health Care Equity

Issues of co-financing of drug provision for the population: international and Russian practice

2020 ◽  
pp. 49-56
Author(s):  
Vasiliy Ryazhenov ◽  
Victoriya Andreyeva ◽  
Elena Zakharochkina
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Health System ◽  
Health Care System ◽  
Russian Federation ◽  
High Quality ◽  
Russian President ◽  
The Russian Federation ◽  
Vladimir Putin ◽  
Drug Provision

Russian President Vladimir Putin defined increase in life expectancy from 72.7 to 78 years by 2024 as a national aim in the Decree № 204 of May 7, 2018. Achievement of this aim depends on drug provision system among other factors. Strategy of drug provision for the population of the Russian Federation for the period until 2025 sets the goal of increasing availability of high quality, effective and safe medicines to meet needs of the population and the health system based on the formation of a rational and balanced system of drug provision for the population of the country with available resources. The health care system should expand the possibilities of using modern and effective mechanisms to ensure the financing of drug provision for the population.

scholarly journals How Public Trust in Health Care Can Shape Patient Overconsumption in Health Systems? The Missing Links

2021 ◽  
Vol 18 (8) ◽  
pp. 3860
Author(s):  
Katarzyna Krot ◽  
Iga Rudawska
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Health System ◽  
Health Systems ◽  
Quantitative Research ◽  
Public Trust ◽  
Complex Problem ◽  
Health Care Consumption ◽  
Mediating Role ◽  
Countries In Transition

Overconsumption of health care is an ever-present and complex problem in health systems. It is especially significant in countries in transition that assign relatively small budgets to health care. In these circumstances, trust in the health system and its institutions is of utmost importance. Many researchers have studied interpersonal trust. Relatively less attention, however, has been paid to public trust in health systems and its impact on overconsumption. Therefore, this paper seeks to identify and examine the link between public trust and the moral hazard experienced by the patient with regard to health care consumption. Moreover, it explores the mediating role of patient satisfaction and patient non-adherence. For these purposes, quantitative research was conducted based on a representative sample of patients in Poland. Interesting findings were made on the issues examined. Patients were shown not to overconsume health care if they trusted the system and were satisfied with their doctor-patient relationship. On the other hand, nonadherence to medical recommendations was shown to increase overuse of medical services. The present study contributes to the existing knowledge by identifying phenomena on the macro (public trust in health care) and micro (patient satisfaction and non-adherence) scales that modify patient behavior with regard to health care consumption. Our results also provide valuable knowledge for health system policymakers. They can be of benefit in developing communication plans at different levels of local government.

Access to health care and Informal Patient Payments for health care in Serbia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Buch Mejsner ◽  
S Lavasani Kjær ◽  
L Eklund Karlsson
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Health Care Services ◽  
Local Population ◽  
Civil Servants ◽  
Care Providers ◽  
Care Services ◽  
Access To Health

Abstract Background Evidence often shows that migrants in the European region have poor access to quality health care. Having a large number of migrants seeking towards Europe, crossing through i.e. Serbia, it is crucial to improve migrants' access to health care and ensure equality in service provision Aim To investigate what are the barriers and facilitators of access to health care in Serbia, perceived by migrants, policy makers, health care providers, civil servants and experts working with migrants. Methods six migrants in an asylum center and eight civil servants in the field of migration were conducted. A complementary questionnaire to key civil servants working with migrants (N = 19) is being distributed to complement the data. The qualitative and quantitative data will be analysed through Grounded Theory and Logistic Regression respectively. Results According to preliminary findings, migrants reported that they were able to access the health care services quite easily. Migrants were mostly fully aware of their rights to access these health care services. However, the interviewed civil servants experienced that, despite the majority of migrants in camps were treated fairly, some migrants were treated inappropriately by health care professionals (being addressed inappropriately, poor or lacking treatment). The civil servants believed that local Serbs, from their own experiences, were treated poorer than migrants (I.e. paying Informal Patient Payments, poor quality of and access to health care services). The interviewed migrants were trusting towards the health system, because they felt protected by the official system that guaranteed them services. The final results will be presented at the conference. Conclusions There was a difference in quality of and access to health care services of local Serbs and migrants in the region. Migrants may be protected by the official health care system and thus have access to and do not pay additional fees for health care services. Key messages Despite comprehensive evidence on Informal Patient Payments (IPP) in Serbia, further research is needed to highlight how health system governance and prevailing policies affect IPP in migrants. There may be clear differences in quality of and access to health care services between the local population and migrants in Serbia.

scholarly journals Prioritising surgical cases deferred by the COVID-19 pandemic: an ethics-inspired algorithmic framework for health leaders

BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000343
Author(s):  
Amit Jain ◽  
Tinglong Dai ◽  
Christopher G Myers ◽  
Punya Jain ◽  
Shruti Aggarwal
Keyword(s):  
Decision Analysis ◽  
Health System ◽  
System Capacity ◽  
Surgical Case ◽  
The World ◽  
The Face ◽  
Algorithmic Framework ◽  
Limited Health ◽  
Healthcare Leaders

Elective surgical suspension during the COVID-19 pandemic resulted in a sizeable surgical case backlog throughout the world. As we ramp back up, how do we decide which cases take priority? Potential future waves (or a future pandemic) may lead to additional surgical shutdown and subsequent reopening. Deciding which cases to prioritise in the face of limited health system capacity has emerged as a new challenge for healthcare leaders. Here we present an ethically grounded and operationally efficient surgical prioritisation framework for healthcare leaders and practitioners, drawing insights from decision analysis and organisational sciences.

scholarly journals Searching for Elysium: teaching universal health care as a human right

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Souza ◽  
T C Garcia ◽  
M N Sayão
Keyword(s):  
High School ◽  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Human Right ◽  
School Class ◽  
Federal Constitution ◽  
High School Class ◽  
Free Health Care ◽  
Care System

Abstract Background Brazil have a huge free health care system. Inspired on UK National Health System (NHS), the Sistema Único de Saúde (SUS, that means Unified Health System) was consolidate as a right for all citizens after 1988's Brazilian Federal Constitution. Despite your spread, part of Brazilian citizens have an opposite opinions about SUS. So, the main question is: How to teach the relevance of a universal free health care system as a human right. Objectives The main aim of this work is teaching the recognize of SUS as a human right and ratified by Brazilian Federal Constitution in a High School class. In this sense, we used the cinema and debate for stimulate an effective comprehension of Universal Declaration of Human Rights (UDHR) and health promotion as a human right in a high school class. We used the movie Elysium (Neill Blomkamp, 2013) that show a dystopian world with two social class: citizen and non-citizen of Elysium (an artificial satellite of the Earth with high technology of cure for your citizens). Results The class has three Lessons: in first lesson we teaching about different notions about rights and the UDHR. In the second lesson we teaching about free health care systems in the world and a historical perspective about SUS. The third lesson we show the movie Elysium and proceed a debate. In debate we discuss about citizenship and rights, how the movie show two societies with different rights about work, transport and health, and how this aspects impact the quality of life of human being. Conclusions What options we have? The notion of free health care as a human right isn't an easy concept. So, efforts are needed for this comprehension and cinema can be used, followed by discussion, as a significant teaching tool for achieving humanistic educational objectives about free health care system as a human right in the high school curriculum. Key messages Health care is a human right and free health care system is a concretization of this right. Cinema can be used for stimulate a critical evaluation and effective understanding of rights in a high school classroom.

scholarly journals Description of a Multi-faceted COVID-19 Pandemic Physician Workforce Plan at a Multi-site Academic Health System

2021 ◽  
Author(s):  
Sachin R. Pendharkar ◽  
Evan Minty ◽  
Caley B. Shukalek ◽  
Brendan Kerr ◽  
Paul MacMullan ◽  
...  
Keyword(s):  
Health System ◽  
Acute Care ◽  
Care Physician ◽  
System Capacity ◽  
Medical Emergency ◽  
Physician Workforce ◽  
Future Health ◽  
Academic Health ◽  
Response Planning ◽  
Implementation Period

Abstract Background The evolving COVID-19 pandemic has and continues to present a threat to health system capacity. Rapidly expanding an existing acute care physician workforce is critical to pandemic response planning in large urban academic health systems. Intervention The Medical Emergency-Pandemic Operations Command (MEOC)—a multi-specialty team of physicians, operational leaders, and support staff within an academic Department of Medicine in Calgary, Canada—partnered with its provincial health system to rapidly develop a comprehensive, scalable pandemic physician workforce plan for non-ventilated inpatients with COVID-19 across multiple hospitals. The MEOC Pandemic Plan comprised seven components, each with unique structure and processes. Methods In this manuscript, we describe MEOC’s Pandemic Plan that was designed and implemented from March to May 2020 and re-escalated in October 2020. We report on the plan’s structure and process, early implementation outcomes, and unforeseen challenges. Data sources included MEOC documents, health system, public health, and physician engagement implementation data. Key Results From March 5 to October 26, 2020, 427 patients were admitted to COVID-19 units in Calgary hospitals. In the initial implementation period (March–May 2020), MEOC communications reached over 2500 physicians, leading to 1446 physicians volunteering to provide care on COVID-19 units. Of these, 234 physicians signed up for hospital shifts, and 227 physicians received in-person personal protective equipment simulation training. Ninety-three physicians were deployed on COVID-19 units at four large acute care hospitals. The resurgence of cases in September 2020 has prompted re-escalation including re-activation of COVID-19 units. Conclusions MEOC leveraged an academic health system partnership to rapidly design, implement, and refine a comprehensive, scalable COVID-19 acute care physician workforce plan whose components are readily applicable across jurisdictions or healthcare crises. This description may guide other institutions responding to COVID-19 and future health emergencies.

scholarly journals Health care network for chronic conditions: an intervention and evaluation in the health system

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C S Cardoso ◽  
N R Baldoni ◽  
C F Melo ◽  
L O Rezende ◽  
K Noronha ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Professionals ◽  
Chronic Conditions ◽  
Panel Study ◽  
Health Indicators ◽  
Institutional Capacity ◽  
Local Health ◽  
Care Network ◽  
Health Care Network

Abstract Background Health assessments are necessary for the (re) formulation of effective public policies and to guarantee the quality of care offered. This study aim to evaluate the perception of health professionals concerning the institutional capacity of the health system to care for Chronic Conditions (CC) after intervention in a medium-sized municipality in Minas Gerais, Brazil. Methods It is a panel study with evaluation before, during and after an intervention in the health system with a focus on three CC, i.e., i) diabetes; ii) hypertension; and iii) pregnant women. Health care professionals from primary and specialized care units were interviewed using the Assessment of Chronic Illness Care (ACIC) scale, which was applied in nine focal groups organized by health care unit. Results A total of 240 professionals participated of this evaluation, being 94, 63 and 82 participants in 2013, 2015 and 2018 respectively. The ACIC scores showed an positive evolution in the capacity of the health system to care for CC over the years. In the first wave the global score was 5.40 (basic capacity), while in the third wave the score was 9.38 (optimal capacity), with a significant increase in the scores (p < 0.01). Conclusions An important gain in the institutional capacity of the municipality was evidenced for the care of chronic conditions after intervention in the health system. Such an enhancement of the health system to operate in the CC might be sustainable over the time. Furthermore, its impact may directly reflect on the health indicators of the population. Key messages The results showed a strengthening of the local health system. These findings can subsidize other municipalities with a similar reality in the organization of the health care network and, consequently improve the care provided to chronic conditions.

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