scholarly journals Spatial Inequity in Access to Intensive Care Unit Beds at Regional Level in Italy

2021 ◽  
Author(s):  
Fabrizio Pecoraro ◽  
Daniela Luzi ◽  
Fabrizio Clemente
Keyword(s):  
Intensive Care ◽  
Health Resources ◽  
Spatial Accessibility ◽  
Policy Makers ◽  
Care Services ◽  
Regional Systems ◽  
Italian Regions ◽  
Short Period ◽  
Critical Issues ◽  
Reallocation Of Resources

The high demand of hospitalization in the intensive care units (ICUs) during the first wave of the COVID-19 outbreak brought out the critical issues of the limited capacity of the regional systems to deal with high patient inflows in a short period of time. In this view, a rapid and efficient reallocation of resources is one of the main challenges to be addressed by regional systems to prevent overload and saturation. Aim of this study is to assess the spatial accessibility of ICU beds in the 20 Italian regions to capture the equity distribution of critical care services across the country. This analysis may contribute to gain a deeper understanding of the allocation of health resources. It can provide input for policy makers in view of a possible reorganization of the national system in terms of both its preparedness for emergency period and routine capability.

scholarly journals Supporting Decision Making in Intensive Care: Ethical Principles for Managing Access to Care During the COVID-19 Pandemic

2021 ◽  
Vol 8 ◽  
Author(s):  
Stefano D'Errico ◽  
Martina Padovano ◽  
Matteo Scopetti ◽  
Federico Manetti ◽  
Martina Zanon ◽  
...  
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Access To Care ◽  
Healthcare Professionals ◽  
Ethical Issues ◽  
Health Resources ◽  
Ethical Considerations ◽  
Healthcare Resources ◽  
Health Threat ◽  
Critical Issues

The pandemic from COVID-19 causes a health threat for many countries and requires an internationally coordinated response due to the high spread of the infection. The current local and international situation gives rise to logistical and ethical considerations regarding the imbalance between needs for assistance and availability of health resources in the continuation of the emergency. A shortage condition will require healthcare professionals to choose between patients who will have access to respiratory support and those who will have to continue without. The sharing of criteria for the introduction of patients to the different therapeutic paths is fundamental to prevent the onset of ethical issues. The present paper analyzes the critical issues related to the scarcity of healthcare resources and the limitation of access to intensive care with the aim of proposing ethically sustainable principles for the management of the current pandemic situation.

scholarly journals Otolaryngology activity in two hospitals in northern and central Italy differently affected by COVID-19 pandemic

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042199848
Author(s):  
Antonio Minni ◽  
Francesco Pilolli ◽  
Massimo Ralli ◽  
Niccolò Mevio ◽  
Luca Roncoroni ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Healthcare System ◽  
Central Italy ◽  
Northern Italy ◽  
Public Hospitals ◽  
Geographical Differences ◽  
Italian Regions

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic had a significant impact on the Italian healthcare system, although geographical differences were present; regions in northern Italy have been the most severely affected while regions in the south of the country were relatively spared. Otolaryngologists were actively involved in the management of the pandemic. In this work, we analyzed and compared the otolaryngology surgical activity performed during the pandemic in two large public hospitals located in different Italian regions. In northern Italy, otolaryngologists were mainly involved in performing surgical tracheotomies in COVID-19 positive patients and contributed to the management of these patients in intensive care units. In central Italy, where the burden of the infection was significantly lower, otolaryngologists focused on diagnosis and treatment of emergency and oncology patients. This analysis confirms the important role of the otolaryngology specialists during the pandemic, but also highlights specific differences between two large hospitals in different Italian regions.

scholarly journals Geographical access to critical care services in Scotland

2017 ◽  
Vol 19 (1) ◽  
pp. 6-14 ◽  
Author(s):  
Philip Emerson ◽  
Naomi Dodds ◽  
David R Green ◽  
Jan O Jansen
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Rural Areas ◽  
Care Facility ◽  
Population Data ◽  
Small Towns ◽  
Health Board ◽  
Care Services ◽  
Geographical Access ◽  
Scottish Population

Background Critical illness requires specialist and timely management. The aim of this study was to create a geographic accessibility profile of the Scottish population to emergency departments and intensive care units. Methods This was a descriptive, geographical analysis of population access to ‘intermediate’ and ‘definitive’ critical care services in Scotland. Access was defined by the number of people able to reach services within 45 to 60 min, by road and by helicopter. Access was analysed by health board, rurality and as a country using freely available geographically referenced population data. Results Ninety-six percent of the population reside within a 45-min drive of the nearest intermediate critical care facility, and 94% of the population live within a 45-min ambulance drive time to the nearest intensive care unit. By helicopter, these figures were 95% and 91%, respectively. Some health boards had no access to definitive critical care services within 45 min via helicopter or road. Very remote small towns and very remote rural areas had poorer access than less remote and rural regions.

Spiritual issues and needs: Perspectives from patients with advanced cancer and nonmalignant disease. A qualitative study

2004 ◽  
Vol 2 (4) ◽  
pp. 371-378 ◽  
Author(s):  
ELIZABETH GRANT ◽  
SCOTT A. MURRAY ◽  
MARILYN KENDALL ◽  
KIRSTY BOYD ◽  
STEPHEN TILLEY ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Qualitative Interviews ◽  
Health Resources ◽  
Well Being ◽  
Spiritual Needs ◽  
Policy Makers ◽  
Self Identity ◽  
Nonmalignant Disease

Objective: Health care professionals and policy makers acknowledge that spiritual needs are important for many patients with life-limiting illnesses. We asked such patients to describe their spiritual needs and how these needs may impinge on their physical, psychological, and social well-being. Patients were also encouraged to explain in what ways their spiritual needs, if they had any, could be addressed.Methods: We conducted two qualitative interviews, 3 months apart, with 20 patients in their last year of life: 13 patients with advanced cancer and 7 with advanced nonmalignant illness. We also interviewed each patient's general practitioner. Sixty-six interviews were tape-recorded, transcribed, and analyzed.Results: Patients' spiritual needs centered around their loss of roles and self-identity and their fear of dying. Many sought to make sense of life in relation to a nonvisible or sacred world. They associated anxiety, sleeplessness, and despair with such issues, which at times resulted in them seeking support from health professionals. Patients were best able to engage their personal resources to meet these needs when affirmed and valued by health professionals.Significance of results: Enabling patients to deal with their spiritual needs through affirmative relationships with health professionals may improve quality of life and reduce use of health resources. Further research to explore the relationship between spiritual distress and health service utilization is indicated.

scholarly journals Critical issues for employees in inter-municipal health care services: a multiple case study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Elisabeth Holen-Rabbersvik ◽  
Tom Roar Eikebrokk ◽  
Rune Werner Fensli ◽  
Elin Thygesen ◽  
Åshild Slettebø
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Multiple Case Study ◽  
Care Services ◽  
Critical Issues ◽  
Multiple Case ◽  
Municipal Health

scholarly journals A Causal Relationship of Home Care Services on the Quality of Life among Survivors of Stroke in Thailand

2021 ◽  
Vol 18 (5) ◽  
Author(s):  
Patoomthip ADUNWATANASIRI ◽  
Siriorn SINDHU ◽  
Napaporn WANITKUN ◽  
Chukiat VIWATWONGKASEM
Keyword(s):  
Quality Of Life ◽  
Home Care ◽  
Functional Status ◽  
Home Care Services ◽  
Self Management ◽  
Stroke Survivors ◽  
Management Support ◽  
Policy Makers ◽  
Care Services

Survivors of stroke suffer impairments associated with a complex need of care from healthcare services after being discharged from hospital and returning home, and these impairments affect the quality of their lives. This cross-sectional study, aimed at evaluating the pathways linking home care services, patient factors, and quality of life (QOL), was carried out by conducting interviews and questionnaires with stroke survivors at their homes. Simple random sampling was used to select the settings for data collection, and multi-stage sampling was used to select the samples. In all, 317 stroke survivors admitted to 13 hospitals in rural and urban setting were selected for participation in the study. The data obtained were analyzed by using Structural Equation Modeling (SEM). The hypothetical model demonstrated a good fit (chi-square = 15.299, df = 9, p = 0.083, GFI = 0.98, CFI = 0.98, RMSEA = 0.047). Statistically significant explanatory variables for the home care service had a direct effect on perceived self-management support, functional status, and QOL (β = 0.39, 0.12 and 0.11, respectively), while number of community supporters had a significant positive indirect effect on QOL through functional status (β = 0.13). The variables accounted for 56 % of the variance in QOL. This finding could be used by policy makers to make important policy development in home care services and help improve health outcomes. In particular, it is also recommended that policy makers push for policies that encompass self-management support and community support groups among stroke survivors in community settings.

scholarly journals Multifunctionality of agriculture, public policies and scientific evidences: Some critical issues of contemporary controversies

2010 ◽  
Vol 4 (1-2) ◽  
pp. 53-58 ◽  
Author(s):  
Catherine Laurent ◽  
Marielle Berriet-Solliec ◽  
Marc Kirsch ◽  
Pierre Labarthe ◽  
AurélieT AurélieTrouvé
Keyword(s):  
Decision Making ◽  
Theoretical Models ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Policy Makers ◽  
Science And Policy ◽  
Public Policy Analysis ◽  
Critical Issues ◽  
The Status ◽  
New Situation

Various theoretical models of public policy analysis are used to treat situations of decision-making in which public deciders have to take into account the multifunctionality of agriculture. For some, science-society relations are not really problematical. Others acknowledge the current attempts of these policy-makers to find adequate scientific knowledge, and the difficulties they encounter. These difficulties stem partly from the very content of knowledge produced by research. Could other modes of production be more efficient? The status of the knowledge produced by these approaches is a subject of debate. Bridging the divide between science and policy more effectively is not only a question of knowledge brokerage.Accessibility and reliability of the existing evidences are also problems to be addressed. The debates around evidence-based practices may provide some landmarks in this new situation although they also emphasize the limits of the tools that can be built for this purpose.  

scholarly journals Evaluation of Job Satisfaction and Job Related Stress Among Community Pharmacists in North Khartoum and its Impact on Providing Pharmaceutical Care Services

2019 ◽  
Vol 2 (2) ◽  
pp. 1-12
Author(s):  
Azza Mohamed Tahir ◽  
Tarig Mohamed Hassan ◽  
Ali Awadallah Ali ◽  
Mazin Yousif Babiker ◽  
Mohamed Awad Mousnad
Keyword(s):  
Job Satisfaction ◽  
Health Services ◽  
Pharmaceutical Care ◽  
Emotional Experience ◽  
Relevant Literature ◽  
Community Pharmacists ◽  
Policy Makers ◽  
Job Satisfaction Survey ◽  
Care Services ◽  
Related Stress

Introduction Pharmacists and pharmaceutical care services are among the most important tools in providing health services to the society. Pharmacists as the key players in presenting health services, critically impact on the health of the society and if they suffer low job satisfaction, their dissatisfaction may relatively threaten health in the society. This study was conducted to determine Sudanese community pharmacists’ job satisfaction and additionally, some causes of dissatisfaction among community pharmacists and their impact on providing pharmaceutical care services have been evaluated. Method The questionnaire was designed after reviewing relevant Literature in addition, The Job Satisfaction survey was used to measure the level of community pharmacists’ satisfaction with their current jobs, and the Toronto Alexithymia Scale (TAS-20) was used to evaluate emotional experience and awareness. Results and Discussion Generally low scores of job satisfaction were concluded among pharmacists while most of them were highly satisfied with being pharmacist. Conclusion Low levels of job satisfaction which were found among Sudanese community pharmacists could be considered as a deficiency of health system in Sudan. Fortunately, inherent interest in the pharmacy profession found among Sudanese pharmacists is an optimistic point at which policy-makers could develop their modifying policies. Health policy-makers must endeavor to take other steps to issue solutions for this current problem.

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