The Impact of COVID-19 on the Romanian Hospitals’ Expenses. A Case Study Toward the Financial Resilience after the Pandemic

The Coronavirus disease 2019 (COVID-19) affect­ed almost all activities worldwide. The medical sec­tor was one of those which were most significantly impacted because the medical infrastructure was not sized for such a high scale shock, specialized human resources and medical infrastructure prov­ing to be much undersized and with slow growth potential. Many changes were required, important financial resources being mobilized in order to mo­tivate medical staff, offer treatments for the most severely affected patients, but also to create new fa­cilities where the increasing number of sick persons could be cured. In our research we want to offer a hospital cost perspective based on empirical analysis of the COVID-19 impact on different categories of expens­es made by Romanian hospitals that treated patients with COVID-19 in different stages of their disease. The period analyzed was January 2019 to December 2020 on a monthly basis. Our results showed that expenses with goods and services, drugs, reagents and human resources are influenced by COVID-19 in a significant manner.

Assessment of Antibiotic Resistance Pattern of Bacteria Prevalent during COVID-19 Pandemic

Owing to disparities in the intensity of the breakouts, state and federal regulations, accessible means, cultural elements, and social consciousness, the global reaction to the COVID-19 pandemic has been varied. The COVID-19 pandemic, on the other hand, has had an impact on all parts of society, notably efforts to combat antimicrobial resistance (AMR). The pandemic has highlighted that a greater burden on medical infrastructure can contribute to higher, often unnecessary antibiotic usage and a de-prioritization of antimicrobial stewardship and surveillance (AMS). The focus of this research is to see if there is a growth in antibiotic resistance during the covid-19 pandemic in the King Salman Hospital in Riyadh, Saudi Arabia, and to investigate the subcomponent that leads to antibiotic resistance. This is a comprehensive review of patients hospitalized at the King Salman Hospital in Riyadh, Saudi Arabia, who were admitted to the Intensive Care Unit (ICU) during the first wave of the covid-19 pandemic, which occurred between March and August 2020. An analysis of the case dataset was performed to determine the rise in antibiotic resistance and relate it to resistant cases before the pandemic (September 2019 to February 2020). Before and throughout the pandemic, fifteen kinds of bacteria were found, with K. pneumonia being the most prevalent bacteria (49; 30.6%), and Ac. Baum/haem being the most removable bacteria during the pandemic (74; 37.3%). Cephalosporin antibiotics, in notably cefotaxime and ceftazidime (100%), cefazolin (96.3%), ceftriaxone (96%), cefuroxime and ceftazidime (95%), cefotaxime ((94.7%). These antibiotics also had the same amount of resistance during the pandemic. In pre-covid-19 and during covid-19, these findings were congruent with the penicillin antibiotics class, ampicillin, and piperacillin (96.3% and 92.1%), accordingly. It is presently uncertain if COVID-19 patients would develop new or growing antibiotic resistance in locations with low historical prevalence, but this should be investigated in retrospective and future clinical and microbiology research.

The Emergence of Healthcare Systems

Some sort of medical infrastructure has existed in all modern states and dependent territories. However, healthcare systems that provide legal entitlements to medical care at least for specific groups of the population, and that regulate access to and provision of healthcare on a national level only came into existence at the end of the nineteenth century. In our chapter, we trace the global emergence of healthcare systems and test whether their introduction date is related to a diffusion process through networks of trade, culture or health-related cooperation, or whether it is mainly influenced by domestic medical needs, capabilities, and wealth.

Evaluating of the Clinical Profile, Laboratory Parameters and Outcome of Covid-19 Patients in Najran City - Saudi Arabia: A Descriptive Analysis

The unprecedented pandemic has been causing devastating damage to the human life and livelihood. The SARS CoV-2 viral strains are currently responsible for the serious of infection waves and high mortality rate. The management of disease requires well developed medical infrastructure such as central oxygen suction, ventilator facility to support the patients with severe complications. Therefore, early diagnosis and monitoring are mandatory in order to control the disease progression and its clinical complications. Current study, we retrospectively analyzed the clinical parameters of the COVID-19 positive patients, and found that the body mass index ratio, oxygen saturation level and the neutrophil, lymphocyte ratio were continuously monitored. Any significant increase in the above said parameters may be correlated with adverse disease progression and patient mortality rate. In this way, developing countries could cut down the necessity for medical infrastructure.

COVID-19 in Multimorbid Patients—A Controlled Microcost Description Analysis of Diagnosis Related Group (DRG)-Case Series in Acute Care without Non-Invasive Ventilation

Diagnosis-related cost analyzes are important for health economic planning and decision-making. They form the basis for further developing of remuneration systems for health services. The rapid increase in hospital stays by COVID-19 patients requires a valid and exact calculation of the treatment costs. COVID-19 patients with many accompanying illnesses increase the requirements for a cost calculation. The focus of this work is to carry out a DRG-related micro-cost analysis, considering the age, length of stay and comorbidities of COVID-19 patients. So far, there is little information about treatment costs for multimorbid patients with COVID-19 who have not received invasive ventilation. The method is based on a standardized cost unit calculation for determining the treatment costs in a German hospital. The costs (€) of inpatients treated with COVID-19 were compared with a control group of the same DRGs of patients without COVID-19. The average total costs for inpatient treatment were €2866. The highest share of costs falls on nursing, personnel, and material costs of the non-medical infrastructure. Frequent comorbidities were heart failure, diabetes mellitus, other respiratory diseases, dizziness, and impairment of the musculoskeletal system.

The use of the dynamic time warping (DTW) method to describe the COVID-19 dynamics in Poland

Research background: In recent times, the whole world has been severely affected by the COVID-19 pandemic. The influence of the epidemic on the society and the economy has caused a great deal of scientific interest. The development of the pandemic in many countries was analyzed using various models. However, the literature on the dissemination of COVID-19 lacks econometric analyzes of the development of this epidemic in Polish voivodeships. Purpose of the article: The aim of the study is to find similarities in time series for infected with and those who died of COVID-19 in Polish voivodeships using the method of dynamic time warping. Methods: The dynamic time warping method allows to calculate the distance between two time series of different lengths. This feature of the method is very important in our analysis because the coronavirus epidemic did not start in all voivodeships at the same time. The dynamic time warping also enables an adjustment of the timeline to find similar, but shifted, phases. Using this method, we jointly analyze the number of infected and deceased people in each province. In the next step, based on the measured similarity of the time series, the voivodeships are grouped hierarchically. Findings & value added: We use the dynamic time warping to identify groups of voivodeships affected by the epidemic to a different extent. The classification performed may be useful as it indicates patterns of the COVID-19 disease evolution in Polish voivodeships. The results obtained at the regional level will allow better prediction of future infections. Decision makers should formulate further recommendations for lockdowns at the local level, and in the long run, adjust the medical infrastructure in the regions accordingly. Policymakers in other countries can benefit from the findings by shaping their own regional policies accordingly.

Lab-on-Paper Devices for Diagnosis of Human Diseases Using Urine Samples—A Review

In recent years, microfluidic lab-on-paper devices have emerged as a rapid and low-cost alternative to traditional laboratory tests. Additionally, they were widely considered as a promising solution for point-of-care testing (POCT) at home or regions that lack medical infrastructure and resources. This review describes important advances in microfluidic lab-on-paper diagnostics for human health monitoring and disease diagnosis over the past five years. The review commenced by explaining the choice of paper, fabrication methods, and detection techniques to realize microfluidic lab-on-paper devices. Then, the sample pretreatment procedure used to improve the detection performance of lab-on-paper devices was introduced. Furthermore, an in-depth review of lab-on-paper devices for disease measurement based on an analysis of urine samples was presented. The review concludes with the potential challenges that the future development of commercial microfluidic lab-on-paper platforms for human disease detection would face.

Burnout and work-life balance among physicians: the role of migration background

Background We want to analyze the effect of migration background (MB) on physician burnout and work-life balance. Methods In September 2019, physicians from various specialties answered a questionnaire on work and health. We analyzed a subsample of 526 physicians that were working full time in a hospital, 14% with an MB and 47.9% were female. Results Multivariate analysis showed that physicians with an MB exhibit significantly less favorable scores on all three burnout dimensions, and this effect persisted in the regression analysis after adding age, gender, and marital status as control variables. There were no differences with regard to work-life balance. Conclusions To our knowledge, our study is the first one to suggest that MB plays a significant role in physician mental health. Future research will benefit from identifying the factors behind that connection, e.g., problems related to acculturation, communication and social integration, which can then be addressed by policymakers in order to maintain and improve the medical infrastructure.