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Uğur ZB, Durak A. The Impact of COVID-19 on Healthcare Utilization in Turkey. Value Health Reg Issues 2024; 43:101000. [PMID: 38754257 DOI: 10.1016/j.vhri.2024.101000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/12/2024] [Accepted: 03/25/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES This study investigates the impact of the COVID-19 pandemic on healthcare utilization in Turkey. METHODS We utilized individual-level data derived from Turkish Statistical Institute's annual surveys between 2014 and 2022 and estimated probit regression models. RESULTS We find that COVID-19 pandemic reduced healthcare utilization by 11.8% after taking into account a large set of background variables. Although our study finds that the elderly and those with health problems are more likely to use healthcare services under normal circumstances, the COVID-19 pandemic has caused notable drops in the healthcare utilization among the elderly (-6.5%) and those with health problems (-3.8%). Although those without health insurance had lower utilization of healthcare services before the pandemic, during the pandemic they were not particularly hit. CONCLUSION We conclude that the pandemic did not lower the healthcare utilization in Turkey because of the supply constraints. Also, the evidence points to the reduced demand due to the fear of contagion rather than financial concerns.
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Affiliation(s)
- Zeynep B Uğur
- Department of Economics/Associate Professor, Social Sciences University of Ankara, Ankara, Turkey.
| | - Ayşenur Durak
- Department of Economics/Research Assistant, Abdullah Gül University, Kayseri, Turkey
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2
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Woodward A, Rivers C. Building Case Investigation and Contact Tracing Programs in US State and Local Health Departments: A Conceptual Framework. Disaster Med Public Health Prep 2023; 17:e540. [PMID: 38031272 DOI: 10.1017/dmp.2023.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
OBJECTIVE At the onset of the COVID-19 pandemic, and to this day, US state, tribal, local, and territorial health departments lacked comprehensive case investigation and contact tracing (CI/CT) guidelines that clearly define the capabilities and capacities of CI/CT programs and how to scale up these programs to respond to outbreaks. This research aims to identify the capabilities and capacities of CI/CT programs and to develop a conceptual framework that represents the relationships between these program components. METHODS This study conducted a narrative literature review and qualitative interviews with 10 US state and local health departments and 4 public health experts to identify and characterize the capacities and capabilities of CI/CT programs. RESULTS This research resulted in the first comprehensive analysis of the capabilities and capacities of CI/CT programs and a conceptual framework that illustrates the interrelationships between the capacities, capabilities, outcomes, and impacts of CI/CT programs. CONCLUSIONS Our findings highlight the need for further guidance to assist jurisdictional health departments in shifting CI/CT program goals as outbreaks evolve. Training the public health workforce on making decisions around CI/CT program implementation during outbreaks is critical to ensure readiness for a variety of outbreak scenarios.
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Affiliation(s)
- Alexandra Woodward
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center for Health Security, Baltimore, MD, USA
| | - Caitlin Rivers
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center for Health Security, Baltimore, MD, USA
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Kaul V, Chahal J, Schrarstzhaupt IN, Geduld H, Shen Y, Cecconi M, Siqueira AM, Markoski MM, Kawano-Dourado L. Lessons Learned from a Global Perspective of Coronavirus Disease-2019. Clin Chest Med 2023; 44:435-449. [PMID: 37085231 PMCID: PMC9684102 DOI: 10.1016/j.ccm.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Coronavirus disease-2019 has impacted the world globally. Countries and health care organizations across the globe responded to this unprecedented public health crisis in a varied manner in terms of public health and social measures, vaccination development and rollout, the conduct of research, developments of therapeutics, sharing of information, and in how they continue to deal with the widespread aftermath. This article reviews the various elements of the global response to the pandemic, focusing on the lessons learned and strategies to consider during future pandemics.
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Affiliation(s)
- Viren Kaul
- Department of Pulmonary and Critical Care Medicine, Crouse Health/Upstate Medical University, 736 Irving Avenue, Syracuse, NY, 13210, USA
| | - Japjot Chahal
- Department of Pulmonary and Critical Care Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA
| | - Isaac N Schrarstzhaupt
- Capixaba Institute of Health Education, Research and Innovation (ICEPi), Rua Duque de Caxias, 267 - Centro, Vitória/ES, 29010-120, Brazil
| | - Heike Geduld
- Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Room 5006 Clinical Building, Stellenbosch University Tygerberg Campus, Cape Town 7505, South Africa
| | - Yinzhong Shen
- Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, China
| | - Maurizio Cecconi
- Department of Anesthesia and Intensive Care, IRCCS Instituto Clinico Humanitas, Via Manzoni 56, Rozzano (Milano), Italy
| | - Andre M Siqueira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, CEP 21040-900, Rio de Janeiro RJ Brazil
| | - Melissa M Markoski
- UFCSPA - Federal University of Health Sciences of Porto Alegre. Sarmento Leite, 245 - Centro Histórico, Porto Alegre - RS, 90050-170, Brazil
| | - Leticia Kawano-Dourado
- Hcor Research Institute, Hospital do Coracao, R. Des Eliseu Guilherme, 200, 8o andar, Sao Paulo, SP 04004-030, Brazil; Pulmonary Division, InCor, University of Sao Paulo.
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van Alphen AMIA, van Hof KS, Gravesteijn BY, Krijkamp EM, Bakx PAGM, Langenbach P, Busschbach JJ, Lingsma HF, Baatenburg de Jong RJ. Minimising population health loss in times of scarce surgical capacity: a modelling study for surgical procedures performed in nonacademic hospitals. BMC Health Serv Res 2022; 22:1456. [PMID: 36451147 PMCID: PMC9713162 DOI: 10.1186/s12913-022-08854-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/17/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The burden of the COVID-19 pandemic resulted in a reduction of available health care capacity for regular care. To guide prioritisation of semielective surgery in times of scarcity, we previously developed a decision model to quantify the expected health loss due to delay of surgery, in an academic hospital setting. The aim of this study is to validate our decision model in a nonacademic setting and include additional elective surgical procedures. METHODS In this study, we used the previously published three-state cohort state-transition model, to evaluate the health effects of surgery postponement for 28 surgical procedures commonly performed in nonacademic hospitals. Scientific literature and national registries yielded nearly all input parameters, except for the quality of life (QoL) estimates which were obtained from experts using the Delphi method. Two expert panels, one from a single nonacademic hospital and one from different nonacademic hospitals in the Netherlands, were invited to estimate QoL weights. We compared estimated model results (disability adjusted life years (DALY)/month of surgical delay) based on the QoL estimates from the two panels by calculating the mean difference and the correlation between the ranks of the different surgical procedures. The eventual model was based on the combined QoL estimates from both panels. RESULTS Pacemaker implantation was associated with the most DALY/month of surgical delay (0.054 DALY/month, 95% CI: 0.025-0.103) and hemithyreoidectomy with the least DALY/month (0.006 DALY/month, 95% CI: 0.002-0.009). The overall mean difference of QoL estimates between the two panels was 0.005 (95% CI -0.014-0.004). The correlation between ranks was 0.983 (p < 0.001). CONCLUSIONS Our study provides an overview of incurred health loss due to surgical delay for surgeries frequently performed in nonacademic hospitals. The quality of life estimates currently used in our model are robust and validate towards a different group of experts. These results enrich our earlier published results on academic surgeries and contribute to prioritising a more complete set of surgeries.
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Affiliation(s)
- Anouk M I A van Alphen
- Department of Otorhinolaryngology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Kira S van Hof
- Department of Otorhinolaryngology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Benjamin Y Gravesteijn
- Department of Otorhinolaryngology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Eline M Krijkamp
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Currently Employed By the Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Pieter A G M Bakx
- Department of Orthopedic Surgery, Maasstad Hospital, Rotterdam, the Netherlands
| | - Peter Langenbach
- CEO and Chairman of Maasstad Hospital, Rotterdam, the Netherlands.,Currently Employed By Zilveren Kruis (Achmea) Health Insurance, Leiden, the Netherlands
| | - Jan J Busschbach
- Department of Medical Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hester F Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
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Cristaldi MA, Catry T, Pottier A, Herbreteau V, Roux E, Jacob P, Previtali MA. Determining the spatial distribution of environmental and socio-economic suitability for human leptospirosis in the face of limited epidemiological data. Infect Dis Poverty 2022; 11:86. [PMID: 35927739 PMCID: PMC9351081 DOI: 10.1186/s40249-022-01010-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background Leptospirosis is among the leading zoonotic causes of morbidity and mortality worldwide. Knowledge about spatial patterns of diseases and their underlying processes have the potential to guide intervention efforts. However, leptospirosis is often an underreported and misdiagnosed disease and consequently, spatial patterns of the disease remain unclear. In the absence of accurate epidemiological data in the urban agglomeration of Santa Fe, we used a knowledge-based index and cluster analysis to identify spatial patterns of environmental and socioeconomic suitability for the disease and potential underlying processes that shape them. Methods We geocoded human leptospirosis cases derived from the Argentinian surveillance system during the period 2010 to 2019. Environmental and socioeconomic databases were obtained from satellite images and publicly available platforms on the web. Two sets of human leptospirosis determinants were considered according to the level of their support by the literature and expert knowledge. We used the Zonation algorithm to build a knowledge-based index and a clustering approach to identify distinct potential sets of determinants. Spatial similarity and correlations between index, clusters, and incidence rates were evaluated. Results We were able to geocode 56.36% of the human leptospirosis cases reported in the national epidemiological database. The knowledge-based index showed the suitability for human leptospirosis in the UA Santa Fe increased from downtown areas of the largest cities towards peri-urban and suburban areas. Cluster analysis revealed downtown areas were characterized by higher levels of socioeconomic conditions. Peri-urban and suburban areas encompassed two clusters which differed in terms of environmental determinants. The highest incidence rates overlapped areas with the highest suitability scores, the strength of association was low though (CSc r = 0.21, P < 0.001 and ESc r = 0.19, P < 0.001). Conclusions We present a method to analyze the environmental and socioeconomic suitability for human leptospirosis based on literature and expert knowledge. The methodology can be thought as an evolutive and perfectible scheme as more studies are performed in the area and novel information regarding determinants of the disease become available. Our approach can be a valuable tool for decision-makers since it can serve as a baseline to plan intervention measures. Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-01010-x.
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Affiliation(s)
- Maximiliano A Cristaldi
- Department of Natural Sciences, College of Humanities and Sciences, National University of Litoral, Santa Fe, Argentina.
| | - Thibault Catry
- ESPACE-DEV, French National Research Institute for Sustainable Development (IRD), University of Montpellier, University of French West Indies, University of French Guiana, University of La Reunion, Montpellier, France
| | - Auréa Pottier
- ESPACE-DEV, French National Research Institute for Sustainable Development (IRD), University of Montpellier, University of French West Indies, University of French Guiana, University of La Reunion, Montpellier, France
| | - Vincent Herbreteau
- ESPACE-DEV, French National Research Institute for Sustainable Development (IRD), University of Montpellier, University of French West Indies, University of French Guiana, University of La Reunion, Montpellier, France
| | - Emmanuel Roux
- ESPACE-DEV, French National Research Institute for Sustainable Development (IRD), University of Montpellier, University of French West Indies, University of French Guiana, University of La Reunion, Montpellier, France.,Sentinela International Joint Laboratory, French National Research Institute for Sustainable Development (IRD), University of Brasilia (UnB), Oswaldo Cruz Foundation (Fiocruz), Brasília, Brazil.,Sentinela International Joint Laboratory, French National Research Institute for Sustainable Development (IRD), University of Brasilia (UnB), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Paulina Jacob
- National Institute of Respiratory Diseases (INER) "Dr. E. Coni"/National Administration of Health Institutes (ANLIS "Dr. C.G. Malbrán"), Santa Fe, Argentina.,Leptospirosis Laboratory, College of Biochemistry and Biological Sciences, National University of Litoral, Santa Fe, Argentina
| | - M Andrea Previtali
- Department of Natural Sciences, College of Humanities and Sciences, National University of Litoral, Santa Fe, Argentina. .,National Scientific and Technical Research Council (CONICET), Santa Fe, Argentina.
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Lee K. Rapid communication for effective medical resource allocation in the COVID-19 pandemic. Acute Crit Care 2021; 36:262-263. [PMID: 34510852 PMCID: PMC8435445 DOI: 10.4266/acc.2021.01046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 08/17/2021] [Indexed: 12/03/2022] Open
Affiliation(s)
- Kwangha Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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