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Abzhandadze T, Hoang MT, Mo M, Mostafaei S, Jurado PG, Xu H, Johnell K, Von Euler M, Eriksdotter M, Garcia-Ptacek S. COVID-19 Pandemic and Stroke Care in Patients with Dementia Compared to Other Stroke Patients. J Am Med Dir Assoc 2024; 25:105011. [PMID: 38702044 DOI: 10.1016/j.jamda.2024.03.122] [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] [Received: 11/30/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES The primary objective of this study was to examine the impact of the COVID-19 pandemic on the quality of stroke care for patients with preexisting dementia, compared with patients who had only stroke. The secondary aim was to investigate how the quality of stroke care changed during the pandemic and post-pandemic periods compared with the pre-pandemic period in patients with preexisting dementia. DESIGN A registry-based, nationwide cohort study in Sweden. SETTING AND PARTICIPANTS We included patients with a first stroke between 2019 and 2022, both with and without dementia. The study periods were defined as follows: pre-pandemic (January 1, 2019, to February 29, 2020), COVID-19 pandemic (March 1, 2020, to February 24, 2022), and post-COVID-19 pandemic period (February 25, 2022, to September 19, 2022). The outcomes examined were the following quality indicators of stroke care, suggested by the national guideline of stroke care in Sweden: stroke admission site, performance of swallowing assessment, reperfusion treatment, assessment for rehabilitation, and early supported discharge. METHODS The associations were studied through group comparisons and binary logistic regressions. RESULTS Of the 21,795 patients with strokes, 1357 had documented preexisting dementia, and 20,438 had stroke without a dementia diagnosis. Throughout all study periods, a significantly lower proportion of patients with stroke with preexisting dementia, compared with stroke-only patients, received reperfusion treatment, assessments for rehabilitation, and early supported discharge from stroke units. In the subgroup of stroke patients with preexisting dementia, no significant associations were found regarding the quality indicators of stroke care before, during, and after the pandemic. CONCLUSIONS AND IMPLICATIONS Disparities in quality of stroke care were observed between stroke patients with preexisting dementia and those with only stroke during the COVID-19 pandemic. However, there were no statistically significant differences in stroke care for patients with dementia across the pandemic.
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Affiliation(s)
- Tamar Abzhandadze
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Minh Tuan Hoang
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Minjia Mo
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Shayan Mostafaei
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pol Grau Jurado
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Hong Xu
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mia Von Euler
- Faculty of Medicine and Health, Department of Neurology and Rehabilitation, Örebro University, Örebro, Sweden
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Aging and Inflammation Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Sara Garcia-Ptacek
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Aging and Inflammation Theme, Karolinska University Hospital, Stockholm, Sweden
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Parsons Leigh J, Moss SJ, Mizen SJ, Sriskandarajah C, FitzGerald EA, Quinn AE, Clement F, Farkas B, Dodds A, Columbus M, Stelfox HT. "We're sinking": a qualitative interview-based study on stakeholder perceptions of structural and process limitations to the Canadian healthcare system. Arch Public Health 2024; 82:56. [PMID: 38664761 PMCID: PMC11044548 DOI: 10.1186/s13690-024-01279-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Despite longstanding efforts and calls for reform, Canada's incremental approach to healthcare changes has left the country lagging behind other OECD nations. Reform to the Canadian healthcare system is essential to develop a higher performing system. This study sought to gain a deeper understanding of the views of Canadian stakeholders on structural and process deficiencies and strategies to improve the Canadian healthcare system substantially and meaningfully. METHODS We conducted individual, ~ 45-minute, semi-structured virtual interviews from May 2022 to August 2022. Using existing contacts and snowball sampling, we targeted one man and one woman from five regions in Canada across four stakeholder groups: (1) public citizens; (2) healthcare leaders; (3) academics; and (4) political decision makers. Interviews centered on participants' perceptions of the state of the current healthcare system, including areas where major improvements are required, and strategies to achieve suggested enhancements; Donabedian's Model (i.e., structure, process, outcomes) was the guiding conceptual framework. Interviews were audio-recorded, transcribed verbatim, and de-identified, and inductive thematic analysis was performed independently and in duplicate according to published methods. RESULTS The data from 31 interviews with 13 (41.9%) public citizens, 10 (32.3%) healthcare leaders, 4 (12.9%) academics, and 4 (12.9%) political decision makers resulted in three themes related to the structure of the healthcare system (1. system reactivity; 2. linkage with the Canadian identity; and 3. political and funding structures), three themes related to healthcare processes (1. staffing shortages; 2. inefficient care; and 3. inconsistent care), and three strategies to improve short- and long-term population health outcomes (1. delineating roles and revising incentives; 2. enhanced health literacy; 3. interdisciplinary and patient-centred care). CONCLUSION Canadians in our sample identified important structural and process limitations to the Canadian healthcare system. Meaningful reforms are needed and will require addressing the link between the Canadian identity and our healthcare system to facilitate effective development and implementation of strategies to improve population health outcomes.
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Affiliation(s)
- Jeanna Parsons Leigh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
| | - Stephana Julia Moss
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Sara J Mizen
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Cynthia Sriskandarajah
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Emily A FitzGerald
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Amity E Quinn
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Fiona Clement
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Brenlea Farkas
- O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Alexandra Dodds
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Melanie Columbus
- O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Henry T Stelfox
- O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Castelletti N, Paunovic I, Rubio-Acero R, Beyerl J, Plank M, Reinkemeyer C, Kroidl I, Noreña I, Winter S, Olbrich L, Janke C, Hoelscher M, Wieser A. A Dried Blood Spot protocol for high-throughput quantitative analysis of SARS-CoV-2 RBD serology based on the Roche Elecsys system. Microbiol Spectr 2024; 12:e0288523. [PMID: 38426747 PMCID: PMC10986497 DOI: 10.1128/spectrum.02885-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/15/2023] [Indexed: 03/02/2024] Open
Abstract
SARS-CoV-2 spreads pandemically since 2020; in 2021, effective vaccinations became available and vaccination campaigns commenced. Still, it is hard to track the spread of the infection or to assess vaccination success in the broader population. Measuring specific anti-SARS-CoV-2 antibodies is the most effective tool to track the spread of the infection or successful vaccinations. The need for venous-blood sampling however poses a significant barrier for large studies. Dried-blood-spots on filter-cards (DBS) have been used for SARS-CoV-2 serology in our laboratory, but so far not to follow quantitative SARS-CoV-2 anti-spike reactivity in a longitudinal cohort. We developed a semi-automated protocol or quantitative SARS-CoV-2 anti-spike serology from self-sampled DBS, validating it in a cohort of matched DBS and venous-blood samples (n = 825). We investigated chromatographic effects, reproducibility, and carry-over effects and calculated a positivity threshold as well as a conversion formula to determine the quantitative binding units in the DBS with confidence intervals. Sensitivity and specificity reached 96.63% and 97.81%, respectively, compared to the same test performed in paired venous samples. Between a signal of 0.018 and 250 U/mL, we calculated a correction formula. Measuring longitudinal samples during vaccinations, we demonstrated relative changes in titers over time in several individuals and in a longitudinal cohort over four follow-ups. DBS sampling has proven itself for anti-nucleocapsid serosurveys in our laboratory. Similarly, anti-spike high-throughput DBS serology is feasible as a complementary assay. Quantitative measurements are accurate enough to follow titer dynamics in populations also after vaccination campaigns. This work was supported by the Bavarian State Ministry of Science and the Arts; LMU University Hospital, LMU Munich; Helmholtz Center Munich; University of Bonn; University of Bielefeld; German Ministry for Education and Research (proj. nr.: 01KI20271 and others) and the Medical Biodefense Research Program of the Bundeswehr Medical Service. Roche Diagnostics provided kits and machines for analyses at discounted rates. The project is funded also by the European-wide Consortium ORCHESTRA. The ORCHESTRA project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No 101016167. The views expressed in this publication are the sole responsibility of the author, and the Commission is not responsible for any use that may be made of the information it contains.IMPORTANCESARS-CoV-2 has been spreading globally as a pandemic since 2020. To determine the prevalence of SARS-CoV-2 antibodies among populations, the most effective public health tool is measuring specific anti-SARS-CoV-2 antibodies induced by infection or vaccination. However, conducting large-scale studies that involve venous-blood sampling is challenging due to the associated feasibility and cost issues. A more cost-efficient and less invasive method for SARS-CoV-2 serological testing is using Dried-Blood-Spots on filter cards (DBS). In this paper, we have developed a semi-automated protocol for quantifying SARS-CoV-2 anti-spike antibodies from self-collected DBS. Our laboratory has previously successfully used DBS sampling for anti-nucleocapsid antibody surveys. Likewise, conducting high-throughput DBS serology for anti-spike antibodies is feasible as an additional test that can be performed using the same sample preparation as the anti-nucleocapsid analysis. The quantitative measurements obtained are accurate enough to track the dynamics of antibody levels in populations, even after vaccination campaigns.
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Affiliation(s)
- Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Institute of Radiation Medicine, Helmholtz Zentrum München, Neuherberg, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
| | - Ivana Paunovic
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany
| | - Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Jessica Beyerl
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany
| | - Michael Plank
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christina Reinkemeyer
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Ivan Noreña
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Simon Winter
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
| | - Laura Olbrich
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - on behalf of the KoCo19/ORCHESTRA Working group
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Institute of Radiation Medicine, Helmholtz Zentrum München, Neuherberg, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, Munich, Germany
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Teng C, Zhu X, Nazar R, Kanwal T. Asymmetric nexus between pandemic uncertainty and public health spendings: Evidence from quantile estimation. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024; 44:991-1006. [PMID: 37802646 DOI: 10.1111/risa.14226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 07/14/2023] [Accepted: 08/04/2023] [Indexed: 10/08/2023]
Abstract
The COVID-19 pandemic has brought significant challenges to healthcare systems worldwide, prompting governments to allocate substantial resources toward public health spendings (PHS). However, the uncertainties surrounding the pandemic have raised questions about the effectiveness and sustainability of such expenditures. This research analyzes the nonlinear link between pandemic uncertainty (PNU) and PHS in countries with highest PNU (USA, India, France, Germany, UK, Saudi Arabia, South Korea, Indonesia, Japan, and China). Previous studies have employed panel data methodologies to establish consistent findings regarding the relationship between pandemics and health spendings, regardless of the fact that several countries have not autonomously recognized this connection. In contrast, this current research adopts a distinctive tool called "quantile-on-quantile," which enables the examination of time series dependency within each economy, providing both international and country-specific perspectives on the relationship between the variables. The estimations indicate that PNU leads to an increase in PHS in the vast majority of economies chosen by us, focusing on definite segments of the data distribution. Moreover, the data demonstrates that there are differences in the asymmetry between the variables across various nations. This underscores the need for policymakers to take careful deliberation when formulating policies related to health spendings and addressing the challenges posed by pandemic uncertainty.
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Affiliation(s)
- Chenmei Teng
- School of Politics and Public Administration, Soochow University, Suzhou, Jiangsu, China
| | - Xiaoya Zhu
- School of Politics and Public Administration, Soochow University, Suzhou, Jiangsu, China
| | - Raima Nazar
- Department of Economics, The Women University, Multan, Pakistan
| | - Tahira Kanwal
- Department of Commerce, Bahauddin Zakariya University, Multan, Pakistan
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Todorović S, Vojinović S, Savić D, Aleksić D, Danilović M. Potential beneficial effect of IFN-β1a and ocrelizumab in people with MS during the COVID-19 pandemic. Acta Neurol Belg 2024; 124:447-455. [PMID: 37962785 DOI: 10.1007/s13760-023-02421-9] [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] [Received: 02/09/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND/AIM Disease-modifying therapy (DMT) has led to added challenges in the management of people with multiple sclerosis (pwMS) during the COVID-19 era. It can reduce relapse in MS or slow down disease progression, but some DMTs can increased risk of infection. The aim of study was to evaluate risk and severity of COVID-19 in pwMS. METHODS The examined group of pwMS were divided in group treated with IFN-β1a, group treated with ocrelizumab and untreated group. The examination included impact of age, gender, duration of MS, type of MS, vaccination status and Expanded Disability Status Scale (EDSS) on the risk and severity of COVID-19 infection. A diagnosis of COVID-19 in pwMS was confirmed by positive polymerase-chain-reaction (PCR) or antigen test. RESULTS Out of 207 pwMS, 82 patients were treated with ocrelizumab, 63 with IFN-β1a, while 62 patients were untreated pwMS. The average duration of the MS was longer in the group of patients treated with ocrelizumab than in the group treated with IFN-β1a (p < 0.05). EDSS was higher in the ocrelizumab group compared to the other two groups (p < 0.001). Untreated (more often unvaccinated) had the same COVID frequency as ocrelizumab-treated (more vaccinated, but higher EDSS). The multivariate logistic regression model indicated that administration of IFN-β1a reduces the risk of COVID-19 infection (p = 0.001, OR = 0.381, 95% CI 0.602-0.160). The use of both DMTs, driven mainly by the IFN-β1a effect, reduces the risk of moderate and severe COVID-19 (p < 0.05, OR = 0.105, 95% CI 0.011-0.968). CONCLUSION This study provides evidence that IFN-β1a can reduce the frequency of COVID-19 infection and that two DMTs, driven mainly by the IFN-β1a effect, do not increase the risk of moderate/severe COVID-19.
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Affiliation(s)
- Stefan Todorović
- Department of Neurology, University Clinical Center Niš, Blvd Dr Zoran Dindjic 48, 18000, Nis, Serbia.
| | - Slobodan Vojinović
- Department of Neurology, University Clinical Center Niš, Blvd Dr Zoran Dindjic 48, 18000, Nis, Serbia
- Faculty of Medicine, University of Niš, Nis, Serbia
| | - Dejan Savić
- Department of Neurology, University Clinical Center Niš, Blvd Dr Zoran Dindjic 48, 18000, Nis, Serbia
- Faculty of Medicine, University of Niš, Nis, Serbia
| | - Dejan Aleksić
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Miloš Danilović
- Military Medical Academy, Clinic for Neurology, Belgrade, Serbia
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Tang Y. Socioeconomic inequalities in healthcare system efficiency in Japan during COVID-19 pandemic: an analysis of the moderating role of vaccination. Front Public Health 2024; 12:1170628. [PMID: 38584913 PMCID: PMC10996399 DOI: 10.3389/fpubh.2024.1170628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/07/2024] [Indexed: 04/09/2024] Open
Abstract
Background In the context of the COVID-19 pandemic, limited research has focused on socioeconomic disparities in Local Healthcare System Efficiency (LHSE) among Japanese prefectures. This study seeks to investigate the moderating impact of vaccination on the relationship between LHSE and socioeconomic characteristics and endowments. Methods To explore these relationships, we first utilized the Data Envelopment Analysis with Slack-Based Measure to measure the LHSE, based on data from Japanese prefectures during waves 2 to 5 of the pandemic. Then estimating the impact of socioeconomic variables on LHSE. Finally, we assessed the changes in the way socioeconomic variables affect LHSE before and after vaccine deployment using the Seemingly Unrelated Estimation t-test methodology. Results The research findings suggest an overall reduction in LHSE disparities across various regions due to the utilization of vaccines. Particularly in areas with relatively nsufficient bed resources, a significant improvement in LHSE was observed in most regions. However, there was no evidence supporting the role of vaccine deployment in mitigating socioeconomic inequalities in LHSE. Conversely, the utilization of vaccines showed a positive correlation between the improvement in LHSE and the proportion of older adult population in regions with sufficient bed resources. In regions facing bed shortages, the enhancement of LHSE became more reliant on reducing the occupancy rate of secured beds for severe cases after the introduction of vaccination. Discussion In regions facing bed shortages, the enhancement of LHSE became more reliant on reducing the occupancy rate of secured beds for severe cases. This underscores the importance for policymakers and implementers to prioritize the treatment of severe cases and ensure an effective supply of medical resources, particularly secured beds for severe cases, in their efforts to improve LHSE, in the post-COVID-19 era with rising vaccine coverage.
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Affiliation(s)
- Yin Tang
- Graduate School of Economics, Keio University, Tokyo, Japan
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Augusti JV, Silva SN. Management of pharmaceutical services in the fight against COVID-19 in universal public health systems: a rapid review. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2024; 32:109-119. [PMID: 38233348 DOI: 10.1093/ijpp/riad093] [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] [Received: 06/22/2023] [Accepted: 12/22/2023] [Indexed: 01/19/2024]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic brought new challenges and lessons were learnt for health services. In the field of pharmaceutical care, several interventions have been proposed to optimize and expand the response capacity of services. OBJECTIVE To identify and characterize interventions performed in the management of pharmaceutical services during the COVID-19 pandemic in universal public health systems. METHODS A rapid literature review was conducted and registered in PROSPERO (CRD42022360902). Systematic searches in the MEDLINE (PubMed), Embase, and Virtual Health Library databases were conducted to identify interventions and practices adopted for the management of pharmaceutical care during the COVID-19 pandemic. RESULTS Thirteen articles reporting interventions developed in six countries were included. The interventions were summarized under three major themes: actions for continuous access to medicines, logistical measures for acquisition and storage, and organizational strategies. Telepharmacy services stand out as a typical action adopted in different services, which highlights the use and consolidation of digital technologies in these services. Strategies for process management were described and focused on the reorganization of the internal service of pharmacies, flow of services, and people management. CONCLUSIONS Many interventions were developed during the pandemic, some of which have already been incorporated into routine service delivery. Although the studies did not measure the effect of each intervention, the strategies developed are a source of information for the future delivery of care. Studies should be conducted to evaluate the potential of similar interventions in other health emergency contexts.
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Affiliation(s)
- Júlia Vasconcellos Augusti
- Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 Pampulha, 31270-90 Belo Horizonte, Minas Gerais, Brazil
| | - Sarah Nascimento Silva
- Fundação Oswaldo Cruz, Instituto Rene Rachou, Núcleo de Avaliação de Tecnologias em Saúde, Av. Augusto de Lima, 1715 Barro Preto, 30190-002 Belo Horizonte, Minas Gerais, Brazil
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Sun X, Lv B, Gao X, Meng K. Can the allocation of primary health care system resources affect efficiency? A spatial Dubin model study in China. BMC PRIMARY CARE 2024; 25:62. [PMID: 38383325 PMCID: PMC10882762 DOI: 10.1186/s12875-024-02290-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 02/01/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND The primary health care (PHC) system plays an important role in China's health care system, but there are challenges such as irrational allocation of health resources and inefficient operation, which need to be improved. The purpose of this study was to explore the impact of resource allocation on the efficiency of the PHC system in China. METHODS The data in 31 provinces were collected from the China Statistical Yearbook 2017-2021 and the China Health Statistical Yearbook 2017-2021. The comprehensive health resource density index (CHRDI) was constructed based on the entropy method and the health resource density index (HRDI), which was used to analyze the allocation of primary health resources in each province. The adjusted efficiency of the PHC system in each province was calculated by the bootstrap data envelopment analysis (DEA). Finally, the spatial Dubin model was used to explore the effect of the CHRDI on efficiency. RESULTS From 2016 to 2020, the allocation of primary health resources in 31 provinces showed an increasing trend, and the average efficiency after correction showed a decreasing state year by year. The spatial direct effect and spatial spillover effect coefficients of CHRDI were 0.820 and 1.471, which positively affect the efficiency. Per capita Gross Domestic Product (GDP), urbanization rate, and the proportion of the elderly were the factors affecting the efficiency of the PHC system. CONCLUSIONS The allocation of primary health resources in all provinces in China has improved each year, but there are still great differences, and efficiency must be further improved. Pay attention to the spatial spillover effect of the level of resource allocation and formulate differentiated measures for different regions. Attention should also be paid to the impact of population aging and economic development on the utilization of primary health resources by increasing health needs and choices.
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Affiliation(s)
- Xinyue Sun
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Bo Lv
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Xiaoyi Gao
- School of Medical Humanities, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Kai Meng
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China.
- Beijing Tiantan Hospital, Capital Medical University, No.119 South of the Fourth Ring Road, Fengtai District, Beijing, 100069, China.
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Xie W, Shi L, Liu M, Yang J, Ma M, Sun G. Disparities and effectiveness of COVID-19 vaccine policies in three representative European countries. Int J Equity Health 2024; 23:16. [PMID: 38287322 PMCID: PMC10825987 DOI: 10.1186/s12939-024-02110-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/16/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE The aim of this study was to examine the Coronavirus disease 2019(COVID-19) vaccine policies disparities and effectiveness in Germany, Denmark and Bulgaria, with a view to providing lessons for global vaccination and response to possible outbreak risks. METHODS This study analyzed big data through public information on the official websites of the Ministries of Health of the European Union, Germany, Denmark and Bulgaria and the official websites of the World Health Organization. We systematically summarized the COVID-19 vaccine policies of the three countries, and selected the following six indicators for cross-cutting vaccination comparisons: COVID-19 vaccine doses administered per 100 people, COVID-19 vaccination rate, the share of people with fully vaccinated, the share of people only partly vaccinated, cumulative confirmed COVID-19 cases per million, cumulative confirmed COVID-19 deaths per million. Meanwhile, we selected the following four indicators for measuring the effectiveness of COVID-19 vaccine policy implementation: daily cases per million, daily deaths per million, the effective reproduction rate (Rt), the moving-average case fatality rate (CFR). RESULTS Although these three EU countries had the same start time for vaccination, and the COVID-19 vaccine supply was coordinated by the EU, there are still differences in vaccination priorities, vaccination types, and vaccine appointment methods. Compared to Germany and Denmark, Bulgaria had the least efficient vaccination efforts and the worst vaccination coverage, with a vaccination rate of just over 30% as of June 2023, and the maximum daily deaths per million since vaccination began in the country was more than three times that of the other two countries. From the perspective of implementation effect, vaccination has a certain effect on reducing infection rate and death rate, but the spread of new mutant strains obviously aggravates the severity of the epidemic and reduces the effectiveness of the vaccine. Among them, the spread of the Omicron mutant strain had the most serious impact on the three countries, showing an obvious epidemic peak. CONCLUSIONS Expanding vaccination coverage has played a positive role in reducing COVID-19 infection and mortality rates and stabilizing Rt. Priority vaccination strategies targeting older people and at-risk groups have been shown to be effective in reducing COVID-19 case severity and mortality in the population. However, the emergence and spread of new variant strains, and the relaxation of epidemic prevention policies, still led to multiple outbreaks peaking. In addition, vaccine hesitancy, mistrust in government and ill-prepared health systems are hampering vaccination efforts. Among the notable ones are divergent types of responses to vaccine safety issue could fuel mistrust and hesitancy around vaccination. At this stage, it is also necessary to continue to include COVID-19 vaccination in priority vaccination plans and promote booster vaccination to prevent severe illness and death. Improving the fairness of vaccine distribution and reducing the degree of vaccine hesitancy are the focus of future vaccination work.
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Affiliation(s)
- Wanzhen Xie
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Leiyu Shi
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Meiheng Liu
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Junyan Yang
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Mengyuan Ma
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Gang Sun
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, 510515, China.
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.
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Yasin YM, Alomari A, Al-Hamad A, Kehyayan V. The impact of COVID-19 on nurses' job satisfaction: a systematic review and meta-analysis. Front Public Health 2024; 11:1285101. [PMID: 38274512 PMCID: PMC10808441 DOI: 10.3389/fpubh.2023.1285101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/27/2023] [Indexed: 01/27/2024] Open
Abstract
Background The global healthcare landscape was profoundly impacted by the COVID-19 pandemic placing nurses squarely at the heart of this emergency. This review aimed to identify the factors correlated with nurses' job satisfaction, the impact of their job satisfaction on both themselves and their patients, and to explore strategies that might have counteracted their job dissatisfaction during the COVID-19 pandemic. Methods The Joanna Briggs Institute (JBI) methodology for systematic reviews of prevalence and incidence was used in this review. The electronic databases of CINAHL, MEDLINE, SCOPUS, PsycINFO and Academic Search Complete were searched between January 2020 to February 2023. Results The literature review identified 23 studies from 20 countries on nurses' job satisfaction during the COVID-19 pandemic. A pooled prevalence of 69.6% of nurses were satisfied with personal, environmental, and psychological factors influencing their job satisfaction. Job satisfaction improved psychological wellbeing and quality of life, while dissatisfaction was linked to turnover and mental health issues. Conclusion This systematic review elucidates key factors impacting nurses' job satisfaction during the COVID-19 pandemic, its effects on healthcare provision, and the potential countermeasures for job dissatisfaction. Core influences include working conditions, staff relationships, and career opportunities. High job satisfaction correlates with improved patient care, reduced burnout, and greater staff retention. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023405947, the review title has been registered in PROSPERO and the registration number is CRD42023405947.
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Affiliation(s)
- Yasin M. Yasin
- Department of Nursing and Midwifery, Collage of Health Sciences, University of Doha for Science and Technology, Doha, Qatar
| | - Albara Alomari
- Department of Nursing and Midwifery, Collage of Health Sciences, University of Doha for Science and Technology, Doha, Qatar
| | - Areej Al-Hamad
- Daphne Cockwell School of Nursing, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON, Canada
| | - Vahe Kehyayan
- Department of Healthcare Management, College of Business Management, University of Doha for Science and Technology, Doha, Qatar
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11
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Amarakoon PM, Gundersen RB, Muhire A, Utvik VA, Braa J. Exploring health information system resilience during COVID-19 pandemic: case studies from Norway, Sri Lanka & Rwanda. BMC Health Serv Res 2023; 23:1433. [PMID: 38110892 PMCID: PMC10726492 DOI: 10.1186/s12913-023-10232-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 10/27/2023] [Indexed: 12/20/2023] Open
Abstract
The study aims at exploring health system resilience by defining the scope on health information systems, one of the six building blocks of the health system. The empirical evidence is derived using qualitative data collection and analysis in the context of Norway, Sri Lanka and Rwanda during the COVID-19 pandemic. The case studies elicit bounce back and bounce forward properties as well as the agility as major attributes of resilience present across the countries. Existing local capacity, networking and collaborations, flexible digital platforms and enabling antecedent conditions are identified as socio-technical determinants of information system resilience based on the case studies across the countries.
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12
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Gize A, Belete Y, Kassa M, Tsegaye W, Hundie GB, Belete BM, Bekele M, Ababaw B, Tadesse Y, Fantahun B, Sirgu S, Ali S, Tizazu AM. Baseline and early changes in laboratory parameters predict disease severity and fatal outcomes in COVID-19 patients. Front Public Health 2023; 11:1252358. [PMID: 38152668 PMCID: PMC10751315 DOI: 10.3389/fpubh.2023.1252358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) has become the worst catastrophe of the twenty-first century and has led to the death of more than 6.9 million individuals across the globe. Despite the growing knowledge of the clinicopathological features of COVID-19, the correlation between baseline and early changes in the laboratory parameters and the clinical outcomes of patients is not entirely understood. Methods Here, we conducted a time series cross-sectional study aimed at assessing different measured parameters and socio-demographic factors that are associated with disease severity and the outcome of the disease in 268 PCR-confirmed COVID-19 Patients. Results We found COVID-19 patients who died had a median age of 61 years (IQR, 50 y - 70 y), which is significantly higher (p < 0.05) compared to those who survived and had a median age of 54 years (IQR, 42y - 65y). The median RBC count of COVID-19 survivors was 4.9 × 106/μL (IQR 4.3 × 106/μL - 5.2 × 106/μL) which is higher (p < 0.05) compared to those who died 4.4 × 106/μL (3.82 × 106/μL - 5.02 × 106/μL). Similarly, COVID-19 survivors had significantly (p < 0.05) higher lymphocyte and monocyte percentages compared to those who died. One important result we found was that COVID-19 patients who presented with severe/critical cases at the time of first admission but managed to survive had a lower percentage of neutrophil, neutrophil to lymphocyte ratio, higher lymphocyte and monocyte percentages, and RBC count compared to those who died. Conclusion To conclude here, we showed that simple laboratory parameters can be used to predict severity and outcome in COVID-19 patients. As these parameters are simple, inexpensive, and radially available in most resource-limited countries, they can be extrapolated to future viral epidemics or pandemics to allocate resources to particular patients.
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Affiliation(s)
- Addisu Gize
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
- CIHLMU Center for International Health, LMU University Hospital, LMU Munich, Germany
| | - Yerega Belete
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Melkayehu Kassa
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Wondewosen Tsegaye
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Gadissa Bedada Hundie
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Birhan Mesele Belete
- Department of Internal Medicine, School of Medicine, College of Health Science and Medicine, Wollo University, Dessie, Ethiopia
| | - Mahteme Bekele
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Berhan Ababaw
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Yosef Tadesse
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bereket Fantahun
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Sisay Sirgu
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Solomon Ali
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Anteneh Mehari Tizazu
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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13
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Walkowiak MP, Domaradzki J, Walkowiak D. Unmasking the COVID-19 pandemic prevention gains: excess mortality reversal in 2022. Public Health 2023; 223:193-201. [PMID: 37672832 DOI: 10.1016/j.puhe.2023.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/11/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVES The purpose of this study was to assess the long-term effectiveness of COVID-19 pandemic prevention measures in saving lives after European governments began to lift restrictions. STUDY DESIGN Excess mortality interrupted time series. METHODS Country-level weekly data on deaths were fitted to the Poisson mixed linear model to estimate excess deaths. Based on this estimate, the percentage of excess deaths above the baseline during the pandemic (week 11 in 2020 to week 15 in 2022) (when public health interventions were in place) and during the post-pandemic period (week 16 in 2022 to week 52 in 2022) were calculated. These results were fitted to the linear regression model to determine any potential relationship between mortality during these two periods. RESULTS The model used in this study had high predictive value (adjusted R2 = 59.4%). Mortality during the endemic (post-pandemic) period alone increased by 7.2% (95% confidence interval [CI]: 5.7, 8.6) above baseline, while each percentage increase in mortality during the pandemic corresponded to a 0.357% reduction (95% CI: 0.243, 0.471) in mortality during the post-pandemic period. CONCLUSIONS The most successful countries in terms of protective measures also experienced the highest mortality rates after restrictions were lifted. The model used in this study clearly shows a measure of bidirectional mortality displacement that is sufficiently clear to mask any impact of long COVID on overall mortality. Results from this study also seriously impact previous cost-benefit analyses of pandemic prevention measures, since, according to the current model, 12.2% (95% CI: 8.3, 16.1) of the gains achieved in pandemic containment were lost after restrictions were lifted.
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Affiliation(s)
- M P Walkowiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland.
| | - J Domaradzki
- Department of Social Sciences and Humanities, Poznan University of Medical Sciences, Poznań, Poland.
| | - D Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznań, Poland.
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14
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Coelho J, Pecune F, Levavasseur Y, De Sevin E, D'incau E, Sagaspe P, Sanchez-Ortuño MM, Micoulaud-Franchi JA, Philip P. From improved sleep regularity to reduced sleep complaints and mental health conditions: a population-based interventional study using a smartphone-based virtual agent. Sleep 2023; 46:zsad165. [PMID: 37282717 DOI: 10.1093/sleep/zsad165] [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] [Received: 12/20/2022] [Revised: 04/28/2023] [Indexed: 06/08/2023] Open
Abstract
STUDY OBJECTIVES To explore the effect of sleep regularity on sleep complaints and mental health conditions (i.e. insomnia, fatigue, anxiety, and depressive symptoms) in a population-based interventional study using a smartphone-based virtual agent. METHODS A populational cohort based on the Kanopée application, which provided interactions with a virtual companion to collect data on sleep and make personalized recommendations to improve sleep over 17 days. A pre-intervention sleep diary and interview were used for cross-sectional analysis (n = 2142), and a post-intervention sleep diary and interview were used for longitudinal analysis (n = 732). The intra-individual mean (IIM) and standard deviation (ISD) of total sleep time (TST) were calculated to measure sleep quantity and sleep regularity. RESULTS The mean age at baseline was 49 years, 65% were female, 72% reported insomnia, 58% fatigue, 36% anxiety, and 17% depressive symptoms. Before the intervention, irregular and short sleep was associated with a higher likelihood of insomnia (Relative risk [RR] = 1.26 [1.21-1.30] for irregular TST and RR = 1.19 [1.15-1.23] for short TST), fatigue, anxiety, and depressive symptoms. After the intervention, the IIM of the TST increased while the ISD of the TST and sleep complaints and mental health conditions decreased. More regular TST was associated with reduced insomnia and depressive symptoms (RR = 1.33 [1.10-1.52] and RR = 1.55 [1.13-1.98], respectively). CONCLUSIONS Our results reveal a longitudinal association between sleep regularity and sleep complaints and mental health conditions. Policymakers, health professionals, and the general population should be aware that, beyond its positive effect on sleep health, regular sleep could promote mental health.
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Affiliation(s)
- Julien Coelho
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Florian Pecune
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Yannick Levavasseur
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Etienne De Sevin
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Emmanuel D'incau
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Patricia Sagaspe
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Maria-Montserrat Sanchez-Ortuño
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- School of Nursing, University of Murcia, Murcia, Spain
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Pierre Philip
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
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15
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Chang W, Zhou X, Nazar R, Ali S. Does pandemic uncertainty spur public health expenditures? Evidence from European Union economies. Nurs Health Sci 2023; 25:434-444. [PMID: 37565598 DOI: 10.1111/nhs.13036] [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] [Received: 10/08/2022] [Revised: 06/08/2023] [Accepted: 06/25/2023] [Indexed: 08/12/2023]
Abstract
This research intends to evaluate the asymmetric relationship between pandemic uncertainty and public health expenditures in selected European Union nations (Germany, France, Sweden, Belgium, Austria, Netherlands, Denmark, Spain, Finland, and Portugal). Earlier studies used panel data methodologies to get consistent results about the pandemic-health expenditures nexus, irrespective of the reality that numerous economies did not identify such a link independently. By contrast, the present research utilizes a unique technique, quantile-on-quantile, that explores time-series dependency in every nation by offering worldwide yet country-related insight into the linkage between the variables. Estimations reveal that pandemic uncertainty increases public health expenditures in most of the selected economies at specified quantiles of data. Additionally, the data indicate that the level of asymmetries among our variables varies by country, stressing the significance of policymakers paying special attention while executing policies concerning health expenditures and pandemic uncertainty.
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Affiliation(s)
- Wentao Chang
- Institute of Contemporary Marxism, Xinyang Normal University, Xinyang, China
| | - Xinjian Zhou
- School of Mathematics and Statistics, Xinyang Normal University, Xinyang, China
| | - Raima Nazar
- Department of Economics, The Women University, Multan, Pakistan
| | - Sajid Ali
- School of Economics, Bahauddin Zakariya University, Multan, Pakistan
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16
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Plaiasu MC, Alexandru DO, Nanu CA. Patients' rights in physicians' practice during Covid-19 pandemic: a cross-sectional study in Romania. BMC Med Ethics 2023; 24:54. [PMID: 37496036 PMCID: PMC10373321 DOI: 10.1186/s12910-023-00935-8] [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: 03/21/2023] [Accepted: 07/24/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Although the Covid-19 epidemic challenged existing medical care norms and practices, it was no excuse for unlawful conduct. On the contrary, legal compliance proved essential in fighting the pandemic. Within the European legal framework for the pandemic, patients were still entitled to be treated equally, by a specialized physician, with the possibility of seeking a second medical opinion, in a confidential setting, following prior and informed consent. This study examines physicians' practices regarding patients' rights during the Covid-19 pandemic and the effects of age, experience, and specialty on physicians' behavior and preferences. Additionally, it explores the nexus of malpractice complaints, malpractice fear, and legal compliance. METHODS A cross-sectional study was conducted on a convenience sample of attending physicians and general practitioners to assess compliance with patients' rights regulations. Respondents were physicians practicing in private and public settings in Southwestern Romania from July 2021 to May 2022. RESULTS 396 attending physicians and 109 general practitioners participated in the research. Attending physicians acknowledged patients' rights in 55.7% of statements, while general practitioners showed a slightly higher level of compliance at 59.9%. Emergency and Anesthesia and Intensive Care physicians showed the lowest compliance. There were no significant behavioral differences based on physicians' age, years in practice, work sector, or location. However, when faced with the question of prioritizing treatment for patients with similar medical conditions, 46.2% of attending physicians reported favoring the younger patients. This preference was common among physicians under 39. Additionally, over half of the attending physicians reported working outside their area of expertise due to staff shortages. Malpractice fear was high among physicians, although unrelated to patients' claims, legal compliance, or working outside the scope of practice. It resulted in pressure and behavioral changes. CONCLUSION Adherence to patients' rights was low during the Covid-19 pandemic. Physicians could benefit from educational and administrative support to ensure better legal compliance. Further research is needed to determine if this behavior persists beyond the pandemic context.
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Affiliation(s)
- Maria Cristina Plaiasu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 2 Petru Rares St, Craiova, 200349, Romania.
| | - Dragos Ovidiu Alexandru
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 2 Petru Rares St, Craiova, 200349, Romania
| | - Codrut Andrei Nanu
- Department no. 14 of Orthopedics, Anesthesia and Intensive Care, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu St., Sector 2, Bucharest, 020021, Romania
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Herrera CA, Kerr AC, Dayton JM, Kakietek JJ. Healthcare service disruption in 14 Latin American and Caribbean countries during the COVID-19 pandemic: Analysis of household phone surveys, 2020-2021. J Glob Health 2023; 13:06023. [PMID: 37469284 PMCID: PMC10359759 DOI: 10.7189/jogh.13.06023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
Background The coronavirus 2019 (COVID-19 pandemic) and associated responses have significantly disrupted healthcare. We aimed to estimate the magnitude of and reasons for households reporting healthcare disruption in 14 Latin America and the Caribbean (LAC) region countries from mid-2020 to mid-2021, and its relationship with country contextual factors. Methods We used COVID-19 high-frequency phone surveys (HFPS) conducted in 14 LAC countries in three rounds in 2020 and one in 2021. We classified the reasons reported for healthcare disruption into four groups: concerns about contracting COVID-19, healthcare supply constraints, financial reasons, and public health measures (PHMs). We used bivariate and multivariate regressions to examine correlates of reported healthcare disruption with the above groups and country context as control variables. Results On average, 20% of households reported a disruption in May-June 2020 (45% to 10% at country level), dropping to 9% in June-July 2020 (31% to 3%) and July-August 2020 (26% to 3%), and declining to 3% in May-July 2021 (11% to 1%). The most common reason reported for disruption was healthcare supply constraints, followed by concerns about contracting COVID-19, PHM, and financial reasons. In multivariable regression analyses, we found that a higher incidence of new COVID-19 cases (regression coefficient (β) = 0.018, P < 0.01), stricter PHM (β = 0.002, P < 0.01), fewer hospital beds per population (β = -0.011, P < 0.01), and lower out-of-pocket health spending (β = -0.0008, P < 0.01) were associated with higher levels of disrupted care. A higher care disruption was associated with a lower gross domestic product (GDP) per person (β = -0.00001, P < 0.01) and lower population density (β = -0.056, P < 0.01). Conclusions Healthcare services for households in LAC were substantially disrupted during the COVID-19 pandemic. Findings about supply and financial constraints can inform the recovery of postponed healthcare services, while public health and contextual factors findings can inform future health system resilience efforts in LAC and elsewhere.
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Affiliation(s)
- Cristian A Herrera
- World Bank, Washington DC, District of Columbia, USA
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Amanda C Kerr
- Department of Economics, University of Maryland, College Park, Maryland, USA
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Sobczak M, Pawliczak R. Which Factors Were Related to the Number of COVID-19 Cases in the 2022/2023 Season Compared to the 2021/2022 Season in Europe? J Clin Med 2023; 12:4517. [PMID: 37445552 DOI: 10.3390/jcm12134517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
The number of COVID-19 cases was greater in early autumn 2022 in contrast to in autumn 2021. Therefore, we decided to examine the factors that may have affected differences in the number of COVID-19 cases between the time periods 2021/2022 and 2022/2023 with consideration of the occurrence of influenza. In this cross-sectional study, we conducted a multiple factor analysis using data from publicly available databases for weeks 35-14 in 2022/2023 and 2021/2022 for Austria, Germany, Greece, Italy, and Slovenia. In the 2021/2022 season, the analyzed countries had similar profiles and were characterized by restrictions, health system policies, and SARS-CoV-2 variants, such as Alpha, Beta, Delta, Kappa, Eta, as well as Omicron sublineages (BA.1, BA.2), which were positively correlated with the number of new cases of COVID-19 per million people. However, in the 2022/2023 season, the analyzed countries were described by groups of variables corresponding to vaccination, influenza, the number of flights, and the Omicron SARS-CoV-2 subvariant. In summary, crucial factors correlated with the increasing of number of COVID-19 cases in the 2021/2022 season were the presence of dominant SARS-CoV-2 variants as well as the lifting of restrictions and strict health system policies.
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Affiliation(s)
- Marharyta Sobczak
- Department of Immunopathology, Division of Biomedical Science, Faculty of Medicine, Medical University of Lodz, 90-752 Lodz, Poland
| | - Rafał Pawliczak
- Department of Immunopathology, Division of Biomedical Science, Faculty of Medicine, Medical University of Lodz, 90-752 Lodz, Poland
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Pourmahmoud J, Bagheri N. Uncertain Malmquist productivity index: An application to evaluate healthcare systems during COVID-19 pandemic. SOCIO-ECONOMIC PLANNING SCIENCES 2023; 87:101522. [PMID: 36777893 PMCID: PMC9894680 DOI: 10.1016/j.seps.2023.101522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/15/2022] [Accepted: 01/24/2023] [Indexed: 06/01/2023]
Abstract
Evaluation of healthcare systems, as a key organization providing different health services, is essential. This issue becomes more crucial when occurring crises such as a pandemic. They need to keep track of their success in the face of the crisis to assess the effects of policy changes and their capability to respond to new challenges. The Malmquist Productivity Index (MPI) is measured to analyze the causes of productivity change between two periods of time. The estimation of the traditional MPI requires reliable and detailed information on the inputs and outputs of decision-making units. However, there are a lot of situations where input and/or output may be imprecise. It is not manageable to reliably measure certain measurement indices, such as quality of treatment or system flexibility. For such cases, experts are invited to model their opinion. Uncertainty theory is a mathematical branch rationally dealing with belief degrees. The primary objective of this study is to apply MPI concept in the nonparametric approach of data envelopment analysis to calculate the efficiency of systems over different periods of time under uncertain conditions. Accordingly, we consider the MPI when inputs and outputs are belief degrees of experts. Furthermore, the sensitivity of the model is analyzed to determine the reliability of the results to the variation of variables. Finally, as an illustrative example, we explore longitudinal efficiency of healthcare systems during COVID-19 pandemic. According to the results of our model, the majority of the countries have improved in the second period which can be the result of efforts to improve pandemic preparedness. The decomposition of MPI into efficiency changes and technical changes indicates that the rise in productivity is entirely related to the progressive change of the production frontier related to policymaking. This application attempts to demonstrate how crucial it is to take uncertainties into account when comparing the performance of different systems over periods of time. The developed model enables us to consider the uncertainty existing in COVID-19 pandemic. The proposed model can handle more accurately the uncertainty during the pandemic. Thus, the result could be more reliable, which can benefit decision-makers in regard to performance improvement.
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Affiliation(s)
- Jafar Pourmahmoud
- Department of Applied Mathematics, Azarbaijan Shahid Madani University, Tabriz, Iran
| | - Narges Bagheri
- Department of Applied Mathematics, Azarbaijan Shahid Madani University, Tabriz, Iran
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Bănică A, Muntele I. Local and regional factors of spatial differentiation of the excess mortality related to the COVID-19 pandemic in Romania. LETTERS IN SPATIAL AND RESOURCE SCIENCES 2023; 16:23. [PMID: 37220627 PMCID: PMC10189221 DOI: 10.1007/s12076-023-00340-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/30/2023] [Indexed: 05/25/2023]
Abstract
COVID-19 revealed some major weaknesses and threats that are related to the level of territorial development. In Romania, the manifestation and the impact of the pandemic were not homogenous, which was influenced, to a large extent, by a diversity of sociodemographic, economic, and environmental/geographic factors. The paper is an exploratory analysis focused on selecting and integrating multiple indicators that could explain the spatial differentiation of COVID-19-related excess mortality (EXCMORT) in 2020 and 2021. These indicators include, among others, health infrastructure, population density and mobility, health services, education, the ageing population and distance to the closest urban center. We analyzed the data from local (LAU2) and county level (NUTS3) by applying multiple linear regression and geographically weighted regression models. The results show that mobility and lower social distancing were far more critical factors for higher mortality than the intrinsic vulnerability of the population, at least in the first two years of COVID-19. However, the highly differentiated patterns and specificities of different areas of Romania resulting from the modelling of EXCMORT factors drive to the conclusion that the decision-making approaches should be place-specific in order to have more efficiency in case of pandemics.
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Affiliation(s)
- Alexandru Bănică
- Alexandru Ioan Cuza” University of Iași, Iași, Romania
- Geographic Research Center, Romanian Academy, Iași Branch, Iași, Romania
| | - Ionel Muntele
- Alexandru Ioan Cuza” University of Iași, Iași, Romania
- Geographic Research Center, Romanian Academy, Iași Branch, Iași, Romania
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Boduroglu E, Atici KB, Omay T. Phase and wave dependent analysis of health expenditure efficiency: A sample of OECD evidence. Front Public Health 2023; 11:1125975. [PMID: 37006529 PMCID: PMC10063912 DOI: 10.3389/fpubh.2023.1125975] [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] [Received: 12/16/2022] [Accepted: 02/24/2023] [Indexed: 03/19/2023] Open
Abstract
Introduction Health expenditures are a factor that reflects the government's public health policy and contributes to the protection of national health. Therefore, this study focuses on measuring the effectiveness of health expenditures in order to evaluate and improve the public health system and policy during the pandemic period. Method In order to examine the effectiveness of health expenditures, the behaviors of the pandemic process were analyzed in two stages. The number of daily cases is analyzed in the first stage by dividing it into waves and phases according to the transmission coefficient (R). For this classification, the discrete cumulative Fourier function estimation is used. In the second stage, the unit root test method was used to estimate the stationarity of the number of cases in order to examine whether the countries made effective health expenditures according to waves and phases. The series being stationary indicates that the cases are predictable and that health expenditure is efficient. Data consists of daily cases from February 2020 to November 2021 for 5 OECD countries. Conclusion The general results are shown that cases cannot be predicted, especially in the first stage of the pandemic. In the relaxation phase and at the beginning of the second wave, the countries that were seriously affected by the epidemic started to control the number of cas es by taking adequate measures, thus increasing the efficiency of their health systems. The common feature of all the countries we examined is that phase 1, which represents the beginning of the waves, is not stationary. After the waves fade, it can be concluded that the stationary number of health cases cannot be sustainable in preventing new waves' formation. It is seen that countries cannot make effective health expenditures for each wave and stage. According to these findings, the periods in which countries made effective health expenditures during the pandemic are shown. Discussion The study aims to help countries make effective short- and long-term decisions about pandemics. The research provides a view of the effectiveness of health expenditures on the number of cases per day in 5 OECD countries during the COVID-19 Pandemic.
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Affiliation(s)
| | - Kazim Baris Atici
- Department of Business Administration, Hacettepe University, Ankara, Türkiye
| | - Tolga Omay
- Economics Department, Atilim University, Ankara, Türkiye
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The Motivation of Medical Staff and the Work Interestedness in the Context of the COVID-19 Pandemic, in a Tertiary Hospital in Romania. Healthcare (Basel) 2023; 11:healthcare11060813. [PMID: 36981470 PMCID: PMC10048156 DOI: 10.3390/healthcare11060813] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the motivation and work interestedness of employees in a tertiary hospital located in the northwest of Romania. In the study, 2230 employee satisfaction questionnaires distributed during 2019–2021 in the Oradea Emergency County Clinical Hospital (CCEHO) were analyzed. The percentage of those who declare themselves motivated at the hospital level remains relatively constant, at around 75%. There were differences between staff categories. The percentage of those who evaluate work interestedness with the qualifier “high” decreased from 45.45% for the year 2019 to 41.78% for the year 2021. The degree of motivation and work interestedness showed a significant increase for TESA staff during the pandemic period compared to the year 2019. A non-significant statistical increase in the percentage of motivated staff was observed among physicians, auxiliary staff and the radiology department staff. The motivation of nurses and laboratory staff decreased, but statistically insignificantly. The COVID-19 pandemic brought statistically significant changes at the level of motivation of the hospital staff only for the administrative staff, and the work interestedness for physicians and nurses decreased statistically significantly, especially in the second year of the pandemic. Older staff with an average level of education are more likely to be unmotivated, as shown by the regression model.
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Wu JS. Measuring efficiency of the global fight against the COVID-19 pandemic. Digit Health 2023; 9:20552076231197528. [PMID: 37654724 PMCID: PMC10467301 DOI: 10.1177/20552076231197528] [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: 04/14/2023] [Accepted: 08/10/2023] [Indexed: 09/02/2023] Open
Abstract
Objectives The ongoing COVID-19 pandemic has led to an unprecedented loss of life and a severe economic downturn across the globe. Countries have adopted various social distancing and vaccination policies to reduce the spread of the disease and lessen the impact on healthcare systems. The world should work together to confront the disaster and challenge of COVID-19. Methods This study uses stochastic frontier analysis to measure the efficiency and influencing factors of the global response to COVID-19 epidemics and to provide follow-up strategies and reference guidelines. Results The results of this study show that (1) the average efficiency of the global response to COVID-19 is not good, with significant space for improvement of up to 60%; (2) adequate medical supplies and equipment can reduce mortality; (3) the initial implementation of social distancing policies and wearing masks can effectively reduce the infection rate; and (4) as infection rates and vaccination rates increase so that most people have basic immunity to COVID-19, the epidemic will gradually be reduced. Conclusions As the world becomes more aware of the COVID-19 disease, humans will gradually return to normal social interaction and lifestyles. The results of this study are expected to provide a reference for the future direction of the global fight against epidemics and the improvement of public health policies.
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Affiliation(s)
- Jih-Shong Wu
- College of General Education, Chihlee University of Technology, New Taipei City, Taiwan
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Rodríguez-Madrid MN, Pastor-Moreno G, Albert-Lopez E, Pastor-Valero M. "You knew you had to be there, it had to be done": Experiences of health professionals who faced the COVID-19 pandemic in one public hospital in Spain. Front Public Health 2023; 11:1089565. [PMID: 37181727 PMCID: PMC10170551 DOI: 10.3389/fpubh.2023.1089565] [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: 11/04/2022] [Accepted: 03/17/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction The COVID-19 pandemic highlighted the lack of a government contingency plan for an effective response to an unexpected health crisis. This study uses a phenomenological approach to explore the experience of healthcare professionals during the first three waves of the COVID-19 pandemic in a public health hospital in the Valencia region, Spain. It assesses the impact on their health, coping strategies, institutional support, organizational changes, quality of care, and lessons learned. Methods We carried out a qualitative study with semi-structured interviews with doctors and nurses from the Preventive Medicine, Emergency, and Internal Medicine Services and the Intensive Care Unit, using the Colaizzi's 7-step data analysis method. Results During the first wave, lack of information and leadership led to feelings of uncertainty, fear of infection, and transmission to family members. Continuous organizational changes and lack of material and human resources brought limited results. The lack of space to accommodate patients, along with insufficient training in treating critical patients, and the frequent moving around of healthcare workers, reduced the quality of care. Despite the high levels of emotional stress reported, no sick leave was taken; the high levels of commitment and professional vocation helped in adapting to the intense work rhythms. Healthcare professionals in the medical services and support units reported higher levels of stress, and a greater sense of neglect by their institution than their colleagues in managerial roles. Family, social support, and camaraderie at work were effective coping strategies. Health professionals showed a strong collective spirit and sense of solidarity. This helped them cope with the additional stress and workload that accompanied the pandemic. Conclusion In the wake of this experience, they highlight the need for a contingency plan adapted to each organizational context. Such a plan should include psychological counseling and continuous training in critical patient care. Above all, it needs to take advantage of the hard-won knowledge born of the COVID-19 pandemic.
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Affiliation(s)
- María Nieves Rodríguez-Madrid
- Programa de Doctorado en Ciencias de la Salud, Universidad de Sevilla, Seville, Spain
- *Correspondence: María Nieves Rodríguez-Madrid,
| | - Guadalupe Pastor-Moreno
- Escuela Andaluza de Salud Pública, Granada, Spain
- Grupo 50 del CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación del Gobierno de España, Madrid, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Enrique Albert-Lopez
- Departamento de Medicina Interna, Hospital Universitario de Basurto, Bilbao, Spain
| | - María Pastor-Valero
- Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández de Elche, Sant Joan d'Alacant, Spain
- Grupo 26 del CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación del Gobierno de España, Madrid, Spain
- Programa de pós-graduação em Saúde Coletiva, Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Spain
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Failla G, Caminiti M, Chen-Xu J, Lo Moro G, Berselli N, Cabral Ferreira M, Malcata F, Peyre-Costa D, Croci R, Soldà G, Capodici A, Morcavallo C, Traglia F, Cedrone F, Storti I, Jaquete AA, Antinozzi M, Vasiliu A. Impact of the COVID pandemic on mental health and training opportunities of Public Health Residents from 4 European countries: A cross-sectional study. Front Public Health 2023; 11:1044171. [PMID: 36960373 PMCID: PMC10028077 DOI: 10.3389/fpubh.2023.1044171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/06/2023] [Indexed: 03/09/2023] Open
Abstract
Objectives There is little evidence on the impact of the COVID-19 pandemic on Public Health Residents' (PHR) mental health (MH). This study aims at assessing prevalence and risk factors for depression, anxiety and stress in European PHR during the COVID-19 pandemic. Methods Between March and April 2021, an online survey was administered to PHR from France, Italy, Portugal and Spain. The survey assessed COVID-19 related changes in working conditions, training opportunities and evaluated MH outcomes using the Depression Anxiety Stress Scales-21. Multivariable logistic regressions were applied to identify risk factors. Results Among the 443 respondents, many showed symptoms of depression (60.5%), anxiety (43.1%) and stress (61.2%). The main outcome predictors were: female gender for depression (adjOR = 1.59, 95%CI [1.05-2.42]), anxiety (adjOR = 2.03, 95%CI [1.33-3.08]), and stress (adjOR = 2.35, 95%CI [1.53-3.61]); loss of research opportunities for anxiety (adjOR = 1.94, 95%CI [1.28-2.93]) and stress (adjOR = 1.98, 95%CI [1.26-3.11]); and COVID-19 impact on training (adjOR = 1.78, 95%CI [1.12-2.80]) for depression. Conclusions The pandemic had a significant impact on PHR in terms of depression, anxiety and stress, especially for women and who lost work-related opportunities. Training programs should offer PHR appropriate MH support and training opportunities.
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Affiliation(s)
- Giovanna Failla
- Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome, Italy
- *Correspondence: Giovanna Failla
| | - Marta Caminiti
- Department of Public Health Sciences, University of Perugia, Perugia, Italy
| | - José Chen-Xu
- Public Health Unit, Primary Health Care Cluster Baixo Mondego, Coimbra, Portugal
| | | | - Nausicaa Berselli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Filipa Malcata
- Public Health Unit, Primary Health Care Cluster Porto Ocidental, Porto, Portugal
| | - David Peyre-Costa
- Public Health Unit, University Hospital of Montpellier, Montpellier, France
| | - Roberto Croci
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Giorgia Soldà
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Angelo Capodici
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Caterina Morcavallo
- Department of Biomedical Sciences and Human Oncology, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Traglia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Fabrizio Cedrone
- Health Management of “SS. Spirito” Hospital of Pescara, Local Health Authority of Pescara, Pescara, Italy
| | - Ilaria Storti
- Department of Cardiothoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Alfonso Alonso Jaquete
- Preventive Medicine and Public Health Unit, Health Department of the Government of Cantabria, Santander, Spain
| | | | - Anca Vasiliu
- Department of Pediatrics, Global Tuberculosis Program, Baylor College of Medicine, Houston, TX, United States
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Predictors and outcomes in primary depression care (POKAL) - a research training group develops an innovative approach to collaborative care. BMC PRIMARY CARE 2022; 23:309. [PMID: 36460965 PMCID: PMC9717547 DOI: 10.1186/s12875-022-01913-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND The interdisciplinary research training group (POKAL) aims to improve care for patients with depression and multimorbidity in primary care. POKAL includes nine projects within the framework of the Chronic Care Model (CCM). In addition, POKAL will train young (mental) health professionals in research competences within primary care settings. POKAL will address specific challenges in diagnosis (reliability of diagnosis, ignoring suicidal risks), in treatment (insufficient patient involvement, highly fragmented care and inappropriate long-time anti-depressive medication) and in implementation of innovations (insufficient guideline adherence, use of irrelevant patient outcomes, ignoring relevant context factors) in primary depression care. METHODS In 2021 POKAL started with a first group of 16 trainees in general practice (GPs), pharmacy, psychology, public health, informatics, etc. The program is scheduled for at least 6 years, so a second group of trainees starting in 2024 will also have three years of research-time. Experienced principal investigators (PIs) supervise all trainees in their specific projects. All projects refer to the CCM and focus on the diagnostic, therapeutic, and implementation challenges. RESULTS The first cohort of the POKAL research training group will develop and test new depression-specific diagnostics (hermeneutical strategies, predicting models, screening for suicidal ideation), treatment (primary-care based psycho-education, modulating factors in depression monitoring, strategies of de-prescribing) and implementation in primary care (guideline implementation, use of patient-assessed data, identification of relevant context factors). Based on those results the second cohort of trainees and their PIs will run two major trials to proof innovations in primary care-based a) diagnostics and b) treatment for depression. CONCLUSION The research and training programme POKAL aims to provide appropriate approaches for depression diagnosis and treatment in primary care.
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Zheng D, Gong J. Impacts of comprehensive reform on the efficiency of Guangdong's County public hospitals in 2014–2019, China. HEALTH POLICY AND TECHNOLOGY 2022. [DOI: 10.1016/j.hlpt.2022.100676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Henriques CO, Gouveia MC. Assessing the impact of COVID-19 on the efficiency of Portuguese state-owned enterprise hospitals. SOCIO-ECONOMIC PLANNING SCIENCES 2022; 84:101387. [PMID: 35937707 PMCID: PMC9339160 DOI: 10.1016/j.seps.2022.101387] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 04/08/2022] [Accepted: 07/05/2022] [Indexed: 06/02/2023]
Abstract
This paper uses Value-Based Data Envelopment Analysis (VBDEA), to assess the impact of the COVID-19 pandemic on the efficiency of 37 state-owned enterprises (SOE) hospitals by employing data publicly available from the Portuguese Health Service database between January and November 2019 and 2020, respectively. Furthermore, a productivity index (specifically adjusted to the VBDEA approach) is also used that allows identifying which factors are behind the relative efficiency changes of these hospitals. The factors considered to perform the efficiency assessment of the Portuguese SOE hospitals include labour, capacity, and activity-related indicators. Out of the 37 SOE hospitals, 21 and 17 were efficient in 2019 and 2020, respectively. Irrespective of the value functions considered, the hospitals more often viewed as a reference for best practices were Santa Maria Maior, Tâmega e Sousa and Entre Douro e Vouga. Santa Maria Maior and Algarve were the only hospitals found to be robustly efficient for both years. Overall, the majority of SOE hospitals showed negative productivity (except for Évora and Santa Maria Maior) and all of them presented negative technological change, thus highlighting the massive impact that the COVID-19 outbreak has had on the performance of these hospitals. An additional conclusion is that inefficient hospitals substantially increased all their resources in 2020 as compared to inefficient hospitals in 2019, suggesting that the inefficiency of these hospitals was not due to the lack of resources. Finally, irrespective of the model employed, the hospitals located in the Portuguese northern region were more resilient to the COVID-19 crisis. All in all, to become more resilient (even for future COVID-19 outbreaks), hospitals should undertake changes that are advantageous irrespective of the obstacles they face and that are even beneficial during normal times. A culture of cooperation within and across hospitals should also be cultivated, which allows exchanging resources where they can be used more efficiently.
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Affiliation(s)
- C O Henriques
- Polytechnic of Coimbra, Coimbra Business School | ISCAC Quinta Agrícola, Bencanta, 3040-316, Coimbra, Portugal
- INESC Coimbra - DEEC, University of Coimbra, Polo 2, 3030-290, Coimbra, Portugal
- Univ Coimbra, CeBER, Faculty of Economics, Av Dias da Silva 165, 3004-512, Coimbra, Portugal
| | - M C Gouveia
- Polytechnic of Coimbra, Coimbra Business School | ISCAC Quinta Agrícola, Bencanta, 3040-316, Coimbra, Portugal
- INESC Coimbra - DEEC, University of Coimbra, Polo 2, 3030-290, Coimbra, Portugal
- Univ Coimbra, CeBER, Faculty of Economics, Av Dias da Silva 165, 3004-512, Coimbra, Portugal
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Bahnsen L, Wild F. Wie sind wir bisher durch die COVID-19-Pandemie gekommen? Ein
vergleichender Blick nach Europa. GESUNDHEITSÖKONOMIE & QUALITÄTSMANAGEMENT 2022. [DOI: 10.1055/a-1965-1964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
ZusammenfassungDie Bewältigung der COVID-19-Pandemie hat weitreichende
Eindämmungsmaßnahmen erfordert. Um die Auswirkungen deutscher
Pandemiepolitik einzuordnen, kann ein europäischer Blick hilfreich sein.
Wir greifen das Konzept der Übersterblichkeit auf, um einen Eindruck vom
bisherigen Pandemieverlauf und implizit auch der Pandemiebewältigung in
den EU-27-Staaten und primär Deutschland zu gewinnen. Alles in allem ist
Deutschland bisher vergleichsweise gut durch die Pandemie gekommen. Dies
dürfte auch auf die ergriffenen Maßnahmen
zurückzuführen sein, deren Effektivität sich im
Einzelnen allerdings nicht feststellen lässt. Um kommenden Pandemien
vorbereitet zu begegnen, müssen klare Zuständigkeiten und
Entscheidungsstrukturen festgelegt und ein begleitendes Pandemiemonitoring
etabliert werden.
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Affiliation(s)
- Lewe Bahnsen
- Wissenschaftliches Institut der Privaten Krankenversicherung
(WIP)
| | - Frank Wild
- Wissenschaftliches Institut der Privaten Krankenversicherung
(WIP)
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Androutsou L, Kokkinos M, Latsou D, Geitona M. Assessing the Efficiency and Productivity of the Hospital Clinics on the Island of Rhodes during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15640. [PMID: 36497714 PMCID: PMC9735861 DOI: 10.3390/ijerph192315640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/11/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: The aim was to measure the efficiency and productivity of 15 specialty clinics during the COVID-19 pandemic period 2020-2021 in the General Hospital of Rhodes. (2) Methods: An input-oriented data envelopment analysis and the Malmquist productivity index are used. Labor and capital were used as inputs, and in-patient discharges and days were used as outputs. (3) Results: Five out of the seven clinics in the pathology sector appeared fully efficient with an optimal productivity, and the rest showed progress in 2021. In 2020 the COVID-19 pathology clinic appeared to be inefficient and less productive, while in 2021, it showed a positive performance change. The surgical sector showed very high efficiency rates or even reached an optimal efficiency in both years. The productivity measurement, in most of the surgical clinics, was satisfactory to very high. In 2020 the COVID-19 surgical clinic appeared to be more efficient and productive than in 2021 when its performance declined. (4) Conclusions: The hospital responded to the pressure during the pandemic, by increasing its efficiency and productivity from 2020 to 2021. This was due to the accomplishment of the appropriate organizational changes in the infrastructure, human resources, and technology. The efficiency and productivity assessments should be incorporated in the hospitals' decision making.
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Affiliation(s)
- Lorena Androutsou
- Department of Economics and Business, School of Economics, Business and Computer Sciences, Neapolis University Pafos, Pafos 8042, Cyprus
| | - Michail Kokkinos
- Department of Economics and Business, School of Economics, Business and Computer Sciences, Neapolis University Pafos, Pafos 8042, Cyprus
- Ophthalmology Department, General Hospital of Rhodes, 85100 Rhodes, Greece
| | - Dimitra Latsou
- Department of Economics and Business, School of Economics, Business and Computer Sciences, Neapolis University Pafos, Pafos 8042, Cyprus
| | - Mary Geitona
- Department of Economics and Business, School of Economics, Business and Computer Sciences, Neapolis University Pafos, Pafos 8042, Cyprus
- Department of Social and Educational Policy, School of Social Sciences, University of Peloponnese, 20132 Corinth, Greece
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Isnain AR, Che Dom N, Abdullah S, Precha N, Salim H. Efficiency of Malaysian states in managing the COVID-19 outbreak in 2020 and 2021. PLoS One 2022; 17:e0275754. [PMID: 36288385 PMCID: PMC9605290 DOI: 10.1371/journal.pone.0275754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/22/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Many developing countries have drastically imbalanced health systems in different regions. The COVID-19 outbreak posed a further challenge as hospital structures, equipped with doctors, critical care units and respirators, were not available to a sufficient extent in all regions. OBJECTIVE This study is a descriptive study on the efficiency of Malaysian states in facing the COVID-19 outbreak. METHODOLOGY The efficiency of all Malaysian states was measured using Data Envelopment Analysis in which each state's Score of COVID Index (SCI) was quantified. The SCI of these states were then further compared between the year 2020 and 2021. A greater disparity would indicate a decline in the performance of a state over time, where nearly all the states in Malaysia experienced an increase in the score of COVID Index (SCI). RESULT This study found that the central region was the most affected, since all the three states in the region (Selangor, Federal Territory of Kuala Lumpur, and Federal Territory of Putrajaya) showed a situation of inadequacy (SCI: >0.75) due to the COVID-19 outbreak. CONCLUSION The ranking of Malaysia's states according to their vulnerability to an outbreak of COVID-19 is vitally significant for the purposes of assisting the government and policymakers in planning their responses to the outbreak and ensuring that resources are distributed appropriately.
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Affiliation(s)
- Abdul Rahim Isnain
- Centre of Environmental Health & Safety studies, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), UITM Cawangan Selangor, Puncak Alam, Selangor, Malaysia
| | - Nazri Che Dom
- Centre of Environmental Health & Safety studies, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), UITM Cawangan Selangor, Puncak Alam, Selangor, Malaysia
- Integrated Mosquito Research Group (I-MeRGe), Universiti Teknologi MARA (UiTM), UITM Cawangan Selangor, Puncak Alam, Selangor, Malaysia
- Institute for Biodiversity and Sustainable Development (IBSD), Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
- * E-mail: (HS); (NCD)
| | - Samsuri Abdullah
- Faculty of Ocean Engineering Technology and Informatics, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Nopadol Precha
- Department of Environmental Health and Technology, School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Hasber Salim
- School of Biological Sciences, Universiti Sains Malaysia, Minden Penang, Malaysia
- * E-mail: (HS); (NCD)
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Sinimole KR. Healthcare efficiency and the best practices of health systems across the world during COVID-19 pandemic. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2126672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- K. R. Sinimole
- Rajagiri Business School, Rajagiri College of Social Sciences, Kochi, Kerala, India
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Cancer care for Ukrainian refugees during the first 6 weeks of 2022 Russian invasion – an experience of a Cancer Reference Centre in Poland. Eur J Cancer 2022; 178:234-242. [DOI: 10.1016/j.ejca.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 12/24/2022]
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Rzymski P, Kasianchuk N, Sikora D, Poniedziałek B. COVID-19 vaccinations and rates of infections, hospitalizations, ICU admissions, and deaths in Europe during SARS-CoV-2 Omicron wave in the first quarter of 2022. J Med Virol 2022; 95:e28131. [PMID: 36068643 PMCID: PMC9537885 DOI: 10.1002/jmv.28131] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/11/2022] [Accepted: 09/04/2022] [Indexed: 01/11/2023]
Abstract
The vaccination campaigns brought hope to minimizing the coronavirus disease 2019 (COVID-19) burden. However, the emergence of novel, highly transmissible Omicron lineage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the waning of neutralizing antibodies a few months after vaccination has brought concerns over the vaccine efficacy. The present work analyzed the relationships between COVID-19 vaccine coverage (completion of primary course and booster dose intake) in the European Economic Area and rates of infection, hospitalizations, admissions to intensive care units (ICU), and deaths during the Omicron wave in the first quarter of 2022 (January-April). As demonstrated, infection rates were not correlated to vaccine coverage in any considered month. For January and February, the rates of hospitalizations, intensive care unit (ICU) admissions, and death due to COVID-19 were strongly negatively correlated (r =- 0.54 to -0.82) with the percentage of individuals who completed initial vaccination protocol and the percentage of those who received a booster dose. However, in March and April, the percentage of the population with primary vaccination course correlated negatively only with ICU admissions (r = -0.77 and -0.46, respectively). The uptake of boosters in March still remained in significant negative correlation with hospitalizations (r = -0.45), ICU admissions (r = -0.70) and deaths due to COVID-19 (r = -0.37), although in April these relationships were no longer observed. The percentage of individuals with confirmed SARS-CoV-2 infection did not correlate with the pandemic indices for any considered month. The study indicates that COVID-19 vaccination, including booster administration, was beneficial in decreasing the overwhelming of healthcare systems during the Omicron wave, but novel vaccine strategies may be required in the long term to enhance the effectiveness and durability of vaccine-induced protection during future waves of SARS-CoV-2 infections.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental MedicinePoznan University of Medical SciencesPoznańPoland,Integrated Science Association (ISA)Universal Scientific Education and Research Network (USERN)PoznańPoland
| | - Nadiia Kasianchuk
- Faculty of BiologyAdam Mickiewicz UniversityPoznańPoland,Faculty of PharmacyBogomolets National Medical UniversityKyivUkraine
| | - Dominika Sikora
- Department of Environmental MedicinePoznan University of Medical SciencesPoznańPoland,Doctoral SchoolPoznan University of Medical SciencesPoznańPoland
| | - Barbara Poniedziałek
- Department of Environmental MedicinePoznan University of Medical SciencesPoznańPoland
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Aparicio Betancourt M, Duarte-Díaz A, Vall-Roqué H, Seils L, Orrego C, Perestelo-Pérez L, Barrio-Cortes J, Beca-Martínez MT, Molina Serrano A, Bermejo-Caja CJ, González-González AI. Global Healthcare Needs Related to COVID-19: An Evidence Map of the First Year of the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10332. [PMID: 36011970 PMCID: PMC9408445 DOI: 10.3390/ijerph191610332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/10/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has exposed gaps and areas of need in health systems worldwide. This work aims to map the evidence on COVID-19-related healthcare needs of adult patients, their family members, and the professionals involved in their care during the first year of the pandemic. We searched the databases MEDLINE, Embase, and Web of Science. Two reviewers independently screened titles and abstracts and assessed full texts for eligibility. Disagreements were resolved by consensus. Descriptive data were extracted and inductive qualitative content analysis was used to generate codes and derive overarching themes. Thirty-six studies met inclusion criteria, with the majority reporting needs from the perspective of professionals (35/36). Professionals' needs were grouped into three main clusters (basic, occupational, and psycho-socio-emotional needs); patients' needs into four (basic, healthcare, psycho-socio-emotional, and other support needs); and family members' needs into two (psycho-socio-emotional and communication needs). Transversal needs across subgroups were also identified and grouped into three main clusters (public safety, information and communication, and coordination and support needs). This evidence map provides valuable insight on COVID-19-related healthcare needs. More research is needed to assess first-person perspectives of patients and their families, examine whether needs differ by country or region, and evaluate how needs have evolved over time.
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Affiliation(s)
- Mariana Aparicio Betancourt
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Helena Vall-Roqué
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Laura Seils
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
| | - Carola Orrego
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 El Rosario, Spain
| | - Jaime Barrio-Cortes
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Fundación para la Investigación e Innovación Biosanitaria en Atención Primaria, 28003 Madrid, Spain
| | | | | | - Carlos Jesús Bermejo-Caja
- Unidad de Apoyo Técnico Dirección Técnica de Sistemas de información, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, 28035 Madrid, Spain
- Departamento de Enfermería. Universidad Autónoma de Madrid, 28034 Madrid, Spain
| | - Ana Isabel González-González
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Unidad de Innovación y Proyectos Internacionales, Dirección General de Investigación, Docencia y Documentación, Consejería de Sanidad, 28034 Madrid, Spain
- Institute of General Practice, Goethe University, 60323 Frankfurt, Germany
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Augustynowicz A, Opolski J, Waszkiewicz M. Health Security: Definition Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10009. [PMID: 36011643 PMCID: PMC9408279 DOI: 10.3390/ijerph191610009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/27/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
The link between security and health is not a discovery. Despite the widespread recognition of the social importance of health security, there is no single common definition of this concept. The study's objective was to search, analyse and evaluate possible original propositions to define the concept of "health security" in Polish professional literature published from 10 January 2017 to 31 March 2022. The research method was a scoping review performed in five stages according to H. Arksey and L. O'Malley. Ultimately, the study criteria were met by four studies. The proposed definition of health security in these papers failed to solve this problem and raised further questions and doubts. It is urgent to start a discourse on the meaning of the concept of "health security" with the broadest possible participation of representatives of various scientific disciplines, but taking into account the knowledge and practice of public health. It seems that it will be impossible to avoid the following questions: what is health security nowadays? What is health security as a personal issue? What are the necessary steps to achieve the consensus? Is it worthwhile to consider it on the international level?
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Affiliation(s)
- Anna Augustynowicz
- Department of Economics of Health and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland
- School of Public Health Centre of Postgraduate Medical Education of Warsaw, 01-813 Warsaw, Poland
| | - Janusz Opolski
- Faculty of Engineering and Management, University of Ecology and Management in Warsaw, 00-792 Warsaw, Poland
| | - Michał Waszkiewicz
- School of Public Health Centre of Postgraduate Medical Education of Warsaw, 01-813 Warsaw, Poland
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Navajas-Romero V, Ceular-Villamandos N, Pérez-Priego MA, Caridad-López del Río L. Sustainable human resource management the mediating role between work engagement and teamwork performance. PLoS One 2022; 17:e0271134. [PMID: 35925955 PMCID: PMC9352011 DOI: 10.1371/journal.pone.0271134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022] Open
Abstract
The present work aims to analyze the properties of the working conditions recorded in the Sixth European Working Conditions Survey (EWCS); with it, it has being built seven independent indexes about different aspects of work’ quality in the health sector, and these constructs are used to evaluate their effects on work engagement (WE). In this sense, the originality of incorporating teamwork as a modulating variable is included. To analyze the effects of the job quality index (JQI) on the WE, a logistic regression model is proposed for a total of 3044 workers within the health sector, differentiating between those who work or not in a team; in a first stage and these estimates are compared with those obtained using an artificial neural network model, and both are used for the consideration of the research hypotheses about several causal factor. An important contributions of the study, it is related to how work commitment is mainly influenced by prospects, social environment, intensity and earnings, all of them related to job performance. Therefore, knowledge of the determinants of work commitment and the ability to modulate its effects in teamwork environments is necessary for the development of truly sustainable Human Resources policies.
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Antohi VM, Ionescu RV, Zlati ML, Mirica C. Approaches related to the effects of Covid-19 pandemics on financing of the healthcare system in Romania. Front Public Health 2022; 10:940021. [PMID: 35968420 PMCID: PMC9363635 DOI: 10.3389/fpubh.2022.940021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe healthcare financial system faced a significant disturbance of the budget balance after the outbreak of the pandemic, amid government measures to combat the disease. These measures have led to shifts in funding weights within the income and expenditure budget structure, with a focus on prevention and treatment of patients infected with SARS-COV 2. The purpose of this research is to analyse the financial balance of the healthcare system and the related modelling to support decision-makers in adopting and implementing appropriate financing measures for the pandemic.MethodsThe working hypotheses of this study were tested using an econometric linear regression model based on the financing budgetary function, which matches funding to the specific need for each expenditure heading. SPSS 25 statistical software was used to define the model and to test the homogeneity of the data and their statistical relevance to the phenomenon under analysis.ResultsThe proposed model showed that there is a significant correlation of the dependent variable, Dynamics of budget revenues in the healthcare sector (TIM), with the regressors. We believe that a problem-solving rebalancing of allocations could help to eliminate the synergy in health. This redistribution should take into account the impact that economic and budgetary factors have on healthcare factors and vice versa, so that at some point after successive adjustments the minimum distance between forecast and realisation or between need and financing of need can be reached. The used data were analysed dynamically to assess changes in trend as absolute data do not allow the construction of an overall picture. Relative data captures changes in financing from year to year and can be linked to events such as pandemics, financial crises or inflation.ConclusionsIn relation to the objectives of the research, it emerges that, under the impact of pandemic stress, measures to improve healthcare management, increase performance and streamline financial allocation are vulnerable and cannot counteract the effects that the pandemic has on the healthcare of the population as reflected in the morbidity and mortality indicators collected during the pandemic. In this regard, it is necessary a rethinking of the strategic healthcare management, a better planning of the procurement of medicines and healthcare supplies, a rethinking of the partnerships with the European Commission and other global entities. This approach can effectively improve the impact of the pandemic on the healthcare status of the population, a rebalancing of the demand-supply balance in healthcare and a maintenance of the strategic programmes, according to the objectives assumed in the planning, given that these programmes protect categories of people already medically affected.
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Affiliation(s)
- Valentin Marian Antohi
- Department of Business Administration, Dunarea de Jos University, Galati, Romania
- Department of Finance, Accounting and Economic Theory, Transylvania University, Brasov, Romania
- *Correspondence: Valentin Marian Antohi
| | - Romeo Victor Ionescu
- Department of Administrative Sciences and Regional Studies, Dunarea de Jos University, Galati, Romania
| | - Monica Laura Zlati
- Department of Accounting, Audit and Finance, Stefan cel Mare University, Suceava, Romania
| | - Cristian Mirica
- Department of Business Administration, Dunarea de Jos University, Galati, Romania
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3 a edizione Giornate della ricerca scientifica e delle esperienze professionali dei giovani: Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI) 25-26 marzo 2022. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E1-E57. [PMID: 36017074 PMCID: PMC9364697 DOI: 10.15167/2421-4248/jpmh2022.63.1s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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