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De Bellis A, McCloud C, Giles J, Apollloni M, Abigail W, Hill P. Rural and remote pharmacists' perspectives of grey nomads with diabetes travelling in Australia. Aust J Rural Health 2024. [PMID: 38766684 DOI: 10.1111/ajr.13139] [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: 10/22/2023] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVE The objective of the research was to explore rural and remote pharmacists' experiences of encountering grey nomads with diabetes. DESIGN A qualitative Interpretive Description design was used to explore and capture the experiences of rural and remote pharmacists interacting with grey nomads who had diabetes. Data from the interviews were analysed thematically. SETTING The Pharmacy Guild of Australia was approached and through their membership rural and remote pharmacists were invited to participate in the research. PARTICIPANTS Nine rural and remote pharmacists who had encounters and provided services to grey nomads with diabetes responded to be interviewed. RESULTS The analysed findings established four major themes including: the influence of rural and remote locations on services; common problems encountered by the pharmacists; preparation for travel by grey nomads with diabetes; and pharmacists' preparedness to support grey nomads with diabetes. CONCLUSION The findings of this study identified that pharmacists needed remuneration for services provided to grey nomads with diabetes. Also, further development of the My Health record and telehealth to include pharmacists would be advantageous for grey nomads who have diabetes. Pharmacists stated there was a need for further education and a continuing professional development module specifically designed for pharmacists on diabetes self-management that moved beyond medications. A pre-travel checklist for grey nomads with diabetes travelling in rural and remote Australia would benefit all stakeholders through better preparation of travellers with diabetes to self-manage, thereby reducing the demand for health services including pharmacies.
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Affiliation(s)
- Anita De Bellis
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Christine McCloud
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Jane Giles
- Rural and Remote Health, SAHealth, Adelaide, South Australia, Australia
| | - Marc Apollloni
- Pharmacy Guild South Australia, Adelaide, South Australia, Australia
| | - Wendy Abigail
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Pauline Hill
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Saulnier DD, Topp SM. We need to talk about 'bad' resilience. BMJ Glob Health 2024; 9:e014041. [PMID: 38320804 PMCID: PMC10859976 DOI: 10.1136/bmjgh-2023-014041] [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: 09/22/2023] [Accepted: 01/26/2024] [Indexed: 02/15/2024] Open
Abstract
In this analysis, we argue against seeing health system resilience as an inherently positive concept. The rise in the popularity of health system resilience has led to its increasingly normative framing. We question this widely accepted perspective by examining the underlying assumptions associated with this normative framing of 'good' resilience. Our focus is on the risks of accepting the assumption, which can lead us to ignore the social nature of health systems and overlook the consequences of change if resilience is seen as a positive, achievable objective. Finally, we suggest that seeing resilience as a normative concept can be detrimental to health system policy and research, and encourage a critical rethinking of these assumptions so that we can maintain resilience's usefulness for health systems.
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Affiliation(s)
- Dell D Saulnier
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Economics, University of Zambia, Lusaka, Zambia
| | - Stephanie M Topp
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
- The University of Melbourne Nossal Institute for Global Health, Melbourne, Victoria, Australia
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3
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Millar AM, Doria AM, Choi LM, McGladrey L, Duffy KA, Berkowitz SJ. Past the Pandemic: a virtual intervention supporting the well-being of healthcare workers through the COVID-19 pandemic. Front Psychol 2023; 14:1227895. [PMID: 38022930 PMCID: PMC10650594 DOI: 10.3389/fpsyg.2023.1227895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
To decrease burnout and improve mental health and resiliency among doctors, nurses, and hospital staff during the COVID-19 pandemic, the University of Colorado partnered with ECHO Colorado to offer the state's healthcare workforce an interactive, psychoeducational, and online intervention that encouraged connection and support. The series utilized the Stress Continuum Model as its underlying conceptual framework. Between July 2020 and February 2022, 495 healthcare workers in Colorado participated in the series across eight cohorts. One-way repeated measures ANOVAs were performed to test for differences in pretest and posttest scores on series' objectives. Healthcare workers showed significant improvement from pretest to posttest in (1) knowing when and how to obtain mental health resources, F(1, 111) = 46.497, p < 0.001, (2) recognizing of the importance of being socially connected in managing COVID-related stress, F(1, 123) = 111.159, p < 0.001, (3) managing worries, F(1, 123) = 94.941, p < 0.001, (4) feeling prepared to manage stressors related to the pandemic, F(1, 111) = 100.275, p < 0.001, (5) feeling capable in dealing with challenges that occur daily, F(1, 111) = 87.928, p < 0.001, and (6) understanding the Stress Continuum Model F(1, 123) = 271.049, p < 0.001. This virtual series showed efficacy in improving the well-being of healthcare workers during a pandemic and could serve as a model for mental health support for healthcare workers in other emergency response scenarios.
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Affiliation(s)
- Amanda M. Millar
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, United States
| | - Amanda M. Doria
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, United States
| | - Leslie M. Choi
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, United States
| | - Laura McGladrey
- College of Nursing, University of Colorado School of Medicine, Aurora, CO, United States
| | - Korrina A. Duffy
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, United States
| | - Steven J. Berkowitz
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, United States
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Arnold-Reed DE, Bulsara CE, Gilkes L. Disruption caused by the COVID-19 pandemic response from a Western Australian metropolitan general practice perspective: a qualitative descriptive study. Aust J Prim Health 2023; 29:385-394. [PMID: 36683177 DOI: 10.1071/py22136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND In 2020 and 2021, Western Australia (WA) was an early adopter of the 'COVID zero' policy, eliminating community transmission and pursuing vaccine roll out to enable a 'soft landing' once coronavirus disease 2019 (COVID-19) infiltrated the community in 2022. Optimisation and augmentation of general practice services were at the forefront of policies. This study explores metropolitan general practice responses to the resulting disruption caused. METHODS Qualitative descriptive methodology, purposive sampling and template analysis were used. Semi-structured interviews were undertaken from March to June 2021 with teams from six general practices in metropolitan WA; six general practitioners, four practice nurses and three practice managers. RESULTS Staff at all levels responded rapidly amid uncertainty and workload challenges with marked personal toll (anxiety and fear of exposure to risks, frustrations of patients and balancing work and family life). Self-reliance, teamwork and communication strategies built on inclusivity, autonomy and support were important. Responding to changes in general patient behaviour was to the fore. Increasing use of telehealth (telephone and video) became important to meet patient needs. Lessons learned from what was implemented in early-stage lockdowns provided practices with preparedness for the future, and smoother transitions during subsequent lockdowns. CONCLUSION The study demonstrates the self-reliance, teamwork and adaptability of the general practice sector in responding to a sudden, unexpected major disruption, yet maintaining ongoing service provision for their patients. Although the COVID-19 landscape has now changed, the lessons learned and the planning that took place will help general practice in WA adapt to similar future situations readily.
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Affiliation(s)
- Diane E Arnold-Reed
- School of Medicine, The University of Notre Dame Australia, 19 Mouat Street, PO Box 1225, Fremantle, WA 6959, Australia
| | - Caroline E Bulsara
- School of Nursing and Midwifery, The University of Notre Dame Australia, 19 Mouat Street, PO Box 1225, Fremantle, WA 6959, Australia; and Institute for Health Research, The University of Notre Dame Australia, 19 Mouat Street, PO Box 1225, Fremantle, WA 6959, Australia
| | - Lucy Gilkes
- School of Medicine, The University of Notre Dame Australia, 19 Mouat Street, PO Box 1225, Fremantle, WA 6959, Australia
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Pace A, Faught BE, Law M, Mateus L, Roy M, Sulowski C, Khowaja A. Economic evaluation of tele-resuscitation intervention on emergency department pediatric visits in the Niagara Region, Canada a pilot study. FRONTIERS IN HEALTH SERVICES 2023; 3:1105635. [PMID: 37342797 PMCID: PMC10277730 DOI: 10.3389/frhs.2023.1105635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/17/2023] [Indexed: 06/23/2023]
Abstract
Introduction The use of telemedicine in critical care is emerging, however, there is a paucity of information surrounding the costs relative to health gains in the pediatric population. This study aimed to estimate the cost-effectiveness of a pediatric tele-resuscitation (Peds-TECH) intervention compared to the usual care in five community hospital emergency departments (EDs). Using a decision tree analysis approach with secondary retrospective data from a 3-year time period, this cost-effectiveness analysis was completed. Methods A mixed methods quasi-experimental design was embedded in the economic evaluation of Peds-TECH intervention. Patients aged <18 years triaged as Canadian Triage and Acuity Scale 1 or 2 at EDs were eligible to receive the intervention. Qualitative interviews were conducted with parents/caregivers to explore the out-of-pocket (OOP) expenses. Patient-level health resource utilization was extracted from Niagara Health databases. The Peds-TECH budget calculated one-time technology and operational costs per patient. Base-case analyses determined the incremental cost per year of life lost (YLL) averted, and additional sensitivity analysis confirmed the robustness of the results. Results Odds ratio for mortality among cases was 0.498 (95% CI: 0.173, 1.43). The average cost of a patient receiving the Peds-TECH intervention was $2,032.73 compared to $317.45 in usual care. In total, 54 patients received the Peds-TECH intervention. Fewer children died in the intervention group resulting in 4.71 YLL. The probabilistic analysis revealed an incremental cost-effectiveness ratio of $64.61 per YLL averted. Conclusion Peds-TECH appears to be a cost-effective intervention for resuscitating infants/children in hospital emergency departments.
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Affiliation(s)
- A. Pace
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - B. E. Faught
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - M. Law
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - L. Mateus
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - M. Roy
- Niagara Health, Niagara Region, ON, Canada
| | - C. Sulowski
- Pediatric Department, McMaster Children’s Hospital, Hamilton, ON, Canada
| | - A. Khowaja
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
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de Carvalho PVR, Bellas H, Viana J, de Castro Nunes P, Arcuri R, da Silva Fonseca V, Carneiro APM, Jatobá A. Transformative dimensions of resilience and brittleness during health systems' collapse: a case study in Brazil using the Functional Resonance Analysis Method. BMC Health Serv Res 2023; 23:349. [PMID: 37032325 PMCID: PMC10084590 DOI: 10.1186/s12913-023-09301-1] [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: 10/12/2022] [Accepted: 03/17/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND As health systems struggle to tackle the spread of Covid-19, resilience becomes an especially relevant attribute and research topic. More than strength or preparedness, to perform resiliently to emerging shocks, health systems must develop specific abilities that aim to increase their potential to adapt to extraordinary situations while maintaining their regular functioning. Brazil has been one of the most affected countries during the pandemic. In January 2021, the Amazonas state's health system collapsed, especially in the city of Manaus, where acute Covid-19 patients died due to scarcity of medical supplies for respiratory therapy. METHODS This paper explores the case of the health system's collapse in Manaus to uncover the elements that prevented the system from performing resiliently to the pandemic, by carrying out a grounded-based systems analysis of the performance of health authorities in Brazil using the Functional Resonance Analysis Method. The major source of information for this study was the reports from the congressional investigation carried out to unveil the Brazilian response to the pandemic. RESULTS Poor cohesion between the different levels of government disrupted essential functions for managing the pandemic. Moreover, the political agenda interfered in the abilities of the system to monitor, respond, anticipate, and learn, essential aspects of resilient performance. CONCLUSIONS Through a systems analysis approach, this study describes the implicit strategy of "living with Covid-19", and an in-depth view of the measures that hampered the resilience of the Brazilian health system to the spread of Covid-19.
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Affiliation(s)
| | - Hugo Bellas
- Centro de Estudos, Estratégicos Antônio Ivo de Carvalho (CEE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Jaqueline Viana
- Centro de Estudos, Estratégicos Antônio Ivo de Carvalho (CEE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Paula de Castro Nunes
- Centro de Estudos, Estratégicos Antônio Ivo de Carvalho (CEE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rodrigo Arcuri
- Programa de Pós-Graduação Em Engenharia de Produção (TPP), Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Valéria da Silva Fonseca
- Centro de Estudos, Estratégicos Antônio Ivo de Carvalho (CEE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Alessandro Jatobá
- Centro de Estudos, Estratégicos Antônio Ivo de Carvalho (CEE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
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Kim KE. Ten Takeaways from the COVID-19 Pandemic for Transportation Planners. TRANSPORTATION RESEARCH RECORD 2023; 2677:517-530. [PMID: 37153166 PMCID: PMC10149348 DOI: 10.1177/03611981221090515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The COVID-19 pandemic has created significant challenges but also unprecedented opportunities for transportation researchers and practitioners. In this article, the major lessons and gaps in knowledge for those working in the transportation sector are identified, including the following: (1) integration between public health and transportation; (2) technology to support contact tracing and tracking of travelers; (3) focus on vulnerable, at-risk operators, patrons, and underserved members of society; (4) re-engineering of travel demand models to support social distancing, quarantine, and public health interventions; (5) challenges with Big Data and information technologies; (6) trust relationships between the general public, government, private sector, and others in disaster management; (7) conflict management during disasters; (8) complexities of transdisciplinary knowledge and engagement; (9) demands for training and education; and (10) transformative change to support community resilience. With a focus on transportation planning and community resilience, the lessons from the pandemic need to be shared and customized for different systems, services, modalities, and users. While many of the interventions during the pandemic have been based on public health, the management, response, recovery, adaptation, and transformation of transportation systems resulting from the crisis require multi-disciplinary, multi-jurisdictional communications and coordination, and resource sharing. Further research to support knowledge to action is needed.
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Affiliation(s)
- Karl E. Kim
- Department of Urban and Regional Planning, University of Hawaii, Honolulu, HI
- Karl E. Kim,
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Arji G, Ahmadi H, Avazpoor P, Hemmat M. Identifying resilience strategies for disruption management in the healthcare supply chain during COVID-19 by digital innovations: A systematic literature review. INFORMATICS IN MEDICINE UNLOCKED 2023; 38:101199. [PMID: 36873583 PMCID: PMC9957975 DOI: 10.1016/j.imu.2023.101199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/12/2023] [Accepted: 02/16/2023] [Indexed: 02/27/2023] Open
Abstract
The worldwide spread of the COVID-19 disease has had a catastrophic effect on healthcare supply chains. The current manuscript systematically analyzes existing studies mitigating strategies for disruption management in the healthcare supply chain during COVID-19. Using a systematic approach, we recognized 35 related papers. Artificial intelligence (AI), block chain, big data analytics, and simulation are the most important technologies employed in supply chain management in healthcare. The findings reveal that the published research has concentrated mainly on generating resilience plans for the management of COVID-19 impacts. Furthermore, the vulnerability of healthcare supply chains and the necessity of establishing better resilience methods are emphasized in most of the research. However, the practical application of these emerging tools for managing disturbance and warranting resilience in the supply chain has been examined only rarely. This article provides directions for additional research, which can guide researchers to develop and conduct impressive studies related to the healthcare supply chain for different disasters.
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Affiliation(s)
- Goli Arji
- Health Information Management, School of Nursing and Midwifery, Saveh University of Medical Sciences, Iran
| | - Hossein Ahmadi
- Centre for Health Technology, Faculty of Health, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Pejman Avazpoor
- Department of Agriculture Economics, Ferdowsi University of Mashhad, Iran
| | - Morteza Hemmat
- Health Information Management, School of Nursing and Midwifery, Saveh University of Medical Sciences, Iran
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Cano-López I, Pérez MI, Puig-Pérez S. Burnout is related to executive dysfunction in primary healthcare professionals working in rural areas. Rev Neurol 2023; 76:91-99. [PMID: 36703502 PMCID: PMC10364042 DOI: 10.33588/rn.7603.2022283] [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: 01/13/2023] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Healthcare professionals are especially vulnerable to burnout, which implies a hypothalamus-pituitary-adrenal dysregulation that could impact the integrity of brain structures needed for cognitive processing. However, a scarce number of studies have analyzed the relationship between burnout and executive functions in this population, and possible modulator factors have not been clarified. This study aims to characterize the burnout level of primary healthcare professionals working in rural areas, and to analyze its relationship with executive functioning, considering the possible modulating role of optimism. SUBJECTS AND METHODS In this cross-sectional study, 32 primary healthcare professionals were recruited from the Carcastillo Health Center (Spain) and underwent an assessment in which burnout was assessed using the Maslach Burnout Inventory - Human Services Survey. Optimism and executive functions were also evaluated. RESULTS 43.8%, 59.4%, and 56.3% of participants experienced high levels of burnout via emotional exhaustion, depersonalization, and personal accomplishment. The path analysis showed that emotional exhaustion was associated with poorer Trail Making Test scores (ß = -0.37, SE = 0.17, p = 0.024, Cohen's f2 = 0.15), but optimism was not a significant moderator of this relationship (p = 0.24). The proposed model yielded excellent fit (CFI = 1.00, RMSEA = 0.0001, SRMR = 0.0001, and ?2(3) = 6.07, p = 0.11). CONCLUSIONS These results suggest that burnout in healthcare professionals could have a detrimental effect on the efficiency of health systems. This has relevant implications, especially for professionals characterized by both work pressure and high cognitive demands, and highlights a need to implement occupation-specific approaches for prevention.
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Affiliation(s)
- Irene Cano-López
- VIU-NED Chair of Global Neuroscience and Social ChangeVIU-NED Chair of Global Neuroscience and Social ChangeVIU-NED Chair of Global Neuroscience and Social ChangeValenciaSpain
- Faculty of Health Sciences. Universidad Internacional de Valencia. Valencia, SpainFaculty of Health SciencesUniversidad Internacional de ValenciaValenciaSpain
| | - Mariola I. Pérez
- Faculty of Health Sciences. Universidad Internacional de Valencia. Valencia, SpainFaculty of Health SciencesUniversidad Internacional de ValenciaValenciaSpain
| | - Sara Puig-Pérez
- VIU-NED Chair of Global Neuroscience and Social ChangeVIU-NED Chair of Global Neuroscience and Social ChangeVIU-NED Chair of Global Neuroscience and Social ChangeValenciaSpain
- Faculty of Health Sciences. Universidad Internacional de Valencia. Valencia, SpainFaculty of Health SciencesUniversidad Internacional de ValenciaValenciaSpain
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Patchett-Marble R, Orrantia E, DeMiglio L, Fageria S. Optimization of physician resources in primary care during a pandemic: A ‘hot’ and ‘cold’ team approach. ETHICS, MEDICINE, AND PUBLIC HEALTH 2023; 26:100834. [PMCID: PMC9686360 DOI: 10.1016/j.jemep.2022.100834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/03/2022] [Indexed: 11/27/2022]
Abstract
Background Healthcare in rural localities has faced unique pressures in the midst of the COVID-19 (coronavirus disease 2019) pandemic. Methodology The Marathon Family Health Team physicians created a novel pandemic model that divides active physicians into ‘hot’ and ‘cold’ teams with a “sideline” reserve based on physician infectious status and ongoing exposure risk, in order to address the potential instability of small medical groups in isolated situations. Results Implemented in stages, the model maximizes group agility and healthcare provisions, while minimizing the risk of physicians as vectors for transmission or a possible healthcare system collapse from simultaneous physician incapacitation. Conclusion The hot/cold pandemic model can be applied to various healthcare facilities, including but not limited to hospitals and assessment centres, and the model's scale can be further adjusted for larger settings. By making use of incapacitated physicians who have been “sidelined” due to illness or burnout but still able to work from home, this model is integrative, efficient and innovative.
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Affiliation(s)
- R. Patchett-Marble
- Northern Ontario School of Medicine University, Thunder Bay, Ontario, Canada,Marathon Family Health Team, Marathon, Ontario, Canada
| | - E. Orrantia
- Northern Ontario School of Medicine University, Thunder Bay, Ontario, Canada,Marathon Family Health Team, Marathon, Ontario, Canada
| | - L. DeMiglio
- Northern Ontario School of Medicine University, Thunder Bay, Ontario, Canada,Marathon Family Health Team, Marathon, Ontario, Canada,Corresponding author. Northern Ontario School of Medicine University, Thunder Bay, Ontario, Canada
| | - S. Fageria
- Marathon Family Health Team, Marathon, Ontario, Canada,Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
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Huang X, Yu D. Assessment of Regional Health Resource Carrying Capacity and Security in Public Health Emergencies Based on the COVID-19 Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2068. [PMID: 36767442 PMCID: PMC9916352 DOI: 10.3390/ijerph20032068] [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: 10/25/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
The Omicron variant of COVID-19, which emerged at the end of 2021, has caused a new wave of infections around the world and is causing a new wave of the crisis due to the extreme variability of the pathogen. In response to public health emergencies such as SARS and COVID-19, the first task is to identify the vulnerabilities of regional health systems and perform a comprehensive assessment of the region's resilience. In this paper, we take the carrying capacity of medical resources as the focus; evaluate the medical, human, and financial resources of various regions; and construct an epidemic safety index based on the actual situation or future trend of the epidemic outbreak to evaluate and predict the risk level of each region in response to the epidemic. The study firstly evaluates the epidemic safety index for each province and city in China and 150 countries around the world, using the first wave of the COVID-19 epidemic in 2020 and the Omicron variant virus in 2022 as the background, respectively, and justifies the index through the actual performance in terms of epidemic prevention and control, based on which the epidemic safety index for 150 countries in the next year is predicted. The conclusions show that Europe, the Americas, and parts of Asia will face a significant risk of epidemic shocks in the coming period and that countries need to formulate policies in response to the actual situation of the epidemic.
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Affiliation(s)
- Xiaoran Huang
- School of Architecture and Art, North China University of Technology, Beijing 100144, China
- Centre for Design Innovation, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Demiao Yu
- School of Architecture and Art, North China University of Technology, Beijing 100144, China
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Islam MI, Bagnulo S, Wang Y, Ramsden R, Wrightson T, Masset A, Colbran R, Edwards M, Martiniuk A. Job Satisfaction of Health Practitioners Providing Outreach Health Services during COVID-19 in Rural New South Wales (NSW) and the Australian Capital Territory (ACT), Australia. Healthcare (Basel) 2022; 11:healthcare11010003. [PMID: 36611463 PMCID: PMC9819187 DOI: 10.3390/healthcare11010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Outreach health practitioners play a key role in enhancing access to healthcare for remote, rural, regional, and Aboriginal and Torres Strait Islander communities in Australia. Outreach health practitioners are those providing ongoing and integrated health services in communities that would otherwise have limited access. In the context of the COVID-19 pandemic, it is important to understand the job satisfaction of health workers as it correlates with long-term retention of the workforce, as well as effectiveness in the role and clinical outcomes for patients. Method: The study analysed data from 258 outreach health practitioners who responded to two cross-sectional surveys conducted by the NSW Rural Doctors Network during the COVID-19 pandemic in 2020/21 and 2021/22 in NSW and the ACT, Australia. Both bivariate and multivariate analyses were employed to assess the associations between the outcome variable (outreach health practitioners' job satisfaction) and independent variables (sociodemographic factors, motivation, self-confidence, communication, capability). Results: Overall, the study showed that 92.2% of health practitioners were satisfied in their role providing outreach health services during the COVID-19 pandemic. In the multivariable model, factors significantly associated with higher satisfaction included good communication with other local health practitioners, using telehealth along with in-person care, and having high self-rated capability compared to those health practitioners who said they had lower job satisfaction. Conclusions: Outreach health practitioners' job satisfaction is important because poor satisfaction may lead to suboptimal healthcare delivery, poor clinical outcomes, and poor retention of staff in rural settings. These findings should be taken into consideration when developing future strategies to improve job satisfaction among rural outreach health practitioners and to enhance attraction, recruitment and retention and may be applicable to the broader health workforce.
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Affiliation(s)
- Md Irteja Islam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
- Centre for Health Research and Faculty of Health, Engineering and Sciences, The University of Southern Queensland, West Street, Darling Heights, Toowoomba, QLD 4350, Australia
- Correspondence:
| | - Sharif Bagnulo
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
- Australasian College of Health Service Management, 11/41-43 Higginbotham Rd., Gladesville, Sydney, NSW 2111, Australia
| | - Yiwen Wang
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
| | - Robyn Ramsden
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
- School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, VIC 3220, Australia
| | - Trent Wrightson
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Amanda Masset
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Richard Colbran
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Mike Edwards
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Alexandra Martiniuk
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
- Office of the Chief Scientist, The George Institute for Global Health, Level 5/1 King Street, Newtown, Sydney, NSW 2042, Australia
- Dalla Lana School of Public Health, The University of Toronto, 155 College Street Room 500, Toronto, ON M5T 3M7, Canada
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Saulnier DD, Duchenko A, Ottilie-Kovelman S, Tediosi F, Blanchet K. Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic. Int J Health Policy Manag 2022; 12:6659. [PMID: 37579465 PMCID: PMC10125099 DOI: 10.34172/ijhpm.2022.6659] [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: 07/28/2021] [Accepted: 11/12/2022] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Health challenges like coronavirus disease 2019 (COVID-19) are becoming increasingly complex, transnational, and unpredictable. Studying health system responses to the COVID-19 pandemic is an opportunity to enhance our understanding of health system resilience and establish a clearer link between theoretical concepts and practical ideas on how to build resilience. METHODS This narrative literature review aims to address four questions using a health system resilience framework: (i) What do we understand about the dimensions of resilience? (ii) What aspects of the resilience dimensions remain uncertain? (iii) What aspects of the resilience dimensions are missing from the COVID-19 discussions? and (iv) What has COVID-19 taught us about resilience that is missing from the framework? A scientific literature database search was conducted in December 2020 and in April 2022 to identify publications that discussed health system resilience in relation to COVID-19, excluding articles on psychological and other types of resilience. A total of 63 publications were included. RESULTS There is good understanding around information sharing, flexibility and good leadership, learning, maintaining essential services, and the need for legitimate, interdependent systems. Decision-making, localized trust, influences on interdependence, and transformation remain uncertain. Vertical interdependence, monitoring risks beyond the health system, and consequences of changes on the system were not discussed. Teamwork, actor legitimacy, values, inclusivity, trans-sectoral resilience, and the role of the private sector are identified as lessons from COVID-19 that should be further explored for health system resilience. CONCLUSION Knowledge of health system resilience has continued to cohere following the pandemic. The eventual consequences of system changes and the resilience of subsystems are underexplored. Through governance, the concept of health system resilience can be linked to wider issues raised by the pandemic, like inclusivity. Our findings show the utility of resilience theory for strengthening health systems for crises and the benefit of continuing to refine existing resilience theory.
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Affiliation(s)
- Dell D. Saulnier
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Duchenko
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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14
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O’Sullivan B. Challenges and innovations in access to community-based rural primary care services during the Covid-19 pandemic in Australia. Int J Health Plann Manage 2022; 37 Suppl 1:115-128. [PMID: 36443892 PMCID: PMC9878203 DOI: 10.1002/hpm.3598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 10/26/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Access to primary care is a significant issue for rural populations. The Covid-19 pandemic imposed a unique operating environment for rural General Practice enabling accessible services. This study aimed to explore the challenges and innovations rural General Practices experienced in promoting accessible primary care during a year of the pandemic. METHODS Longitudinal semi-structured interviews were done with key informants (General Practitioners or Practice Managers) from purposefully selected General Practices from different rural towns in different subregions. Interviews occurred at three stages of the pandemic, June 2020-June 2021. They explored participant perspectives of the emerging challenges and innovatinos as they sought to support accessible primary care services during the pandemic. The data were thematically coded using a deductive framework of access challenges and innovations over time. RESULTS Of 12 practices approached, 11 key informants responded, providing around 30 h of interview data. The challenges and innovations related to access, changed over time as the pandemic evolved. A common theme concerned reflexive action. Practices had been on a journey during the pandemic to embed new planning processes, digital health options and to innovate to protect and support patients and staff to sustain access. CONCLUSION This study provides useful insights into the challenges and innovations experienced in rural general practice during the Covid-19 pandemic to reflect on models, strategies and approaches that can apply to promote access to rural primary care services going forward.
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Affiliation(s)
- Belinda O’Sullivan
- Monash University School of Rural HealthBendigoVictoriaAustralia,The University of Queensland Rural Clinical SchoolToowoombaQueenslandAustralia
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15
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Ashworth M, Thompson R, Fletcher E, Clancy GL, Johnson D. Recovery housing predictors of closure risk during COVID-19. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2144505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Madison Ashworth
- Department of Research and Evaluation, Fletcher Group, Inc, London, KY, USA
- Department of Economics, University of Wyoming, Laramie WY, USA
| | - Robin Thompson
- Department of Research and Evaluation, Fletcher Group, Inc, London, KY, USA
| | - Ernest Fletcher
- Department of Research and Evaluation, Fletcher Group, Inc, London, KY, USA
| | - Grace L. Clancy
- Department of Research and Evaluation, Fletcher Group, Inc, London, KY, USA
| | - David Johnson
- Department of Research and Evaluation, Fletcher Group, Inc, London, KY, USA
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16
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Xiong A, Li Y, Liu S, Li H. Knowledge acquisition and precautionary behaviors for individual resilience to the COVID-19 pandemic: A study of rural Latin America. JOURNAL OF RURAL STUDIES 2022; 95:373-381. [PMID: 36185827 PMCID: PMC9513338 DOI: 10.1016/j.jrurstud.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 08/20/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
The concept of resilience gains prominence as human society faces more frequent and impactful shocks and disturbances. This study seeks to investigate how rural populations build resilience amid the COVID-19 pandemic. A simple theoretical model is presented to illustrate the determinants of knowledge acquisition and precautionary behaviors among rural residents. Based on a High Frequency Phone Survey of 10,583 Latin American adults, this study found that rural residents were less capable of using informal channels (e.g., the internet) to collect COVID-19 information. Younger generations were generally less likely to adopt precautionary behaviors than the elderly. The age disparity, however, was relatively minor for rural populations. Costly preventive measures such as staying at home are less affordable for rural residents. Meanwhile, confidence in government ensures better compliance to ensure public health guidelines. We argue that internet skills, prosociality, and political confidence are necessary to build rural residents' resilience during the pandemic.
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Affiliation(s)
- Ailun Xiong
- Research Center for Enterprise Management, Institute of Digital Intelligence Strategy and Talent Development, Chongqing Technology and Business University, Chongqing, China
- Research Center for Econonmy of Upper Reaches of the Yangtse River, Chongqing Technology and Business University, Chongqing, China
| | - Yuheng Li
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Shuang Liu
- Research Center for Econonmy of Upper Reaches of the Yangtse River, Chongqing Technology and Business University, Chongqing, China
| | - Hongyi Li
- School of Business, Chinese University of Hong Kong, Hong Kong, China
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17
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Stengel S, Roth C, Breckner A, Cordes L, Weber S, Ullrich C, Peters-Klimm F, Wensing M. Resilience of the primary health care system - German primary care practitioners' perspectives during the early COVID-19 pandemic. BMC PRIMARY CARE 2022; 23:203. [PMID: 35948965 PMCID: PMC9365682 DOI: 10.1186/s12875-022-01786-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 07/05/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Primary care is a relevant pillar in managing not only individual, but also societal medical crises. The COVID-19 pandemic has demanded a rapid response from primary care with interventions in the health care system. The aim of this paper was to explore the responses of primary care practitioners (PCP) during the early COVID-19 pandemic and to analyze these with a view on the resilience of the primary health care system from the PCPs perspective. METHODS Shortly after the first COVID-19 wave (July-October 2020) n = 39, semi-structured telephone interviews were conducted with PCP in practices and at Corona contact points (CCP) in Baden-Wuerttemberg (Germany). Qualitative content analysis was applied, and the evolved categories were related to in a framework for resilience. RESULTS Primary care had an overall strong ability to adapt and show resilience, albeit with wide variance in speed and scope of the responses. When coping with uncertainty, the reasons given by PCPs in favor of opening a CCP mainly involved intrinsic motivation and self-initiative; the reasons against doing so were i.e. the lack of personal protective equipment, problems with space, and worries about organizational burden. A strong association existed between the establishment of a CCP and the use of resources (i.e. existing networks, personal protective equipment, exercising an office of professional political function). Our study predominantly found adaptive aspects for measures taken at medical practices and transformative aspects for setting up outpatient infection centers. PCPs played an important role in the coordination process (i.e. actively transferring knowledge, integration in crisis management teams, inclusion in regional strategic efforts) reaching a high level in the dimensions knowledge and legitimacy. The dimension interdependence repeatedly came into focus (i.e. working with stakeholders to open CCP, interacting among different types of primary care facilities, intersectoral interfaces). A need for regional capacity planning was visible at the time of the interviews. CONCLUSIONS The results can be used for practical and research-based institutional and capacity planning, for developing resilience in primary care and for augmentation by perspectives from other stakeholders in the primary health care system.
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Affiliation(s)
- Sandra Stengel
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany.
| | - Catharina Roth
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Amanda Breckner
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Lara Cordes
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Sophia Weber
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Charlotte Ullrich
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Frank Peters-Klimm
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
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Juárez-Ramírez C, Reyes-Morales H, Gutiérrez-Alba G, Reartes-Peñafiel DL, Flores-Hernández S, Muños-Hernández JA, Escalante-Castañón A, Malo M. Local Health Systems Resilience in Managing the COVID-19 Pandemic: Lessons from Mexico. Health Policy Plan 2022; 37:1278-1294. [PMID: 35799347 PMCID: PMC9278258 DOI: 10.1093/heapol/czac055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/27/2022] [Accepted: 07/06/2022] [Indexed: 11/23/2022] Open
Abstract
The concept of resilience was applied to the public health field to investigate the way health systems are impacted by health crises, what conditions allow them to mitigate the blow, and how they reorganize once the crisis is over. In 2020, the COVID-19 pandemic caused by the SARS-CoV-2 virus represented a global challenge demanding immediate response to an unprecedented health crisis. Various voices drew attention to the intensity of the crisis in countries with greater inequalities, where the pandemic converged with other social emergencies. We documented the experiences of health personnel who faced the pandemic at the primary care level while simultaneously maintaining the functioning of other areas of medical care. Our results derived from a qualitative study comprising 103 participants from five states of Mexico. We aimed to show through inferential analysis their perspective on what we call “the resilience of local health systems.” We observed three stages of experience during the crisis: (a) Preparation (official guidelines received to organize care, training, and planning of epidemiological surveillance); (b) Adaptation (performance of community-based prevention activities, infrastructure modifications, telehealth); (c) Learning (participatory governance with city councils, business sector, and organized population). The study suggests that the local health systems analyzed benefited from the initiatives of health personnel that in some cases positively exceeded their duties. In terms of the resilience analysis, they were able to handle the impact of the crisis and cope with it. Their transformative capacity came from the strategies implemented to adapt health services by managing institutional resources. Their experience represents a lesson on the strengthening of the essential functions of health systems and shows a way to address successfully the increasingly complex health challenges of the present and future times.
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Affiliation(s)
- Clara Juárez-Ramírez
- Center for Health Systems Research, National Institute of Public Health, 7a privada de Fray Pedro de Gante, Sección XVI, Tlalpan 14000, CDMX, México
| | - Hortensia Reyes-Morales
- Center for Health Systems Research, National Institute of Public Health, Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Mor. CP 62100
| | - Gaudencio Gutiérrez-Alba
- Instituto de Ciencias de la Salud, Universidad Veracruzana, Luis Castelazo Ayala s/n, Col. Industrial Animas, C.P.91190, Xalapa, Veracruz, México
| | | | - Sergio Flores-Hernández
- Dirección de Estadística CIEE. Instituto Nacional de Salud Pública, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, CP 62100, México
| | - José Alberto Muños-Hernández
- Instituto de Ciencias de la Salud, Universidad Veracruzana, Luis Castelazo Ayala s/n, Col. Industrial Animas, C.P. 91190, Xalapa, Veracruz, México
| | - André Escalante-Castañón
- Independent Consultor, Av. Venustiano Carranza 1115, C.P. 78230, Tequisquiapan, San Luis Potosí, México
| | - Miguel Malo
- Pan American Health Organization, Montes Urales 440, Lomas Virreyes. C.P. 11000, Ciudad de México, México
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Barnes A, Crilly J. Review article: Impact of pandemics on rural emergency departments: A scoping review. Emerg Med Australas 2022; 34:312-321. [PMID: 35231959 DOI: 10.1111/1742-6723.13938] [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: 06/30/2021] [Revised: 12/04/2021] [Accepted: 01/10/2022] [Indexed: 11/27/2022]
Abstract
Pandemics can cause much distress to communities and present a major burden to the resources and functioning of hospitals. This scoping review aimed to identify, evaluate and summarise current literature regarding how pandemics impact rural EDs in terms of staff wellbeing, structure, function and resources. A systematic search of six databases using search terms including pandemic, ED and rural and remote was undertaken. Articles were included if they were peer-reviewed, written in English, original research, published between January 2010 and October 2021 and discussed the impact of pandemics on rural EDs. Articles were critically appraised using the Mixed Methods Appraisal Tool (MMAT). Three articles, one from Canada and two from the United States, met the inclusion criteria. The articles included were quantitative in design and fulfilled most of the MMAT critical analysis criteria. Pandemics reported on included H1N1 and COVID-19. These pandemics impacted rural EDs in terms of functioning and resourcing; no description of staff wellbeing or structure was identified. Rural ED functioning was affected in terms of input; with an increase in patient presentations and time to physician assessment during H1N1, but a decrease in patient presentations and transfers during COVID-19. Rural ED resources were impacted in regard to staffing, difficulty in obtaining stocks of personal protective equipment and medication, and community response. Further research to understand and address the short- and long-term impacts pandemics may have on rural EDs is required.
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Affiliation(s)
- Amber Barnes
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
| | - Julia Crilly
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia
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20
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Castro MG, Sloane PD. The Role of a Federally Qualified Health Center in Identification and Management of an Occupational COVID-19 Outbreak: Lessons for Future Infection Surveillance and Response. J Ambul Care Manage 2022; 45:13-21. [PMID: 34392258 PMCID: PMC8612894 DOI: 10.1097/jac.0000000000000397] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Federally Qualified Health Centers (FQHCs) have been essential in response to COVID-19 outbreaks among vulnerable populations. Our rural FQHC had a primary role in early detection of and response to a poultry plant-related outbreak at the outset of the pandemic that disproportionately and gravely affected the local Hispanic community. The health center activated a rapid local response that included the community's first mass testing event and first acute respiratory treatment clinic, both of which were central to abatement. Lessons learned from this experience provide important guidance for the potential role of FQHCs in infection outbreak preparedness in marginalized communities.
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Affiliation(s)
- Maria Gabriela Castro
- Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Philip D. Sloane
- Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
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21
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Wulandari RD, Laksono AD, Prasetyo YB, Nandini N. Socioeconomic Disparities in Hospital Utilization Among Female Workers in Indonesia: A Cross-Sectional Study. J Prim Care Community Health 2022; 13:21501319211072679. [PMID: 35068256 PMCID: PMC8793371 DOI: 10.1177/21501319211072679] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The study aims to analyze the relationship between socioeconomic and hospital utilization among female workers in Indonesia. METHODS The study analyzed secondary data from the 2018 Indonesian Basic Health Survey. The study gathered 161 186 female workers through stratification and multistage random sampling. As control factors, the study looked at age, marital status, education, occupation, and health insurance, in addition to the categories of socioeconomic and hospital utilization. The study used binary logistic regression to evaluate the data in the final step. RESULTS The result shows female workers with poorer wealth status are 1.142 times more likely than the most impoverished female workers to utilize the hospital (AOR 1.142; 95% CI 1.135-1.148). Female workers with median wealth status are 1.509 times more likely than the poorest female workers to take advantage of the hospital (AOR 1.509; 95% CI 1.501-1.517). Female workers with wealthier wealth status are 1.808 times more likely than the poorest female workers to use the hospital (AOR 1.808; 95% CI 1.799-1.817). The wealthiest female workers are 2.399 times more likely than the poorest female workers to utilize the hospital (2.399; 95% CI 2.387-2.411). CONCLUSION The study concluded a relationship between socioeconomic status and hospital utilization among female workers in Indonesia. The better the socioeconomic, the better the hospital utilization.
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Affiliation(s)
- Ratna Dwi Wulandari
- Universitas Airlangga, Surabaya, Indonesia
- The Airlangga Centre for Health Policy, Surabaya, Indonesia
| | - Agung Dwi Laksono
- The Airlangga Centre for Health Policy, Surabaya, Indonesia
- The National Agency for Research and Innovation of The Republic of Indonesia, Jakarta, Indonesia
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22
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Associations of the Initial COVID-19 Lockdown on Self-Reported Happiness and Worry about Developing Loneliness: A Cross-Sectional Analysis of Rural, Regional, and Urban Australian Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189501. [PMID: 34574425 PMCID: PMC8467504 DOI: 10.3390/ijerph18189501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 01/09/2023]
Abstract
Australia adopted hard lockdown measures to eliminate community transmission of COVID-19. Lockdown imposes periods of social isolation that contributes to increased levels of stress, anxiety, depression, loneliness, and worry. We examined whether lockdowns have similar psychosocial associations across rural and urban areas and whether associations existed between happiness and worry of loneliness in the initial wave of the COVID-19 pandemic in Australia. Data were collected using the "COVID-19 Living Survey" between 13 and 20 May 2020 by BehaviourWorks Australia at the Monash Sustainable Development Institute. The mean self-reported feeling of happiness and anxiousness (N = 1593), on a 10-point Likert scale with 0 being least happy or highly anxious, was 6.5 (SD = 2.4) and 3.9 (2.9), respectively. Factors associated with happiness were older age and having a postgraduate education. Participants worried about becoming lonely also exhibited reduced happiness (estimate = -1.58, 95%CI = -1.84--1.32) and higher anxiousness (2.22, 1.93-2.51) scores, and these conditions remained associated after adjusting for demographics. Interestingly, worry about loneliness was greater in rural areas than in urban communities. The negative impact of the COVID-19 lockdown on rural youth and those less-educated was evident. Participants in rural Australia who were worried about becoming lonely were reportedly less happy than participants in major cities. This dataset provides a better understanding of factors that influence psychological well-being and quality of life in the Australian population and helps to determine whether happiness may be an associative factor that could mitigate self-feelings of anxiety and worry about loneliness.
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Ambrose JW, Layne DM, Catchpole K, Evans H, Nemeth LS. A Qualitative Protocol to Examine Resilience Culture in Healthcare Teams during COVID-19. Healthcare (Basel) 2021; 9:1168. [PMID: 34574942 PMCID: PMC8465421 DOI: 10.3390/healthcare9091168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 12/23/2022] Open
Abstract
Resilience allows teams to function at their optimal capacity and skill level in times of uncertainty. The SARS-CoV-2 (COVID-19) pandemic created a perfect opportunity to study resilience culture during a time of limited healthcare team experience, protocols, and specific personal protective equipment (PPE) needed. Little is known about healthcare team resilience as a phenomenon; existing definitions and empiric referents do not capture the nature of healthcare team resilience, as the traditional focus has been placed on individual resilience. This qualitative research protocol provides the rationale and methodology to examine this phenomenon and builds a bridge between resilience engineering and individual resilience. The sample is composed of healthcare team members from the US. This research may add to the body of knowledge on resilience culture in healthcare teams during the COVID-19 pandemic. This qualitative research protocol paper outlines the rationale, objective, methods, and ethical considerations entailed in this research.
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Affiliation(s)
- John W. Ambrose
- College of Nursing, The Medical University of South Carolina, Charleston, SC 29425, USA; (D.M.L.); (L.S.N.)
| | - Diana M. Layne
- College of Nursing, The Medical University of South Carolina, Charleston, SC 29425, USA; (D.M.L.); (L.S.N.)
| | - Ken Catchpole
- College of Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA; (K.C.); (H.E.)
| | - Heather Evans
- College of Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA; (K.C.); (H.E.)
| | - Lynne S. Nemeth
- College of Nursing, The Medical University of South Carolina, Charleston, SC 29425, USA; (D.M.L.); (L.S.N.)
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Kumpunen S, Webb E, Permanand G, Zheleznyakov E, Edwards N, van Ginneken E, Jakab M. Transformations in the landscape of primary health care during COVID-19: Themes from the European region. Health Policy 2021; 126:391-397. [PMID: 34489126 PMCID: PMC8364142 DOI: 10.1016/j.healthpol.2021.08.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/15/2021] [Accepted: 08/09/2021] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic has dramatically impacted primary health care (PHC) across Europe. Since March 2020, the COVID-19 Health System Response Monitor (HSRM) has documented country-level responses using a structured template distributed to country experts. We extracted all PHC-relevant data from the HSRM and iteratively developed an analysis framework examining the models of PHC delivery employed by PHC providers in response to the pandemic, as well as the government enablers supporting these models. Despite the heterogenous PHC structures and capacities across European countries, we identified three prevalent models of PHC delivery employed: (1) multi-disciplinary primary care teams coordinating with public health to deliver the emergency response and essential services; (2) PHC providers defining and identifying vulnerable populations for medical and social outreach; and (3) PHC providers employing digital solutions for remote triage, consultation, monitoring and prescriptions to avoid unnecessary contact. These were supported by government enablers such as increasing workforce numbers, managing demand through public-facing risk communications, and prioritising pandemic response efforts linked to vulnerable populations and digital solutions. We discuss the importance of PHC systems maintaining and building on these models of PHC delivery to strengthen preparedness for future outbreaks and better respond to the contemporary health challenges.
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Affiliation(s)
| | - Erin Webb
- Department of Health Care Management, Technical University of Berlin and European Observatory on Health Systems and Policies, Berlin, Germany
| | | | | | | | - Ewout van Ginneken
- Department of Health Care Management, Technical University of Berlin and European Observatory on Health Systems and Policies, Berlin, Germany
| | - Melitta Jakab
- WHO European Centre for Primary Health Care, Almaty, Kazakhstan
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25
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Jonnagaddala J, Godinho MA, Liaw ST. From telehealth to virtual primary care in Australia? A Rapid scoping review. Int J Med Inform 2021; 151:104470. [PMID: 34000481 DOI: 10.1016/j.ijmedinf.2021.104470] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/05/2021] [Accepted: 04/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The COVID-19 pandemic and its socio-economic impacts have disrupted our health systems and society. We sought to examine informatics and digital health strategies that supported the primary care response to COVID-19 in Australia. Specifically, the review aims to answer: how Australian primary health care responded and adapted to COVID-19, the facilitators and inhibitors of the Primary care informatics and digital health enabled COVID-19 response and virtual models of care observed in Australia. METHODS We conducted a rapid scoping review complying with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews guidelines. Two reviewers independently performed the literature search, data extraction, and synthesis of the included studies. Any disagreement in the eligibility screening, data extraction or synthesis was resolved through consensus meeting and if required. was referred to a third reviewer. Evidence was synthesised, summarised, and mapped to several themes that answer the research question s of this review. RESULTS We identified 377 papers from PubMed, Scopus, Web of Science and Embase. Following title, abstract and full-text screening, 29 eligible papers were included. The majority were "perspectives" papers. The dearth of original research into digital health and COVID-19 in primary care meant limited evidence on effectiveness, access, equity, utility, safety, and quality. Data extraction and evidence synthesis identified 14 themes corresponding to 3 research questions. Telehealth was the key digital health response in primary care, together with mobile applications and national hotlines, to enable the delivery of virtual primary care and support public health. Enablers and barriers such as workforce training, digital resources, patient experience and ethical issues, and business model and management issues were identified as important in the evolution of virtual primary care. CONCLUSIONS COVID-19 has transformed Australian primary care with the rapid adaptation of digital technologies to complement "in-person" primary care with telehealth and virtual models of care. The pandemic has also highlighted several literacy, maturity/readiness, and micro, meso and macro-organisational challenges with adopting and adapting telehealth to support integrated person-centred health care. There is a need for more research into how telehealth and virtual models of care can improve the access, integration, safety, and quality of virtual primary care.
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Affiliation(s)
- Jitendra Jonnagaddala
- WHO Collaborating Centre on eHealth, School of Population Health, UNSW Sydney, Australia.
| | - Myron Anthony Godinho
- WHO Collaborating Centre on eHealth, School of Population Health, UNSW Sydney, Australia
| | - Siaw-Teng Liaw
- WHO Collaborating Centre on eHealth, School of Population Health, UNSW Sydney, Australia.
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