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Podolanczuk AJ, Raghu G. Idiopathic pulmonary fibrosis mortality: update on trends in the modern treatment era. Eur Respir J 2024; 64:2401305. [PMID: 39174288 DOI: 10.1183/13993003.01305-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Accepted: 07/08/2024] [Indexed: 08/24/2024]
Affiliation(s)
- Anna J Podolanczuk
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Ganesh Raghu
- Center for Interstitial Lung diseases, Department of Medicine and Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
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Lawson McLean A, Vetrano IG, Lawson McLean AC, Conti A, Mertens P, Müther M, Nemir J, Peschillo S, Santacroce A, Sarica C, Tuleasca C, Zoia C, Régis J. Revitalizing neurosurgical frontiers: The EANS frontiers in neurosurgery committee's strategic framework. BRAIN & SPINE 2024; 4:102794. [PMID: 38601776 PMCID: PMC11004717 DOI: 10.1016/j.bas.2024.102794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/12/2024]
Abstract
Introduction The field of neurosurgery faces challenges with the increasing involvement of other medical specialties in areas traditionally led by neurosurgeons. This paper examines the implications of this development for neurosurgical practice and patient care, with a focus on specialized areas like pain management, peripheral nerve surgery, and stereotactic radiosurgery. Research question To assess the implications of the expanded scope of other specialties for neurosurgical practice and to consider the response of the EANS Frontiers in Neurosurgery Committee to these challenges. Materials and methods Analysis of recent trends in neurosurgery, including the shift in various procedures to other specialties, demographic challenges, and the emergence of minimally invasive techniques. This analysis draws on relevant literature and the initiatives of the Frontiers in Neurosurgery Committee. Results We explore a possible decrease in neurosurgical involvement in certain areas, which may have implications for patient care and access to specialized neurosurgical interventions. The Frontiers in Neurosurgery Committee's role in addressing these concerns is highlighted, particularly in terms of training, education, research, and networking for neurosurgeons, especially those early in their careers. Discussion and conclusion The potential decrease in neurosurgical involvement in certain specialties warrants attention. This paper emphasizes the importance of carefully considered responses by neurosurgical societies, such as the EANS, to ensure neurosurgeons continue to play a vital role in managing neurological diseases. Emphasis on ongoing education, integration of minimally invasive techniques, and multidisciplinary collaboration is essential for maintaining the field's competence and quality in patient care.
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Affiliation(s)
- Aaron Lawson McLean
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena University Hospital, Jena, Germany
| | - Ignazio G. Vetrano
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna C. Lawson McLean
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena University Hospital, Jena, Germany
| | - Alfredo Conti
- UOC Neurochirurgia, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Patrick Mertens
- Department of Neurosurgery, University Hospital of Neurology and Neurosurgery, Hospices Civils de Lyon, University Lyon 1, Lyon, France
| | - Michael Müther
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
| | - Jakob Nemir
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
| | - Simone Peschillo
- Endovascular Neurosurgery, Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Antonio Santacroce
- Department of Neurosurgery, St. Barbara-Klinik Hamm-Heessen, Hamm, Germany
- Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
- European Radiosurgery Center Munich, Munich, Germany
| | - Can Sarica
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontatio, Canada
| | - Constantin Tuleasca
- Lausanne University Hospital (CHUV), Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland
- University of Lausanne (UNIL), Faculty of Biology and Medicine (FBM), Lausanne, Switzerland
| | - Cesare Zoia
- UOC Neurochirurgia, Ospedale Moriggia Pelascini, Gravedona e Uniti, Italy
| | - Jean Régis
- Aix Marseille University, Department of Functional Neurosurgery, CHU Timone, Marseille, France
| | - EANS Frontiers in Neurosurgery Committee
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena University Hospital, Jena, Germany
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- UOC Neurochirurgia, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Alma Mater Studiorum Università di Bologna, Bologna, Italy
- Department of Neurosurgery, University Hospital of Neurology and Neurosurgery, Hospices Civils de Lyon, University Lyon 1, Lyon, France
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
- Endovascular Neurosurgery, Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
- Department of Neurosurgery, St. Barbara-Klinik Hamm-Heessen, Hamm, Germany
- Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
- European Radiosurgery Center Munich, Munich, Germany
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontatio, Canada
- Lausanne University Hospital (CHUV), Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland
- University of Lausanne (UNIL), Faculty of Biology and Medicine (FBM), Lausanne, Switzerland
- UOC Neurochirurgia, Ospedale Moriggia Pelascini, Gravedona e Uniti, Italy
- Aix Marseille University, Department of Functional Neurosurgery, CHU Timone, Marseille, France
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Saulitis A. Personalized messaging enhances hospital debt collection while prosocial appeals fail: Evidence from a field experiment. Digit Health 2024; 10:20552076241277035. [PMID: 39355661 PMCID: PMC11443582 DOI: 10.1177/20552076241277035] [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: 02/22/2024] [Accepted: 08/05/2024] [Indexed: 10/03/2024] Open
Abstract
Objective This study aimed to understand how different communication strategies influence patients' behaviour in paying unpaid hospital bills. The research focused on a healthcare system where patients have to pay a significant portion of their medical costs out-of-pocket. Methods The research was conducted in collaboration with a debt collection agency in Latvia. The field experiment involved 9196 individuals with unpaid hospital bills. These individuals received randomly assigned reminders through mobile text messages and e-mails. The study compared the effectiveness of personalized messages, which included the recipient's name, with generic reminders and messages that appealed to social norms or public good contributions. Results The findings revealed that personalized messages, specifically those that included the recipient's name, significantly improved payment rates compared with generic reminders. Conversely, messages that used social norms or public good appeals did not have a significant impact on payment rates. Conclusions The study highlights the importance of personalized communication strategies in improving hospital debt collection. Even simple, cost-effective modifications in communication, like adding the recipient's name, can significantly enhance payment compliance. This approach not only keep the financial books of healthcare providers balanced but also suggests that personalized strategies can be extended to other areas of healthcare management. However, while these findings are promising, they indicate that more personalized and nuanced communication strategies are needed to address the broader issue of unpaid hospital bills effectively.
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Affiliation(s)
- Andris Saulitis
- Institute of Philosophy and Sociology, University of Latvia, Riga, Latvia
- Collegio Carlo Alberto, Turin, Italy
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Petrovici N, Belbe SȘ, Mare CC, Cotoi CC. Hybrid health regimes: Access to primary care physicians and COVID-19 vaccine uptake across municipalities in Romania. Soc Sci Med 2023; 337:116305. [PMID: 37857237 DOI: 10.1016/j.socscimed.2023.116305] [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: 04/01/2023] [Revised: 09/01/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
This study analyses COVID-19 vaccine uptake at the municipal level in Romania using the global health regimes and vaccine hesitancy perspectives. Our spatial regression (SARAR-het Durbin) shows that the number of primary care physicians is a significant predictor of vaccine uptake, and municipalities with higher access to the labour market have higher vaccination rates. We provide a historical perspective to demonstrate that the current health regime in Romania is a hybrid of internationalist and global health regimes, with socialist investments affecting labour participation, education, poverty, and vaccination rates. Our findings highlight the impact of regional disparities and partial privatization of the health system.
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Affiliation(s)
- Norbert Petrovici
- Dep. of Sociology, Faculty of Sociology and Social Work, Babes-Bolyai University, 1, Anghel Saligny, 400394, Cluj-Napoca, Romania; Interdisciplinary Centre for Data Science, Babes-Bolyai University, 68, Avram Iancu Str., 400083, 4th Floor, Cluj-Napoca, Romania.
| | - Stefana Ștefana Belbe
- Dep. of Statistics, Forecasts, Mathematics, Faculty of Economics and Business Administration, Babes-Bolyai University, 58-60, Teodor Mihali Str., 400591, Cluj-Napoca, Romania; Interdisciplinary Centre for Data Science, Babes-Bolyai University, 68, Avram Iancu Str., 400083, 4th Floor, Cluj-Napoca, Romania.
| | - Codruta Codruța Mare
- Dep. of Statistics, Forecasts, Mathematics, Faculty of Economics and Business Administration, Babes-Bolyai University, 58-60, Teodor Mihali Str., 400591, Cluj-Napoca, Romania; Interdisciplinary Centre for Data Science, Babes-Bolyai University, 68, Avram Iancu Str., 400083, 4th Floor, Cluj-Napoca, Romania.
| | - Calin Călin Cotoi
- Dep. of Sociology, Faculty of Sociology and Social Work, University of Bucharest, 9, Schitu Magureanu Blv., Sector 1, Bucharest, Romania.
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Ramšak M, Orzechowski M, Bielińska K, Chowaniec A, Doričić R, Nowak M, Skuban-Eiseler T, Tutić Grokša I, Łuków P, Muzur A, Zupanič-Slavec Z, Steger F. Diversity awareness, diversity competency and access to healthcare for minority groups: perspectives of healthcare professionals in Croatia, Germany, Poland, and Slovenia. Front Public Health 2023; 11:1204854. [PMID: 37546324 PMCID: PMC10400770 DOI: 10.3389/fpubh.2023.1204854] [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: 04/12/2023] [Accepted: 07/07/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Due to cultural, language, or legal barriers, members of social minority groups face challenges in access to healthcare. Equality of healthcare provision can be achieved through raised diversity awareness and diversity competency of healthcare professionals. The aim of this research was to explore the experiences and attitudes of healthcare professionals toward the issue of social diversity and equal access to healthcare in Croatia, Germany, Poland, and Slovenia. Methods The data reported come from semi-structured interviews with n = 39 healthcare professionals. The interviews were analyzed using the methods of content analysis and thematic analysis. Results Respondents in all four countries acknowledged that socioeconomic factors and membership in a minority group have an impact on access to healthcare services, but its scope varies depending on the country. Underfunding of healthcare, language barriers, inadequate cultural training or lack of interpersonal competencies, and lack of institutional support were presented as major challenges in the provision of diversity-responsive healthcare. The majority of interviewees did not perceive direct systemic exclusion of minority groups; however, they reported cases of individual discrimination through the presence of homophobia or racism. Discussion To improve the situation, systemic interventions are needed that encompass all levels of healthcare systems - from policies to addressing existing challenges at the healthcare facility level to improving the attitudes and skills of individual healthcare providers.
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Affiliation(s)
- Mojca Ramšak
- Faculty of Medicine, Institute for History of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Marcin Orzechowski
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Katarzyna Bielińska
- Faculty of Philosophy, Center for Bioethics and Biolaw, University of Warsaw, Warszawa, Poland
| | - Anna Chowaniec
- Faculty of Philosophy, Center for Bioethics and Biolaw, University of Warsaw, Warszawa, Poland
| | - Robert Doričić
- Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- Department of Public Health, Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
| | - Marianne Nowak
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Tobias Skuban-Eiseler
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Ivana Tutić Grokša
- Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Paweł Łuków
- Faculty of Philosophy, Center for Bioethics and Biolaw, University of Warsaw, Warszawa, Poland
| | - Amir Muzur
- Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- Department of Public Health, Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
| | - Zvonka Zupanič-Slavec
- Faculty of Medicine, Institute for History of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Florian Steger
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
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Hussein M, Erjavec K, Velikonja NK. Management Barriers to Inter-Organizational Collaboration in Preoperative Treatment of Patients with Hip or Knee Osteoarthritis. Healthcare (Basel) 2023; 11:healthcare11091280. [PMID: 37174822 PMCID: PMC10178117 DOI: 10.3390/healthcare11091280] [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: 03/03/2023] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Inter-organizational collaboration among healthcare institutions is widely recognized to improve healthcare services. Because there is a research gap in examining the management barriers to inter-organizational collaboration in countries with less efficient healthcare systems and the reasons for non-implementation of innovations, the aim of this study was to identify key management barriers to inter-organizational collaboration in the preoperative treatment of patients with hip or knee osteoarthritis in Slovenia using a mixed-methods approach with key stakeholders. A cross-sectional study was conducted using multiple methods. An online survey (n = 135) and a multilevel qualitative approach were used, interviewing patients (n = 21), healthcare professionals, and other stakeholders (n = 42). The overall assessment of barriers affecting the integrated approach at the macro, meso, and micro levels revealed that macro-level factors were statistically significantly perceived as the major barriers, while micro-level factors were the minor barriers. There was no significant difference between public and private sector respondents in the barriers at the three levels. However, there were significant differences in the perceptions of different professional groups at the micro and meso levels, but not at the macro level. The analysis of the in-depth interviews confirmed the importance of macro-level barriers. A culture of noncooperation combined with "managerial indecision" prevails in the Slovenian healthcare system due to weak management support for inter-organizational collaboration, with managers and other key stakeholders failing to make urgent decisions due to a lack of autonomy. Interviewees commonly noted that one of the major barriers to inter-organizational collaboration was a lack of resources and staff, particularly of primary care physicians and nurses. In the preoperative treatment of patients with hip or knee osteoarthritis, the culture of non-collaboration and executive indecision are the major macro-level barriers to inter-organizational collaboration in Slovenia.
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Affiliation(s)
- Mohsen Hussein
- Artros Ljubljana, University of Novo Mesto, 1000 Ljubljana, Slovenia
- Faculty of Health Sciences, University of Novo Mesto, 8000 Novo Mesto, Slovenia
| | - Karmen Erjavec
- Faculty of Health Sciences, University of Novo Mesto, 8000 Novo Mesto, Slovenia
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Kullamaa L, Reile R. Socio-demographic and regional differences in unmet healthcare needs among migrants in Europe. PLoS One 2023; 18:e0285886. [PMID: 37200280 DOI: 10.1371/journal.pone.0285886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/12/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Different barriers that hinder migrants' access to healthcare may have detrimental effect on health but also contribute to health inequalities. Given the lack of evidence on unmet healthcare needs among European migrant population, the study aimed to analyse the demographic, socio-economic and health-related patterning of unmet healthcare needs among migrants in Europe. METHODS European Health Interview Survey data from 2013-2015 covering 26 countries was used to analyse associations of individual-level factors and unmet healthcare needs among migrants (n = 12,817). Prevalences and 95% confidence intervals for unmet healthcare needs were presented for geographical regions and countries. Associations between unmet healthcare needs and demographic, socio-economic, and health indicators were analysed using Poisson regression models. RESULTS The overall prevalence of unmet healthcare needs among migrants was 27.8% (95% CI 27.1-28.6) but the estimate varied substantially across geographical regions in Europe. Unmet healthcare needs due to cost or access were patterned by various demographic, socio-economic, and health-related indicators but higher prevalence of UHN were universally found for women, those with the lowest income, and poor health. CONCLUSIONS While the high level of unmet healthcare needs illustrate migrants' vulnerability to health risks, the regional variations in the prevalence estimates and individual-level predictors highlight the variations in national policies regarding migration and healthcare legislations and differences in welfare-systems across Europe in general.
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Affiliation(s)
- Lembe Kullamaa
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Rainer Reile
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
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Vojvodic K, Terzic-Supic Z, Todorovic J, Gagliardi C, Santric-Milicevic M, Popovic M. Financial Burden of Medical Care, Dental Care, and Medicines among Older-Aged Population in Slovenia, Serbia, and Croatia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063325. [PMID: 35329013 PMCID: PMC8953375 DOI: 10.3390/ijerph19063325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/25/2022] [Accepted: 03/09/2022] [Indexed: 11/18/2022]
Abstract
The aim was to explore the factors associated with the financial burden (FB) of medical care, dental care, and medicines among older-aged people in Slovenia, Serbia, and Croatia using EU-SILC 2017. The highest frequency of FB of medical care and medicines was in Croatia (50% and 69.1%, respectively) and of dental care in Slovenia (48.5%). The multivariate logistic regression analysis with FB as an outcome variable showed that the FB of medical care was associated with being married (OR: 1.54), reporting not severe (OR: 1.51) and severe limitations in daily activities (OR: 2.05), having higher education (OR: 2.03), and heavy burden of housing costs (OR: 0.51) in Slovenia, with very bad self-perceived health (OR: 5.23), having the slight (OR: 0.69) or heavy (OR: 0.47) burden of housing costs, making ends meet fairly easily or with some difficulty (OR: 3.58) or with difficulty or great difficulty (OR: 6.80) in Serbia, and with being married (OR: 1.43), having heavy burden of housing costs (OR: 0.62), and making ends meet fairly easily or with some difficulty (OR: 2.08) or with difficulty or great difficulty (OR: 2.52) in Croatia. The older-aged have the FB of healthcare, especially the poorest or those with health problems.
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Affiliation(s)
- Katarina Vojvodic
- Department for Healthcare Quality Improvement, Institute of Public Health of Belgrade, 11000 Belgrade, Serbia
- Correspondence:
| | - Zorica Terzic-Supic
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, 11000 Belgrade, Serbia; (Z.T.-S.); (J.T.); (M.S.-M.)
| | - Jovana Todorovic
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, 11000 Belgrade, Serbia; (Z.T.-S.); (J.T.); (M.S.-M.)
| | - Cristina Gagliardi
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA-National Institute of Health and Science on Ageing, 60124 Ancona, Italy;
| | - Milena Santric-Milicevic
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, 11000 Belgrade, Serbia; (Z.T.-S.); (J.T.); (M.S.-M.)
| | - Marina Popovic
- Department of Nuclear Medicine, Institute for Oncology and Radiology of Serbia, 11000 Belgrade, Serbia;
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Takura T, Miura H. Socioeconomic Determinants of Universal Health Coverage in the Asian Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042376. [PMID: 35206562 PMCID: PMC8872323 DOI: 10.3390/ijerph19042376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/02/2022] [Accepted: 02/16/2022] [Indexed: 02/04/2023]
Abstract
The World Health Organization (WHO) states that examining medical financial systems is the most important process in evaluating universal health coverage (UHC). This study used the service coverage index (SCI) as a proxy of the progress toward UHC in eleven Asian countries. We employed a fixed-effects regression model to analyze panel data from 2015 to 2017, to explain the interrelationship between the SCI and major socioeconomic indicators. We also conducted a performance analysis (ratio of achieved SCI level to gross domestic product (GDP) or health expenditure displacement) to examine the balance between the degree of achievements related to UHC and a country’s economic level. The results showed that GDP and health expenditure were significantly positively correlated with the SCI (p < 0.01). The panel data analysis results showed that GDP per capita was a factor that greatly influenced the SCI as well as poverty (partial regression coefficient: 0.0017, 95% CI: 0.0013–0.0021). The results of the performance analysis showed that the Philippines had the highest scores (GDP: 1.84 SCI score/USD per capita, health expenditure: 1.04 SCI score/USD per capita) and South Korea the lowest. We conclude that socioeconomic factors, such as GDP, health expenditure, unemployment, poverty, and population influence the progress of UHC, regardless of system maturity or geographic characteristics.
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Affiliation(s)
- Tomoyuki Takura
- Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
- Correspondence: ; Tel.: +81-3-5800-9523; Fax: +81-3-5800-8948
| | - Hiroko Miura
- Division of Disease Control and Epidemiology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari 061-0293, Japan;
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Kazungu J, Meyer CL, Sargsyan KG, Qaiser S, Chukwuma A. The burden of catastrophic and impoverishing health expenditure in Armenia: An analysis of Integrated Living Conditions Surveys, 2014-2018. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000494. [PMID: 36962546 PMCID: PMC10021688 DOI: 10.1371/journal.pgph.0000494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 09/05/2022] [Indexed: 11/06/2022]
Abstract
Armenia's health spending is characterized by low public spending and high out-of-pocket expenditure (OOP), which not only poses a financial barrier to accessing healthcare for Armenians but can also impoverish them. We analyzed Armenia's Integrated Living Conditions Surveys 2014-2018 data to assess the incidence and correlates of catastrophic health expenditure (CHE) and impoverishment. Households were considered to have incurred CHE if their annual OOP exceeded 40 percent of the per capita annual household non-food expenditure. We assessed impoverishment using the US$1.90 per person per-day international poverty line and the US$5.50 per person per-day upper-middle-income country poverty line. Logistic regression models were fitted to assess the correlates of CHE and impoverishment. We found that the incidence of CHE peaked in 2017 before declining in 2018. Impoverishment decreased until 2017 before rising in 2018. After adjusting for sociodemographic factors, households were more likely to incur CHE if the household head was older than 34 years, located in urban areas, had at least one disabled member, and had at least one member with hypertension. Households with at least one hypertensive member or who resided in urban areas were more likely to be impoverished due to OOP. Paid employment and high socioeconomic status were protective against both CHE and impoverishment from OOP. This detailed analysis offers a nuanced insight into the trends in Armenia's financial risk protection against catastrophic and impoverishing health expenditures, and the groups predominantly affected. The incidence of CHE and impoverishment in Armenia remains high with a higher incidence among vulnerable groups, including those living with chronic disease, disability, and the unemployed. Armenia should consider different mechanisms such as subsidizing medication and hospitalization costs for the poorest to alleviate the burden of OOP.
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Affiliation(s)
- Jacob Kazungu
- Health Economics Research Unit, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
| | - Christina L Meyer
- RTI International Center for Global Noncommunicable Diseases, Seattle, WA, United States of America
| | - Kristine Gallagher Sargsyan
- Health, Nutrition, and Population Global Practice, World Bank Group, Washington, D.C., United States of America
| | - Seemi Qaiser
- Health, Nutrition, and Population Global Practice, World Bank Group, Washington, D.C., United States of America
| | - Adanna Chukwuma
- Health, Nutrition, and Population Global Practice, World Bank Group, Washington, D.C., United States of America
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Judickas Š, Stasiūnaitis R, Žučenka A, Žvirblis T, Šerpytis M, Šipylaitė J. Outcomes and Risk Factors of Critically Ill Patients with Hematological Malignancy. Prospective Single-Centre Observational Study. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121317. [PMID: 34946262 PMCID: PMC8707137 DOI: 10.3390/medicina57121317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 01/06/2023]
Abstract
Background and Objectives: Oncohematological patients have a high risk of mortality when they need treatment in an intensive care unit (ICU). The aim of our study is to analyze the outcomes of oncohemathological patients admitted to the ICU and their risk factors. Materials and Methods: A prospective single-center observational study was performed with 114 patients from July 2017 to December 2019. Inclusion criteria were transfer to an ICU, hematological malignancy, age >18 years, a central line or arterial line inserted or planned to be inserted, and a signed informed consent form. Univariate and multivariable logistic regression models were used to evaluate the potential risk factors for ICU mortality. Results: ICU mortality was 44.74%. Invasive mechanical ventilation in ICU was used for 55.26% of the patients, and vasoactive drugs were used for 77.19% of patients. Factors independently associated with it were qSOFA score ≥2, increase of SOFA score over the first 48 h, mechanical ventilation on the first day in ICU, need for colistin therapy, lower arterial pH on arrival to ICU. Cut-off value of the noradrenaline dose associated with ICU mortality was 0.21 μg/kg/min with a ROC of 0.9686 (95% CI 0.93-1.00, p < 0.0001). Conclusions: Mortality of oncohematological patients in the ICU is high and it is associated with progression of organ dysfunction over the first 48 h in ICU, invasive mechanical ventilation and need for relatively low dose of noradrenaline. Despite our findings, we do not recommend making decisions regarding treatment limitations for patients who have reached cut-off dose of noradrenaline.
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Affiliation(s)
- Šarūnas Judickas
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, 08661 Vilnius, Lithuania; (M.Š.); (J.Š.)
- Correspondence:
| | - Raimundas Stasiūnaitis
- Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, 03101 Vilnius, Lithuania;
| | - Andrius Žučenka
- Clinic of Internal Diseases, Family Medicine and Oncology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, 08661 Vilnius, Lithuania;
| | - Tadas Žvirblis
- Department of Mechanics and Material Engineering, Faculty of Mechanics, Vilnius Gediminas Technical University Vilnius, J. Basanaviciaus Str. 28, 03224 Vilnius, Lithuania;
| | - Mindaugas Šerpytis
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, 08661 Vilnius, Lithuania; (M.Š.); (J.Š.)
| | - Jūratė Šipylaitė
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, 08661 Vilnius, Lithuania; (M.Š.); (J.Š.)
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The Field of “Public Health” as a Component of Sustainable Development—Poland Compared to the European Union. SUSTAINABILITY 2021. [DOI: 10.3390/su131810351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of the article is to analyse selected indicators of sustainable development in the field of “public health”, especially those related to health and health-related inequalities. The article focuses on the analysis of indicators in the field of “public health” presented by Eurostat. These indicators were presented in terms of averages and medians. Moreover, the paper indicates the amount of funds allocated for prevention in health care. In addition, the cluster method was used to identify EU countries similar to each other in terms of the leading indicator of sustainable development (SD). The study was conducted using annual data for 2010–2019 for Poland as compared to other EU countries. The study used data from the Eurostat and OECD databases. In almost all of the analysed countries, in relation to the demographic and health situation, there is a close link between the financial situation, health and inequalities in health-related fields. Patients’ sense of safety has decreased in Poland, which is the result of the growing consumption of health services and emerging problems with the availability of health care services as well as environmental pollution. Among others, the percentage of people with health problems and low income has increased. Although the percentage of unmet needs resulting from income inequalities has decreased over the past year in the analysed groups of countries, it is still high in Poland. The low level of expenditure on prevention makes these difficulties even more severe. In summary, capturing changes in indicators describing public health in the context of its impact on sustainable development plays a key role in balancing out inequalities in the EU countries and in managing a common policy.
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Kolossváry E, Björck M, Behrendt CA. A Divide between the Western European and the Central and Eastern European Countries in the Peripheral Vascular Field: A Narrative Review of the Literature. J Clin Med 2021; 10:jcm10163553. [PMID: 34441848 PMCID: PMC8397088 DOI: 10.3390/jcm10163553] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/19/2022] Open
Abstract
Thirty years after the transition period, starting from 1989, Central and Eastern European countries (CEECs), representing one-fifth of the entire European population, share many historical, societal, political, economic, and cultural characteristics. Although accumulating data on coronary heart diseases and cerebrovascular diseases support these observations, in the case of peripheral arterial disease, data are scarce. The present review attempts to summarise the shreds of data that may highlight a divide in this field between CEECs and Western European countries. Disparities in risk factors and peripheral vascular care across Europe seem to be tangible and can be seen as a signal of existing differences. Improvements in research and development and the collection and cross-border share of scientific data are essential to initiate and facilitate convergence in this field.
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Affiliation(s)
- Endre Kolossváry
- Department of Angiology, St. Imre University Teaching Hospital, 1115 Budapest, Hungary
- Correspondence: ; Tel.: +36-30-3069605; Fax: +36-1-2033652
| | - Martin Björck
- Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, 75121 Uppsala, Sweden;
| | - Christian-Alexander Behrendt
- Department of Vascular Medicine, Research Group GermanVasc, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
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Karasiewicz M, Chawłowska E, Lipiak A, Więckowska B. A Step towards Understanding and Tackling Health Inequalities: The Use of Secondary Prevention Services and the Need for Health Promotion in a Rural Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168492. [PMID: 34444237 PMCID: PMC8394776 DOI: 10.3390/ijerph18168492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 01/01/2023]
Abstract
Poland has recently intensified its health promotion in an effort to extend healthy life expectancy and reduce health inequalities. Our aim was to reach a deprived rural population, increase its health literacy, and explore its use of and barriers to cancer screening and public health care. A CBPR study was conducted in one of the poorest districts in Wielkopolska region, Poland, among 122 beneficiaries of health education workshops. A self-developed questionnaire was used. The reported barriers to participation in cancer screening included: lack of time, lack of need, or feeling healthy (32.8%); long waiting times (17.2%); fear of costs (9%). Physicians seldom recommended screening to their patients. Only 7.4% of respondents had ever received dermatoscopy. Among women, 18.2% did not perform any breast exams and 25% had never had smear tests. Diagnostics was often financed out of pocket (thyroid ultrasound = 58.1%; smear test = 48.5%; breast ultrasound = 36.8%). The health system needs mentioned by participants included better access to physicians (65.6%), promotion of free screening tests (54.9%), and access to public health programmes (22.1%). There is an urgent need to translate national strategies into action. Health promotion and better access to care must become priorities in deprived areas, while primary care providers should become key figures in delivering these services.
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Affiliation(s)
- Monika Karasiewicz
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (E.C.); (A.L.)
- Correspondence:
| | - Ewelina Chawłowska
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (E.C.); (A.L.)
| | - Agnieszka Lipiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (E.C.); (A.L.)
| | - Barbara Więckowska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
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