scholarly journals Regional Health Disparities in the Aftermath of Health System Reforms in Turkey

Author(s):  
Zeynep UGUR ◽  
Abdullah TİRGİL
2020 ◽  
Vol 26 (3) ◽  
pp. 698-720
Author(s):  
E.V. Lobkova ◽  
A.S. Petrichenko

Subject. This article studies the mechanism of State health regulation and methods of management of efficiency of regional healthcare institutions. Objectives. The article aims to analyze the territorial health system in the context of the urgent need to optimize budget expenditures and address public health problems, as well as develop directions to improve the effectiveness of the regional health system of the Krasnoyarsk Krai. Methods. For the study, we used the method of index numbers and calculation of dynamics indicators using official statistics data. Results. We have developed and now present a system of indicators of regional health efficiency assessment, focused mainly on public health indicators and quality of medical services. We also offer our own version of the Luenberger observer modification adapted to the objectives of the regional health system analysis. Conclusions and Relevance. The article concludes that it is necessary to optimize the regional health system using the parameters of medical and social efficiency of the system. The proposed approach to assessing the effectiveness of regional health system can be used as a mechanism to develop recommendations for the management of the network of medical and prophylactic institutions of the region.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S251-S253
Author(s):  
Charles Teixeira ◽  
Henry Shiflett ◽  
Deeksha Jandhyala ◽  
Jessica Lewis ◽  
Scott R Curry ◽  
...  

Abstract Background COVID-19, first described in Wuhan, China, is now a global pandemic. We describe a cohort of patients (pts) admitted to our academic health system (HS) in the southeast, where demographics and comorbidities differ significantly from other regions in the U.S. Methods This was a retrospective review of 161 consecutive pts admitted with COVID-19 from 3/12/20 to 6/1/20. We assessed demographics, comorbidities, presenting symptoms, treatments and outcomes and compared pts who died during hospitalization to those who survived to discharge (EpiInfo 7.2, Atlanta, GA). Results Mean age was 60.5 years, 51.6% were female, 72% African American (AA) and 69.6% admitted from home. 54.5% had a BMI >30, 72% had HTN, 47.2% diabetes, and 33.6% COPD or asthma. The majority (68.8%) presented with fever (>38.0) and required supplemental oxygen within 8 hours of admission (63.4%). Cough (65.6%), dyspnea (57.5%), myalgias (30.6%) and diarrhea (23.8%) were also common. 40.4% received hydroxychloroquine, 23.6% steroids and 19.9% convalescent plasma. 42.9% required ICU care, 27.3% were intubated, and 19.3% died. Characteristics associated with death included older age, male sex, HTN, ESRD on HD, and cancer. Symptoms associated with death included absence of cough, absence of myalgias, previous admission for COVID-19, tachypnea, need for supplemental oxygen, elevated BUN and creatinine, and elevated ferritin. Interventions associated with death included use of steroids, receipt of ICU care, intubation, delay to intubation, and use of vasopressors or inotropes. Complications associated with death included development of a new arrhythmia, bacteremia, pneumonia, ARDS, thrombosis, and new renal failure requiring HD (Table). Table 1. Patient Characteristics by Death Table 2. Patient Characteristics by Death Table 3. Patient Characteristics by Death Conclusion COVID-19 pts admitted to our southeast U.S. HS had significant comorbidities, most commonly obesity, HTN, and diabetes. Additionally, AA comprised a disproportionate share (72%) of our cohort compared to the general population of our state (30%), those tested in our region (32.9%), and those found to be positive for COVID-19 (35.8%). In-hospital mortality was 19.3% and intubation, particularly if delayed, was associated with death as were several complications, most notably arrhythmia, ARDS, and renal failure with HD. Disclosures All Authors: No reported disclosures


Author(s):  
Keith L. Grant ◽  
Dora E. Wiskirchen ◽  
Ulysses Wu ◽  
Michael R. Grey ◽  
Pracha P. Eamranond

2020 ◽  
Vol 144 (11) ◽  
pp. 1321-1324
Author(s):  
Tamera A. Paczos

Context.— Declining reimbursement shifts hospital laboratories from system assets to cost centers. This has resulted in increased outsourcing of laboratory services, which can jeopardize a hospital systems' ability to respond to a health care crisis. Objectives.— To demonstrate that investment in a core laboratory serving an academic medical center equipped a regional health system to respond to the Coronavirus disease 2019 (COVID-19) pandemic. Design.— COVID-19 diagnostic testing data were analyzed. Volumes were evaluated by result date (March 16, 2020–May 6, 2020), and the average of received-to-verified turnaround time was calculated and compared for in-house and send-out testing, and different in-house testing methodologies. Results.— Daily viral diagnostic testing capacity increased by greater than 3000% (from 21 tests per day to 658 tests per day). Total viral diagnostic testing reported by the core laboratory increased by 128 times during 22 days of test method validation and 826 times during the analysis period, while average turnaround time per day for send-out testing increased from 3.7 days to 21 days. Decreased overall average turnaround time was observed at the core laboratory (0.45 days) versus send-out testing (7.63 days) (P < .001). Conclusions.— Investment in a core laboratory provided the health system with the necessary expertise and resources to mount a robust response to the pandemic. Local access to testing allowed rapid triage of patients and conservation of scarce personal protective equipment (PPE). In addition, the core laboratory was able to support regional health departments and several hospitals outside of the system.


2020 ◽  
Vol 12 (4) ◽  
pp. 487-497
Author(s):  
Laurie A. Schintler ◽  
Jiayi Wu ◽  
Connie L. McNeely

2016 ◽  
Vol 47 (6) ◽  
pp. 985-992 ◽  
Author(s):  
Stephen P. H. Whiteside ◽  
Chelsea M. Ale ◽  
Brennan Young ◽  
Mark W. Olsen ◽  
Bridget K. Biggs ◽  
...  

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