Showing posts sorted by relevance for query healthcare. Sort by date Show all posts
Showing posts sorted by relevance for query healthcare. Sort by date Show all posts

Thursday, October 10, 2024

Extensive new evidence released regarding Israel’s killing, detention and torture of Palestinian healthcare workers

October 9, 2024
Labour Hub Editors

In a comprehensive reportHealthcare Workers Watch (HWW) is sharing first-hand testimony from Palestinian healthcare workers who have been tortured while in Israeli detention.  The Killing, Detention, and Torture of Healthcare Workers in Gaza contains the organisation’s detailed research, compiled over the past year, regarding Israel’s killing and detention of healthcare workers, including an analysis of the devastating impact on the provision of healthcare to the population of Gaza.

Through the rigorous evidence collected as primary data by HWW, this report outlines patterns of human rights violations carried out by the Israeli Occupation Forces that are unambiguously consistent with deliberate acts to inflict upon a specific population – the Palestinians living in Gaza – serious physical and psychological harm, consistent with the intent of genocide. These patterns of conduct include the targeted killing, injuring, detention and systemic torture of healthcare workers in a manner that is leading to death and disability of the Palestinian population by depriving them of healthcare, both in the short and long term.

This report also provides evidence of a wider pattern of genocidal conduct that has led to the largescale destruction of the healthcare system of Gaza. This includes the military besiegement, invasion and deliberate destruction of hospitals and medical equipment, forcing hospitals out of service, in some cases permanently. As a direct result of these crimes, tens of thousands of Palestinians are dying entirely preventable deaths due to a lack of access to adequate healthcare.

Dr. Muath Alser, the founder of HWW says: “In this report, we use rigorous evidence to demonstrate how the Israeli Occupation Forces are systematically targeting the healthcare workforce of Gaza. The patterns of human rights violations are unambiguously consistent with the intent of genocide.”

He goes on to say: “The key message from Healthcare Workers Watch is that all healthcare workers – especially those working in areas of conflicts and war zones – must be protected, supported, and respected instead of being targeted, tortured, and detained.”

Among the report’s findings are:

  • HWW has confirmed the killing of a total of 587 healthcare workers in Gaza since October 7th 2023, and are in the process of verifying the killing of a further 420 healthcare workers. One third of those confirmed killed are women (194).
  • HWW data shows that 105 senior physicians were killed or detained by the Israeli military since October 7th 2023, constituting 23% of Gaza’s most experienced physicians. This includes 39 killed consultants, 41 detained consultants, 19 killed specialists and 6 detained specialists.
  • As of September 20th 2024, HWW documented 264 cases of unlawful detention of Palestinian healthcare workers in the Gaza Strip by Israeli Occupation Forces since October 7th 2023. These include 73 physicians, 2 dentists, 80 nurses, 36 paramedics, six pharmacists, one optometrist, 21 technicians, 29 healthcare administrative staff, four healthcare students, three volunteers, and nine others. Four of those detained were killed while in detention, 127 remain in detention currently, 23 are missing, and 110 were released (three of them were detained twice, then released). Fifty-five were from North Gaza, 91 from Gaza City, one from the Middle Area, 115 from Khan Younis, and two from Rafah.
  • Several released healthcare workers interviewed by Healthcare Workers Watch reported being subjected to systematic torture and inhumane treatment in Israeli detention.

According to messages received from several healthcare workers in Northern Gaza, and also a statement recently released by the Palestinian Ministry of Health in Gaza, Israeli Occupation Forces are now threatening all healthcare workers and patients in northern Gaza’s hospitals, ordering them to evacuate to the south or they will face the same fate as Al-Shifa Hospital, where mass graves of men, women and children were found following the withdrawal of Israeli forces.

 So far, Israeli Occupation Forces have detained a paramedic while transferring a critically ill patient from the ICU of Kamal Adwan Hospital. The fate of the paramedic is unknown.

HWW are profoundly concerned about the safety of healthcare workers and the existence of the northern Gaza population as they are “facing a serious escalation of genocidal acts that render northern Gaza unliveable due to indiscriminate military actions and the destruction of the healthcare system through the killing, detention, and torture of healthcare workers and the wanton destruction of hospitals.”

Regarding the new report, HWW say: “We release this report in memory of the hundreds of healthcare workers killed in Gaza by the Israeli Occupation Forces, given the complete absence of effective international response, utter impunity, and failure of concerned organisations to prevent or stop these crimes, let alone hold their perpetrators accountable.”

Healthcare Workers Watch is powered by dedicated volunteers committed to documenting the Israeli attacks against healthcare workers in Palestine, and taking action accordingly. For more information, see www.healthcareworkerswatch.org


Sunday, December 11, 2022

Digital healthcare, location optimization and road improvements are recommended to improve healthcare in Ho Chi Minh City

Peer-Reviewed Publication

UNIVERSITY OF EASTERN FINLAND

The best and poorest quality hospitals and clinics in Ho Chi Minh City. 

IMAGE: THE BEST AND POOREST QUALITY HOSPITALS AND CLINICS IN HO CHI MINH CITY. THE BEST HOSPITALS AND CLINICS ARE MARKED RED AND THE POOREST ARE MARKED BLUE. (HEALTHCARE QUALITY SCORE). view more 

CREDIT: THE AUTHORS.

The quality and accessibility of healthcare plays a crucial role in preventing and mitigating health problems. A study conducted in Ho Chi Minh City, Vietnam’s largest city of 9 million residents, showed that people living in the city’s established and new urban areas have access to better-quality and better-accessible healthcare than people living in the suburban areas. According to the researchers, digital healthcare, road improvements and better urban planning could be used to promote more equal healthcare in a cost-effective manner.

Conducted by the University of Eastern Finland, the University of Social Sciences and Humanities – Vietnam National University Ho Chi Minh City, and the Ho Chi Minh City Institute for Development Studies, the study showed that nearly 1.2 million people in Ho Chi Minh City live in deficiently served areas in terms of healthcare. Their travel time to the nearest hospital is more than 30 minutes, and more than 15 minutes to the nearest clinic.

Published in BMC Health Services Research, the study utilised data from public registers on hospitals, health clinics, streets, roads, population, and healthcare quality. The researchers analysed the quality and accessibility of healthcare and, relying on international studies, they also examined the opportunities of digital healthcare to improve the provision of services.

In Ho Chi Minh City, healthcare services are provided by public and private hospitals and clinics. Some hospitals are focused on specialised medical care, while clinics typically provide primary and emergency care. In the city’s new developing urban areas, healthcare facilities have been built in cooperation with private sector developers, thus aiming to improve their accessibility. In suburban areas in the outskirts of the city, however, sporadic demand and small market for healthcare have led to its poor quality and poor accessibility.

“This is a shortcoming that requires action and new solutions. Our study links digital healthcare solutions to the planning of healthcare and urban development, while also providing an example and tools for planning a more equal system of digital and physical healthcare also elsewhere,” says Researcher Khanh Hung Le of Vietnam National University Ho Chi Minh City.

The researchers recommended prompt adoption and development of digital healthcare services by hospitals and clinics capable of doing so, while also setting an example for others.

“Ho Chi Minh City has set the digitalisation of healthcare as a goal in its digital transformation programme for 2030,” Researcher Thi Xuan Phuong La of HCMC Institute for Development Studies notes.

“Remote clinics, self-monitoring, remote monitoring and healthcare applications should be developed in order to improve the quality and cost-effectiveness of healthcare services, for example in situations where the demand for healthcare services is sporadic and the supply does not adequately meet the demand. The development of remote healthcare services would also reduce the need for travel,” says Professor Markku Tykkyläinen of the University of Eastern Finland.

Hospital Service Areas. Maximum patient travel time 10, 20 and 30 minutes and respective distances along the street and road network to the nearest hospital at the average speed of 20 km/h. (Service Area).

Clinic service areas. Maximum patient travel time 5, 10 and 15 minutes and respective distances along the street and road network to the nearest clinic at the average speed of 20 km/h. (Service Area).

CREDIT

The Authors.

Saturday, April 12, 2025

 

Waning Visions of Equity: Healthcare Privatisation in India and its Many Discontents



Vivek Divan 


Contrary to the Bhore Committee’s vision of an egalitarian and humane healthcare framework, India has systematically stifled public healthcare, endorsing in its stead an essentially unregulated private sector, straying further from the goal of effectuating the constitutional right to health.

The bhore Committee reoort Of 1946 charted a course for public health investments and infrastructure for the emerging nation state. Its recommendations were manifold, all with the aim of making healthcare equitable and universal. Among them, some key ones included a vision of a healthcare system that had – 

  1. three levels – primary health centres (‘PHCs’) at the village level, secondary health centres (hospitals) in districts, and tertiary level hospitals in metropolises 

  2. a focus on preventive health, over curative services; free and universal healthcare and,

  3. investment in human resources for health through medical and nursing education at scale.

Vitally, it recommended a significant proportion of the government’s budget – 15 percent – to be dedicated to health. Its vision included a thirty year timeframe within which all these components were to be fully realised.

What is visible today is, at best, a partial implementation of these recommendations, and a healthcare system which is the opposite of the egalitarian and humane approach that the Bhore Committee espoused. Over time inequity in Indian healthcare has become further entrenched. Although a three-tier system was implemented, reporting reveals the abysmal state of much primary healthcare, the shambolic condition of district hospitals, and increasing number of poorly resourced government tertiary health institutions due to lower financial outlays for public health. 

What is visible today is, at best, a partial implementation of these recommendations, and a healthcare system which is the opposite of the egalitarian and humane approach that the Bhore Committee espoused.

While certain preventive programmes such as immunisation, maternal and child health services, and sanitation have been put in place, a large emphasis of healthcare in India has historically been around curative medicine. And, the shortfall in human resources for health in rural India has been abundantly recorded. Finally, the Union government’s budgetary commitment to health has reached nowhere near the figures envisioned by the committee.

There are many reasons why quality healthcare in India has skewed in favour of those who can afford it, making it one of the many starkly unequal sectors in India. One of them has been the stepping away of the government from being the primary provider of healthcare. Indeed, one of the better-known appalling facts about financial precarity in India is that out-of-pocket expenditure (‘OOPE’) on healthcare is the chief reason that drives families and individuals into poverty. This is because with the shrivelling or under-resourcing of government healthcare provisioning, most turn to a largely unregulated private sector to seek care, where expenses lead to severe indebtedness.        

Policy trajectories

In 1983, as the Indian government issued the first National Health Policy (‘NHP’), a path which increased the role of the private sector opened up. Simultaneously, the public exchequer’s contribution towards provision of healthcare remained stagnant. While the NHP 1983 envisioned a larger role for private providers to alleviate the burden on government, the introduction of user fees in public healthcare during the Eighth Five-Year Plan (1992-1997) demonstrated another step in the commodification of healthcare. To be sure, neither of these policy moves were devoid of welfare-oriented instincts. The NHP in 1983 spoke of decentralising healthcare to move resources closer to needy communities, and of cost-effectiveness that elevated affordable healthcare solutions. Planning in the 1990s, around the time of liberalisation of the Indian economy,  was pre-occupied with how to generate revenue for a resource-constrained health sector, while also acknowledging the need to encourage greater use of public health services, and improve access for the poor. User charges were seen as a panacea for this, with a push coming from the World Bank of its Health Systems Development Project. Many states implemented this approach in the next decade.

Succeeding this, and among other things that it recommended, the NHP of 2002 was notable for its push to increase government health spending from 0.9 percent to 2 percent of GDP by 2010, primarily driven by a larger contribution from the central government, including at the state level. The policy noted that it “welcomes the participation of the private sector in all areas of health activities – primary, secondary or tertiary”  while envisaging “the enactment of suitable legislation for regulating minimum infrastructure and quality standards in clinical establishments/ medical institutions by 2003. Also, statutory guidelines for the conduct of clinical practice and delivery of medical services are targeted to be developed over the same period.” Notably, the Clinical Establishments (Registration and Regulation) Act (‘CEA’) was passed by Parliament in 2010, as were guidelines and standards to govern healthcare delivery. The CEA provides for the regulation and registration of healthcare establishments, and minimum standards for facilities and services.

Most recently, the Union government issued the NHP of 2017. It is under this policy framework and the preceding Rashtriya Swasthya Bima Yojana of 2008 that earlier visions of universal health ‘care’ were morphed into the idea of health ‘coverage’ – a healthcare access system anchored in insurance schemes, realised today in the form of Ayushman Bharat  – Pradhan Mantri Jan Aarogya Yojana (‘AB-PMJAY’). While encouraging the use of digital technologies in health, the policy suggests an increase in public health expenditure to 2.5 percent of GDP by 2025 and allocating two-thirds of health spending to primary healthcare. NHP 2017 also encourages private sector collaboration in healthcare delivery through public-private partnerships (‘PPPs’). 

Now the private sector has also entered health delivery at the primary level – through working with the government in setting up Ayushman Arogya Mandirs (‘AAMs’, formerly PHCs or Health & Wellness Centres) under the AB-PMJAY.

What of access and equity?

Hitherto health policy in India envisioned a complementary role for private healthcare provision, partly at the secondary and mostly at the tertiary level. Now the private sector has also entered health delivery at the primary level – through working with the government in setting up Ayushman Arogya Mandirs (‘AAMs’, formerly PHCs or Health & Wellness Centres) under the AB-PMJAY. Entities such as the Federation of Indian Chambers of Commerce & Industry (‘FICCI’) and NATHEALTH are partners in primary healthcare delivery. 

Such involvement of the private sector has also been espoused by the Niti Aayog, which suggested a new model for financing public healthcare – blended finance – in a 2022 White Paper. While doing so the paper notes: “But the investments and capital raised [for health] have been from established market players with a strong focus on profitability and growth and not necessarily on accessibility and affordability.” It goes on to respond to this by stating that AB-PMJAY is the vehicle through which these concerns of accessibility and affordability are addressed. 

But does the AB-PMJAY meet this challenge? Are the most serious concerns of access and affordability to quality healthcare truly addressed so that the constitutional right to health is fully realised in a domain which is witnessing rampant privatisation? 

The answers to ensuring healthcare access and equity are hardly as straightforward as that. 

While ambitious, the AB-PMJAY has limitations. The scheme restricts eligibility, although it does cater to the neediest in the populace (and, it has been encouraging to note that governmental intent is to increase the pool of beneficiaries that it covers; most recently the scheme was extended to include all citizens above seventy years, irrespective of socio-economic status). The packages it offers, while considerable, are not comprehensive, thereby excluding some medical care and procedures from its fold. 

In a context such as this, the sanguine manner in which the private healthcare sector – one which has the driving motive to make profits – has been made a partner in schemes like AB-PMJAY coupled with how it has mushroomed essentially unregulated, suggests that it will inundate healthcare in a country with vast socio-economic disparities.

But most importantly, it applies to only empanelled government and private hospitals. Available information points to 34,678 hospitals being empanelled under the scheme, of which around 43 percent have historically been private hospitals. How will private healthcare institutions not empanelled under PMJAY be governed to ensure that access and affordability are satisfactorily addressed? A recent report notes that over 600 private hospitals have opted out of the scheme since 2018. 

What of them, and the thousands of other private hospitals that are not empanelled? How are they governed? Does the answer lie in the CEA and its complementary Rules (‘CER’)?

Unaccountability in private healthcare

While the CEA should be the robust legal basis on which the private healthcare sector is made to conduct its work in a transparent and accountable manner, the law’s uptake has been poor. It has been adopted by only 15 states and union territories. While some states have their versions of the CEA, these are varied in their rigour.* Vast gaps remain in the implementation of the CEA and similar laws. A report of the Comptroller and Auditor General of India (‘CAG’) in 2024 painted a dismal picture for Haryana, where registration of several establishments was not undertaken, leaving them outside the regulatory ambit, and where the State Clinical Establishments Council was non-functional

Similarly, the CAG denounced the management of health services in Maharashtra under that state’s relevant law, noting that periodic inspections are not undertaken, and many healthcare institutions fall outside the scope of the law. Research indicates many other flaws such as the uneven registration of clinical establishments in other states, inspections of establishments by designated authorities being infrequent, and penalties being levied rarely against violating institutions. 

Among the many things that the CEA and its Rules are supposed to regulate are price transparency and price standardisation of medical procedures and services. This is critical in the context of India, which is replete with profiteering by the private healthcare sector. During the COVID-19 pandemic, a private hospital in Delhi priced a bed at Rs. 25,000 in a general ward and 72,000 within ICU with a ventilator. Also in Delhi, private super-specialty hospitals were found by the Competition Commission of India to have profit margins on syringes in the range of 269.84 percent to 527 percent in 2014-15 and 276.96 percent to 527 percent in 2015-16 by forcing patients to purchase these products from the hospital’s pharmacy. In Chhattisgarh, OOPE for outpatient services (including healthcare provider fees, medicines and diagnostic tests) revealed that private healthcare establishments charge amounts six times greater than costs incurred in public healthcare. Another study found that OOPE incurred on hospitalisation was almost twice in the private sector than in the public sector in Haryana.   

In a context such as this, the sanguine manner in which the private healthcare sector – one which has the driving motive to make profits – has been made a partner in schemes like AB-PMJAY coupled with how it has mushroomed essentially unregulated, suggests that it will inundate healthcare in a country with vast socio-economic disparities. Compounded with the appalling disregard that governments have demonstrated in weakening public healthcare by squeezing it financially, it would be reasonable to be deeply sceptical about whether the constitutional right to health will ever be delivered to the populace.

A word about the law. The government’s obligation to deliver on the right to health is clearly articulated through its international commitments, and by constitutional courts in India. The International Covenant on Economic, Social and Cultural Rights (‘ICESCR’) binds India to ensure the right in all its dimensions – by guaranteeing availability,  accessibility, acceptability and quality of health, and respecting, protecting, and fulfilling the right. Much is contained within these terms, including access to health facilities, services, hospitals and clinics; non-discrimination, economic and informational accessibility, medical ethics such as consent and confidentiality, skilled medical personnel, scientifically approved unexpired drugs, regulation of the private sector, and ensuring a robust public health sector. Courts in India have repeatedly and emphatically reified the right to health, and in doing so enjoined the government “to seriously consider expanding its health budget if their right to life and right to equality as enumerated in Articles 14 and 21, are not to be rendered illusionary.” This being the basis for all healthcare policy and programming adherence, surely a serious reconsideration of enthusiastic privatisation and the disintegration of public sector provisioning of health is of the essence.

In most developed countries, widescale healthcare access is largely achieved through public financing. Studies show that increased public health expenditure has led to a surge in the utilisation of public healthcare facilities, particularly among poorer sections of society, both outpatient and inpatient care across different regions. This shift resulted in a substantial decline in OOPE, consequently reducing the overall financial burden on patients. The need of the hour, then, is a recommitment to improving the public healthcare architecture – investing significantly more funds, and augmenting human resources and infrastructure, while ensuring accessibility, affordability, quality and transparency.

Note: *Maharashtra Nursing Homes Registration Act, 1949; Tamil Nadu Private Clinical Establishments (Regulation) Act, 1997; West Bengal Clinical Establishments (Registration, Regulation, and Transparency) Act, 2017; Punjab Clinical Establishments (Registration and Regulation) Ordinance, 2020; Karnataka Private Medical Establishments (KPME) Act, 2007; Andhra Pradesh Allopathic Private Medical Care Establishments (Registration and Regulation) Act, 2002; Telangana Allopathic Private Medical Care Establishments (Registration and Regulation) Act, 2002.

Vivek Divan heads the Centre fo

Sunday, November 13, 2022

Administrative fellowship programs may reinforce gender disparities in healthcare leadership

Peer-Reviewed Publication

WOLTERS KLUWER HEALTH

November 11, 2022 – While administrative leadership programs positively impact the career paths of individual leaders, male leaders benefit more from these programs than female leaders do, according to a longitudinal study featured in the November/December issue of Journal of Healthcare Management (JHM)an official publication of the American College of Healthcare ExecutivesThe journal is published in the Lippincott portfolio by Wolters Kluwer.

The study looked at the value of administrative fellowship programs on career attainment as well as whether career attainment differs by gender. Findings indicate that “although fellowships can accelerate career progression for both men and women, the effect is significantly stronger for men, suggesting that, in aggregate, there is some risk that fellowships may be widening the leadership gender gap, rather than attenuating it,” write Julie Robbins, PhD, The Ohio State University, along with Brooke Z. Graham, MBA, MS, James Madison University, Andrew N. Garman, PsyD, Rush University, Randa Smith Hall, MBA, MHSA, University of Alabama-Birmingham, and Jeffrey Simms, MSPHA, University of North Carolina at Chapel Hill, in the November issue of the Journal of Healthcare Management (JHM).

Diverse leadership can lead to higher quality of care

While women account for nearly 80% of the total healthcare workforce in the United States (and 70% globally), they represent just 30% of C-suite positions. Further, a recent survey reported 86% of women in healthcare believe change is needed to increase women in senior leadership positions. Many experts and analysts believe women leaders—and more diverse leadership in general—are critical for an efficient healthcare organization that provides high-quality care to patients from all backgrounds.

Administrative fellowship programs are highly selective and designed to help graduates move directly into healthcare leadership positions, offering practical experience as well as professional networking opportunities. Many programs focus on increasing gender diversity, yet there are few studies of the programs’ impact on career progression and on gender disparities in leadership.

The research team set out to uncover whether there is a difference in career attainment between female and male graduates, between those who graduated from an administrative fellowship program and those who did not, and between female and male administrative fellows.

Demographic and career attainment data were collected in 2018 from historical records, alumni databases, and career resources of the graduating classes of 2013, 2008, and 1998 from 15 administrative fellowship programs. The sample included 689 student records.

Closing the gender gap in healthcare leadership requires career-supporting strategies and initiatives

Among the findings, women were found to be a slight majority of graduates across the three graduating classes. Those who began their careers in administrative fellowships increased to 38% in 2013. Further, 52% of graduates across the three classes held senior management or executive positions as of 2018. Finally, while beginning a healthcare career in an administrative fellowship appears to accelerate career attainment for both women and men, the effect is significantly stronger for men.

While additional studies and efforts are needed, the authors believe “this research can help early careerists and especially women better understand their career planning steps and developmental opportunities to reach leadership positions.” It is clear that administrative fellowship programs are a valuable vehicle for leadership development.

The article goes on to suggest that administrative fellowship program directors can help reduce this gender gap by, for example, re-designing programs to be more equitable, further expanding program access to women, and tracking program application patterns by gender.

Read [Closing the Gender Gap in Healthcare Leadership: Can Administrative Fellowships Play a Role?]

DOI: 10.1097/JHM-D-21-00314

###

About the Journal of Healthcare Management

The Journal of Healthcare Management (JHM) is an official journal of the American College of Healthcare Executives (ACHE). Published bimonthly, JHM is a peer-reviewed publication dedicated to providing healthcare leaders with the information they need to manage complex healthcare issues and to make effective strategic decisions. JHM provides a forum for discussion of current trends and presentation of new research as applied to healthcare management.

About the American College of Healthcare Executives

The American College of Healthcare Executives is an international professional society of more than 48,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations. ACHE's mission is to advance its members and healthcare leadership excellence. ACHE offers its prestigious FACHE® credential, signifying board certification in healthcare management. ACHE's established network of 76 chapters provides access to networking, education and career development at the local level. In addition, ACHE is known for its magazine, Healthcare Executive, and its career development and public policy programs. Through such efforts, ACHE works toward its vision of being the preeminent professional society for leaders dedicated to improving health.

The Foundation of the American College of Healthcare Executives was established to further advance healthcare management excellence through education and research. The Foundation of ACHE is known for its educational programs, including the annual Congress on Healthcare Leadership, which draws more than 4,000 participants and groundbreaking research. Its publishing division, Health Administration Press, is one of the largest publishers of books and journals on health services management, including textbooks for college and university courses. For more information, visit www.ache.org.

About Wolters Kluwer

Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer reported 2021 annual revenues of €4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,800 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

For more information, visit www.wolterskluwer.com, follow us on TwitterFacebookLinkedIn, and YouTube.

Friday, December 06, 2024

U$A FOR PROFIT HEALTHCARE

Forbes Healthcare Summit: AI can improve the quality, cost of healthcare

The healthcare summit is an annual event sponsored by Forbes and includes leaders in the nation's $4 trillion healthcare industry.

THE SUMMIT WHERE UNITED HEALTHCARE CEO 


Forbes Chairman and Editor-in-Chief Steve Forbes speaks at the 2024 Forbes Healthcare Summit at Murphy Alumni Hall - NYU Langone Health in New York City on Wednesday. Photo by John Angelillo/UPI | License Photo

Dec. 4 (UPI) -- Artificial intelligence can improve the effectiveness and affordability of how healthcare is delivered, attendees at the 2024 Forbes Healthcare Summit in New York City were told Wednesday.

Ajay Shah, Cytovale co-founder and chief executive officer, said artificial intelligence tools are helping patients stay healthier while caregivers are lowering their healthcare delivery costs.

Cytovale is the maker of the IntelliSep AI tool that specifically diagnosis sepsis that it says is common, costly and difficult to diagnose.

"The conversation is really about the clinical operation and financial benefits to hospitals and healthcare systems," Shah said when asked about the healthcare benefits of AI tools, like IntelliSep.

"Some of what we've been able to share over the last year is demonstrating a reduction in length of stay by over a day for every patient tested with IntelliSep," Shah said.

"That's the result of enabling the physician and the providers to see the right diagnosis from the first minute of that patient's visit and dramatically changing their care pathways," he added.

"The long-term effects of sepsis are really meaningful," Shah said. "Getting patients aggressive care quickly improves the outcome of their long-term costs."

The healthcare summit is an annual event sponsored by Forbes and includes leaders in the nation's $4 trillion healthcare industry.

AI "is a powerful and disruptive area of computer science, with the potential to fundamentally transform the practice of medicine and the delivery of healthcare," the National Institutes of Health reported in 2021.

AI can help healthcare systems around the world to achieve the four-part goal of improving population health, patients' care, caregivers' experiences and lowering the cost of healthcare delivery.

"Aging populations, growing burden of chronic diseases and rising costs of healthcare globally are challenging governments, payers, regulators and providers to innovate and transform models of healthcare deliver," the NIH said.

The recent COVID-19 pandemic also demonstrated shortfalls in the available healthcare workforce and inequities in accessing care that the NIH says AI could help alleviate.

"The application of technology and artificial intelligence in healthcare has the potential to address some of these supply-and-demand challenges," the NIH said.

President Joe Biden agrees and last year issued an executive order requiring the federal government to "prioritize generative AI and other critical and emerging technologies" to accelerate their responsible use in the nation's healthcare systems and other industries.

"AI holds extraordinary potential for both promise and peril," Biden said in the executive order.

"Responsible AI use has the potential to help solve urgent challenges while making our world more prosperous, productive, innovative and secure," Biden said. "At the same time, irresponsible use could exacerbate societal harms."

He said, "harnessing AI for good and realizing its myriad benefits requires mitigating its substantial risks."

Mitigating the risks requires a "society-wide effort that includes government, the private sector, academia and civil society,"Biden said.

The Healthcare Summit fits within the context of Biden's executive order.

"The AI revolution is unleashing new ways to discover drugs, personalize medicine and even manage a doctor's paperwork," Healthcare Summit organizers said.

The invitation-only annual event at Murphy Alumni Hall, NYU Langone Health, is the 13th that Forbes has held.

Sunday, May 29, 2022

Autistic individuals have poorer health and healthcare

Peer-Reviewed Publication

UNIVERSITY OF CAMBRIDGE

Autistic individuals are more likely to have chronic mental and physical health conditions, suggests new research from the University of Cambridge. Autistic individuals also report lower quality healthcare than others. These findings, published in Molecular Autism, have important implications for the healthcare and support of autistic individuals.

Many studies indicate that autistic people are dying far younger than others, but there is a paucity of research on the health and healthcare of autistic people across the adult lifespan. While some studies have previously suggested that autistic people may have significant barriers to accessing healthcare, only a few, small studies have compared the healthcare experiences of autistic people to others.

In the largest study to date on this topic, the team at the Autism Research Centre (ARC) in Cambridge used an anonymous, self-report survey to compare the experiences of 1,285 autistic individuals to 1,364 non-autistic individuals, aged 16-96 years, from 79 different countries. 54% of participants were from the UK. The survey assessed rates of mental and physical health conditions, and the quality of healthcare experiences.

The team found that autistic people self-reported lower quality healthcare than others across 50 out of 51 items on the survey. Autistic people were far less likely to say that they could describe how their symptoms feel in their body, describe how bad their pain feels, explain what their symptoms are, and understand what their healthcare professional means when they discuss their health. Autistic people were also less likely to know what is expected of them when they go to see their healthcare professional, and to feel they are provided with appropriate support after receiving a diagnosis, of any kind.

Autistic people were over seven times more likely to report that their senses frequently overwhelm them so that they have trouble focusing on conversations with healthcare professionals. In addition, they were over three times more likely to say they frequently leave their healthcare professional’s office feeling as though they did not receive any help at all. Autistic people were also four times more likely to report experiencing shutdowns or meltdowns due to a common healthcare scenario (e.g., setting up an appointment to see a healthcare professional).

The team then created an overall ‘health inequality score’ and employed novel data analytic methods, including machine learning. Differences in healthcare experiences were stark: the models could predict whether or not a participant was autistic with 72% accuracy based only on their ‘health inequality score’. The study also found worryingly high rates of chronic physical and mental health conditions, including arthritis, breathing concerns, neurological conditions, anorexia, anxiety, ADHD, bipolar disorder, depression, insomnia, OCD, panic disorders, personality disorders, PTSD, SAD, and self-harm.

Dr Elizabeth Weir, a postdoctoral scientist at the ARC in Cambridge, and the lead researcher of the study, said: “This study should sound the alarm to healthcare professionals that their autistic patients are experiencing high rates of chronic conditions alongside difficulties with accessing healthcare. Current healthcare systems are failing to meet very fundamental needs of autistic people.”

Dr Carrie Allison, Director of Strategy at the ARC and another member of the team, added: “Healthcare systems must adapt to provide appropriate reasonable adjustments to autistic and all neurodiverse patients to ensure that they have equal access to high quality healthcare.”

Professor Sir Simon Baron-Cohen, Director of the ARC and a member of the team, said: “This study is an important step forward in understanding the issues that autistic adults are facing in relation to their health and health care, but much more research is needed. We need more research on long term outcomes of autistic people and how their health and healthcare can be improved. Clinical service providers need to ask autistic people what they need and then meet these needs.”

The research was funded by the Autism Centre of Excellence, the Rosetrees Trust, the Cambridge and Peterborough NHS Foundation Trust, the Corbin Charitable Trust, the Queen Anne’s Gate Foundation, the MRC, the Wellcome Trust and the Innovative Medicines Initiative.

Reference

Weir, E., Allison, C., & Baron-Cohen, S. Autistic adults have poorer quality healthcare and worse health based on self-report data. Molecular Autism (2022).

Thursday, February 09, 2023

Hand hygiene is focus of updated advice to prevent healthcare-associated infections

Only 7% of healthcare personnel fully clean their hands

Reports and Proceedings

SOCIETY FOR HEALTHCARE EPIDEMIOLOGY OF AMERICA

Five medical organizations are recommending updated best practices for hand hygiene to protect patients and staff in healthcare settings. The recommendations emphasize the importance of healthy skin and nails and easy access to alcohol-based hand sanitizers.

Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene: 2022 Update, one in a series of expert guidance documents known collectively as the Compendium, was published today in the journal Infection Control & Hospital Epidemiology.

“Hand hygiene is a basic function of healthcare safety,” said lead author Janet Glowicz, PhD, RN, CIC, with the Centers for Disease Control and Prevention. “By engaging healthcare personnel and establishing reliable processes described in the Compendium, we can achieve effective, consistent hand hygiene. Commitment by healthcare leadership is also necessary to establishing a culture of safety.”

The document addresses how facilities can train healthcare personnel in proper technique, monitor their compliance, engage them in the selection of products to keep their skin healthy, and properly use gloves. It also discusses where facilities should place and how they should maintain alcohol-based sanitizer dispensers and sinks.

The guidance reviews the evidence around nail polish, gel, and shellac, which shows that short, natural nails with standard polish or no polish are easiest to clean. The authors found no new evidence specific to chipped nail polish and artificial nails but note previous findings that they can harbor germs. The guidance leaves specific policies about nail polish, gels, shellac, and artificial nail extenders to the discretion of infection prevention programs at each facility, with the exception of policies for those who scrub for surgery or work in high-risk areas. These personnel should maintain short, natural fingernails free of polish and nail extenders.

Citing research that shows only 7% of healthcare personnel effectively clean the entire surface of their hands, the guidance recommends ongoing training in handwashing and proper use of sanitizer. Thumbs and fingertips were most frequently missed.

The authors recommend that healthcare personnel not be provided with individual, pocket-sized hand sanitizers in lieu of wall-mounted sanitizer dispensers and emphasize that hand sanitizer dispensers always be widely available and never prohibited, even in situations when washing with soap and water are indicated. When healthcare personnel suspect organisms that are difficult to remove, such as C. difficile and noroviruses, healthcare personnel should wear gloves and follow structured techniques for hand washing and hand sanitizing.  In addition, facilities should not top-off sanitizer dispensers meant for single use or provide antimicrobial soaps that contain Triclosan. Facilities also should discourage the use of double gloves, except in certain circumstances.

To encourage compliance and to support healthy skin and nails, facilities should include healthcare personnel in the selection of hand sanitizers and moisturizers, while ensuring the products are compatible with antiseptics and gloves used on site. Maintaining healthy skin is a crucial element of hand hygiene.

Surgical settings require special care, but waterless hand hygiene with surgical hand rubs is acceptable, especially as it improves compliance. Brushes should be avoided in surgery prep due to their negative impact on skin health.

This document updates the 2014 Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. The Compendium, first published in 2008, is sponsored by the Society for Healthcare Epidemiology (SHEA). It is the product of a collaborative effort led by SHEA, with the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The Compendium is a multiyear, highly collaborative guidance-writing effort by over 100 experts from around the world.

Upcoming Compendium updates will include strategies to prevent catheter-associated urinary tract infections, Clostridium difficile infections, methicillin-resistant Staphylococcus aureus infections, and surgical site infections. Strategies for preventing central line-associated bloodstream infections and pneumonia were updated earlier in 2022. Each Compendium article contains infection prevention strategies, performance measures, and example implementation approaches. Compendium recommendations are derived from a synthesis of systematic literature review and evaluation of the evidence, practical and implementation-based considerations, and expert consensus.

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About ICHE
Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 24th out of 94 Infectious Disease Journals in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 2,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society’s work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online at shea-online.org, facebook.com/SHEApreventingHAIs and twitter.com/SHEA_Epi.