目的:分析农村贫困人群住院服务需求和救助现状,为完善医疗救助政策提供参考。方法:利用湖北省A地2014-2016年新农合和医疗救助补偿数据库,从全民健康覆盖(Universal Health Coverage,UHC)评价维度中的服务覆盖和费用覆盖两方面对农村...目的:分析农村贫困人群住院服务需求和救助现状,为完善医疗救助政策提供参考。方法:利用湖北省A地2014-2016年新农合和医疗救助补偿数据库,从全民健康覆盖(Universal Health Coverage,UHC)评价维度中的服务覆盖和费用覆盖两方面对农村贫困人群的住院服务需求和救助水平进行分析。结果:农村贫困人群2016年医保目录外费用占自付费用比例为64.22%,远高于全人群(35.91%)。农村贫困人群中县外就诊的患者自付费用比例为42.83%,高于县内(14.08%)。疾病诊断方面,贫困患者以恶性肿瘤等重大疾病为主。建议:针对贫困人群拓宽医疗救助目录;提高自付费用较高患者医疗救助比例;促进贫困人群医疗救助县外就诊直接结算。展开更多
Introduction: Prematurity continues to stand as a major public health issue worldwide and more particularly for low incomes countries like Burkina Faso. Indeed, it is the main cause of high death rate and infant morbi...Introduction: Prematurity continues to stand as a major public health issue worldwide and more particularly for low incomes countries like Burkina Faso. Indeed, it is the main cause of high death rate and infant morbidity, neurologic deficiencies being one of them. Objective: From March 1st to September 30th, 2020, evaluate the fetal neuroprotection protocol using sulfate magnesium during births before thirty-three (33) weeks of amenorrhea at the University Health Centers (UHC) of Yalgado Ouedraogo and Bogodogo in Ouagadougou, Burkina Faso. Patients and Methods: It was a prospective cohort survey, exposed or unexposed. The exposed ones are from the UHC of Yalgado Ouedraogo, while the unexposed ones are from the UHC of Bogodogo. Analysis of the results showed 87 newborns from the exposed and 180 from the unexposed. The mortality rate, as well as neonatal neurologic complications, was higher with unexposed than with exposed. Although antenatal exposure to magnesium sulfate was not statistically associated with mortality and morbidity in newborns at a threshold of 0.05%, it has shown an overall good neurological prognosis in newborns exposed. Conclusion: A survey of a large sample of the population would be relevant in order to better assess the determinants of this influence. Proposition: In light of the results, the use of magnesium sulfate for neuroprotective purposes could be considered in our countries.展开更多
Countries are seeking to diversify sources of revenue for Universal Health Coverage (UHC), and strategies vary among countries at different stages on the road to UHC. The study tends to document these trade-offs by fa...Countries are seeking to diversify sources of revenue for Universal Health Coverage (UHC), and strategies vary among countries at different stages on the road to UHC. The study tends to document these trade-offs by factoring successful economies across the globe. A review of peer-reviewed literature retrieved country-wise on the basis of successful UHC economies to establish the major factor associated with development of UHC. Political will has been recognized as one of the critical factors. Overcoming barriers associated with development of an adequate and sustainable financing mechanism and selecting the right package of services are other essential determinants. Reaching vulnerable groups and efficient use of resources were other factors that contributed to UHC development in Mexico and south-east Asian countries. UHC development is at threshold where nations should learn from one another, especially from those systems which appear to be doing better, and are more prepared to innovate, test and evaluate new approaches.展开更多
<b>Title:</b> Assessment of haemostasis in anaesthesia for surgery at the Sylvanus Olympio University Hospital Center in Lomé. <b>Objectives:</b> Evaluate the prescription of the preoperat...<b>Title:</b> Assessment of haemostasis in anaesthesia for surgery at the Sylvanus Olympio University Hospital Center in Lomé. <b>Objectives:</b> Evaluate the prescription of the preoperative haemostasis assessment. <b>Methodology:</b> This was a prospective descriptive and observational study which had taken place in the central operating room and in the operating room of the ENT department at UHC SO of Lomé from January 1 to June 31, 2016. It had concerned all patients who had anaesthesia for scheduled surgery after pre-anesthetic consultation and the haemostasis assessment carried out according to the anaesthesia technique and the type of surgery. <b>Results:</b> Two hundred and sixty (260) patients underwent anaesthesia during the study period. The male sex predominated (60%), the age group 18 - 40 years predominated (50.4%). GA was more practiced (62.7%) followed by spinal anaesthesia (30.3%). Minor ENT surgery was more performed (28%). ASA1 patients predominated (48.5%). The pre-anesthetic haemostasis assessment including platelet count, prothrombin rate, activated partial thromboplastin time and bleeding time was almost always done. The platelet count was achieved in all patients followed by the activated partial thromboplastin time (94%). No haemorrhagic complication related to a haemostasis disorder was observed in the perioperative period in anaesthesia than in surgery. <b>Conclusion:</b> The prescription of the pre-anesthetic haemostasis assessment should not be systematic. It must take into account the clinical history, the patient’s bleeding history during the anaesthesia consultation, the type of anaesthesia, the surgery planned and the age.展开更多
Background: Myanmar’s National Health Plan 2017-2021 set out concrete steps to strengthen the health system on the way to achieving the goal of universal health coverage by 2030. Ensuring these steps include the 7.7 ...Background: Myanmar’s National Health Plan 2017-2021 set out concrete steps to strengthen the health system on the way to achieving the goal of universal health coverage by 2030. Ensuring these steps include the 7.7 million older adults in Myanmar’s population by 2030 will require novel strategies that improve health and reduce financial burden of health expenditures. An examination of the relationship between social networks and selected health outcomes was undertaken to determine whether these networks can safeguard older adults’ continued contributions to family, society and their own health. Methods: Secondary analysis of a nationally representative study of adults aged 60 years and older. Ordered logistic regression analyses with weighted data were used to examine the relationship between a social network variable and a number of health outcomes. Findings: Stronger social networks were associated with better health outcomes like better memory (OR 1.2), lower reported walking difficulties (OR 0.58), better self-reported health (R 1.15). People with higher social ties were also more like to receive regular assistance and provide care for other household members. Interpretation: Social networks play a role in mediating health outcomes and interactions with the health care systems. Social network interventions should be explored as part of policy mechanisms to ensure universal health coverage for older adults in Myanmar.展开更多
Abstract： UHC （Universal Health Coverage） is at the center of the Sustainable Development Agenda. In this study, the authors made an evaluation of the indicators allowing quantification of the impact of health cove...Abstract： UHC （Universal Health Coverage） is at the center of the Sustainable Development Agenda. In this study, the authors made an evaluation of the indicators allowing quantification of the impact of health coverage schemes on patients, applied in 4 sub-Saharan Africa countries： Rwanda, Burundi, the DRC （Democratic Republic of Congo） and Mall After an analysis of potential health coverage indicators, the most relevant ones were calculated on the basis of patient administrative and health insurance data, collected via OpenClinic GA, an HIMS （health information management system） used in 8 sub-Saharan hospitals during the period 2010-2016. The results show that the PHSC （patient health services coverage） rate is highest （81.5%-92.7%） in the 2 hospitals of Rwanda and in 2 hospitals of Burundi （37.7%-77.7%）. The PHSP （patient health service payment） rate as the proportion of costs paid by the patient versus total health service costs is below the 25% threshold recommended by WHO only for the 2 hospitals in Rwanda. The POOP （patient out-of-pocket） payment is below the threshold of 180USD per patient per year for all hospitals. The HIEXs （health insurance expenditures） are funded by the university private insurance （86% of expenses covered） in 2 university teaching hospitals in DRC, by CBHI （community based health insurance） （69%） in 2 hospitals in Rwanda, by the free care policy （77%） in 2 hospitals in Burundi and by the SHI （social health insurance） （100%） in the 2 hospitals in Mali. PHSC in the 8 reference hospitals reflects the national trend towards UHC in each country. With this study, we demonstrate the possibility to assess the degree of UHC in developing countries, by a methodology based on indicators calculated via information extraction from routine data in electronic health records.展开更多
文摘目的:分析农村贫困人群住院服务需求和救助现状,为完善医疗救助政策提供参考。方法:利用湖北省A地2014-2016年新农合和医疗救助补偿数据库,从全民健康覆盖(Universal Health Coverage,UHC)评价维度中的服务覆盖和费用覆盖两方面对农村贫困人群的住院服务需求和救助水平进行分析。结果:农村贫困人群2016年医保目录外费用占自付费用比例为64.22%,远高于全人群(35.91%)。农村贫困人群中县外就诊的患者自付费用比例为42.83%,高于县内(14.08%)。疾病诊断方面,贫困患者以恶性肿瘤等重大疾病为主。建议:针对贫困人群拓宽医疗救助目录;提高自付费用较高患者医疗救助比例;促进贫困人群医疗救助县外就诊直接结算。
文摘Introduction: Prematurity continues to stand as a major public health issue worldwide and more particularly for low incomes countries like Burkina Faso. Indeed, it is the main cause of high death rate and infant morbidity, neurologic deficiencies being one of them. Objective: From March 1st to September 30th, 2020, evaluate the fetal neuroprotection protocol using sulfate magnesium during births before thirty-three (33) weeks of amenorrhea at the University Health Centers (UHC) of Yalgado Ouedraogo and Bogodogo in Ouagadougou, Burkina Faso. Patients and Methods: It was a prospective cohort survey, exposed or unexposed. The exposed ones are from the UHC of Yalgado Ouedraogo, while the unexposed ones are from the UHC of Bogodogo. Analysis of the results showed 87 newborns from the exposed and 180 from the unexposed. The mortality rate, as well as neonatal neurologic complications, was higher with unexposed than with exposed. Although antenatal exposure to magnesium sulfate was not statistically associated with mortality and morbidity in newborns at a threshold of 0.05%, it has shown an overall good neurological prognosis in newborns exposed. Conclusion: A survey of a large sample of the population would be relevant in order to better assess the determinants of this influence. Proposition: In light of the results, the use of magnesium sulfate for neuroprotective purposes could be considered in our countries.
文摘Countries are seeking to diversify sources of revenue for Universal Health Coverage (UHC), and strategies vary among countries at different stages on the road to UHC. The study tends to document these trade-offs by factoring successful economies across the globe. A review of peer-reviewed literature retrieved country-wise on the basis of successful UHC economies to establish the major factor associated with development of UHC. Political will has been recognized as one of the critical factors. Overcoming barriers associated with development of an adequate and sustainable financing mechanism and selecting the right package of services are other essential determinants. Reaching vulnerable groups and efficient use of resources were other factors that contributed to UHC development in Mexico and south-east Asian countries. UHC development is at threshold where nations should learn from one another, especially from those systems which appear to be doing better, and are more prepared to innovate, test and evaluate new approaches.
文摘<b>Title:</b> Assessment of haemostasis in anaesthesia for surgery at the Sylvanus Olympio University Hospital Center in Lomé. <b>Objectives:</b> Evaluate the prescription of the preoperative haemostasis assessment. <b>Methodology:</b> This was a prospective descriptive and observational study which had taken place in the central operating room and in the operating room of the ENT department at UHC SO of Lomé from January 1 to June 31, 2016. It had concerned all patients who had anaesthesia for scheduled surgery after pre-anesthetic consultation and the haemostasis assessment carried out according to the anaesthesia technique and the type of surgery. <b>Results:</b> Two hundred and sixty (260) patients underwent anaesthesia during the study period. The male sex predominated (60%), the age group 18 - 40 years predominated (50.4%). GA was more practiced (62.7%) followed by spinal anaesthesia (30.3%). Minor ENT surgery was more performed (28%). ASA1 patients predominated (48.5%). The pre-anesthetic haemostasis assessment including platelet count, prothrombin rate, activated partial thromboplastin time and bleeding time was almost always done. The platelet count was achieved in all patients followed by the activated partial thromboplastin time (94%). No haemorrhagic complication related to a haemostasis disorder was observed in the perioperative period in anaesthesia than in surgery. <b>Conclusion:</b> The prescription of the pre-anesthetic haemostasis assessment should not be systematic. It must take into account the clinical history, the patient’s bleeding history during the anaesthesia consultation, the type of anaesthesia, the surgery planned and the age.
文摘Background: Myanmar’s National Health Plan 2017-2021 set out concrete steps to strengthen the health system on the way to achieving the goal of universal health coverage by 2030. Ensuring these steps include the 7.7 million older adults in Myanmar’s population by 2030 will require novel strategies that improve health and reduce financial burden of health expenditures. An examination of the relationship between social networks and selected health outcomes was undertaken to determine whether these networks can safeguard older adults’ continued contributions to family, society and their own health. Methods: Secondary analysis of a nationally representative study of adults aged 60 years and older. Ordered logistic regression analyses with weighted data were used to examine the relationship between a social network variable and a number of health outcomes. Findings: Stronger social networks were associated with better health outcomes like better memory (OR 1.2), lower reported walking difficulties (OR 0.58), better self-reported health (R 1.15). People with higher social ties were also more like to receive regular assistance and provide care for other household members. Interpretation: Social networks play a role in mediating health outcomes and interactions with the health care systems. Social network interventions should be explored as part of policy mechanisms to ensure universal health coverage for older adults in Myanmar.
文摘Abstract： UHC （Universal Health Coverage） is at the center of the Sustainable Development Agenda. In this study, the authors made an evaluation of the indicators allowing quantification of the impact of health coverage schemes on patients, applied in 4 sub-Saharan Africa countries： Rwanda, Burundi, the DRC （Democratic Republic of Congo） and Mall After an analysis of potential health coverage indicators, the most relevant ones were calculated on the basis of patient administrative and health insurance data, collected via OpenClinic GA, an HIMS （health information management system） used in 8 sub-Saharan hospitals during the period 2010-2016. The results show that the PHSC （patient health services coverage） rate is highest （81.5%-92.7%） in the 2 hospitals of Rwanda and in 2 hospitals of Burundi （37.7%-77.7%）. The PHSP （patient health service payment） rate as the proportion of costs paid by the patient versus total health service costs is below the 25% threshold recommended by WHO only for the 2 hospitals in Rwanda. The POOP （patient out-of-pocket） payment is below the threshold of 180USD per patient per year for all hospitals. The HIEXs （health insurance expenditures） are funded by the university private insurance （86% of expenses covered） in 2 university teaching hospitals in DRC, by CBHI （community based health insurance） （69%） in 2 hospitals in Rwanda, by the free care policy （77%） in 2 hospitals in Burundi and by the SHI （social health insurance） （100%） in the 2 hospitals in Mali. PHSC in the 8 reference hospitals reflects the national trend towards UHC in each country. With this study, we demonstrate the possibility to assess the degree of UHC in developing countries, by a methodology based on indicators calculated via information extraction from routine data in electronic health records.
