Health system characteristics and COVID-19 performance in high-income countries.

BACKGROUND: The COVID-19 pandemic has shaken everyday life causing morbidity and mortality across the globe. While each country has been hit by the pandemic, individual countries have had different infection and health trajectories. Of all welfare state institutions, healthcare has faced the most immense pressure due to the pandemic and hence, we take a comparative perspective to study COVID-19 related health system performance. We study the way in which health system characteristics were associated with COVID-19 excess mortality and case fatality rates before Omicron variant. METHODS: This study analyses the health system performance during the pandemic in 43 OECD countries and selected non-member economies through three healthcare systems dimensions: (1) healthcare finance, (2) healthcare provision, (3) healthcare performance and health outcomes. Health system characteristics-related data is collected from the Global Health Observatory data repository, the COVID-19 related health outcome indicators from the Our World in Data statistics database, and the country characteristics from the World Bank Open Data and the OECD statistics databases. RESULTS: We find that the COVID-19 excess mortality and case fatality rates were systematically associated with healthcare system financing and organizational structures, as well as performance regarding other health outcomes besides COVID-19 health outcomes. CONCLUSION: Investments in public health systems in terms of overall financing, health workforce and facilities are instrumental in reducing COVID-19 related mortality. Countries aiming at improving their pandemic preparedness may develop health systems by strengthening their public health systems.

General practitioner care in nursing homes during the first wave of the COVID-19 pandemic in Germany: a retrospective survey among nursing home managers.

BACKGROUND: Though evidence on the detrimental impact of the COVID-19 pandemic in nursing homes is vast, research focusing on general practitioners' (GP) care during the pandemic in nursing homes is still scarce. METHODS: A retrospective online survey among 1,010 nursing home managers in Germany was conducted during the first wave of the COVID-19 pandemic between November 2020 and February 2021. Associations between perceived deficits in GP care (routine and acute visits) and both general and COVID-19-related characteristics of nursing homes were analysed using multiple logistic regression analyses. RESULTS: The majority of nursing home managers reported no deficits in GP care (routine visits, 84.3%; acute visits, 92.9%). Logistic regression analyses revealed that deficits in GP care (routine visits) were significantly associated with visiting restrictions for GPs and nursing home size. Small nursing homes (1-50 residents) were significantly more likely to report deficits in GP care (routine visits) compared to medium (51-100 residents) and large nursing homes (> 100 residents). Further, deficits in GP care (acute visits) were significantly associated with dementia as a focus of care and the burden of insufficient testing for SARS-CoV-2 among residents. Moreover, visiting restrictions for GPs were significantly associated with dementia as the focus of care and the COVID-19 incidence at the federal state level. Finally, COVID-19 cases in nursing homes were significantly associated with size of nursing homes, COVID-19-incidence on the federal state level and the burden of insufficient testing capacities for SARS-CoV-2 among residents. CONCLUSION: We found structural factors associated with GP care deficits during the pandemic. New concepts for GP care should be implemented in pandemic preparedness plans to ensure high quality, consistent, and reliable GP care as well as effective infection prevention measures in nursing homes.

Impact of COVID-19 pandemic on cancer care: A cross-sectional study of Egyptian patients' perspectives and concerns.

BACKGROUND: Worldwide, COVID-19 greatly reduced healthcare accessibility and utilization by non-COVID patients including cancer. This study aimed to quantify and characterize cancer care adjustments experienced by cancer patients/survivors; and to explore their concerns, beliefs, and knowledge regarding COVID-19. METHODS: A cross-sectional study was conducted using a questionnaire distributed through social media patients' groups (June-December 2020). Questionnaire included basic information, care adjustments (in "care provision" and in "treatment plan"), and patients' concerns, beliefs, and knowledge. Data description and analysis were done. RESULTS: Out of 300 participants, there were 68.0% on-treatment and 32.0% in follow-up stage. Care adjustments were reported by 29.7%; mostly in care provision (27.3%) rather than treatment plan (4.9%). Adjustments were less likely to occur when healthcare facility was in governorate other than that of residence (OR:0.53, 95%CI:0.30-0.96, P = 0.037) and more likely with long-standing diagnosis (≥12 months) compared with recent (<3 months) (adjusted-OR:4.13, 95%CI:1.19-14.34, P = 0.026). Lower proportion of on-treatment patients used remote consultation than patients in follow-up [4.4% versus 17.7%, P < 0.001]. Patients were concerned about fulfilling their care visits more than the probable COVID-19 infection (72.3%). It was uncommon to feel that the risk of COVID-19 infection is higher in care places than in the community (27.3%) or to feel safe with remote consultations (34.3%). However, patients increased their infection control practice (64.0%) and the majority were aware of their increased susceptibility to complications (86.0%). Somewhat, they were also concerned about the care quality (57.3%). Many had adequate access to COVID-19 information (69.0%) and their main sources were the Ministry of Health webpage and ordinary media (radio/TV). CONCLUSION: Cancer patients were primarily concerned about fulfilling their planned care and COVID-19 infection was less appreciated. POLICY SUMMARY: Launching of a policy for enhancement of telemedicine experience through more patients' engagement-as essential stakeholders-may be required. To heighten pandemic resilience for cancer care in Egypt, more investment in establishing specialized end-to-end cancer care facilities that ensure continuity of care may be justified.

Surveilling public health through statistical process monitoring: A literature review and a unified framework

A challenge, in the era of economic crisis and uncertainty, is to provide health care services in an efficient and effective manner. The protection of public health, the provision of quality healthcare services to patients, the location of health centers, the geographical distribution of patients, and the provision of specialist services are some of the topics that the government and/or a health organization responsible for health care services provision has to arrange. Other topics are the assessment of quality, safety, and effectiveness of healthcare services provided by healthcare providers. Moreover, a central pylon in designing healthcare policy is expenditure monitoring and control. However, among all these topics the most significant is the protection of public health;especially now that viruses such as Coronavirus are spreading rapidly worldwide. This paper aims to review the use of Statistical Process Monitoring techniques in the public health domain in order to improve health care decision-making under uncertainty and further on to provide an innovative three-layer framework for the collection, processing, and real-time analysis of related data like Coronavirus or any other infectious disease that will emerge in the future for both proper and effective case management and effective health policy planning. © 2022 Taylor & Francis Group, LLC.

Evaluating a Smart Healthcare System Design Through Participatory Approach.

Advances in computer communication technology have enabled the rapid growth of e-health services for delivering healthcare, such as facilitating online consent and data sharing between patients and health professionals. Developing a patient-centric healthcare system is challenging because by necessity, it should be secure, reliable, and resilient to cyber threats, whilst remaining user-friendly. Key to any development aiming for a refined proof-of-concept (PoC) system is the pursuit of comprehensive public system testing and evaluation. This paper focuses on the methodology and results obtained from the participatory approach adopted by the EU H2020 project Serums to evaluate and demonstrate the effectiveness of a smart healthcare system based on emergent technologies like blockchain, data lake, and multi-factor authentication. We discuss the challenges faced by remote PoC system evaluations with end-users as a consequence of the Covid-19 pandemic.

Assessing the scale of adoption of sustainability practices by community pharmacies in Spain in the time of COVID-19.

Community pharmacies play a critical societal role and are well placed to enable the progress of national health systems towards sustainability. Nevertheless, there is a dearth of research which has been set up to understand sustainability practices adopted by community pharmacies and evaluate the drivers behind their adoption. This study undertook an exploratory analysis of 95 community pharmacies in Spain, measured their engagement with sustainability practices and assessed these practices in light of the COVID-19 pandemic. The results demonstrated the room for improvement in the adoption of green procurement practices in pharmacies and in their engagement with the community. Moreover, the study showcased that, during the COVID-19 crisis, the pharmacies with the largest extent of adoption of sustainability practices implemented preventative measures against the pandemic in a more diverse number during the first weeks of the lockdown, compared to their less sustainable counterparts. This indicates that, to build resilience to future (health) crises, the implementation of sustainable practices in community pharmacies should be encouraged by both policy makers and pharmaceutical firms.