The people, process, and technology for population management in community health.

Population health expands the focus of health care from individual, in-person care to the proactive management of cohorts that can occur asynchronously from a clinical encounter. In its most successful form, the approach segments populations by defined characteristics and promotes outreach and engagement to deliver targeted interventions, even among those who have missed recent or routine care. The triple aim, supported by the Institutes for Health Care Improvement, emphasizes improving the health of populations, cost of care, and patient and care team experience and has influenced new approaches in primary care. In primary care settings such as community health centers, the goal of improving outcomes leverages technology to expand focus from point-of-care interventions to population-level approaches to deliver high-quality preventive services and chronic disease management that benefit entire families and communities. Developments in informatics have introduced technology tools for population management and underscored the need to align technology with effective processes and stakeholder engagement for success. Informed by a review of the literature and observations across multiple implementations of population health strategies in community health, in this conceptual paper, we describe the steps (process), domains of team expertise (people), and health information technology components (technology) that contribute to the success of a population health strategy. We also explore future opportunities to expand the reach and impact of population health through patient engagement, analytics, interventions to address social determinants of health, responses to emerging public health priorities, and prioritization-of-use cases by assessing community-specific needs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cause-of-death distributions and mortality trends in Turkey between 2009 and 2017.

BACKGROUND: Making the right decisions in the field of public health depends on the reliable recording of statistical data such as death and birth. There have been radical changes and innovations in the death registration since 2009 in Turkey to improve reporting. AIMS: To examine the distribution and the trend of causes of death between the years 2009 and 2017 in Turkey. STUDY DESIGN: Descriptive study. METHODS: In this study, the causes of death were evaluated in three groups used in the Global Burden of Disease study. Group I included infectious, maternal, perinatal, and nutritional conditions; group II included noncommunicable diseases; and group III included injuries. Age-standardized mortality rates were calculated per 100,000 according to age, sex, and cause of death. Joinpoint regression was used to evaluate the trend in mortality rates. In addition, the leading causes of death were also determined. RESULTS: In total, age-standardized mortality rates increased significantly on average annually (1.5% per year). When the trends of causes of death were examined according to gender, there was a significant increase in deaths from group I in both genders and a significant increase in deaths from group III in males, whereas there was no statistically significant change in deaths from group II between 2009 and 2017. CONCLUSION: A significant quantitative improvement in death registration was seen in Turkey between the years 2009 and 2017. This is due to the increase in the number of reported deaths. The change in the distribution of causes of death is noteworthy. This research can provide the basis for further researches that will examine the change in causes of death.

Plan estratégico de preparación y respuesta para la enfermedad por coronavirus 2019 (COVID-19): pautas para la planificación operativa de la preparación y la respuesta de los países / Strategic preparedness and response plan for coronavirus disease 2019 (COVID-19): guidelines for operational planning of country preparedness and response

En el plan estratégico de preparación y respuesta se describen las medidas de salud pública que deben tomarse para ayudar a los países a prepararse y responder a la COVID-19. El plan puede usarse para adaptar rápidamente los planes nacionales de acción para la seguridad sanitaria y los planes de preparación para una gripe pandémica a la COVID19, tomando lo que hemos aprendido hasta ahora sobre el virus y plasmando esos conocimientos en una acción estratégica para guiar la labor de todos los asociados nacionales e internacionales con el fin de respaldar a los gobiernos nacionales.

Acercamiento y negociación comunitaria: modelo incluyente en salud [MIS] / Community approach and negotiation: inclusive model in health [MIS]

Bajo la premisa aportada por el Convenio 169, en el artículo 25 que establece que: "Los servicios de salud…deberán planearse y administrarse en cooperación con los pueblos interesados y tener en cuenta sus condiciones económicas, geográficas, sociales y culturales, así como sus métodos de prevención, prácticas curativas y medicamentos tradicionales." Por ello, el modelo presentado, establece que "toda acción que se planifica desde fuera de la comunidad, altera su camino normal y se constituyen en intervenciones que reconfigura su cultura, formas de vida y cosmopercepción. Es necesario reconsiderar que las comunidades saben vivir y desarrollarse desde sus realidades, y que las intervenciones constituirán acciones para apoyar sus procesos históricos, incluyendo las de salud. Y agrega que: "debe tomar en cuenta las condiciones económicas, geográficas sociales y culturales de los pueblos; este párrafo justifica plenamente del porqué la planeación y administración de los servicios deben darse en conjunto; por cuanto ellos son los que conocen sus propias necesidades, sus realidades, su cultura, su organización local y todo lo referente a la comunidad."

Salud en Todas las Políticas e intersectorialidad en la promoción de la salud: el Plan Interdepartamental de Salud Pública (PINSAP) de Cataluña / Health in all policies and intersectoriality in health promotion: the Public Health Interdepartmental Plan of Catalonia

En febrero de 2014, el Gobierno de Cataluña aprobó el Plan Interdepartamental de Salud Pública (PINSAP), que concreta para esta comunidad la estrategia de Salud en Todas las Políticas recomendada por la Organización Mundial de la Salud y otras instituciones internacionales. El PINSAP, recogido en la Ley de Salud Pública de Cataluña, es vinculante para el gobierno. Fue elaborado por la Comisión Interdepartamental de Salud, en la que participan todos los departamentos de la Generalitat de Catalunya, y recibió aportaciones de 42 entidades locales, sociales y científicas. Aparte de las actuaciones propias de cada departamento que tienen más impacto sobre la salud, propone 30 actuaciones de marcado carácter intersectorial centradas en los determinantes de la salud, y con especial énfasis en la lucha frente a las desigualdades y la evaluación del impacto en salud. El PINSAP potencia la actuación interdepartamental e intersectorial sobre los determinantes de la salud. Aunque solo está en su primer año de implementación, muchas de sus actuaciones ya están en marcha e implica a numerosos profesionales de Cataluña (AU)

In February 2014, the autonomous government in Catalonia, the Generalitat de Catalunya, approved the Catalan Public Health System Interdepartmental Plan (PINSAP, as per the Catalan acronym), responsible for the strategy in Catalonia for Health in All Policies, as recommended by the WHO and other international institutions. The PINSAP, as outlined under the Catalan Public Health Law, is binding for the government. The Plan was drawn up by the Interdepartmental Health Commission (CIS, as per the Catalan acronym) and is a collaboration between all Departments of the Generalitat. The Plan also receives contributions from 42 local, social and scientific bodies. Apart from the specific initiatives performed by each department which have a greater impact on health, the Plan proposes 30 initiatives, which are defined by their collaboration between public sectors, targeting determining health factors and paying special attention to combating inequalities and measuring the impact on health. The PINSAP encourages interdepartmental initiatives and collaboration between public sectors regarding determinants of health. Although it is only in its first year of implementation, many of their initiatives are already up and running and involving many healthcare professionals in Catalonia (AU)

[Overbooking in an outpatient healthcare facility in the Brazilian Unified National Health System]. / Técnica de overbooking no atendimento público ambulatorial em uma unidade do Sistema Único de Saúde.

Management issues like resource optimization, cost cuts, quality gains, and improvements in care have become increasingly important and are essential to the sustainability of healthcare organizations. This study analyzed the efficiency of public outpatient care, where the high rate of patient no-show leads to low use of resources, while paradoxically the demand for medical care clearly exceeds the supply. A quantitative and descriptive approach analyzed the use of "overbooking" to reduce the effects of patient no-show in a public outpatient clinic. Using statistical and mathematical methods and based on patient and appointment data collected from a survey, an interesting comparison was made between levels of overbooking and the respective resource utilization rates and service levels for each scenario. The findings point to important gains in efficiency, thus demonstrating the potential of increasing the number of services in the same asset base.

Técnica de overbooking no atendimento público ambulatorial em uma unidade do Sistema Único de Saúde / Overbooking in an outpatient healthcare facility in the Brazilian Unified National Health System / Práctica de overbooking en la atención ambulatoria pública dentro de una unidad del Sistema Único de Salud

Aspectos como otimização de recursos, redução de custos, ganhos de qualidade e melhoria no atendimento receberam importância e são fundamentais para a sustentabilidade das organizações. Este trabalho analisa a eficiência no atendimento público ambulatorial, onde a alta taxa de absenteísmo por parte dos usuários implica baixa utilização de recursos, enquanto que, paradoxalmente, a demanda por atendimento médico é nitidamente superior à oferta. A abordagem, quantitativa e de caráter descritivo, analisa a utilização da técnica de overbooking para reduzir os efeitos do absenteísmo em um ambulatório da rede pública. Mediante o uso de métodos estatísticos e matemáticos, com base em dados de pacientes e agendamentos coletados em pesquisa, desenhou-se um interessante comparativo entre níveis de overbooking e respectivas taxas de utilização de recursos e níveis de serviço para cada cenário analisado. Os resultados obtidos apontam ganhos expressivos de eficiência, demonstrando o potencial de aumento do número de atendimentos para uma mesma base de ativos.

Management issues like resource optimization, cost cuts, quality gains, and improvements in care have become increasingly important and are essential to the sustainability of healthcare organizations. This study analyzed the efficiency of public outpatient care, where the high rate of patient no-show leads to low use of resources, while paradoxically the demand for medical care clearly exceeds the supply. A quantitative and descriptive approach analyzed the use of “overbooking” to reduce the effects of patient no-show in a public outpatient clinic. Using statistical and mathematical methods and based on patient and appointment data collected from a survey, an interesting comparison was made between levels of overbooking and the respective resource utilization rates and service levels for each scenario. The findings point to important gains in efficiency, thus demonstrating the potential of increasing the number of services in the same asset base.

Aspectos de gestión, tales como la optimización de recursos, reducción de costes, mejora de la calidad y servicio han adquirido cada vez más importancia y son fundamentales para mantener organizaciones sosteniblemente. Esta investigación analiza la eficiencia del servicio médico ambulatorio público, donde no se presenta una alta tasa de pacientes, lo que lleva a una baja utilización de los recursos existentes, mientras que, paradójicamente, la demanda de servicios médicos es claramente superior a su disponibilidad. El enfoque cuantitativo y descriptivo analiza la utilización de un exceso de reservas técnicas, con el fin de reducir el efecto de pacientes que no se dirigen, finalmente, a un servicio médico público ambulatorio. Se aplicaron métodos estadísticos y matemáticos en la información proporcionada por pacientes y en la recogida de información de la base de datos de consultas, que dieron lugar a una interesante comparación entre los niveles de exceso de reservas y su tasa de utilización, respecto a los recursos y niveles de servicio dentro de cada uno de los escenarios analizados. Los resultados obtenidos muestran un aumento significativo en la eficiencia.

Measuring the performance of telephone-based disease surveillance systems in local health departments.

OBJECTIVES: We tested telephone-based disease surveillance systems in local health departments to identify system characteristics associated with consistent and timely responses to urgent case reports. METHODS: We identified a stratified random sample of 74 health departments and conducted a series of unannounced tests of their telephone-based surveillance systems. We used regression analyses to identify system characteristics that predicted fast connection with an action officer (an appropriate public health professional). RESULTS: Optimal performance in consistently connecting callers with an action officer in 30 minutes or less was achieved by 31% of participating health departments. Reaching a live person upon dialing, regardless of who that person was, was the strongest predictor of optimal performance both in being connected with an action officer and in consistency of connection times. CONCLUSIONS: Health departments can achieve optimal performance in consistently connecting a caller with an action officer in 30 minutes or less and may improve performance by using a telephone-based disease surveillance system in which the phone is answered by a live person at all times.

Feasibility and costs of water fluoridation in remote Australian Aboriginal communities.

BACKGROUND: Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries. The water supplies of many remote Indigenous communities do not contain adequate levels of natural fluoride. The small and dispersed nature of communities presents challenges for the provision of fluoridation infrastructure and until recently smaller settlements were considered unfavourable for cost-effective water fluoridation. Technological advances in water treatment and fluoridation are resulting in new and more cost-effective water fluoridation options and recent cost analyses support water fluoridation for communities of less than 1,000 people. METHODS: Small scale fluoridation plants were installed in two remote Northern Territory communities in early 2004. Fluoride levels in community water supplies were expected to be monitored by local staff and by a remote electronic system. Site visits were undertaken by project investigators at commissioning and approximately two years later. Interviews were conducted with key informants and documentation pertaining to costs of the plants and operational reports were reviewed. RESULTS: The fluoridation plants were operational for about 80% of the trial period. A number of technical features that interfered with plant operation were identified and addressed though redesign. Management systems and the attitudes and capacity of operational staff also impacted on the effective functioning of the plants. Capital costs for the wider implementation of these plants in remote communities is estimated at about $US 94,000 with recurrent annual costs of $US 11,800 per unit. CONCLUSION: Operational issues during the trial indicate the need for effective management systems, including policy and funding responsibility. Reliable manufacturers and suppliers of equipment should be identified and contractual agreements should provide for ongoing technical assistance. Water fluoridation units should be considered as a potential priority component of health related infrastructure in at least the larger remote Indigenous communities which have inadequate levels of natural fluoride and high levels of dental caries.

Applied medical & care compunetics to public health disease surveillance and management: Leveraging external data sources--a key to public health preparedness.

In today's global community the ability to prepare for a disease outbreak in order to mitigate the public health, social, and economic impacts on a community depends upon data to support the decision and response process. Data can come from a variety of sources. These sources not only include the medical and health care community, but also geographic, demographic, and socio-economic data. The ability to capture and utilize the data effectively from these types of data sources can mean the difference between a manageable disease outbreak that represents little or no threat to a community and one that causes a significant social and economic impact. As the health profession expands the applied use of information technology within the medical and health care communities, opportunities are created to expand the use of new data sources to support information based decisions. Information that can be used to provide early warning for disease outbreaks both naturally occurring or through a bioterrorist event; information that can be used to plan, analyze and respond to a disease event; information that can support a community's preparedness activities in order to minimize a public health event. This chapter illustrates how applied compunetics can be used to support health care as the public health professional responds to, and manages, naturally occurring diseases as well as emerging new disease threats. An electronic health environment (EHE) vision is presented that capitalizes on the use of a variety of environmental, medical, and health care data to support disease early warning, reporting, case and outbreak management and community preparedness.

A local department of public health and the geospatial data infrastructure.

Local health departments (LHD) are the most widely distributed aspect of the United States public health infrastructure. The role of LHDs has changed since the terrorist attacks of September 11, 2001, and an increased concern about bioterrorism. This concern resulted in more emphasis on disease surveillance and the need for new institutional linkages of LHDs with other entities for effective response. These changes coincide with technological changes in spatial data integration and the growth of medical informatics in public health. The integration of GIS into the daily work of an LHD holds promise of improving not only bioterrorism response capabilities, but also the management of emerging infectious diseases, such as West Nile Virus or food borne illness, as well as longstanding programs focused on nutrition and safety. Still, the impediments to using GIS at an LHD remain strong as funding decisions and a complex technology continue to challenge implementation efforts.

[Resources-technologies relationship in public health]. / Vzaimootnosheniia resursov i tekhnologii v zdravookhranenii.

Analysis of the resources-technologies relationships brought the authors to two underlying conclusions: 1) a practical public health system is primarily a system of technological equipment and sufficient staff. A liberal public health system is primarily a system of medical and concomitant technologies based on the requirements of patients. 2) Management of a practical public health system is priority management of the form, namely, technological basis and staff members, or in fact administrative distribution of resources. Regulation of the activities of a liberal public health system is the priority modification of its content, i.e., creation and adaptation of technologies determining this system (including medical) evoked by certain requirements and largely by the market.

[Computerized technologies in public health administration]. / Komp'iuterizatsiia upravleniia zdravookhraneniem v regione.

The paper deals with the problems in making the computer monitoring of qualitative, quantitative, structural, and functional indices at all levels of the public health system in the Sverdlovsk Region. The sources of information were defined at all levels of an informational field and informational channels were set up. The monitoring systems are reinforced by the currently available systems and the systems under design. The programme complexes realize the methods of multifactorial analysis, taxonomy, econometry, identification of large systems and they are adjusted to the existing information collection system based on the corporative control network of public health.

Programa de entrenamiento para administradores de salud (PEAS) / Training program fror health administrators (PHA)

El objetivo central del programa fue mejorar la capacidad de gestión de los profesionales a cargo de la administración de servicios del Ministerio de SAlud, fundamentalmente a nivel local, proporcionándoles capacitación en administración y epidemiología

Sistema regional administrativo financiero / sss

El presente manual tiene por objetivo planificar, programar y evaluar la ejecución financiera de las actividades en salud en todas las unidades ejecutoras de la red de servicios a partir de las necesidades de salud de la población, garantizando la oportuna transferencia de los recursos asignados y la correcta dotación y utilización de los bienes y servicios, en cada una de ellas a fin de contribuir a alcanzar los objetivos y metas del sector y brindar prestaciones en salud. Además presenta el reglamento para uso de vehículos de la Secretaria Regional de Salud Potosí. Instrumento para el manejo económico en administración financiera