Nurses

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Today, we show appreciation for the brave medical professionals who are working on the front lines of this pandemic. Over a century ago, in the face of an unprecedented global crisis, the nation also looked to nurses and doctors for support as seen in this World War I poster in our Graphic Arts collection. 

Milton Herbert Bancroft, Wanted 25000 Student Nurses, 1917. Poster print.  

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Health services Digital transformation

WEBEX

Health Equity

Walking the Walk: The Case for Internal Equity, Diversity, and Inclusion Work Within the Canadian Public Health Sector

Ankur Shahi

, 

Fareen Karachiwalla

, and 

Nagma Grewal

Published Online:2 May 2019https://doi.org/10.1089/heq.2019.0008

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Abstract

Equity is fundamental to public health practice. However, limited work has evaluated public health units, as employers, in ensuring equitable workplaces. Public health units must examine their policies for promoting equity, diversity, and inclusiveness. We suggest strategies that these organizations may adopt to establish a diverse workforce, including programs of responsibility, broader advertisement of employment opportunities, and standardized application processes. These practices are site dependent and are more effective when supported by senior management. By considering these strategies, institutions of public health can improve equity, diversity, and inclusion in their workplaces while addressing health equity in the communities they serve.

Self-Care

WHO Consolidated Guideline on Self-Care Interventions for Health

June 24, 2019

These guidelines provide recommendations on self-care interventions; the purpose of the guidance is to “develop a people-centered, evidence-based normative guideline that will support individuals, communities and countries with quality health services and self-care interventions.” With an estimated shortage of up to 18 million health workers by 2030, strategies presented in these guidelines provide an innovative approach for health care that can augment the sometimes limited health care services worldwide.

TAKE ACTION!

•           Read more about how health care providers are promoting self-care here
•           Tweet: Infographics on self-care interventions for health #SelfCare @WHO and tag us at @HealthEquidad or #HENA to share knowledge across the Americas.
• Guía consolidada de la OMS sobre intervenciones de cuidado personal para la salud
  24 de junio, 2019
  Estas directrices proporcionan recomendaciones sobre las intervenciones del cuidado personal; El propósito de la guía es "desarrollar una guía normativa centrada en las personas y basada en la evidencia que apoyará a las personas, comunidades y países con servicios de salud de calidad e intervenciones del cuidado personal". Con una escasez estimada de hasta 18 millones de trabajadores de salud para el 2030, las estrategias presentadas en estas directrices proporcionan un enfoque innovador para la atención médica que puede aumentar los servicios de atención médica a veces limitados en todo el mundo.
  TOMAR ACCIÓN!
  •           Lea más sobre cómo los proveedores de atención médica están promoviendo el autocuidado aquí
  •           Tweet: Infografías sobre las intervenciones de cuidado personal para la salud #CuidadoPersonal @WHO y nos etiquetan en @HealthEquidad o #RAES para compartir el conocimiento en las Américas.

Universal Health Coverage: World Bank

World Bank Health‏ @WBG_Health

Why should universal health coverage be important to all governments and why investing in it should be a priority. Blog: http://wrld.bg/maAD30p0K0N  @NOIweala

Health Care Spending in US

Health Care Spending in the United States and Other High-Income Countries

Irene Papanicolas, PhD^1,2,3; Liana R. Woskie, MSc^1,2,3; Ashish K. Jha, MD, MPH^1,2

Author Affiliations Article Information

JAMA. 2018;319(10):1024-1039. doi:10.1001/jama.2018.1150

Audio Interview(18:22)

Health Care Spending in the United States and Other High-Income Countries

Video(MM:SS)

Health Care Spending in the United States and Other High-Income Countries

Video(6:00)

The Top JAMA Network Articles of 2018

Key Points

Question  Why is health care spending in the United States so much greater than in other high-income countries?

Findings  In 2016, the United States spent nearly twice as much as 10 high-income countries on medical care and performed less well on many population health outcomes. Contrary to some explanations for high spending, social spending and health care utilization in the United States did not differ substantially from other high-income nations. Prices of labor and goods, including pharmaceuticals and devices, and administrative costs appeared to be the main drivers of the differences in spending.

Meaning  Efforts targeting utilization alone are unlikely to reduce the growth in health care spending in the United States; a more concerted effort to reduce prices and administrative costs is likely needed.

Abstract

Importance  Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs.

Objective  To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations.

Evidence  Analysis of data primarily from 2013-2016 from key international organizations including the Organisation for Economic Co-operation and Development (OECD), comparing underlying differences in structural features, types of health care and social spending, and performance between the United States and 10 high-income countries. When data were not available for a given country or more accurate country-level estimates were available from sources other than the OECD, country-specific data sources were used.

Findings  In 2016, the US spent 17.8% of its gross domestic product on health care, and spending in the other countries ranged from 9.6% (Australia) to 12.4% (Switzerland). The proportion of the population with health insurance was 90% in the US, lower than the other countries (range, 99%-100%), and the US had the highest proportion of private health insurance (55.3%). For some determinants of health such as smoking, the US ranked second lowest of the countries (11.4% of the US population ≥15 years smokes daily; mean of all 11 countries, 16.6%), but the US had the highest percentage of adults who were overweight or obese at 70.1% (range for other countries, 23.8%-63.4%; mean of all 11 countries, 55.6%). Life expectancy in the US was the lowest of the 11 countries at 78.8 years (range for other countries, 80.7-83.9 years; mean of all 11 countries, 81.7 years), and infant mortality was the highest (5.8 deaths per 1000 live births in the US; 3.6 per 1000 for all 11 countries). The US did not differ substantially from the other countries in physician workforce (2.6 physicians per 1000; 43% primary care physicians), or nursing workforce (11.1 nurses per 1000). The US had comparable numbers of hospital beds (2.8 per 1000) but higher utilization of magnetic resonance imaging (118 per 1000) and computed tomography (245 per 1000) vs other countries. The US had similar rates of utilization (US discharges per 100 000 were 192 for acute myocardial infarction, 365 for pneumonia, 230 for chronic obstructive pulmonary disease; procedures per 100 000 were 204 for hip replacement, 226 for knee replacement, and 79 for coronary artery bypass graft surgery). Administrative costs of care (activities relating to planning, regulating, and managing health systems and services) accounted for 8% in the US vs a range of 1% to 3% in the other countries. For pharmaceutical costs, spending per capita was $1443 in the US vs a range of $466 to $939 in other countries. Salaries of physicians and nurses were higher in the US; for example, generalist physicians salaries were $218 173 in the US compared with a range of $86 607 to $154 126 in the other countries.

Conclusions and Relevance  The United States spent approximately twice as much as other high-income countries on medical care, yet utilization rates in the United States were largely similar to those in other nations. Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drivers of the difference in overall cost between the United States and other high-income countries. As patients, physicians, policy makers, and legislators actively debate the future of the US health system, data such as these are needed to inform policy decisions.

Primary H. Care

New global commitment to primary health care for all at Astana conference Share Tweet Forward Share On 25 October 2018, United Nations Member States unanimously agreed to the Declaration of Astana, vowing to strengthen their primary health care systems as an essential step toward achieving universal health coverage. The Declaration of Astana reaffirms the historic 1978 Declaration of Alma-Ata, the first time world leaders committed to primary health care. Whether you are a health care provider, an academic, a policy maker, a health care manager, a representative of an organization, or an interested individual, you can alsomake a commitment to advance primary health care. We want to hear from you!

Declaration of Astana

Health-care Quality

Three global health-care quality reports in 2018

Universal health coverage (UHC) is the central thread of Sustainable Development Goal (SDG) 3. However, without improvements in the quality of the health system, UHC will prove an empty vessel and billions of people will not gain from benefits that could arrive from UHC. Instead, they will be victims of patient safety hazards, underuse of evidence-based care, overuse of inappropriate care, lack of patient-centred care, delays, inefficiency, inequity, financial insecurity, collusion, and corruption. For example, injuries from failures in patient safety are estimated to take as many lives as tuberculosis or malaria globally.1 Safety failures account for 15% of hospital costs in nations in the Organisation for Economic Co-operation and Development (OECD).1 The burden of poor quality care is especially onerous in low-income and middle-income countries (LMICs) where, because of resource limitations and poverty-related threats to health, people are especially vulnerable to quality defects in the care provided to them.

The global health-care community is now awakening to that challenge. In the past 2 years, three efforts have been mounted to delineate the size of the global health-care quality gap and identify approaches to closing it. We represent leaders from each of those efforts.

Regards

Payman Salamati, MD, MPH,

Professor of Social Medicine,

Tehran University of Medical Sciences, Tehran, Iran.