Search

In this article, the authors describe some approaches to medicine price formation in the Republic of Moldova. Following the study, we can say that the health system of the Republic of Moldova (Moldova) is part of the social sphere, and medicines are an important element in the treatment of various diseases. Thus, at the same time with the reform actionsand development of the pharmaceutical sector, a high-priority issue is the price setting of medicines, which is influenced by a number of factors. The research was based on the multitude of normative acts and the specialized literature, where the priority problem was established - the development of the pharmaceutical sector. The authors, through this research, using the methods of observation, analysis and deduction, aimed to analyze the normative basis at national level and the literature, to distinguish some problematic aspects in the field, to estimate the current state of medicine pricing quality. In order to achieve this goal the authors used the following methods: analysis, observation, comparison, etc. The following indicators were analyzed in this paper: the indicators on healthcare expenditure in the consolidated budget; the fundraising mechanism to support the activity of the health sector; the dynamics of the development of the medical institutions network in the Republic of Moldova; the mechanism of supply and regulation of medicines.

Objective: To describe adaptations in the provision of rehabilitation services proposed by scientific and professional rehabilitation organizations to avoid interruptions to patients rehabilitation process and delays in starting rehabilitation in patients with COVID-19. Methods: A narrative review approach was used to identify the recommendations of scientific and professional organizations in the area of rehabilitation. A systematic search was performed in the main data-bases in 78 international and regional web portals of rehabilitation organizations. A total of 21 publications from these organizations were identified and selected. Results: The results are presented in 4 categories: adequacy of inpatient services, including acute care services and intensive care unit for patients with and without COVID-19; adequacy of outpatient services, including home-based rehabilitation and tele-rehabilitation; recommendations to prevent the spread of COVID-19; and regulatory standards and positions during the COVID-19 pandemic expressed by organizations for protecting the rights of health workers and patients. Conclusion: Health systems around the world are rapidly learning from actions aimed at the reorganization of rehabilitation services for patients who are in the process of recovery from acute or chronic conditions, and the rapid response to the rehabilitation of survivors of COVID-19, as well as from efforts in the prevention of contagion of those providing the services.

Objectives: The aim of this study was to develop a validated model to predict current and future Australian costs for people with dementia to help guide decision makers allocate scarce resources in the presence of capacity constraints. Methods: A hybrid discrete event simulation was developed to predict costs borne in Australia for people with dementia from 2015 to 2050. The costs captured included community-based care, permanent and respite residential aged care, hospitalisation, transitional care, pharmaceuticals, aged care assessments, out of hospital medical services and other programs. Results: The costs borne for people with dementia in Australia are predicted to increase from A$11.8 billion in 2015 to A$33.6 billion in 2050 at 2013–14 prices, ceteris paribus. If real per capita health and social expenditure increased by 1.0% annually, these costs are predicted to increase by around A$14.2 billion to a total of around A$47.8 billion by 2050. Conclusions: This simulation provides useful estimates of the potential future costs that will be borne for people with dementia and allows the exploration of the effects of capacity constraints on these costs. The model demonstrates that the level of real annual per capita growth in health and social expenditure has significant implications for the future sustainability of dementia care in Australia. What is known about the topic?: With the aging of the Australian population, the number of people living with dementia is predicted to rise markedly in the next four decades. As the number of people living with dementia increases, so too will the financial burden these debilitating and degenerative diseases place on private and public resources. These increases are likely to challenge the efficiency and sustainability of many health systems in the developed world. What does this paper add?: This research provides a validated model to predict current and future Australian costs for people with dementia to help guide decision makers allocate scarce resources in the presence of capacity constraints (i.e. where the supply of resources does not meet demand). The model predicts an increase in costs for people with dementia from A$11.8 billion in 2015 to A$33.6 billion in 2050 at 2013–14 prices. If real per capita health and social expenditure increased by 1.0% annually, these costs are predicted to increase by around A$14.2 billion to a total of around A$47.8 billion by 2050. What are the implications for practitioners?: This simulation provides useful estimates of the potential future costs that will be borne for people with dementia and allows the exploration of the effects of capacity constraints on these costs. The model demonstrates that the level of real annual per capita growth in health and social expenditure has significant implications for the future sustainability of dementia care in Australia. [ABSTRACT FROM AUTHOR]

Introduction: Today, interprofessional collaboration and team care as well as interprofessional education are inevitable necessities for addressing healthcare needs of societies. Due to a contradiction between the need to provide team care at health centers and the lack of prioritization and implementation of team-based and interprofessional approaches to education in the health system, this study was conducted to explain the barriers to implementation of team care and interprofessional education in Iran from the viewpoints of educational managers of the health system. Methods: This qualitative content analysis study with a conventional approach was carried out from August 2013 to Jul 2014. The data were collected through semi–structured individual interviews with 16 educational managers and researchers in universities of medical sciences and medical education development centers who were selected by purposive sampling. All interviews were transcribed word by word and then analyzed using MAXQD software. Results:Two categories and eight subcategories were identified explaining the barriers to implementation of team care and interprofessional education from educational managers’ viewpoints. The two main categories included cultural-attitudinal barriers and structural-functional barriers. The first category consisted of subcategories such as weakness of systemic thinking, individualistic culture, profession-orientedness, physicians’ predominance, and role models. The second category included subcategories of management structure, stunted growth of educational management, inadequate understanding and weak evidence. Conclusion:Existent barriers and their influence on each other have prevented the implementation of team care and interprofessional education by creating a vicious cycle. Since the cultural and attitudinal changes occur over a long period, it is necessary to move towards changing the culture and attitudes and implementing team care and interprofessional education through restructuring the educational management as well as implementation of interprofessional education pilot programs and developing research and evidence accordingly.

Objective: To characterize the cross-sector policies aimed at the teenager, from the following analytical variables: adolescence, interdisciplinary, intersectionality and Health System; vulnerability and territory, healthy municipalities and communities. Methods: A documental literature review, in which we sought the meaning of adolescence, the ratio of public investment in this segment and a discussion on the social norm and the state apparatus for their support. We used as categories of analysis: intersectionality, systemic complexity of health, territory of vulnerability, spatial delimitation of policy, social network and healthy spaces. Results: Public policies integrated into healthy spaces have been implemented in several places having adolescence as a focal object. Policies aimed at teenagers, whose symbolic representation considers them more independent and positive in social reality, tend to create more meaningful opportunities and empowerment of individuals. Conclusion: In Brazilian State, new spaces of sociability of the adolescent are welcome, serving as socializing agencies, contributing to the construction of the subjectivity of the adolescent, based in the recovery of social values and preparing for life as from an ethical and civicconsciousness.

Background: Rising caesarean section rate is a concerning trend for the future of Oman. Every woman wants to have a vaginal birth with short labour, no, or little pain relief and an intact perineum. Care during labour was different in olden days. The rate has gone up steadily since the introduction of a lot of technology during childbirth. Caesarean section carries increased risk for the mother and baby. The present work is aimed at studying the various reasons for this rising rate and measures to reduce the caesarean section rates. Methods: A retrospective analysis of the rising rates of caesarean section was done from year 2006 up to 2011 and the main indications and complications for caesarean section in year 2011 were analysed. Results: A rising trend of caesarean section has been observed in the last six years as the rate has increased from 15.1% in 2006 to 18.9% in 2011. The main indications for caesarean section in descending order have been fetal distress, malpresentation, followed by a large group which included maternal request, macrosomia > 4kgs, abnormal placentation followed by repeat caesarean section and non-progress of labour. There were many maternal complications observed in this group, like wound infections, anaesthetic complications and a few cases of exploratory laparotomy. Conclusion: Multilevel, multidisciplinary approach and strategies are needed to change the system that would help the midwives, obstetricians and various working groups together to achieve a common goal of developing care to reduce caesarean sections in Oman. [ABSTRACT FROM AUTHOR]

To document how out-of-pocket health expenditure can lead to debt in a poor rural area in Cambodia. After a dengue epidemic, 72 households with a dengue patient were interviewed to document health-seeking behaviour, out-of-pocket expenditure, and how they financed such expenditure. One year later, a follow-up visit investigated how the 26 households with an initial debt had coped with it. The amount of out-of-pocket health expenditure depended mostly on where households sought care. Those who had used exclusively private providers paid on average US$103; those who combined private and public providers paid US$32, and those who used only the public hospital US$8. The households used a combination of savings, selling consumables, selling assets and borrowing money to finance this expenditure. One year later, most families with initial debts had been unable to settle these debts, and continued to pay high interest rates (range between 2.5 and 15% per month). Several households had to sell their land. In Cambodia, even relatively modest out-of-pocket health expenditure frequently causes indebtedness and can lead to poverty. A credible and accessible public health system is needed to prevent catastrophic health expenditure, and to allow for other strategies, such as safety nets for the poor, to be fully effective. [ABSTRACT FROM AUTHOR]