The relevance of the study is due to the fact that in the Republic of Kazakhstan there is not enough information regarding the system of compulsory health insurance. During the study, theoretical ...methods were used (literature analysis, generalization); interviewing (using the online platform); empirical (study of the experience of medical organizations, regulatory documentation); methods of mathematical statistics and graphical presentation of results. The authors of this study calculated the performance indicators of the health care system according to the performance indicators: the work of doctors and medical personnel in primary health care; organization of specialized and high-tech care for patients; work of medical and social programs. Medical workers were asked to anonymously evaluate working conditions, choosing one of the three parameters “good”, “satisfactory”, “poor”. An anonymous survey was also conducted among patients who underwent preventive examinations in public medical institutions at the beginning of 2018 and 36 months later. They needed to evaluate their own health. Positive dynamics was noted in all aspects studied. In the course of the study, new questions and problems have arisen that need to be addressed.
The energy usage intensity of healthcare institutions is extensive. The recorded relative typical energy consumption of hospitals has been noted to be in the range of 43 to 93 kWh/bed/day. Currently, ...with the global COVID 19 pandemic, the overall energy consumption of these hospitals has proportionally increased with these higher patient occupancy rates. The demand for hot water is directly proportional to occupancy rates and contributes to a large proportion of the energy consumed. Reducing the energy and associated costs of water heating processes may prove highly beneficial to the currently severely overstrained healthcare sector.
In this paper the operation of a multifarious water heating system with energy recovery was optimized in order to minimize the grid energy costs based on the ToU tariff and maximum demand charges from the utility, while the required hot water temperature was maintained.
A life cycle cost analysis between two baseline systems, consisting of the multifarious water heating system with and without energy recovery was compared to the optimal control approach. The results indicate that the energy recovery system with optimal control in 5.3 years. Retrospectively, the proposed initiatives may result in a potential saving of 68.23%, over a 20 year project lifetime.
•A multifarious water heating system with energy recovery and optimal control in a healthcare institution is modelled.•The potential cost savings of the system under the ToU tariff and maximum demand charges were evaluated.•A comparative life cycle cost analysis revealed that the optimal system would reduce the breakeven point by 2.2 years.
The article analyzes the book Forensic Medical Expert Service of the Moscow region: history and modernity edited by Doctor of Medical Sciences, Professor Vladimir Alexandrovich Klevno and Doctor of ...Medical Sciences, Associate Professor Viktor Yurievich Nazarov, presents an objective assessment of the published data on the history and current state of the forensic medical expert service of the Moscow region and the development of Russias largest state forensic institution State Budgetary Healthcare Institution of the Moscow region Bureau of Forensic Medical Examination. The purpose of the review is to give an objective assessment of the information contained in the scientific publication and to determine their value for science and practice.
First of all, the author notes the uniqueness of the publication, in which for the first time the history of forensic medicine of the Moscow region is covered in detail and reliably, the main milestones of the history of the Bureaus development are scrupulously and carefully outlined, an unprecedented number of little-known facts and reliably generalized information are included (archival data, accurate statistical reports, detailed biographies). The conclusion is substantiated that by its 100th anniversary, the state budgetary healthcare institution of the Moscow region Bureau of Forensic Medical Examination, under the leadership of Professor V.A. Klevno, has achieved leading positions in all indicators of forensic expert activity and has become the leading among state forensic expert institutions in the healthcare system of the Russian Federation. It is noted that the book Forensic Medical Expert Service of the Moscow region: history and modernity, written at the highest scientific level, includes an unprecedented amount of little-known and reliably generalized information.
The author noted that the book was written at the highest scientific level and, undoubtedly, is a significant contribution to the history of the national forensic medical service.
It can be argued that with the publication of the book Forensic Medical Expert Service of the Moscow Region: History and Modernity, a whole and reliable picture of the true history of the Moscow Regional forensic medicine is being created, covering the main significant time intervals.
Without a doubt, this work will serve for many years as a source of reliable information for forensic experts, historians and a wide range of people interested in the past, present and future of forensic medicine in Russia.
Increasing the competitiveness of health care institutions is an urgent issue for health care in the new funding environment. The purpose of this work is to analyze the existing tools for ...competitiveness management in the healthcare sector. The problems of competitiveness management development are investigated. State regulation, political dynamics, changing socio-demographic characteristics and constant technological development cause significant changes in the healthcare sector, but despite this, state restrictions, conservatism of Ukrainian healthcare and lack of management specialists are the main problems of Ukrainian healthcare. This necessitates the use of the principles of competitiveness management of modern health care institutions. The main methodological approach used in the work is a review of literature sources. The analysis of scientific literature revealed the absence of unified methodological approaches to measuring competitiveness, and many of the proposed methods do not take into account the specifics of the health care system, as well as the areas of activity of the medical organization. The existing models of competitiveness management tools differ from each other, and their use is conditioned by many factors. The role and impact of competition in the healthcare sector is considered separately. The theoretical basis of the study is a systematic approach to understanding the relationship between different levels of health care. Important conceptual issues of measuring competition in healthcare, including S.W.O.T. analysis, competitive advantages, human resources assessment, benchmarking, etc. are considered. The results of this study form the methodological and practical basis for improving the competitiveness management system of health care institutions in Ukraine, which operate in difficult socio-economic conditions.
Many academic and practice articles have been published in healthcare operations management literature documenting the experience of implementing lean thinking (LT) in healthcare institutions. But, ...none of them have developed a procedure for assessing the implementation of LT in healthcare institutions. Lack of assessment procedures make it difficult to evaluate the progress made during the implementation of LT. The current study attempts to address this gap by developing and demonstrating an assessment procedure to evaluate the extent of lean implementation in a healthcare institution To begin with, different lean tenets and elements applied in healthcare institutions were identified through a literature review. Following it, a Fuzzy-Logic Input Based Healthcare Institution Lean Implementation Assessment (FLB-HLIA) was developed and deployed in an Indian case hospital to compute “Healthcare Institution’s Lean Implementation Index” (HLII). FLB-HLIA revealed that the case hospital has to focus on two lean tenets, namely establishing pull system, and seeking perfection, to improve its HLII. Assessment also revealed the lean elements that the case hospital can focus to upgrade its HLII. HLII can be used by practitioners to perform intra-benchmarking and inter-benchmarking of healthcare institutions. Results of FLB-HLIA provide a future action plan for the lean implementation journey of the healthcare institution by identifying the possible areas of improvement for future.
COVID-19 is an acute infectious respiratory disease caused by SARS-CoV-2, a subtype of the coronavirus. In addition to normal levels of biometric measures, a healthy lifestyle has been considered an ...indispensable element in preventing complications of coronavirus infection. Demographic characteristics are also critical in determining risk levels. Aim: Investigate potential significant associations between health behaviors, biometric screenings, demographics, and COVID-19 hospitalization in Loma Linda University Health employees. Methods: Participants are employees covered under the employer-sponsored health plan at Loma Linda University Health, Loma Linda, CA, who tested positive for COVID-19. Logistic regression models were applied to analyze demographics, biometric screenings, and lifestyle factors associated with COVID-19 hospitalization. In our study, 7% of participants required hospitalization. Variables independently associated with COVID-19 hospitalization included higher age (OR = 1.05 1.01–1.08, P = .005), non-White race compared to the White race (OR = 3.2 1.22–8.38, P = .018), higher HbA1C levels showing a marginal association (OR = 1.31 .99–1.72, P = .057), and lower vegetable consumption (OR = 4.39 2.06–9.40, P < .001). Lower protein consumption decreased the Odds of hospitalization (OR = .40 .19–.87, P = .021). Our results suggest that a diet that includes more vegetables and lower protein may confer some protection against COVID-19 hospitalization.
•A model of a PV tracking system with energy storage was developed and validated.•The economic dispatch of energy was simulated for a healthcare institution.•An economic analysis was conducted to ...evaluate the feasibility of the system.•Potential energy savings of 40.9% were attained.•The system was projected to break-even in 7.1 years.
Healthcare institutions, ranks the second highest energy intensive buildings in the commercial sector, with daily energy consumption ranging from 43 to 92 kWh per bed. Energy management in this sector may prove difficult due to the demand's critical and non-deferrable nature. Therefore, in this paper, a validated optimal power dispatch model of a proposed hybrid energy system connected to a healthcare institution is developed. The healthcare institution considered in this study, which will remain anonymous,11The healthcare institution considered in this paper is located in the Bloemfontein area and referred to as an anonymous healthcare entity in order to maintain confidentiality and privacy of sensitive data used in this study. is subjected to Time-of-Use (ToU) tariffs and maximum demand charges and is considering the implementation of renewable energy technologies to reduce energy costs. Consequently, given the geographical location of the building, a system consisting of a photovoltaic tracking system with a battery bank and grid connection supplying the load is proposed and modelled. The aim is to optimize the power flow between the hybrid system and battery in order to minimize the grid energy costs based on the ToU tariff while reducing the maximum demand charges from the utility. Annual potential cost savings of up to 40.9% were attained, while a projected break-even point of 7.1 years is noted with the proposed optimally controlled system as compared to the load exclusively supplied by the grid.
Transforming research into practice via implementation science may improve institution-wide implementation success rates for lifestyle medicine (LM). Implementation science (IS) is the study of ...methods that facilitate the uptake of evidence-based practice and research into regular use by practitioners and policymakers. Multiple IS frameworks, such as the Reach, Effectiveness, Adoption, Implementation, Maintenance/Practical Robust Implementation Strategy Model (RE-AIM/PRISM) model, Exploration, Preparation, Implementation, Sustainment (EPIS) model, and Consolidated Framework for Implementation Research (CFIR) model, have been developed. IS frameworks provide a strong yet adaptable foundation for launching initiatives, minimizing barriers by challenging implementers to identify and address problems that impede implementation, and promoting long-term sustainability and positive outcomes. The trouble-shooting tips provided in this article are strategically aligned with the RE-AIM/PRISM model of IS to maximize the likelihood of implementation success within the LM space. These tips provide guidance on how to effectively implement interventions, sustain their delivery, and avoid or overcome barriers to implementation. This article presents 12 tips intended as a list of options to facilitate the implementation phases of an initiative, as opposed to offering an all-or-nothing approach to implementation strategy. Current IS priorities emphasize system change and sustainability, which are essential components of successful implementation of LM initiatives.
Disinfectants are used intensively to control and prevent healthcare-associated infections. With continuous use and exposure to disinfectants, bacteria may develop reduced susceptibility. The study ...aimed to check the hygiene of devices in the physiotherapy department. For isolated bacterial strains, we aimed to determine the minimum inhibitory concentration of five different disinfectant wipe products currently in use. Microbiological environmental sampling in four various institutions in four different cities from two counties was performed, followed by CFU calculation and identification using matrix-assisted laser desorption and ionization with time-of-flight analyzer mass spectrometry (MALDI-TOF). The sampling was performed on three different occasions: before patient use, after patient use, and after disinfection. The susceptibility of isolates to three different alcohol-based and three different quaternary ammonium compounds (QAC) disinfectant wipes was examined by determining the minimal inhibitory concentrations (MIC). We identified 27 different bacterial species from 11 different genera. Gram-positive bacteria predominated. The most abundant genera were
,
, and
. The average MIC values of alcohol-based disinfectants range between 66.61 and 148.82 g/L, and those of QAC-based disinfectants range between 2.4 and 3.5 mg/L. Distinctive strains with four-fold increases in MIC values, compared to average values, were identified. The widespread use of disinfectants can induce a reduction in the susceptibility of bacteria against disinfectants and affect the increase in the proportion of antibiotic-resistant bacteria. Therefore, it is urgent to define clear criteria for defining a microorganism as resistant to disinfectants by setting epidemiological cut-off (ECOFF) values and standardizing protocols for testing the resistance of microorganisms against disinfectants.
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