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Congenital Heart Disease 2024年第2期19卷 131-138页

作者： Dominique Vervoort Amy Verstappen Sreehari Madhavankutty Nair Chong Chin Eu Bistra Zheleva Institute of health Policy Management and EvaluationUniversity of TorontoTorontoCanada Division of Cardiac Surgery University of TorontoTorontoCanada Global Alliance for Rheumatic and Congenital Hearts PhiladelphiaUSA Department of health Services Government of KeralaKeralaIndia Ministry of health PutrajayaMalaysia Children’s HeartLink MinneapolisUSA

1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%of the avertable morbidity and mortality due to congenital anomalies would result from scaling congenital heart surgery services[2].Every year,nearly 300,000 children and adults die from CHD,the majority of whom live in low-and middle-income countries(LMICs)[3].Approximately 49%of all individuals with CHD will require surgical or interventional care at some point in their lifetime[4];as a result of advances in access to and the delivery of such services,over 95%of children born with CHD in high-income countries now live into adulthood[3].Here,adults have surpassed children in the number of CHD cases at a ratio of 2:1[5].

关键词： Congenital heart disease pediatric heart disease global health health systems health policy

Frameworks for health systems performance assessment:how comprehensive is Ghana’s holistic assessment tool?

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Global health Research and Policy 2020年第1期5卷 344-355页

作者： Emmanuel Kumah Samuel E.Ankomah Adam Fusheini Emmanuel Kusi Sarpong Eric Anyimadu Ato Quist Brian Koomson Policy PlanningMonitoring&Evaluation UnitKomfo Anokye Teaching HospitalKumasiGhana Department of Preventive and Social Medicine Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand Center for health Literacy and Rural health Promotion P.O.Box GP1563AccraGhana Biostatistics Unit Komfo Anokye Teaching HospitalKumasiGhana

Background:Measuring the performance of a health system is an essential requirement in creating systems that generate efficient,equitable,patient-focused,accessible and sustainable results.A fundamental requirement for a performance measurement system is the development of an assessment framework within which specific performance measures could be defined and applied *** paper examines the comprehensiveness of Ghana’s health system assessment framework called the Holistic Assessment Tool in relation to some of the internationally recognized *** paper also analyzes trends in the performance of the health system to understand whether or not an improvement has been recorded following the adoption and implementation of the Holistic Assessment ***:Mainly secondary data were used in this *** were conducted on Google Scholar,PubMed,Scopus and Science Direct between May and July,2019 for published documents on health system performance *** also obtained unpublished documents from Ghana’s Ministry of health,Ghana health Service website,and Ghana Statistical Service *** statistics were used to examine trends in the performance of the Ghanaian health ***:While the tool provides a national framework for evaluating the performance of the Ghana health system in several domains,the Holistic Assessment Tool does not cover key health system domains such as information systems for health,access to essential medicines,and ***,the scope of the assessment program seems limited to the evaluation of the Ministry of health’s annual plans,programs and ***,the health system has recorded improvements in population health indicators,such as life expectancy at birth,infant mortality,under-5 mortality,HIV prevalence and disease burden(in terms of disability adjusted life years).Conclusions:The Holistic Assessment Tool is a useful framework,but needs further refinement,both in sco

关键词： health systems Performance assessment framework health indicators Trend assessment Developing country health system in Ghana

Moving from medical to health systems classifications of deaths:extending verbal autopsy to collect information on the circumstances of mortality

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Global health Research and Policy 2016年第1期1卷 3-17页

作者： Lucia D’Ambruoso Kathleen Kahn Ryan G.Wagner Rhian Twine Barry Spies Maria van der Merwe F.Xavier Gómez-Olivé Stephen Tollman Peter Byass Institute of Applied health Sciences University of AberdeenScotlandUK UmeåCentre for Global health Research UmeåUniversityUmeåSweden MRC/Wits Rural Public health and health Transitions Research Unit School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa Directorate for Maternal ChildWomen and Youth Health and NutritionMpumalanga Department of HealthNelspruitMpumalangaSouth Africa INDEPTH:An International Network for the Demographic Evaluation of Populations and Their health AccraGhana.

Background:Verbal autopsy(VA)is a health surveillance technique used in low and middle-income countries to establish medical causes of death(CODs)for people who die outside hospitals and/or without *** virtue of the deaths it investigates,VA is also an opportunity to examine social exclusion from access to health *** aims were to develop a system to collect and interpret information on social and health systems determinants of deaths investigated in ***:A short set of questions on care pathways,circumstances and events at and around the time of death were developed and integrated into the WHO 2012 short form VA(SF-VA).Data were subsequently analysed from two census rounds in the Agincourt health and Socio-Demographic Surveillance Site(HDSS),South Africa in 2012 and 2013 where the SF-VA had been *** and descriptive analysis were used to calculate cause-specific mortality fractions(CSMFs),and to examine responses to the new indicators and whether and how they varied by medical CODs and age/sex ***:One thousand two hundred forty-nine deaths were recorded in the Agincourt HDSS censuses in 2012-13 of which 1,196(96%)had complete VA *** and non-communicable conditions accounted for the majority of deaths(47%and 39%respectively)with smaller proportions attributed to external,neonatal and maternal causes(5%,2%and 1%respectively).5%of deaths were of indeterminable *** new indicators revealed multiple problems with access to care at the time of death:39%of deaths did not call for help,36%found care unaffordable overall,and 33%did not go to a *** problems were reported consistently across age and sex *** conditions and younger age groups had fewer problems with overall costs but more with not calling for help or going to a *** illustrative health systems interpretation suggests extending and promoting existing provisions for transport and financial access in this ***

关键词： Verbal autopsy Social determinants health systems Civil registration and vital statistics health surveillance South Africa

A longitudinal surgical systems strengthening research program for medical students:the exploration of a model for global health education

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Global health Research and Policy 2021年第1期6卷 149-157页

作者： Gregory L.Peck Joseph S.Hanna Erin M.Scott Dhaval Mehta Zina Model Deesha Sarma Elizabeth E.Ginalis Zachary Berlant Fernando Ferrera Javier Escobar Carlos A.Ordoñez Carlos Morales Vicente H.Gracias Department of Surgery Rutgers Robert Wood Johnson Medical School125 Paterson Street-Suite 6300New BrunswickNJ 08901USA Rutgers School of Public health PiscatawayNJUSA Department of Surgery University of Massachusetts Medical SchoolWorcesterMAUSA Department of Emer-gency Medicine New York Presbyterian-Brooklyn Methodist HospitalNew YorkNYUSA Department of Orthopaedic Surgery Harvard Medical SchoolBostonMAUSA Department of Emergency Medicine Beth Israel Deaconess Medical CenterBostonMAUSA Department of Neurological Surgery Rutgers Biomedical and Health SciencesNew BrunswickNJUSA Department of Pediatrics New York Presbyterian-Columbia University Medical CenterNew YorkNYUSA Department of Orthopaedic Surgery UPMC Hamot Medical CenterPittsburghPAUSA Rutgers Biomedical and health Sci-ences Rutgers UniversityNew BrunswickNJUSA Department of Surgery Universidad del ValleCaliColombia Department of Surgery Universidad de AntioquiaMedellínColombia

Background:In response to the staggering global burden of conditions requiring emergency and essential surgery,the development of international surgical system strengthening(SSS)is fundamental to achieving universal,timely,quality,and affordable surgical *** exists in identifying optimal collaborative processes that both promote global surgery research and SSS,and include medical *** study explores an education model to engage students in academic global surgery and SSS via institutional support for longitudinal ***:We set out to design a program to align global health education and longitudinal health systems research by creating an education model to engage medical students in academic global surgery and *** design and implementation:In 2015,medical schools in the United States and Colombia initiated a collaborative partnership for academic global surgery research and *** included development of two longitudinal academic tracks in global health medical education and academic global surgery,which we differentiated by level of institutional *** is a retrospective evaluation of the first two years of this program by using commonly recognized academic output *** achievements:In the first two years of the program,there were 76 total applicants to the two longitudinal *** of the 16(37.5%)accepted students selected global surgery faculty as mentors(Acute Care Surgery faculty participating in SSS with Colombia).These global surgery students subsequently spent 24 total working weeks abroad over the two-year period participating in culminating research experiences in *** a quantitative measure of the program’s success,the students collectively produced a total of twenty scholarly pieces in the form of accepted posters,abstracts,podium presentations,and manuscripts in partnership with Colombian research *** implications:The establishment of scholarly global health education and re

关键词： Global health health systems systems strengthening Surgical education Medical student education Global surgery

The Role of Public health Within the United Nations Post-2015 Framework for Disaster Risk Reduction

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International Journal of Disaster Risk Science 2015年第1期6卷 28-37页

作者： Virginia Murray Amina Aitsi-Selmi Kevin Blanchard Public health Strategy Division Public Health England

This article explores the role of public health systems before, during, and after disasters, particularly within the scope of the United Nations Post-2015 Framework for Disaster Risk Reduction. It also examines the role of scientific and technological developments in assisting with improving the resilience of public health professionals and the communities they work in. In addition, it explores how the wide-ranging activities in public health have already contributed to the improved management of disasters and a decrease in associated risks. The article identifies areas of synergy in five key areas of recent policy and practice in public health(the health systems approach, risk assessments, the WHO/UNISDR/HPA Disaster Risk Management fact sheets, chronic disease and disasters, and mental health impacts following disasters) and makes suggestions based on lessons identified from the previous(2005) global disaster risk reduction framework. In particular, we advocate the use of scientific evidence that addresses health and disaster risk simultaneously to increase the effectiveness of policy and practice in disaster risk reduction, health, and public health.

关键词： Disaster risk reduction health systems Post-2015 framework Public health Risk assessments

Hyperledger fabric platform for healthcare trust relations—Proof-of-Concept

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Blockchain(Research and Applications) 2023年第4期4卷 63-74页

作者： Aleksandar Nedakovic Anton Hasselgren Katina Kralevska Danilo Gligoroski Department of Information Security and Communication Technology Norwegian University of Science and Technology(NTNU)7034 TrondheimNorway Department of Neuromedicine and Movement Science Norwegian University of Science and Technology(NTNU)7034 TrondheimNorway

In recent years,blockchain technologies have expanded from the finance field to other areas that rely on trustbased *** healthcare industry represents one such area,as digital transformation disrupts relationships between patients,healthcare professionals,and healthcare *** and healthcare institutes lack a proficient tool to verify the credentials of medical professionals in a digital ***,healthcare professionals lack a tool where they are in control over their *** first contribution of this paper is a proposal of a solution that leverages the private permissioned Hyperledger Fabric blockchain and smart contracts to provide a source of transparent trust for relationships within the healthcare ***,we pave the ground for GDPR compliance by storing only the hash values on the ***,we solve the problem of patient authentication by utilizing cryptographic ***,we prove the usability of the proposed solution by implementing a user interface and creating a live deployment.

关键词： Blockchain Hyperledger fabric health systems Distributed ledger

Exploring China's Western and Central County systems Performance Measured by Outcomes Framework Scores-A Cross-sectional Survey of Routine healthcare Data

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2011年第4期31卷 419-425页

作者：石军张亮刘岳王江波 Chris Scarf 熊巨洋 School of Medicine and health Management Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China Office of Academic Affairs Huazhong University of Science and Technology Wuhan 430074 China Center for Project Supervision and Management Ministry of Health Beijing 100009 China P.O. Box 636 Roseville NSW 2069 Australia

This study was designed to measure the performance of county health systems in central and western China utilizing routine healthcare *** on a literature review and expert consultation,the study established a theoretical framework and an indicator system for performance *** were designed and disseminated to collect empirical data on health system performance in four counties of two central and western *** data were subjected to descriptive statistical analysis through *** dimensions were introduced in the performance review framework—health outcomes,financial risk protection and consumer and provider *** outcomes were assessed from four secondary indicators：infant mortality rate;maternal mortality rate;under-5 child mortality rate;and the incidence of Class A and Class B notifiable *** risk was assessed using two secondary indicators：the proportion of the cost of inpatient care that was reimbursed under the New Cooperative Medical System（NCMS） insurance scheme,and the rate of NCMS funds *** assessment of satisfaction was made using two secondary indicators：the overall satisfaction of local residents with healthcare services,and the satisfaction of health practitioners at the township and village *** study indicated better health system performance in the two counties in Chongqing than those in *** was concluded that outcome framework scores can fairly reveal performance differences among county health systems in central and western China,and can provide practical evidence for optimizing the operation and inputs of county health *** needs to be exercised in generalizing such performance outcomes as many factors such as spending and organization that contribute to county health system performance were not included in the study.

关键词： county health systems performance outcome measurement

Chronic disease in a digital health environment

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Family Medicine and Community health 2018年第1期6卷 20-25页

作者： Christopher Pearce Australasian College of health Informatics Outcome health Department of health Informatics University of Melbourne Department of General Practice Monash University Digital health Committee of the Australian College of Rural and Remote Medicine

Although we know that there are benefits to individual patients from electronic data,the next potential,and potentially the biggest,benefit will come from the technologies known as big data,machine learning,and artificial *** the potential of computers to sift through large amounts of data will result in the possibility of generating insights into individual patients,and into whole populations,predicting the risk of hospital admission for an individual,or track-ing influenza epidemics to prepare adequate *** the data are reliable,recorded in a computer-interpretable way,new horizons will open.

关键词： Ehealth digital health chronic disease patient centred medicine health systems

Understanding the dynamic interactions driving the sustainability of ART scale-up implementation in Uganda

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Global health Research and Policy 2018年第1期3卷 131-142页

作者： Henry Zakumumpa Nkosiyazi Dube Respicius Shumbusho Damian Elizeus Rutebemberwa School of Public health Makerere UniversityKampalaUganda School of health and Community Development University of the WitwatersrandJohannesburgSouth Africa Faculty of Social Sciences University of Dar es SalaamDar es SalaamTanzania

Background:Despite increasing recognition that health-systems constraints are the fundamental barrier to attaining anti-retroviral therapy(ART)scale-up targets in Sub-Saharan Africa,current discourses are dominated by a focus on financial *** the health system dynamics framework,this study aimed to explore the interactions in health system components and their influence on the sustainability of ART scale-up implementation in ***:This study entailed qualitative organizational case-studies within a two-phased mixed-methods sequential explanatory research *** Phase One,a survey of 195 health facilities across Uganda which commenced ART services between 2004 and 2009 was *** Phase Two,six health facilities were purposively selected for in-depth examination involving i)In-depth interviews(n=44)ii)and semistructured interviews(n=35).Qualitative data was analyzed by coding and thematic *** statistics were managed in STATA(v 13).Results:Five dynamic interactions in ART program sustainability drivers were identified;i)Failure to update basic ART program records contributed to chronic ART medicines stock-outs ii)health workforce shortages and escalating patient volumes prompted adaptations in ART service delivery models iii)Broader governance issues manifested in poor road networks undermined ART medicines supply chains iv)Sustained financing for ART programs was influenced by external donors v)The values associated with the ownership-type of a health facility affected ART service delivery and ***:The sustainability of ART programs at the facility-level in Uganda is a function of a complex interaction in elements of the health system and must be understood beyond sustaining international funding for ART scale-up.

关键词： health systems Sustainability HIV treatment Dynamic interactions systems thinking

Virtual healthcare services and digital health technologies deployed during coronavirus disease 2019(COVID-19)pandemic in South Africa:a systematic review

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Global health Journal 2022年第2期6卷 102-113页

作者： Elliot Mbunge John Batani Goabaone Gaobotse Benhildah Muchemwa Department of Computer Science Faculty of Science and EngineeringUniversity of EswatiniKwaluseniManziniEswatini Department of Information Technology Faculty of Accounting and InformaticsDurban University of TechnologySouth Africa Faculty of Engineering and Technology Botho UniversityLesotho Department of Biological Sciences and Biotechnology Faculty of ScienceBotswana International University of Science and TechnologyBotswana

Aims:To identify virtual healthcare services and digital health technologies deployed in South Africa during coronavirus disease 2019(COVID-19)and the challenges associated with their ***:To determine the status of digital health utilization during COVID-19 in South Africa,the preferred reporting items for systematic reviews and meta-analyses model was used to perform a systematic and in-depth critical analysis of previously published studies in well-known and trusted online electronic databases using specific search keywords words that are relevant to this *** selected published peer-reviewed articles available from the onset of COVID-19 to July ***:Total of 24 articles were included into this *** study revealed that South Africa adopted digital technologies such as SMS-based solutions,mobile health applications,telemedicine and telehealth,WhatsApp-based systems,artificial intelligence and chatbots and robotics to provide healthcare services during COVID-19 *** innovative technologies have been used for various purposes including screening infectious and non-infectious diseases,disease surveillance and monitoring,medication and treatment compliance,creating awareness and *** study also revealed that teleconsultation and e-prescription,telelaboratory and telepharmacy,teleeducation and teletraining,teledermatology,teleradiology,telecardiology,teleophthalmology,teleneurology,telerehabilitation,teleoncology and telepsychiatry are among virtual healthcare services delivered through digital health technologies during COVID-19 in South ***,these smart digital health technologies face several impediments such as infrastructural and technological barriers,organization and financial barriers,policy and regulatory barriers as well as cultural ***:Although COVID-19 has invigorated the use of digital health technologies,there are still some *** outbreak of pandemics like COVID-19 in t

关键词： Digital health technology Virtual healthcare Coronavirus disease 2019(COVID-19) health systems South Africa