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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

Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review

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Infectious Diseases of Poverty 2022年第4期11卷 9-28页

作者： Kira Elsbernd Karl MFEmmert-Fees Amanda Erbe Veronica Ottobrino Arne Kroid Till Barnighausen Benjamin P Geisler Stefan Kohler Division of Infectious Diseases and Tropical Medicine Faculty of MedicineLudwig Maximilians UniversityMunichGermany Institute for Medical Information Processing Biometryand Epidemiology(IBE)Faculty of Medicine Ludwig Maximilian UniversityMunichGermany Department of Sports and health Sciences Technical University of MunichMunichGermany Institute of health Economics and health Care Management Helmholtz Zentrum MunchenMunichGermany Heidelberg Institute of Global health Heidelberg UniversityHeidelbergGermany Department of health Management and health Economics University of OsloOsloNorway German Center for Infection Research(DZiF) Partner SiteMunichGermany Massachusetts General Hospital/Harvard Medical School BostonMAUSA Institute of Social Medicine Epidemiology and HealthEconomicsCharite-Universitatsmedizin BerlinBerlinGermany

Background:Continuing progress in the global pediatric human immunodeficiency virus(HIV)response depends on timely identification and care of infants with HIV.As countries scale-out improvements to HIV early infant diagnosis(EID),economic evaluations are needed to inform program design and implementation.This scoping review aimed to summarize the available evidence and discuss practical implications of cost and cost-effectiveness analyses of HIV EID.Methods:We systematically searched bibliographic databases(Embase,MEDLINE and EconLit)and grey literature for economic analyses of HIV EID in low-and middle-income countries published between January 2008 and June 2021.We extracted data on unit costs,cost savings,and incremental cost-effectiveness ratios as well as outcomes related to health and the HIV EID care process and summarized results in narrative and tabular formats.We converted unit costs to 2021 USD for easier comparison of costs across studies.Results:After title and abstract screening of 1278 records and full-text review of 99 records,we included 29 studies:17 cost analyses and 12 model-based cost-effectiveness analyses.Unit costs were 21.46-51.80 USD for point-of-care EID tests and 16.21-42.73 USD for laboratory-based EID tests.All cost-effectiveness analyses stated at least one of the interventions evaluated to be cost-effective.Most studies reported costs of EID testing strategies;however,few studies assessed the same intervention or reported costs in the same way,making comparison of costs across studies challenging.Limited data availability of context-appropriate costs and outcomes of children with HIV as well as structural heterogeneity of cost-effectiveness modelling studies limits generalizability of economic analyses of HIV EID.Conclusions:The available cost and cost-effectiveness evidence for EID of HIV,while not directly comparable across studies,covers a broad range of interventions and suggests most interventions designed to improve EID are cost-effective or cost-saving.Further studies captur

关键词： Cost effectiveness Diagnostics Low-and middle-income countries Point of care Early infant diagnosis health systems

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 solutions.The healthcare industry represents one such area,as digital transformation disrupts relationships between patients,healthcare professionals,and healthcare institutes.Patients and healthcare institutes lack a proficient tool to verify the credentials of medical professionals in a digital environment.Furthermore,healthcare professionals lack a tool where they are in control over their credentials.The 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 industry.Second,we pave the ground for GDPR compliance by storing only the hash values on the blockchain.Third,we solve the problem of patient authentication by utilizing cryptographic techniques.Finally,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

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 use.Metiiods: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 study.We selected published peer-reviewed articles available from the onset of COVID-19 to July 2021.Results:Total of 24 articles were included into this study.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 pandemic.These 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 communication.The 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 Africa.However,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 barriers.Conclusion:Although COVID-19 has invigorated the use of digital health technologies,there are still some shortcomings.The outbreak of pandemics like COVID-19 in the future is not inevitable.Therefore,we recomme

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

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 data.Drawing on a literature review and expert consultation,the study established a theoretical framework and an indicator system for performance review.Questionnaires were designed and disseminated to collect empirical data on health system performance in four counties of two central and western provinces.Quantitative data were subjected to descriptive statistical analysis through SPSS12.0.Three dimensions were introduced in the performance review framework—health outcomes,financial risk protection and consumer and provider satisfaction.health 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 diseases.Financial 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 utilization.The 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 level.The study indicated better health system performance in the two counties in Chongqing than those in Shanxi.It 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 systems.Caution 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

Commentary:restarting NTD programme activities after the Ebola outbreak in Liberia

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Infectious Diseases of Poverty 2017年第1期6卷 455-458页

作者： Brent C.Thomas Karsor Kollie Benjamin Koudou Charles Mackenzie Centre for Neglected Tropical Diseases(CNTD) Liverpool School of Tropical MedicineLiverpoolUK Neglected Tropical Disease Non-Communicable Disease and Eye Health GroupMinistry of HealthMonroviaLiberia

It is widely known that the recent Ebola Virus Disease(EVD)in West Africa caused a serious disruption to the national health system,with many of ongoing disease focused programmes,such as mass drug administration(MDA)for onchocerciasis(ONC),lymphatic filariasis(LF)and schistosomiasis(SCH),being suspended or scaled-down.As these MDA programmes attempt to restart post-EVD it is important to understand the challenges that may be encountered.This commentary addresses the opinions of the major health sectors involved,as well as those of community members,regarding logistic needs and challenges faced as these important public health programmes consider restarting.There appears to be a strong desire by the communities to resume NTD programme activities,although it is clear that some important challenges remain,the most prominent being those resulting from the severe loss of trained staff.

关键词： West Africa Ebola Neglected tropical diseases Mass drug administration health systems

Researching social innovation:is the tail wagging the dog?

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Infectious Diseases of Poverty 2020年第1期9卷 77-81页

作者： Emma L.M.Rhule Pascale A.Allotey United Nations University-International Institute for Global health Kuala LumpurMalaysia

Background:Social Innovation in health initiatives have the potential to address unmet community health needs.For sustainable change to occur,we need to understand how and why a given intervention is effective.Bringing together communities,innovators,researchers,and policy makers is a powerful way to address this knowledge gap but differing priorities and epistemological backgrounds can make collaboration challenging.Main text:To overcome these barriers,stakeholders will need to design policies and work in ways that provide an enabling environment for innovative products and services.Inherently about people,the incorporation of community engagement approaches is necessary for both the development of social innovations and accompanying research methodologies.Whilst the'appropriate'level of participation is linked to intended outcomes,researchers have a role to play in better understanding how to harness the power of community engagement and to ensure that community perspectives form part of the evidence base that informs policy and practice.Conclusions:To effectively operate at the intersection between policy,social innovation,and research,all collaborators need to enter the process with the mindset of learners,rather than experts.Methods-quantitative and qualitative-must be selected according to research questions.The fields of implementation research,community-based participatory research,and realist research,amongst others,have much to offer.So do other sectors,notably education and business.In all this,researchers must assume the mantel of responsibility for research and not transfer the onus to communities under the guise of participation.By leveraging the expertise and knowledge of different ecosystem actors,we can design responsive health systems that integrate innovative approaches in ways that are greater than the sum of their parts.

关键词： Social innovation health systems Mixed methods Participation Community engagement Policymaker Implementation research

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 intelligence.Harnessing 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 responses.Once 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