This document summarizes a presentation on health economics. It discusses the history and evolution of the field, principles of health economics including costs, efficiency, and equity. It also describes the four main types of economic evaluation used in health - cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis, and cost-minimization analysis. The document then reviews the current status and challenges of economic evaluations in India and discusses the role of health technology assessment. It concludes by thanking the audience and providing details on the next week's presentation.
This presentation gives a basic introduction to the field of health economics and includes important concepts like that of efficiency, equity, opportunity costs, demand and supply and also includes financial evaluation
Health system in the perspectives of health economicsBPKIHS
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The document provides an overview of basic health economics concepts. It discusses 1) how health expenditures relate to overall economic growth, 2) how resources are allocated in healthcare systems to maximize efficiency, and 3) issues regarding the long-term sustainability of healthcare systems. Key points include how economic analysis can help optimize resource allocation to meet needs, how rising drug costs and an aging population impact sustainability, and the risk of a "trade war" over pharmaceutical prices between the US and other countries.
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behaviour in the production and consumption of health and health care.
In broad terms, health economists study the functioning of health care systems and health- affecting behaviour such as smoking.
It is the discipline of economics applied to the health care.
This document provides an overview of health economics. It defines health economics as the study of how scarce resources are allocated for health care and promotion. The document outlines several key areas studied in health economics, including the value of health, determinants of health, demand and supply of health care, economic evaluations, and health care organization and financing. It also discusses positive and normative analyses and concepts related to equity in health care systems.
Health economics from basics to appliedNayyar Kazmi
The document discusses several key concepts in health economics including:
1. Allocative efficiency and technical efficiency in health activities.
2. Types of economic costs including total cost, fixed cost, and variable cost. Marginal cost is defined as the change in total cost from a one unit change in output.
3. Economic evaluation methods for health programs including cost-minimization analysis, cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis.
students wonder exactly what health economics is. is it about money in health, more health for the same money ? about health in hospitals or health of the country.
discussion on Health Economics and Health Care in our country and abroad, and what resources are given by the private sectors and with the very scarce help from the DOH, national and local government, and from the support given by WHO.
This document provides an overview of key concepts in health economics. It discusses the definition and scope of health economics, as well as important microeconomic and macroeconomic factors that influence the health sector. Some key methods covered include economic evaluation techniques like cost-effectiveness analysis, cost-benefit analysis, and cost-utility analysis. Health outcomes measures like QALYs and DALYs are also explained. The document aims to introduce foundational ideas around applying economic principles and evaluation to issues of health, healthcare delivery, and resource allocation.
This document discusses health economic evaluations and their importance. It defines key concepts such as health systems, health economics, scarcity, opportunity cost, and efficiency. It explains the basic framework for economic evaluations including defining the problem, identifying options, measuring costs and outcomes, and selecting the appropriate technique. The main techniques discussed are cost-minimization analysis, cost-effectiveness analysis, and cost-utility analysis, with a focus on measuring and comparing costs and outcomes.
This document provides an overview of health economics. It defines health economics as the study of how scarce resources are allocated for health and healthcare based on individual and societal choices. The document outlines several key areas of study in health economics including the value of health, determinants of health, demand and supply of healthcare, economic evaluations, and healthcare organization and financing. It also discusses important concepts like positive and normative analysis and equity in healthcare.
The document provides an overview of key concepts in health economics, including:
1) It discusses who has access to healthcare based on ability to pay and examines issues of equity, finance, delivery, and outcomes in healthcare systems.
2) It explores expenditures on healthcare as a percentage of GDP and characteristics of the insured population in the US.
3) It introduces basic questions of economic systems that also apply to health economics, such as what and for whom to produce, and how to achieve economic growth with scarce resources.
Health economics is the study of how limited resources are used in the health care industry and how they affect health care systems. It aims to provide the best quality health care to as many people as possible given financial constraints. Key aspects of health economics include cost accounting, cost-benefit analysis, cost-effectiveness analysis, and analyzing the effects of factors like technology, population changes, and policies on health care systems. Resources in health care may be evaluated using quantitative techniques like cost minimization and cost-effectiveness analysis.
Health economics can contribute to primary care in three key ways:
1. It provides a framework to help primary care establish objectives and make choices about how to allocate scarce resources in the most efficient way to maximize health outcomes.
2. It helps primary care acknowledge that needs will always outpace available resources and make decisions about priority needs.
3. It offers tools like cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis to help primary care rationally decide how to distribute limited funds and achieve the best health outcomes at the lowest cost.
This document provides an overview of key concepts in health economics, including:
1. Efficiency refers to maximizing benefits for society at the least cost and includes technical efficiency of minimizing costs without compromising quality and allocative efficiency of distributing resources optimally.
2. Equity concerns fair and impartial distribution of health resources based on need.
3. National income concepts measure economic activity, including GDP, GNP, NNP, and per capita income.
1) Health economics lies at the interface between health/medicine and economics. It applies economic principles to issues relating to health.
2) Resources for the health sector are limited, so health economics studies how scarce resources are allocated among alternative uses in health care at both the micro and macro levels. This involves weighing the costs and benefits of different options.
3) Topics related to health economics include the production and demand of health and health services, health economic evaluation, health insurance, and the analysis of health care markets.
The document provides an overview of health economics. It defines health economics as the study of how scarce resources are allocated for health care and promotion. It discusses key areas studied in health economics including the value of health, determinants of health, demand and supply of health care, economic evaluations, and health care organization and financing. The document also introduces important concepts in health economics such as perspectives, equity, efficiency, and provides examples to illustrate these concepts.
This document discusses the importance of economic evaluation in healthcare. It defines economic evaluation as the comparative analysis of alternative courses of action in terms of both their costs and consequences. The main methods of economic evaluation are described as cost-minimization, cost-effectiveness, cost-utility, and cost-benefit analysis. Quality-adjusted life years (QALYs) are discussed as a measure of health outcomes that accounts for both quality and quantity of life when performing cost-utility analysis. Economic evaluation aims to maximize health from available resources.
The document defines health economics as the application of economic principles to the health care system. It discusses key concepts in health economics including supply and demand of health care, costs associated with health care like fixed vs variable costs, and methods of economic evaluation used in health care planning like cost-benefit analysis. The document also outlines factors that influence health expenditures like changing demographics and disease patterns, new technologies, and rising public expectations. Overall, the document provides a broad overview of the basic concepts and scope of health economics as a field of study.
Building institutions for an effective health systemIDS
This presentation was given by Bloom to the International Health Economics Association Conference 2009 in Beijing. It is research conducted as part of the Future Health Systems Research Programme Consortium www.futurehealthsystems.org.
Beyond scaling up Bloom at the Global SymposiumIDS
The document discusses pathways to universal access to health services. It addresses the challenges of rapidly scaling up health systems, including managing change in complex contexts and meeting the needs of the poor. It also discusses taking management systems to scale, spreading learning from pilots, public sector reform, innovation systems for health, and discontinuity and disruption in health services. The objectives of the document are to explore approaches that foster innovation, learning and impact at large scale while considering context, and to identify practical collaboration approaches between stakeholders to strengthen health systems for the poor.
Pathways to scaling up health services Peters and PainaIDS
This document discusses scaling up health services in complex adaptive systems. It argues that health systems behave like complex adaptive systems, characterized by heterogeneous actors that interact in dynamic and unpredictable ways. Scaling up is therefore not a linear or controlled process. The document outlines several concepts from complexity science that are relevant to scaling up, such as feedback loops, emergent behavior, tipping points, and path dependence. It suggests using theories and methods from complexity science to better understand scaling up and facilitate decision making. Key lessons are that scaling up requires flexibility, recognizing local conditions, and developing sustainable institutions over the long term through learning-based approaches.
The document discusses topics for health systems research and strengthening health systems. It provides an overview of suggested research topics such as human resources, health care delivery, private sector approaches, and governance. It also outlines different models for health policy including rationalist, incremental, and problem identification approaches. The document emphasizes translating evidence into action and factors that influence using research evidence in policymaking. It recommends researchers provide brief summaries, ensure timely and relevant research, and argue the relevance to policymaker demands.
What must be done to ehance capacity for health systems research?IDS
This presentation was written by Sara Bennett, Ligia Paina, Christine Kim, Irene Agyepong, Somsak Chunharas, Di McIntyre and Stefan Nachuk for the Global Symposium on Health Systems Research, November, 2010.
Putting The Sexy Into Safer Sex. Building Bridges Between The Sex World And P...IDS
This presentation was delivered by the Pleasure Project to a workshop at the Liverpool School of Tropical Medicine on improving the use of research in policy and practice.
This study examined how individual, family, and school-level factors influence the age of sexual initiation in adolescents using data from the National Longitudinal Study of Adolescent Health. Hierarchical linear models were used to predict age of sexual initiation separately for boys and girls. Results found that more favorable attitudes about sex at the school level were associated with younger age of sexual initiation for both boys and girls. The school-level mean parental education also moderated the influence of individual attitudes about sex on age of initiation. Perception of maternal approval and peer approval were the most important predictors of younger age of initiation for boys, while more factors were significant predictors for girls. The findings support the need for school-wide prevention programs that address attitudes
This document summarizes research on the relationship between poverty and sexual risk-taking in Africa. It finds that urban slum residents, especially women, engage in riskier sexual behaviors like early sexual debut and multiple partners. Poor girls also tend to have sex earlier in some countries. While poverty is linked to increased risk, wealthier groups have higher overall HIV rates, possibly due to under-reporting of risk behaviors among the rich. More research is still needed to fully understand the complex links between poverty, context, and sexual health outcomes.
Analysis of cross-country changes in health services IDS
This presentation was given in a session at the Global Symposium on Health Systems Research which was organised by the Future Health Systems Consortium. The author is Toru Matsubayashi from Johns Hopkins Bloomberg School of Public Health
The Thailand HiT reports that sustained political commitment to the health of the population since the 1970s has resulted in significant investment in health infrastructure, in particular primary health care, district and provincial referral hospitals, and strengthened the overall functioning of the Thai health system. After Thailand achieved universal health coverage in 2002, public expenditure on health significantly increased from 63% to 77% and out-of-pocket expense was reduced from 27.2% to 12.4% of the total health spending in 2011.
The Republic of Korea HiT notes that economic development and universal health coverage through national health insurance has led to a rapid improvement in health outcomes. Overall, the health status of the Korean population is better than that of many other Asian countries. Reducing inequality in health coverage outcomes, strengthening primary health care and improving coordination between hospitals and long-term care facilities to meet the needs of the aged population are the challenges facing the Government.
Indonesia has a mixed health system with both public and private provision of care. Key achievements include increased life expectancy and reductions in communicable disease rates. However, challenges remain such as the dual burden of disease, natural disasters, weak health information systems, and high out-of-pocket expenditures. Future prospects include expanding the use of telemedicine, incentivizing an even workforce distribution, and passing more legislation to clarify the health system framework.
The document proposes a microfinance health insurance scheme to improve access to quality primary healthcare in rural communities. It would establish a nodal center at community health centers to provide minimum premiums, cashless benefits, and reimbursement for out-of-pocket medical expenses. Profits would be reinvested in self-help groups and cooperatives to generate revenue and develop local infrastructure. This aims to increase utilization of existing healthcare services, strengthen referrals, empower communities, and boost the local economy through a sustainable community-level solution.
This document summarizes a presentation on integrated care and support given by representatives from NHS England and ADASS. It discusses the context of integration between health and social care services, identifies three "wicked issues" challenges to integration, and outlines next steps. Graphs and figures are included showing relationships between long-term conditions, costs of care, and the potential impact and cost savings of integrated models of care. The presentation addresses definitions of integration, evidence challenges, barriers such as information governance, and emphasizes the importance of person-centered coordinated care and building the capacity of patients to engage in self-management.
The Cambodia HiT reports that the national health sector reforms initiated two decades ago have had a positive impact on Cambodia’s health sector. The country’s health status has substantially improved since 1993 and is on track to achieve the Millennium Development Goal targets. Improving the quality of care is now the most pressing imperative in health-system strengthening.
The presentation gives a brief overview of the concept of the following :
1. what are user chargers
2. should we abolish them or not.
3. What could be the impact of either keeping them or abolishing them,
4. What role would the abolishment of User Charges play in achieving the goal of Universal Health Coverage?
Typical Cost Containment Policies during Economic StagnationRuby Med Plus
COST CONTAINMENT IN HEALTH CARE: A REVIEW AND RECOMMENDATIONS. Two Important questions to be addressed: what the right amount is that countries should spend on health care ? (societies’ preference not just the countries’ economy)
whether cost-containment should be directed at total expenditure or public expenditure ?
Cost containment is the business practice of maintaining expense levels to prevent unnecessary spending or thoughtfully reducing expenses to improve profitability without long-term damage to the company.Economic stagnation is a prolonged period of slow economic growth (traditionally measured in terms of the GDP growth), usually accompanied by high unemployment.
Integrating Financing Schemes to Achieve Universal Coverage in Thailand:Anal...CREHS
1) Thailand achieved universal health care coverage in 2002 by introducing a tax-funded universal coverage scheme that provided insurance to 47 million people not covered by other programs.
2) The universal coverage policy aimed to remove financial barriers to healthcare through tax-funding and shifting costs from out-of-pocket payments to taxes.
3) Analysis found the universal coverage policy improved equity in healthcare use and financial risk protection, with healthcare use becoming more pro-poor and out-of-pocket costs becoming less regressive over time.
Richard Mendelsohn- Beyond 2010: SMART Living Paneleventwithme
The document discusses a digitally enabled citizen program called Birmingham OwnHealth that aims to improve health outcomes for those with chronic diseases. The program provides personalized care plans, information prescriptions, and support for self-management through telehealth and care managers. Initial outcomes include reductions in avoidable hospitalizations and emergency visits, as well as improvements in clinical metrics like HbA1c and blood pressure. An independent university study found participants in the program experienced greater reductions in these measures compared to controls.
Data Analysis ....Stepping Towards Achieving Universal Health Coverage(UHC) b...Nazmulislambappy
The document discusses a study on Shasthya Surokhsha Karmasuchi (SSK), a special health care project in Bangladesh aimed at ensuring quality health services without financial hardship. The study aims to assess if SSK can meet universal health coverage requirements and reduce out-of-pocket health expenditures. Interviews were conducted with SSK patients and health providers. Findings indicate SSK successfully eliminates costs for admitted patients but many still face health costs. SSK coverage and services need expansion to better achieve financial protection goals. Challenges include limited treatments covered, scarce resources, and poor infrastructure.
The document discusses health systems and financing. It begins by defining a health system as all actors, institutions, and resources that undertake health actions, with the primary intent of improving health. Not all policies that influence health are part of the health system. The document then discusses the goals of health systems, including improving health and ensuring financial contribution. It outlines the key functions of health systems as stewardship, financing, resource generation, and service delivery. The document emphasizes the importance of aligning financing with national health plans to avoid fragmentation. It also discusses concepts of coverage, effectiveness, and factors that influence health outcomes.
The document summarizes a study on the financial burden and ability to access healthcare services of households in Thuy Van commune, Vietnam. The study found that households bear 72% of total health expenditures in Vietnam. While public health services are convenient for minor illnesses, households resort to private providers and hospitals for serious conditions, burdening the poor. Inpatient costs exceeded 1-2% of income for poor households, indicating health costs trap them in poverty. The study recommends expanding community-based insurance, regulating drug costs, and investing in primary care to improve access and affordability for the poor.
The document discusses the medical home model as a disruptive innovation for primary care. It proposes paying primary care physicians for coordinating patient care and managing health outcomes and costs through a medical home model. This shifts care from a specialist-focused model to a simpler, rules-based primary care model. The medical home aims to provide integrated, whole-person care through teams led by primary care physicians. It also discusses pilots of medical homes, challenges, and the potential for cost savings through reduced errors, care gaps, and procedures.
Greece: Primary Care in a time of crisis. 2nd VdGM Forum, Dublin 2015Evangelos Fragkoulis
2nd Vasco Da Gama Movement Forum, Dublin 2015
The Effect of the Economic Crisis on the Health Systems of the peripheral countries: Greece, Ireland, Spain, Portugal and Italy.
Japan has made numerous achievements in health most notably the world’s highest life-expectancy in the past two decades, since its founding Universal Health Insurance System in 1961. However, ageing population with low-fertility rates, stagnating economy, increasing burden of NCDs and growing use of expensive technologies pose the critical challenges in service delivery and financial stability in health. Japan HiT reports current health system reforms undertaken and also recent discussion on paradigm shift to the new system as proposed in Japan Vision: Health Care 2035.
The document analyzes health care access in Bangladesh using data from a survey of 664 households. It investigates the determinants of illness, choice of health care provider, and household out-of-pocket health expenditures. The summary is:
- The study uses survey data from 664 Bangladeshi households to analyze factors that influence illness, choice of health care provider, and household health care spending.
- Independent variables include individual characteristics, illness conditions, health facility attributes, household characteristics, environment, and economic status. Dependent variables include illness, choice of provider, and out-of-pocket expenditures.
- Preliminary univariate analysis of the survey data shows that 59% of respondents were young adults
Similar to 3 Country Presentation For Vientiane Conference (20)
The scale and scope of private contributions to health systemsIDS
This presentation was given at a session at the Global Symposium on Health Systems Research in November 2010. Panelists included Ruth Berg, Gerry Bloom, Birger Forsberg, Kara Hanson, Gina Lagomarsino, Dominic Montagu, Stefan Nachuk
Presentation on the literature review of interventions to improve health care...IDS
This presentation was given in a Future Health System Consortium organised session at the Global Symposium on Health Systems Research in November 2010. The author is Alex Rowe from the Centers for Disease Control and Prevention.
Evidence on Improving Health Service Delivery in Developing CountriesIDS
This presentation by David Peters of the Future Health Systems Consortium was given at the Global Symposium on Health Systems Research in November 2010.
Pathways to Scaling up Health Services in Complex Adaptive SystemsIDS
This presentation by Ligia Paina & David Peters was given as part of a Future Health System Consortium session at the Global Symposium on Health Systems Research. It is part of our Beyond Scaling Up stream of work.
The Parliamentarians’ Perception of the Public Health Sector in Afghanistan IDS
This document summarizes a survey of Afghan parliamentarians on their perceptions of the public health sector. Key findings include:
- Most parliamentarians agreed that the quality and amount of health services have improved but disagreed that people are happy with services or know what the Ministry is doing.
- Top health problems were seen as child health, maternal health, and mental health.
- Resources should focus on both rural and urban areas.
- User fees should not be implemented in clinics or hospitals.
- The health sector budget should be increased from 10% actual to 19% recommended.
Institutional Analysis of the Ministry of Public Health at Central and Provin...IDS
The document summarizes the findings of an institutional analysis of the Ministry of Public Health in Afghanistan at the central and provincial levels. It identifies strengths and challenges in key stewardship functions like setting strategies, developing technical guidelines, coordination, budgeting, monitoring and evaluation. It provides recommendations to address gaps in policies, guidelines, capacity and resources to help the Ministry strengthen its stewardship role over the health sector.
Implementing Rapid Medical Security reform in China: Importance of a Learning...IDS
A presentation by Zhenzhong ZHANG and Yunping WANG of the China National Health Development Research Center. This was given at a Future Health Systems Consortium organised event at the Global Symposium on Health System Research.
This presentation was given by Zhenzhong ZHANG and Yunping WANG of the China National Health Development Research Center at the Global Symposium on Health System Research.
Making the right to health a reality to Indigenous People in Brazil IDS
The document summarizes Brazil's efforts to provide universal healthcare coverage, particularly for indigenous peoples, through its public health system (SUS). It discusses how the SUS expanded coverage from 1.1 million people in 1994 to 96.1 million in 2009, and reduced infant mortality rates from 47.1 to 19.3 per 1000 births from 1990 to 2007. It also notes indigenous peoples still face health inequities, with infant mortality rates of 22.9 for whites, 34.9 for blacks, and 51.14 for indigenous peoples. The document outlines Brazil's creation of an Indigenous Health Subsystem in 1999 to decentralize services and improve quality and access for indigenous communities, but notes challenges remain around uneven health gains and centralization.
This presentation was given at the Global Symposium on Health System Research in November 2010. The authors are L P Singh, Olakunle Alonge, Anubhav Agarwal,
Kayhan Natiq, S D Gupta and David Peters.
What must be done?Capacity building for health systems research in low & mid...IDS
This presentation was given in plenary by Sara Bennett of the Future Health Systems Consortium at the Global Symposium on Health Systems Research, November 2010.
IMPROVING HEALTH SERVICE DELIVERY IN DEVELOPING COUNTRIES: FROM EVIDENCE TO ...IDS
This presentation was given by David Peters, Sameh El-Saharty, Banafsheh Siadat, Katja Janovsky, and Marko Vujicic at the Global Symposium on Health Systems Research, November 2010.
The document summarizes a program in Northern Nigeria aimed at improving health outcomes through strengthening governance and service delivery. It discusses the political and historical context, outlines the program's goals and theories of change, describes early successes like establishing an integrated local health system board, and concludes that achieving health system reform requires addressing both technical and political factors through multifaceted engagement strategies tailored to the local context.
This document discusses informal markets for health in Bangladesh. It finds that informal providers, like village doctors and drug sellers, make up a large share of the healthcare market, especially in rural areas, due to limited formal public services. Medical representatives are an important source of drug information for informal providers. They provide incentives to village doctors that can encourage overprescription. The study also examines the informal market for sexual and reproductive health services. Both men and women frequently visit informal providers like village doctors and drug sellers for common health issues, and spend a significant portion of their income on treatment.
This presentation was given at the 'Beyond Scaling Up: Pathways to Universal Access' workshop which was held at the Institute of Development Studies, Brighton on the 24-25 May, 2010. This event was co-sponsored by the Future Health Systems Research Programme Consortium and the STEPS Centre. Mackintosh presented on supply chains.
Beyond Scaling Up: Universal Access to Effective Malaria Prevention and Treat...IDS
This document discusses strategies for achieving universal access to effective malaria prevention and treatment. It argues that a mixed model approach is needed, using both public and private sector engagement. For prevention, long-lasting insecticidal nets (LLINs) distributed through both mass campaigns and routine channels can rapidly increase and sustain high coverage levels. Price support for LLINs sold in the commercial sector can help increase access, competition, and market sustainability over the long term. The goal is for vulnerable groups to be protected through both public and private health services.
This presentation was given at the 'Beyond Scaling Up: Pathways to Universal Access' workshop which was held at the Institute of Development Studies, Brighton on the 24-25 May, 2010. This event was co-sponsored by the Future Health Systems Research Programme Consortium and the STEPS Centre. Simmons presented on the work of ExpandNet.
This presentation gives a clear explanation of hemodynamics and cardiac electrophysiology which will be helpful for students of bpharmacy sem 5 as a part of the pharmacology. the presentation is explained diagramatically which makes ease for the students.
principles underlying microarray technology, explores the various types of mi...bniranjan0010
This PowerPoint presentation is designed to help students gain a comprehensive understanding of microarrays. It delves into the fundamental principles underlying microarray technology, explores the various types of microarrays, and provides a detailed overview of the procedures involved in their use. Additionally, the presentation examines the advantages and disadvantages of microarrays, offering a balanced perspective on their utility. Finally, it highlights the wide range of applications for microarray technology, showcasing its significance in various scientific and medical fields.
Principles of Cleaning
Nonsurgical root canal treatment is a predictable method of retaining a tooth that otherwise would require extraction. Success of root canal treatment in a tooth with a vital pulp is higher than that of a tooth that is necrotic with periradicular pathosis. The difference is the persistent irritation of necrotic tissue remnants, and the inability to remove the microorganisms and their by-products. The most significant factors affecting this process are tooth anatomy and morphology, and the instruments and irrigants available for treatment. Instruments must contact and plane the canal walls to debride the canal.
Morphologic factors such as lateral and accessory canals, canal curvatures, canal wall irregularities, fins, cul-de-sacs, and isthmuses make total debridement virtually impossible. Therefore the goal of cleaning not total elimination of the irritants but it is to reduce the irritants.
Currently there are no reliable methods to assess cleaning. The presence of clean dentinal shavings, the color of the irrigant, and canal enlargement three file sizes beyond the first instrument to bind have been used to assess the adequacy; however, these do not correlate well with debridement. Obtaining glassy smooth walls is a preferred indicator. The properly prepared canals should feel smooth in all dimensions when the tip of a small file is pushed against the canal walls. This indicates that files have had contact and planed all accessible canal walls thereby maximizing debridement (recognizing that total debridement usually does not occur).
Principles of Shaping
The purpose of shaping is to
1) facilitate cleaning and
2) provide space for placing the obturating materials.
The main objective of shaping is to maintain or develop a continuously tapering funnel from the canal orifice to the apex. This decreases procedural errors when cleaning and enlarging apically. The degree of enlargement is often dictated by the method of obturation. For lateral compaction of gutta percha the canal should be enlarged sufficiently to permit placement of the spreader to within 1-2 millimeters of the corrected working length. There is a correlation between the depth of spreader penetration and the apical seal.5 For warm vertical compaction techniques the coronal enlargement must permit the placement of the pluggers to within 3 to 5 mm of the corrected working length.6
As dentin is removed from the canal walls the root is weakened.7 The degree of shaping is determined by the preoperative root dimension, the obturation technique, and the restorative treatment plan. Narrow thin roots such as the mandibular incisors cannot be enlarged to the same degree as more bulky roots such as the maxillary central incisors. Post placement is also a determining factor in the amount of coronal dentin removal.
Introduction of mental health nursing, Perspective of mental health and mental health nursing, Evolution of mental health services, treatment and nursing practices Mental health team, Nature and scope of mental health nursing, Role & function of mental health nurse inn various settings and factors affecting the level of nursing practice, concept of normal and abnormal behavior
Co-Chairs, Hussein Tawbi, MD, PhD, and Prof. Christian Blank, MD, PhD, discuss melanoma in this CME activity titled “Deploying the Immune GAMBIT Against Melanoma: Guidance on Advances and Medical Breakthroughs With ImmunoTherapy.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at https://bit.ly/4edfNpE. CME credit will be available until July 5, 2025.
Regenerative Medicine in Chronic Pain ManagementReza Aminnejad
Regenerative technologies are the future of medicine. The current clinical strategy focuses primarily on treating the symptoms but regenerative medicine seeks to replace tissue or organs that have been damaged by age, disease, trauma, or congenital issues.
Are you ready to reap the benefits of this best magnesium supplement now? Visit us today to learn more about its health and vitality benefits.
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As a leading rheumatologist in Chandigarh, Dr. Aseem specializes in the diagnosis and management of a wide range of rheumatic conditions, including but not limited to:
Rheumatoid Arthritis: An autoimmune disorder that causes chronic inflammation of the joints.
Osteoarthritis: A degenerative joint disease characterized by the breakdown of cartilage.
Lupus: A systemic autoimmune disease that can affect the skin, joints, kidneys, and other organs.
Ankylosing Spondylitis: A type of arthritis that primarily affects the spine, causing pain and stiffness.
Gout: A form of arthritis characterized by sudden, severe attacks of pain, redness, and tenderness in the joints.
Psoriatic Arthritis: A type of arthritis that affects some people with psoriasis.
Vasculitis: An inflammation of the blood vessels that can cause a variety of symptoms.
Sjogren’s Syndrome: An autoimmune disorder characterized by dry eyes and mouth.
Accurate diagnosis is crucial for effective treatment. Dr. Aseem Goyal utilizes advanced diagnostic techniques to identify the underlying causes of rheumatic conditions. Our state-of-the-art facility is equipped with the latest technology to provide comprehensive diagnostic services, including:
Blood Tests: To check for markers of inflammation and autoimmune activity.
Imaging Studies: Such as X-rays, MRI, and ultrasound to assess joint and soft tissue damage.
Joint Fluid Analysis: To examine the fluid in the joints for signs of inflammation or infection.
Biopsy: In certain cases, a small tissue sample may be taken for further examination.
Treatment Approaches
Dr. Aseem Goyal adopts a holistic and patient-centered approach to treatment. Depending on the specific condition and its severity, treatment options may include:
Medications
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): To reduce inflammation and relieve pain.
Disease-Modifying Antirheumatic Drugs (DMARDs): To slow the progression of rheumatic diseases.
Biologic Agents: Targeted therapies that block specific pathways in the immune system.
Corticosteroids: To control severe inflammation quickly.
THE MANAGEMENT OF PENILE CANCER. PowerPointBright Chipili
This PowerPoint includes all the relevant information and science about penile cancer and its management. Information is based on Campbell 12th edition and EAU 2024 updated guidelines.
A medical treatment that uses high doses of radiation to kill cancer cells or shrink tumors by damaging their DNA. When the DNA is damaged, cancer cells can no longer divide and grow, and they eventually die.
The Revolutionary Nature of Needleless Double Transfer Spikes in HealthcareNanchang Kindly Meditech
It's likely that you have witnessed medical personnel using needles to transmit fluids or medicines if you have ever visited a hospital or other healthcare facility. But as technology advances, needleless double transfer spikes are becoming more and more common and revolutionizing the delivery of healthcare.
General Endocrinology and mechanism of action of hormonesMedicoseAcademics
This presentation, given by Dr. Faiza, Assistant Professor of Physiology, delves into the foundational concepts of general endocrinology. It covers the various types of chemical messengers in the body, including neuroendocrine hormones, neurotransmitters, cytokines, and traditional hormones. Dr. Faiza explains how these messengers are secreted and their modes of action, distinguishing between autocrine, paracrine, and endocrine effects.
The presentation provides detailed examples of glands and specialized cells involved in hormone secretion, such as the pituitary gland, pancreas, parathyroid gland, adrenal medulla, thyroid gland, adrenal cortex, ovaries, and testis. It outlines the special features of hormones, differentiating between peptides and proteins based on their amino acid composition.
Key principles of endocrinology are discussed, including hormone secretion in response to stimuli, the duration of hormone action, hormone concentrations in the blood, and secretion rates. Dr. Faiza highlights the importance of feedback control in hormone secretion, the occurrence of hormonal surges due to positive feedback, and the role of the suprachiasmatic nucleus (SCN) of the hypothalamus as the master clock regulating rhythmic patterns in biological clocks of neuroendocrine cells and endocrine glands.
The presentation also addresses the metabolic clearance of hormones from the blood, explaining the mechanisms involved, such as metabolic destruction by tissues, binding with tissues, and excretion by the liver and kidneys. The differences in half-life between hydrophilic and hydrophobic hormones are explored.
The mechanism of hormone action is thoroughly covered, detailing hormone receptors located on the cell membrane, in the cell cytoplasm, and in the cell nucleus. The processes of upregulation and downregulation of receptors are explained, along with various types of hormone receptors, including ligand-gated ion channels, G protein–linked hormone receptors, and enzyme-linked hormone receptors. The presentation elaborates on second messenger systems such as adenylyl cyclase, cell membrane phospholipid systems, and calcium-calmodulin linked systems.
Finally, the methods for measuring hormone concentrations in the blood, such as radioimmunoassay and enzyme-linked immunosorbent assays (ELISA), are discussed, providing a comprehensive understanding of the tools used in endocrinology research and clinical practice.
Interventional radiology is a medical specialty that uses imaging techniques, such as X-rays, CT scans, and ultrasound, to guide minimally invasive procedures to diagnose and treat a variety of conditions. These procedures can be an alternative to open surgery, often resulting in shorter recovery times for patients.
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Hemodialysis: Chapter 12, Venous Catheter: Complications (Diagnosis and Manag...
3 Country Presentation For Vientiane Conference
1. Conference Health and social protection: Meeting the needs of the poor Vientiane 2008 Cambodia, China and Lao PDR Initial thoughts from POVILL www.povill.com
3. We will report on… Different types of major illness affecting household livelihoods Health-seeking behaviors Coping strategies to finance health care expenditure Impact of HEF on hospital utilization
4. Three level health system with first level organized in health district (health centers and referral hospital) Public health services are highly subsidized Public health facilities adopt “flat fees” charging system Staff working in public health facilities have modest economic incentive Most staff earn their living by dual practices Private practices are loosely regulated Cambodian Health Care System
10. Self-reported serious illness last year N= 33,161 Total number of individual in sample Percentage of reported serious illness Mongkol Borei 11,495 13.82% Sotr Nikum 10,950 14.94% Kirivong 10,716 16.48% Average over three ODs 15.05%
11. Major illness includes more than inpatient care N=4992 Total number of Individual in Sample (M.I.) Received Inpatient treatment Mongkol Borei 1589 29.64% Sotr Nikum 1637 30.05% Kirivong 1766 29.38% Average over three ODs 29.68%
12. Working days lost due to serious illness N= 4992 Frequency Percentage no working days lost 426 11.51% 1-5 workdays lost 343 9.26% 6-10 workdays lost 550 14.86% 11-15 workdays lost 421 11.37% 16-30 workdays lost 696 18.80% >30 workdays lost 1265 34.17% Children 1291 25.86%
13. A highly fragmented health system Distribution of health seeking behaviors over respective providers (30 days recall period), RHS Public sector: 18%
14. Different incentives for health professionals with dual practices in public and private settings (n=55)
16. Coping strategies with major illness Frequency Percent Using saving 86 1.4 Reduce food expenditures 24 0.4 Remove children from school 19 0.3 Sell stored food 319 5.3 Sell household assets 99 1.7 Sell production tools 206 3.4 Sell livestock 317 5.3 Sell land 93 1.6 Borrow money from friends/relatives 911 15.2 Borrow money from informal money lender 1,594 26.7 Borrow money from credit institute 234 3.9 Seek additional work 615 10.3 Total of HH reported severe financial problem due serious illness 3,068 (51% total sample)
17. Redressing health seeking behaviors: HEF as part of the solution? HEF is a mechanism or fund that is operated by an independent organisation in the interest of poor people, purchases health care for those poor people (from a public health care provider), and also pays for all the associated costs (from non-medical providers). Independent = purchaser-provider split , the organisation does not belong to the Ministry of Health.
18. Functions of HEF -> Local NGOs are particularly suited to perform these various functions
20. HEF boosts utilization of public hospitals (Logistic regression (of likelihood to go to public hospitals (vs other option) for seriously ill people who got the advice from a qualified expert to seek inpatient care (N=1567) RHS) Odds for a HEF card holder to go to the public hospital are 2.4 higher than someone with a same profile without a HEF card!
21. Conclusion Illness is a major burden for rural households (suffering, health care expenditures, lost days…). Several factors have led to a fragmentation of the Cambodian health system. Many providers are loosely regulated; this leads to unsatisfactory quality of care, irrationnal prescription and unnecessary health care expenditure. Due to coping mechanisms adopted by households, households can be tipped into poverty. Health equity funds (and the civil society) can be part of the solution to this problem. Yet, other measures are needed: improve quality of service and care in public facilities to attract users, maintain a system of public hospitals close to the rural population and regulate private health care facilities, including informal providers.
22. More to come More analysis on RHS and In-depth data Further analysis or follow-up study on households with chronic diseases More analysis on informal health providers
24. Quantitative Research: Major Research questions and methods Research questions Dependent variables Independent variables Samples collected Impact of Major illness on household livelihood Household livelihood Major illness Coping strategies Rapid Household survey: 12000 HH In-depth Interview: 600HH NCMS ’ effect on the out-of-pocket inpatient care expenses. NCMS ’ effect on utilization of inpatient service among rural residents. Medical expenditure Out-of pocket payment Inpatient care schemes As above Unnecessary care and drug, and unnecessary cost to the poor Unnecessary drug, tests, services Poor/non-poor 3 tracer conditions 628 inpatient care Impact of scheme on unnecessary care, drug Unnecessary drug, test and services With/wo scheme As above
26. 1 Diversity of Major Illness Concept/definition, Perception from different actors Complicated concept: economically, socially, medically Household perception in terms of inpatient care; large amount of money spent; long time drugs-taken; disabled; great amount of working days lost NCMS: not adequate response
27. Outpatient and inpatient use for selected serious illness groups Type of serious illness Percent using inpatient treatment Percent using only outpatient services Percent other Circulatory 13.5 60.5 25.9 Respiratory 16.6 62.6 20.9 Digestive 16.5 57.8 25.7 Urinogenital 15.2 65.2 19.6
28. 2 Demographic changes and its implication for healthcare intervention Household composition and out migration Changing patterns of household composition: Unit of analysis Migrant labor and their health seeking behavior: Scheme: population targeted Impact of changing demographic pattern on household health seeking behavior and their livelihoods Preliminary findings from household study in China
30. The distribution of the social economic situation of households by NCMS ● The poorest were less inclined to be covered by NCMS
31. Method Multiple Linear regression Result The effect of NCMS participation on out-of-pocket expenses of hospitalization of households with major illness is not statistically significant ( P >0.05).
32. Method Two-level logistic regression Result The effect of NCMS on utilization of hospital service of households with major illness is not statistically significant ( P >0.05)
33. Different household social economic status of MFA targets 0.66% of the poorest households were covered by MFA The overall coverage rate(0.31%) is low
35. Regression of log transformed total cost of pneumonia +: P <0.1; *: P <0.05; **: P <0.01; ***: P <0.001 NCMS: New Cooperative Medical Scheme Model 1 Model 2 Model 3 Model 4 Economic status (Ref.: Low) Middle 0.240* 0.230* 0.176+ 0.195* High 0.386** 0.375** 0.279* 0.312* Facility level (Ref.: County hospital) Township Health centre -0.801** -0.701* -0.652* Health insurance (Ref.: No insurance) NCMS -0.299* -0.273* Other insurance -0.234+ -0.166 Doctor education level (Ref.: <3) 3 -0.080 >=5 0.000 Age of the patient -0.114* Squared age 0.015* _cons 6.491** 6.533** 6.782** 6.777** N 207.000 207.000 199.000 201.000
39. Qualitative research Major Research questions and methods Research Questions Methods Policy process of the NCMS and MFA at national level; Impact of the policy context and the interplay of relevant stakeholders on policy process - Literature and record review: documents/published paper/gray report/ news; Key informants interview : officials from MOH, MOCA, MOF; hospital managers; Focus group discussion: rural residents - Participatory observation: policy seminar by MOCA, workshops
40. Qualitative research --Main findings Rural health policy process: response to the transitional context of China - unequal share of the resources distributed; - unequal access to essential health care; - political priority shift to harmonious development; - rising concern on rural health development; - more revenues to support Stakeholder analysis: - political elites & academic elites: significant role - the media: active in shaping public opinion - rural residents: passive recipients of policies Formal/informal mechanisms: not sufficiently to voice out the interest of rural residents
41. “ Its not the end, its just the end of beginning” ----Churchill With the unique datasets, More findings are coming 6000 household survey 600 household In-depth interview
42. Next steps To Provide the evidence by Dealing with selection bias Dealing with confounding factors To Influence evidence-based policy making process to Improve better targeting of scheme Improve design and implementation of schemes Improve provider’s performance for cost-effective services
44. Topics to be covered in the presentation Country profile Enforcement of medical law Findings from the research into the level and causes of household poverty and health seeking behaviour Analysis of the way in which the Health Equity Fund is working Some findings related to provider performance Further issues to be explored
45. Country Profile & Health Indicators Population: 5.82 millions (2007) GDP 701US$ per capita (2007) GDP annual growth rate: 7.9% (2007) 30% of the population under poverty line (2005) Life expectancy 61 years (female 62, male 59) (2005) IMR 70 per 1000 live births (2005) U5MR 98 per 1000 live births (2005) MMR 405 per 100.000 live births (2005) Data source: National report 2006-07 and National census 2005.
46. National Health Expenditure 3.6% of GDP in 2005 17.5 USD per capita in 2005 - Out of pocket: 79.8 % of THE - Donor: 11.3 % of THE - Domestic Gov. : 8.9% of THE GGE on Health as % of GGE: 4.6% Social security fund as % of GGHE: 11.2% Data source: NHA unit, EIP/HSF/CEP, WHO, Geneva 2007
47. Transform of Medical Law into practice Lao has a strong legal framework to protect poor people from catastrophic illness. However, Law dissemination is yet saturated in public and whose responsibility is not clear, Institutional arrangement to enforce the Law’s implementation is yet sufficient, Fee exemption for poor is not standardized, Inconsistent in identifying poverty level in different sectors.
48. Graph 1: Percentage of number of poor households officially recognized ( N= 3000 HHs )
49. Graph 2 : Comparison of Percentage of main reasons of being poor among 9% of poor (n = 270 recognized as poor households) a = Poor environment (e.g. unfertile soil, no land, natural disaster, crops damage by wild animals e.g. insects and mice…) b = Labor shortage c = Many dependents d = Illness / disability e = Other
50. Rapid HH Survey [ in general ] (n=3000hh) : In-Dept Studies [ serious illness ] (n=150hh) . Self Treatm. Out Patient In Patient . Type of facility No ( n=809) (%) No (n=70hh) (%) No(n=99hh) (%) No(n=99hh) (%) 1. Govt. hospital : 353 43.64 15 21.5 65 65.6 65 65.6 a. Provincial Hospital : 138 17.1 9 12.9 44 44.4 44 44.4 b. District Hospital ] : 215 26.6 6 8.6 21 21.2 21 21.2 2. Govt. primary facility: 101 12.5 3 4.3 11 11.1 11 11.1 [ Health center ] 3. Private facility : 30 3.7 7 10 2 2 2 4. Pharmacy: 182 22.5 33 47.1 3 3 3 5.. TBA/VHW : 19 2.3 1 1.4 3 3 3 3 6. Drugstore/shop/trader : 4 0.5 0 0 0 0 0 0 7. Traditional healer : 14 1.7 9 12.9 4 4.04 4 4.04 8. Religious faith healer : 4 0.5 1 1.4 2 2 2 2 9. Other : 94 11.6 1 1.4 9 9.1 9 9.1 10. Did not seek care: 8 0.9 0 0 0 0 0 0 Total 809 100 70 100 99 100 99 100 Remarks : 1. Poor households : 9% ( out of 3000 hh ) 2. Death: n = 90 persons =>0.53% out of 17 093 persons 3. Serious health problem no treated because of cost: n = 102hh =>47.67 (out of 214 hh get serious health problem [ n = 219 persons] ) Health seeking behavior of people in the last month before the survey
51. Health seeking behavior of people with severe illnesses Type of facilities Number of Households (n = 3000 ) Percent ( %) 1. Central hospital : 51 1.7 2. Provincial hospital : 712 23.7 3. District Hospital : 1545 51.5 4. Health Centre : 440 14.67 5. Private clinic : 75 2.5 6. Outside country : 10 0.3 7. Other ** : 167 5.63 Total 3000 100 . Remark : Specified places ** : 1. Military hospital : 81 HH => 48.51% out of 167 HH 2. Traditional medicine : 40 HH => 23.96 % ; 3. Pharmacy : 12 HH => 7.19% .
52. Coverage of Health Equity Fund General poverty level: Three different situation from Sepone (very poor but changing very fast) to average rural situation (Nambak) and low poverty rate (in Vientiane Province but ranging from 1 to 15% across districts) HEF coverage: Lower rate of HEF pre-identification in Nambak and Vientiane Province versus general poverty level defined by government (30% in 2005) Decrease HEF in Nambak, and stable in Vientiane and Sepone * NGPES = National Growth and Poverty Eradication Strategy
53. HEF by Wealth index. Study sites: Nambak, Vangvieng and Sepone HEF Bénéficiaires (n=88) HEF Non Bénéficiaires (n=1412) Source: RHS
54. Utilization of HEF OPD: Visible positive impact of HEFB in Nambak and Vientiane Province IPD: Visible positive impact of HEFB in the 3 HEF Schemes
55. Costs Yearly data (Nambak, Vientiane province: 2007, Sepone: 2007/08) Nambak district Vientiane Province (11 districts) Sepone district Total benefits/year $19,717 $54,896 $19,108 total benefits/HEFB capita HEF Pre-id: $2,3; HEF Post-id: $1,9 HEF Pre-id: $2,8; HEF Post-id: $2,2 HEF Pre-id: $1,7 % OPD-IPD 12% vs 88% 19% vs 81% 18% vs 82% % medical fees-transport-others 82% vs 16% vs 2% 74% vs 13% vs 13% 82% vs 11% vs 7%
56. Knowledge on types of services for free with the HEF members Knowledge on benefits of HEF HEF Beneficiaries NEF NB N % N % Free medical services 78 98.7 470 98.5 Free food and soap while hospitalized 24 30.4 213 44.7 Free ambulance transportation to upper level 36 45.6 188 39.4 Free transportation back home of a relative’s body dead while hospitalized 34 43.0 147 30.8 Other (Room) 1 2.6 3 0.6
57. Provider performance No significant differences in treating poor and non poor patients Use of Essential Medicines is high in treating pneumonia 95% in poor patient (T1), 94% in near poor (T2) and 100% in non poor (T3) Unnecessary cost may not be high since many Essential Medicines prescribed
58.
59. Provider performance continued However informal payment was 32% considered as unnecessary cost Access to health care for the poor may be a problem as expressed by one villager: “ having no money for the care cost I would prefer dying at home rather than going to hospital”
60.
61. Issues for further exploration How do we increase knowledge amongst potential users of the benefits of the Health Equity Fund beyond free medical care? Should we extend the Health Equity Fund to the 15% of the population classed as very poor who are not currently covered? How? How can we encourage patients to utilise health centres? What is the optimum strategy for preventing the misuse of the Health Equity Fund? What institutional arrangement should be seriously made to enforce the medical law?