2014 Immunizations in Iowa, Iowa Immunization Program Annual Report, January 11, 2016

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.

Looking in the wrong place for healthcare improvements: a system dynamics study of an accident and emergency department

Accident and Emergency (A&E) units provide a route for patients requiring urgent admission to acute hospitals. Public concern over long waiting times for admissions motivated this study, whose aim is to explore the factors which contribute to such delays. The paper discusses the formulation and calibration of a system dynamics model of the interaction of demand pattern, A&E resource deployment, other hospital processes and bed numbers; and the outputs of policy analysis runs of the model which vary a number of the key parameters. Two significant findings have policy implications. One is that while some delays to patients are unavoidable, reductions can be achieved by selective augmentation of resources within, and relating to, the A&E unit. The second is that reductions in bed numbers do not increase waiting times for emergency admissions, their effect instead being to increase sharply the number of cancellations of admissions for elective surgery. This suggests that basing A&E policy solely on any single criterion will merely succeed in transferring the effects of a resource deficit to a different patient group.

Inquérito de saúde: condições de vida e usos de serviços de saúde das mães e crianças de Botucatu-SP, 2001-2002

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Cancelamento de cirurgias de catarata em um hospital público de referência

OBJETIVO: Analisar a incidência e causas de cancelamento de cirurgias de catarata em um hospital público de referência. MÉTODOS: Trata-se de um estudo retrospectivo em que foram analisados o número de cancelamentos de facectomias durante o ano de 2009. Foram analisados sexo, idade, tipo de procedimento suspenso (facoemulsificação ou extração extracapsular do cristalino), tipo de anestesia, convênio (Sistema Único de Saúde ou convênio/particular) e motivo de suspensão da cirurgia (causas clínicas, institucionais ou pessoais). RESULTADOS: Foram agendadas no período 2.965 cirurgias de catarata, havendo 650 cancelamentos (21,92%). Dentre as principais razões para a suspensão do procedimento destacaram-se as causas clínicas (86,90%). Os meses de inverno apresentaram os maiores índices de suspensão de cirurgias de catarata. CONCLUSÃO: A taxa de cancelamento de cirurgia de catarata em serviços públicos parece ser a mesma que há 10 anos. A principal causa de suspensão deve-se por condições clínicas (hipertensão, diabetes, falta de exames, etc.).

Beneficencia, medicina e higiene /

Mode of access: Internet.

Informe.

Description based on: 1910.

Annual report /

Some reports issued in combined form: 1931/32-1934/35; 1942/43-1946/47; 1949/50-1950/51.

Iowa Immunization Program Annual Report 2013, April 30, 2014

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.

Performance evaluation of hospitals that provide care in the public health system, Brazil

OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System.METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction.RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed.CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

Chronic disease prevention and health promotion. Public policies and social network analysis of the hospitals services and oyhers health and social organizations to support joint action for children with diabetes

Comunicação apresentada na 18th Conference International of Health Promotion Hospitals & Health Services "Tackling causes and consequences of inequalities in health: contributions of health services and the HPH network", em Manchester de 14-16 de april de 2010

Was ageing a cause for the increase in hospitalization costs, in the Portuguese public hospitals, between 1994 and 2010?

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Access of WetAMD and DME patients to treatment in public hospitals

Degeneration (WetAMD) and Diabetic Macular Edema (DME) patients’ access to treatment in public hospitals, by identifying bottlenecks and stress points that prevent timely and adequate care to patients who suffer from a degenerative disease, and consequently for whom the lack of access to treatment can have disastrous consequences. Considering the specificity and degenerative traits of these conditions, the long queues for specialty appointments in public hospitals are a significant threat to patients’ health, as the disease may be misdiagnosed and or progress significantly, causing unnecessary permanent and non-reversible loss in visual acuity. Therefore optimizing the patient journey will increase patients’ access to adequate treatment, and prevent avoidable progress of a degenerative condition which causes permanent and non-reversible blindness. Following the investigation which supports this thesis, the patient journey was broken down into its different phases, so that key issues could be identified, and referred back to the main stress points highlighted during the interviews with physicians and administrators. Finally results were scrutinized and systematized, and a set of action points was proposed, considering what may cause major impact and is actually feasible to implement.

Value for Money and Policy Review of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals - Final Report

This Value for Money and Policy Review (VFM&PR) of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals was initiated by the Department of Health and Children in June 2009 and was conducted under the auspices of the Governmentâ?Ts Value for Money & Policy Review Initiative 2009-2011. The Review was overseen by an independently chaired National Steering Group comprised of senior representatives from the Department of Health and Children, the Department of Finance, and the Health Service Executive (HSE). Download document here Download Explanatory Note  

Value for Money and Policy Review of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals - Interim Report

This report sets out a revised costing methodology and an estimate of the gap which currently exists between private and semi-private bed charges and the average economic cost. While the Steering Group considers the costing methodology proposed as an improvement on the approach taken in previous years and a good overall approximation of the difference on average between economic costs and current charges, it recognises that the current charging regime does not take sufficient account of the variation between different categories of patient. Download document here Note to Readers

A comparative study of congenital toxoplasmosis between public and private hospitals from Uberlândia, MG, Brazil

The main purpose of the present study was to examine if there is difference in terms of incidence rates of congenital toxoplasmosis among populations assisted in public and private hospitals from Uberlândia, state of Minas Gerais, Brazil. A total of 805 serum samples from cord blood were collected, being 500 from public hospital and 305 from private hospital, and all patients answered a questionnaire about pregnancy and newborns. An indirect enzyme linked immunosorbent assay (ELISA) was performed to detect IgG antibodies to Toxoplasma gondii and the positive samples were retested to verify the presence of specific IgM and IgA antibodies in a capture ELISA. We found significant differences among data from both hospitals with respect to maternal age, origin city, gestational age, number of visits to physicians during pregnancy, type of delivery, and birth weight. Seroprevalence of IgG antibodies against T. gondii for patients from public and private hospitals was 57.6% and 41.9% respectively, and this difference was statistically significant (P < 0.0001). In addition, the frequency of congenital toxoplasmosis measured by the presence of IgM and/or IgA antibodies toward T. gondii was exclusively located in samples from public hospital (0.8%), and no positive sample was seen in private hospital (0%). Considering that almost all babies suffering from congenital toxoplasmosis, if undiagnosed and untreated, will develop visual or neurological impairments by adulthood, the results presented herein emphasized the importance to accomplish screening programs for toxoplasmosis during pregnancy, particularly in the public hospitals, due to the expressive rate of congenital disease showed in the patients attended at these centers.