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This study examines cesarean section (C‐section) deliveries in Ghana from 2008 to 2017 in 10 regions, distinguishing between scheduled and emergency procedures. Scheduled C‐sections target specific maternal conditions, such as advanced age, multiparity, and medical history, while emergency C‐sections address acute fetal distress, preeclampsia, bleeding, and other urgent situations. The analysis reveals various regional patterns, with the Brong‐Ahafo Region showing a potential deceleration after 2017 and the Upper West Region indicating a possible acceleration. The high number of C‐sections in Greater Accra and Ashanti may be related to population density and health facilities. The study proposes empirical models, including linear, quadratic, and exponential components, emphasizing quasilinearity. The exponential model suggests transient and permanent phases of cesarean frequency, with the latter dominated by quasilinearity. Optimal parameter values are determined, which highlights the stability of the model. However, caution is advised when projecting too far into the future due to the inevitable slowing of observed trends. The findings offer insights for healthcare planning, resource allocation, and policymaking, emphasizing the need for region‐specific approaches and ongoing monitoring of cesarean dynamics to inform nuanced interventions. [ABSTRACT FROM AUTHOR]

Healthcare human resource planning is one of the biggest challenges facing the healthcare systems in many countries. Inadequate decisions in human resource planning can lead to an insufficient number of healthcare professionals then healthcare inequalities. One of the components of resource planning in the healthcare system is long-term data monitoring and the identification of potential trends. Since 1990, the number of physicians in Lithuania has decreased by 15.3% (−2266), but the decrease in the population has led to a 13.61% increase in the number of physicians per 10,000 inhabitants (5.32). During the analyzed period, the largest decrease in the number of physicians workforce by specialty was the number of medical physicians (−73.08%), epidemiology and hygiene (−69.30%), children's diseases (−49.08%), the most increased number was of family/general practitioners (GPs), geneticists, physical medicine, and rehabilitation specialists. Since 1992, the number of visits to physicians in Lithuania, which has been decreasing for a long time, began increasing, and in 2022 (9.3 visits) it has almost reached the number of visits (9.5) per capita as in 1991. The aim of this research was to collect long-term data from various databases, summarize them, and identify possible trends and the reasons for data changes. The study analyzed data from the Lithuanian healthcare system from the Declaration of Independence of Lithuania to the last 30 years. The data includes or affects the indicators of the healthcare system, changes in population and doctors, the number of visits to doctors, the number of medical students and residents, and data determining inequalities in the healthcare system. Long-term data analysis is useful for developing a model of healthcare human resource planning and for planning healthcare resources. [ABSTRACT FROM AUTHOR]

Abstract Background Gravity models are often hard to apply in practice due to their data-hungry nature. Standard implementations of gravity models require that data on each variable is available for each supply node. Since these model types are often applied in a competitive context, data availability of specific variables is commonly limited to a subset of supply nodes. Methods This paper introduces a methodology that accommodates the use of variables for which data availability is incomplete, developed for a health care context, but more broadly applicable. The study uses simulated data to evaluate the performance of the proposed methodology in comparison with a conventional approach of dropping variables from the model. Results It is shown that the proposed methodology is able to improve overall model accuracy compared to dropping variables from the model, and that model accuracy is considerably improved within the subset of supply nodes for which data is available, even when that availability is sparse. Conclusion The proposed methodology is a viable approach to improve the performance of gravity models in a competitive health care context, where data availability is limited, and especially where a the supply nodes with complete data are most relevant for the practitioner.

Background: Gravity models are often hard to apply in practice due to their data-hungry nature. Standard implementations of gravity models require that data on each variable is available for each supply node. Since these model types are often applied in a competitive context, data availability of specific variables is commonly limited to a subset of supply nodes. Methods: This paper introduces a methodology that accommodates the use of variables for which data availability is incomplete, developed for a health care context, but more broadly applicable. The study uses simulated data to evaluate the performance of the proposed methodology in comparison with a conventional approach of dropping variables from the model. Results: It is shown that the proposed methodology is able to improve overall model accuracy compared to dropping variables from the model, and that model accuracy is considerably improved within the subset of supply nodes for which data is available, even when that availability is sparse. Conclusion: The proposed methodology is a viable approach to improve the performance of gravity models in a competitive health care context, where data availability is limited, and especially where a the supply nodes with complete data are most relevant for the practitioner. [ABSTRACT FROM AUTHOR]

Healthcare human resource planning is one of the biggest challenges facing the healthcare systems in many countries. Inadequate decisions in human resource planning can lead to an insufficient number of healthcare professionals then healthcare inequalities. One of the components of resource planning in the healthcare system is long-term data monitoring and the identification of potential trends. Since 1990, the number of physicians in Lithuania has decreased by 15.3% (−2266), but the decrease in the population has led to a 13.61% increase in the number of physicians per 10,000 inhabitants (5.32). During the analyzed period, the largest decrease in the number of physicians workforce by specialty was the number of medical physicians (−73.08%), epidemiology and hygiene (−69.30%), children’s diseases (−49.08%), the most increased number was of family/general practitioners (GPs), geneticists, physical medicine, and rehabilitation specialists. Since 1992, the number of visits to physicians in Lithuania, which has been decreasing for a long time, began increasing, and in 2022 (9.3 visits) it has almost reached the number of visits (9.5) per capita as in 1991. The aim of this research was to collect long-term data from various databases, summarize them, and identify possible trends and the reasons for data changes. The study analyzed data from the Lithuanian healthcare system from the Declaration of Independence of Lithuania to the last 30 years. The data includes or affects the indicators of the healthcare system, changes in population and doctors, the number of visits to doctors, the number of medical students and residents, and data determining inequalities in the healthcare system. Long-term data analysis is useful for developing a model of healthcare human resource planning and for planning healthcare resources.

The aim of this article is to highlight the significance of actively involving young children in their own healthcare and paediatric healthcare planning. Based on a study conducted in a hospital setting, which revealed a lack of personalized care and inadequate understanding among younger children, this article discusses the potential benefits of empowering young patients. The theoretical framework explores various dimensions, including child-centred care, communication strategies, child development, and the impact of involving children in decision-making processes. By fostering children’s participation and creating a safe environment, healthcare professionals can enhance the overall quality of care and promote positive health outcomes for young patients.

The ever-increasing number of hospital Emergency Department (ED) visits pose a challenge to the effective running of health systems in many countries globally and multiple strategies have been adopted over the years to tackle the plight. According to a systematic review of the available literature, of the numerous models of healthcare systems used to address the issue in western countries, the FSED Model has the greatest potential for reducing hospital ED overcrowding as it can reduce the additional load by diverting minor cases, freeing up space for more urgent cases. The aim of the study is to shed light on the Free Standing Emergency Department (FSED) model and compare it with the traditional Hospital Based Emergency Department (HBED) in international contexts. In this study, 23 papers have been collected in a literature review and the main features have been highlighted; 12 case studies have been analyzed from a layout point of view and data have been collected in terms of surfaces, functions, and flow patterns. The percentages of floor areas devoted to each function have been compared to define evolution strategies in the development of emergency healthcare models and analyses. The use of FSED models is an interesting way to face the overcrowding problem and a specific range for functional area layout has been identified. Further studies on its application in different contexts are encouraged. [ABSTRACT FROM AUTHOR]

Objective To determine the pattern of various skin disorders in Paediatric patients of Faisalabad for improving health care planning and management. Methods Patients of both genders and ages up to 14 years, presenting to the Outpatient Department of Paediatric Dermatology Children hospital / Institute of Child Health, Faisalabad over a period of one year, were included in this cross-sectional study. Their detailed history and cutaneous examination were carried out. Skin biopsies and relevant investigations were performed, where indicated, for the confirmation of diagnoses. Results A total of 24,342 children presented to the Dermatology Department. Out of those, 11,245 (46%) patients were females and 13,097 (54%) were males. Mean age noted was 6.2 ± 5.3 years. Total number of dermatoses observed was 183. Out of them, 16 dermatoses were most commonly seen and involved 89.31% of patients. Papular urticaria was the commonest disorder seen in 26.21% cases, followed by Scabies (18.29%), Folliculitis (9.1%), Impetigo (7.56%) and Atopic eczema (6.07%). Rest of the dermatoses were divided into Miscellaneous (8.23%) and Rare dermatoses (2.52%). Conclusion Dermatological disorders of paediatric patients have been overlooked for long. Better management and timely prevention of these diseases can greatly reduce burden on health care system and population at large. [ABSTRACT FROM AUTHOR]

Background: Health care planning in low-and-medium-income countries can be intellectually demanding. However, users’ centric planning approach is intuitively promising to enhance utilization, resource allocation, and strengthening of the health system. Objective: This study examines the relative importance of health status and access on intention to use the health services and the mediating role of prior experience and perceived quality of care on utilization intention. Methods: This study was a cross-sectional survey method in a suburban location in Nigeria with administration of a questionnaire on a random sample of voluntary and non-remunerated participants. The study utilized structural equation model that encompasses the relationship between these variables based on survey data from five hundred and nineteen (519) respondents. Results: The study found that access was a stronger determinant of intention to use health services than self-rated health status; in addition, negative prior experiences in the health system was found to be a disincentive to intentions to use health services. Conclusions: It seems of benefit to initiate and encourage programs that seek to improve the health care professionals’ competence in management of individual-health facilities contact experience and strengthen the bond between perceived health status and responsive attitude to use health services. Health facilities planning approach need to consider the location models that facilitate physical access and seek to deconstruct administrative barriers to obtaining care

Objectives: Coronavirus disease 2019 has put unprecedented pressure on healthcare systems worldwide, leading to a reduction of the available healthcare capacity. Our objective was to develop a decision model to estimate the impact of postponing semielective surgical procedures on health, to support prioritization of care from a utilitarian perspective.Methods: A cohort state-transition model was developed and applied to 43 semielective nonpediatric surgical procedures commonly performed in academic hospitals. Scenarios of delaying surgery from 2 weeks were compared with delaying up to 1 year and no surgery at all. Model parameters were based on registries, scientific literature, and the World Health Organization Global Burden of Disease study. For each surgical procedure, the model estimated the average expected disability-adjusted life-years (DALYs) per month of delay.Results: Given the best available evidence, the 2 surgical procedures associated with most DALYs owing to delay were bypass surgery for Fontaine III/IV peripheral arterial disease (0.23 DALY/month, 95% confidence interval [CI]: 0.13-0.36) and transaortic valve implantation (0.15 DALY/month, 95% CI: 0.09-0.24). The 2 surgical procedures with the least DALYs were placing a shunt for dialysis (0.01, 95% CI: 0.005-0.01) and thyroid carcinoma resection (0.01, 95% CI: 0.01-0.02).Conclusion: Expected health loss owing to surgical delay can be objectively calculated with our decision model based on best available evidence, which can guide prioritization of surgical procedures to minimize population health loss in times of scarcity. The model results should be placed in the context of different ethical perspectives and combined with capacity management tools to facilitate large-scale implementation. [ABSTRACT FROM AUTHOR]

The ever-increasing number of hospital Emergency Department (ED) visits pose a challenge to the effective running of health systems in many countries globally and multiple strategies have been adopted over the years to tackle the plight. According to a systematic review of the available literature, of the numerous models of healthcare systems used to address the issue in western countries, the FSED Model has the greatest potential for reducing hospital ED overcrowding as it can reduce the additional load by diverting minor cases, freeing up space for more urgent cases. The aim of the study is to shed light on the Free Standing Emergency Department (FSED) model and compare it with the traditional Hospital Based Emergency Department (HBED) in international contexts. In this study, 23 papers have been collected in a literature review and the main features have been highlighted; 12 case studies have been analyzed from a layout point of view and data have been collected in terms of surfaces, functions, and flow patterns. The percentages of floor areas devoted to each function have been compared to define evolution strategies in the development of emergency healthcare models and analyses. The use of FSED models is an interesting way to face the overcrowding problem and a specific range for functional area layout has been identified. Further studies on its application in different contexts are encouraged.

Abstract Background Recently, patient engagement has been identified as a promising strategy for supporting healthcare planning. However, the context and structure of universalistic, “one-size-fits-all” approaches often used for patient engagement may not enable diverse patients to participate in decision-making about programs intended to meet their needs. Specifically, standard patient engagement approaches are gender-blind and might not facilitate the engagement of those marginalized by, for example, substance use, low income, experiences of violence, homelessness, and/or mental health challenges—highly gendered health and social experiences. The project’s purpose was to develop a heuristic model to assist planners to engage patients who are not traditionally included in healthcare planning. Methods Using a qualitative research approach, we reviewed literature and conducted interviews with patients and healthcare planners regarding engaging marginalized populations in health services planning. From these inputs, we created a model and planning manual to assist healthcare planners to engage marginalized patients in health services planning, which we piloted in two clinical programs undergoing health services design. The findings from the pilots were used to refine the model. Results The analysis of the interviews and literature identified power and gender as barriers to participation, and generated suggestions to support diverse populations both to attend patient engagement events and to participate meaningfully. Engaging marginalized populations cannot be reduced to a single defined process, but instead needs to be understood as an iterative process of fitting engagement methods to a particular situation. Underlying this process are principles for meaningfully engaging marginalized people in healthcare planning. Conclusion A one-size-fits-all approach to patient engagement is not appropriate given patients’ diverse barriers to meaningful participation in healthcare planning. Instead, planners need a repertoire of skills and strategies to align the purpose of engagement with the capacities and needs of patient participants. Just as services need to meet diverse patients’ needs, so too must patient engagement experiences.

Throughout South Asia a proliferation of cities and middle-sized towns is occurring. While larger cities tend to receive greater attention in terms national level investments, opportunities for healthy urban development abound in smaller cities, and at a moment where positive trajectories can be established. In Bangladesh, municipalities are growing in size and tripled in number especially district capitals. However, little is known about the configuration of health services to hold these systems accountable to public health goals of equity, quality, and affordability. This descriptive quantitative study uses data from a GIS-based census and survey of health facilities to identify gaps and inequities in services that need to be addressed. Findings reveal a massive private sector and a worrisome lack of primary and some critical care services. The study also reveals the value of engaging municipal-level decision makers in mapping activities and analyses to enable responsive and efficient healthcare planning. [ABSTRACT FROM AUTHOR]

Abstract Background Researchers, healthcare planners, and policymakers convey a sense of urgency in using eMental healthcare technologies to improve pediatric mental healthcare availability and access. Yet, different stakeholders may focus on different aspects of implementation. We conducted a systematic review to identify implementation foci in research studies and government/organizational documents for eMental healthcare technologies for pediatric mental healthcare. Methods A search of eleven electronic databases and grey literature was conducted. We included research studies and documents from organization and government websites if the focus included eMental healthcare technology for children/adolescents (0–18 years), and implementation was studied and reported (research studies) or goals/recommendations regarding implementation were made (documents). We assessed study quality using the Mixed Methods Appraisal Tool and document quality using the Appraisal of Guidelines for Research & Evaluation II. Implementation information was grouped according to Proctor and colleagues’ implementation outcomes—acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability—and grouped separately for studies and documents. Results Twenty research studies and nine government/organizational documents met eligibility criteria. These articles represented implementation of eMental healthcare technologies in the USA (14 studies), United Kingdom (2 documents, 3 studies), Canada (2 documents, 1 study), Australia (4 documents, 1 study), New Zealand (1 study), and the Netherlands (1 document). The quality of research studies was excellent (n = 11), good (n = 6), and poor (n = 1). These eMental health studies focused on the acceptability (70%, n = 14) and appropriateness (50%, n = 10) of eMental healthcare technologies to users and mental healthcare professionals. The quality of government and organizational documents was high (n = 2), medium (n = 6), and low (n = 1). These documents focused on cost (100%, n = 9), penetration (89%, n = 8), feasibility (78%, n = 7), and sustainability (67%, n = 6) of implementing eMental healthcare technology. Conclusion To date, research studies have largely focused on acceptability and appropriateness, while government/organizational documents state goals and recommendations regarding costs, feasibility, and sustainability of eMental healthcare technologies. These differences suggest that the research evidence available for pediatric eMental healthcare technologies does not reflect the focus of governments and organizations. Partnerships between researchers, healthcare planners, and policymakers may help to align implementation research with policy development, decision-making, and funding foci.

Background: Trauma continues to be a common cause of mortality in Singapore. By understanding the epidemiology of Traumatic Brain Injury (TBI), healthcare professionals can be better equipped to tackle the increasing socioeconomic burden of disease, adopting better strategies in healthcare planning.Methodology: A retrospective review of 367 patients admitted with TBI to a tertiary medical institution from January to December 2014 was performed, studying demographic profiles, injury details and outcomes of these patients. Data was retrieved from the National Trauma Registry and the institution's database.Results: Two hundred thirty-four of the 367 patients included in this study fell into two age groups-−19 to 40 years and ≥65 years. 58% of the TBI population were aged >60. Predominant mechanism of injuries in these groups were road traffic accidents and unwitnessed falls respectively. 39% of the Elderly group were on antiplatelet/anticoagulant agents (p < 0.001). While aggressive surgical intervention was more common in younger patients (p < 0.001), the elderly group had significantly longer lengths of hospital stay (p < 0.001). Though Glasgow Outcome Scale (GOS) scores at discharge were not significantly different between the two groups, elderly patients showed greater percentages of post-injury improvement subsequently.Conclusion: The demographics of TBI patients appears to have shifted toward an older population as compared to a decade ago, with an increased incidence of falls, highlighting a huge healthcare concern. We hope that this study will drive further nationwide studies in future, looking at the incidence and prevalence of TBI, and with the focus on tackling preventable causes of TBI.

Introduction: For the past 2400 years, the spatial relationship between health and location has been a concern for researchers. Studies have been conducted for decades to understand such a relationship, which has led to the identification of a number of healthcare planning issues. Geographic Information Systems (GIS) technology has contributed to addressing such issues by applying analytical approaches at the level of epidemiological surveillance and evaluating the spatial inequality of access to healthcare. Consequently, the importance of reviewing healthcare planning issues and recognition of the role of GIS are integral to relevant studies. Such research will contribute to increasing the understanding of how to apply analytical approaches for dealing with healthcare planning issues using GIS. Methods: This paper aims to provide an examination of healthcare planning issues and focuses on reviewing the potential of GIS in dealing with such issues by applying analytical approaches. The method of a typical literature review was used through collecting data from various studies selected based on temporal and descriptive considerations. Results: Researchers have focused on developing and applying analytical approaches using GIS to support two important aspects of healthcare planning: first, epidemic surveillance and modeling, despite a lack of health information and its management, and, second, evaluating the spatial inequality of access to healthcare in order to determine the optimum distribution of health resources. Conclusion: GIS is an effective tool to support spatial decision-making in public health through applying the evolving analytical approaches to dealing with healthcare planning issues. This requires a literature review before preparing relevant studies, particularly because of the continuous development of GIS technologies.

Doing More with Less: A Client-Centred Approach to Healthcare Logistics in a Nursing Home Setting Dutch nursing homes are currently confronted with two seemingly incompatible goals: a more client-centred approach and the necessity to reduce costs at the same time. It is becoming increasingly apparent that healthcare logistics can contribute to providing high-quality care and support at a reasonable cost. Moreover, care and support which takes the client’s preferences as starting point. A literature study revealed that there is very little in terms of a framework for healthcare logistics that embodies both aspects. Therefore, the authors developed a conceptual framework that meets both requirements. Existing insights on client-centredness and healthcare logistics were used to develop the framework, which offers a structure for both future research and practice in healthcare logistics in nursing home care. This paper reveals that further empirical research is needed to better understand how variability, volume and predictability are interrelated and how they influence the plannability of healthcare activities in terms of what, when, where and by whom. Meer met minder doen: een cliëntgerichte benadering van zorglogistiek in een verpleeg- en/of verzorgingshuissetting Nederlandse verpleeg- en verzorgingshuizen zien zich geconfronteerd met twee schijnbaar tegengestelde opdrachten: het vergroten van de invloed van de cliënt op de zorgverlening en zorglevering, ook wel vraagsturing genoemd en het reduceren van de kosten. Steeds duidelijker wordt dat zorglogistiek een belangrijke bijdrage kan leveren aan het betaalbaar houden van een kwalitatief goede zorg- en hulpverlening. Zorg- en hulpverlening die bovendien de wensen van cliënten als vertrekpunt kiest. Uit literatuuronderzoek blijkt dat er geen zorglogistiek denkraam voor een verpleeg- of verzorgingshuissetting bestaat waarmee beide opdrachten gelijktijdig kunnen worden beschouwd. Deze constatering is voor de auteurs aanleiding geweest om een denkraam of model te ontwikkelen dat wel aan deze eis voldoet. Daarbij is gebruik gemaakt van bestaande inzichten over vraagsturing en (zorg)logistiek. Het gepresenteerde model biedt aanknopingspunten voor toekomstig onderzoek en praktijkbeslissingen op het gebied van zorglogistiek in een verpleeg- en/ of verzorgingshuissetting. Deze paper laat zien dat toekomstig onderzoek nodig is om meer inzicht te krijgen in hoe variabiliteit, volume en voorspelbaarheid onderling samenhangen en de mate van planbaarheid van zorgactiviteiten in termen van wat, wanneer, waar en door wie.

From the Bhore Committee Report of 1946 to the present Universal Health Coverage (UHC) 2011, nothing much has changed in terms of health status in India. The overall health status continues to be dismal and disappointing. One factor that is mainly responsible for this state of affairs is that healthcare has not been realized as a right. If healthcare becomes a right, the state will become responsible and accountable to the people, for enhancing their health. If people are invoked into a sense of belonging to the health system and made to look at healthcare as their right, there is a strong possibility of a positive change in the overall health status of the people. The article looks at healthcare from the rights perspective and explores the methods in which it can be translated into reality. It tries to look at the moral basis of the right to healthcare. For healthcare to be achieved as a right, the state can no longer be a mute spectator of the predominant market forces dictating the healthcare delivery system. The article argues that translation of healthcare as a right is only possible if the state takes full responsibility to improve the health status of the people.

Abstract Current trends in population ageing show that, in the near future, while more people will live longer, more will also die at any one time. Health systems, as well as individual practitioners, are only just becoming aware of the extent of this problem. Health systems will have to rapidly change practice to manage the number of people dying in the coming years, many with complex multimorbid conditions. The changes involved should include a personal recognition by all health professionals of their role in caring for the dying, and healthcare education must include end-of-life care management as part of the core curriculum. Further, health systems must improve integration between primary care and specialist clinicians to ensure the burden is shared efficiently across the system. Finally, it should be recognised that end-of-life care is not terminal care, but should be anticipated months or sometimes years ahead through advance care planning for known future complications by the patient’s clinical team, as well as by patients and their main carers, to manage crises as they ariserather than react to them once they arise. Please see related article: https://bmcmedicine.biomedcentral.com/articles/ 10.1186/s12916-017-0860-2 .

Rare diseases are those with a particularly low prevalence; in Europe, diseases are considered to be rare when they affect not more than 5 in 10 000 persons in the European Union. The specificities of rare diseases make the area a veritable public health challenge: the limited number of patients and scarcity of knowledge and expertise single rare diseases out as a distinctive domain of high European added-value. The Orphan Medicinal Product Regulation of 1999 was the first European legislative text concerning rare diseases, followed by many initiatives, including recommendations by the Council of Ministers of the European Union in 2009. These initiatives contributed to the development of rare diseases policies at European and national level aimed at improving care for patients with rare diseases. A review of the political framework at European level and in European countries is provided to demonstrate how legislation has created a dynamic that is progressively improving care for patients with rare diseases. This article is part of a Special Issue entitled: “Current Research on the Neuronal Ceroid Lipofuscinoses (Batten Disease)”. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to describe the demographics, training, and practice characteristics of consultant vascular surgeons across the UK to provide an assessment of current, and inform future prediction of workforce needs. Methods A questionnaire was developed using a modified Delphi process to generate questionnaire items. The questionnaire was emailed to all consultant vascular surgeons ( n = 450) in the UK who were members of the Vascular Society of Great Britain & Ireland. Results 352 consultant vascular surgeons from 95 hospital trusts across the UK completed the survey (78% response rate). The mean age was 50.6 years old, the majority (62%) were mid-career, but 24% were above the age of 55. Currently, 92% are men and only 8% women. 93% work full-time, with 60% working >50 hours, and 21% working >60 hours per week. The average team was 5 to 6 (range 2–10) vascular surgeons, with 23% working in a large team of ≥8. 17% still work in small teams of ≤3. Over 90% of consultant vascular surgeons perform the major index vascular surgery procedures (aneurysm repair, carotid endarterectomy, infra-inguinal bypass, amputation). While 84% perform standard endovascular abdominal aortic aneurysm repair (EVAR), <50% perform more complex endovascular aortic therapy. The majority of vascular surgeons “like their job” (85%) and are “satisfied” (69%) with their job. 34% of consultant vascular surgeons indicated they were “extremely likely” to retire within the next 10 years. Conclusions This study provides the first detailed analysis of the new specialty of vascular surgery as practiced in the UK. There is a need to plan for a significant expansion in the consultant vascular surgeon workforce in the UK over the next 10 years to maintain the status quo. [ABSTRACT FROM AUTHOR]

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Copyright of Journal of Social Intervention: Theory & Practice is the property of Universiteit Utrecht and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Health data of refugees and asylum seekers (ASR) is not routinely collected in Germany. Based on health data of ASR collected in 2018 in regional accommodation centres, we developed a dashboard to estimate regional burden of disease in Baden-Wuerttemberg, Germany. We aimed to find out how scientific data can support actors involved in healthcare planning for ASR in Germany and, within this scope, to explore how healthcare planning is conducted in this context. We conducted 12 qualitative semi-structured interviews including a usability test for a health data dashboard with regional decision-makers. Results showed that healthcare planning processes for ASR in Germany involve a complex set of actors in both long- and short-term decision-making. Data gained from representative surveys can support long-term decision-making and thus support the resilience of the health system, but it must balance the need for simple data presentation with transparent communication of potentially complex methods.

Abstract: Study objective: The goals of this investigation were to study the temporal relationships between the demands for key resources in the emergency department (ED) and the inpatient hospital, and to develop multivariate forecasting models. Methods: Hourly data were collected from three diverse hospitals for the year 2006. Descriptive analysis and model fitting were carried out using graphical and multivariate time series methods. Multivariate models were compared to a univariate benchmark model in terms of their ability to provide out-of-sample forecasts of ED census and the demands for diagnostic resources. Results: Descriptive analyses revealed little temporal interaction between the demand for inpatient resources and the demand for ED resources at the facilities considered. Multivariate models provided more accurate forecasts of ED census and of the demands for diagnostic resources. Conclusion: Our results suggest that multivariate time series models can be used to reliably forecast ED patient census; however, forecasts of the demands for diagnostic resources were not sufficiently reliable to be useful in the clinical setting. [Copyright &y& Elsevier]

Assuming a constant stream of new biotechnology products in the future, three key issues are likely to influence the growth of the biotechnology industry in an increasingly competitive healthcare market: (a) biotechnology products are more expensive than comparable traditional pharmaceuticals; (b) many biotechnology products target small patient populations for which they may provide the only therapy that substantially improves their condition; (c) the physiological and pathophysiological effects of some biotechnology products are not completely understood, which may require additional resources to characterise and manage patient risks. We show how these issues can be addressed with the help of pharmacoeconomic tools and how they will probably affect the growth of the biotechnology industry. [ABSTRACT FROM AUTHOR]