Hospitals during economic crisis: a systematic review based on resilience system capacities framework

Foroughi, Zeynab; Ebrahimi, Parvin; Aryankhesal, Aidin; Maleki, Mohammadreza; Yazdani, Shahram

doi:10.1186/s12913-022-08316-4

Cited by 9 publications

(10 citation statements)

References 96 publications

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“…It remains challenging in the interim to analyse epidemiological data, as most data have a latency period of 2–5 years 106. Nevertheless, results stress the global dimension and critical importance of public health and the adoption of countercyclical policies, which are policy measures which counteract the effects of the economic cycle, during times of crisis (eg, fiscal stimulus, cutting taxes, increasing governmental spending) 14 72 107–112. Country-comparative results reveal that to achieve resilient healthcare systems during crisis events, social protection systems and countercyclical policies to mitigate socioeconomic effects are needed to protect the most vulnerable populations since the earliest days to break a ‘never-ending-cycle’ 113.…”

Section: Discussionmentioning

confidence: 99%

2008 economic crisis impact on perinatal and infant mortality in Southern European countries

Doetsch

Almendra

Severo

et al. 2023

J Epidemiol Community Health

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IntroductionThe study of crisis events provides important lessons to prepare for upcoming events. The Great Recession’s impact on perinatal health in Europe can provide relevant insights into the healthcare and social protection systems’ response to the protection of the health of the most vulnerable groups.ObjectiveTo assess time trends and international disparities in perinatal mortality rates (PMR) and infant mortality rates (IMR), following the Great Recession, and their association with socioeconomic indicators in Portugal, Greece, Italy and Spain.MethodsAssociations were assessed through generalised linear models for all four countries. A Poisson joinpoint regression model was applied to explore PMR and IMR trend changes between 2000 and 2018. Country disparities were analysed using mixed-effects multilevel models.ResultsIMR and PMR have decreased overall in the four selected countries between 2000 and 2018. Still, whereas in Spain, Italy and Portugal the decreasing pace was attenuated after 2009, in Greece a positive trend was found after the 2008 crisis. IMR and PMR were significantly associated with socioeconomic indicators in all four countries. National disparities in the evolution of IMR and PMR were significantly associated with most socioeconomic indicators between 2000 and 2018.ConclusionOur results confirm the impact of the Great Recession on PMR and IMR trends in all four countries, taking recurring associations between macroeconomic cycles, variations in mortality trends, macroeconomic volatility and stagnation of IMR and PMR into account. The association with socioeconomic indicators stresses the need to strengthen social protection and healthcare systems to better protect the population’s health from the earliest days.

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Section: Discussionmentioning

confidence: 99%

2008 economic crisis impact on perinatal and infant mortality in Southern European countries

Doetsch

Almendra

Severo

et al. 2023

J Epidemiol Community Health

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“…21,22 This is predominately due to the difficult economic climate since the global financial crisis in 2008 but has also been exacerbated by austerity measures and the COVID-19 pandemic. 23 In the era of tight fiscal control in health care, this article adds to the evidence-base available surrounding pinnaplasty.…”

Section: Discussionmentioning

confidence: 99%

“…However, prominent ears is remains widely considered as a cosmetic condition, pinnaplasty as an aesthetic procedure and commissioning remains difficult across many parts of the United Kingdom 21, 22 . This is predominately due to the difficult economic climate since the global financial crisis in 2008, but has also been exacerbated by austerity measures and the COVID-19 pandemic 23 . In the era of tight fiscal control in healthcare, this paper adds to the evidence-base available surrounding pinnaplasty.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

A Retrospective Analysis of Pinnaplasty Outcomes: The Welsh Experience

et al. 2023

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Prominent ears (PE) are the most frequent congenital external ear deformity, occurring in approximately 5% of the population. Although the deformity does not usually cause functional difficulties, it can significantly affect the patient's psychological and social health. The authors aim to present the Welsh experience of pinnaplasty, reviewing our outcomes and complications. A retrospective cross-sectional study was performed of all patients undergoing pinnaplasty in Morriston hospital, Swansea, Wales. We represent the tertiary plastic surgery referral unit across Wales. We included all patients undergoing pinnaplasty between 2015 and 2022 inclusive. We excluded patients undergoing revision procedures or those who had no follow-up. Over the seven-year period, 236 pinnaplasties were performed and 203 were included in the analysis. 96% of cases were performed using a cartilage-sparring approach, which represents the mainstay in our unit. The mean follow-up length for our cases was 12 months. Revision procedures were required in 4% of cases. 3 hematomas (1.5%) and 1 (0.5%) wound dehiscence due to infection were recorded and required a return to theatre. Suture extrusion was noted in 5% of cases (10 patients). 4.5% (9) cases were affected by either hypertrophic or keloid scarring. Across the United Kingdom, cosmetic procedures have come under scrutiny, namely because of a difficult economic climate. In the era of tight fiscal control in healthcare, it is pertinent to analyse the outcomes and performance metrics of our operations regularly, thus aiding in the development of an established evidence base to advocate for our respective patients.

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“…During times of crisis, the healthcare system often experiences deterioration and fragmentation as a result of heightened violence and insecurity, reduced effectiveness of governance, and depletion of resources [16]. Yet, an economic crisis can present an opportunity to enhance the performance and resilience of hospitals [17,18]. Hospital accreditation may provide a solution to improving healthcare quality by providing a basis for service delivery and ensuring a culture of safety and preparedness in hospitals [19].…”

Section: Health System In Time Of Crisismentioning

confidence: 99%

Revolutionizing Healthcare: Lessons Learned from an Integrative Approach to Transforming the Hospital Accreditation System in Lebanon

Jardali

2024

J Med Healthcare

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Background: Lebanon was the first country in the Eastern Mediterranean region to develop and implement a national hospital accreditation system, but the system has not been updated since 2011. This study aims to describe the process of developing and piloting context-specific hospital accreditation standards in Lebanon, and share lessons from extensive stakeholder consultations. Methods: Mixed-methods approach was used for development and piloting of standards. This included extensive documentation review, stakeholder and expert consultations, standard review, and capacity building for piloting. Experts were required to review standards using pre-identified criteria and expert sub-group meetings were conducted to discuss changes. Piloting of standards included assessment of feasibility and compliance with standards/guiding measures in addition to implementation considerations. Results: More than 60 experts were consulted. Pilot testing showed a positive outcome for clarity, feasibility, and compliance of hospitals to standards. Managing stakeholders’ expectation was challenging at the policy-political encounter. The rigorous expert review led to the development of context-specific and robust standards that provided guidance for hospitals to improve quality care. Results showed that health system changes at the governance, finance and delivery levels are needed to achieve and sustain the gains of accreditation. Conclusions: The study methodology showed the promising influence of using science in development of accreditation standards. Stakeholder involvement remains critical to push the agenda of accreditation. Continuous follow-up to the survey process is recommended to ensure optimal impact of the accreditation system. The process can be scaled up and replicated in the Eastern Mediterranean Region (EMR) and beyond. Patient or Public Contribution: Patients and public where not involved in this study. While patients and the public bring are key for sharing lived experiences, the development of the standards required deep understanding and expertise especially with regards to healthcare and health systems. Highlights Implications for policy makers • Study can be replicated in contexts without a national accreditation system • Ensuring political commitment is critical for implementation of accreditation • Rigorous approaches are key in managing resistance to change • Stakeholder engagement is pivotal for developing contextualized standards

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Hospitals during economic crisis: a systematic review based on resilience system capacities framework

Cited by 9 publications

References 96 publications

2008 economic crisis impact on perinatal and infant mortality in Southern European countries

2008 economic crisis impact on perinatal and infant mortality in Southern European countries

A Retrospective Analysis of Pinnaplasty Outcomes: The Welsh Experience

Revolutionizing Healthcare: Lessons Learned from an Integrative Approach to Transforming the Hospital Accreditation System in Lebanon

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