Public hospital management in times of crisis: Lessons learned from Cienfuegos, Cuba (1996–2008)

Vos, Pol De; Ordúñez-García, Pedro O.; Santos-Peña, Moisés; Stuyft, Patrick Van der

doi:10.1016/j.healthpol.2010.01.005

Cited by 20 publications

(29 citation statements)

References 31 publications

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“…of pregnant women at maternal homes – increased, hospital admittances decreased. In the late 1990s, when most of the acute threats were over, the number of hospital beds was rationalized (De Vos et al. 2010).…”

Section: Discussionmentioning

confidence: 99%

Public health services, an essential determinant of health during crisis. Lessons from Cuba, 1989–2000

Vos

García-Fariñas²,

Alvarez-Pérez³

et al. 2012

Tropical Med Int Health

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During the 1990s, Cuba was able to overcome a severe crisis, almost without negative health impacts. This national retrospective study covering the years 1989-2000 analyses the country's strategy through essential social, demographic, health process and health outcome indicators. Gross domestic product (GDP) diminished by 34.76% between 1989 and 1993. In 1994 slow recuperation started. During the crisis, public health expenses increased. The number of family doctors rose from 9.22 to 27.03 per 104 inhabitants between 1989 and 2000. Infant mortality rate and life expectancy exemplify a series of health indicators that continued to improve during the crisis years, whereas low birth weight and tuberculosis incidence are among the few indicators that suffered deterioration. GDP is inversely related to tuberculosis incidence, whereas the average salary is inversely related to low birth weight. Infant mortality rate has a strong negative correlation with the health expenses per inhabitant, the number of maternal homes, the number of family doctors and the proportion of pregnant women receiving care in maternal homes. Life expectancy has a strong positive correlation with health expenses, the number of nursing personnel and the number of medical contacts per inhabitant. The Cuban strategy effectively resolved health risks during the crisis. In times of serious socio-economic constraints, a well conceptualized public health policy can play an important role in maintaining the overall well-being of a population.keywords public health, determinants of health, health services, economic crisis, Cuba, international health

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Section: Discussionmentioning

confidence: 99%

Public health services, an essential determinant of health during crisis. Lessons from Cuba, 1989–2000

Vos

García-Fariñas²,

Alvarez-Pérez³

et al. 2012

Tropical Med Int Health

Self Cite

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“…For this study, we also used hospitalization in one hospital (Kingston Public hospital) and hospitalization at another government hospital (Spanish Town Hospital) in Jamaica for time period t [equation (2)]:…”

Section: Theoretical Frameworkmentioning

confidence: 99%

“…Public hospital management has had to deal with a number of operating fundamentals and management challenges inclusive of inadequate infrastructure, inefficient analytic processes, insufficient staffing and recruitment pool, increased patient demands and new re-emerging health conditions, resource constraints and physio-psychological trauma [1,2]. Furthermore, public healthcare managers need to be armed with the necessary data and information to assist them to be more proactive in managing the limited resources allotted.…”

Section: Introductionmentioning

confidence: 99%

Substitution and Complementary Effects of Hospitalizations in Jamaica: an Analysis of Spanish Town and Kingston Public Hospitals

Bourne¹

2016

J Healthc Commun

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Background and purpose: Despite significant medical and public health advances in Jamaica all too often health care planning lacks the flexibility to respond appropriately to the increased and varied demand of the population due to inadequate or inaccurate information. The accuracy of the information is pertinent to forward effective changes in the health care arena, which is instrumental in the coordination of care leading to cost reduction in health care management. This study sought to investigate: 1) Probabilities of hospitalization at two government hospitals in Jamaica; 2) Elasticities of hospitalization between two government hospitals in Jamaica; 3) Response-ability of patient-sharing between two government hospitals in Jamaica; and 4) The dual effect of patient-sharing in two government hospitals in Jamaica.

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“…A post-intervention evaluation showed greater use of aspirin and beta blockers in 1999, associated with a signifi cant drop in AMI hospital case fatality. [14,15] A key therapy in AMI treatment is reperfusion [6,11], and at HGAL the only reperfusion option available is thrombolysis. Recanalization of the artery associated with the infarction-if early, complete and maintained-improves prognosis, limits infarction size and preserves ventricular function.…”

Section: Clinical Practice Guidelinesmentioning

confidence: 99%

“…This set of initiatives, ongoing since 1994-which we refer to as HGAL's institutional AMI plan-was undertaken under the aegis of the hospital's new quality assurance system. [6] Their impact was systematically assessed on an ongoing basis, with adjustments made according to results observed.…”

Section: Introductionmentioning

confidence: 99%

Reducing case fatality from acute myocardial infarction in cienfuegos, Cuba, 1994-2009

Navarro¹,

Falcón²,

Iraola³

et al. 2012

MEDICC rev.

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Between 1994 and 2009, the Dr Gustavo Aldereguía University Hospital of Cienfuegos, Cuba implemented a series of interventions that reduced acute myocardial infarction case fatality rate from 47% to 15%. These interventions were part of an institutional plan for myocardial infarction included in the hospital's overall quality assurance strategy. Outcomes resulted primarily from organizational changes (from upgrading of the hospital emergency department and provincial emergency system to creation of a comprehensive coronary care unit and a chest pain center); optimizing use of effective drugs (streptokinase, aspirin, ACE inhibitors and beta blockers); adherence to clinical practice guidelines; and continual and participatory evaluation and adjustment.

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Public hospital management in times of crisis: Lessons learned from Cienfuegos, Cuba (1996–2008)

Cited by 20 publications

References 31 publications

Public health services, an essential determinant of health during crisis. Lessons from Cuba, 1989–2000

Public health services, an essential determinant of health during crisis. Lessons from Cuba, 1989–2000

Substitution and Complementary Effects of Hospitalizations in Jamaica: an Analysis of Spanish Town and Kingston Public Hospitals

Reducing case fatality from acute myocardial infarction in cienfuegos, Cuba, 1994-2009

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