Sustainable medicine: good for the environment, good for people

Thompson, Trevor; Ballard, Tim

doi:10.3399/bjgp11x548875

Cited by 13 publications

(11 citation statements)

References 10 publications

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“…While it has been suggested that countries with a gatekeeper system have a significantly lower 1-year relative cancer survival than systems without such gatekeeper functions [14], our study identified wide variations in the degree of gatekeeping between countries, with no simple binary model as to whether or not a country has a “PCP-as-gatekeeper” system. Further research on how system factors affect cancer survival rates is needed.…”

Section: Discussionmentioning

confidence: 62%

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How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes

Harris

Frey

Esteva

et al. 2017

Scandinavian Journal of Primary Health Care

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ObjectiveEuropean cancer survival rates vary widely. System factors, including whether or not primary care physicians (PCPs) are gatekeepers, may account for some of these differences. This study explores where patients who may have cancer are likely to present for medical care in different European countries, and how probability of presentation to a primary care clinician correlates with cancer survival rates.DesignSeventy-eight PCPs in a range of European countries assessed four vignettes representing patients who might have cancer, and consensus groups agreed how likely those patients were to present to different clinicians in their own countries. These data were compared with national cancer survival rates.SettingA total of 14 countries.SubjectsConsensus groups of PCPs.Main outcome measuresProbability of initial presentation to a PCP for four clinical vignettes.ResultsThere was no significant correlation between overall national 1-year relative cancer survival rates and the probability of initial presentation to a PCP (r = −0.16, 95% CI −0.39 to 0.08). Within that there was large variation depending on the type of cancer, with a significantly poorer lung cancer survival in countries where patients were more likely to initially consult a PCP (lung r = −0.57, 95% CI −0.83 to −0.12; ovary: r = −0.13, 95% CI −0.57 to 0.38; breast r = 0.14, 95% CI −0.36 to 0.58; bowel: r = 0.20, 95% CI −0.31 to 0.62).ConclusionsThere were wide variations in the degree of gatekeeping between countries, with no simple binary model as to whether or not a country has a “PCP-as-gatekeeper” system. While there was case-by-case variation, there was no overall evidence of a link between a higher probability of initial consultation with a PCP and poorer cancer survival.Key pointsEuropean cancer survival rates vary widely, and health system factors may account for some of these differences.The data from 14 European countries show a wide variation in the probability of initial presentation to a PCP.The degree to which PCPs act as gatekeepers varies considerably from country to country.There is no overall evidence of a link between a higher probability of initial presentation to a PCP and poorer cancer survival.

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Section: Discussionmentioning

confidence: 62%

“…Healthcare systems considered to have a primary care gatekeeper system tend to have a significantly lower 1-year relative cancer survival than systems without such gatekeeper functions [ 14 ]. However, achieving more timely cancer diagnoses in primary care poses a considerable challenge [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes

Harris

Frey

Esteva

et al. 2017

Scandinavian Journal of Primary Health Care

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“…In response to the growing number of allegations related to medical tourism, pediatricians from Seattle have created their own program with a very precise assignment: "To ethically address underlying health issues and to provide sustainable public health interventions and medical assistance for underserved communities in developing countries" (Suchdev et al 2007, p. 317). To enable doctors and future doctors to better understand the spirit of sustainable development and to develop medical students' knowledge, skills, and attitudes about the interdependence of human health and ecosystems health, the concepts of "a sustainable physician" (Mortimer 2010) and sustainable medicine (Thompson and Ballard 2011) were introduced to the medical education program, as well as an "environmentally sustainable medical curriculum" which includes the effects of environmental change on health and healthcare's impact and dependence on the local and global environment. Walpole et al (2017Walpole et al ( , p. 1048 accentuate that medical schools, educators, and students not only have a responsibility but also an opportunity to promote a sustainable medical curriculum for the advancement of our global and local environment, with consequential reimbursements to individual and global health.…”

Section: Medical Tourism In the Concept Of Sustainable Developmentmentioning

confidence: 99%

Sustainable Medical Tourism: Conceptual Framework

Lubowiecki-Vikuk¹,

Machnik²

2019

Encyclopedia of the UN Sustainable Development Goals

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Referring to the definition of sustainable tourism and taking into consideration the specifics of medical tourism, it can be assumed that sustainable medical tourism is a conscious and sustainable human activity, in which a medical tourist/ mobile patient aims to obtain broadly understood healthcare outside their permanent place of residence (at home or abroad), consisting mainly in maintaining (obtaining better) health, and/or aesthetic appearance of one's own body, often combined with rest and consumption of tourist packages. This balance should address all three aspectssocial, economic, and environmental. Therefore, the provision of sustainable medical tourism services, most often by commercial healthcare entities, should be carried out with rational spatial distribution resulting in the strengthening of local economies and improving the quality of life of the society while respecting natural resources and using innovative solutions in the medical tourism business.

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“…This model extends to create a healthy workspace for healthcare professionals as well. The healthcare infrastructure should be built using sustainable technologies and operate with energy conservation and responsibility such as waste reduction, recycling, lower CO 2 production, water conservation and pollution prevention [25,26]. Changing of work habit to lean processes is an important activity to create green healthcare.…”

Section: Sustainable and Green Medicinementioning

confidence: 99%

A Sustainable Medical Tourism FrameworkBased on the Enterprise ArchitectureDesign:The Case in Thailand

Mayakul

Kiattisin

Prasad

2018

JGE

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Presently, medical tourism is a rapidly growing business in Thailand, while sustainable medicine is still being widely used as the basis for health policies. To improve the quality of life of people through holistic management, Enterprise Architecture (EA) is used as the strategic management concept in accordance with digital disruption. EAcombines both business and technology to align policies and establish governance. This paper presents a medical tourism framework based on the EA concept for sustainable development in Thailand. This novel framework has been developed both through comprehensive literature review as well as requirement analysis based on the i* model consisting of five layers including leadership, business, application, data, and technology. Moreover, the i* model is used to prove a relationship between the entities, especially the key stakeholders, the standards, and the compliance for each layer. The content validity and the kappa statistic were used for quantitative evaluation. This framework demonstrates that technology would contribute to enhance the medical tourism industry through the layers of data and application. Furthermore, the interoperability standard for health services, preventive medicine, and wellness activities are important for business layers. The proposed framework would generate advantages for the government in terms of good governance, transparency as well as process improvement.

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Sustainable medicine: good for the environment, good for people

Cited by 13 publications

References 10 publications

How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes

How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes

Sustainable Medical Tourism: Conceptual Framework

A Sustainable Medical Tourism FrameworkBased on the Enterprise ArchitectureDesign:The Case in Thailand

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