Suchergebnisse

India is a pluralistic, multilingual and multi-ethnic country located in Southeast Asia. It is the 2nd largest populated country which has the 7th position in the geographical area. Since 1990 India has emerged as one of the wealthiest economies in the developing world. Recently it is the second fastest growing major economy in the world. Despite the fact that economical development in India has been accompanied by increases in life expectancy, literacy rates and food security, India's performance in the area of health care has been still far from satisfactory. The system of financing health care as a one of the most privatized in the world faces especially many problems. This paper would therefore attempt to describe and assess the system of financing health care in India. In order to outline to the readers the overall country context the first section will provide a brief description of the demographic, economic and health profile of the Indian population. The second and third sections will present the main methods of funding health care in India as well as and the budget of health care system. The concluding section would attempt to assess the financing system in India and offer a way forward for the better achievement of health care system goals.

The surge in cases of severe COVID-19 has resulted in clinicians triaging intensive care unit (ICU) admissions in places where demand has exceeded capacity. In order to assist difficult triage decisions, clinicians require clear guidelines on how to prioritise patients. Existing guidelines show significant variability in their development, interpretation, implementation and an urgent need for a robust synthesis of published guidance. To understand how to manage which patients are admitted to ICU, and receive mechanical ventilatory support, during periods of high demand during the COVID-19 pandemic, a systematic review was performed. Databases of indexed literature (Medline, Embase, Web of Science, and Global Health) and grey literature (Google.com and MedRxiv), published from 1 January until 2 April 2020, were searched. Search terms included synonyms of COVID-19, ICU, ventilation, and triage. Only formal written guidelines were included. There were no exclusion criteria based on geographical location or publication language. Quality appraisal of the guidelines was performed using the Appraisal of Guidelines for Research and Evaluation Instrument II (AGREE II) and the Appraisal of Guidelines for Research and Evaluation Instrument Recommendation EXcellence (AGREE REX) appraisal tools, and key themes related to triage were extracted using narrative synthesis. Of 1902 unique records identified, nine relevant guidelines were included. Six guidelines were national or transnational level guidance (UK, Switzerland, Belgium, Australia and New Zealand, Italy, and Sri Lanka), with one state level (Kansas, USA), one international (Extracorporeal Life Support Organization) and one specific to military hospitals (Department of Defense, USA). The guidelines covered several broad themes: use of ethical frameworks, criteria for ICU admission and discharge, adaptation of criteria as demand changes, equality across health conditions and healthcare systems, decision-making processes, communication of decisions, and guideline ...