Displaying publications 81 - 100 of 597 in total

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  1. Ali A, Al-Rimy BAS, Alsubaei FS, Almazroi AA, Almazroi AA
    Sensors (Basel), 2023 Jul 28;23(15).
    PMID: 37571545 DOI: 10.3390/s23156762
    The swift advancement of the Internet of Things (IoT), coupled with the growing application of healthcare software in this area, has given rise to significant worries about the protection and confidentiality of critical health data. To address these challenges, blockchain technology has emerged as a promising solution, providing decentralized and immutable data storage and transparent transaction records. However, traditional blockchain systems still face limitations in terms of preserving data privacy. This paper proposes a novel approach to enhancing privacy preservation in IoT-based healthcare applications using homomorphic encryption techniques combined with blockchain technology. Homomorphic encryption facilitates the performance of calculations on encrypted data without requiring decryption, thus safeguarding the data's privacy throughout the computational process. The encrypted data can be processed and analyzed by authorized parties without revealing the actual contents, thereby protecting patient privacy. Furthermore, our approach incorporates smart contracts within the blockchain network to enforce access control and to define data-sharing policies. These smart contracts provide fine-grained permission settings, which ensure that only authorized entities can access and utilize the encrypted data. These settings protect the data from being viewed by unauthorized parties. In addition, our system generates an audit record of all data transactions, which improves both accountability and transparency. We have provided a comparative evaluation with the standard models, taking into account factors such as communication expense, transaction volume, and security. The findings of our experiments suggest that our strategy protects the confidentiality of the data while at the same time enabling effective data processing and analysis. In conclusion, the combination of homomorphic encryption and blockchain technology presents a solution that is both resilient and protective of users' privacy for healthcare applications integrated with IoT. This strategy offers a safe and open setting for the management and exchange of sensitive patient medical data, while simultaneously preserving the confidentiality of the patients involved.
    Matched MeSH terms: Delivery of Health Care
  2. Solomon AJ, Marrie RA, Viswanathan S, Correale J, Magyari M, Robertson NP, et al.
    Neurology, 2023 Aug 08;101(6):e624-e635.
    PMID: 37321866 DOI: 10.1212/WNL.0000000000207481
    BACKGROUND AND OBJECTIVES: Recent data suggest increasing global prevalence of multiple sclerosis (MS). Early diagnosis of MS reduces the burden of disability-adjusted life years and associated health care costs. Yet diagnostic delays persist in MS care and even within national health care systems with robust resources, comprehensive registries, and MS subspecialist referral networks. The global prevalence and characteristics of barriers to expedited MS diagnosis, particularly in resource-restricted regions, have not been extensively studied. Recent revisions to MS diagnostic criteria demonstrate potential to facilitate earlier diagnosis, but global implementation remains largely unknown.

    METHODS: The Multiple Sclerosis International Federation third edition of the Atlas of MS was a survey that assessed the current global state of diagnosis including adoption of MS diagnostic criteria; barriers to diagnosis with respect to the patient, health care provider, and health system; and existence of national guidelines or national standards for speed of MS diagnosis.

    RESULTS: Coordinators from 107 countries (representing approximately 82% of the world population), participated. Eighty-three percent reported at least 1 "major barrier" to early MS diagnosis. The most frequently reported barriers included the following: "lack of awareness of MS symptoms among general public" (68%), "lack of awareness of MS symptoms among health care professionals" (59%), and "lack of availability of health care professionals with knowledge to diagnose MS" (44%). One-third reported lack of "specialist medical equipment or diagnostic tests." Thirty-four percent reported the use of only 2017 McDonald criteria (McD-C) for diagnosis, and 79% reported 2017 McD-C as the "most commonly used criteria." Sixty-six percent reported at least 1 barrier to the adoption of 2017 McD-C, including "neurologists lack awareness or training" by 45%. There was no significant association between national guidelines pertaining to MS diagnosis or practice standards addressing the speed of diagnosis and presence of barriers to early MS diagnosis and implementation of 2017 McD-C.

    DISCUSSION: This study finds pervasive consistent global barriers to early diagnosis of MS. While these barriers reflected a lack of resources in many countries, data also suggest that interventions designed to develop and implement accessible education and training can provide cost-effective opportunities to improve access to early MS diagnosis.

    Matched MeSH terms: Delivery of Health Care
  3. Rehman A, Abbas S, Khan MA, Ghazal TM, Adnan KM, Mosavi A
    Comput Biol Med, 2022 Nov;150:106019.
    PMID: 36162198 DOI: 10.1016/j.compbiomed.2022.106019
    In recent years, the global Internet of Medical Things (IoMT) industry has evolved at a tremendous speed. Security and privacy are key concerns on the IoMT, owing to the huge scale and deployment of IoMT networks. Machine learning (ML) and blockchain (BC) technologies have significantly enhanced the capabilities and facilities of healthcare 5.0, spawning a new area known as "Smart Healthcare." By identifying concerns early, a smart healthcare system can help avoid long-term damage. This will enhance the quality of life for patients while reducing their stress and healthcare costs. The IoMT enables a range of functionalities in the field of information technology, one of which is smart and interactive health care. However, combining medical data into a single storage location to train a powerful machine learning model raises concerns about privacy, ownership, and compliance with greater concentration. Federated learning (FL) overcomes the preceding difficulties by utilizing a centralized aggregate server to disseminate a global learning model. Simultaneously, the local participant keeps control of patient information, assuring data confidentiality and security. This article conducts a comprehensive analysis of the findings on blockchain technology entangled with federated learning in healthcare. 5.0. The purpose of this study is to construct a secure health monitoring system in healthcare 5.0 by utilizing a blockchain technology and Intrusion Detection System (IDS) to detect any malicious activity in a healthcare network and enables physicians to monitor patients through medical sensors and take necessary measures periodically by predicting diseases. The proposed system demonstrates that the approach is optimized effectively for healthcare monitoring. In contrast, the proposed healthcare 5.0 system entangled with FL Approach achieves 93.22% accuracy for disease prediction, and the proposed RTS-DELM-based secure healthcare 5.0 system achieves 96.18% accuracy for the estimation of intrusion detection.
    Matched MeSH terms: Delivery of Health Care
  4. Zhang B, Rahmatullah B, Wang SL, Zhang G, Wang H, Ebrahim NA
    J Appl Clin Med Phys, 2021 Oct;22(10):45-65.
    PMID: 34453471 DOI: 10.1002/acm2.13394
    PURPOSE: Medical images are important in diagnosing disease and treatment planning. Computer algorithms that describe anatomical structures that highlight regions of interest and remove unnecessary information are collectively known as medical image segmentation algorithms. The quality of these algorithms will directly affect the performance of the following processing steps. There are many studies about the algorithms of medical image segmentation and their applications, but none involved a bibliometric of medical image segmentation.

    METHODS: This bibliometric work investigated the academic publication trends in medical image segmentation technology. These data were collected from the Web of Science (WoS) Core Collection and the Scopus. In the quantitative analysis stage, important visual maps were produced to show publication trends from five different perspectives including annual publications, countries, top authors, publication sources, and keywords. In the qualitative analysis stage, the frequently used methods and research trends in the medical image segmentation field were analyzed from 49 publications with the top annual citation rates.

    RESULTS: The analysis results showed that the number of publications had increased rapidly by year. The top related countries include the Chinese mainland, the United States, and India. Most of these publications were conference papers, besides there are also some top journals. The research hotspot in this field was deep learning-based medical image segmentation algorithms based on keyword analysis. These publications were divided into three categories: reviews, segmentation algorithm publications, and other relevant publications. Among these three categories, segmentation algorithm publications occupied the vast majority, and deep learning neural network-based algorithm was the research hotspots and frontiers.

    CONCLUSIONS: Through this bibliometric research work, the research hotspot in the medical image segmentation field is uncovered and can point to future research in the field. It can be expected that more researchers will focus their work on deep learning neural network-based medical image segmentation.

    Matched MeSH terms: Delivery of Health Care
  5. Puri A, Mohite P, Maitra S, Subramaniyan V, Kumarasamy V, Uti DE, et al.
    Biomed Pharmacother, 2024 Jan;170:116083.
    PMID: 38163395 DOI: 10.1016/j.biopha.2023.116083
    As we navigate the modern era, the intersection of time-honoured natural remedies and contemporary scientific approaches forms a burgeoning frontier in global healthcare. For generations, natural products have been foundational to health solutions, serving as the primary healthcare choice for 80% to 85% of the world's population. These herbal-based, nature-derived substances, significant across diverse geographies, necessitate a renewed emphasis on enhancing their quality, efficacy, and safety. In the current century, the advent of biogenic phytonanoparticles has emerged as an innovative therapeutic conduit, perfectly aligning with principles of environmental safety and scientific ingenuity. Utilizing green chemistry techniques, a spectrum of metallic nanoparticles including elements such as copper, silver, iron, zinc, and titanium oxide can be produced with attributes of non-toxicity, sustainability, and economic efficiency. Sophisticated herb-mediated processes yield an array of plant-originated nanomaterials, each demonstrating unique physical, chemical, and biological characteristics. These attributes herald new therapeutic potentials, encompassing antioxidants, anti-aging applications, and more. Modern technology further accelerates the synthesis of natural products within laboratory settings, providing an efficient alternative to conventional isolation methods. The collaboration between traditional wisdom and advanced methodologies now signals a new epoch in healthcare. Here, the augmentation of traditional medicine is realized through rigorous scientific examination. By intertwining ethical considerations, cutting-edge technology, and natural philosophy, the realms of biogenic phytonanoparticles and traditional medicine forge promising pathways for research, development, and healing. The narrative of this seamless integration marks an exciting evolution in healthcare, where the fusion of sustainability and innovation crafts a future filled with endless possibilities for human well-being. The research in the development of metallic nanoparticles is crucial for unlocking their potential in revolutionizing fields such as medicine, catalysis, and electronics, promising groundbreaking applications with enhanced efficiency and tailored functionalities in future technologies. This exploration is essential for harnessing the unique properties of metallic nanoparticles to address pressing challenges and advance innovations across diverse scientific and industrial domains.
    Matched MeSH terms: Delivery of Health Care
  6. Yip CH, Samiei M, Cazap E, Rosenblatt E, Datta NR, Camacho R, et al.
    Asian Pac J Cancer Prev, 2012;13(4 Suppl):23-36.
    PMID: 22631594
    Survival following a diagnosis of cancer is contingent upon an interplay of factors, some non-modifiable (e.g., age, sex, genetics) and some modifiable (e.g., volitional choices) but the majority determined by circumstance (personal, social, health system context and capacity, and health policy). Accordingly, mortality and survival rates vary considerably as a function of geography, opportunity, wealth and development. Quality of life is impacted similarly, such that aspects of care related to coordination and integration of care across primary, community and specialist environments; symptom control, palliative and end-of-life care for those who will die of cancer; and survivorship challenges for those who will survive cancer, differs greatly across low, middle and high-income resource settings. Session 3 of the 4th International Cancer Control Congress (ICCC-4) focused on cancer care and treatment through three plenary presentations and five interactive workshop discussions: 1) establishing, implementing, operating and sustaining the capacity for quality cancer care; 2) the role of primary, community, and specialist care in cancer care and treatment; 3) the economics of affordable and sustainable cancer care; 4) issues around symptom control, support, and palliative/end-of-life care; and 5) issues around survivorship. A number of recommendations were proposed relating to capacity-building (standards and guidelines, protocols, new technologies and training and deployment) for safe, appropriate evidence-informed care; mapping and analysis of variations in primary, community and specialist care across countries with identification of models for effective, integrated clinical practice; the importance of considering the introduction, or expansion, of evidence-supported clinical practices from the perspectives of health economic impact, the value for health resources expended, and sustainability; capacity-building for palliative, end-of-life care and symptom control and integration of these services into national cancer control plans; the need for public education to reduce the fear and stigma associated with cancer so that patients are better able to make informed decisions regarding follow-up care and treatment; and the need to recognize the challenges and needs of survivors, their increasing number, the necessity to integrate survivorship into cancer control plans and the economic and societal value of functional survival after cancer. Discussions highlighted that coordinated care and treatment for cancer patients is both a ' systems'challenge and solution, requiring the consideration of patient and family circumstances, societal values and priorities, the functioning of the health system (access, capacity, resources, etc.) and the importance assigned to health and illness management within public policy.
    Matched MeSH terms: Delivery of Health Care/organization & administration*
  7. Allotey P, Reidpath DD, Yasin S, Chan CK, de-Graft Aikins A
    Lancet, 2011 Feb 5;377(9764):450-1.
    PMID: 21074257 DOI: 10.1016/S0140-6736(10)61856-9
    Matched MeSH terms: Delivery of Health Care*
  8. Bulgiba AM
    Asia Pac J Public Health, 2004;16(1):64-71.
    PMID: 18839870 DOI: 10.1177/101053950401600111
    In 1998, Malaysia opened its first hospital based on the "paperless and filmless" concept. Two are now in operation, with more to follow. Telemedicine is now being used in some hospitals and is slated to be the technology to watch. Future use of technology in health care will centre on the use of centralised patient databases and more effective use of artificial intelligence. Stumbling blocks include the enormous capital costs involved and difficulty in getting sufficient bandwidth to support applications on a national scale. Problems with the use of information technology in developing countries still remain; mainly inadequate skilled resources to operate and maintain the technology, lack of home-grown technology, insufficient experience in the use of information technology in health care and the attitudes of some health staff. The challenge for those involved in this field will not be in building new "paperless and filmless" institutions but in transforming current "paper and film-based" institutions to "paperless and filmless" ones and changing the mindset of health staff. Universities and medical schools must be prepared to respond to this new wave by incorporating elements of medical/health informatics in their curriculum and assisting governments in the planning and implementation of these projects. The experience of the UMMC is highlighted as an example of the difficulty of transforming a paper-based hospital to a "paperless and filmless" hospital.
    Matched MeSH terms: Delivery of Health Care/trends*
  9. Phua KL
    J Emerg Manag, 2015;13(3):255-63.
    PMID: 26150369 DOI: 10.5055/jem.2015.0239
    In the twenty-first century, climate change is emerging as a significant threat to the health and well-being of the public through links to the following: extreme weather events, sea level rise, temperature-related illnesses, air pollution patterns, water security, food security, vector-borne infectious diseases, and mental health effects (as a result of extreme weather events and climate change-induced population displacement). This article discusses how national healthcare systems can be redesigned through changes in its components such as human resources, facilities and technology, health information system, and health policy to meet these challenges.
    Matched MeSH terms: Delivery of Health Care/organization & administration*
  10. Suleiman AB
    Int J Med Inform, 2001 May;61(2-3):103-12.
    PMID: 11311664
    The people of Malaysia generally enjoy a high standard of health. This is largely attributed to the comprehensive range of health services provided by the Government and the private sector at affordable costs. However, there are changing trends that now seriously challenge this status quo. The changing population structure, lifestyle, disease patterns and globalization are causing healthcare costs to rise. New and innovative ways will have to be devised to further improve the health status and at the same time contain costs. Information and Communication Technology (ICT) presents unprecedented opportunities to help the health sector in Malaysia reinvent itself and transform the way health and healthcare is managed and delivered in the future. Malaysia's Telehealth initiative under the Multimedia Super Corridor (MSC) project is designed to realize Malaysia's health vision and goals and meet future health challenges. Multimedia and Internet technology will be fully harnessed to deploy services that will shift the emphasis from episodic management of illness to proactive promotion of lifelong wellness and disease prevention. Health information content and interactive applications will engage the people to work as partners of health with healthcare professionals in maintaining their own health or managing their illnesses.
    Matched MeSH terms: Delivery of Health Care, Integrated*
  11. George VC
    Med J Malaysia, 2003 Mar;58 Suppl A:19-22.
    PMID: 14556347
    Matched MeSH terms: Delivery of Health Care/legislation & jurisprudence*
  12. Chen PCY
    World Health Forum, 1989;10(2):190-2.
    PMID: 2610830
    A primary health care system is being developed in Baram District, Sarawak, Malaysia, for the benefit of the Penans, who, until recently, were largely nomadic. Many of them are now attempting to adopt a settled mode of existence, and this in itself creates special health problems because the people lack the skills needed for living in one place. Substantial progress has already been achieved in mother and child care and in immunization coverage.
    Matched MeSH terms: Delivery of Health Care*
  13. Croke K, Mohd Yusoff MB, Abdullah Z, Mohd Hanafiah AN, Mokhtaruddin K, Ramli ES, et al.
    Health Policy Plan, 2019 Dec 01;34(10):732-739.
    PMID: 31563946 DOI: 10.1093/heapol/czz089
    There is growing evidence that political economy factors are central to whether or not proposed health financing reforms are adopted, but there is little consensus about which political and institutional factors determine the fate of reform proposals. One set of scholars see the relative strength of interest groups in favour of and opposed to reform as the determining factor. An alternative literature identifies aspects of a country's political institutions-specifically the number and strength of formal 'veto gates' in the political decision-making process-as a key predictor of reform's prospects. A third group of scholars highlight path dependence and 'policy feedback' effects, stressing that the sequence in which health policies are implemented determines the set of feasible reform paths, since successive policy regimes bring into existence patterns of public opinion and interest group mobilization which can lock in the status quo. We examine these theories in the context of Malaysia, a successful health system which has experienced several instances of proposed, but ultimately blocked, health financing reforms. We argue that policy feedback effects on public opinion were the most important factor inhibiting changes to Malaysia's health financing system. Interest group opposition was a closely related factor; this opposition was particularly powerful because political leaders perceived that it had strong public support. Institutional veto gates, by contrast, played a minimal role in preventing health financing reform in Malaysia. Malaysia's dramatic early success at achieving near-universal access to public sector healthcare at low cost created public opinion resistant to any change which could threaten the status quo. We conclude by analysing the implications of these dynamics for future attempts at health financing reform in Malaysia.
    Matched MeSH terms: Delivery of Health Care/economics
  14. Low LL, A B Rahim FI, Hamzah NAR, Ismail MS
    PLoS One, 2021;16(1):e0245125.
    PMID: 33428645 DOI: 10.1371/journal.pone.0245125
    BACKGROUND: In combating the increasing trend of non-communicable diseases (NCDs) over the last two decades in the country, the Ministry of Health Malaysia developed the Enhanced Primary Health Care (EnPHC) initiative to improve care management across different levels of the public service delivery network. An evaluation research component was embedded to explore the implementation issues in terms of fidelity, feasibility, adaptation and benefit of the initiative's components which were triage, care coordination, screening, risk management and referral system.

    METHODS: A mixed methods study was conducted at 20 participating EnPHC clinics in Johor and Selangor, two months after the intervention was initiated. Data collected from self-reported forms and a structured observation checklist were descriptively analysed. In-depth interviews were also conducted with 20 participants across the clinics selected to clarify any information gaps observed in each clinic, and data were thematically analysed.

    RESULTS: Evaluation showed that all components of EnPHC intervention had been successfully implemented except for the primary triage counter and visit checklist. The challenges were mainly discovered in terms of human resource and physical structure. Although human resource was a common implementation challenge across all interventions, clinic-specific issues could still be identified. Among the adaptive measures taken were task sharing among staff and workflow modification to match the clinic's capacity. Despite the challenges, early benefits of implementation were highlighted especially in terms of service outcomes.

    CONCLUSIONS: The evaluation study disclosed issues of human resource and physical infrastructure when a supplementary intervention is implemented. To successfully achieve a scaled-up PHC service delivery model based on comprehensive management of NCDs patient-centred care, the adaptive measures in local clinic context highlight the importance of collaboration between good organisational process and good clinical practice and process.

    Matched MeSH terms: Delivery of Health Care*
  15. Weatherall J, Simonsen J, Odlaug BL
    J Med Econ, 2020 Oct;23(10):1186-1192.
    PMID: 32573296 DOI: 10.1080/13696998.2020.1786393
    AIM: To compare the health economic efficiency of health care systems across nations, within the area of schizophrenia, using a data envelopment analysis (DEA) approach.

    METHODS: The DEA was performed using countries as decision-making units, schizophrenia disease investment (cost of disease as a percentage of total health care expenditure) as the input, and disability-adjusted life years (DALYs) per patient due to schizophrenia as the output. Data were obtained from the Global Burden of Disease 2017 study, the World Bank Group, and a literature search of the PubMed database.

    RESULTS: Data were obtained for 44 countries; of these, 34 had complete data and were included in the DEA. Disease investment (percentage of total health care expenditure) ranged from 1.11 in Switzerland to 6.73 in Thailand. DALYs per patient ranged from 0.621 in Lithuania to 0.651 in Malaysia. According to the DEA, countries with the most efficient schizophrenia health care were Lithuania, Norway, Switzerland and the US (all with efficiency score 1.000). The least efficient countries were Malaysia (0.955), China (0.959) and Thailand (0.965).

    LIMITATIONS: DEA findings depend on the countries and variables that are included in the dataset.

    CONCLUSIONS: In this international DEA, despite the difference in schizophrenia disease investment across countries, there was little difference in output as measured by DALYs per patient. Potentially, Lithuania, Norway, Switzerland and the US should be considered 'benchmark' countries by policy makers, thereby providing useful information to countries with less efficient systems.

    Matched MeSH terms: Delivery of Health Care/organization & administration*
  16. Choi S, Park S, Kim SY
    Asia Pac J Public Health, 2018 07;30(5):458-469.
    PMID: 30051720 DOI: 10.1177/1010539518789351
    We examined the constitutional provisions on the right to health in the Western Pacific region countries and compared universal health coverage (UHC) achievement. In 9 of the 11 countries, the constitution had provisions related to health rights, of which 7 countries also included details related to the health care system. Additionally, 5 countries also had provisions for the vulnerable. The countries with weak state obligation and no clear provisions on health rights (China and Laos) all recorded low UHC achievement scores. Australia and Malaysia, which do not have constitutional provisions regarding health, have achieved high UHC achievement scores. Constitution is the supreme law of a country and the basis for developing and implementing health and medical laws and policies. In addition, laws or constitutions that regulate the rights to health can help gain access to health care. Follow-up research related to the constitutional right to health will be needed.
    Matched MeSH terms: Delivery of Health Care/legislation & jurisprudence*
  17. Alanazi HO, Abdullah AH, Qureshi KN
    J Med Syst, 2017 Apr;41(4):69.
    PMID: 28285459 DOI: 10.1007/s10916-017-0715-6
    Recently, Artificial Intelligence (AI) has been used widely in medicine and health care sector. In machine learning, the classification or prediction is a major field of AI. Today, the study of existing predictive models based on machine learning methods is extremely active. Doctors need accurate predictions for the outcomes of their patients' diseases. In addition, for accurate predictions, timing is another significant factor that influences treatment decisions. In this paper, existing predictive models in medicine and health care have critically reviewed. Furthermore, the most famous machine learning methods have explained, and the confusion between a statistical approach and machine learning has clarified. A review of related literature reveals that the predictions of existing predictive models differ even when the same dataset is used. Therefore, existing predictive models are essential, and current methods must be improved.
    Matched MeSH terms: Delivery of Health Care/organization & administration*
  18. Johnson CD, Haldeman S, Chou R, Nordin M, Green BN, Côté P, et al.
    Eur Spine J, 2018 09;27(Suppl 6):925-945.
    PMID: 30151805 DOI: 10.1007/s00586-018-5720-z
    PURPOSE: Spine-related disorders are a leading cause of global disability and are a burden on society and to public health. Currently, there is no comprehensive, evidence-based model of care for spine-related disorders, which includes back and neck pain, deformity, spine injury, neurological conditions, spinal diseases, and pathology, that could be applied in global health care settings. The purposes of this paper are to propose: (1) principles to transform the delivery of spine care; (2) an evidence-based model that could be applied globally; and (3) implementation suggestions.

    METHODS: The Global Spine Care Initiative (GSCI) meetings and literature reviews were synthesized into a seed document and distributed to spine care experts. After three rounds of a modified Delphi process, all participants reached consensus on the final model of care and implementation steps.

    RESULTS: Sixty-six experts representing 24 countries participated. The GSCI model of care has eight core principles: person-centered, people-centered, biopsychosocial, proactive, evidence-based, integrative, collaborative, and self-sustaining. The model of care includes a classification system and care pathway, levels of care, and a focus on the patient's journey. The six steps for implementation are initiation and preparation; assessment of the current situation; planning and designing solutions; implementation; assessment and evaluation of program; and sustain program and scale up.

    CONCLUSION: The GSCI proposes an evidence-based, practical, sustainable, and scalable model of care representing eight core principles with a six-step implementation plan. The aim of this model is to help transform spine care globally, especially in low- and middle-income countries and underserved communities. These slides can be retrieved under Electronic Supplementary Material.

    Matched MeSH terms: Delivery of Health Care/organization & administration*
  19. Kopansky-Giles D, Johnson CD, Haldeman S, Chou R, Côté P, Green BN, et al.
    Eur Spine J, 2018 09;27(Suppl 6):915-924.
    PMID: 30151804 DOI: 10.1007/s00586-018-5725-7
    PURPOSE: The purpose of this report is to describe the development of a list of resources necessary to implement a model of care for the management of spine-related concerns anywhere in the world, but especially in underserved communities and low- and middle-income countries.

    METHODS: Contents from the Global Spine Care Initiative (GSCI) Classification System and GSCI care pathway papers provided a foundation for the resources list. A seed document was developed that included resources for spine care that could be delivered in primary, secondary and tertiary settings, as well as resources needed for self-care and community-based settings for a wide variety of spine concerns (e.g., back and neck pain, deformity, spine injury, neurological conditions, pathology and spinal diseases). An iterative expert consensus process was used using electronic surveys.

    RESULTS: Thirty-five experts completed the process. An iterative consensus process was used through an electronic survey. A consensus was reached after two rounds. The checklist of resources included the following categories: healthcare provider knowledge and skills, materials and equipment, human resources, facilities and infrastructure. The list identifies resources needed to implement a spine care program in any community, which are based upon spine care needs.

    CONCLUSION: To our knowledge, this is the first international and interprofessional attempt to develop a list of resources needed to deliver care in an evidence-based care pathway for the management of people presenting with spine-related concerns. This resource list needs to be field tested in a variety of communities with different resource capacities to verify its utility. These slides can be retrieved under Electronic Supplementary Material.

    Matched MeSH terms: Delivery of Health Care/organization & administration*
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