Introduction, purpose of the study: In Central Europe, in Hungary, the state guarantees access to health care and basic health services partly through the Semmelweis Plan adopted in 2011. The Health Plan aims to optimize and transform the health system. The objectives of hospital integration, as set out in the Plan, started with the state ownership of municipal hospitals in 2012, continued with the launch of integration processes in 2012–2013 and culminated today. The transformation of a health system can have an impact on health services and thus on meeting the needs of the population. We aim to study the effectiveness of integration through access to CT diagnostic testing. Our hypothesis is that integration has resulted in increased access to modern diagnostic services. The specialty under study is computed tomography (CT) diagnostic care. Our research shows that the number of people receiving CT diagnostic care has increased significantly because of integration, which has also brought a number of positive benefits, such as reduced health inequalities, reduced travel time, costs and waiting lists. Test material and method: Our quantitative retrospective research was carried out in the hospital of Kalocsa through document analysis. The research material was comparing two time periods in the Kalocsa site of Bács-Kiskun County, Southern Hungary. The number of patients attending CT examinations by area of duty of care according to postal codes was collected: Pre-integration period 2014.01.01–2017.11.30. (Kalocsa did not have CT equipment, so patients who appeared in Kecskemét Hospital but were under the care of Kalocsa), post-integration period 2017.12.01–2019.12.31. (period after the installation of CT in Kalocsa). The target group of the study consisted of women and men together, aged 0–99 years, who appeared for a CT diagnostic examination. The study sample size was 6721 persons. Linear regression statistics were used to evaluate the results. Based on empirical experience, a SWOT analysis was carried out to further investigate the effectiveness of integration. Results: As a result of the integration, the CT scan machine purchased in the Kalocsa District Hospital has enabled an average of 129.7 patients per month to receive CT scans on site without travelling. The model used is significant, explaining 86% of the change in the number of patients served (F = 43.535; p < 0.001, adjusted R² = 0.860). The variable of integration in the model is significant, with an average increase in the number of patients served of 129.7 per month (t = 22.686; p < 0.001) following the introduction of CT due to integration. None of the month variables representing seasonal effects were found to be significant, with no seasonal effect on care. The SWOT analysis has clearly identified the strengths, weaknesses, opportunities and threats related to the integration, the main outcome of which is the acquisition of a CT diagnostic tool. Conclusions: Although we only looked at one segment of the evidence for the effectiveness of hospital integration, integration in the study area has had a positive impact on CT availability, reducing disparities in care.

Management education in health service industry is essential to enhance systems performance and should offer a broad curriculum that contain the context of practice, research awareness and skills of critical appraisal, a grounding in a range of disciplines and a reflective approach towards general management skill. With the improvement of living standard and significant growth of aging population, there is an obvious gap between health service coverage and the demand in China, especially the shortage of workforce with professional health service management knowledge. The objective of this essay is to compare the element of health service management education in China and British.

Climate change is occurring more quickly and has more complex effects than expected. The well-being of populations in general and financial resources have been impacted by climate change in recent years. Children, pregnant women and the elderly bear the brunt of the impacts caused by climate-related risks. This research aims to assess the perceptions of health personnel and clients on climate change as well as these impacts in the Greater Lomé health region in Togo. Furthermore, this research examines the differences between the perceptions of caregivers, patients and scientific observations in this area. Based on field observations, an interview guide and a questionnaire, the information collected shows that nearly 75.95% of those questioned perceived climate change, particularly in the form of an increase in precipitation concentrated on a cost duration causing floods and the scarcity of rain at the end of the year leading to droughts. More than 25.40% and 61.86% respectively perceive that droughts and floods impact their livelihoods, but do not fully understand the causes. The results are useful for planning useful actions to facilitate the management of climate-related risks in health establishments in the Greater Lomé health region. It is therefore important to carry out awareness campaigns, train stakeholders and take necessary measures to make health systems resilient.

Background: In an increasingly globalized world, public health is a challenge in the future of health systems. Nursing is a fundamental profession in health systems and the purpose of the study is to quantify the scientific production in global public health carried out by nursing to demonstrate its competence, capacity and specialization in this subject. Methods: A bibliometric study was carried out to understand the scientific production of public health nursing in WoS. A total of 17,545 documents were analyzed using Bibliometrix software in version 4.0.5. Results: A notable increase in production is observed over time, a sign of specialization and capacity. The theme focuses on three stages: hygiene and sanitation, infectious diseases and quality, prevention and non-communicable diseases coinciding with the real social needs of each moment. Most of the production is in English and produced by countries with developed economies. Nursing is aligned with current public health needs. Conclusions: Bibliometrics is a good method to quantify scientific production. The results show extensive scientific production in public health nursing, which translates into extensive knowledge of public health by nursing. There is a growth in production in accordance with time as well as an adaptation to the most current themes in accordance with population needs. Public health is an area of concern to countries and nursing can actively participate in studies, planning and leadership of health systems. Public health nursing should not be considered relegated to medicine but independent and of crucial importance to the “Onehealth” concept. Public, private and educational administrations must promote and support nursing research in public health, and it is not advisable to reduce the teaching load of global public health in nursing studies, in favor of the family and community environment.

Climate change has adverse effects on ecosystems and several socio-economic sectors including health. Indeed, infrastructure, continuity of medical services, and the hospital environment are all directly affected by the effects of climate-related risks. This study aims to describe the observations of the effects of climate change risks on health systems in the Greater Lomé health region of Togo. We used an interview guide and a questionnaire to collect information. The observations allowed us to assess the effects caused by climate risks. According to the results, 84.62% of respondents attest that health centers experience flooding during rainy periods and damage caused by strong winds is noticeable among 76.92% of respondents. More than 25.40% and 61.86% respectively of respondents mention that droughts and floods have effects on health systems. The results of this study will allow health system managers to become aware of how to plan useful actions to facilitate the management of climate-related risks in health facilities in the Greater Lomé health region. In view of all these results, it is necessary that measures be taken to strengthen the resilience of health systems through awareness campaigns and training of actors throughout the health pyramid.

Introduction: In Central Europe, in Hungary, the state guarantees access to health care and basic health services partly through the Semmelweis Plan adopted in 2011. The primary objectives of the Semmelweis Plan include the optimisation and transformation of the health care system, starting with the integration of hospitals and the state control of previously municipally owned hospitals. The transformation of the health care system can have an impact on health services and thus on meeting the needs of the population. In addition to reducing health inequalities and costs, the relevant benefits include improving patients’ chances of recovery and increasing patient safety. The speciality under study is decubitus care. Our hypothesis is that integration will improve the chances of recovery for decubitus patients through access to smart dressings to promote patient safety. Objective: to investigate and demonstrate the effectiveness of integration in improving the chances of recovery for decubitus ulcer patients. Material and methods: The research compared two time periods in the municipality of Kalocsa, Bács-Kiskun County, Southern Hungary. We collected the number of decubitus patients arriving and leaving the hospital from the nursing records and compared the pre-integration period when decubitus patients were provided with conventional dressings (01.01.2006–2012.12.31) and the post-integration period, which entailed the introduction of smart dressings in decubitus care (01.01.2013–2012.12.31). The target population of the study was men and women aged 0–99 years who had developed some degree of decubitus. The sample size of the study was 4456. Independent samples t-test, Chow test and linear trend statistics were used to evaluate the results. Based on the empirical evidence, a SWOT analysis was conducted to further examine the effectiveness of integration. Results: The independent samples t-test model used was significant (for Phase I: t (166) = −16.872, p < 0.001; for Phase II: t (166) = −19.928, p < 0.001; for Phase III: t (166) = −19.928, p < 0.001; for Phase III: t (166) = −16.872, p < 0.001). For stage III: t (166) = −10.078, p < 0.001; for stage IV: t (166) = −10.078, p < 0.001; for stage III: t (166) = −10.078, p < 0.001). for stage III: t (166) = −14.066, p < 0.001). For the Chow test, the p-values were highly significant, indicating a structural break. Although the explanatory power of the regression models was variable (R-squared values ranged from 0.007 to 0.617), they generally supported the change in patient dynamics after integration. Both statistical analyses and SWOT analysis supported our hypothesis and showed that integration through access to smart dressings improves patients’ chances of recovery. Conclusions: Although only one segment of the evidence on the effectiveness of hospital integration was examined in this study, integration in the study area had a positive impact on the effective care of patients with decubitus ulcers, reduced inequalities in care and supported patient safety. In the context of the results obtained, these trends may reflect different systemic changes in patient management strategies in addition to efficient allocation of resources and quality of care.