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.
This research aims to identify the development of research theme trends that were carried out from 1999 to 2024. Thus, the study’s results can provide recommendations regarding research themes that can be developed to meet theoretical and practical needs. Researchers use bibliometric analysis to obtain the appropriate analysis. This analysis method can be developed to support the dynamic development of public health science with settings and researchers from developing countries, both through quantitative and qualitative interpretation. The analysis results show that over 25 years, public health science, from the perspective of researchers and developing countries, has experienced dynamic development. This change was driven by the emergence of various issues in society itself. For example, the 1999–2009 shows that lifestyle changes have resulted in multiple diseases. In the following period, the concept of sustainability emerged, which encouraged awareness of sustainable development and resource scarcity that would affect public health quality. As for the 2020–2024 period, the emergence of Covid 19 changed the previous research paradigm.
Universal Health Coverage is a health insurance system that ensures every citizen in the population has equitable access to quality and effective promotive, preventive, curative, and rehabilitative health services. Meanwhile, the Medan City Government of Indonesia is trying to improve health services through the Medan Berkah Health Insurance Program by adopting Universal Health Coverage, which aims to provide Universal Health Coverage to the entire community. This study aims to explain the implementation and projection of the development of health services of the Medan City Government with the Universal Health Coverage System in the Medan Berkah Health Insurance Program which is intended as a step in providing opportunities for all people to get equal opportunities in health services, especially for the poor. This research uses qualitative research by using the literacy study method by studying related documents and conducting in-depth observations. Data analysis included data reduction, presentation, and conclusion drawing. The Medan City Government implemented the Universal Health Coverage Program in Jaminan Kesehatan Medan Berkah, which aims to improve health services in the city. The government is committed to simplifying the bureaucracy, managing the medical workforce, and collaborating with stakeholders and the community. However, challenges include low community participation, limited resources, lack of coordination, and limited access to information, which hinder the successful implementation of the program.
The COVID-19 outbreak on international cruise ships during the early stages of the pandemic has exposed deficiencies in the governance of public health emergencies within the framework of existing international law. These deficiencies encompass various aspects, including the shortcomings of the system of flag state jurisdiction, the vague definition and reasonableness of governments’ “additional health measures” as stipulated in the International Health Regulations (IHR) of 2005, the role of World Health Organization (WHO) in the protection of the fundamental rights of passengers and crew members during epidemic outbreaks on cruise ships, the application of the free pratique rule under the international health law, and other challenges that have not been adequately addressed in current international law. In the post-COVID era, it is essential to revisit these core issues of international law and reassess the allocation of responsibilities among all evolving actors to foster effective multilateral cooperation in epidemic control. This paper adopts the “Diamond Princess” incident as a case study, examining how such public health emergencies pose challenges to international laws, particularly when they occur within the context of a cruise ship. The paper argues that cooperation on global health emergencies will continue to be a challenge until responsibility is more clearly allocated among stakeholders. Additionally, the paper formulates three principles for enhancing governmental cooperation, namely the fairness principle, the nationality principle, and the principle of common but differentiated responsibilities. It is advisable to carefully consider these key principles when reevaluating the international laws on public health emergencies in the post-COVID era.
In the history of public health, space has evolved through several stages driven by shifts in concepts of disease control. The history of public health is summarized by George Rosen in six phases: Origins (before 500 CE), Middle Ages (500–1500), Mercantilism and Absolutism (1500–1750), Enlightenment and Revolution (1750–1830), Industrialism and the Sanitary Movement (1830–1875), and the Bacteriological Era (1875–present). By integrating architectural sociology—a temporal lens examining the interplay between architecture, individuals, and society—this study investigates how architects historically responded to public health challenges, offering critical insights for contemporary healthy habitat design. Architecture not only addresses survival needs but also materializes societal consciousness. The progression of health-related cognition (e.g., germ theory), behavioural norms (e.g., hygiene practices), infrastructure systems (e.g., sanitation networks), and scientific advancements collectively redefined spatial paradigms. Architects constructed temples, thermae, lazarettos, Beitian Yangbingfang (charitable infirmaries), anatomical theaters, quarantine hospitals, tenements, mass housing, and biosafety laboratories. These cases exemplify the co-evolution of “Concept” (disease control ideologies), “Technology” (construction methods), and “Space” (built environments). By synthesizing centuries of public health spatial practices, this research deciphers the dynamic interplay among “Concept, Technology, and Space”. Leveraging historical patterns, we propose a predictive framework to refine future spatial strategies in anticipation of emerging health crises.
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