Spatial Access Matters: An Analysis of Policy Change and Its Effects on Avoidable Infant Mortality in Portugal

Weiland, Morgan; Santana, Paula; Costa, Claúdia; Doetsch, Julia Nadine; Pilot, Eva

doi:10.3390/ijerph18031242

Cited by 6 publications

(10 citation statements)

References 27 publications

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“…Accessibility and capacity of medical resources are two foundations for population health promotion and protection. The United Nationals Sustainable Development Goal three requires accessibility to health care service for all to achieving universal health care coverage, and sufficient medical capacity can insure the inclusiveness, in particular for emergency preparedness and response like COVID19 pandemic (United Nations, 2015; Wang et al, 2021;Weiland et al, 2021). The medical resources in China, though improved significantly in the past two decades, are characterized by inequality and low efficiency, represented by extreme rich in resources in the east mega regions and thus leading to resources waste, and extreme poor both in high quality medical re-sources and medical care capacity in many regions in the west (Zhou and Yuan, 2018).…”

Section: Introductionmentioning

confidence: 99%

Incorporating Exercise Efficiency to Evaluate the Accessibility and Capacity of Medical Resources in Tibet, China

et al. 2022

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Accessibility and capacity of medical resources are key for the health care and emergency response, while the efficiency of the medical resources is very much limited by hypoxia in Tibet, China. Through introducing exercise efficiency, this study explores the accessibility of township residence to county-ship medical resources in Tibet using weighted mean travel time (WMT), and evaluates the medical capacity accordingly. The results show that: 1) the average travel time of township residence to county-level hospital is around 2 h by motor vehicle in Tibet. More than half of the population can not reach the county-ship hospital within 1 h, 33.24% of the population can not reach within 2 h, and 3.75% of the population can not reach within 6 h. 2) When considering the catchment of the medical resources and the population size, the WMT of the county-ship medical resources ranges from 0.25 h to 10.92 h. 3) After adjusted by travel time and exercise efficiency, the county-ship medical capacity became more unequal, with 38 out of 74 counties could not meet the national guideline of 1.8 medical beds per 1000. 4) In total, there are 17 counties with good WMT and sufficient medical resources, while 13 counties having very high WMT and low capacity of medical resources in Tibet. In the end, suggestions on medical resources relocation and to improve the capacity are provided. This study provides a method to incorporate exercise efficiency to access the accessibility and evaluate medical capacity that can be applied in high altitude ranges.

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Section: Introductionmentioning

confidence: 99%

Incorporating Exercise Efficiency to Evaluate the Accessibility and Capacity of Medical Resources in Tibet, China

et al. 2022

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“…Moreover, the four selected countries are comparable in their healthcare system types: state regulation for member states provides for universal health insurance or service coverage in Greece, Italy and Portugal or nearly universal coverage in Spain for healthcare through compulsory schemes 50. Higher healthcare expenditure,51 better healthcare access52 53 and universal healthcare coverage are directly connected to declining IMR,52 54 55 which could thus be an additional factor in the observed overall declining trends.…”

Section: Discussionmentioning

confidence: 99%

2008 economic crisis impact on perinatal and infant mortality in Southern European countries

Doetsch

Almendra

Severo

et al. 2023

J Epidemiol Community Health

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IntroductionThe study of crisis events provides important lessons to prepare for upcoming events. The Great Recession’s impact on perinatal health in Europe can provide relevant insights into the healthcare and social protection systems’ response to the protection of the health of the most vulnerable groups.ObjectiveTo assess time trends and international disparities in perinatal mortality rates (PMR) and infant mortality rates (IMR), following the Great Recession, and their association with socioeconomic indicators in Portugal, Greece, Italy and Spain.MethodsAssociations were assessed through generalised linear models for all four countries. A Poisson joinpoint regression model was applied to explore PMR and IMR trend changes between 2000 and 2018. Country disparities were analysed using mixed-effects multilevel models.ResultsIMR and PMR have decreased overall in the four selected countries between 2000 and 2018. Still, whereas in Spain, Italy and Portugal the decreasing pace was attenuated after 2009, in Greece a positive trend was found after the 2008 crisis. IMR and PMR were significantly associated with socioeconomic indicators in all four countries. National disparities in the evolution of IMR and PMR were significantly associated with most socioeconomic indicators between 2000 and 2018.ConclusionOur results confirm the impact of the Great Recession on PMR and IMR trends in all four countries, taking recurring associations between macroeconomic cycles, variations in mortality trends, macroeconomic volatility and stagnation of IMR and PMR into account. The association with socioeconomic indicators stresses the need to strengthen social protection and healthcare systems to better protect the population’s health from the earliest days.

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“…These areas require strategic actions in order to reduce premature mortality. In health care planning, at different management levels (state, regional and local), the main gaps in maternal and child health care need to be considered, including deaths that may be prevented through healthcare actions (Mendes et al, 2019;Weiland et al, 2021). Strengthening and expanding the obstetrics and neonatology care network, prioritizing immediate low-cost actions, such as early prenatal care, would reduce the number of premature deaths (Al-Sheyab et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Incorporation of spatial analysis techniques into public health management helps detecting priority regions with higher risk of morbidity/mortality and/or areas with difficult access to healthcare (Tesema and Teshale, 2021). Thus, it directs planned investments into public policies toward maternal and child health (Weiland et al, 2021). The aim of this study was to analyse the spatial patterns of the total mortality over the first 24 hours of life, and that due to preventable causes in the state of Pernambuco, Brazil over the period 2000 to 2019.…”

Section: Introductionmentioning

confidence: 99%

Spatial patterns of the total mortality over the first 24 hours of life and that due to preventable causes

Silva¹,

Araújo²,

Silva³

et al. 2022

Geospat Health

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This is an ecological study analysing spatial patterns of the total mortality over the first 24 hours of life and that due to preventable causes using data from the mortality information system (SIM) and live birth information system (SINASC) based on the municipalities of Pernambuco State, Brazil. The total mortality rates over the first 24 hours and that due to preventable causes were calculated for each municipality for the decades of 2000 to 2009 and for 2010 to 2019 to enable a comparison of the spatial patterns with spatial scan statistic used to identify clusters. Over the first 24 hours of life, a total of 13,571 deaths were reported, out of which 10,476 (77.2%) were preventable. The total mortality rate over the first 24 hours of life decreased from 5.5 in the 2000- 2009 period to 3.7 per 1000 live births in the following decade: a reduction of 32.7%, while the mortality rate due to preventable causes decreased from 4.4 to 2.8 per 1000 live births, a reduction of 36.7%. In the first decade, spatial exploratory analysis found three mortality rate clusters encompassing 56 municipalities over the first 24 hours of life. With respect to preventable causes over the first 24 hours of life, two mortality rate clusters were identified encompassing 41 municipalities. Risk areas for mortality over the first 24 hours of life were detected through spatial scan statistic. This method, directed towards uncovering the geographical distribution of deaths of very premature infants, can act as a tool for identifying priority areas to guide healthcare interventions.

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Spatial Access Matters: An Analysis of Policy Change and Its Effects on Avoidable Infant Mortality in Portugal

Cited by 6 publications

References 27 publications

Incorporating Exercise Efficiency to Evaluate the Accessibility and Capacity of Medical Resources in Tibet, China

Incorporating Exercise Efficiency to Evaluate the Accessibility and Capacity of Medical Resources in Tibet, China

2008 economic crisis impact on perinatal and infant mortality in Southern European countries

Spatial patterns of the total mortality over the first 24 hours of life and that due to preventable causes

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