Health Systems and the Challenge of Chronic Disease— Through the Lens of Breast Cancer
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Transcript of Health Systems and the Challenge of Chronic Disease— Through the Lens of Breast Cancer
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Ebnacak Okrab LgkunHkrvkrf Mni`kn Bquaty AgataktavbHkrvkrf Obfackn SchiinMni`kn Vksl Eircb ig Bxpkgfbf Kccbss ti Ckgcbr Ckrb kgf CigtrinObxackg Hbknth Eiugfktaig
Voktbni k TbchiRgaig eir Agtbrgktaigkn Ckgcbr Cigtrin
Okrch 01, 04;6
Hbknth Systbos kgf thbChknnbgmb ie Chrigac Fasbksb
Vhriumh thb Nbgs ie @rbkst Ckgcbr
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Erio kgbcfitb
ti bvafbgcb
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Jkgukry, 0448
Jugb, 044=
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ti bvafbgcb
Erio kgbcfitb
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MVE.CCC ?
mni`kn hbknth +
ckgcbr ckrb
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Chknnbgmb kgf fasprivb thboyths k`iut ckgcbr
O;. Rggbcbsskry
O0. Rgkeeirfk`nb O3. AgkppripraktbO6: Aopissa`nb
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Ckgcbr as k fasbksb ie `ith rach kgf piir< ybt at asagcrbksagmny thb piir whi sueebr:
;. Bxpisurb ti rasl ekctirs 0. Trbvbgtk`nb ckgcbrs (agebctaig)
3. Fbkth kgf fask`anaty erio trbktk`nbckgcbr
6. Stamok kgf fascraoagktaig
2. Kviafk`nb pkag kgf sueebragm
Vhb Ckgcbr Favafb: Kg Bquaty Aopbrktavb
E k c b t s
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Nbulkboak
Knn ckgcbrs
Siurcb: Lgkun, Krrbink, Obgfbz. bstaoktbs `ksbf ig AKPC, Mni`ickg, 04;4.
;44%
@rbkst
Cbrvax
Vbstas
Tristktb
Gig-hiflags
Hiflags
Vyriaf
Chagk
;44%
Chagk
Obxaci
Ckgkfk
Obxaci
Ckgkfk
Vhb Ippirtugaty ti Survavb (O/A) ShiunfGit @b Fbeagbf `y Agciob
Chanfrbg
Siurcb: Lgkun, Krrbink, Obgfbz. bstaoktbs `ksbf ig AKPC, Mni`ickg, 04;4.
NI]
AGCIO
HAMH
AGCIOB
NI]
AGCIO
HAMH
AGCIOB
Ag Ckgkfk, knoist 14% ie chanfrbg wath nbulboak survavb.Ag thb piirbst ciugtrabs igny ;4% survavb.
14% ;4%
hb `k k f fb
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Nktag Kobrack
Kerack
Chagk :;,0=5
Vhb Mni`kn Tkag favafb
Obxaci :0,344
0=0,444 om
05=,444 om3=,444 om
Gig-obthkfigb, Oirphagb Bquavknbgt ipaiafcigsuoptaig pbr fbkth erio HAU ir ckgcbr agpkag
:Tiirbst ;4% ;4% : 26 om
Pachbst ;4% ;4% : 1=,644 omRS/Ckgkfk : 0=4,444 om
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Vhb i i k i k b h b
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Vhb cists i ag kct ig krb humb:Si wb oust Agvbst A G kctaig
Vi`kcci as k humb bcigioac rasl: 3.5% niwbr MFT3.5
Vitkn bcigioac cist ie ckgcbr, 04;4: 0-6% ie mni`kn MFT0 6 MFT
Trbvbgtaig kgf trbktobgt ieebr pitbgtakn wirnf skvagms ie$ RS ;34-164 `annaig
;344 1644
kviafk`nb ckgcbr fbkths: ;/3-;/0, 0.6-3.= oannaig< 84% NAOCs;/3-;/0 064
3=4 84%
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Vhb cists ti cnisb thb ckgcbr favafboky `b nbss thkg okgy ebkr:
Tkag obfacktaig as chbkp
Tracbs frip: Hbp@ kgf HTU vkccagbs Fbnavbry & eagkgcagm pnkteiros & aggivktaigs krbugfbrutanazbf kgf ugfbvbnipbf
Turchksagm as erkmobgtbf, pricurbobgt as ugstk`nb
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Chknnbgmb kgf fasprivb thboyths k`iut ckgcbr
O;. Rggbcbsskry
O0. Rgkeeirfk`nbO3. Agkppripraktb
O6: Aopissa`nb
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]iobg kgf oithbrs ag NOACsekcb okgy rasls thriumh thb naeb cycnb
]iobg ;2-21, kggukn fbkths ;2-21
Fak`btbs
;04,881
@rbkstckgcbr
;55,2==
Siurcb: Bstaoktbs ksbf ig fktk erio ]HI: Mni`kn Hbknth I`sbrvktiry, 0448 kgf Ourrky bt kn Nkgcbt 04;;.
Cbrvacknckgcbr
;60,=66
Oirtknatyag
chanf`arth
360,144
-32% ag34 ybkr
34
32%
? 634, 0;4 fbkths
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Eknsb fachitioabs chknnbgmb Rgavbrskn HbknthCivbrkmb (RHC)
Cioougack`nb ir agebctaigkssicaktbf
GCF
Chrigac
HAU/KAFs (LS) @rbkst ckgcbr
Kcutb
Fakrrhbks
Pbsparktiry agebctaig
KOA
Agekgt Nbulkboak
Fasbksb: y chr igacaty kgf agebctaig
Cbrvackn Ckgcbr H TU) N igm tbro fask`anaty pist age bctaig (pina i)
Chr igac w kcutb bpasifbs: Ksthok, obgtkn
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Hbknth SystboEugctaigs
Stkmb ie Chrigac Fasbksb Naeb Cycnb /ciopigbgts CCC
TraokryTrbvbgtaig
Sbcigfkryprbvbgtaig
Fakmgisas
Vrbktobgt
Survavirshap/Pbhk`anatktaig
/
Tknnaktaig/Bgf-ie-naeb ckrb
/
Stbwkrfshap
Eagkgcagm
Fbnavbry
PbsiurcbMbgbrktaig
Pbspigfagm ti thb chknnbgmb ie chrigacaty:Hbknth systbo eugctaigs `y ckrb cigtaguuo
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K rbspigsb ti chrigac anngbss rbquarbs kg kpprikchthkt agtbmrktbs agtbrvbgtaigs knigm thb cigtaguuo ie
fasbksb kgf naeb cycnb
;. Traokry prbvbgtaig
0. Sbcigfkry prbvbgcag (bkrny fbtbctaig) ( )
3. Fakmgisas 6. Vrbktobgt
2. Survavirshap
5. Tknnaktavb ckrb
BRHC ?Beebctavb Civbrkmb + Beebctavb Eagkgcakn Tritbctaig
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Fakmigknazagm Ckgcbr Ckrb:Eagkgcagm & Fbnavbry
& ;. Eagkgcagm: Agtbmrktb ckgcbr ckrb agti gktaigkn
agsurkgcb kgf sicakn sbcuraty primrkos
Obxaci , Chagk , Agfak 0. Fbnavbry: Hkrgbss pnkteiros `y agtbmrktagm
`rbkst kgf cbrvackn ckgcbr prbvbgtaig, scrbbgagm
kgf survavirshap ckrb agti OCH, SPH,HAU/KAFS, sicakn wbnekrb kgf kgta-pivbrty primrkos.
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O;. Rggbcbsskry
O0. Rgkeeirfk`nbO3. Agkppripraktb
O6: Aopissa`nb
Chknnbgmb kgf fasprivb thboyths k`iut ckgcbr
0443 Ob i Pb i
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0443 Obxaci PbeiroLby Eagkgcagm Bnbobgts:
;. Kccbss ti pu`nacny-eugfbf, hbkvany su`safazbf, primrbssavb
hbknth agsurkgcb Sbmuri Tipunkr - eir knn ekoanabs bxcnufbferio Sicakn Sbcuraty
-
0. Sbpkrktb `ufmbtagm kgf eugfs eir pu`nac hbknth miifs wathugavbrskn civbrkmb
3. Tkclkmb ie pbrsigkn hbknth sbrvacbs `ksbf ig cist-
beebctavbgbss kgf `urfbg ie fasbksb bxpkgfs ivbr taob
6. Eugf eir cktkstriphac anngbss civbragm spbcaeac agtbrvbgtaigseir spbcaeac fasbksbs bxpkgfs ivbr taob
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Obxaci 0443 Hbknth rbeiro crbktbf Sbmur i Tipunkr 0443
Hirazigtkn Civbrkmb:
@bgbeacakrabs
U b r t a c k
n C i v b r k m b
F a s b k s b s k g
f A g t b r v b g
t a i g s :
@ b g b
e a t s T k c
l k m b
Keeanaktaig : 0446: 5.2 o 524 04;0: 26.5 o 2654
@bgbeat pkclkmb:
0446: ;;3
04;0: 086+2=
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Kccbnbrktbf, ugavbrskn, vbrtackn civbrkmb `y fasbksbwath kg beebctavb pkclkmb ie agtbrvbgtaigs
0446/5: HAU/KAFS, cbrvackn ckgcbr, KNN agchanfrbg
044=: Knn pbfaktrac ckgcbrs< @rbkst ckgcbr 04;;: Vbstacunkr kgf Tristktb ckgcbr kgf GHN
04;0: Ivkrakg (cinirbctkn) ckgcbr
Obxaci Sbmuri Tipunkr : fakmigkn, eagkgcakn pritbctaig eir cktkstriphac anngbss
Sb i Ti k kgf kg b
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Sbmuri Tipunkr kgf ckgcbr:Bvafbgcb ie aopkct
@rbkst ckgcbr kfhbrbgcb ti trbktobgt :
0442: 044/54404;4: ;4/144
Sagcb thb agcirpirktaig ie chanfhiifckgcbrs agti thb Sbmuri Tipunkr
34-oigth survavkn: 34% ti knoist =4% 3434% =4%kfhbrbgcb ti trbktobgt: =4% ti 12%.
=4% 12%
Vhb huokg ekcbs ie Sbmuri
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Vhb huokg ekcbs ie SbmuriTipunkr: Muannbroagk Kvank
&
K`ash Piobi
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% fakmgisbf ag Stkmb 6 `y stktb6 # 0 lannbr ie wiobg
34-2634-26 0
2-;4% fbtbctbf agStkmb 4-;
2-;4% 4-;
Tiir ougacapknatbs:
24% Stkmb 6< 2x thbrktb eir rach 24%
6
@rbkst Ckgcbr: Fbnavbry ekanurb
Tiir
Pach
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Beebctavb Rgavbrskn Hbknth Civbrkmb (BRHC )
@bgbeacakrabs : @bmaggagm wath Uungbrk`nb mriups
@bgbeats -thb pkclkmb : Bxpnacat: agtbrvbgtaigs, fasbksbs, hbknth cigfataigs
Ciopnbtb: Cioougaty, pu`nac, pbrsigkn kgf cktkstriphac
Cist-beebctavb: agcrbksagm ut git bxhukstavb Trikctavb: ti prioitb bquaty kgf ramhts Hamh quknaty
Eagkgcakn pritbctaig
A gtbmrktbf kccriss thb naeb cycnb
B b t b gkg k i b k b i k
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Beebctavb eagkgcakn civbrkmb ie kchrigac fasbksb: `rbkst ckgcbr
Obxaci: Nkrmb kgf bxbopnkry agvbstobgt ag eagkgcakn pritbctaigeir ckgcbr prbvbgtaig kgf trbktobgt eir wiobg, ybt k niw survavknrktb. Ippirtugatabs ti aoprivb fbnavbry
Ckgcbr Cigtrin-Ckrb cigtaguuo -
TraokryTrbvbgtaig
BkrnyFbtbctaig
Fakmgisas
Vrbktobgt
Survavirshap
Tknnaktaig
Fbnavbry kgf eagkgcakn pritbctaig chknnbgmbs:
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@ b g b e a
t s : c i v b r b
f a g t b r v b g
t a i g s
Fbnavbry kgf eagkgcakn pritbctaig chknnbgmbs:
Sbmuri Tipunkr ag Obxaci
KCCBNBPKVBF UBPVACKN CIUBPKMB eir Cktkstriphac Anngbssbsagcnufbf ag thb Eugf : `rbkst ckgcbr, KAFS
Cioougaty kgf Tu`nac Hbknth Sbrvacbs
Tiir Pach
CHANFPBG: Hbknth agsurkgcb eir k Gbw Mbgbrktaig
Tkclkmb ie bssbgtakn pbrsigknsbrvacbs
@bgbeacakrabs
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Jukgatk:Kfvkgcbf obtkstktac `rbkst ckgcbr fub
ti oassbf ippirtugatabs
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Agcnufagm cbrvackn kgf `rbkst ckgcbr kwkrbgbss eirbkrny fbtbctaig ag Ipirtugafkfbs
Ipirtugafkfbs
Muk fb irabgtkcag yckpkcatkcag k tatunkrbs`bgbeacakrais fbn primrkokIpirtugafkfbs agcnufbsageiroktaig ig `rbkst ckgcbr ks ie0441/;4 0441 ;4
;.2 oannaig cipabs ti prioitbr
;24 Pbkchbs 2.8 oannaig ekoanabs ?
oirb thkg 14% ie piir hiusbhinfs28414%
Fakmigknazagm Fbnavbry:
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Fakmigknazagm Fbnavbry:
Vrkagagm praokry ckrb privafbrs ag bkrny fbtbctaig kgf
okgmbobgt ie `rbkst ckgcbr Trioitbrs (+6444), Gursbs & OFs
(+;644), obfackn stufbgts (+=24) Gubvi Nbig, Jknasci, Oirbnis, Tub`nkSamgaeackgt agcrbksb ag lgiwnbfmb, bspbcaknny ag C@B
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@rbkst Ckgcbr Agataktavb:Bxpniragm k fakmigkn kpprikch ag Chagk
Hkrvkrf Schiin ie Tu`nac Hbknth kgf Hkrvkrf Mni`kn BquatyAgataktavb krb cinnk`irktagm wath thb Knn-Chagk ]iobgs Ebfbrktaig kgf Gktaigkn Cbgtbr eir ]iobgs kgfChanfrbgs Hbknth ti cigfuct panit prijbcts kcriss saxciugtabs ag Chagk, bxpniragm kg bvafbgcb-`ksbf, fakmigknoifbn eir `rbkst ckgcbr bfucktaig kgf kwkrbgbss kt thbpraokry nbvbn ie ckrb kfkptagm kgf bxtbgfagm thb Obxacioifbn
5
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@b kgiptaoastiptaoknast