Natl Med J India
-
Health policy discussions in India have primarily centred around the low level of public health financing, ignoring that total health expenditure in India is at par with many other countries with similar economic development. India spends 3.7% of its gross domestic product (GDP) on healthcare, but the health outcomes are not commensurate with spending. ⋯ We argue that increasing resource allocation in the present pattern of financing may even worsen the situation. We give recommendations to correct inefficiencies in current health financing arrangements before more allocations are made to improve the performance of the health financing system.
-
. We sought to establish reference values of the functional independence measure (WeeFIM; Unified Data System for Medical Rehabilitation, Buffalo, NY, USA) for children aged 3-7 years in India using this cross-sectional study. ⋯ . We have provided reference values for WeeFIM in children of India aged 3-7 years (35-84 months). There were no differences between boys and girls regarding WeeFIM performance. Children in private schools showed better performance versus children in government schools in the early age ranges. We could not find any effect of socioeconomic status on WeeFIM raw rating or functional independence level.
-
. There is lack of comprehensive data on substance use and associated factors among school students in Delhi, India. ⋯ . The study results bring to attention the prevalent and important problem of substance use among schoolchildren. We recommend that (i) intervention strategies for school settings are important and need to factor in the use of illicit substances (cannabis); (ii) psychosocial intervention by trained school counsellors in school settings is the mainstay for intervention for cannabis and inhalants; and (iii) heroin users should be referred to healthcare facilities for detoxification.
-
. Effective patient-doctor communication is a key component of patient-centred care, which is one of the six pillars of quality healthcare delivery. Structured and effective communication skills training for healthcare providers is the need of hour in medical education. We assessed the efficacy of role play and simulation in developing communication skills. ⋯ . The use of 'role play' to teach communication skills is effective and superior to lecture-based teaching. Further structured and interactive programmes in communication skills training will improve patient care, relatives' satisfaction and the image of medical profession.
-
Pocket site infection after implantation of a pacemaker is a dreaded complication which requires removing the device and reimplanting it at a contralateral site. Difficulties arise when the patient is dependent on pacing and when there are issues with venous access at the contralateral site. We report a patient with pacemaker pocket site infection with congenital complete heart block managed with explantation of the device, semi-permanent pacing during antibiotic treatment, reimplantation of the device at the contralateral site and management of subtotal subclavian vein stenosis noted during reimplantation.