Browsing by Author "Herrera, Cristian A."
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- ItemCOVID-19 Disruption To Routine Health Care Services: How 8 Latin American And Caribbean Countries Responded(2023) Herrera, Cristian A.; Juárez-Ramírez, Clara; Reyes-Morales, Hortensia; Bedregal, Paula; Reartes-Peñafiel, Diana L.; Díaz-Portillo, Sandra P.; Klazinga, Niek; Kringos, Dionne S.; Veillard, Jeremy; Herrera, CristianLatin America and the Caribbean was one of the regions hardest hit globally by SARS-CoV-2. This qualitative exploratory study examined how the COVID-19 pandemic disrupted the delivery of routine health services from the perspective of health care system decision makers and managers. Between May and December 2022, we conducted forty-two semistructured interviews with decision makers from ministries of health and health care managers with responsibilities during the COVID-19 pandemic in eight countries in Latin America and the Caribbean. On the basis of these interviews, we identified themes in three domains: impacts on the provision of routine health services, including postponed and forgone primary care and hospital services; barriers to maintaining routine health services due to preexisting structural health care system weaknesses and difficulties attributed to the pandemic; and innovative strategies to sustain and recover services such as public-private financing and coordination, telemedicine, and new roles for primary care. In the short term, policy efforts should focus on recovering postponed services, including those for noncommunicable diseases. Medium- and long-term health care system reforms should strengthen primary care and address structural issues, such as fragmentation, to promote more resilient health care systems.
- ItemEvaluation of the educational environment in medical specialty programs(SOC MEDICA SANTIAGO, 2012) Herrera, Cristian A.; Olivos, Trinidad; Roman, Jose Antonio; Larrain, Antonia; Pizarro, Margarita; Solis, Nancy; Sarfatis, Alberto; Torres, Patricio; Padilla, Oslando; Le Roy, Catalina; Riquelme, ArnoldoBackground: The Postgraduate Hospital Education Environment Measure (PHEEM) questionnaire, is a valid and reliable instrument to measure the educational environment (EE) in postgraduate medical education. Aim: To evaluate the EE perceived by the residents of a postgraduate training program using the PHEEM. Material and Methods: The PHEEM was applied in 2010-2011 in 35 specialty programs. We calculated their individual results and compared means of both global and individual domain scores of the PHEEM, by gender, university of origin and nationality. Cronbach's alpha coefficients and D study (Generalizability theory) were performed for reliability. Results: Three hundred eighteen residents were surveyed (75.7% of the total universe). The mean score of the PHEEM was 105.09 +/- 22.46 (65.7% of the maximal score) which is considered a positive EE. The instrument is highly reliable (Cronbach's alpha = 0.934). The D study found that 15 subjects are required to obtain reliable results (G coefficient = 0.813). There were no significant differences between gender and university of origin. Foreigners evaluated better the EE than Chileans and racism was not perceived. The programs showed a safe physical environment and teachers with good clinical skills. The negative aspects perceived were a lack of information about working hours, insufficient academic counseling, and scanty time left for extracurricular activities. Conclusions: This questionnaire allowed us to identify positive aspects of the EE, and areas to be improved in the specialty programs. The PHEEM is a useful instrument to evaluate the EE in Spanish-speaking participants of medical specialty programs. (Rev Med Chile 2012; 140: 1554-1561).
- ItemGlobal cancer surgery: delivering safe, aff ordable, and timely cancer surgery(2015) Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O.; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F.; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M. M.; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A.; Holmer, Hampus; Ilbawi, Andre M.; Jarnheimer, Anton; Ji, Jia-fu; Kingham, T. Peter; Liberman, Jonathan; Leather, Andrew J. M.; Meara, John G.; Mukhopadhyay, Swagoto; Murthy, Shilpa S.; Omar, Sherif; Parham, Groesbeck P.; Pramesh, C. S.; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V.; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T.; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, ArnieSurgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, aff ordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and fi nancing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US$ 6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery-eg, pathology and imaging-are also inadequate. Our analysis identifi ed substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, aff ordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.
- ItemThe Evidence-Informed Policy Network (EVIPNet) in Chile: lessons learned from a year of coordinated efforts(2017) Mansilla, Cristian; Herrera, Cristian A.; Basagoitia, Andrea; Pantoja, TomasInforming the health policymaking process with the best available scientific evidence has become relevant to health systems globally. Knowledge Translation Platforms (KTP), such as the World Health Organization' Evidence Informed Policy Networks (EVIPNet), arc a recognized strategy for linking research to action.