Health Systems and the Challenge of Chronic Disease— Through the Lens of Breast Cancer

8/12/2019 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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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


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

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Health Systems and the Challenge of Chronic Disease— Through the Lens of Breast Cancer