This study aims to clarify the factors influencing the financial burden of medical waste management (MWM) on public hospitals, and develop a best-reduced model for predicting MWM cost for hospitals. The medical waste generation rate was computed considering the hospital type and its location. MWM cost in selected hospitals was calculated using the variable pricing method. The mean medical waste generation rate was 0.70 kg per bed per day and 11 kg per surgical procedure. On average, with a daily 420 kg medical waste generated, urban hospitals were the major sources of medical waste. MWM cost in urban hospitals was much greater than that in rural hospitals. The results present an evaluation of how well MWM cost can be predicted by the number of surgical procedures, outpatients and distance of the hospital from the city centre. This study highlights the fact that cost-saving strategies at hospital organizational level are essential for reducing the enhanced MWM cost in hospitals.

Aims: To evaluate available information on therapeutic drug monitoring (TDM) education programmes and their implementation across different countries. Methods: The study was performed in two phases. First, a scoping review of scientific literature on available education programmes was performed. Afterwards, a questionnaire was distributed among a worldwide network of professionals engaged in the practice of TDM. Results: Eight scientific articles discussing TDM educational programmes were found. They described in depth an educational programme on TDM, which was primarily offered as postgraduate education programme for hospital staff. We received a total 23 responses (30% response rate); of these, 68% were from academia. For 70% of respondents, TDM is part of the educational programme of healthcare professionals, and for 56% it is offered at both undergraduate and postgraduate level, aimed mainly at physicians (39%) and pharmacists (65%). TDM is mainly performed in infectious diseases (n = 15), neurology (n = 14) and psychiatry (n = 12), as well as for antibiotics (83%), monoclonal antibodies (53%), and oncology and psychotropics (48%). Funding for TDM is derived mostly from public health insurance (48%), hospital (44%), patients (39%). In some cases, patients might co‐pay to hospital or to health insurance fund. Conclusions: Education on TDM is scattered across different subjects, disciplines and degrees. It is oriented essentially towards physicians and pharmacists, and its funding is mainly public. General guidelines are lacking. In light of this, it is necessary to consider developing a comprehensive educational programme on TDM, oriented towards relevant drugs and diseases, and encompassing appropriate analytical and pharmacological methods.

Kamuda sağlık hizmeti sunan kuruluşlar, diğer kamu kuruluşlarından farklı olarak kendine münhasır, spesifik özelliklere sahiptir. Sağlık hizmeti sunan kuruluşlar, hizmeti sunabilmek için farklı mesleklerden uzmanların işgücüne ve tıp teknolojisine, basit sarf malzemeden robotik özellikli tıbbi cihazlara kadar geniş perspektifte maddi kaynağa ihtiyaç duyarlar. Yoğun emek ve yüksek teknoloji kullanılan sağlık kurumları, karmaşık bir yapıya sahip olma ile beraber farklı mesleklerden sağlık çalışanlarının ekip halinde, disiplinler arası uyum içinde çalışmalarının sağlanmasının önünde profesyonel ve organizasyonel zorlukların bulunduğu örgütlerdir. Bu çalışmada, sağlık kurumlarını yönetmenin diğer sektörlere özgü yönetim anlayışından hangi perspektiflerde ayrıldığı konusunda teorik ve güncel tartışmalar özetlenmektir.

Bu çalışma, Türkiye’de ve Birleşik Krallık’taki tütün ve tütün ürünleri kullanımının sonlandırılmasına yönelik politikaları karşılaştırmalı olarak incelemeyi amaçlamaktadır. Öncelikle Dünya Sağlık Örgütü tarafından önerilen tütün kontrol stratejileri ve her iki ülkedeki uygulamalar incelenmiş, ardından bırakma tedavisi politikaları karşılaştırılmıştır. İlaç tedavileri, sağlık eğitimi ve destekleyici davranış terapisi ve kısa müdahaleden oluşan tütün bırakma hizmetleri, Birleşik Krallık'ta kısmen ücretsiz olarak karşılanmaktadır. Türkiye'de tütün bırakma tedavisinde kullanılan farmakoterapi ürünlerinin bedeli Sosyal Güvenlik Kurumu tarafından karşılanmamakta ancak Sağlık Bakanlığı tarafından temin edilen tütün bırakma ilaçları ücretsiz olarak dağıtılmaktadır. Tütün bırakma hizmetlerine erişim, tütün kontrolünde eşitsizliğin ortadan kaldırılması ve hakkaniyetin sağlanması açısından kritik öneme sahiptir. Bu nedenle tütün kontrol politikalarını etkili hale getirmek için daha fazla çabaya ihtiyaç vardır.

Introduction: The COVID-19 pandemic has had an extensive impact on public health worldwide. However, in many countries burden of disease indicators for COVID-19 have not yet been calculated or used for monitoring. The present study protocol describes an approach developed in the project “The Burden of Disease due to COVID-19. Towards a harmonization of population health metrics for the surveillance of dynamic outbreaks” (BoCO-19). The process of data collection and aggregation across 14 different countries and sub-national regions in Southern and Eastern Europe and Central Asia is described, as well as the methodological approaches used. Materials and methods: The study implemented in BoCO-19 is a secondary data analysis, using information from national surveillance systems as part of mandatory reporting on notifiable diseases. A customized data collection template is used to gather aggregated data on population size as well as COVID-19 cases and deaths. Years of life lost (YLL), as one component of the number of Disability Adjusted Life Years (DALY), are calculated as described in a recently proposed COVID-19 disease model (the ‘Burden-EU’ model) for the calculation of DALY. All-cause mortality data are collected for excess mortality sensitivity analyses. For the calculation of Years lived with disability (YLD), the Burden-EU model is adapted based on recent evidence. Because Covid-19 cases vary in terms of disease severity, the possibility and suitability of applying a uniform severity distribution of cases across all countries and sub-national regions will be explored. An approach recently developed for the Global Burden of Disease Study, that considers post-acute consequences of COVID-19, is likely to be adopted. Findings will be compared to explore the quality and usability of the existing data, to identify trends across age-groups and sexes and to formulate recommendations concerning potential improvements in data availability and quality. Discussion: BoCO-19 serves as a collaborative platform in order to build international capacity for the calculation of burden of disease indicators, and to support national experts in the analysis and interpretation of country-specific data, including their strengths and weaknesses. Challenges include inherent differences in data collection and reporting systems between countries, as well as assumptions that have to be made during the calculation process.