Natl Med J India
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. Community-based health insurance (CBHI) is a health-financing mechanism based on voluntary membership, risk pooling, with a non-profit objective and relies on social capital as a driving force. It aims to improve equity in healthcare utilization in the community. We did this study to understand if CBHI schemes reach the poor, improve healthcare utilization and protect them from catastrophic health events. ⋯ . CBHI schemes improve healthcare utilization and protect against catastrophic health expenditure among those who get hospitalized. However, there also exists a socioeconomic gradient both in membership and in utilization of healthcare services favouring those who are more affluent.
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Cardiopulmonary resuscitation (CPR) is widely practised by healthcare professionals to revive heart beat and breathing in a patient suffering from cardiac/respiratory arrest. It is increasingly being recognized that in some patients with specific medical conditions, CPR does not alter the overall outcome of illness, and is likely to increase suffering and further deteriorate the quality of life. ⋯ While ordering DNAR on the patient's medical case record, every effort should be made to treat the underlying disease and continue optimal medical care with compassion. This policy document describes the principles for DNAR, offers an algorithm and format for its implementation, and guidance on frequently asked questions.
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. Surgical healthcare across low- and middle-income countries is plagued with concerns over scarcity of anaesthesiologists. Orthopaedic surgeons working in such resource-limited settings are often caught in a dilemma to provide emergency orthopaedic surgical care without an attending anaesthesiologist. Therefore, an effective, low-risk solution is necessary to ensure safe emergency orthopaedic care. ⋯ . Axillary regional block is an efficacious, low-risk anaesthesia for emergency orthopaedic procedures of the hand, forearm and elbow, in resource-limited settings where an anaesthesiologist is not available.