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Choices of medical institutions and associated factors in older patients with multimorbidity in stabilization period in China: A study based on logistic regression and decision tree model 中国多病老年患者在病情稳定期对医疗机构的选择及相关因素:基于逻辑回归和决策树模型的研究
Pub Date : 2023-10-16 DOI: 10.1002/hcs2.73
Xiaoran Wang, Dan Zhang

Background

As China's population ages, its disease spectrum is changing, and the coexistence of multiple chronic diseases has become the norm with respect to the health status of its elderly population. However, the health institution choices of older patients with multimorbidity in stabilization period remains underresearched. This study investigate the factors influencing the choices of older patients with multimorbidity to provide references for the rational allocation of healthcare resources.

Methods

A multistage, stratified, whole-group random-sampling method was used to select eligible older patients from September to December of 2022 who attended the Community Health Service Center of Guangdong Province. We adopted a self-designed questionnaire to collect patients' general, disease-related, social-support information, their intention to choose a healthcare provider. A binary logistic regression and decision tree model based on the Chi-squared automatic interaction detector algorithm were implemented to analyze the associated factors involved.

Results

A total of 998 patients in stabilization period were included in the study, of which 593 (59.42%) chose hospital and 405 (40.58%) chose primary care. Our binary logistic regression results revealed that age, sex, individual average annual income, educational level, self-reported health status, activities of daily living, alcohol consumption, family doctor contracting, and family supervision of medication or exercise were the principal factors influencing the choice of medical institutions for older patients with multimorbidity (p < 0.05). The decision-tree model reflected three levels and 11 nodes, and we screened a total of four influencing factors: activities of daily living, age, a family doctor contract, and patient sex. The data showed that the logistic regression model possessed an accuracy of 72.9% and that the decision tree model exhibited an accuracy of 68.7%. Prediction using the binary logistic regression was thus statistically superior to the categorical decision-tree model based on the Chi-squared automatic interaction detector algorithm (Z = 3.238, p = 0.001).

Conclusion

More than half of older patients with multimorbidity in stabilization period chose hospitals for healthcare. Efforts should be made to improve the quality of healthcare services and increase the medical contracting rate and recognition of family docto

背景 随着中国人口老龄化的加剧,疾病谱也在发生变化,多种慢性病并存已成为老年人群健康状况的常态。然而,对于患有多种疾病的老年患者在病情稳定期对医疗机构的选择研究仍然不足。本研究探讨影响多病老年患者选择医疗机构的因素,为合理分配医疗资源提供参考。 方法 采用多阶段、分层、整群随机抽样的方法,选取 2022 年 9 月至 12 月在广东省社区卫生服务中心就诊的符合条件的老年患者。采用自行设计的调查问卷,收集患者的一般信息、疾病相关信息、社会支持信息、选择医疗机构的意向等。采用二元逻辑回归和基于Chi-squared自动交互检测算法的决策树模型对相关因素进行分析。 结果 本研究共纳入了 998 名处于稳定期的患者,其中 593 人(59.42%)选择了医院,405 人(40.58%)选择了基层医疗机构。我们的二元逻辑回归结果显示,年龄、性别、个人平均年收入、教育程度、自我报告的健康状况、日常生活活动、饮酒量、家庭医生签约、家庭对用药或运动的监督是影响老年多发病患者选择医疗机构的主要因素(P <0.05)。决策树模型反映了三个层次和 11 个节点,我们共筛选出四个影响因素:日常生活活动、年龄、家庭医生签约和患者性别。数据显示,逻辑回归模型的准确率为 72.9%,决策树模型的准确率为 68.7%。因此,使用二元逻辑回归进行预测在统计学上优于基于Chi-squared自动交互检测算法的分类决策树模型(Z = 3.238,P = 0.001)。 结论 半数以上的多病老年患者在病情稳定期选择了医院就医。应努力提高医疗服务质量,提高医疗签约率和家庭医生的认可度,以吸引老年多发病患者到基层医疗机构就医。
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引用次数: 0
Artificial intelligence for emergency medical care 用于急救医疗的人工智能
Pub Date : 2023-10-13 DOI: 10.1002/hcs2.72
Shivam Rajput, Pramod Kumar Sharma, Rishabha Malviya
Abstract There is increasing research into the potential benefits of incorporating artificial intelligence (AI) and machine learning algorithms into emergency medical services. AI is finding new applications across a wide range of sectors, one of which is healthcare, where it is being used to enhance clinical diagnostics. AI solutions have enormous untapped potential to improve healthcare efficiency and quality, thus researchers have focused heavily on emergency medicine (EM). Many individuals without prior experience with any physician often receive their initial medical care in the emergency room. Two areas that could benefit from the implementation of AI are reducing waiting times and enhancing diagnostic capabilities. This study provides further explanation of how AI is used in emergency rooms. Several machine learning‐based algorithms are also addressed. In this research, we summarise recent developments in the use of AI in EM. This research tries to summarise the usefulness of AI in EM by looking at recent developments in emergency department operations and clinical patient management.
关于将人工智能(AI)和机器学习算法纳入紧急医疗服务的潜在益处的研究越来越多。人工智能正在广泛的领域寻找新的应用,其中之一是医疗保健,它被用于增强临床诊断。人工智能解决方案在提高医疗效率和质量方面具有巨大的未开发潜力,因此研究人员将重点放在急诊医学(EM)上。许多没有任何医生经验的人通常在急诊室接受他们最初的医疗护理。人工智能的实施可以使两个领域受益:减少等待时间和增强诊断能力。这项研究进一步解释了人工智能如何在急诊室中使用。还讨论了几种基于机器学习的算法。在本研究中,我们总结了人工智能在EM中使用的最新进展。本研究试图通过查看急诊科手术和临床患者管理的最新进展来总结人工智能在EM中的有用性。
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引用次数: 0
The effect of older population on public health spending: Evidence from Spain 老年人口对公共卫生支出的影响:来自西班牙的证据
Pub Date : 2023-10-12 DOI: 10.1002/hcs2.68
Carlos Navarro-García, Antonio Sarria-Santamera

Background

The gradual ageing of the population, and its effect on public spending, constitutes an urgent challenge for advanced economies. Through this study, we analyse the effect of older people, and their health and individual characteristics, on public health spending.

Methods

Using logistic regression methods, we have analysed the use of different health services and health technologies by older people in Spain, controlled for several health, socioeconomic, and other individual factors.

Results

The main factors that explain the consumption of both health services and health technology, above age, are related to the so-called need factors: self-reported health status, presence of chronic diseases, and disability.

Conclusion

Knowing the main factors that imply greater public health spending is a topic of special interest for designing efficient health policies, in a context of growth in public health spending. In this way, preventive attention on the so-called need factors may be an important driver to improve the effectiveness of spending.

背景人口的逐渐老龄化及其对公共支出的影响,是发达经济体面临的紧迫挑战。通过这项研究,我们分析了老年人及其健康和个人特征对公共卫生支出的影响。方法采用逻辑回归方法,我们分析了西班牙老年人对不同卫生服务和卫生技术的使用情况,并考虑了几个健康、社会经济和其他个人因素。结果解释年龄以上的医疗服务和医疗技术消费的主要因素与所谓的需求因素有关:自我报告的健康状况、是否患有慢性病和残疾。结论在公共卫生支出增长的背景下,了解意味着增加公共卫生支出的主要因素是设计有效卫生政策的一个特别感兴趣的话题。这样,对所谓需求因素的预防性关注可能是提高支出有效性的重要驱动因素。
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引用次数: 0
Ethical and policy considerations for organ trafficking and transplant tourism: Based on the UK's first international case of human trafficking for the purpose of organ removal 器官贩运和移植旅游的伦理和政策考虑:基于英国首例以器官切除为目的的人口贩运国际案件
Pub Date : 2023-10-10 DOI: 10.1002/hcs2.70
Lanyi Yu, Xiaomei Zhai

This study examines the UK's May 2023 judgment in an international organ trafficking and organ tourism case. Human trafficking for organ removal is one of the least understood but growing forms of trafficking worldwide. Countries in the Middle East, Asia, and the Americas are often widely criticized by the international transplant community as sites for organ trafficking. However, we believe that when discussing this issue, it is not just these areas that need to be addressed. What is particularly special is that this case not only involves transnational human trafficking, organ trafficking, and illegal organ transplantation interest chains but also involves the participation of national political officials and complex social and humanistic factors. This article focuses on the current ethical and policy issues involved in organ transplant tourism and organ trafficking and analyzes the implications of this case for our country's donation and transplantation work.

这项研究考察了英国2023年5月对一起国际器官贩运和器官旅游案的判决。为切除器官而贩运人口是世界范围内最不为人所知但日益增多的贩运形式之一。中东、亚洲和美洲国家经常被国际移植界广泛批评为器官贩运场所。然而,我们认为,在讨论这个问题时,需要处理的不仅仅是这些领域。特别的是,本案不仅涉及跨国人口贩运、器官贩运和非法器官移植利益链,还涉及国家政治官员的参与和复杂的社会人文因素。本文关注当前器官移植旅游和器官贩运中涉及的伦理和政策问题,并分析该案件对我国捐赠和移植工作的影响。
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引用次数: 0
Development trends of etiological research contents and methods of noncommunicable diseases 非传染性疾病病原学研究内容和方法的发展趋势
Pub Date : 2023-10-09 DOI: 10.1002/hcs2.69
Dafang Chen, Yujia Ma, Han Xiao, Zeyu Yan

Noncommunicable diseases (NCDs) are a significant public concern, greatly impacting the economic and social development in China. In 2019, NCDs accounted for a staggering 88.5% of total deaths in China, with cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes—the four major chronic diseases—contributing to a premature mortality rate of 16.5% [1]. The complexity of NCDs arises from the involvement of multiple genetic and environmental factors that interact in intricate ways. The complexity is characterized by a multitude of interactions among genes, proteins, and metabolic pathways throughout the various stages of life. Furthermore, these interactions demonstrate time-dependent specificity during the different phases of the life course. Prior research on the etiology of NCDs tended to focus on “specificity,” which overlooked the concept of “universality.” Studies are often conducted from one risk factor, one disease, or one dimension, leading to an insufficient understanding of NCD etiology and less than satisfactory outcomes in prevention and control efforts. Therefore, the aim of this review is to highlight and propose a new trend in NCD etiology research, considering the research focus and research methodology.

The relationships among NCDs are intricate, and patients often show distinct patterns of multiple diseases, reflecting population heterogeneity in comorbidity. The study of comorbidity patterns among populations affected by NCDs can offer valuable insights for developing effective prevention and management strategies. In a retrospective study by Jansana et al. [2] using electronic health records, five multimorbidity clusters were identified among breast cancer survivors in Spain; notably, the “musculoskeletal and cardiovascular disease” pattern showed a significantly higher risk of mortality than other NCDs. Advancements in computational science contribute to the emergence of network analysis based on graph theory as a powerful tool for understanding the complexity of comorbidity from a holistic and systemic perspective. Graph theory in network analysis facilitates the construction of comorbidity networks in which disease status is represented as nodes and risk associations are shown as edges, thereby visualizing the co-occurrence of diseases in a concise and intuitive manner. Such topological approaches enable the prioritization of disease severity and identification of the core disease within a comorbidity network. Furthermore, network clustering techniques have been applied to identify specific comorbidity patterns in NCDs. However, cautiousness in interpreting the identified patterns is essential because some network topology indexes may lack practical significance. The challenge in interpreting the identified patterns can be addressed by considering association rules. Typically, association rule mining is used to identify comorbidity patterns, and network analysis is used to

非传染性疾病(NCDs)是公众关注的一个重要问题,极大地影响了中国的经济和社会发展。2019年,非传染性疾病占中国总死亡人数的88.5%,心血管疾病、癌症、慢性呼吸道疾病和糖尿病这四种主要慢性病的过早死亡率高达16.5%[1]。非传染性疾病的复杂性源于多种遗传和环境因素的参与,这些因素以复杂的方式相互作用。这种复杂性的特点是在生命的各个阶段,基因、蛋白质和代谢途径之间存在大量的相互作用。此外,在生命过程的不同阶段,这些相互作用表现出与时间相关的特异性。先前对非传染性疾病病因的研究往往侧重于“特异性”,而忽略了“普遍性”的概念。研究往往从一个风险因素、一种疾病或一个维度进行,导致对非传染性病毒病因的理解不足,预防和控制工作的结果也不令人满意。因此,本综述的目的是在考虑研究重点和研究方法的基础上,突出并提出非传染性疾病病因研究的新趋势。非传染性疾病之间的关系是复杂的,患者往往表现出多种疾病的不同模式,反映出共病的人群异质性。对非传染性疾病患者共病模式的研究可以为制定有效的预防和管理策略提供有价值的见解。在Jansana等人[2]使用电子健康记录进行的回顾性研究中,在西班牙的癌症幸存者中确定了五个多发病集群;值得注意的是,“肌肉骨骼和心血管疾病”模式的死亡率明显高于其他非传染性疾病。计算科学的进步有助于基于图论的网络分析的出现,它是从整体和系统的角度理解共病复杂性的有力工具。网络分析中的图论有助于构建共病网络,其中疾病状态表示为节点,风险关联表示为边缘,从而以简洁直观的方式可视化疾病的共现。这种拓扑方法能够在共病网络中确定疾病严重程度的优先级和核心疾病的识别。此外,网络聚类技术已被应用于识别非传染性疾病的特定共病模式。然而,谨慎地解释识别的模式是至关重要的,因为一些网络拓扑索引可能缺乏实际意义。解释已识别模式的挑战可以通过考虑关联规则来解决。通常,关联规则挖掘用于识别共病模式,网络分析用于可视化和确定共病网络中的核心疾病。例如,Hernández等人[3]使用关联规则在爱尔兰成年人中发现了几种共病模式,随后通过网络分析发现,高胆固醇、高血压和关节炎与其他疾病的关联次数最多,将其列为共病网络中的核心疾病。非传染性疾病的发展是一个漫长而渐进的过程,其特点是风险随着时间的推移而积累。疾病进展过程中的复杂变化意味着患者可能有不同的轨迹,导致相同的疾病模式。至关重要的是要考虑每种疾病成分进展的时间特征,即使是在特定的共病模式中。在人群层面识别疾病轨迹对于预防特定非传染性疾病人群的共病至关重要,并为了解共病病因提供了重要的流行病学证据,使共病轨迹研究成为当前的研究热点。Jensen等人[4]利用覆盖丹麦全体人口的电子健康登记处的数据,对暂时性疾病进展模式进行了发现驱动的分析。他们确定了1171个重要的轨迹,并将其分组为以关键诊断为中心的模式,如慢性阻塞性肺病和痛风,这对疾病进展和早期诊断至关重要,以减轻不良后果。普通人群的共病轨迹研究在研究设计、数据分析和结果解释方面提出了挑战,因此此类研究通常在患有特定疾病的人群中进行,从而简化了设计、数据解析和结果解释。例如,Jeong等人[5]在嵌套的病例对照研究设计中,使用全人群的索赔数据调查了2型糖尿病。 在反式组学分析中,一组生物分子或表型被视为单一变量,整合为信息层,形成多级结构数据库。这种方法能够客观全面地重建连接人类基因组、暴露体和人体内现象的复杂网络。鉴于网络的复杂性,生物网络模型已成为首选[16]。这种模型放弃了从单个分子或组学水平研究疾病病因的单一视角,而是使用生物信息学和计算技术来发现分子之间的相互作用,从而在不同类型的生物数据层之间建立高维的内部联系。这种方法导致了复杂分子信息网络的形成,并符合系统生物学的原理[17]。因此,基于跨组学数据识别致病途径和构建致病网络对于揭示非传染性疾病的根本原因变得不可或缺[16,18,19]。Bodein等人[20]充分利用转录组学、蛋白质组学和代谢组学的纵向数据构建单个组学网络,然后通过随机游动使用网络传播在多个组学层之间建立调控网络。通过识别单组学分析无法捕捉到的组间相互作用,他们发现了两个核心的动态生物学集群,它们将糖尿病的病因网络与肾小管酸中毒和不宁腿综合征联系起来。这一突破性发现为糖尿病发病和进展的潜在机制和相互作用提供了新的见解。网络比较对于获得致病网络和途径的统计证据至关重要。网络比较有两种典型的分析策略。(1) 假设驱动策略,需要全面了解感兴趣疾病的生理、生化和病理机制。基于先前细胞实验、动物研究或组学分析的先验理解,提前概述了合理的假设致病网络/途径。随后,在人群水平上检查组间差异和网络/通路节点的影响,以评估基于初始假设的致病网络/通路在人群中的有效性和实用性。(2) 数据驱动策略,在没有任何预定义假设的情况下,在人群水平上获得高通量组学标记。系统生物学方法用于构建一个连接暴露因素、生物标志物和疾病终点的网络。在人群水平上评估网络/途径的组间差异和效果,并用于为进一步的实验验证、药物靶点识别和预防或治疗措施的制定提供基础[21]。Ji等人[22]提出了一种强大的基于分数的统计测试(NetDifM)来测量加权生物网络中的群体差异。他们成功地捕捉到了卵巢癌症患者和健康对照者之间基因表达网络的差异,并确定了致病性PI3K-AKT信号通路、Notch信号通路及其下游子网络。在非传染性疾病的病因研究中,复杂生物系统的动态属性共同要求时间性和高维性,这表明需要研究疾病发生和发展的整个生命过程的代谢特征。目前,非传染性疾病的研究主要集中在成年人身上;例如,对28-74岁人群的Framingham研究[23],对37-85岁人群的英国生物库研究[24],以及对30-79岁人群的中国慢性病前瞻性研究[25]。然而,健康与疾病的发育起源理论提出,母亲在怀孕期间的营养和环境暴露可能会影响后代成年后患非传染性疾病的风险[26,27]。该提案建议,非传染性疾病的病因研究应从主要关注成年人的特定阶段视角过渡到包括妊娠、儿童、青少年、青年、中年和老年在内的生命历程方法,以确定与非传染性疾病发展和整个生命期其他健康结果相关的风险因素,称为生命过程流行病学[28]。生命过程流行病学主要由风险累积模型和关键时期模型组成。风险累积模型假设环境暴露、社会经济地位和行为因素等风险因素独立或协同对健康产生长期影响。 因此,该模型侧重于暴露的积累和聚集,因为疾病不仅与个人暴露有关,还与家庭暴露和社会经济地位有关[28,29]。关键时期模型强调,关键发育时期的生物编程可能会受到后期生理或心理压力的影响[28,29]。轨迹分析是生命历程流行病学中常用的纵向数据处理方法。轨迹分析方法用于通过重复的纵向测量将生长轨迹与个体暴露数据拟合,识别群体中具有潜在不同生长轨迹的亚组,集体和单独描述暴露因子生长曲线的趋势,通过分析生长曲线参数,探讨暴露对疾病发生和发展的累积影响和临界/敏感期[30,31]。传统的轨迹分析方法包括基于Z分数的增长曲线拟合、多级建模、基于组的轨迹建模和潜在类别混合效应模型[32,33]。张等人[34]进行了生命历程轨迹分析和中介分析,以量化儿童至成年肥胖的生命历程累积负担,并表明肥胖对心血管健康的不利影响始于儿童时期,并在整
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引用次数: 0
Inception of the Indian Digital Health Mission: Connecting…the…Dots 印度数字健康使命的开端:连接…点
Pub Date : 2023-10-09 DOI: 10.1002/hcs2.67
Gerard Marshall Raj, Sathian Dananjayan, Neeraj Agarwal

The purpose of the National Digital Health Mission (or more precisely, the Ayushman Bharat Digital Mission) is to promote and facilitate the evolution of the National Digital Health Ecosystem in India. The Health Facility Registry, the Healthcare Professionals Registry, and the Unified Health Interface are the major components of the proposed system—which is intended to be a co-operative federated architecture with optimal interoperability provision coupled with authorized access.

国家数字健康使命(或者更准确地说,阿尤什曼·巴拉特数字使命)的目的是促进和促进印度国家数字健康生态系统的发展。卫生设施注册处、医疗保健专业人员注册处和统一健康接口是拟议系统的主要组成部分,该系统旨在成为一个合作的联邦架构,具有最佳的互操作性和授权访问。
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引用次数: 0
China's aging population: A review of living arrangement, intergenerational support, and wellbeing 中国人口老龄化:生活安排、代际支持和幸福感综述
Pub Date : 2023-10-09 DOI: 10.1002/hcs2.64
Litao Zhao

China's rapid population aging and remarkable family-level changes have raised concerns about the weakening of its family-based elderly care. The last decade indeed has seen a clear departure from multigenerational living to alternative living arrangements such as living with spouse only and solo living. However, ample evidence suggests that Chinese families have demonstrated considerable resilience amidst profound sociodemographic changes. This review article highlights the importance of government–society cooperation in meeting the social challenges of population aging. A key factor is the persistient filial piety norms, which enable children living far or close, migrant or nonmigrant, to rearrange financial, instrumental, and emotional support to aging parents. Equally important is the step-in of the government to share elderly care responsibilities, provide support through deepening pension and healthcare reforms, and implement the active and healthy aging agenda. How the two factors play out over the next decade and beyond will have profound implications on the living arrangement, intergenerational support, and wellbeing of older adults in China.

中国快速的人口老龄化和显著的家庭水平变化引发了人们对家庭养老弱化的担忧。在过去的十年里,确实看到了从多代人生活到替代生活安排的明显转变,如只与配偶生活和独自生活。然而,充分的证据表明,中国家庭在深刻的社会人口结构变化中表现出了相当大的韧性。这篇综述文章强调了政府与社会合作在应对人口老龄化的社会挑战方面的重要性。一个关键因素是持续的孝道规范,它使居住在远方或附近、移民或非移民的孩子能够重新安排对年迈父母的经济、工具和情感支持。同样重要的是,政府介入分担养老责任,通过深化养老金和医疗改革提供支持,并实施积极健康的老龄化议程。这两个因素在未来十年及以后的发展将对中国老年人的生活安排、代际支持和福祉产生深远影响。
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引用次数: 0
Financial burden of seeking diabetes mellitus care in India: Evidence from a Nationally Representative Sample Survey 印度寻求糖尿病护理的经济负担:来自全国代表性抽样调查的证据
Pub Date : 2023-10-04 DOI: 10.1002/hcs2.65
Mehak Nanda, Rajesh Sharma

Background

Diabetes mellitus (DM) is a major public health concern in India, and entails a severe burden in terms of disability, death, and economic cost. This study examined the out-of-pocket health expenditure (OOPE) and financial burden associated with DM care in India.

Methods

The study used data from the latest round of the National Sample Survey on health, which covered 555,115 individuals from 113,823 households in India. In the present study, data of 1216 individuals who sought inpatient treatment and 6527 individuals who sought outpatient care for DM were analysed.

Results

In India, 10.04 per 1000 persons reported having DM during the last 15 days before the survey date, varying from 6.94/1000 in rural areas to 17.45/1000 in urban areas. Nearly 38% of Indian households with diabetic members experienced catastrophic health expenditure (at the 10% threshold) and approximately 10% of DM-affected households were pushed below the poverty line because of OOPE, irrespective of the type of care sought. 48.5% of households used distressed sources to finance the inpatient costs of DM. Medicines constituted one of the largest proportion of total health expenditure, regardless of the type of care sought or type of healthcare facility visited. The average monthly OOPE was over 4.5-fold and 2.5-fold higher for households who sought inpatient and outpatient care, respectively, from private health facilities, compared with those treated at public facilities. Notably, the financial burden was more severe for households residing in rural areas, those in lower economic quintiles, those belonging to marginalised social groups, and those using private health facilities.

Conclusion

The burden of DM and its associated financial ramifications necessitate policy measures, such as prioritising health promotion and disease prevention strategies, strengthening public healthcare facilities, improved regulation of private healthcare providers, and bringing outpatient services under the purview of health insurance, to manage the diabetes epidemic and mitigate its financial impact.

背景糖尿病(DM)是印度一个主要的公共卫生问题,在残疾、死亡和经济成本方面带来了严重的负担。这项研究调查了印度与糖尿病护理相关的自付医疗支出(OOPE)和经济负担。方法该研究使用了最新一轮全国健康抽样调查的数据,该调查覆盖了印度113823个家庭的555115人。在本研究中,分析了1216名寻求住院治疗的患者和6527名寻求DM门诊治疗的患者的数据。结果在印度,在调查日期前的最后15天内,每1000人中有1004人报告患有糖尿病,从农村地区的6.94/1000人到城市地区的17.45/1000人不等。近38%患有糖尿病的印度家庭经历了灾难性的医疗支出(达到10%的阈值),约10%的糖尿病患者家庭因OOPE而被推到贫困线以下,无论寻求何种护理。48.5%的家庭使用不良来源来支付糖尿病的住院费用。无论寻求的护理类型或访问的医疗机构类型如何,药物在总医疗支出中所占比例最大。与在公共医疗机构接受治疗的家庭相比,从私人医疗机构寻求住院和门诊护理的家庭每月平均OOPE分别高出4.5倍和2.5倍以上。值得注意的是,居住在农村地区的家庭、经济五分位数较低的家庭、属于边缘化社会群体的家庭和使用私人卫生设施的家庭的经济负担更为严重。结论糖尿病的负担及其相关的财务影响需要采取政策措施,如优先考虑健康促进和疾病预防战略,加强公共医疗设施,改善对私人医疗服务提供者的监管,并将门诊服务纳入健康保险的范围,管理糖尿病流行并减轻其财务影响。
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引用次数: 0
Challenges and opportunities of big data analytics in healthcare 医疗保健领域大数据分析的挑战和机遇
Pub Date : 2023-10-04 DOI: 10.1002/hcs2.66
Priyanshi Goyal, Rishabha Malviya

Data science is an interdisciplinary discipline that employs big data, machine learning algorithms, data mining techniques, and scientific methodologies to extract insights and information from massive amounts of structured and unstructured data. The healthcare industry constantly creates large, important databases on patient demographics, treatment plans, results of medical exams, insurance coverage, and more. The data that IoT (Internet of Things) devices collect is of interest to data scientists. Data science can help with the healthcare industry's massive amounts of disparate, structured, and unstructured data by processing, managing, analyzing, and integrating it. To get reliable findings from this data, proper management and analysis are essential. This article provides a comprehensive study and discussion of process data analysis as it pertains to healthcare applications. The article discusses the advantages and disadvantages of using big data analytics (BDA) in the medical industry. The insights offered by BDA, which can also aid in making strategic decisions, can assist the healthcare system.

数据科学是一门跨学科学科,它利用大数据、机器学习算法、数据挖掘技术和科学方法从大量结构化和非结构化数据中提取见解和信息。医疗保健行业不断创建关于患者人口统计、治疗计划、体检结果、保险范围等的大型重要数据库。物联网设备收集的数据引起了数据科学家的兴趣。数据科学可以通过处理、管理、分析和集成来帮助医疗保健行业处理大量不同、结构化和非结构化的数据。要从这些数据中获得可靠的发现,正确的管理和分析至关重要。本文对过程数据分析进行了全面的研究和讨论,因为它与医疗保健应用程序有关。本文讨论了在医疗行业使用大数据分析(BDA)的优势和劣势。BDA提供的见解也可以帮助做出战略决策,可以帮助医疗系统。
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引用次数: 0
COVID-19 retreats and world recovers: A silver lining in the dark cloud 新冠肺炎消退,世界复苏:乌云中的一线希望
Pub Date : 2023-08-08 DOI: 10.1002/hcs2.57
Amol Chhatrapati Bisen, Sristi Agrawal, Sachin Nashik Sanap, Heamanth Ganesan Ravi Kumar, Nelam Kumar, Rajdeep Gupta, Rabi Sankar Bhatta

The coronavirus disease (COVID-19), which the World Health Organization classified as the Sixth Public Health Emergency Of International Concern (PHEIC) on January 30, 2020, is no longer a PHEIC. Millions were affected due to unawareness. The increase in fatalities and shortage of medicine was the first outrage of COVID-19. As per the Johns Hopkins COVID-19 resource center database, it was observed that the disease has spread dynamically across 200+ nations worldwide affecting more than 600 million people from 2019 to 2023, and over thousands of people were victimized regularly at a 2% mortality rate (approx.). In the midway, the mutant variants of concern like omicron, and delta have also created havoc and caused significant impact on public health, global economy, and lifestyle. Since 2019, 3 years now passed and the dynamic disease statistics seem decelerated; moreover, the prevalence of COVID-19 is also fading. The Johns Hopkins resource center has also stopped recording the data of the global pandemic recently from March 10, 2023. Hence, based on the facts, we are presenting a concise report on the pandemic from 2019 to 2023, which includes a brief discussion of the global pandemic. We have highlighted global epidemiology, emphasizing the Indian COVID scenario, vaccination across the globe, and the psychosocial and geopolitical consequences of COVID-19 with a brief background to pathology, clinical management, and the worldwide response against triage. A lot has changed and still needs to change after three tough years of COVID-19. Even though science has progressed and advanced research in medicine is pointing toward future generations, there is no standard care supplied for COVID-19-like calamities. COVID-19 cases might have declined but its influence on the society is still stagnant. This COVID experience has taught us that, despite our bleak beginnings, there is always hope for the future and that we must act with foresight to improve things for future generations.

2020年1月30日,世界卫生组织将冠状病毒疾病(新冠肺炎)列为第六次国际关注的突发公共卫生事件(PHEIC),但该疾病已不再是PHEIC。数百万人由于不知情而受到影响。死亡人数的增加和药品短缺是新冠肺炎引发的第一次愤怒。根据约翰斯·霍普金斯新冠肺炎资源中心的数据库,据观察,该疾病已在全球200多个国家动态传播,从2019年到2023年,影响了6亿多人,数千人经常以2%的死亡率(约)受害,三角洲也造成了严重破坏,对公共卫生、全球经济和生活方式造成了重大影响。自2019年以来,3年过去了,动态疾病统计数据似乎在减速;此外,新冠肺炎的流行率也在下降。约翰斯·霍普金斯资源中心最近也从2023年3月10日起停止记录全球疫情的数据。因此,基于事实,我们将提交一份关于2019年至2023年疫情的简明报告,其中包括对全球疫情的简短讨论。我们强调了全球流行病学,强调了印度新冠肺炎的情况、全球疫苗接种以及新冠肺炎的心理社会和地缘政治后果,并简要介绍了病理学、临床管理和全球对分诊的反应。在经历了三年的新冠肺炎后,很多事情已经发生了变化,仍然需要改变。尽管科学取得了进步,医学的先进研究指向了子孙后代,但没有针对类似新冠肺炎的灾难提供标准的护理。新冠肺炎病例可能有所下降,但其对社会的影响仍然停滞不前。这次新冠肺炎疫情的经历告诉我们,尽管我们的开端黯淡,但对未来总是有希望的,我们必须有远见地行动,为子孙后代改善现状。
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引用次数: 1
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