Background: Standard Precautions (SP) is the basic requirement in infection control measures to reduce healthcare-associated infections (HAIs) as well occupational infection in healthcare settings. Many interventions have been done to increase the knowledge and practice of SP among healthcare workers (HCWs). Objectives: To assess the effectiveness of interventions to improve knowledge and practice on Standard Precautions among HCWs. Materials and Methods: Articles were searched through Pubmed, Medline, Scopus and Google Scholar search engines using keywords “Standard Precautions OR infection control AND interventional study OR experimental study”. Types of studies included are randomised control trials of individuals, cluster-randomised trials, non-randomised trials, controlled before-after studies, and cross sectional study. Only articles written in English published from 2010 to 2018 and accessible as free full texts were included in this review. The articles must evaluate the multiple components of Standard Precautions simultaneously. Result: There are 14 articles included in this study. Most of the studies implemented educational and training intervention with or without infection control support. Other intervention strategies were theory-based module, self-instructed computer module with clinical case simulation, checklist and coloured cues for communication enhancement as well as Healthcare-Associated Infection Prevention Initiative (CHAIPI). However, different studies used different measures to assess the knowledge and practice of Standard Precautions among HCWs. Conclusion: Because of this heterogeneity, it is difficult to draw a clear conclusion about the effectiveness of different interventions. However, it was shown that interventions do promote Standard Precautions knowledge and practice, but further research is warranted to determine which interventions are the most effective. Keywords: Standard Precautions, intervention, healthcare workers, knowledge, practice.
背景:标准预防措施(SP)是感染控制措施的基本要求，以减少卫生保健相关感染(HAIs)以及卫生保健环境中的职业感染。已经采取了许多干预措施，以增加保健工作者(HCWs)对SP的认识和实践。目的:评估干预措施的有效性，以提高卫生保健工作者对标准预防措施的认识和实践。材料和方法:通过Pubmed、Medline、Scopus和Google Scholar搜索引擎，检索关键词为“Standard measures OR infection control and interventional study OR experimental study”。研究类型包括个体随机对照试验、集群随机试验、非随机试验、前后对照研究和横断面研究。本综述只收录了2010年至2018年发表的英文文章，并提供免费全文。文章必须同时评估标准预防措施的多个组成部分。结果:本研究共纳入14篇文献。大多数研究实施了教育和培训干预，有或没有感染控制支持。其他的干预策略包括:以理论为基础的模块、以临床个案模拟为基础的电脑自学模块、加强沟通的核对表和彩色提示，以及医疗保健相关感染预防行动(CHAIPI)。然而，不同的研究使用不同的措施来评估卫生保健工作者对标准预防措施的了解和实践。结论:由于这种异质性，很难对不同干预措施的有效性得出明确的结论。然而，研究表明，干预措施确实促进了标准预防措施的知识和实践，但需要进一步研究以确定哪些干预措施最有效。关键词:标准预防措施，干预，医护人员，知识，实践。
{"title":"THE INTERVENTIONS TO IMPROVE STANDARD PRECAUTIONS (SP) KNOWLEDGE AND PRACTICE AMONG HEALTHCARE WORKERS (HCWS): A SYSTEMATIC REVIEW","authors":"R. Waramlah, B. Huda","doi":"10.32827/ijphcs.6.3.53","DOIUrl":"https://doi.org/10.32827/ijphcs.6.3.53","url":null,"abstract":"Background: Standard Precautions (SP) is the basic requirement in infection control measures to reduce healthcare-associated infections (HAIs) as well occupational infection in healthcare settings. Many interventions have been done to increase the knowledge and practice of SP among healthcare workers (HCWs). Objectives: To assess the effectiveness of interventions to improve knowledge and practice on Standard Precautions among HCWs. Materials and Methods: Articles were searched through Pubmed, Medline, Scopus and Google Scholar search engines using keywords “Standard Precautions OR infection control AND interventional study OR experimental study”. Types of studies included are randomised control trials of individuals, cluster-randomised trials, non-randomised trials, controlled before-after studies, and cross sectional study. Only articles written in English published from 2010 to 2018 and accessible as free full texts were included in this review. The articles must evaluate the multiple components of Standard Precautions simultaneously. Result: There are 14 articles included in this study. Most of the studies implemented educational and training intervention with or without infection control support. Other intervention strategies were theory-based module, self-instructed computer module with clinical case simulation, checklist and coloured cues for communication enhancement as well as Healthcare-Associated Infection Prevention Initiative (CHAIPI). However, different studies used different measures to assess the knowledge and practice of Standard Precautions among HCWs. Conclusion: Because of this heterogeneity, it is difficult to draw a clear conclusion about the effectiveness of different interventions. However, it was shown that interventions do promote Standard Precautions knowledge and practice, but further research is warranted to determine which interventions are the most effective. Keywords: Standard Precautions, intervention, healthcare workers, knowledge, practice.","PeriodicalId":14315,"journal":{"name":"International Journal of Public Health and Clinical Sciences","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91434033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : Research animal facilities had been identified as a risky environment for the development of Laboratory Animal Allergy (LAA). The risk degree is in parallel with the nature of contact, intensity of exposure and individual susceptibility. Early recognition of LAA via active clinical surveillance is imperative before it progresses into chronic disability. Method: This cross-sectional study recruited 87 workers exposed to animal allergen and 87 control subjects. Self-administered LAA questionnaire contained details of occupational and socio-environmental history as well as pulmonary function test were employed as study tools. Statistical analysis performed with SPSS version 20, utilizing descriptive analysis, cross tabulation, independent t-test, Mann Whitney U-test and Multivariable Logistic Regression (MLR). Results : More than half of the exposed subjects were reported at least one LAA symptoms (58.6%) and declined ling function (56.3%). Upper respiratory symptoms were the most prevalent LAA symptoms (49.4%). There was significant association between the reported symptoms and abnormal lung profile (p<0.05). In term of lung function values, the mean FEV1, FEV1/FVC and median FVC were significantly lower among the exposed group compared to the control group (p<0.001). MLR substantiated that atopic workers, smokers and those did not comply with full PPE regularly upon animal contact were more likely to develop LAA. Conclusion : LAA is an acknowledged occupational hazard. Therefore knowing the existing prevalence and its risk factors to design an effective LAA prevention program consisted of exposure avoidance and exposure reduction which combines the engineering control, administrative control and PPE is of paramount importance. Keywords : laboratory animal allergy, animal workers, research animal facilities, clinical survey
背景:研究动物设施已被确定为实验室动物过敏(LAA)发展的危险环境。风险程度与接触性质、暴露强度和个体易感性呈正相关。在LAA发展为慢性残疾之前，通过积极的临床监测来早期识别LAA是必要的。方法:采用横断面研究方法，选取接触动物过敏原的工人87名，对照87名。研究工具为自我填写的LAA问卷，包括职业和社会环境史的详细信息以及肺功能测试。统计分析采用SPSS version 20，采用描述性分析、交叉表、独立t检验、Mann Whitney u检验和多变量Logistic回归(MLR)。结果:半数以上暴露者出现至少一种LAA症状(58.6%)，灵功能下降(56.3%)。上呼吸道症状是LAA最常见的症状(49.4%)。报告的症状与肺廓形异常有显著相关性(p<0.05)。肺功能值方面，暴露组的平均FEV1、FEV1/FVC和中位数FVC均显著低于对照组(p<0.001)。MLR证实，特应性工作人员、吸烟者和那些在与动物接触时不定期佩戴全套个人防护装备的人更有可能发生LAA。结论:LAA是公认的职业危害。因此，了解LAA的流行现状及其危险因素，设计一套工程控制、行政控制和个人防护相结合的有效的避免暴露和减少暴露的LAA预防方案至关重要。关键词:实验动物过敏，动物工作者，实验动物设施，临床调查
{"title":"LABORATORY ANIMAL ALLERGY (LAA) AMONG THE ANIMAL FACILITIES’ WORKERS IN A RESEARCH INSTITUTE: A CLINICAL SURVEY","authors":"H. Pei, Fadzli Shah Abd Aziz","doi":"10.32827/ijphcs.6.3.232","DOIUrl":"https://doi.org/10.32827/ijphcs.6.3.232","url":null,"abstract":"Background : Research animal facilities had been identified as a risky environment for the development of Laboratory Animal Allergy (LAA). The risk degree is in parallel with the nature of contact, intensity of exposure and individual susceptibility. Early recognition of LAA via active clinical surveillance is imperative before it progresses into chronic disability. Method: This cross-sectional study recruited 87 workers exposed to animal allergen and 87 control subjects. Self-administered LAA questionnaire contained details of occupational and socio-environmental history as well as pulmonary function test were employed as study tools. Statistical analysis performed with SPSS version 20, utilizing descriptive analysis, cross tabulation, independent t-test, Mann Whitney U-test and Multivariable Logistic Regression (MLR). Results : More than half of the exposed subjects were reported at least one LAA symptoms (58.6%) and declined ling function (56.3%). Upper respiratory symptoms were the most prevalent LAA symptoms (49.4%). There was significant association between the reported symptoms and abnormal lung profile (p<0.05). In term of lung function values, the mean FEV1, FEV1/FVC and median FVC were significantly lower among the exposed group compared to the control group (p<0.001). MLR substantiated that atopic workers, smokers and those did not comply with full PPE regularly upon animal contact were more likely to develop LAA. Conclusion : LAA is an acknowledged occupational hazard. Therefore knowing the existing prevalence and its risk factors to design an effective LAA prevention program consisted of exposure avoidance and exposure reduction which combines the engineering control, administrative control and PPE is of paramount importance. Keywords : laboratory animal allergy, animal workers, research animal facilities, clinical survey","PeriodicalId":14315,"journal":{"name":"International Journal of Public Health and Clinical Sciences","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88368973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. A.S, O. Mardiana, M. P. Farahana, R. I. R. Najwa, I. Faisal
Background: In November 2016, the WHO has declared Zika virus (ZIKV) infection as a public health emergency of international concern. Affected countries have to decide on the suitable control measures of ZIKV outbreak. This article aims to apply the Rational Model in the decision-making of ZIKV outbreak control measures. Materials and Methods: Adopting a scoping review method, articles were identified using three databases through the keywords “decision making theories” or “problem solving” and “public health” or “community health”. Only articles written and published in English within the last 15 years were included. After filtering, 10 articles were reviewed. Result: The Rational decision-making model is positioned as the most promising, effective, and functional decision-making approach for ZIKV outbreak as it reduces chances of error and optimize resources. There are five domains of control measures in ZIKV outbreak which are decision support tools; technology development; surveillance and monitoring; infrastructural development and behavioural. In Malaysia, integrated vector management, entomological and disease surveillance, enhance infrastructural development and behavioural were practiced in control measures of ZIKV outbreak. Conclusion: The most common models used in decision making is the Rational Model and the Contingency Model. The basic concepts of Rational Model in decision-making for preventative measure of ZIKV outbreak were discussed in this article. Keywords: decision making, rational model, Zika virus outbreak
{"title":"APPLYING RATIONAL MODEL APPROACH IN DECISION MAKING FOR PREVENTIVE MEASURES OF ZIKA OUTBREAK","authors":"A. A.S, O. Mardiana, M. P. Farahana, R. I. R. Najwa, I. Faisal","doi":"10.32827/ijphcs.6.3.77","DOIUrl":"https://doi.org/10.32827/ijphcs.6.3.77","url":null,"abstract":"Background: In November 2016, the WHO has declared Zika virus (ZIKV) infection as a public health emergency of international concern. Affected countries have to decide on the suitable control measures of ZIKV outbreak. This article aims to apply the Rational Model in the decision-making of ZIKV outbreak control measures. Materials and Methods: Adopting a scoping review method, articles were identified using three databases through the keywords “decision making theories” or “problem solving” and “public health” or “community health”. Only articles written and published in English within the last 15 years were included. After filtering, 10 articles were reviewed. Result: The Rational decision-making model is positioned as the most promising, effective, and functional decision-making approach for ZIKV outbreak as it reduces chances of error and optimize resources. There are five domains of control measures in ZIKV outbreak which are decision support tools; technology development; surveillance and monitoring; infrastructural development and behavioural. In Malaysia, integrated vector management, entomological and disease surveillance, enhance infrastructural development and behavioural were practiced in control measures of ZIKV outbreak. Conclusion: The most common models used in decision making is the Rational Model and the Contingency Model. The basic concepts of Rational Model in decision-making for preventative measure of ZIKV outbreak were discussed in this article. Keywords: decision making, rational model, Zika virus outbreak","PeriodicalId":14315,"journal":{"name":"International Journal of Public Health and Clinical Sciences","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86930286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. H. Johani, Muhammad Aklil Abd Rahim, Z. Othman, S. Shah, Nazarudin Safian
Today around 80% of smokers worldwide live in low- and middle-income countries, and in most countries, regardless of country income group, tobacco use is more concentrated in low socioeconomic status (SES) populations. This meta-analysis was conducted to review current available evidences to determine the effectiveness of financial incentive strategies on smoking cessation among low-SES smokers. Database search using PubMed, Science Direct and Cochrane Library were used to search financial incentive intervention prior to October 2018. Appraisal of methodological quality was assessed using Cochrane Collaboration’s tool. Six identified randomized control trials with 2450 and 2437 participants in intervention and control group respectively were included in the analysis. The random-effect model was used to combine results from individual studies. The pooled odds ratio (OR) was 2.16 (95% CI: 1.66-2.82) comparing financial incentive intervention with control. Heterogeneity was not significant across studies (Chi 2 = 8.17, p = 0.15, I 2 = 39%). Current evidences from the RCT researches suggest that financial incentives are promising potential strategy to encourage smoking cessation among low-SES smokers. Keyword: financial incentive, smoking cessation, low socioeconomic status, meta-analysis
今天，全世界约80%的吸烟者生活在低收入和中等收入国家，在大多数国家，无论国家收入群体如何，烟草使用更多地集中在社会经济地位较低的人群中。本荟萃分析旨在回顾现有证据，以确定经济激励策略对低社会地位吸烟者戒烟的有效性。使用PubMed、Science Direct和Cochrane Library进行数据库检索，检索2018年10月之前的财务激励干预。方法学质量评价采用Cochrane协作工具进行评估。干预组和对照组分别有2450例和2437例随机对照试验纳入分析。随机效应模型用于综合各个研究的结果。合并优势比(OR)为2.16 (95% CI: 1.66-2.82)。各研究间异质性不显著(Chi 2 = 8.17, p = 0.15, I 2 = 39%)。目前来自随机对照试验研究的证据表明，经济激励是鼓励低社会地位吸烟者戒烟的有希望的潜在策略。关键词:财务激励;戒烟;低社会经济地位
{"title":"SHOULD WE PAY THE SMOKERS? A META-ANALYSIS OF FINANCIAL INCENTIVES FOR SMOKING CESSATION AMONG SMOKERS IN LOW SOCIOECONOMIC GROUP","authors":"F. H. Johani, Muhammad Aklil Abd Rahim, Z. Othman, S. Shah, Nazarudin Safian","doi":"10.32827/ijphcs.6.2.113","DOIUrl":"https://doi.org/10.32827/ijphcs.6.2.113","url":null,"abstract":"Today around 80% of smokers worldwide live in low- and middle-income countries, and in most countries, regardless of country income group, tobacco use is more concentrated in low socioeconomic status (SES) populations. This meta-analysis was conducted to review current available evidences to determine the effectiveness of financial incentive strategies on smoking cessation among low-SES smokers. Database search using PubMed, Science Direct and Cochrane Library were used to search financial incentive intervention prior to October 2018. Appraisal of methodological quality was assessed using Cochrane Collaboration’s tool. Six identified randomized control trials with 2450 and 2437 participants in intervention and control group respectively were included in the analysis. The random-effect model was used to combine results from individual studies. The pooled odds ratio (OR) was 2.16 (95% CI: 1.66-2.82) comparing financial incentive intervention with control. Heterogeneity was not significant across studies (Chi 2 = 8.17, p = 0.15, I 2 = 39%). Current evidences from the RCT researches suggest that financial incentives are promising potential strategy to encourage smoking cessation among low-SES smokers. Keyword: financial incentive, smoking cessation, low socioeconomic status, meta-analysis","PeriodicalId":14315,"journal":{"name":"International Journal of Public Health and Clinical Sciences","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80054211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Poor sleep quality among healthcare workers are common due to their evolving work requirements. An effective interventional program is indicated to minimise the escalating medical costs to manage ill health related to poor sleep quality among them. This article aims to review the available evidence of various approaches to improve sleep quality among healthcare workers. Materials and Methods: Electronic databases (PubMed, CINAHL, Medline, Science Direct) were used to perform systematic literature search using the keywords [“sleep training” OR “sleep hygiene education” OR “sleep quality intervention” OR “behavioural intervention” OR “interventional workshop”] AND [“healthcare workers” OR “nurses” OR “health professionals” OR “clinic workers”]. Other inclusion criteria were research articles, publications between 1 January 2009 and 31 October 2018, and availability of full text articles. Result: A total of 7 articles were included in this review. The intervention can be broadly classified into health education and behavioural therapy. Findings showed that sleep hygiene education alone was not effective; behavioural therapy had been added as a non-pharmacological modality for patients. Most literature recommended the combined sleep health education and behavioural approach due to the proven effectiveness to improve sleep quality. Sessions conducted by non-specialist occupational health staffs were equally effective too. Individualised sessions coupled with group meeting received better response from participants. Theory based interventions were commonly used in which both the strengths and limitations had been highlighted. Small sample size or relatively short observation period may have affected the result interpretation. Conclusion: Effective interventions to improve sleep quality should include combination of education and behavioural approaches, conducted with respective individual and group sessions, and utilising user-friendly study tools. Keywords: healthcare workers, interventional program, sleep quality
{"title":"SYSTEMATIC REVIEW OF INTERVENTIONAL PROGRAMS TO IMPROVE POOR SLEEP QUALITY AMONG HEALTHCARE WORKERS","authors":"H. Rahmawati, M. Wan","doi":"10.32827/ijphcs.6.2.100","DOIUrl":"https://doi.org/10.32827/ijphcs.6.2.100","url":null,"abstract":"Background: Poor sleep quality among healthcare workers are common due to their evolving work requirements. An effective interventional program is indicated to minimise the escalating medical costs to manage ill health related to poor sleep quality among them. This article aims to review the available evidence of various approaches to improve sleep quality among healthcare workers. Materials and Methods: Electronic databases (PubMed, CINAHL, Medline, Science Direct) were used to perform systematic literature search using the keywords [“sleep training” OR “sleep hygiene education” OR “sleep quality intervention” OR “behavioural intervention” OR “interventional workshop”] AND [“healthcare workers” OR “nurses” OR “health professionals” OR “clinic workers”]. Other inclusion criteria were research articles, publications between 1 January 2009 and 31 October 2018, and availability of full text articles. Result: A total of 7 articles were included in this review. The intervention can be broadly classified into health education and behavioural therapy. Findings showed that sleep hygiene education alone was not effective; behavioural therapy had been added as a non-pharmacological modality for patients. Most literature recommended the combined sleep health education and behavioural approach due to the proven effectiveness to improve sleep quality. Sessions conducted by non-specialist occupational health staffs were equally effective too. Individualised sessions coupled with group meeting received better response from participants. Theory based interventions were commonly used in which both the strengths and limitations had been highlighted. Small sample size or relatively short observation period may have affected the result interpretation. Conclusion: Effective interventions to improve sleep quality should include combination of education and behavioural approaches, conducted with respective individual and group sessions, and utilising user-friendly study tools. Keywords: healthcare workers, interventional program, sleep quality","PeriodicalId":14315,"journal":{"name":"International Journal of Public Health and Clinical Sciences","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74485239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Globally, total health expenditure is rising including in Malaysia. Healthcare demand is the decision that is made based on variety of choices that is available for utilising healthcare, consequently stimulating productivity. Among others, healthcare demand can be represented by healthcare expenditure. The concept of estimation of health production function provides derivative of utility/satisfaction. Elasticity is the responsiveness of quantity demanded that alters with respect to for example, income. Healthcare is generally inelastic; therefore there is increment of expenditure on healthcare despite price increment for healthcare utilisation - reflecting quantity demanded for healthcare. The aim of this manuscript is to critically analyse demand-side of rising healthcare expenditure. Materials and Methods: A systematic review was conducted using the PRISMA 2009 flow. Public domains used were PubMed, Medline, CINAHL and Scopus. Keywords used were health OR health care OR medical care AND expenditure OR household expenditure OR spending AND demand OR demand side OR demand-side. Inclusion criteria included publications in English and were published within 15 years. Reviews and commentaries were excluded. Finally, 30 articles were included in the review. Result and Discussion: The chosen articles are divided into sections on healthcare demand and expenditure and also health insurance. Based on the review, rising healthcare expenditure can be as a result of the demand for healthcare according to healthcare expenditure and financial hardship, prepayment programme and also demand-side policies, Conclusion: This review showed that the rise of healthcare expenditure could be resulted from healthcare demand based on healthcare expenditure and financial hardship, prepayment programme and also demand-side policies. The rise would not be solved with just the exchange of private sector’s third-party payment to public domain system. Third-party payers and consumers should implement cost-sharing and more importantly a cost effective national health policy be present without the compromise of a good quality healthcare service. Keywords: healthcare, health, medical care, household expenditure, demand, demand side
{"title":"RISING HEALTHCARE EXPENDITURE – DEMAND SIDE: A SYSTEMATIC REVIEW","authors":"Z. A. Zamzairee, M. H. Juni","doi":"10.32827/ijphcs.6.2.58","DOIUrl":"https://doi.org/10.32827/ijphcs.6.2.58","url":null,"abstract":"Background: Globally, total health expenditure is rising including in Malaysia. Healthcare demand is the decision that is made based on variety of choices that is available for utilising healthcare, consequently stimulating productivity. Among others, healthcare demand can be represented by healthcare expenditure. The concept of estimation of health production function provides derivative of utility/satisfaction. Elasticity is the responsiveness of quantity demanded that alters with respect to for example, income. Healthcare is generally inelastic; therefore there is increment of expenditure on healthcare despite price increment for healthcare utilisation - reflecting quantity demanded for healthcare. The aim of this manuscript is to critically analyse demand-side of rising healthcare expenditure. Materials and Methods: A systematic review was conducted using the PRISMA 2009 flow. Public domains used were PubMed, Medline, CINAHL and Scopus. Keywords used were health OR health care OR medical care AND expenditure OR household expenditure OR spending AND demand OR demand side OR demand-side. Inclusion criteria included publications in English and were published within 15 years. Reviews and commentaries were excluded. Finally, 30 articles were included in the review. Result and Discussion: The chosen articles are divided into sections on healthcare demand and expenditure and also health insurance. Based on the review, rising healthcare expenditure can be as a result of the demand for healthcare according to healthcare expenditure and financial hardship, prepayment programme and also demand-side policies, Conclusion: This review showed that the rise of healthcare expenditure could be resulted from healthcare demand based on healthcare expenditure and financial hardship, prepayment programme and also demand-side policies. The rise would not be solved with just the exchange of private sector’s third-party payment to public domain system. Third-party payers and consumers should implement cost-sharing and more importantly a cost effective national health policy be present without the compromise of a good quality healthcare service. Keywords: healthcare, health, medical care, household expenditure, demand, demand side","PeriodicalId":14315,"journal":{"name":"International Journal of Public Health and Clinical Sciences","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77828840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Out-of-pocket (OOP) expenditure is a cost for health care that are paid by individuals at the time of treatment through user fees, co-payments and direct payments. It is the most common way of paying for health services in developing nations particularly in low and middle-income countries. OOP payments are typically perceived to be the most regressive instrument of health finance and high reliance to it create a significant financial barrier in accessing health care. Objectives: To assess the determinants of OOP expenditures for health care. Materials and Methods: Journal and articles related on determinants of OOP health expenditures were compiled using a major online database, PubMed and Science Direct. The search was limited to full-text papers published in English and studies conducted within the last 10 years (2007-2017). The selection of articles to be reviewed is done according to the PRISMA checklist. Result: The main determinants of OOP health expenditure identified were age, gender, place of living, education and income level, household size and presence of comorbidities. Other determinants were marital status, insurance status, payments for medical supplies and pharmaceuticals and distance to health facilities Conclusion: OOP payments is not an equitable nor efficient financing mechanism. A government need to formulate the best health financing mechanism to achieve a complete universal health coverage status. This review can help policy-makers in identifying the determinants of OOP, focussing on the mechanisms driving them, and formulate policy options for building stronger health financing mechanisms. Keywords: Determinants, Out-of-Pocket, Expenditure, Health Care
{"title":"DETERMINANTS OF OUT-OF-POCKET EXPENDITURE FOR HEALTH CARE: A SYSTEMATIC REVIEW","authors":"A. Fakhri, M. H. Juni","doi":"10.32827/ijphcs.6.2.44","DOIUrl":"https://doi.org/10.32827/ijphcs.6.2.44","url":null,"abstract":"Background: Out-of-pocket (OOP) expenditure is a cost for health care that are paid by individuals at the time of treatment through user fees, co-payments and direct payments. It is the most common way of paying for health services in developing nations particularly in low and middle-income countries. OOP payments are typically perceived to be the most regressive instrument of health finance and high reliance to it create a significant financial barrier in accessing health care. Objectives: To assess the determinants of OOP expenditures for health care. Materials and Methods: Journal and articles related on determinants of OOP health expenditures were compiled using a major online database, PubMed and Science Direct. The search was limited to full-text papers published in English and studies conducted within the last 10 years (2007-2017). The selection of articles to be reviewed is done according to the PRISMA checklist. Result: The main determinants of OOP health expenditure identified were age, gender, place of living, education and income level, household size and presence of comorbidities. Other determinants were marital status, insurance status, payments for medical supplies and pharmaceuticals and distance to health facilities Conclusion: OOP payments is not an equitable nor efficient financing mechanism. A government need to formulate the best health financing mechanism to achieve a complete universal health coverage status. This review can help policy-makers in identifying the determinants of OOP, focussing on the mechanisms driving them, and formulate policy options for building stronger health financing mechanisms. Keywords: Determinants, Out-of-Pocket, Expenditure, Health Care","PeriodicalId":14315,"journal":{"name":"International Journal of Public Health and Clinical Sciences","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77656444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Si Dung Chu, M. Tran, K. Q. Pham, Dung T. Vu, Tan Nguyen
Background: A survey was conducted for inpatient satisfaction about medical examination and treatment process in Vietnam National Heart Institute at Bachmai Hospital using the Tools of Victorian Patient Satisfaction Monitor (VPSM) 2012. Methods: The study obtained feedback from adult inpatients over a period of one month, during a middle of January to middle of February 2014. We were finished interviewed immediately before inpatients leave hospital, the attendant, a modified version of the PS by the VPSM with 6 items (25 score) was used in the hospital. Results: In total, 325 inpatients were interviewed and completed the survey. Levels of inpatient satisfaction about medical examination and treatment process were influenced by the VPSM with 6 items (25 score) and Cronbach alpha coefficient’s 0.928, Including the Access and Admission, General Patient information, Treatment and Related information, Complaints Management, Physical Environment, Discharge and Follow. Overall, the level of highly inpatient satisfaction in the hospital was explained almost 74.621% what could be archieved. There is no difference in the assessment of the inpatient satisfaction for medical examination and treatment process between level of education; there is difference in the assessment of the inpatient satisfaction for medical examination and treatment process under the Gender, and the monthly income level with the model of research. Conclusion: The levels of inpatient satisfaction about medical examination and treatment process is influenced by the VPSM with 6 items (25 score). The VPSM provides feedback on the PS for medical examination and treatment process of a public hospital experience from the adult inpatient's perspective. Keywords: Medical examination and treatment process, inpatient, patient satisfaction, VPSM
{"title":"MEASURING INPATIENT SATISFACTION FOR TREATMENT PROCESS AT THE NATIONAL HEART INSTITUTE AT BACHMAI HOSPITAL IN VIETNAM BY TOOLS OF VICTORIAN PATIENT SATISFACTION MONITOR","authors":"Si Dung Chu, M. Tran, K. Q. Pham, Dung T. Vu, Tan Nguyen","doi":"10.32827/ijphcs.6.2.238","DOIUrl":"https://doi.org/10.32827/ijphcs.6.2.238","url":null,"abstract":"Background: A survey was conducted for inpatient satisfaction about medical examination and treatment process in Vietnam National Heart Institute at Bachmai Hospital using the Tools of Victorian Patient Satisfaction Monitor (VPSM) 2012. Methods: The study obtained feedback from adult inpatients over a period of one month, during a middle of January to middle of February 2014. We were finished interviewed immediately before inpatients leave hospital, the attendant, a modified version of the PS by the VPSM with 6 items (25 score) was used in the hospital. Results: In total, 325 inpatients were interviewed and completed the survey. Levels of inpatient satisfaction about medical examination and treatment process were influenced by the VPSM with 6 items (25 score) and Cronbach alpha coefficient’s 0.928, Including the Access and Admission, General Patient information, Treatment and Related information, Complaints Management, Physical Environment, Discharge and Follow. Overall, the level of highly inpatient satisfaction in the hospital was explained almost 74.621% what could be archieved. There is no difference in the assessment of the inpatient satisfaction for medical examination and treatment process between level of education; there is difference in the assessment of the inpatient satisfaction for medical examination and treatment process under the Gender, and the monthly income level with the model of research. Conclusion: The levels of inpatient satisfaction about medical examination and treatment process is influenced by the VPSM with 6 items (25 score). The VPSM provides feedback on the PS for medical examination and treatment process of a public hospital experience from the adult inpatient's perspective. Keywords: Medical examination and treatment process, inpatient, patient satisfaction, VPSM","PeriodicalId":14315,"journal":{"name":"International Journal of Public Health and Clinical Sciences","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76595925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Food safety protects consumers from risks of foodborne diseases and addresses the proper handling, preparing and storing of food. With foodborne diseases still remaining an important cause of morbidity and mortality worldwide, food safety continues to be emphasized and enhancing consumer food safety knowledge and practice is one important measure to prevent foodborne diseases. Although there are efforts of food safety education in schools, there is still limited research regarding food safety knowledge and practice amongst consumers especially school students. Therefore, this research aims to determine the level and factors associated with food safety practice among form four students in Hulu Langat district, Selangor. Materials and Methods: A cross-sectional study using multi-stage sampling was conducted involving 610 form four students from six secondary schools in Hulu Langat. A self-administered questionnaire was used to determine the students’ food safety knowledge scores. A cut-off point of 70% was used (scores above or below this are considered ‘Good’ or ‘Insufficient’ level of knowledge). Descriptive and analytical analysis was done using the SPSS version 22.0 Result: The level of food safety knowledge is insufficient for majority of the students (62.8%). Good food safety knowledge was higher among the Malays (40.8%), those in the Pure Science stream (44%), those with parents who are food handlers (51.3%) and those with a previous experience of food poisoning (40.7%). The level of food safety knowledge is significantly associated with ethnicity (p=0.03), academic stream (p=0.02), whether their parents are food handlers (p=0.03) and previous experience of food poisoning (p=0.01). Conclusion: Majority of the form four students had insufficient level of knowledge on food safety. Thus, there is a need to further improve their knowledge. Factors like racial differences, family and academic background should be taken into consideration when constructing educational interventions to improve the level of knowledge. Keywords: food safety knowledge, students, secondary schools
{"title":"FACTORS ASSOCIATED WITH LEVEL OF FOOD SAFETY KNOWLEDGE AMONG FORM FOUR STUDENTS IN HULU LANGAT DISTRICT, SELANGOR","authors":"S. Syahira, B. Huda, Mohd Rafee B.B","doi":"10.32827/ijphcs.6.2.252","DOIUrl":"https://doi.org/10.32827/ijphcs.6.2.252","url":null,"abstract":"Background: Food safety protects consumers from risks of foodborne diseases and addresses the proper handling, preparing and storing of food. With foodborne diseases still remaining an important cause of morbidity and mortality worldwide, food safety continues to be emphasized and enhancing consumer food safety knowledge and practice is one important measure to prevent foodborne diseases. Although there are efforts of food safety education in schools, there is still limited research regarding food safety knowledge and practice amongst consumers especially school students. Therefore, this research aims to determine the level and factors associated with food safety practice among form four students in Hulu Langat district, Selangor. Materials and Methods: A cross-sectional study using multi-stage sampling was conducted involving 610 form four students from six secondary schools in Hulu Langat. A self-administered questionnaire was used to determine the students’ food safety knowledge scores. A cut-off point of 70% was used (scores above or below this are considered ‘Good’ or ‘Insufficient’ level of knowledge). Descriptive and analytical analysis was done using the SPSS version 22.0 Result: The level of food safety knowledge is insufficient for majority of the students (62.8%). Good food safety knowledge was higher among the Malays (40.8%), those in the Pure Science stream (44%), those with parents who are food handlers (51.3%) and those with a previous experience of food poisoning (40.7%). The level of food safety knowledge is significantly associated with ethnicity (p=0.03), academic stream (p=0.02), whether their parents are food handlers (p=0.03) and previous experience of food poisoning (p=0.01). Conclusion: Majority of the form four students had insufficient level of knowledge on food safety. Thus, there is a need to further improve their knowledge. Factors like racial differences, family and academic background should be taken into consideration when constructing educational interventions to improve the level of knowledge. Keywords: food safety knowledge, students, secondary schools","PeriodicalId":14315,"journal":{"name":"International Journal of Public Health and Clinical Sciences","volume":"222 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74948807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nurul Adhiyah Wan Ishak, Hafizuddin Awang, Rafidah Abd Aziz, A. Abdullah, Norlita Bahari
Background: Diabetes mellitus is one of public health concerns in Malaysia. Insulin therapy refusal is getting prevalent among Malaysian diabetic patients due to various attributes. The purpose of this study was to determine the prevalence of insulin therapy refusal among type 2 diabetes patients and to determine its associated factors. Materials and Methods: A cross-sectional study was conducted from August 2015 to February 2016 in four selected health clinics in East Coast Region of Peninsular Malaysia. Diabetic patients who fulfilled the study criteria were recruited. Descriptive statistics, simple and multiple logistic regressions were used for data analysis. Result: A total of 460 patients were recruited in this study. The prevalence of patients refused insulin therapy was 15.0%. The mean (±SD) age of patients refusing insulin therapy was 59.93 (±1.13) year old. Majority of insulin-refusing patients were female (76.8%), Malay (81.1%) and attained secondary education level (50.7%). The mean (±SD) duration of diabetes among insulin-refusing patients was 7.5 (±0.49) year. Majority of insulin-refusing patients had co-morbidities (84.1%) and diabetic complication (76.8%). Male gender, Malay ethnicity, duration of having diabetes and presence of diabetic complications were the significant associated factors for refusing insulin therapy with an adjusted odds ratio (AOR) of 2.41 (95%CI: 1.37,4.26; p=0.002), 4.17 (95%CI: 2.27,7.66; p<0.001), 0.92 (95%CI: 0.87,0.97; p=0.003) and 3.50 (95%CI: 1.37,8.98; p=0.009), respectively. Conclusion: Insulin therapy refusal is quite common in Malaysia. More proactive actions from healthcare providers needed in accordance to the pinpointed factors in order to attain better insulin therapy acceptance among diabetic patients. Keywords: insulin therapy refusal, prevalence, type 2 diabetes mellitus, associated factors.
{"title":"PREVALENCE AND DETERMINANTS FOR INSULIN THERAPY REFUSAL AMONG TYPE 2 DIABETES MELLITUS PATIENTS IN PRIMARY HEALTHCARE FACILITIES IN EAST COAST REGION OF PENINSULAR MALAYSIA","authors":"Nurul Adhiyah Wan Ishak, Hafizuddin Awang, Rafidah Abd Aziz, A. Abdullah, Norlita Bahari","doi":"10.32827/ijphcs.6.2.160","DOIUrl":"https://doi.org/10.32827/ijphcs.6.2.160","url":null,"abstract":"Background: Diabetes mellitus is one of public health concerns in Malaysia. Insulin therapy refusal is getting prevalent among Malaysian diabetic patients due to various attributes. The purpose of this study was to determine the prevalence of insulin therapy refusal among type 2 diabetes patients and to determine its associated factors. Materials and Methods: A cross-sectional study was conducted from August 2015 to February 2016 in four selected health clinics in East Coast Region of Peninsular Malaysia. Diabetic patients who fulfilled the study criteria were recruited. Descriptive statistics, simple and multiple logistic regressions were used for data analysis. Result: A total of 460 patients were recruited in this study. The prevalence of patients refused insulin therapy was 15.0%. The mean (±SD) age of patients refusing insulin therapy was 59.93 (±1.13) year old. Majority of insulin-refusing patients were female (76.8%), Malay (81.1%) and attained secondary education level (50.7%). The mean (±SD) duration of diabetes among insulin-refusing patients was 7.5 (±0.49) year. Majority of insulin-refusing patients had co-morbidities (84.1%) and diabetic complication (76.8%). Male gender, Malay ethnicity, duration of having diabetes and presence of diabetic complications were the significant associated factors for refusing insulin therapy with an adjusted odds ratio (AOR) of 2.41 (95%CI: 1.37,4.26; p=0.002), 4.17 (95%CI: 2.27,7.66; p<0.001), 0.92 (95%CI: 0.87,0.97; p=0.003) and 3.50 (95%CI: 1.37,8.98; p=0.009), respectively. Conclusion: Insulin therapy refusal is quite common in Malaysia. More proactive actions from healthcare providers needed in accordance to the pinpointed factors in order to attain better insulin therapy acceptance among diabetic patients. Keywords: insulin therapy refusal, prevalence, type 2 diabetes mellitus, associated factors.","PeriodicalId":14315,"journal":{"name":"International Journal of Public Health and Clinical Sciences","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90621870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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