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Communication Factors, Dispositions, Resources, And Bureaucratic Structure Have An Effect On The Implementation Of Close Contact Tracing Of COVID-19 In Banjar Regency, With Policy As A Moderating Variable 以政策为调节变量,沟通因素、处置、资源和官僚结构对 Banjar 地区实施 COVID-19 密切接触者追踪的影响
IF 0.6 Q4 Health Professions Pub Date : 2023-12-03 DOI: 10.24083/apjhm.v18i3.2675
Dicky Andiarsa, Juhairiyah Juhairiyah, R. Adhani, Taufik Arbain, Syamsul Arifin, Ardik Lahdimawan, Agung Dwi Laksono
Background: various regions of Indonesia have unfulfilled close contact tracing for COVID-19 as prevention and control, including Banjar Regency which is part of the contributors to the low goal. The four factors influenced are communication, disposition, resource, and bureaucratic structure of tracer as implementing actors of close contact tracing, but other factors can strengthen or weaken policy implementation. This study aims to analyse the factors. Methods: Quantitative study used a cross-sectional approach with the moderator variable is the policy context. The independent variables are communication, disposition, resource, and bureaucratic structure. The dependent variable is the implementation of close contact tracing of COVID-19. The instrument is a questionnaire with a sample of 119 respondents that were taken with Proportional random sampling. Data analysis used SPSS 26 application with moderated regression analysis (MRA). Results: The four factors together communication, disposition, resource, and bureaucratic structure affected the implementation of close contact tracing of COVID-19 by 51.8% and the other variables were not observed in this study. The effect increased to 55.7% after introducing the policy context variable. In the partial variable test, there is no effect on the resource, but after the interaction of the moderator variable in the policy context, there is a significant p-value of 0.036 on the resource variable. Conclusions: Communication, disposition, resource, and bureaucratic structure simultaneously on tracers in the implementation of close contact tracing of COVID-19 in Banjar Regency increased with a policy context variable as a moderator variable. The policy context variable can increase the effect of the resource factor as a pure moderator.
背景:印度尼西亚多个地区未能完成将COVID-19密切接触者追踪作为预防和控制的工作,包括班贾尔县,这是导致目标较低的部分原因。影响密切接触者追踪的四个因素是追踪者的沟通、配置、资源和官僚结构,但其他因素可以加强或削弱政策的实施。本研究旨在分析这些因素。方法:定量研究采用横断面方法,调节变量为政策背景。自变量是沟通、配置、资源和官僚结构。因变量是COVID-19密切接触者追踪的实施情况。该工具是一份问卷,其中119名受访者采用比例随机抽样。数据分析采用SPSS 26软件,采用适度回归分析(MRA)。结果:沟通、处置、资源和官僚结构4个因素对COVID-19密切接触者追踪实施的影响为51.8%,其他变量未见。引入政策上下文变量后,效果提高到55.7%。在部分变量检验中,对资源没有影响,但在政策语境中调节变量相互作用后,对资源变量的p值显著为0.036。结论:班贾尔县在开展COVID-19密切接触者追踪工作中,对追踪者的沟通、处置、资源和官僚结构同时增加,政策背景变量是调节变量。策略上下文变量可以增加资源因素作为纯粹调节因素的效果。
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引用次数: 0
Prioritizing the Precursors of Patients’ Experience in Indian Corporate Hospitals: Application of hybrid RIDIT-GRA approach 优先考虑印度企业医院患者体验的先决条件:混合 RIDIT-GRA 方法的应用
IF 0.6 Q4 Health Professions Pub Date : 2023-12-03 DOI: 10.24083/apjhm.v18i3.2375
Shubham Senapati, R. Panda
Objective: This study aims to identify, understand, and prioritize the influence of distinct patient experience (PX) antecedents that have substantial evidence in shaping the patients’ preferences and experiences in Indian corporate hospitals. The study is expected to assist healthcare managers in the personalization and alignment of clinical services with consumer expectations and demands.Design/ Methodology: A cross-sectional study was conducted across eight corporate hospitals to collect 220 patient data samples. A recent measurement model, titled ‘Patient Experience Questionnaire’, was adopted to harness pre-validated PX factors and related items. Further, two independent prioritization techniques, Relative to an Identified distribution (RIDIT) analysis and Grey Relational Analysis (GRA), were executed to render item precedence of the precursors of PX.Results: Through RIDIT, items belonging to factors 'doctor services' and 'nursing services' secured favorable performance ratings, whereas items under 'information' and 'next-of-kin' obtained comparatively less favorable responses. There was evidence of minimal deviations when the results were verified through GRA, but the ranks obtained in both the independent techniques (RIDIT & GRA) revealed a robust correlation of 99.5%. Moreover, the applicability of two independent prioritization techniques enhances the rigor and reliability of findings. Conclusions: Although the respondents were mostly satisfied with their care providers, an effective provider-patient communication was not evident in the care system. Patients seemed to be overly dependent on their physicians and showed limited intention to participate in a collaborative process. Lack of patient-centric culture, deficit infrastructure, excessive workload on healthcare providers, and restricted translation of patient-centric concepts into practice deterred organizations from fully benefiting from patients' involvement in clinical facets.
目的:本研究旨在识别、理解不同患者体验(PX)前因的影响,并对其进行优先排序,这些前因在塑造印度企业医院患者的偏好和体验方面有大量证据。该研究预计将帮助医疗保健管理人员在个性化和对齐临床服务与消费者的期望和需求。设计/方法:在八家公司医院进行横断面研究,收集220例患者数据样本。采用了一种名为“患者体验问卷”的最新测量模型来利用预先验证的PX因素和相关项目。此外,两种独立的优先排序技术,相对于识别分布(RIDIT)分析和灰色关联分析(GRA),执行渲染项目优先级的PX前体。结果:通过RIDIT,属于“医生服务”和“护理服务”的项目获得了良好的绩效评价,而属于“信息”和“近亲”的项目获得了相对较差的评价。当通过GRA验证结果时,有证据表明偏差最小,但在两种独立技术(RIDIT和GRA)中获得的排名显示出99.5%的强相关性。此外,两种独立的优先排序技术的适用性增强了研究结果的严谨性和可靠性。结论:虽然受访者对他们的护理提供者大多满意,但有效的医患沟通在护理系统中并不明显。患者似乎过度依赖他们的医生,并表现出有限的意愿参与合作过程。缺乏以患者为中心的文化,基础设施不足,医疗保健提供者的工作量过大,以及将以患者为中心的概念转化为实践的限制,阻碍了组织从患者参与临床方面充分受益。
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引用次数: 0
Detection And Management of Lower Body Deformity And Ulceration Extremity In People With A Lived Experience of Diabetes 糖尿病患者下肢畸形和溃疡的检测与管理
IF 0.6 Q4 Health Professions Pub Date : 2023-12-02 DOI: 10.24083/apjhm.v18i3.2435
Chinmaya Mahapatra, Awanish Kumar
Background: Diabetes is a silent killer, wherein prolonged poor glucose control could lead to acute diabetic ulcers that are responsible for foot ulcers in the lower body extremities. A diabetic foot is a skin sore formed as a result of skin tissue breaking down and exposing the tissue layers underneath. Chronic conditions of the disease lead to amputation of the limb which is a lifelong disability as well as morbidity.Objective: We have compiled an interesting and informative review on diabetic foot ulceration. Topics and subtopics discussed in the article have scientific relevance for the readers of health management journals.Main Outcome and Results: The cascade of events that lead to ulceration is responsible for degrading vascular changes in nerve fibers, resulting in poor motor neuropathy in the lower extremities. Therefore, detection of diabetic foot and ulceration in the early stage is crucial for proper disease management. Various tools in this regard have been used to detect and monitor diabetic foot occurrence apart from a conventional assessment such as the severity of the infection, infection of the skin, extent or size of the ulcer, depth of tissue infection, and loss of sensation from various parts of the lower body. Furthermore, recent advancement in medical technology has also given some critical diagnostic tools EMG (Electromyography), NCV (Nerve Conduction Velocity), PPG (Photoplethysmography), and SSEP (Somatosensory Evoked Potential).Conclusion: The review discusses various complications related to people with a lived experience of diabetic foot ulcers and some advanced tools to diagnose them. Furthermore, a conclusive discussion on a holistic view of diabetic foot diagnosis methods and available treatments has been summarized which could be more explored for better detection/management of the disease.
背景:糖尿病是一个沉默的杀手,长期血糖控制不良可导致急性糖尿病溃疡,导致下肢足部溃疡。糖尿病足是由于皮肤组织分解并暴露下面的组织层而形成的皮肤溃疡。这种疾病的慢性状况导致截肢,这是一种终身残疾,也是一种发病率。目的:我们对糖尿病足溃疡进行了有趣而翔实的综述。文章中讨论的主题和子主题对健康管理期刊的读者具有科学相关性。主要结局和结果:导致溃疡的一系列事件是神经纤维血管变化退化的原因,导致下肢运动神经病变不良。因此,早期发现糖尿病足和溃疡对于正确的疾病管理至关重要。除了传统的评估,如感染的严重程度、皮肤感染、溃疡的程度或大小、组织感染的深度和下体各个部位的感觉丧失,在这方面已经使用了各种工具来检测和监测糖尿病足的发生。此外,最近医疗技术的进步也提供了一些关键的诊断工具,如肌电图(EMG)、神经传导速度(NCV)、光电体积脉搏图(PPG)和体感诱发电位(SSEP)。结论:本文讨论了糖尿病足溃疡患者的各种并发症以及一些诊断糖尿病足溃疡的先进工具。此外,总结了糖尿病足诊断方法和现有治疗方法的整体观点,并对其进行了结论性讨论,以便更好地检测和管理该疾病。
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引用次数: 0
The Effect of Leader-Member Exchange On Job Craftıng in Nursıng: The medıatıng role of psychologıcal safety 领导与成员之间的交流对护理工作技能的影响:心理安全的医疗作用
IF 0.6 Q4 Health Professions Pub Date : 2023-12-01 DOI: 10.24083/apjhm.v18i3.2519
Eren Akman, Emre İşci̇
Background: Nurses are expected to make prompt and accurate decisions, have high crisis management skills, and exhibit proactive behaviors due to the nature of their service. Nevertheless, this situation is thought to be affected by the directors' approach and the working environment's structure. Therefore, this study aims to determine the mediating role of psychological safety in the effect of leader-member exchange on job crafting. Methods: This study is a descriptive cross-sectional study. The study was conducted with 782 nurses in Istanbul, Turkey. Structural equation modeling was used in the study. AMOS software was used for model analysis, and SPSS software was used for descriptive statistics and correlation analysis. Results: The results indicate that the effects of leader-member exchange on job crafting (β = .541, p < .05) and psychological safety (β = .430, p < .05) are statistically significant. Moreover, the effect of psychological safety on job crafting is statistically significant (β = .453, p < .05). Based on the path analysis, it was determined that psychological safety has a mediating role in the relationship between leader-member exchange and job crafting (Confidence Interval; LB=0.059, UB=0.172). Conclusion: This study revealed that psychological safety is a mechanism that contributes to the explanation of the relationship between leader-member exchange and job crafting. The findings will create ideas for directors to provide a healthier working environment. This situation is predicted to bring more positive results for employees and patients.
背景:由于护士的服务性质,他们需要做出及时准确的决定,具有较高的危机管理技能,并表现出积极主动的行为。然而,这种情况被认为是受董事的方法和工作环境结构的影响。因此,本研究旨在确定心理安全在领导-成员交换对工作制作的影响中的中介作用。方法:本研究为描述性横断面研究。这项研究是在土耳其伊斯坦布尔的782名护士中进行的。本研究采用结构方程模型。采用AMOS软件进行模型分析,采用SPSS软件进行描述性统计和相关性分析。结果:领导-成员交换对工作制作(β = .541, p < 0.05)和心理安全(β = .430, p < 0.05)的影响有统计学意义。此外,心理安全对工作制作的影响具有统计学意义(β = .453, p < .05)。通过路径分析,我们发现心理安全在领导-成员交换与工作制作的关系中起中介作用(置信区间;磅= 0.059,乌兰巴托= 0.172)。结论:本研究揭示心理安全是解释领导-成员交换与工作塑造关系的机制。研究结果将为董事们提供更健康的工作环境提供思路。预计这种情况将为员工和患者带来更多积极的结果。
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引用次数: 0
Gender Differential In Symptoms, Morbidity, And Case Fatality Rate In The COVID-19 Pandemic In India 印度 COVID-19 大流行病在症状、发病率和病死率方面的性别差异
IF 0.6 Q4 Health Professions Pub Date : 2023-12-01 DOI: 10.24083/apjhm.v18i3.1227
Shubham Ranjan, Anupreet Kaur, R. Thakur
Background: The COVID-19 epidemic has taken a considerable toll worldwide and has harmed both male and female health. Statistics revealed that fewer females were directly affected than males; however, the latter may be more affected by the consequences. Some studies at the global level have suggested gender as the key determining factor in COVID-19, but there is a lack of such studies in developing countries like India. In light of the situation, this study has analyzed the gender-wise pattern of symptoms, morbidity, multimorbidity, and mortality due to COVID-19 in Karnataka, India.Methods: We used patient-level raw data from COVID19-India application programming interface (API) from 09th March to 05th September 2020. We have used descriptive statistics such as frequency, percentage distribution, and latent class analysis (LCA) to carry out this analysis.Findings: The study comprised 78,983 COVID-19 patients who were 63.6% males and 36.4 % females. Out of the total patients, 10.1% were reported as deceased, of which 68.4% were males and 31.6% were females. We found that all three symptoms (cough, breathlessness, and fever) were higher among males than females in the case of disease symptoms. Males had a higher risk of severe infection and mortality in general. In comparison, females suffered from comorbidities like diabetes and hypertension were at higher risk of mortality due to COVID-19 than their male counterparts. The latent class analysis also revealed that females had a more significant proportion of two or more symptoms, whereas males had more than two comorbidities.Interpretation: Given the differences in lethality between the two genders, we believe that our study has found the root causes of the gender differentials in the COVID-19 pandemic. Furthermore, our research mapped gender differences in various aspects of COVID-19, which will help policymakers find suitable interventions to reduce the burden.
背景:2019冠状病毒病(COVID-19)疫情在全球造成了巨大损失,并损害了男性和女性的健康。统计数据显示,直接受影响的女性少于男性;然而,后者可能更容易受到后果的影响。全球层面的一些研究表明,性别是COVID-19的关键决定因素,但在印度等发展中国家缺乏此类研究。鉴于这种情况,本研究分析了印度卡纳塔克邦COVID-19的症状、发病率、多病性和死亡率的性别模式。方法:使用2020年3月09日至9月05日来自covid - 19印度应用程序编程接口(API)的患者级原始数据。我们使用了描述性统计,如频率、百分比分布和潜在类分析(LCA)来进行此分析。研究结果:该研究包括78,983例COVID-19患者,其中男性占63.6%,女性占36.4%。死亡病例占总病例的10.1%,其中男性占68.4%,女性占31.6%。我们发现所有三种症状(咳嗽、呼吸困难和发烧)在疾病症状中男性高于女性。总体而言,男性患严重感染和死亡的风险更高。相比之下,患有糖尿病和高血压等合并症的女性因COVID-19死亡的风险高于男性。潜在类别分析还显示,女性有两种或两种以上症状的比例更显著,而男性有两种以上的合并症。鉴于两种性别在致死率方面的差异,我们认为我们的研究已经找到了COVID-19大流行中性别差异的根本原因。此外,我们的研究绘制了COVID-19各方面的性别差异,这将有助于政策制定者找到适当的干预措施来减轻负担。
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引用次数: 0
Emergency Department Nurses’ Clinical Competence and Its Related Factors: A cross-sectional study 急诊科护士的临床能力及其相关因素:横断面研究
IF 0.6 Q4 Health Professions Pub Date : 2023-12-01 DOI: 10.24083/apjhm.v18i3.2195
Fatemeh Jalalian, S. M. Hosseininejad, Seyed Hossein Montazer, Ali Hesamzadeh
Objectives: This study aimed to assess perceived clinical competence levels of emergency department nurses in Iran and to identify association with the demographic variables.Methods: In this cross-sectional study, all 131 employed nurses from emergency departments of four educational hospitals were included in the study using a census method. Data collection tools included a demographic information form and the “Nurse Competence Scale”. Data were analyzed using descriptive and analytical statistics.Results: The mean age of the nurses was 32.41± 6.35 years. 14 nurses were male and 117 nurses were female, the average work experience of the nurses was 8.48±5.98 years. The mean score of nurses' clinical competence score of the nurses was 68.68 ± 3.24 out of 100, which was a “good level”. Among the subscales of clinical competence, the highest mean score was related to “managing situation” and lowest to “ensuring quality”. There was no statistically significant difference of clinical competence by gender, age, and academic degree. However, the level of clinical competence differed significantly depending on work experience.Conclusions: The emergency department nurses at Mazandaran University of Medical Sciences, Iran, reported a good level of clinical competence across all categories. Hospital managers’ awareness of the level clinical competence of emergency department nurses helps them design educational programs and effective training session to improve the quality of nursing services. Moreover, it is necessary to upgrade nursing education programs at all levels of nursing education in to improve graduating nurses’ clinical competences.
目的:本研究旨在评估伊朗急诊科护士的临床能力水平,并确定其与人口统计学变量的关系。方法:采用横断面调查方法,对四所教育医院的131名在职护士进行调查。数据收集工具包括人口统计信息表和“护士能力量表”。采用描述性统计和分析性统计对数据进行分析。结果:护理人员平均年龄32.41±6.35岁。男14名,女117名,平均工作年限为8.48±5.98年。护士临床能力得分平均为68.68 ± 3.24分(满分100分),处于“良好水平”。临床能力各分量表中,“管理状况”得分最高,“保证质量”得分最低。临床能力的性别、年龄、学历差异无统计学意义。然而,临床能力水平因工作经验的不同而有显著差异。结论:伊朗Mazandaran医科大学急诊科的护士报告了所有类别的良好临床能力水平。医院管理者对急诊科护士临床能力水平的认识有助于他们设计教育方案和有效的培训课程,以提高护理服务质量。此外,有必要提高各级护理教育的护理教育课程,以提高毕业护士的临床能力。
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引用次数: 0
The Effect of Psychological Empowerment on Job Satisfaction: Regulatory role of generations X and Y 心理授权对工作满意度的影响:X 代和 Y 代的调节作用
IF 0.6 Q4 Health Professions Pub Date : 2023-12-01 DOI: 10.24083/apjhm.v18i3.2143
Pınar Erdoğan, İlknur Çevik Tekin
The objective of this study is to determine the moderator role of generation gap in the effect of psychological empowerment perception on job satisfaction. The population (N: 200) and sample (n=136) of the study consists of health professionals working in the Karaman Provincial Health Directorate, Türkiye. In the research data were collected with a questionnaire technique and the hypotheses were tested through the SPSS Macro Process program. The significance of the regulatory role (statistically) was calculated by the bootstrap test. As a result of the analyzes made, it was found that the moderator effect of psychological empowerment perception on job satisfaction differed between the X and Y generations.While the effect of the psychological empowerment perceptions of the X Generation employees on job satisfaction did not show a statistically significant difference, this effect was found to be statistically significant in the Y Generation employees. It has been found that generations have a moderator effect on the effect of psychological empowerment perceptions of health workers on job satisfaction (X and Y).
本研究旨在探讨代沟在心理授权感知对工作满意度的调节作用。该研究的人口(N: 200)和样本(N =136)由在 rkiye省卡拉曼卫生局工作的卫生专业人员组成。在研究中,采用问卷调查技术收集数据,并通过SPSS宏观过程程序检验假设。调节作用的显著性(统计上)通过bootstrap检验计算。通过分析,我们发现心理授权感知对工作满意度的调节作用在X代和Y代之间存在差异。X一代员工的心理授权感知对工作满意度的影响没有统计学上的显著差异,而Y一代员工的心理授权感知对工作满意度的影响具有统计学上的显著性。研究发现,世代对卫生工作者心理赋权感知对工作满意度的影响有调节作用(X和Y)。
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引用次数: 0
The Analysis of Maternal Characteristics and Regulation of Antenatal Care on Pregnancy Risk Status Based on The Independent Family Health Evaluation (IFHE) 基于独立家庭健康评估(IFHE)的产妇特征和产前护理对妊娠风险状况的影响分析
IF 0.6 Q4 Health Professions Pub Date : 2023-11-30 DOI: 10.24083/apjhm.v18i3.2381
Diyan Indriyani, E. Yunitasari, Ferry Efendi, Asmuji Asmuji, Sri Wahyuni Adriyani
Background: High-risk pregnancy is a serious problem and needs to be detected early. Pregnant women with risk categories have a direct impact on the fetus. This study aimed to analyze maternal characteristics and the consistency of antenatal care visits in relation to the pregnancy risk status of pregnant women using the Independent Family Health Evaluation (IFHE) Methods: This study used a cross-sectional study with a correlational design. The sample was the third-trimester pregnant women who have a maternal and child health record booklet, with a total sample of 128 respondents. The instrument used was a questionnaire adopted from the identification of family health in the IFHE application system. Data analysis was carried out using multiple logistics regression. Results: The results showed that age (p = 0.004), height (p = 0.027), number of pregnancies (p = 0.0001), history of pregnancy (p = 0.0001), history of childbirth (p = 0.001), having children under 2 years of age (p = 0.001), pregnancy complications (p = 0.0001), and history of regular antenatal care (p = 0.0001) had a significant effect on pregnancy risk status. While history of tetanus toxoid immunization showed no relationship with pregnancy risk (p = 0.332). The final modelling of multiple logistic regression showed that the influential variables were age, the number of pregnancies and consistency of antenatal care. The number of pregnancies was the variable that had the strongest influence on pregnancy risk status (OR= 40.192). Conclusion: This research contributes valuable insights into the factors influencing pregnancy risk, providing a foundation for more effective antenatal care and ultimately better health for expectant mothers and their infants. Healthcare providers can use this information to identify pregnant women at higher risk and implement targeted interventions, thereby improving maternal and fetal outcomes.
背景:高危妊娠是一个严重的问题,需要及早发现。高危孕妇对胎儿有直接影响。本研究旨在利用独立家庭健康评估(IFHE)分析孕妇特征和产前检查的一致性与孕妇妊娠风险状况的关系:本研究采用相关设计的横断面研究。样本为持有母婴健康记录手册的怀孕三个月的孕妇,共有 128 名受访者。所使用的工具是一份问卷,采用的是 IFHE 应用系统中的家庭健康识别系统。数据分析采用多元物流回归法。结果显示结果显示,年龄(p = 0.004)、身高(p = 0.027)、怀孕次数(p = 0.0001)、怀孕史(p = 0.0001)、分娩史(p = 0.001)、有 2 岁以下子女(p = 0.001)、妊娠并发症(p = 0.0001)和定期产前检查史(p = 0.0001)对妊娠风险状况有显著影响。而破伤风类毒素免疫接种史与妊娠风险没有关系(p = 0.332)。多元逻辑回归的最终建模结果显示,影响怀孕风险的变量是年龄、怀孕次数和产前护理的连贯性。怀孕次数是对怀孕风险状况影响最大的变量(OR= 40.192)。结论这项研究对影响妊娠风险的因素提出了宝贵的见解,为更有效的产前保健和最终改善准妈妈及其婴儿的健康奠定了基础。医疗保健提供者可以利用这些信息来识别高风险孕妇,并实施有针对性的干预措施,从而改善孕产妇和胎儿的预后。
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引用次数: 0
Cost Analysis of Physical Therapy Clinic In Thailand: The impact of the COVID-19 outbreak 泰国理疗诊所的成本分析:COVID-19 爆发的影响
IF 0.6 Q4 Health Professions Pub Date : 2023-11-30 DOI: 10.24083/apjhm.v18i3.2297
Raoyrin Chanavirut, S. Nakmareong, Ponlapat Yonglitthipagon, Pisamai Malila, W. Kamruecha
Objective: The aim of the study was to identify the financial burden and compare the unit costs that Coronavirus disease 2019 (COVID-19) imposed on a physical therapy clinic that are one of the primary forms of healthcare facilities in Thailand.Design and Setting: The study was a retrospective study conducted at the physical therapy clinic, Khon Kaen University Community Outreach Center (KKUCOMOC) in Thailand. To assess the impact of the outbreak, the service unit was divided into two units: physical therapy (PT) and Thai massage (TM), and the annual report for the 2019-2021 fiscal year was analyzed as representative of before and during an outbreak. The study tool was the Handbook of Unit Cost Analysis from the Office of the Permanent Secretary. Revenue, expenses, and the number of patient visits were all gathered. The data was then analyzed and summarized using Microsoft Excel programs, and descriptive statistics were presented. Results: The COVID-19 pandemic not only reduced the number of patient visits but also the revenue. During the pandemic, the percentage of expense to the facility’s revenue increased in both units. Labor, material, and capital costs were the major cost components, with labor costs accounting for the majority of direct costs. The first emerged in the 2020 fiscal year, resulting in an increase in PT's and TM's unit costs of 26.66% ($US10.24 to $US12.97) and 22.69% ($US6.92 to $US8.49), respectively. Following that, it continued to rise in both units throughout the subsequent fiscal year. As a result, at the end of the study, the unit costs of PT and TM were $US13.95 and $US9.22 respectively. Conclusions: The COVID-19 pandemic reduced the number of patient visits and revenue. Furthermore, it raised the unit cost of PT and TM to $US13.95 and $US9.22 respectively.
研究目的该研究旨在确定 2019 年冠状病毒病(COVID-19)对理疗诊所(泰国主要医疗机构之一)造成的经济负担并比较其单位成本:本研究是在泰国孔敬大学社区外展中心(KKUCOMOC)理疗诊所进行的一项回顾性研究。为了评估疫情的影响,该服务单位被分为两个单位:物理治疗(PT)和泰式按摩(TM),并分析了 2019-2021 财年的年度报告,作为疫情爆发前和爆发期间的代表。研究工具是常务秘书办公室的《单位成本分析手册》。收入、支出和患者就诊次数都被收集起来。然后使用 Microsoft Excel 程序对数据进行分析和汇总,并提供描述性统计数字。结果COVID-19 大流行不仅减少了就诊人数,也减少了收入。大流行期间,两个单位的支出占收入的比例都有所增加。人工、材料和资本成本是主要的成本构成,其中人工成本占直接成本的大部分。首次出现在 2020 财年,导致 PT 和 TM 的单位成本分别增加了 26.66%(10.24 美元至 12.97 美元)和 22.69%(6.92 美元至 8.49 美元)。此后,在随后的整个财政年度中,这两个单位的成本继续上升。因此,在研究结束时,PT 和 TM 的单位成本分别为 13.95 美元和 9.22 美元。结论:COVID-19 大流行减少了患者就诊次数和收入。此外,它还将 PT 和 TM 的单位成本分别提高到 13.95 美元和 9.22 美元。
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引用次数: 0
Improving the quality and sustainability of home-based acute care models using virtual care technology 利用虚拟护理技术提高家庭急症护理模式的质量和可持续性
IF 0.6 Q4 Health Professions Pub Date : 2023-11-30 DOI: 10.24083/apjhm.v18i3.2785
James Brown, Judi Cavanagh, Brian Dorricott, Vickie Irving, Cathie LaRiviere
Importance COVID-19 has facilitated the rise of a new service model that combines HITH service provision with technology to create ‘virtual hospitals’, but evidence on the impact of this new model in terms of cost and clinical outcomes, compared to usual Hospital in the Home (HITH) care, is currently lacking. Objective To assess the clinical and financial impacts of virtual care technology on Hospital in the Home models of care. Design Quasi-experimental study comparing outcomes of a control group receiving ‘usual’ home-based acute care and a virtual care cohort using remote monitoring technology while also receiving usual Hospital in the Home (HITH) care. Main Outcomes and Measures Readmissions within 28 days, unplanned emergency department (ED) presentations, transfers-in to facility-based hospital beds, and average length of stay. Results During the study period, 151 adult and 26 paediatric patients utilised virtual care technology for the majority, or all, of their home-based acute care. Use of such technology was associated with a statistically significant reduction in risk of hospital readmission within 28 days—from 43% to 21%. The risk of hospital readmission within 28 days for the same diagnosis-related group (DRG) dropped from 18% to 4%, and the length of stay for the top three DRGs by volume decreased from a mean of 7.2 days to 4.0 days, saving an average of $3,698 per admission. Use of technology was also associated with reduced rates of unplanned ED presentations and transfers-in to traditional hospital beds compared to usual care for adults. Conclusions Our findings confirm there are clinical and economic benefits associated with embedding virtual care technology in Hospital in the Home (HITH) service models that warrant consideration in health systems facing capacity constraints and rising costs.
重要性 COVID-19 促进了一种新服务模式的兴起,这种模式将家庭医院服务的提供与技术相结合,创建了 "虚拟医院",但与通常的家庭医院(HITH)护理相比,这种新模式在成本和临床效果方面的影响目前还缺乏证据。 目标 评估虚拟医疗技术对居家医院医疗模式的临床和财务影响。 设计 一项准实验研究,比较接受 "常规 "居家急症护理的对照组和使用远程监控技术的虚拟护理组在接受常规居家医院 (HITH) 护理的同时所取得的结果。 主要结果和测量指标 28 天内的再入院率、非计划性急诊室就诊率、转院住院率和平均住院时间。 结果 在研究期间,151 名成人患者和 26 名儿科患者利用虚拟医疗技术进行了大部分或全部的居家急症护理。使用这种技术后,患者在 28 天内再次入院的风险从 43% 降至 21%,这在统计学上有显著的相关性。同一诊断相关组(DRG)28 天内再次入院的风险从 18% 降至 4%,按住院量计算的前三位 DRG 住院时间从平均 7.2 天降至 4.0 天,平均每次入院可节省 3698 美元。与成人常规护理相比,技术的使用还降低了非计划性急诊室就诊率和转入传统医院病床的比率。 结论 我们的研究结果证实,将虚拟医疗技术嵌入到 "居家医院"(HITH)服务模式中可以带来临床和经济效益,这值得面临能力限制和成本上升的医疗系统加以考虑。
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引用次数: 0
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Asia Pacific Journal of Health Management
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