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Blockchain-Based Healthcare Monitoring System Using Patient Electronic Health Record 基于区块链的患者电子健康记录医疗监控系统
Q4 Health Professions Pub Date : 2023-09-10 DOI: 10.24083/apjhm.v18i2.2397
Sonal Jain, Arya Kumar, Prabha Kiran, S.Si.T Kartini
The majority of hospitals and other healthcare institutions have made the switch from paper-based techniques to something that is known as electronic health records, or EHRs. This change was made possible by technological advancements. Various parties need to exchange the data records they keep on one another, and users need to be allowed to exercise control over who has access to the information they have on file. The Electronic Health Record (EHR) system is beset by issues relating to managing problems, challenges with trust, and data protection. Data stored on blockchains are immutable, private, and accessible only by their intended users. Blockchain technology's use has also led to managing a system with the potential to provide decentralized data storage. In this research, we determine whether it is appropriate to deploy blockchain technology in EHR and explore its potential uses in the efficient leadership of the COVID-19 pandemic.
大多数医院和其他医疗机构已经从纸质技术转向电子健康记录(EHRs)。技术的进步使这种变化成为可能。各方需要交换彼此保存的数据记录,用户需要被允许控制谁可以访问他们存档的信息。电子健康记录(EHR)系统受到管理问题、信任挑战和数据保护等问题的困扰。存储在区块链上的数据是不可变的、私有的,只有它们的目标用户才能访问。区块链技术的使用也导致了管理一个有可能提供分散数据存储的系统。在本研究中,我们确定在电子病历中部署区块链技术是否合适,并探索其在COVID-19大流行的有效领导中的潜在用途。
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引用次数: 0
An Effective Health Care System through Health Technology Assessment and Evidence Based Payment System in India 通过卫生技术评估和基于证据的支付系统在印度建立有效的卫生保健系统
Q4 Health Professions Pub Date : 2023-09-10 DOI: 10.24083/apjhm.v18i2.2403
Arya Kumar, Rajni Mathur, T Shirmila, Rahul More, Ravindra Kaikini, Kuldeep Bhalerao
The purpose of this research is to discuss the significance of health care insurance compensation for obtaining comprehensive medical treatment in India. Through a systematic review survey focusing on the keywords like out-of-pocket, Health Technology Assessment and Health care system was conducted by using the searches from Google Scholar, Science Direct, PubMed and ProQuest Database, it is observed that India ranks among the greatest out-of-pocket (OOP) healthcare expenditures in the globe. This seems to be notwithstanding the deployment of several public health plans and the provision of a significant variety of both private and public health coverage schemes. Decrease in the treatment quality across many healthcare institutions of government is a key cause causing the typical Indian individual to constantly rely on medical services provided by private firms, heading up OOP expenses. Among the most significant problems in implementing universal health care (UHC) in India is a poor acceptance of insurance products and awareness between many Indians. The burden of large OOP expenditures on people might be lessened by increasing medical insurance acceptance, which may be accomplished by enhancing India's medical claims system.
本研究的目的是探讨医疗保险补偿在印度获得全面医疗的意义。通过使用Google Scholar、Science Direct、PubMed和ProQuest数据库的搜索,对自付、卫生技术评估和卫生保健系统等关键词进行了系统回顾调查,发现印度是全球自付医疗保健支出最高的国家之一。尽管部署了若干公共卫生计划,并提供了种类繁多的私人和公共卫生保险计划,但情况似乎仍然如此。许多政府卫生保健机构的治疗质量下降是导致典型印度人不断依赖私营公司提供的医疗服务的一个关键原因,这导致了OOP费用的增加。在印度实施全民医疗保健(UHC)的最重要问题之一是许多印度人对保险产品的接受程度和意识不强。通过提高医疗保险接受度,可能会减轻人们对大型OOP支出的负担,这可以通过加强印度的医疗索赔制度来实现。
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引用次数: 0
Relationship Between Workplace Incivility, Employee Performance And Employee Engagement In Healthcare Institutions 医疗机构工作场所不文明行为、员工绩效与员工敬业度的关系
Q4 Health Professions Pub Date : 2023-09-06 DOI: 10.24083/apjhm.v18i2.2409
Sakshee Singh, Indra Meghrajani, Garima Vijh, Jain Prabhu Thomas, Sagar Mohite
Workplace incivility is a well-known problem that affects every firm and its environment. Employee engagement may result in physical and mental suffering, impacting how well people perform. The study aims to ascertain the relationship between employee engagement, employee performance, and workplace incivility. For this, scales of the investigated variables were used to build a well-structured questionnaire. The survey questionnaire was sent out to workers and employees of Health Care Institutions. There were 212 valid responses in total. SEM, or structural equation modelling, was utilized to establish relationships. The study's findings rejected hypotheses H1 and H2 showing workplace incivility (WPI) has a detrimental effect on employee engagement (EENG) at ( β= - 0.34, P >.05) and employee performance (EP) at (β = -0.27, P >.05). While adopting the hypothesis H3, employee engagement had a favourable impact on the performance of employees at (β = 0.36 P 0.05).
职场不文明是一个众所周知的问题,影响着每一家公司及其环境。员工敬业度可能会导致身体和精神上的痛苦,影响人们的表现。本研究旨在确定员工敬业度、员工绩效和工作场所不文明行为之间的关系。为此,使用调查变量的量表来构建结构良好的问卷。调查问卷发放给卫生保健机构的职工。有效问卷共212份。利用结构方程模型(SEM)来建立关系。研究结果拒绝了假设H1和H2,即工作场所不文明行为(WPI)对员工敬业度(EENG) (β = - 0.34, P > 0.05)和员工绩效(EP) (β = -0.27, P > 0.05)有不利影响。在采用假设H3时,员工敬业度对员工绩效有显著的正向影响(β = 0.36 P 0.05)。
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引用次数: 0
Examining Challenges In The Adoption of Big Data In Health Care Institutions And Its Impact On Patients Satisfaction: An empirical study in Delhi, India 在医疗保健机构中采用大数据的挑战及其对患者满意度的影响:印度德里的一项实证研究
IF 0.6 Q4 Health Professions Pub Date : 2023-09-05 DOI: 10.24083/apjhm.v18i2.2407
A. Sao, Neetu Sharma, Sakshee Singh, Bharati Vishwas Yelikar, Anoop Bhardwaj
The study aims to investigate the obstacles and factors influencing the adoption of big data in healthcare organizations, and its subsequent impact on patient satisfaction. Big data in healthcare refers to the collecting, analysis, and use of clinical data from patients that is too massive or complex to be grasped by standard data processing methods. Adopting big data in health care will enable manages to render services to patient and customer satisfaction. However, in the health care sector, firms must overcome several hurdles and problems by adopting new technology. A detailed literature review was undertaken to examine many obstacles associated with the use of Big Data. A well-structured questionnaire was prepared in Likert scale to find the elements that influence big data adoption and its impact on patient satisfaction. To evaluate factors, exploratory factor analysis using SPSS 21 was performed, and Structural Equation Modelling (SEM) was performed to assess key significant factors that impact patient satisfaction. The data was gathered from employees associated with the hospitals. The survey received responses from 212 participants. Following the analysis of the data, it was found that five challenging factors influences big data adoption. These are data integration, data understanding, technology and infrastructure, lack of expert and regulation barrier. These factors explained 70.36% of variance. Whereas, SEM analysis indicated that both data integration, data understanding and lack of expertise significantly affect big data adoption Furthermore, big data adoption in hospitals will help in improving patient satisfaction.
本研究旨在探讨影响医疗机构采用大数据的障碍和因素,以及其对患者满意度的后续影响。医疗领域的大数据是指对患者临床数据的收集、分析和使用,这些数据过于庞大或复杂,无法用标准的数据处理方法掌握。在医疗保健中采用大数据将使管理人员能够为患者和客户提供满意的服务。然而,在卫生保健部门,企业必须通过采用新技术来克服若干障碍和问题。我们进行了详细的文献综述,以检查与使用大数据相关的许多障碍。以李克特量表编制了一份结构良好的问卷,以找出影响大数据采用的因素及其对患者满意度的影响。为了评估因素,使用SPSS 21进行探索性因素分析,并使用结构方程模型(SEM)评估影响患者满意度的关键显著因素。这些数据是从与医院有关的员工那里收集的。该调查收到了212名参与者的回复。通过对数据的分析,我们发现了影响大数据采用的五大挑战因素。这些是数据集成、数据理解、技术和基础设施、缺乏专家和监管障碍。这些因素解释了70.36%的方差。然而,SEM分析表明,数据整合、数据理解和缺乏专业知识都会显著影响大数据的采用。此外,医院采用大数据将有助于提高患者满意度。
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引用次数: 0
Physicians’ Antibiotics Prescribing Patterns for Common Diseases and Knowledge on Antimicrobial Resistance: A descriptive cross-sectional study 医生对常见疾病的抗生素处方模式和抗菌药物耐药性知识:一项描述性横断面研究
IF 0.6 Q4 Health Professions Pub Date : 2023-08-12 DOI: 10.24083/apjhm.v18i2.1979
Rabeya Sultana, Ibrahim Arafat Mohim, Mona Rahim, Munira Rahim, M. S. Islam
Purpose: This study was conducted to assess the Knowledge, Attitude, and Practice (KAP) of patients or their caregivers, and prescribers of antibiotics toward antimicrobial resistance in Bangladesh.Method: This was a mixed-method research study. Data were collected from pre-determined study areas using a sample survey of 583 respondents, 11 Focus Group Discussions (FGDs), 11 Key-Informant Interviews (KIIs), and 11 In-depth Interviews (IDIs). A scale of 11 points was used to measure attitudes.Results: About 59% of the respondents (patients or carers) were between 1 to 20 years old. The difference of age of patients by sex was found statistically significant at .001 level. About 25.7% of the respondents visited an MBBS doctor and 8.1% visited a BDS dentist, and 66.2% went to traditional healers and the pharmacy. Men take more antibiotics for treatment purposes compared to their female counterparts. The difference between men and women, with regard to the treatment of common diseases, was found to be statistically significant.  Usually, new graduate doctors and traditional healers prescribe antibiotics of longer duration. The duration of prescriptions for antibiotics and type of the physician was found statistically significant. Physicians prescribed common antibiotics for upper respiratory tract infections (26%), cold and fever (21%), diarrhea (12%), STDs (9%), HTN (8%), UTIs (7.5%), diabetes (5%), and lower respiratory infections (4%). Cephalosporin (31.4%), macrolides (27.6%), quinolones (17.8%), metronidazole (13%), and penicillin (10.10%) were used. About 65.8% of the caregivers did not have any knowledge about antimicrobial resistance and the negative effects of the overuse of antibiotics.Conclusion: The majority of the respondents had poor knowledge of antimicrobial resistance and the negative effects of the overuse of antibiotics. A community-based awareness program was found important to create awareness of antimicrobial resistance and the negative effects of the overuse of antibiotics.
目的:本研究旨在评估孟加拉国患者或其护理人员以及抗生素开处方者对抗菌素耐药性的知识、态度和行为(KAP)。方法:采用混合方法进行研究。通过对583名受访者的抽样调查,11次焦点小组讨论(fgd), 11次关键信息访谈(KIIs)和11次深度访谈(IDIs),从预先确定的研究领域收集数据。调查采用了11分的量表来衡量态度。结果:59%的受访者(患者或护理人员)年龄在1 ~ 20岁之间。患者性别年龄差异在0.001水平上有统计学意义。约25.7%的受访者去看MBBS医生,8.1%的受访者去看BDS牙医,66.2%的受访者去看传统治疗师和药房。为了治疗目的,男性比女性服用更多的抗生素。在常见疾病的治疗方面,男女之间的差异在统计上是显著的。通常,新毕业的医生和传统治疗师开的抗生素持续时间更长。抗生素处方的持续时间和医生的类型有统计学意义。医生为上呼吸道感染(26%)、感冒和发烧(21%)、腹泻(12%)、性传播疾病(9%)、HTN(8%)、uti(7.5%)、糖尿病(5%)和下呼吸道感染(4%)开出常用抗生素。头孢菌素(31.4%)、大环内酯类药物(27.6%)、喹诺酮类药物(17.8%)、甲硝唑(13%)、青霉素(10.10%)。约65.8%的护理人员对抗生素耐药性和过度使用抗生素的负面影响一无所知。结论:大部分受访人员对抗菌药物耐药性及过度使用抗菌药物的负面影响了解不足。以社区为基础的提高认识项目对于提高人们对抗菌素耐药性和过度使用抗生素的负面影响的认识非常重要。
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引用次数: 0
Impact of the COVID-19 Pandemic on Blood Transfusion Service: A case study from Kolkata, India 新冠肺炎大流行对输血服务的影响:来自印度加尔各答的案例研究
IF 0.6 Q4 Health Professions Pub Date : 2023-08-11 DOI: 10.24083/apjhm.v18i2.2137
Kriti Karmakar, P. Ray
Background: The emergence of coronavirus disease (COVID-19) has posed a significant threat to public health all over the world and it has been a difficult challenge for blood banks in India to cope with the situation. In this study, the effect of the COVID-19 pandemic on the blood transfusion service of India has been assessed. Method: The present study is conducted in a stand-alone community blood bank situated in the city of Kolkata, India. A comparative evaluation of supply, demand, and utilization of blood components by analysing pre-pandemic and post-pandemic data from 2017 to 2020 has been presented.Result: As no blood donation camp could be organized due to the country-wide lockdown along with restrictions in mobility and large gatherings during the initial period after the outbreak of the pandemic, a significant reduction of 80.35% in blood collection was observed. The demand for the Packed Red Blood Cell was decreased by 75% due to the postponement of elective surgeries and non-urgent clinical interventions. Blood utilization patterns also changed as 40% of the Packed Red Blood Cell was issued to thalassemia patients during this period. Conclusion: Based on the evaluation of blood bank performance under pre-pandemic and post-pandemic conditions, recommendations such as spreading public awareness, maintaining sufficient safety stock, proper training of blood banking staff, communicating with nearby hospitals, donors, and medical professionals have been identified to be helpful to mitigate the adverse effects of extreme situations such as a pandemic.
背景:冠状病毒疾病(新冠肺炎)的出现对世界各地的公共卫生构成了重大威胁,印度的血库应对这种情况一直是一个困难的挑战。在这项研究中,评估了新冠肺炎大流行对印度输血服务的影响。方法:本研究在印度加尔各答市的一个独立的社区血库中进行。通过分析2017年至2020年疫情前和疫情后的数据,对血液成分的供应、需求和利用进行了比较评估。结果:由于在疫情爆发后的最初阶段,由于全国范围的封锁以及行动和大型集会的限制,无法组织献血营,因此血液采集量显著减少了80.35%。由于选择性手术和非紧急临床干预的推迟,对浓缩红细胞的需求减少了75%。血液利用模式也发生了变化,因为在此期间,40%的红细胞被分配给地中海贫血患者。结论:基于对血库在疫情前和疫情后条件下的表现的评估,建议传播公众意识、保持足够的安全储备、对血库工作人员进行适当培训、与附近医院、捐赠者沟通、,医疗专业人员已被确定有助于减轻疫情等极端情况的不利影响。
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引用次数: 0
Understanding Workplace Spirituality in Health Care Systems: Practice and challenges 理解卫生保健系统中的工作场所灵性:实践与挑战
IF 0.6 Q4 Health Professions Pub Date : 2023-08-09 DOI: 10.24083/apjhm.v18i2.1701
Harshit Soni, Chitra Soni, Brijesh Singh
Purpose of the Study: The purpose of this paper is to make an enquiry into work place spirituality in health care systems. Based on a theoretical study of spirituality and its growing importance in health care systems; workplace spirituality is discussed with doctors and elements of spirituality which are applied in treating patients are identified. The study has also explored the individual level and system level challenges while practicing spirituality through the identified elements in the health care systems.Methodology adopted: This is an inductive form of research which involved enquiry into the existing literature of spirituality and further records the focused discussions of doctors for capturing the idea of spirituality in health care systems, identification of elements of spirituality and implementation challenges of spiritual elements in health care systems.Findings:  The idea of spirituality in healthcare systems includes the trust and belief in supreme power, peace of mind, spiritual care and identifying spirituality as an asset. Gratitude and prayers, counseling, inclusion of the yogic techniques and investment of self in the work are identified as elements of spirituality in healthcare systems. Analysis of data also implied challenges in implementation of spirituality in health care systems.Practical implications: The findings of the study have identified the elements of spirituality in health care systems not addressed in the previous research. The present study suggests to consider the emotional labor and stress of the doctors developed in the treatment process as the role of doctors is crucial in maintaining the integral health of patients. The implementation challenges of spiritual practices in health care systems are also discussed.
研究目的:本文旨在探讨医疗保健系统中的工作场所精神。基于对精神及其在医疗保健系统中日益重要的理论研究;与医生讨论了工作场所的精神,并确定了用于治疗患者的精神元素。该研究还探讨了个人层面和系统层面的挑战,同时通过医疗保健系统中确定的元素来实践精神。采用的方法:这是一种归纳式的研究形式,涉及对现有精神文献的调查,并进一步记录了医生为在医疗保健系统中捕捉精神理念、确定精神要素以及在医疗保健体系中实施精神要素的挑战而进行的重点讨论。研究结果:医疗系统中的精神理念包括对最高权力的信任和信念、心灵的平静、精神关怀以及将精神视为一种资产。感恩和祈祷、咨询、瑜伽技巧的融入以及对工作的自我投资被认为是医疗系统中的精神元素。对数据的分析也意味着在医疗保健系统中落实精神方面的挑战。实际意义:该研究的发现确定了先前研究中没有涉及的医疗保健系统中的精神元素。本研究建议考虑医生在治疗过程中产生的情绪劳动和压力,因为医生的作用对维持患者的整体健康至关重要。还讨论了精神实践在医疗保健系统中的实施挑战。
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引用次数: 0
Cultural And Social Barrier in Community Physiotherapy Practice: Ethics in the Indian context 社区物理治疗实践中的文化和社会障碍:印度背景下的伦理学
IF 0.6 Q4 Health Professions Pub Date : 2023-08-08 DOI: 10.24083/apjhm.v18i2.2063
Abishek J R, H. S, Anbu Priya M
Background: Ethics becomes inevitable in the physiotherapy profession as it is concerned with professionalism and patient outcomes by avoiding patient-therapist conflicts and helps avoiding medical negligence.Objctive: This study aims to explore the impedance faced by the community physiotherapist in implementing the code of ethics.Methodology: A structured interview-based questionnaire was framed to assess the perception of ethics, role of ethics and the barriers faced in implementing ethical guidelines by community physiotherapist during their practice.Results: Ethics is important as it dignifies the profession and gains the confidences of the patient and helps in developing a good rapport with the patient. The most important barriers faced by the physiotherapist in abiding by the code of ethics were the unawareness among the patient and their cultural belief alongside with lack of inter-sectorial harmony.Conclusion: This study concludes that educating the patients and creating an inter-sectoral harmony will be most effective in breaking the barriers in ethical implementation in practice.
背景:伦理在物理治疗行业中变得不可避免,因为它通过避免患者-治疗师冲突来关注专业精神和患者结果,并有助于避免医疗疏忽。目的:本研究旨在探讨社区物理治疗师在执行职业道德规范时所面临的障碍。方法:采用结构化的访谈问卷,评估社区物理治疗师在执业过程中对道德的认知、道德的作用以及在实施道德准则时面临的障碍。结果:道德是重要的,因为它使职业尊严,获得病人的信心,并有助于与病人建立良好的关系。物理治疗师在遵守道德规范方面面临的最重要障碍是患者及其文化信仰的不了解以及缺乏跨部门和谐。结论:对患者进行教育,营造跨部门和谐,是打破实践中伦理执行障碍的最有效途径。
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引用次数: 0
Participation In Online Health Communities: Decoding the antecedents and outcomes 参与在线健康社区:解读前因和结果
IF 0.6 Q4 Health Professions Pub Date : 2023-08-08 DOI: 10.24083/apjhm.v18i2.1387
Shveta Kalra, Chhavi Taneja, Neha Singhal
A significant number (49 %) of Indian users tend to rely on digital media to either access health-related information or use the internet as a precursor to visit a doctor [20]. According to a report by Raheja [48], "The Internet of Things” (IoT) connection has the potential to change the malfunctioning medical system into a comprehensive, effective, and individualised system. This will allow for a more proactive approach to wellness and overall health, reducing medical expenses through these inclusive practices. Online health communities in India demonstrate significant clout to transform the healthcare industry by empowering patients. They offer a platform to all key stakeholders, that are, the healthcare professionals, patients and even the caregivers alike, to come forth, share their experiences and develop remedies for various issues faced by the healthcare industry.This paper examines the antecedents involved in the empowerment of patients in Online Health Communities (OHCs) and the outcomes of this in the form of participant compliance. The research additionally examines the moderating impact of certain factors such as the patients’ e-health literacy and health locus of control (HLOC) and the physicians’ paternalism, in examining the relationship between patient empowerment and compliance.The findings of the research propose a construct or a theoretical model for the numerous factors and moderators associated with the patient’s participation in online health communities. The social support available to patients leads to more empowered patients, ultimately resulting in higher Patient compliance. Further, this patient empowerment, which comprises of sense of autonomy, competence and self-efficacy makes people more compliant. The theoretical construct between patient empowerment and patient compliance, is further moderated by the patients’ e-health literacy and health locus of control (HLOC) and the physicians’ paternalism.
相当多(49%)的印度用户倾向于依赖数字媒体来获取与健康相关的信息,或将互联网作为就诊的前兆[20]。根据Raheja的一份报告[48],“物联网”连接有可能将故障的医疗系统转变为一个全面、有效和个性化的系统。这将允许采取更积极主动的方法来实现健康和整体健康,通过这些包容性的做法减少医疗费用。印度的在线健康社区展示了通过赋予患者权力来改变医疗保健行业的巨大影响力。他们为所有关键利益相关者提供了一个平台,即医疗保健专业人员、患者甚至护理人员,让他们站出来,分享他们的经验,并为医疗保健行业面临的各种问题制定补救措施。本文研究了在线健康社区(OHCs)中患者赋权的前因,以及参与者依从性的结果。该研究还考察了某些因素的调节作用,如患者的电子健康素养和健康控制点(HLOC)以及医生的家长作风,以考察患者赋权和依从性之间的关系。研究结果为患者参与在线健康社区的众多因素和调节因素提出了一个结构或理论模型。患者可获得的社会支持使患者更有能力,最终提高患者的依从性。此外,这种由自主感、能力感和自我效能感组成的患者赋权使人们更加顺从。患者的电子健康素养和健康控制点(HLOC)以及医生的家长作风进一步调节了患者赋权和患者依从性之间的理论结构。
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引用次数: 0
Out-of-Pocket Expenditure in Hypertension Related Care in India: Estimates from National Sample Survey 2017-18 印度高血压相关护理的自付费用:来自2017-18年全国抽样调查的估计
IF 0.6 Q4 Health Professions Pub Date : 2023-08-02 DOI: 10.24083/apjhm.v18i2.1763
S. Rajasulochana, P. S, Saravanan E, Mathan Kumar, Jeyanthi E, Anurag Gola, S. Kar
Background: Studies estimating treatment cost associated with hypertension care in the Indian context are limited and show considerable variations.Objective: To estimate the extent of out-of-pocket expenditure (OOPE) for hypertension care at the population level and its financial impact on households in India.Methods: We analysed the data of the 75th round of the of NSSO survey (India) on the social consumption of health care conducted in 2017-18.  OOPE was assessed after deducting the amount reimbursed by insurance from the total medical expenditure per episode of hypertension-related hospitalisation and outpatient visit during the survey period. OOPE for hypertension care was considered catastrophic if exceeding 10% of the household’s monthly per capita expenditure. The determinants of catastrophic health expenditures were examined using a multivariate logistic regression analysis.  Results:  A total of 1,351 and 6,379 individuals reported hypertension-related hospitalization and outpatient care, respectively, in the survey. The overall hypertension-related hospitalization rate was 54 per 100,000 persons.  OOPE associated with hypertension-related hospitalisation were on an average INR 3,491 (SD 6,176) and INR 24,565 (SD 37,343) in public hospitals and private hospitals, respectively. The OOPE for hypertension related to outpatient visit was INR 277 (SD 571) in public facilities but was in the range of INR 457 (SD 556) – INR 695 (SD 1,431) based on the type of private hospitals/clinics. OOPE on medicines constituted on an average 43% (95% CI: 32-52%) and 66% (95% CI: 54-64%) of public sector hospitalisation and outpatient care respectively. The risk of catastrophic expenditure due to hypertension care was 41% among the poorest households.Conclusion: Direct expenses on drugs and diagnostic tests contribute significantly to OOPE. The on-going public health efforts towards controlling hypertension need to ensure better access to essential hypertensive drugs and diagnostic tests in public facilities.
背景:在印度,估计与高血压护理相关的治疗费用的研究是有限的,并且显示出相当大的差异。目的:估计印度人口层面高血压护理的自付支出(OOPE)程度及其对家庭的财务影响。方法:我们分析了2017年至2018年进行的第75轮NSSO社会医疗消费调查(印度)的数据。OOPE是在从医疗总额中扣除保险报销金额后进行评估的调查期间高血压相关住院和门诊就诊的每次支出。如果超过家庭每月人均支出的10%,用于高血压护理的OOPE被认为是灾难性的。使用多变量逻辑回归分析来检验灾难性卫生支出的决定因素。结果:在调查中,共有1351人和6379人分别报告了与高血压相关的住院治疗和门诊治疗。与高血压相关的总住院率为每100000人中有54人。在公立医院和私立医院,与高血压相关住院相关的OOPE平均值分别为3491卢比(6176 SD)和24565卢比(37343 SD)。与门诊就诊相关的高血压的OOPE在公共设施中为277印度卢比(571 SD),但根据私立医院/诊所的类型,在457印度卢比(556 SD)-695印度卢比(1431 SD)之间。药品OOPE平均分别占公共部门住院和门诊的43%(95%CI:32-52%)和66%(95%CI:54-64%)。在最贫穷的家庭中,高血压护理导致灾难性支出的风险为41%。结论:药物和诊断测试的直接费用对OOPE有显著影响。正在进行的控制高血压的公共卫生工作需要确保在公共设施中更好地获得基本高血压药物和诊断测试。
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引用次数: 0
期刊
Asia Pacific Journal of Health Management
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