Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

Portugal is one of the European Union countries with the highest rates of people aged 65 or more. The old-age dependency index is the third highest in Europe. Longevity is a remarkable human achievement but without a comprehensive approach to fostering healthy ageing over the life-course, the burden on health and care systems and social services will increase. This issue is compounded as life expectancy rises, but many of these additional years are not lived in good health. Promoting healthy ageing is an essential political and moral strategy for the well-being both of individuals and societies. Concerning this, Portugal endorsed the Lisbon Outcome Statement drawn up based on the 2023 Regional Summit on Policy Innovation for Healthy Ageing and made its commitment for the creation of age-friendly environments. The National Programme for Age-Friendly Cities and Communities in Portugal is one of the first concrete steps to fulfill that endorsement.

This paper aims to establish an intelligent delivery system integrated with track logistics and explores its impact on the clinical transportation of goods. The study analyzed hospital delivery items before and after the implementation of an intelligent delivery system combined with automated track logistics in 2023. Delivery conditions prior to the system's activation served as the control group, while those post-implementation formed the observation group. This research assesses the effects on transportation efficiency, resource allocation, transport safety, and satisfaction among medical staff. The average delivery time of goods significantly decreased following the adoption of the intelligent delivery system combined with automated track logistics (P < .01). The total number of adverse delivery-related events was reduced from 25 to 4 (P < .01). Departmental medical staff reported substantial increases in scores for delivery efficiency, error incidence, and overall satisfaction with the delivery process (P < .01). The integration of the intelligent delivery system with automated track logistics significantly enhances the efficiency of clinical goods transportation, optimizes resource allocation, ensures the safe transport of items, and improves the patient experience and clinical staff satisfaction with delivery operations. Regular system maintenance and adjustments, supported by professional technical personnel, are essential to fully leverage the system's advantages.

The study focuses on the complex interconnection of race, sexuality, and socioeconomic background in shaping the stories of mothers struggling with addiction disorders as they attempt to recover from traumatic experiences. A sample of 45 mothers was employed in the study. Using case study analysis methodologies, the stories of 6 mothers were used as representative cases based on their individual characteristics, community settings, and institutional experiences. Further, the 6 cases were used to describe the difficulties experienced by participants across 3 major life transitions: (1) childhood (2) initiation to drug use and addiction disorders (3) motherhood. Across these life transitions, participants emphasized the relevance of traumatic experiences and mental health disorders as main reasons for their drug addiction. For each theme highlighted in the narrative of each case, a connection to all other participants was made to summarize the findings in the whole sample. The analysis indicates that while most mothers experienced trauma during their lifetime, mothers who identified as members of racial/ethnic minorities and those who identified as lesbians were more likely to report trauma from prejudice and discrimination. Furthermore, the analysis highlights that mothers who identified as members of racial minorities were more likely to have their children placed in foster care. In the study, mothers' involvement with the criminal legal system contributed to the challenges they experienced while renegotiating their relationships with their children. These mothers' lived experiences and the complexity of the dynamics they described-especially their interactions with the legal system-could potentially help other researchers frame new hypotheses that could be tested by larger empirical studies.

The rapid digital transformation in the public healthcare sector demands effective digital leadership to improve organizational performance. This study investigates the impact of digital leadership on employee empowerment and its subsequent effects on techno-work engagement and sustainability performance within public healthcare institutions in Pakistan. A survey-cum questionnaire method was employed for 334 respondents of employees of public healthcare institutions in the Punjab Province of Pakistan. It used structured questionnaires to measure digital leadership, sense of empowerment, techno-work engagement, and sustainability performance. Structural Equation Modeling (SEM) was performed on data to examine the proposed relationships among the variables. The findings of SEM showed that digital leadership positively influences employees' sense of empowerment. Empowerment significantly predicted techno-work engagement and sustainability performance. Techno-work engagement also positively affected sustainability performance. Mediation analysis revealed that the sense of empowerment mediates the relationship between digital leadership and both techno-work engagement and sustainability performance. The findings demonstrate that digital leadership enhances employee empowerment, which in turn boosts techno-work engagement and sustainability performance in the public healthcare sector. Organizations should promote digital leadership practices to empower employees and achieve sustainable outcomes.

Health care price transparency aims to empower patients to make better-informed purchasing decisions. However, the prospective availability of patients' out-of-pocket costs may lead to an increased rate of forgone care. The objective of this study was to examine whether obtaining a prospective out-of-pocket cost estimate is associated with the likelihood of canceling or not arriving at a scheduled outpatient health care appointment. We surveyed adult individuals with scheduled outpatient imaging appointments at a large health care system in Georgia. In this case-control pilot study, we estimated the adjusted association between obtaining an out-of-pocket cost estimate for a scheduled imaging appointment (did not obtain an estimate, did not seek an estimate but received it via an unsolicited phone call from the health care system, and actively sought and obtained an estimate) and not attending the appointment using multivariable logistic regression that controlled for the type of primary health insurance and patient demographics. Actively seeking an out-of-pocket cost estimate was not associated with appointment cancelation or no-show (adjusted odds ratio [aOR] = 0.81, P = .75). Passively receiving an out-of-pocket cost estimate via an unsolicited phone call from the health care system was marginally associated with lower odds of appointment cancelation or no-show (aOR = 0.24; P = .076). This study did not find evidence of an association between prospective exposure of patients to out-of-pocket cost information and the likelihood of health care appointment cancelation or no-show.

The evolving gambling environment, marked by increased accessibility and innovative promotions, has led to rising expenditures globally. Despite this, the relationship between social media use and problem gambling in the Czech Republic remains underexplored. To investigate the association between social media use and problem gambling severity among Czech adults using the Problem Gambling Severity Index (PGSI). Is there a difference in gambling severity based on demographic characteristics? (1); Is there a relationship between social media news consumption and gambling severity? (2); Is there a connection between negative motives for social media use and problematic usage? (3); Is there a link between problematic social media use and gambling severity? (4). Primary research, designed as a cross-sectional study, was conducted in the Czech Republic in November 2024 on a sample of 3093 respondents (48.4% male). All participants were aged 16 years or older. The sample was selected using quota sampling based on multiple identifying quota variables, with minimal differences in the proportions of quota indicators compared to the general population. Non-parametric tests and ordinal logistic regression analyzed relationships between demographics, social media use, and PGSI scores. Higher PGSI scores were found among males, younger participants, those with lower education, and the unemployed or students. Greater social media news consumption correlated with increased gambling severity. Disruptive social media behaviors, such as waking up to check notifications and interrupting activities, were significantly associated with higher PGSI scores. Problematic social media use involving deceit and family conflict substantially heightened the risk of severe gambling problems. These findings highlight the need for targeted prevention initiatives, regulatory policies, and enhanced digital literacy to safeguard vulnerable groups from the risks posed by digital gambling platforms. Addressing both gambling behaviors and problematic social media use is crucial in mitigating potential harms.

Food advertising may influence food preferences and consumption. Due to these advertisements' role in health, the present study has updated the data available on television and radio food advertisements in Iran until 2020. Meanwhile, food advertisements on billboards have been analyzed for the first time. All programs broadcast on two TV and radio channels were downloaded and saved 24 h daily for one week (November 10-16th, 2020). Also, on November 15th billboards located on the busy highways of Tehran were photographed. Validated protocols analyzed the advertisements. A total of 6026 advertisements were analyzed, including 4287 on TV, 1545 on radio, and 194 on billboards. The total duration of TV and radio advertising was 48.6 h. Food products were the most displayed advertisements on TV, radio, and billboards (33.6%). Overall, "condiments" and "desserts" were the most frequently advertised food products among all the studied media (20% and 17%, respectively). The most common advertising appeal included "High quality" on TV and billboards and "Stimulation of profiteering and profit-seeking" on the radio. Advertising violation based on Iran's regulations, Nutrient profile model for the marketing of food and non-alcoholic beverages to children in the WHO Eastern Mediterranean Region, and International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research Monitoring and Action Support (INFORMAS) was reported to be 13%, 74%, and 51%, respectively. Food products ranked the highest among all the advertisements. A clear violation of domestic and international advertising regulations was observed which given the high share of food advertising in the studied media, could endanger public health. This study supports the need for stricter regulations and adherence to international standards to improve nutritional status.

Research suggests that the quality of care provided by family members may be influenced by the quality of relationship they have with the person living with dementia. The study investigated this in the context of assisting with daily activities. The quality of the relationship was assessed using the conceptual framework of relationship continuity/discontinuity which focuses on whether the carer experiences their relationship as continuous or discontinuous with the pre-dementia relationship. Thirty spousal carers completed the Birmingham Relationship Continuity Measure. Participants were also interviewed about how they provide care for their partner's daily activities. Passages consistent with a more person-centered approach were identified, and the total number of these in each transcript was used as the measure of care quality. There was a significant correlation between questionnaire scores and the number of person-centered passages: Those reporting greater continuity more frequently described using a person-centered approach. Findings were consistent with earlier research suggesting associations between the quality of the relationship and the quality of care. The concept of relationship continuity suggests ways in which relationship and care quality are connected, and these suggestions could be used to develop interventions to help family carers provide better care.

The Age-Friendly Health System (AFHS) movement continues to grow in the United States as more health systems implement the 4Ms framework. Despite this growth, there are relatively few studies that evaluate outcomes related to AFHS implementation. This study assessed patient satisfaction with AFHS by analyzing the rate at which patients returned to the clinic for future health care, serving as a measure of quality. A retrospective cohort design using electronic health record (EHR) data obtained from patients 65 years of age and older who received care at a large national network of convenient care clinics in the U.S. (N = 987,197) between January 2021 and March 2024. We assessed the level of AFHS 4Ms care received by these individuals in relation to their subsequent visit back to the clinic through descriptive statistics, a time-to-event analysis using the Kaplan-Meier cumulative incidence approach, and a Cox proportional Hazards model, adjusted for age, race, sex, prior appointments, and number of ICD-10 code diagnoses. Throughout the study period, patients who received complete AFHS 4Ms care exhibited greater rates of returning to the convenient care clinic compared to those who received partial or no 4Ms 4Ms care. Kaplan-Meier curves demonstrated that the cumulative probability of returning to the clinic was higher in patients that received 4Ms over time, compared to patients that did not receive 4Ms. Results from the Cox Proportional Hazards model demonstrated a risk ratio of 3.91 (p < .001) of returning to the clinic, after adjustment. The results indicate that patients are more likely to seek additional care in the future at the same health system when they receive complete 4Ms care, possibly due to increased satisfaction with care. As patient satisfaction is an indicator of quality care, this finding can further inform and spread the AFHS movement.

This study examined the interplay between physical workload, psychological stress, and the prevalence of work-related musculoskeletal disorders (WMSDs) among construction workers in Indonesia. This cross-sectional study used a purposive sampling technique to gather quantitative data from 409 respondents working in four construction companies through structured questionnaires. Data collection tools included the Copenhagen Psychosocial Questionnaire III (COPSOQ III), the K10 scale for psychosocial distress, and the Nordic Body Map for musculoskeletal symptoms. Independent variables encompassed demographic factors, physical work environment, and psychosocial aspects, while the dependent variable was the presence of work-related musculoskeletal disorders (WMSDs) symptoms over the past 7 days and 12 months. Descriptive statistics and logistic regression analyses were performed using IBM SPSS Statistics Grad Pack 29.0 PREMIUM. The study revealed a high prevalence of WMSDs among workers, with 36.2% reporting symptoms in the past 7 days and 31.5% in the past 12 months. These symptoms primarily affected the neck, shoulders, back, and waist. Both physical and psychosocial factors were found to the risk, with high levels of somatic stress and sleep disorders significantly increasing the likelihood of WMSDs. Psychological distress emerged as a particularly strong predictor to these disorders. The findings underscore the importance of implementing targeted interventions and safety policies to mitigate WMSDs risks and improve occupational health within the construction industry.