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

The healthcare supply chain relies on real-time logistics Management Information System (LMIS). Despite Ethiopia's adoption of a digital LMIS in 2009, ongoing evaluation of software, infrastructure, and sustainability remains essential for improving performance from users' and health system's perspectives. The study aimed to evaluate the performance of the facility version of digital LMIS at public health facilities in the Amhara Region, Ethiopia. An institution-based cross-sectional study was used. Out of 102 surveyed facilities, only 37 implemented the digital LMIS. Data was collected using interviewer-administered questionnaires. Out of 37 facilities using digital LMIS, 28 (75.7%) were functional. The average frequency of use across 27 sub-dashlets was 3.13 ± 0.67 out of 4. End users rated the digital LMIS performance as 3.21 ± 0.43 out of 5 (64.2%). Significant differences in LMIS performance related to organizational support were found due to varying end users' experience and internet access (P-value < .05). The digital LMIS performance from end users' perspective was 64.2%, with significant differences in agreement related to health system and organizational support, influenced by internet access and users' experience.

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.

The Age-Friendly Health System (AFHS) movement has spread widely in recent years, with nearly 5000 healthcare organizations across the country recognized as Age-Friendly. Despite this broad recognition, there is little focus on how AFHS are implemented and the impact of implementation. The objectives of this study were to describe the strategies employed to support AFHS implementation in outpatient settings and to identify the measures used to evaluate implementation and effectiveness. We conducted a systematic review of literature from multiple databases spanning 2015 to March 2024, identified eligible studies using predefined inclusion/exclusion criteria, and extracted key data (eg, study design, study population, implementation strategies, outcomes/measures). We identified ten eligible studies from primary care clinics (N = 8), convenient care clinics (N = 1) and a cancer center (N = 1). The studies employed over 65 implementation strategies and 98 outcomes or measures. The vast majority of measures mapped to components of the 4Ms (Mobility, Mentation, Medication, What Matters), with up to ten measures per M category. Five of ten studies had reporting discrepancies and four did not fully define outcomes. The ten included studies serve as clear examples for the need for more evidence to support AFHS implementation in outpatient settings. Existing research lacks strategy specification and standardization of measures. We present gaps and opportunities to advance from AFHS "recognition" to impact.

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.

Kenya is experiencing a significant increase in the prevalence of non-communicable diseases (NCDs) such as cardiovascular diseases, hypertension, Type 2 diabetes, and certain cancers (bowel, lung, prostate, and uterine). This case is not unique to Kenya but is common in many Low and Middle-Income Countries (LMICs) in Africa. Many NCDs, are linked to diets high in added sugars, sodium, saturated fat, and low in fiber. There is a notable lack of information regarding the demographic differences among supermarket customers and their purchasing habits of healthy versus unhealthy foods in some parts of Africa. This gap in knowledge hinders the ability to connect grocery purchase patterns to NCDs, including obesity. Supermarkets in LMICs offer valuable demographic insights through grocery data. This research utilizes NOVA classification tool, data mining and unsupervised machine learning techniques to analyze grocery purchase patterns in 10 supermarkets across 5 counties in Kenya between 2022 and 2023. The apriori algorithm was used to create association rules and an analysis was done on the association rules to find out the relationship between demography (location, gender, and age) with purchase patterns. Individual data was collected along with transaction data, since the supermarkets logged transactions done by loyalty card customers. The main aim is to provide guidance to policymakers in public health. We collected 3 934 122 unique transactions and each transaction was associated with a customer who was identified with a unique customer ID. Findings from this research demonstrate that 53% of food purchases from these transactions were mainly industrially processed food items and males above the age of 50 years were the main consumers of these food items. The findings lead to the conclusion that this purchase trend has a chance of rising NCDs in older people. Therefore we recommend that policymakers adopt our recommendations to safeguard public health.

Despite extensive global research on second-hand smoking (SHS) exposure, there is a noticeable lack of studies focusing on the knowledge and attitudes of university students in Bangladesh. This cross-sectional study aimed to address this gap by assessing the levels of knowledge and attitudes towards SHS exposure among university students in Bangladesh. Utilizing a convenience sampling technique, data were collected from 383 university students, encompassing socio-demographic information, as well as knowledge and attitude-related inquiries. Statistical analyses were conducted using SPSS software, including independent t-tests and analysis of variance (ANOVA) and multiple linear regression. The findings revealed that participants exhibited a moderate level of knowledge and attitude towards SHS exposure. Multiple linear regression identified age, gender, mother's education, and self-rated health status as significant predictors of knowledge, explaining 12.9% of its variance (R² = 0.129, F = 6.117, P < .001). Furthermore, age, gender, and living with parents emerged as significant predictors of attitude, explaining 14.7% of its variance (R² = 0.147, F = 7.165, P < .001). The study highlights the need for interventions aimed at enhancing awareness and fostering positive attitudes towards SHS exposure among university students in Bangladesh. It is recommended that university authorities organize seminars and implement health education initiatives targeting vulnerable populations to address the findings and promote a smoke-free environment on campus.

The global nursing shortage poses challenges to healthcare accessibility, clinical outcomes, and patient safety. Researchers have explored factors that influence nursing attrition, and the Nurses' Perceived Professional Benefits (NPPB) is one such factor that has gained attention. This cross-sectional study aims to assess the NPPB among registered nurses in Macao, a multicultural city with a unique healthcare system. A 33-item online questionnaire was used to collect data from 279 nurses. The questionnaire measured NPPB across 5 dimensions: positive occupational perception, personal enhancement, recognition from family and friends, decent nurse-patient relationships, and team belongingness. This study indicated that Macao nurses had a moderate level of NPPB. Nurse-patient relationships, income, and job stability received the most positive responses, while team belongingness received the lowest scores. These findings suggest that improvements are needed in team building, providing more opportunities for specialized training, and offering more career advancement opportunities.

Screening high-risk groups for Latent Tuberculosis Infection (LTBI) is crucial for TB elimination, as the large global reservoir of Mycobacterium tuberculosis bacilli poses a significant challenge to TB control globally. Assessing the cost-effectiveness of LTBI screening strategies is also crucial in determining the optimal approach. In 2022, Sri Lanka initiated a new program to manage latent tuberculosis infection among high-risk groups, including healthcare personnel, which recorded an 18% Latent Tuberculosis prevalence. This study aimed to evaluate the cost-effectiveness of implementing a screening program for Healthcare Personnel as part of this initiative in Sri Lanka. A decision tree model was developed to assess the cost-effectiveness of LTBI screening among Healthcare Personnel from the health system perspective, using secondary data from 2021 to 2022. The decision tree model was used to evaluate the cost-effectiveness of initiating LTBI screening for Healthcare Personnel in government hospitals. The findings are presented as the Incremental Cost-Effectiveness Ratio (ICER), compared to locally appropriate cost-effectiveness thresholds. The direct costs incurred for the standard LTBI tests and prophylaxis were assessed at the program level. The ICER represents the incremental cost of LTBI screening per Disability Adjusted Life Year (DALY) gained by preventing future active TB cases through treatment of latent TB infection. The total cost for managing an active TB case was $80.44, markedly higher than the $20.84 cost for a Latent TB case. The total cost difference between managing an active TB case and a Latent TB case was $59.60. The Incremental Cost-Effectiveness Ratio was $2381.29 per Disability Adjusted Life Year averted. The decision analysis model indicated that screening Healthcare Personnel for latent tuberculosis infection is highly cost-effective and can be recommended for implementation in Sri Lanka.

Promoting healthy ageing would benefit from an understanding of what this means to stakeholders. We explored healthy ageing perceptions in rural and peri-urban Ugandan communities. Community dialogues, focus group discussions with older persons, community members, community-based organization leaders, key informant interviews with Ministries of Gender (2), Health (1), non-governmental organizations (3) and elderly representatives (5) were held. Thematic content analysis framework was used. Physical perceptions of ageing healthy included physical fitness, absence of health challenges, good physical appearance and looking younger. Emotional perceptions were a stress-free life with children's care, a balanced diet, basic needs and activity involvement. Socio-economic included financial stability, medical accessibility, future planning and network engagement. Spirituality, ageing with dignity and knowledge of body changes were others. The study provides insight into physical, emotional, and socio-economic perceptions of healthy ageing. Additional research in other settings would inform the UN Decade of Healthy Ageing.