Pub Date : 2024-09-20eCollection Date: 2024-01-01DOI: 10.2147/RMHP.S472993
Tingting Qin, Junjun Guo, Yutong Yang, Mingyu Gu, Yao Wang, Xingming Li
Objective: This study aimed to evaluate the organizational health literacy of healthcare institutions in Beijing and to analyse its influencing factors to provide suggestions for the construction of health-promoting medical institutions.
Methods: This study used multi-stage cluster sampling and conducted an online survey of medical staff in the sampled healthcare institutions in Beijing from May to July 2023. The Chinese version of the Health Literate Health Care Organization 10-item Questionnaire (HLHO-10-C) was used to assess the organizational health literacy of healthcare institutions. Univariate analysis and generalized linear models (GLM) were used to analyze the influencing factors.
Results: Finally, 2527 participants were included. The majority of participants were female (87.6%). More than half of the participants indicated that they had engaged in outpatient or inpatient health education work. The respondents' score for HLHO-10-C was 6.170±1.056. The score of the respondents from tertiary hospitals (6.003±1.167) was slightly lower than those from secondary hospitals (6.328±0.747) and primary healthcare centers (6.418±0.864). All healthcare institutions scored relatively high on institutional environmental construction support (6.284±1.034). The results of the GLM showed that educational level, healthcare institution level, and engagement in health education work were factors influencing HLHO-10-C (P<0.05).
Conclusion: Overall, the organizational health literacy of healthcare institutions in Beijing was relatively good. However, there is room for improvement in tertiary hospitals. In the future, to promote the construction of health-literate hospitals, targeted measures should be taken to encourage healthcare workers to engage in health education.
{"title":"Analysis of Influencing Factors of Organizational Health Literacy in Healthcare Institutions in Beijing, China: A Cross-Sectional Study.","authors":"Tingting Qin, Junjun Guo, Yutong Yang, Mingyu Gu, Yao Wang, Xingming Li","doi":"10.2147/RMHP.S472993","DOIUrl":"https://doi.org/10.2147/RMHP.S472993","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the organizational health literacy of healthcare institutions in Beijing and to analyse its influencing factors to provide suggestions for the construction of health-promoting medical institutions.</p><p><strong>Methods: </strong>This study used multi-stage cluster sampling and conducted an online survey of medical staff in the sampled healthcare institutions in Beijing from May to July 2023. The Chinese version of the Health Literate Health Care Organization 10-item Questionnaire (HLHO-10-C) was used to assess the organizational health literacy of healthcare institutions. Univariate analysis and generalized linear models (GLM) were used to analyze the influencing factors.</p><p><strong>Results: </strong>Finally, 2527 participants were included. The majority of participants were female (87.6%). More than half of the participants indicated that they had engaged in outpatient or inpatient health education work. The respondents' score for HLHO-10-C was 6.170±1.056. The score of the respondents from tertiary hospitals (6.003±1.167) was slightly lower than those from secondary hospitals (6.328±0.747) and primary healthcare centers (6.418±0.864). All healthcare institutions scored relatively high on institutional environmental construction support (6.284±1.034). The results of the GLM showed that educational level, healthcare institution level, and engagement in health education work were factors influencing HLHO-10-C (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>Overall, the organizational health literacy of healthcare institutions in Beijing was relatively good. However, there is room for improvement in tertiary hospitals. In the future, to promote the construction of health-literate hospitals, targeted measures should be taken to encourage healthcare workers to engage in health education.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"2281-2290"},"PeriodicalIF":2.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luan Thanh Nguyen, Kien Gia To, Thuong Chi Tang, Tuan Nhat Pham, Long Bui Nguyen Thanh, Truc Thanh Thai
Purpose: Falls among inpatients represent a significant global health concern and are among the leading causes of accidental death. However, hospital falls are context- and population dependent. This study aimed to investigate the risk factors contributing to falls and the fall profiles among Vietnamese inpatients. Methods: A nested case–control study was conducted at nine public hospitals in Ho Chi Minh City. For every fall identified through the medical fall incident reporting system, four controls (ie, nonfall patients) were also selected from medical records within the same department and timeframe. Medical records were extracted, which included detailed information about the falls. Results: Among 101 fall cases and 404 nonfall controls, several risk factors for falls were found, including reduced strength and mobility (OR=3.08, 95% 1.30– 7.30), nocturia (OR=9.08, 95% CI 4.04– 20.45), having more than two diseases (OR=2.76, 95% CI 1.53– 4.98), using walking aids (OR=23.26, 95% CI 10.20– 53.03), using medical devices (OR=3.44, 95% CI 1.92– 6.15) and using antiepileptics (OR=3.94, 95% CI 1.22– 12.77). About 19.8% of the falls occurred within the first 24 hours from admission and the most common time of falls was from 0:00 am to 5:59 am (44.6%). The patient bed and bathroom were the most frequent locations for falls, accounting for 44.55% and 37.62% of the cases, respectively. More than 40% of the falls occurred when the patients were with their personal caregivers. Conclusion: Although intervention programs can use these risk factors to target those who have a high risk of falling, to optimize resources, such programs should consider the fall patterns found in our study.
Keywords: falls, associated factors, inpatients, profile, Vietnam
目的住院病人跌倒是全球关注的重大健康问题，也是意外死亡的主要原因之一。然而，医院跌倒与环境和人群有关。本研究旨在调查导致跌倒的风险因素以及越南住院病人的跌倒情况：在胡志明市的九家公立医院开展了一项嵌套病例对照研究。每通过医疗跌倒事件报告系统确认一起跌倒事件，就从同一科室和同一时间段的医疗记录中选择四名对照组（即非跌倒患者）。提取的医疗记录包括跌倒的详细信息：结果：在 101 名跌倒病例和 404 名非跌倒对照病例中，发现了一些导致跌倒的危险因素，包括体力和活动能力下降（OR=3.08，95% 1.30- 7.30）、夜尿症（OR=9.08，95% CI 4.04- 20.45）、患有两种以上疾病（OR=3.08，95% CI 1.30- 7.30）。45）、患有两种以上疾病（OR=2.76，95% CI 1.53-4.98）、使用助行器（OR=23.26，95% CI 10.20-53.03）、使用医疗器械（OR=3.44，95% CI 1.92-6.15）和使用抗癫痫药（OR=3.94，95% CI 1.22-12.77）。约19.8%的跌倒发生在入院后的24小时内，最常见的跌倒时间是凌晨0:00至5:59（44.6%）。病床和浴室是最常见的跌倒地点，分别占 44.55% 和 37.62%。40%以上的跌倒发生在患者与个人护理人员在一起的时候：尽管干预计划可以利用这些风险因素来针对高跌倒风险人群进行干预，但为了优化资源，这些计划应考虑到我们研究中发现的跌倒模式。 关键词：跌倒；相关因素；住院病人；概况；越南
{"title":"Risk Factors and Profiles of Falls Among Inpatients in Vietnam: A Multicenter Nested Case–Control Study","authors":"Luan Thanh Nguyen, Kien Gia To, Thuong Chi Tang, Tuan Nhat Pham, Long Bui Nguyen Thanh, Truc Thanh Thai","doi":"10.2147/rmhp.s471895","DOIUrl":"https://doi.org/10.2147/rmhp.s471895","url":null,"abstract":"<strong>Purpose:</strong> Falls among inpatients represent a significant global health concern and are among the leading causes of accidental death. However, hospital falls are context- and population dependent. This study aimed to investigate the risk factors contributing to falls and the fall profiles among Vietnamese inpatients.<br/><strong>Methods:</strong> A nested case–control study was conducted at nine public hospitals in Ho Chi Minh City. For every fall identified through the medical fall incident reporting system, four controls (ie, nonfall patients) were also selected from medical records within the same department and timeframe. Medical records were extracted, which included detailed information about the falls.<br/><strong>Results:</strong> Among 101 fall cases and 404 nonfall controls, several risk factors for falls were found, including reduced strength and mobility (OR=3.08, 95% 1.30– 7.30), nocturia (OR=9.08, 95% CI 4.04– 20.45), having more than two diseases (OR=2.76, 95% CI 1.53– 4.98), using walking aids (OR=23.26, 95% CI 10.20– 53.03), using medical devices (OR=3.44, 95% CI 1.92– 6.15) and using antiepileptics (OR=3.94, 95% CI 1.22– 12.77). About 19.8% of the falls occurred within the first 24 hours from admission and the most common time of falls was from 0:00 am to 5:59 am (44.6%). The patient bed and bathroom were the most frequent locations for falls, accounting for 44.55% and 37.62% of the cases, respectively. More than 40% of the falls occurred when the patients were with their personal caregivers.<br/><strong>Conclusion:</strong> Although intervention programs can use these risk factors to target those who have a high risk of falling, to optimize resources, such programs should consider the fall patterns found in our study.<br/><br/><strong>Keywords:</strong> falls, associated factors, inpatients, profile, Vietnam<br/>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: This study uses grounded theory to explore the process and conceptual framework of how nursing students’ attitudes toward others and different cultures change after receiving education on multicultural understanding. Methods: This study used the Corbin and Strauss grounded theory throughout data collection and analysis. We used purposive sampling to select participants and then gathered data through in-depth interviews with 18 students who completed a multicultural understanding education course. Results: Two researchers conducted a comparative semantic analysis of the transcribed data, applying open, axial, and selective coding techniques. With the collected data, the two researchers exchanged opinions to categorize and structure the data according to the research questions. Through the analysis, open coding yielded 11 categories and 26 subcategories from 135 concepts. In a model that recombined nine categories through axial coding, the central phenomenon was “distance”, while the core category was “perceive people from different cultures as others/accept with reduced distance”. Conclusion: Since nursing students are more likely to care for patients from diverse cultural backgrounds in their future clinical practice, they must have specialized cultural knowledge.
Keywords: multicultural, education, cultural barrier, distance, nursing student
{"title":"Reducing Cultural Barriers: A Grounded Theory Approach to Nursing Student Attitudes After Multicultural Education","authors":"Myeongjeong Chae, Boyoung Kim","doi":"10.2147/rmhp.s480088","DOIUrl":"https://doi.org/10.2147/rmhp.s480088","url":null,"abstract":"<strong>Purpose:</strong> This study uses grounded theory to explore the process and conceptual framework of how nursing students’ attitudes toward others and different cultures change after receiving education on multicultural understanding.<br/><strong>Methods:</strong> This study used the Corbin and Strauss grounded theory throughout data collection and analysis. We used purposive sampling to select participants and then gathered data through in-depth interviews with 18 students who completed a multicultural understanding education course.<br/><strong>Results:</strong> Two researchers conducted a comparative semantic analysis of the transcribed data, applying open, axial, and selective coding techniques. With the collected data, the two researchers exchanged opinions to categorize and structure the data according to the research questions. Through the analysis, open coding yielded 11 categories and 26 subcategories from 135 concepts. In a model that recombined nine categories through axial coding, the central phenomenon was “distance”, while the core category was “perceive people from different cultures as others/accept with reduced distance”.<br/><strong>Conclusion:</strong> Since nursing students are more likely to care for patients from diverse cultural backgrounds in their future clinical practice, they must have specialized cultural knowledge.<br/><br/><strong>Keywords:</strong> multicultural, education, cultural barrier, distance, nursing student<br/>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"7 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aimed to develop a predictive model for assessing internal bleeding risk in elderly aspirin users using machine learning. Methods: A total of 26,030 elderly aspirin users (aged over 65) were retrospective included in the study. Data on patient demographics, clinical features, underlying diseases, medical history, and laboratory examinations were collected from Affiliated Dongyang Hospital of Wenzhou Medical University. Patients were randomly divided into two groups, with a 7:3 ratio, for model development and internal validation, respectively. Least absolute shrinkage and selection operator (LASSO) regression, extreme gradient boosting (XGBoost), and multivariate logistic regression were employed to develop prediction models. Model performance was evaluated using area under the curve (AUC), calibration curves, decision curve analysis (DCA), clinical impact curve (CIC), and net reduction curve (NRC). Results: The XGBoost model exhibited the highest AUC among all models. It consisted of six clinical variables: HGB, PLT, previous bleeding, gastric ulcer, cerebral infarction, and tumor. A visual nomogram was developed based on these six variables. In the training dataset, the model achieved an AUC of 0.842 (95% CI: 0.829– 0.855), while in the test dataset, it achieved an AUC of 0.820 (95% CI: 0.800– 0.840), demonstrating good discriminatory performance. The calibration curve analysis revealed that the nomogram model closely approximated the ideal curve. Additionally, the DCA curve, CIC, and NRC demonstrated favorable clinical net benefit for the nomogram model. Conclusion: This study successfully developed a predictive model to estimate the risk of bleeding in elderly aspirin users. This model can serve as a potential useful tool for clinicians to estimate the risk of bleeding in elderly aspirin users and make informed decisions regarding their treatment and management.
{"title":"Predictive Model of Internal Bleeding in Elderly Aspirin Users Using XGBoost Machine Learning","authors":"Tenggao Chen, Wanlin Lei, Maofeng Wang","doi":"10.2147/rmhp.s478826","DOIUrl":"https://doi.org/10.2147/rmhp.s478826","url":null,"abstract":"<strong>Objective:</strong> This study aimed to develop a predictive model for assessing internal bleeding risk in elderly aspirin users using machine learning.<br/><strong>Methods:</strong> A total of 26,030 elderly aspirin users (aged over 65) were retrospective included in the study. Data on patient demographics, clinical features, underlying diseases, medical history, and laboratory examinations were collected from Affiliated Dongyang Hospital of Wenzhou Medical University. Patients were randomly divided into two groups, with a 7:3 ratio, for model development and internal validation, respectively. Least absolute shrinkage and selection operator (LASSO) regression, extreme gradient boosting (XGBoost), and multivariate logistic regression were employed to develop prediction models. Model performance was evaluated using area under the curve (AUC), calibration curves, decision curve analysis (DCA), clinical impact curve (CIC), and net reduction curve (NRC).<br/><strong>Results:</strong> The XGBoost model exhibited the highest AUC among all models. It consisted of six clinical variables: HGB, PLT, previous bleeding, gastric ulcer, cerebral infarction, and tumor. A visual nomogram was developed based on these six variables. In the training dataset, the model achieved an AUC of 0.842 (95% CI: 0.829– 0.855), while in the test dataset, it achieved an AUC of 0.820 (95% CI: 0.800– 0.840), demonstrating good discriminatory performance. The calibration curve analysis revealed that the nomogram model closely approximated the ideal curve. Additionally, the DCA curve, CIC, and NRC demonstrated favorable clinical net benefit for the nomogram model.<br/><strong>Conclusion:</strong> This study successfully developed a predictive model to estimate the risk of bleeding in elderly aspirin users. This model can serve as a potential useful tool for clinicians to estimate the risk of bleeding in elderly aspirin users and make informed decisions regarding their treatment and management.<br/><br/><strong>Keywords:</strong> aspirin, bleeding, haemorrhage, predictive model, extreme gradient boosting, nomogram<br/>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"3 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ru Yan, Songqing Jin, Chen Ji, Cindy Feng, Huan Wang, Jiayang Lyu, Scott Rozelle
Purpose: Depression is a growing public health concern around the world. For adolescents, depression not only impedes healthy development, but is negatively associated with academic performance. The purpose of this paper is to examine the prevalence of adolescent depressive symptoms in a sample of rural primary and junior high school students. Additionally, we examine various factors to identify subgroups within the sample that may be more vulnerable to depression. Finally, we explore the extent to which depression correlates with academic performance and conduct a series of heterogeneity analyses. Patients and Methods: We utilize cross-sectional data derived from 30 schools in underdeveloped regions of rural China encompassing primary and junior high school students (n = 1,609). Results: We find a high prevalence of depression, with 23% and 9% of students experiencing general depression (depression score ≥ 14) and severe depression (depression score ≥ 21), respectively. Female gender, elevated stress and anxiety levels, boarding at school, exposure to bullying, and having depressed caregiver(s) are positively correlated with depressive symptoms, while high social support exhibits a negative association. Importantly, our analyses consistently show a significantly negative link between depression and academic performance, which is measured using standardized math tests. For instance, transitioning from a non-depressed state to a state of general depression (depression score ≥ 14) is linked to a decline of 0.348– 0.406 standard deviations in math scores (p < 0.01). Heterogeneity analyses reveal that this adverse relationship is more pronounced for male students, boarding students, those with lower social support, individuals with more educated mothers, and those with lower family assets. Conclusion: Our findings underscore the high prevalence of depression in rural schools and the detrimental impact on academic performance. We advocate for the implementation of policies aimed at reducing student depression, particularly within vulnerable populations and subgroups.
Keywords: adolescent health, academic performance, rural China, developing countries
{"title":"Depression Takes a Toll on Academic Performance: Evidence from Rural Students in China","authors":"Ru Yan, Songqing Jin, Chen Ji, Cindy Feng, Huan Wang, Jiayang Lyu, Scott Rozelle","doi":"10.2147/rmhp.s469836","DOIUrl":"https://doi.org/10.2147/rmhp.s469836","url":null,"abstract":"<strong>Purpose:</strong> Depression is a growing public health concern around the world. For adolescents, depression not only impedes healthy development, but is negatively associated with academic performance. The purpose of this paper is to examine the prevalence of adolescent depressive symptoms in a sample of rural primary and junior high school students. Additionally, we examine various factors to identify subgroups within the sample that may be more vulnerable to depression. Finally, we explore the extent to which depression correlates with academic performance and conduct a series of heterogeneity analyses.<br/><strong>Patients and Methods:</strong> We utilize cross-sectional data derived from 30 schools in underdeveloped regions of rural China encompassing primary and junior high school students (n = 1,609).<br/><strong>Results:</strong> We find a high prevalence of depression, with 23% and 9% of students experiencing general depression (depression score ≥ 14) and severe depression (depression score ≥ 21), respectively. Female gender, elevated stress and anxiety levels, boarding at school, exposure to bullying, and having depressed caregiver(s) are positively correlated with depressive symptoms, while high social support exhibits a negative association. Importantly, our analyses consistently show a significantly negative link between depression and academic performance, which is measured using standardized math tests. For instance, transitioning from a non-depressed state to a state of general depression (depression score ≥ 14) is linked to a decline of 0.348– 0.406 standard deviations in math scores (p < 0.01). Heterogeneity analyses reveal that this adverse relationship is more pronounced for male students, boarding students, those with lower social support, individuals with more educated mothers, and those with lower family assets.<br/><strong>Conclusion:</strong> Our findings underscore the high prevalence of depression in rural schools and the detrimental impact on academic performance. We advocate for the implementation of policies aimed at reducing student depression, particularly within vulnerable populations and subgroups.<br/><br/><strong>Keywords:</strong> adolescent health, academic performance, rural China, developing countries<br/>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"40 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xingyuan Gao, Man Yu, Yuyang Sun, Tiansi Zhang, Xin Li, Lingli Zhang, Changqing Wang
Purpose: The increasing global burden of cancer has become a significant challenge for public health. The Chinese government introduced the National Drug Price Negotiation (NDPN) policy with the goal of lowering the prices of innovative drugs and enhancing their accessibility. This study aims to evaluate the impact of the 2021 NDPN policy on the availability, utilization, and cost of anticancer medicines in China. Methods: Data was gathered from 1519 hospitals between April 2021 and December 2022, with a focus on eight anticancer drugs affected by the 2021 NDPN policy. The availability, Defined Daily Doses (DDDs), and cost per Defined Daily Dose (DDDc) before and after the intervention were evaluated through interrupted time series analysis. Results: The NDPN policy resulted in a substantial 5.10% increase in the availability of anticancer drugs (p < 0.001). Utilization also experienced a significant surge, with an immediate increase of 11,254.36 DDDs (p < 0.001) and a monthly increase of 1208.28 DDDs (p < 0.001) following policy implementation. The DDDc decreased by US&dollar 111.00 (p < 0.001) immediately after the policy. Disparities in regional drug utilization were evident, with higher usage in the eastern region. Conclusion: The 2021 NDPN policy has notably enhanced the availability and utilization of anticancer medications in China while reducing their cost, in line with the policy’s objectives. However, continuous monitoring is essential to ensure sustained access and to tackle regional disparities in drug utilization.
Keywords: anticancer medicines, national drug price negotiation, China, availability, utilization, cost, interrupted time series analysis
{"title":"New Evidence of the Impact of the National Drug Price Negotiation Policy on the Availability, Utilization, and Cost of Anticancer Medicines in China: An Interrupted Time Series Study","authors":"Xingyuan Gao, Man Yu, Yuyang Sun, Tiansi Zhang, Xin Li, Lingli Zhang, Changqing Wang","doi":"10.2147/rmhp.s473846","DOIUrl":"https://doi.org/10.2147/rmhp.s473846","url":null,"abstract":"<strong>Purpose:</strong> The increasing global burden of cancer has become a significant challenge for public health. The Chinese government introduced the National Drug Price Negotiation (NDPN) policy with the goal of lowering the prices of innovative drugs and enhancing their accessibility. This study aims to evaluate the impact of the 2021 NDPN policy on the availability, utilization, and cost of anticancer medicines in China.<br/><strong>Methods:</strong> Data was gathered from 1519 hospitals between April 2021 and December 2022, with a focus on eight anticancer drugs affected by the 2021 NDPN policy. The availability, Defined Daily Doses (DDDs), and cost per Defined Daily Dose (DDDc) before and after the intervention were evaluated through interrupted time series analysis.<br/><strong>Results:</strong> The NDPN policy resulted in a substantial 5.10% increase in the availability of anticancer drugs (p < 0.001). Utilization also experienced a significant surge, with an immediate increase of 11,254.36 DDDs (p < 0.001) and a monthly increase of 1208.28 DDDs (p < 0.001) following policy implementation. The DDDc decreased by US&dollar 111.00 (p < 0.001) immediately after the policy. Disparities in regional drug utilization were evident, with higher usage in the eastern region.<br/><strong>Conclusion:</strong> The 2021 NDPN policy has notably enhanced the availability and utilization of anticancer medications in China while reducing their cost, in line with the policy’s objectives. However, continuous monitoring is essential to ensure sustained access and to tackle regional disparities in drug utilization.<br/><br/><strong>Keywords:</strong> anticancer medicines, national drug price negotiation, China, availability, utilization, cost, interrupted time series analysis<br/>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"31 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saifudheen Faroog, Zainudheen Faroog, Abdul Rehman Zia Zaidi, Baraa Alghalyini
Background: Tobacco use significantly impacts health and economic sectors. In the Maldives, 4 out of 10 men smoke daily, despite anti-tobacco policies. The Maldives Global Youth Tobacco Survey (GYTS) shows fluctuating cigarette smoking prevalence among secondary school students: 6.9% (2004), 3.8% (2007), 4.3% (2011), and 4.7% (2019). No studies have investigated smoking prevalence and attitudes toward anti-smoking policies among higher-secondary students in Addu City. This study examines smoking habits, susceptibility, and attitudes toward anti-smoking regulations to support policy development. Methods: We conducted an observational cross-sectional study using a self-administered survey based on the GYTS and the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS), involving 335 high school students in Addu City. Variables included sociodemographic factors, ever-smokers, current smokers, age at first cigarette, smoking dependency, use of other tobacco products, smoking susceptibility, willingness to quit, and reasons to quit or not smoke. Results with p-values < 0.05 were statistically significant. Results: 22.8% of the students had tried smoking, with 4.74% currently smoking, predominantly males. Additionally, 32.2% had tried e-cigarettes. Smoking susceptibility was 44.2%. Seven students showed smoking dependency, with a significant gender difference (75.4% boys vs 33.3% girls, p < 0.05). Among smokers, 20% wanted to quit, and 70% cited cost as a deterrent. Only 20% of smokers supported a total ban on smoking in media compared to 49.8% of non-smokers (p = 0.03). Non-smokers significantly supported anti-smoking measures (73% vs 12.5% of smokers). Conclusion: Cigarette smoking among high school students in Addu is below the national average, but the high number of ever-smokers and interest in smoking and e-cigarettes suggest potential future increases. Policymakers should enact stronger legislation, enforce age restrictions, raise tobacco taxes, and implement comprehensive smoking cessation programs to address tobacco use effectively.
{"title":"Youth Smoking Behavior and Policy Attitudes: A Study of High-School Students in the Maldives","authors":"Saifudheen Faroog, Zainudheen Faroog, Abdul Rehman Zia Zaidi, Baraa Alghalyini","doi":"10.2147/rmhp.s464706","DOIUrl":"https://doi.org/10.2147/rmhp.s464706","url":null,"abstract":"<strong>Background:</strong> Tobacco use significantly impacts health and economic sectors. In the Maldives, 4 out of 10 men smoke daily, despite anti-tobacco policies. The Maldives Global Youth Tobacco Survey (GYTS) shows fluctuating cigarette smoking prevalence among secondary school students: 6.9% (2004), 3.8% (2007), 4.3% (2011), and 4.7% (2019). No studies have investigated smoking prevalence and attitudes toward anti-smoking policies among higher-secondary students in Addu City. This study examines smoking habits, susceptibility, and attitudes toward anti-smoking regulations to support policy development.<br/><strong>Methods:</strong> We conducted an observational cross-sectional study using a self-administered survey based on the GYTS and the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS), involving 335 high school students in Addu City. Variables included sociodemographic factors, ever-smokers, current smokers, age at first cigarette, smoking dependency, use of other tobacco products, smoking susceptibility, willingness to quit, and reasons to quit or not smoke. Results with p-values < 0.05 were statistically significant.<br/><strong>Results:</strong> 22.8% of the students had tried smoking, with 4.74% currently smoking, predominantly males. Additionally, 32.2% had tried e-cigarettes. Smoking susceptibility was 44.2%. Seven students showed smoking dependency, with a significant gender difference (75.4% boys vs 33.3% girls, p < 0.05). Among smokers, 20% wanted to quit, and 70% cited cost as a deterrent. Only 20% of smokers supported a total ban on smoking in media compared to 49.8% of non-smokers (p = 0.03). Non-smokers significantly supported anti-smoking measures (73% vs 12.5% of smokers).<br/><strong>Conclusion:</strong> Cigarette smoking among high school students in Addu is below the national average, but the high number of ever-smokers and interest in smoking and e-cigarettes suggest potential future increases. Policymakers should enact stronger legislation, enforce age restrictions, raise tobacco taxes, and implement comprehensive smoking cessation programs to address tobacco use effectively.<br/><br/>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"28 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate the clinical characteristics, risk factors and outcomes of brain-heart syndrome (BHS) in patients with acute cerebrovascular diseases (ACVDs). Methods: A retrospective analysis was conducted of 100 patients who were admitted to our hospital with ACVDs between January 2023 and December 2023. The demographic, clinical, laboratory and imaging data of the patients were collected, and the presence and severity of BHS were evaluated. The neurological and cardiac outcomes of the patients at discharge and at 12-month follow-up were also assessed. Results: Out of the 100 patients, 38% had BHS, classified as mild (18%), moderate (12%) and severe (8%). The most prevalent ACVDs were cerebral infarction (58%), cerebral haemorrhage (32%) and subarachnoid haemorrhage (10%). Cardiac complications included arrhythmia (26%), myocardial ischaemia (18%) and heart failure (10%). Patients with BHS had higher results for blood pressure, heart rate, white blood cell count, C-reactive protein, IL-6, D-dimer and troponin, more severe neurological deficits, higher mortality and poorer functional outcomes. Multivariable analysis identified age, hypertension, diabetes, coronary artery disease, prior cardiovascular events, cerebral haemorrhage, brainstem infarction and hypothalamic or insular lesions as independent risk factors for BHS. Conclusion: Brain-heart syndrome is a frequent, severe complication in patients with ACVD, linked with multiple risk factors and poor prognosis. Prompt diagnosis and treatment are crucial for improving patient outcomes.
{"title":"A Retrospective Study of Brain-Heart Syndrome in Patients with Acute Cerebrovascular Diseases","authors":"Hui Tang, Xiurong Xing, Yingna Han, Daiquan Gao, Piu Chan, Shengfang Zhang, Huixin Xue","doi":"10.2147/rmhp.s467205","DOIUrl":"https://doi.org/10.2147/rmhp.s467205","url":null,"abstract":"<strong>Objective:</strong> To investigate the clinical characteristics, risk factors and outcomes of brain-heart syndrome (BHS) in patients with acute cerebrovascular diseases (ACVDs).<br/><strong>Methods:</strong> A retrospective analysis was conducted of 100 patients who were admitted to our hospital with ACVDs between January 2023 and December 2023. The demographic, clinical, laboratory and imaging data of the patients were collected, and the presence and severity of BHS were evaluated. The neurological and cardiac outcomes of the patients at discharge and at 12-month follow-up were also assessed.<br/><strong>Results:</strong> Out of the 100 patients, 38% had BHS, classified as mild (18%), moderate (12%) and severe (8%). The most prevalent ACVDs were cerebral infarction (58%), cerebral haemorrhage (32%) and subarachnoid haemorrhage (10%). Cardiac complications included arrhythmia (26%), myocardial ischaemia (18%) and heart failure (10%). Patients with BHS had higher results for blood pressure, heart rate, white blood cell count, C-reactive protein, IL-6, D-dimer and troponin, more severe neurological deficits, higher mortality and poorer functional outcomes. Multivariable analysis identified age, hypertension, diabetes, coronary artery disease, prior cardiovascular events, cerebral haemorrhage, brainstem infarction and hypothalamic or insular lesions as independent risk factors for BHS.<br/><strong>Conclusion:</strong> Brain-heart syndrome is a frequent, severe complication in patients with ACVD, linked with multiple risk factors and poor prognosis. Prompt diagnosis and treatment are crucial for improving patient outcomes.<br/><br/><strong>Keywords:</strong> brain-heart syndrome, acute cerebrovascular diseases, cerebral infarction, cerebral haemorrhage<br/>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"58 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yang Li, Huihui Fan, Wei Wei, Hanyu Zhu, Haifeng Wang, Dayao Lyu, Zengrui Zhang, Ying Tan
Introduction: The primary clinical manifestation of venous thrombosis is discomfort in the lower extremities. Some early Parkinson’s disease (PD) patients feel discomfort in the lower limbs. Venous thrombosis can risk lives by causing pulmonary embolism. This study examines the incidence of DVT in early PD patients and its correlation with different clinical and lab features. Methods: A cross-sectional study was conducted on 117 patients with early-stage PD. Ultrasonography was employed to detect the presence of DVT. Factors such as age, gender, body mass index, lifestyle habits (smoking and drinking), medical history (hypertension, diabetes, atrial fibrillation, and tumor), and other lab tests linked to thrombosis were analyzed. Results: In 117 patients, 11 (9.4%) had DVT, while 106 (90.6%) did not. There were no significant differences in gender, BMI, habits, medical history, or other thrombosis-related tests between both groups. However, DVT patients were older with higher d-dimer levels. They also showed an increased right substantia nigra ultrasound echo area, higher HY grades, higher UPDRS 3 scores, less improvement in UPDRS 3 scores and levodopa response. Discussion: The primary risk factors for lower extremity venous thrombosis were found to be age, d-dimer levels, and low-dose levodopa. Therefore, for elderly patients with early-stage PD, it is crucial to conduct d-dimer and lower extremity vascular ultrasound tests. The prevention of venous thrombosis in the lower extremities of early PD patients is of utmost importance.
Keywords: deep vein thrombosis, early-stage, Parkinson’s disease, ultrasonography, risk
{"title":"A Silent Threat: Deep Vein Thrombosis in Early-Stage Parkinson’s Disease","authors":"Yang Li, Huihui Fan, Wei Wei, Hanyu Zhu, Haifeng Wang, Dayao Lyu, Zengrui Zhang, Ying Tan","doi":"10.2147/rmhp.s469725","DOIUrl":"https://doi.org/10.2147/rmhp.s469725","url":null,"abstract":"<strong>Introduction:</strong> The primary clinical manifestation of venous thrombosis is discomfort in the lower extremities. Some early Parkinson’s disease (PD) patients feel discomfort in the lower limbs. Venous thrombosis can risk lives by causing pulmonary embolism. This study examines the incidence of DVT in early PD patients and its correlation with different clinical and lab features.<br/><strong>Methods:</strong> A cross-sectional study was conducted on 117 patients with early-stage PD. Ultrasonography was employed to detect the presence of DVT. Factors such as age, gender, body mass index, lifestyle habits (smoking and drinking), medical history (hypertension, diabetes, atrial fibrillation, and tumor), and other lab tests linked to thrombosis were analyzed.<br/><strong>Results:</strong> In 117 patients, 11 (9.4%) had DVT, while 106 (90.6%) did not. There were no significant differences in gender, BMI, habits, medical history, or other thrombosis-related tests between both groups. However, DVT patients were older with higher d-dimer levels. They also showed an increased right substantia nigra ultrasound echo area, higher HY grades, higher UPDRS 3 scores, less improvement in UPDRS 3 scores and levodopa response.<br/><strong>Discussion:</strong> The primary risk factors for lower extremity venous thrombosis were found to be age, d-dimer levels, and low-dose levodopa. Therefore, for elderly patients with early-stage PD, it is crucial to conduct d-dimer and lower extremity vascular ultrasound tests. The prevention of venous thrombosis in the lower extremities of early PD patients is of utmost importance.<br/><br/><strong>Keywords:</strong> deep vein thrombosis, early-stage, Parkinson’s disease, ultrasonography, risk<br/>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"37 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wenyu Li, Yanqiu Hou, Jiayu An, Linxuan Chen, Shan Lu
Purpose: The objective of this study was to explore the connection between family doctor contract services and preventable hospitalizations. Additionally, we sought to examine the role of primary health care quality as a mediating factor in the link between family doctor contract services and preventable hospitalizations among patients with hypertension. Patients and Methods: This cross-sectional study was performed in Dangyang (Hubei Province, Central China) and Xishui (Guizhou Province, Western China) counties in July–August 2023. Participants comprised 625 patients selected via a multi-stage sampling method. Causal mediation analysis was conducted to explore the effect of family doctor contract services on preventable hospitalizations and the mediating effect of primary healthcare quality on this relationship. Results: Utilization rate of family doctor contract services of hypertensive patients was 58.6%, score of primary health service quality was 70.75 and incidence of preventable hospitalizations was 28.2%. Amongst hypertensive patients, utilization of family doctor contract services decreased the occurrence of preventable hospitalizations, with a total effect of − 0.22 (p < 0.001). Primary healthcare quality mediates the association, with a mediate effect of − 0.05 (p < 0.001), explaining 22.73% of the total effect. Conclusion: Improving the utilization of family doctor contract services and primary healthcare quality may result in lower rates of preventable hospitalizations amongst hypertensive patients.
Keywords: family doctor contract services, preventable hospitalizations, primary healthcare quality, hypertension, mediation analysis
{"title":"Impact of Family Doctor Contract Services on Preventable Hospitalizations Amongst Patients with Hypertension in Rural China: Mediating Role of Primary Healthcare Quality","authors":"Wenyu Li, Yanqiu Hou, Jiayu An, Linxuan Chen, Shan Lu","doi":"10.2147/rmhp.s474933","DOIUrl":"https://doi.org/10.2147/rmhp.s474933","url":null,"abstract":"<strong>Purpose:</strong> The objective of this study was to explore the connection between family doctor contract services and preventable hospitalizations. Additionally, we sought to examine the role of primary health care quality as a mediating factor in the link between family doctor contract services and preventable hospitalizations among patients with hypertension.<br/><strong>Patients and Methods:</strong> This cross-sectional study was performed in Dangyang (Hubei Province, Central China) and Xishui (Guizhou Province, Western China) counties in July–August 2023. Participants comprised 625 patients selected via a multi-stage sampling method. Causal mediation analysis was conducted to explore the effect of family doctor contract services on preventable hospitalizations and the mediating effect of primary healthcare quality on this relationship.<br/><strong>Results:</strong> Utilization rate of family doctor contract services of hypertensive patients was 58.6%, score of primary health service quality was 70.75 and incidence of preventable hospitalizations was 28.2%. Amongst hypertensive patients, utilization of family doctor contract services decreased the occurrence of preventable hospitalizations, with a total effect of − 0.22 (p < 0.001). Primary healthcare quality mediates the association, with a mediate effect of − 0.05 (p < 0.001), explaining 22.73% of the total effect.<br/><strong>Conclusion:</strong> Improving the utilization of family doctor contract services and primary healthcare quality may result in lower rates of preventable hospitalizations amongst hypertensive patients.<br/><br/><strong>Keywords:</strong> family doctor contract services, preventable hospitalizations, primary healthcare quality, hypertension, mediation analysis<br/>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"39 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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