Pub Date : 2021-01-01DOI: 10.36648/1479-1072.29.3.41-46
Bruck Tesfaye, Geroma Morka
Background: Danger signs of pregnancies are a signs that women encounter during pregnancy, child birth and postpartum which is fatal for both Mather and child health. It is important, to know these warning signs for women and health care providers to rule out serious complications and initiate treatment immediately. Objectives: To determine the level of knowledge, attitude, and practice of pregnant mothers on danger signs during pregnancy among antenatal care attendants at Malka Oda general Hospital, 2019. Methods: A cross-sectional study was conducted among 208 pregnant women attending Antenatal Care from March 11-June 20/2019. A total 208 pregnant mother was selected randomly using Systematic random sampling technique. Data was collected by face to face interview. Data were processed and Analyzed. Results: This study found that 80(38.5%) were heard about obstetric danger signs while 128(61.5%) were not. One hundred ninety-two (92.3%), 15(7.2%) mothers agreed on importance of seeking medical advice on dangerous signs during pregnancy. Sixty-two (29.8%) had experienced any of danger sign during pregnancy. Of those who had experienced any of the danger signs, 59(95.2%) were sought medical care while 3 of the mothers reported that they sought care from traditional birth attendants. Conclusion: The study showed that More than two fourth of the study participants had good knowledge about danger signs during pregnancy and large number of participants had good practice. In addition, almost two over four of the studied pregnant mothers had a positive attitude towards danger sign during pregnancy.
{"title":"Knowledge, attitude and practice of danger signs during pregnancy among mothers attending antenatal care at Melka Oda hospital, southeast Ethiopia","authors":"Bruck Tesfaye, Geroma Morka","doi":"10.36648/1479-1072.29.3.41-46","DOIUrl":"https://doi.org/10.36648/1479-1072.29.3.41-46","url":null,"abstract":"Background: Danger signs of pregnancies are a signs that women encounter during pregnancy, child birth and postpartum which is fatal for both Mather and child health. It is important, to know these warning signs for women and health care providers to rule out serious complications and initiate treatment immediately. Objectives: To determine the level of knowledge, attitude, and practice of pregnant mothers on danger signs during pregnancy among antenatal care attendants at Malka Oda general Hospital, 2019. Methods: A cross-sectional study was conducted among 208 pregnant women attending Antenatal Care from March 11-June 20/2019. A total 208 pregnant mother was selected randomly using Systematic random sampling technique. Data was collected by face to face interview. Data were processed and Analyzed. Results: This study found that 80(38.5%) were heard about obstetric danger signs while 128(61.5%) were not. One hundred ninety-two (92.3%), 15(7.2%) mothers agreed on importance of seeking medical advice on dangerous signs during pregnancy. Sixty-two (29.8%) had experienced any of danger sign during pregnancy. Of those who had experienced any of the danger signs, 59(95.2%) were sought medical care while 3 of the mothers reported that they sought care from traditional birth attendants. Conclusion: The study showed that More than two fourth of the study participants had good knowledge about danger signs during pregnancy and large number of participants had good practice. In addition, almost two over four of the studied pregnant mothers had a positive attitude towards danger sign during pregnancy.","PeriodicalId":88096,"journal":{"name":"Quality in primary care","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82916955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1479-1072.29.3.23-25
Fatima A. Dirani, Doaa H. Jaffal, Rami M. Sammour, Fadi Isk, Arani
Introduction: Peritoneal dialysis for end stage renal disease of bowel perforation. Although extremely rare, it must be is not the treatment of choice in the pediatric population. It considered during imaging especially when the patient is not has many complications related to the procedure itself or to compliant to medical instructions. Less than 40 cases have been the inserted catheter. One of its rarest complications is the reported worldwide and all of which belong to the adult population. perforation of the colon by the peritoneal dialysis catheter. Conclusion: Like all other medical and surgical procedures Case Presentation: A 6 years old boy on peritoneal dialysis for the treatment of patients’ medical conditions, peritoneal presented for a peritoneal dialysis catheter emerging out of his dialysis requires regular follow up from the patient in order to anus without any signs of peritonitis and bowel perforation. avoid possible dangerous complications. Discussion: Besides obstruction, leakage and displacement
{"title":"Peritoneal Dialysis Catheter Inducing Colon Perforation","authors":"Fatima A. Dirani, Doaa H. Jaffal, Rami M. Sammour, Fadi Isk, Arani","doi":"10.36648/1479-1072.29.3.23-25","DOIUrl":"https://doi.org/10.36648/1479-1072.29.3.23-25","url":null,"abstract":"Introduction: Peritoneal dialysis for end stage renal disease of bowel perforation. Although extremely rare, it must be is not the treatment of choice in the pediatric population. It considered during imaging especially when the patient is not has many complications related to the procedure itself or to compliant to medical instructions. Less than 40 cases have been the inserted catheter. One of its rarest complications is the reported worldwide and all of which belong to the adult population. perforation of the colon by the peritoneal dialysis catheter. Conclusion: Like all other medical and surgical procedures Case Presentation: A 6 years old boy on peritoneal dialysis for the treatment of patients’ medical conditions, peritoneal presented for a peritoneal dialysis catheter emerging out of his dialysis requires regular follow up from the patient in order to anus without any signs of peritonitis and bowel perforation. avoid possible dangerous complications. Discussion: Besides obstruction, leakage and displacement","PeriodicalId":88096,"journal":{"name":"Quality in primary care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77730678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1479-1072.21.29.60-64
Wossen Ayalew Tegegne
Purpose: The major purpose of this study was to examine factors influencing trainees’ career choice among technical and vocational training trainees. Materials and Methods: This study was delimited to see factors influencing trainees’ career choice like family influence, peer influence, job opportunity influence and school influence on trainees’ career choice in the study area. This study was conducted in Kidus Lalibela and Kobo technical and vocational colleges. A total of 140 (78 male and 62 female) trainees was taken as samples of the study. The Stratified random sampling technique was applied to select these samples. The data gathering instruments used in the study were questionnaire. Cronbach alpha was employed to test the reliability of the instrument. The data were analyzed by using mean, variance; standard deviation and one sample t-test to describe the characteristics of the sample. Result: The findings of this study revealed that: there was a statistically significant mean difference between peer influence, school influence, job opportunity influence and the expected mean value, but there was no statistically significant mean difference between trainee’s family influence on career choice and expected mean value. Conclusion: Family, school, ministry of labor and social affairs and ministry of education should work jointly in providing accurate, timely, and relevant career related information for students at different levels.
{"title":"Factors Influencing Trainees Career Choice among Technical and Vocational Training Trainees: Implications for Psycho-Educational Intervention","authors":"Wossen Ayalew Tegegne","doi":"10.36648/1479-1072.21.29.60-64","DOIUrl":"https://doi.org/10.36648/1479-1072.21.29.60-64","url":null,"abstract":"Purpose: The major purpose of this study was to examine factors influencing trainees’ career choice among technical and vocational training trainees. Materials and Methods: This study was delimited to see factors influencing trainees’ career choice like family influence, peer influence, job opportunity influence and school influence on trainees’ career choice in the study area. This study was conducted in Kidus Lalibela and Kobo technical and vocational colleges. A total of 140 (78 male and 62 female) trainees was taken as samples of the study. The Stratified random sampling technique was applied to select these samples. The data gathering instruments used in the study were questionnaire. Cronbach alpha was employed to test the reliability of the instrument. The data were analyzed by using mean, variance; standard deviation and one sample t-test to describe the characteristics of the sample. Result: The findings of this study revealed that: there was a statistically significant mean difference between peer influence, school influence, job opportunity influence and the expected mean value, but there was no statistically significant mean difference between trainee’s family influence on career choice and expected mean value. Conclusion: Family, school, ministry of labor and social affairs and ministry of education should work jointly in providing accurate, timely, and relevant career related information for students at different levels.","PeriodicalId":88096,"journal":{"name":"Quality in primary care","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90240046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1479-1072.21.29.52-59
Mequanint Kassa Getahun
This study was conducted to explore major factors of elders who engaged in begging life. The study applied a qualitative research method. The participants were 11 elder beggars selected using accidental sampling technique and head of Bahir Dar City Administration Labour and Social affairs Department using purposive sampling technique. The main data gathering instruments used for this study were interview, observation and document review. In-depth interviews were used to collect data from participants. The study revealed that the major factors of elders to engage in begging were death of support providers, disengagement from work places, economic, family, environmental, and physical and health problems. Finally, the study recommended that the local government must include the help of NGOs, Social psychologists and also the civic bodies, so that the growth of beggary can be eliminated.
{"title":"Major Factors of Elders Begging in Bahir Dar City Administration Ethiopia","authors":"Mequanint Kassa Getahun","doi":"10.36648/1479-1072.21.29.52-59","DOIUrl":"https://doi.org/10.36648/1479-1072.21.29.52-59","url":null,"abstract":"This study was conducted to explore major factors of elders who engaged in begging life. The study applied a qualitative research method. The participants were 11 elder beggars selected using accidental sampling technique and head of Bahir Dar City Administration Labour and Social affairs Department using purposive sampling technique. The main data gathering instruments used for this study were interview, observation and document review. In-depth interviews were used to collect data from participants. The study revealed that the major factors of elders to engage in begging were death of support providers, disengagement from work places, economic, family, environmental, and physical and health problems. Finally, the study recommended that the local government must include the help of NGOs, Social psychologists and also the civic bodies, so that the growth of beggary can be eliminated.","PeriodicalId":88096,"journal":{"name":"Quality in primary care","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82352991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1479-1072.29.3.36-40
J. Benbassat, D. Gilon, Z. Fridlender
Educators have repeatedly commented on the poor physical examination (PE) skills that students display during clerkship rotations, and since the 1970s, there have been calls to replace the traditional head-to-toe examination by other teaching approaches. The need to update the teaching of the PE is further indicated by the availability of hand-held devices. In this monograph we propose an approach to teaching the respiratory PE that consists of (a) teaching by purpose of the PE and by its clinical context (b) restricting the number of PE maneuvers by discerning between "essential", "important" and "optional" PE signs, and (c) combining the instruction of the PE with the use of hand-held devices.
{"title":"Integrating the Physical Examination of The Respiratory System With Hand-Held Devices","authors":"J. Benbassat, D. Gilon, Z. Fridlender","doi":"10.36648/1479-1072.29.3.36-40","DOIUrl":"https://doi.org/10.36648/1479-1072.29.3.36-40","url":null,"abstract":"Educators have repeatedly commented on the poor physical examination (PE) skills that students display during clerkship rotations, and since the 1970s, there have been calls to replace the traditional head-to-toe examination by other teaching approaches. The need to update the teaching of the PE is further indicated by the availability of hand-held devices. In this monograph we propose an approach to teaching the respiratory PE that consists of (a) teaching by purpose of the PE and by its clinical context (b) restricting the number of PE maneuvers by discerning between \"essential\", \"important\" and \"optional\" PE signs, and (c) combining the instruction of the PE with the use of hand-held devices.","PeriodicalId":88096,"journal":{"name":"Quality in primary care","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81497741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What I am about to say will make all doctors reconsider whether they will remain in the profession or look for a different one. It will also irrevocably change the way doctors practice medicine and how people in the general population view medicine. More importantly, it will forever alter the relationship between medicine and society. And last, it will change the profession and society in ways that we can scarcely fathom but that will greatly reduce the profession’s footprint and influence and greatly increase individual and general wellbeing.
{"title":"Medicine and civilization: The role of medicine in population control and civilization building from the dawn of civilization until the present time","authors":"Kevin M Galalae","doi":"10.33140/mcr.03.01.04","DOIUrl":"https://doi.org/10.33140/mcr.03.01.04","url":null,"abstract":"What I am about to say will make all doctors reconsider whether they will remain in the profession or look for a different one. It will also irrevocably change the way doctors practice medicine and how people in the general population view medicine. More importantly, it will forever alter the relationship between medicine and society. And last, it will change the profession and society in ways that we can scarcely fathom but that will greatly reduce the profession’s footprint and influence and greatly increase individual and general wellbeing.","PeriodicalId":88096,"journal":{"name":"Quality in primary care","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74730412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.29011/2576-9588.100016
Muhammad Zafar, Huma Sabir
Doxorubicin, also known as Adriamycin, is an anthracycline drug commonly used in cancer chemotherapy. Adriamycin is being used clinically for solid tumours, e.g. adenocarcinoma of breast, malignant sarcomas, neuroblastoma, ovarian cancer, small lung cancer as well as hematologic malignancies including lymphomas and leukaemias. In this review we can answers different questions from which mainly we focus on that how we can prevent its toxicity and interactions with other agents and which parameters we use for to overcome this. Unfortunately, its therapeutic potential can be limited to cardiotoxicity so for to overcome this liposomal encapsulation of doxorubicin done for to overcome toxicity problems. However its use has been limited by its major clinical side effect, cardiotoxicity. Toxic effect of Adriamycin can be prevented by using different pharmacologic substances like antioxidants. Adriamycin produces its antineoplastic effect by multiple mechanisms and the exact mechanism of action of Adriamycin is still unknown. The proposed mechanism of the antineoplastic effect of Adriamycin at the cellular level is drug binding to DNA by intercalation between base pairs and inhibition of RNA synthesis by template disordering and steric obstruction.
{"title":"Pharmacological Study and Overcome theCardiotoxicity Associated with Anticancer DrugDoxorubicin","authors":"Muhammad Zafar, Huma Sabir","doi":"10.29011/2576-9588.100016","DOIUrl":"https://doi.org/10.29011/2576-9588.100016","url":null,"abstract":"Doxorubicin, also known as Adriamycin, is an anthracycline drug commonly used in cancer chemotherapy. Adriamycin is being used clinically for solid tumours, e.g. adenocarcinoma of breast, malignant sarcomas, neuroblastoma, ovarian cancer, small lung cancer as well as hematologic malignancies including lymphomas and leukaemias. In this review we can answers different questions from which mainly we focus on that how we can prevent its toxicity and interactions with other agents and which parameters we use for to overcome this. Unfortunately, its therapeutic potential can be limited to cardiotoxicity so for to overcome this liposomal encapsulation of doxorubicin done for to overcome toxicity problems. However its use has been limited by its major clinical side effect, cardiotoxicity. Toxic effect of Adriamycin can be prevented by using different pharmacologic substances like antioxidants. Adriamycin produces its antineoplastic effect by multiple mechanisms and the exact mechanism of action of Adriamycin is still unknown. The proposed mechanism of the antineoplastic effect of Adriamycin at the cellular level is drug binding to DNA by intercalation between base pairs and inhibition of RNA synthesis by template disordering and steric obstruction.","PeriodicalId":88096,"journal":{"name":"Quality in primary care","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75849681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-05-20DOI: 10.1200/JCO.2016.34.15_SUPPL.1547
Haiyun Wang, C. Snyder, Sharon Larson, V. Vogel, H. Kirchner, Haiyan Sun, Xiaowei Yan
Purpose: Despite breast cancer chemoprevention recommendations, chemoprevention use remains low. We assess primary care providers’ (PCP) awareness and use of breast cancer chemoprevention, and perceived barriers/ solutions. Methods: We conducted an online survey to investigate PCPs’ awareness and use of breast cancer chemoprevention, and perceived barriers/solutions. 161/426 (38%) eligible PCPs completed the survey. Results: Of providers, 42% reported using breast cancer risk assessment models, only 9% prescribed breast cancer chemoprevention drugs in the past year. Providers using risk models were more likely to have made a breast cancer diagnosis in the past year (77% vs. 56%; p=0.01). Providers prescribed chemoprevention were older (mean 49 years vs. 40; p=0.01), more likely to be in practice ≥ 10 years (71% vs. 43%; p=0.04) and full time (79% vs. 49%; P=0.04); they all had diagnosed breast cancer in the past year (100% vs. 61%; p=0.002). Top three reported barriers to chemoprevention guideline adherence were lack of knowledge about chemoprevention drugs, unaware of chemoprevention guidelines, and inability to identify high-risk women. After adjustment for other provider characteristics and barriers, the PCPs who are unaware of chemoprevention guidelines have 3.1 increased odds (CI: 1.4-6.7) for not using risk assessment models. If high-risk women can be identified, 85% of respondents prefer referring appropriate women to a high-risk breast clinic. Conclusion: PCPs infrequently assess breast cancer risk and rarely prescribe chemoprevention drugs for risk reduction. PCP education on breast cancer prevention and establishing high-risk breast clinics may improve breast cancer chemoprevention uptake.
目的:尽管有乳腺癌化学预防的建议，化学预防的使用仍然很低。我们评估初级保健提供者(PCP)对乳腺癌化学预防的认识和使用，以及感知到的障碍/解决方案。方法:通过在线调查，了解pcp对乳腺癌化学预防的认知和使用情况，以及感知到的障碍/解决方案。161/426(38%)合资格的pcp完成调查。结果:42%的提供者报告使用乳腺癌风险评估模型，只有9%的提供者在过去一年中开了乳腺癌化学预防药物。使用风险模型的提供者在过去一年中更有可能做出乳腺癌诊断(77%对56%;p = 0.01)。开化学预防处方的提供者年龄较大(平均49岁vs. 40岁;P =0.01)，更有可能在实践≥10年(71% vs. 43%;P =0.04)和全职(79% vs. 49%;P = 0.04);他们都在过去一年中被诊断出患有乳腺癌(100%比61%;p = 0.002)。据报道，遵守化学预防指南的前三大障碍是缺乏对化学预防药物的了解，不了解化学预防指南，以及无法识别高危妇女。在对其他提供者特征和障碍进行调整后，不了解化学预防指南的pcp不使用风险评估模型的几率增加了3.1 (CI: 1.4-6.7)。如果可以确定高危妇女，85%的答复者倾向于将适当的妇女转到高危乳房诊所。结论:pcp很少评估乳腺癌风险，很少开具化学预防药物以降低风险。预防乳腺癌的PCP教育和建立高危乳腺诊所可以提高乳腺癌化学预防的接受度。
{"title":"Breast Cancer Chemoprevention in Primary Care- Assessing Readiness for Change","authors":"Haiyun Wang, C. Snyder, Sharon Larson, V. Vogel, H. Kirchner, Haiyan Sun, Xiaowei Yan","doi":"10.1200/JCO.2016.34.15_SUPPL.1547","DOIUrl":"https://doi.org/10.1200/JCO.2016.34.15_SUPPL.1547","url":null,"abstract":"Purpose: Despite breast cancer chemoprevention recommendations, chemoprevention use remains low. We assess primary care providers’ (PCP) awareness and use of breast cancer chemoprevention, and perceived barriers/ solutions. \u0000Methods: We conducted an online survey to investigate PCPs’ awareness and use of breast cancer chemoprevention, and perceived barriers/solutions. 161/426 (38%) eligible PCPs completed the survey. \u0000Results: Of providers, 42% reported using breast cancer risk assessment models, only 9% prescribed breast cancer chemoprevention drugs in the past year. Providers using risk models were more likely to have made a breast cancer diagnosis in the past year (77% vs. 56%; p=0.01). Providers prescribed chemoprevention were older (mean 49 years vs. 40; p=0.01), more likely to be in practice ≥ 10 years (71% vs. 43%; p=0.04) and full time (79% vs. 49%; P=0.04); they all had diagnosed breast cancer in the past year (100% vs. 61%; p=0.002). Top three reported barriers to chemoprevention guideline adherence were lack of knowledge about chemoprevention drugs, unaware of chemoprevention guidelines, and inability to identify high-risk women. After adjustment for other provider characteristics and barriers, the PCPs who are unaware of chemoprevention guidelines have 3.1 increased odds (CI: 1.4-6.7) for not using risk assessment models. If high-risk women can be identified, 85% of respondents prefer referring appropriate women to a high-risk breast clinic. \u0000Conclusion: PCPs infrequently assess breast cancer risk and rarely prescribe chemoprevention drugs for risk reduction. PCP education on breast cancer prevention and establishing high-risk breast clinics may improve breast cancer chemoprevention uptake.","PeriodicalId":88096,"journal":{"name":"Quality in primary care","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81898852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juan Lu, Erin Britton, Jacquelyn Ferrance, Emily Rice, Anton Kuzel, Alan Dow
Background: Improving health and controlling healthcare costs requires better tools for predicting future health needs across populations. We sought to identify factors associated with transitioning of enrollees in an indigent care program from an intermediate cost segment to a high cost segment of this population.
Methods: We analyzed data from 9,624 enrollees of the Virginia Coordinated Care program between 2010 and 2013. Each fiscal year included all enrollees who were classified in intermediate cost segment in the preceding year and also enrolled in the program in the following year. Using information from the preceding year, we built logistic regression models to identify the individuals in the top 10% of expenditures in the following year. The effect of demographics, count of chronic conditions, presence of the prevalent chronic conditions, and utilization indicators were evaluated and compared. Models were compared via the Bayesian information criterion and c-statistic.
Results: The count of chronic conditions, diagnosis of congestive heart failure, and numbers of total hospital visits and prescriptions were significantly and independently associated with being in the future high cost segment. Overall, the model that included demographics and utilization indicators had a reasonable discrimination (c=0.67).
Conclusions: A simple model including demographics and health utilization indicators predicted high future costs. The count of chronic conditions and certain medical diagnoses added additional predictive value. With further validation, the approach could be used to identify high-risk individuals and target interventions that decrease utilization and improve health.
{"title":"Identifying Future High Cost Individuals within an Intermediate Cost Population.","authors":"Juan Lu, Erin Britton, Jacquelyn Ferrance, Emily Rice, Anton Kuzel, Alan Dow","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Improving health and controlling healthcare costs requires better tools for predicting future health needs across populations. We sought to identify factors associated with transitioning of enrollees in an indigent care program from an intermediate cost segment to a high cost segment of this population.</p><p><strong>Methods: </strong>We analyzed data from 9,624 enrollees of the Virginia Coordinated Care program between 2010 and 2013. Each fiscal year included all enrollees who were classified in intermediate cost segment in the preceding year and also enrolled in the program in the following year. Using information from the preceding year, we built logistic regression models to identify the individuals in the top 10% of expenditures in the following year. The effect of demographics, count of chronic conditions, presence of the prevalent chronic conditions, and utilization indicators were evaluated and compared. Models were compared via the Bayesian information criterion and c-statistic.</p><p><strong>Results: </strong>The count of chronic conditions, diagnosis of congestive heart failure, and numbers of total hospital visits and prescriptions were significantly and independently associated with being in the future high cost segment. Overall, the model that included demographics and utilization indicators had a reasonable discrimination (c=0.67).</p><p><strong>Conclusions: </strong>A simple model including demographics and health utilization indicators predicted high future costs. The count of chronic conditions and certain medical diagnoses added additional predictive value. With further validation, the approach could be used to identify high-risk individuals and target interventions that decrease utilization and improve health.</p>","PeriodicalId":88096,"journal":{"name":"Quality in primary care","volume":"23 6","pages":"318-326"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874657/pdf/nihms755930.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34509538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：