Frontiers in Public HealthPub Date : 2025-02-04eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1467745
Wei Huang, Ying Hu, Lingzhi Li, Chendi Wang, Luyao Liu
{"title":"The 4E theory-based performance benchmarking of aged care service provision in community care facilities: a case study of Nanjing, China.","authors":"Wei Huang, Ying Hu, Lingzhi Li, Chendi Wang, Luyao Liu","doi":"10.3389/fpubh.2025.1467745","DOIUrl":"10.3389/fpubh.2025.1467745","url":null,"abstract":"<p><p>The global aging population is growing rapidly, and due to its large population, China is expected to become a 'super-aged society' within the next decade. Therefore, ensuring that older people can 'age in place' has become a major national priority. Community-care facilities (CCFs) play a key role in this process, but their service performance often faces challenges, with high input costs and limited output benefits. This paper aims to evaluate and improve the social and economic performance of CCFs by proposing a comprehensive framework based on the 4E (Economy, Efficiency, Effectiveness, Equity) theory. Specifically, based on the 4E theory, a literature review and correlation analysis are conducted to select performance indicators. The input-output relationships are then established according to the four dimensions of the 4E theory. These indicators and input-output relationships form the foundation for applying the δ-SBM DEA model, which is used to assess the performance of 75 CCFs in Nanjing. The study finds that the economic performance of CCFs generally lags behind their social performance, with many facilities showing inefficiency in economic indicators, characterized by high operational costs and limited profitability. Projection analysis reveals major issues in low-performing CCFs, including uneven regional distribution of facility performance, poor profitability, a shortage of skilled older people care professionals, and insufficient older people's participation. Based on these findings, the paper provides specific policy recommendations for government authorities, industry associations, and CCFs, focusing on improving cost-effectiveness, increasing the number of professionals, and enhancing older people's participation.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1467745"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Analysis of indoor radon concentration levels and trends in China.","authors":"Bowei Ding, Yunyun Wu, Yanchao Song, Changsong Hou, Bing Shang","doi":"10.3389/fpubh.2025.1524179","DOIUrl":"10.3389/fpubh.2025.1524179","url":null,"abstract":"<p><p>A systematic review of publicly available papers on indoor radon data from 1980 to 2023 was conducted to provide a preliminary understanding of indoor radon concentration levels and trends in China. Keywords were used to collect literature on indoor radon surveys in China during the periods of before 2000, 2000-2010 and after 2010 in the CNKI, WANFANG, VIP and PubMed databases. This paper also collected indoor radon concentration data from WHO, UNSCEAR publications and PubMed databases for other countries. A total of 37,886 indoor radon concentration data points were collected in China, covering 31 provinces. The results showed that the weighted and arithmetic mean radon concentrations in China were 29.4 Bq/m<sup>3</sup> and 33.2 Bq/m<sup>3</sup> (<i>n</i> = 17,940) before 2000, 44.7 Bq/m<sup>3</sup> and 43.3 Bq/m<sup>3</sup> (<i>n</i> = 10,692) in 2000-2010, 57.6 Bq/m<sup>3</sup> and 60.8 Bq/m<sup>3</sup>(<i>n</i> = 9,254) after 2010, respectively. It indicated an increasing trend in indoor radon concentrations in China. The differences in mean indoor radon concentrations across time periods were significant (<i>p</i> < 0.001). In the regional analysis, the differences in indoor radon concentrations between different administrative geographic regions for each time period were significant (<i>p</i> < 0.05). Furthermore, the differences in indoor radon concentrations among climatic areas were significant for the periods 2000-2010 and after 2010 (<i>p</i> < 0.05). Additionally, this paper collected indoor radon data from 63 countries worldwide. The mean radon concentrations across the three periods-before 2000, 2000-2010 and after 2010-were 56.5 Bq/m<sup>3</sup>, 67.9 Bq/m<sup>3</sup> and 81 Bq/m<sup>3</sup>, respectively. Meanwhile, a comparison of indoor radon concentration was made before and after 2000 among 26 countries, of which 16 countries showed an increasing trend. So, it can be seen the increase in indoor radon concentration in China is not an isolated phenomenon, and the issue of indoor radon pollution still requires further attention.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1524179"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in Public HealthPub Date : 2025-02-04eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1548553
Greta Colombi, Paolo Vineis
{"title":"Editorial: The relationship between health and environment under the lens of climate change: insights for policy makers.","authors":"Greta Colombi, Paolo Vineis","doi":"10.3389/fpubh.2025.1548553","DOIUrl":"10.3389/fpubh.2025.1548553","url":null,"abstract":"","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1548553"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in Public HealthPub Date : 2025-02-04eCollection Date: 2024-01-01DOI: 10.3389/fpubh.2024.1463532
Xuxin Zou, Jiadi Min, Shuang Meng, Wenguan Dai, Xinyang Li
{"title":"Can digital governance stimulate green development? Evidence from the program of \"pilot cities regarding information for public well-being\" in China.","authors":"Xuxin Zou, Jiadi Min, Shuang Meng, Wenguan Dai, Xinyang Li","doi":"10.3389/fpubh.2024.1463532","DOIUrl":"10.3389/fpubh.2024.1463532","url":null,"abstract":"<p><p>Digital governance is an important goal of government digital transformation, and the policy of \"pilot cities regarding information for public well-being\" in China is an important initiative to promote the reform of government governance system and realize green development. Based on the panel data of 282 cities in China from 2007 to 2020, this paper analyzes the mechanism and path of the impact of digital governance on green development using the program of \"pilot cities regarding information for public well-being\" as a quasi-natural experiment. The double-difference model and mediation effect model are utilized. The results show that digital governance can significantly promote green development, and the path of influence is the supererogation and the rationalization of industrial structure, i.e., digital governance can promote the green development of the cities by enhancing the supererogation and the rationalization of industrial structure. In addition, there is obvious heterogeneity in the impact of digital governance on green development. The policy exerts a stronger effect on economically developed cities than on economically backward cities, and a stronger effect on large cities than on small- and medium-sized cities. Therefore, the relevant departments should continue to optimize the pilot policy regarding information for public well-being, strive to improve the government's digital governance, focus on economically backward cities and small-sized cities, actively cultivate the green development, promote the optimization and upgrading of industrial structure, and vigorously support cross-regional exchanges and cooperation, so as to jointly achieve green and high-quality development.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"12 ","pages":"1463532"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in Public HealthPub Date : 2025-02-04eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1507075
Chunmei Chen, Yujie Zhu, Fanghao Xiao
{"title":"Research on the relationship between social support and academic self-efficacy among college students: a multivariate empirical analysis.","authors":"Chunmei Chen, Yujie Zhu, Fanghao Xiao","doi":"10.3389/fpubh.2025.1507075","DOIUrl":"10.3389/fpubh.2025.1507075","url":null,"abstract":"<p><strong>Background: </strong>The critical role of social support in college students' academic development cannot be ignored. This study aims to analyze the interrelationships and potential mechanisms between social support, sense of security, family cultural capital and academic self-efficacy.</p><p><strong>Methods: </strong>A multivariate moderated mediation model was constructed by surveying 1,119 college students using the Social Support Scale, the Sense of Security Scale, the Academic Self-efficacy Scale, and the Family Cultural Capital Scale.</p><p><strong>Results: </strong>(1) social support significantly increases sense of security; (2) sense of security significantly enhances academic self-efficacy; (3) social support directly contributes to academic self-efficacy; and (4) sense of security partially mediates the relationship between social support and academic self-efficacy; (5) family cultural capital plays a moderating role in the effects of social support on academic self-efficacy, especially in the first half of the direct and indirect effects.</p><p><strong>Conclusion: </strong>These findings could provide an important theoretical basis and practical guidance for further understanding and enhancing academic self-efficacy among college students.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1507075"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in Public HealthPub Date : 2025-02-04eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1510311
Silin Wu, Zhaoxia Lei, Tinglian Liu, Lan Chen, Yang Qin
{"title":"The analysis of factors influencing patient choice of healthcare providers between tertiary hospitals and community clinics.","authors":"Silin Wu, Zhaoxia Lei, Tinglian Liu, Lan Chen, Yang Qin","doi":"10.3389/fpubh.2025.1510311","DOIUrl":"10.3389/fpubh.2025.1510311","url":null,"abstract":"<p><strong>Background: </strong>The uneven distribution of medical resources in China has led to persistently low utilization rates of primary healthcare institutions. The tiered healthcare delivery system aims to optimize resource allocation and strengthen primary care, yet patient preferences for tertiary hospitals hinder its effective implementation. Understanding the factors influencing healthcare-seeking behaviors is crucial for improving policies and promoting system efficiency.</p><p><strong>Objective: </strong>To analyse the factors influencing patient choices between a tertiary hospital and a community health service center in Chengdu and provide recommendations for advancing the tiered healthcare system.</p><p><strong>Methods: </strong>A random sampling method was used in August 2023 to survey patients at a tertiary hospital (Group A) and a community health service center (Group B). The survey assessed demographics, health status, factors influencing provider choice, and awareness of the family doctor system. Chi-square, t-tests, or Wilcoxon rank-sum tests were used for group comparisons, while logistic regression identified factors associated with primary care visits.</p><p><strong>Results: </strong>Among 865 valid responses (Group A: 420; Group B: 445; 92.02% response rate), Group A had significantly higher education levels and household incomes (<i>p</i> < 0.001), while Group B had higher chronic disease prevalence and family doctor contract rates (71.5% vs. 59.3, 44.5% vs. 25.5%; both <i>p</i> < 0.01). Positive factors for choosing community healthcare included better equipment and medication availability (46.9%), lower costs with higher reimbursement (45.0%), and convenient transport (41.2%). Negative factors included distrust in community care quality (39.1%) and limited familiarity with family doctors (32.8%). Logistic regression indicated that being over 60 years old (OR: 1.94, CI: 1.02-3.69) and awareness of the tiered healthcare system (OR: 2.48, CI: 1.56-3.96) were significant factors for seeking primary care.</p><p><strong>Conclusion: </strong>Patients with higher education and income prefer tertiary hospitals, while chronic disease patients are more likely to utilize community care. Low family doctor contract rates and trust in community healthcare quality remain barriers. Strengthening community resources and promoting the tiered healthcare system could improve patient participation and alleviate pressure on tertiary hospitals.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1510311"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in Public HealthPub Date : 2025-02-03eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1531140
Marzena Mikla, Anna Maria Cybulska, Antonio Rios, Mariusz Panczyk, Kamila Rachubińska, Artur Kotwas, Beata Karakiewicz, Elżbieta Grochans, Daria Schneider-Matyka
{"title":"Attitudes of polish medical students toward organ donation.","authors":"Marzena Mikla, Anna Maria Cybulska, Antonio Rios, Mariusz Panczyk, Kamila Rachubińska, Artur Kotwas, Beata Karakiewicz, Elżbieta Grochans, Daria Schneider-Matyka","doi":"10.3389/fpubh.2025.1531140","DOIUrl":"10.3389/fpubh.2025.1531140","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to analyze determinants affecting attitudes toward organ donation among medical students at medical universities in Poland.</p><p><strong>Materials and methods: </strong>The study involved 1,348 medical students. It was performed using a validated questionnaire of attitude toward organ donation and transplantation (ODT) [PCID-DTO RIOS: A questionnaire designed by the International Collaborative Organ Donation project about organ transplantation and donation].</p><p><strong>Results: </strong>It was shown that those who would not donate their family member's organs for transplantation were far more likely to believe it was not their moral duty (<i>p</i> = 0.013) and to feel no solidarity with those in need (<i>p</i> = 0.000). Those who spoke to their families believed it was their moral duty (<i>p</i> = 0.000), and believed they would do it out of solidarity with those in need (<i>p</i> = 0.000). It was found that having family conversations about donating one's organs for transplantation was statistically significantly related to being a blood donor (<i>p</i> = 0.002), fear of desecration/disfigurement of the body after death in case of organ donation (<i>p</i> = 0. 000), a belief that it may be necessary to become an organ recipient in the future (<i>p</i> = 0.000), and knowledge of loved ones' opinions about ODT (father <i>p</i> = 0.000, mother <i>p</i> = 0.000), partner (<i>p</i> = 0.000).</p><p><strong>Conclusion: </strong>1. The reluctance to donate the organs of loved ones for transplantation is accompanied by a lack of a sense of moral obligation and a lack of solidarity with those in need. Conversely, conversations among loved ones about organ donation are thought-provoking, causing a sense of moral obligation and solidarity with those in need. 2. Regardless of the stance on organ donation and family discussions on the subject, the respondents do not care what happens to the body after organ donation, but they also do not know the opinions of their loved ones about ODT. 3. Conversations with loved ones contribute to the acceptance of circumstances in which organs would be harvested for transplantation without consent.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1531140"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in Public HealthPub Date : 2025-02-03eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1459517
Yanan Cheng, Meijiazi Yang, Sha Ma
{"title":"Exploring challenges and coping strategies in providing care for older adults with dementia: a qualitative study conducted in China.","authors":"Yanan Cheng, Meijiazi Yang, Sha Ma","doi":"10.3389/fpubh.2025.1459517","DOIUrl":"10.3389/fpubh.2025.1459517","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of dementias in China has imposed a substantial burden on caregivers, posing a serious threaten to their physical and mental well-being. It is imperative to explore practical measures to alleviate the stress experienced by those caregivers of older adults with dementia.</p><p><strong>Methods: </strong>A semi-structured questionnaire was adopted for conducting interviews with the participants from December 2022 to January 2023. Subsequently, the interviews were meticulously recorded and transcribed in their entirety, followed by a rigorous analysis of the resulting data and information.</p><p><strong>Results: </strong>A total of 17 participants who provided care for older adults with dementia were interviewed across various settings including rural areas, communities, hospitals, and nursing homes in Shandong Province. These caregivers encountered challenges such as limited social interaction, significant mental strain, deteriorating physical health, financial insufficiency, and a lack of professional expertise. The current social support systems were deemed insufficient for families caring for older adults with dementia. To alleviate the burden on dementia caregivers, particularly for those with low-income status, the government needs to prioritize enhancing the coverage of the long-term healthcare system and expanding the essential medication list. Given the growing population of older adults in China and the fact that most individuals with dementia are cared for by family members, it is recommended to establish a multifaceted support system involving collaboration among government, social organizations, and volunteers within both urban and rural communities.</p><p><strong>Conclusion: </strong>The gradual expansion of coverage of long-term care insurance, the proactive inclusion of dementia treatment drugs into the essential medication list, and optimization of a diversified dementia care system ought to be a matter of significant concern.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1459517"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in Public HealthPub Date : 2025-02-03eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1520675
Xiaorui Huang
{"title":"Internet usage and environmental governance satisfaction in China: environmental pollution perception as a mediator.","authors":"Xiaorui Huang","doi":"10.3389/fpubh.2025.1520675","DOIUrl":"10.3389/fpubh.2025.1520675","url":null,"abstract":"<p><strong>Background: </strong>Public perception and satisfaction with environmental governance are essential for evaluating the effectiveness of national environmental policies and advancing the United Nations Sustainable Development Goals (UN-SDGs). However, the role of Internet usage in shaping these perceptions and satisfaction levels remains underexplored. This study examines the influence of different types of Internet use on residents' satisfaction with local environmental governance, with a particular focus on the mediating role of perceived environmental pollution.</p><p><strong>Methods: </strong>Data were retrieved from 3,046 respondents who participated in the 2021 Chinese Social Survey (CSS). Ordinary least squares (OLS) regression and mediation effect models were employed to analyze the relationships between Internet use, perceived environmental pollution, and satisfaction with environmental governance.</p><p><strong>Results: </strong>Frequent Internet use for browsing news (β = 0.019, SE = 0.006) and studying (β = 0.020, SE = 0.006) is positively associated with greater satisfaction with environmental governance. However, environmental pollution perception functions as a suppressing mediator in the association of Internet use for news browsing (effect = -0.004, SE = 0.001) and studying (effect = -0.004, SE = 0.001), with environmental governance satisfaction (EGS).</p><p><strong>Conclusions: </strong>This study is the first to apply expectancy-disconfirmation theory to explore public satisfaction with environmental governance. The findings provide novel insights into the role of Internet usage in shaping perceptions of environmental management and offer practical recommendation for leveraging digital engagement to enhance EGS among the public.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1520675"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in Public HealthPub Date : 2025-02-03eCollection Date: 2025-01-01DOI: 10.3389/fpubh.2025.1448803
Cynthia Qi, Pushpa Narayanaswami, Ashley E L Anderson, Deborah Gelinas, Yuebing Li, Jeffrey T Guptill, Dakshinamoorthy Amirthaganesan, Charlotte Ward, Rupesh Panchal, Amit Goyal, Glenn Phillips
{"title":"Racial disparities in acute care utilization among individuals with myasthenia gravis.","authors":"Cynthia Qi, Pushpa Narayanaswami, Ashley E L Anderson, Deborah Gelinas, Yuebing Li, Jeffrey T Guptill, Dakshinamoorthy Amirthaganesan, Charlotte Ward, Rupesh Panchal, Amit Goyal, Glenn Phillips","doi":"10.3389/fpubh.2025.1448803","DOIUrl":"10.3389/fpubh.2025.1448803","url":null,"abstract":"<p><strong>Objective: </strong>In myasthenia gravis (MG), evidence on the impact of social determinants of health on disparities in disease burden and healthcare resource utilization is limited. This study aimed to investigate the independent association between race/ethnicity and acute care utilization during the 2 years post-diagnosis among patients with MG.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among adults (≥18 years) with newly diagnosed MG in the United States using Optum's de-identified Market Clarity Data from January 1, 2010, to December 31, 2019. Multivariable regression models were used to assess the association between acute care utilization and race/ethnicity, insurance, exacerbation at index, and other covariates.</p><p><strong>Results: </strong>A total of 7,058 patients met the study inclusion criteria, of whom 57% (<i>n</i> = 4,052) identified as Caucasian, 6% (<i>n</i> = 445) African American, 3% (<i>n</i> = 235) Hispanic, 1% (<i>n</i> = 94) Asian, and 32% (<i>n</i> = 2,232) with missing race/ethnicity information. Compared with patients identifying as Caucasian, those identifying as African American had 37% higher odds of having an emergency department visit in year 1, and those identifying as Hispanic had 70% increase in odds of having a hospitalization event in year 2 post-diagnosis. Among other covariates, Medicaid usage, exacerbation at index, and number of outpatient visits were significantly associated with acute care utilization.</p><p><strong>Conclusion: </strong>Racial disparities significantly impacted acute care utilization in the first 2 years post-MG diagnosis. Future studies should aim to examine specific factors that may contribute to disparities such as barriers to healthcare access, greater severity of MG symptoms, and poorly controlled disease.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1448803"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}