Health Services Insights最新文献

{"title":"Understanding of Maternal Health Status in Different Social Groups in India Using NFHS Data.","authors":"Santosh Tamang, Uttam Kumar Sikder","doi":"10.1177/11786329241254206","DOIUrl":"https://doi.org/10.1177/11786329241254206","url":null,"abstract":"<p><p>Maternal health is a major public health concern in India. MMR of India has declined significantly but maternal health status has not much improved. The prevalence of anemia and low Body Mass Index (BMI) is more severe among the women belonging to the Scheduled Caste (SC) and Scheduled Tribe (ST) categories. In this paper, attempts have been made to examine the maternal health status and to identify the factors responsible for poor health status among SC and ST women. The study is purely based on secondary data taken from latest 3 rounds of NFHS (2005-6, 2015-16 & 2019-21). Multivariate analysis have been carried out using panel regression model to understand the impact of determinants on maternal healthcare. The study found that the SC and ST women are more prone to anemia than others (GENERAL category women). Maternal health status is mostly controlled by per capita health expenditure and health infrastructure variables like no. of hospitals and nurses, irrespective of social class. Thus poor maternal health status in India, especially among socially disadvantaged groups of society, have been major concern. The government should be more focused on existing policies related to maternal healthcare.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345198","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}

{"title":"The Use of Antibiotics at the End of Life: A Cross-Sectional Study.","authors":"Brayan Miranda-Chavez, Andre Fuentes-Yufra, Miguel Hueda-Zavaleta, Cesar Copaja-Corzo, Javier A Flores-Cohaila, Marco Rivarola-Hidalgo","doi":"10.1177/11786329241280812","DOIUrl":"https://doi.org/10.1177/11786329241280812","url":null,"abstract":"<p><strong>Objective: </strong>To identify and analyze antibiotics' prescription patterns and associated factors among terminally ill patients at a hospital in southern Peru.</p><p><strong>Methodology: </strong>A cross-sectional analytical study was conducted on adult patients who died in Hospital III Daniel Alcides Carrion in Tacna, Peru, 2023. Data were collected from electronic medical records, focusing on antibiotic use during the last hospitalization. Univariate, bivariate, and multivariate analyses were performed using Poisson regression to adjust for potential confounders.</p><p><strong>Results: </strong>The study included 239 patients with an average age of 76. Antibiotics were administered to 93.72% of patients, with 42.46% lacking an identified infectious focus. Ceftriaxone, Meropenem, and Vancomycin were the most used antibiotics. A lower use of antibiotics within 72 hours prior to death was associated with hospitalizations longer than 18 days and having 2 or more comorbidities.</p><p><strong>Conclusion: </strong>The high prevalence of antibiotic use at the end of life, often without an infectious focus, suggests a need for better guidelines and education on palliative care to avoid inappropriate antibiotic prescribing. Improved communication between healthcare providers, patients, and families is essential for optimizing end-of-life care.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284466","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}

{"title":"Multi-Dimensional Analysis of Japanese Telemedicine Patient Satisfaction.","authors":"Andrew N Mason, Toshio Naito, Shinichi Fukushima, Keiko Asano, Ken Yamaji, Ryohei Kuwatsuru","doi":"10.1177/11786329241280864","DOIUrl":"https://doi.org/10.1177/11786329241280864","url":null,"abstract":"<p><strong>Introduction: </strong>Telemedicine is a growing segment of the healthcare industry. As telemedicine gains prominence in Japan, the importance of telemedicine patient satisfaction research will also grow. This study examines whether Japanese patients are equally impacted by the same latent dimensions discovered in the multi-dimensional service satisfaction model used by a United States (U.S.) study.</p><p><strong>Methods: </strong>The subjects (n = 110) were patients who received telemedicine service between January and December 2023 at Juntendo University Hospital, Tokyo, Japan. Patient satisfaction perceptions were collected using a questionnaire composed of Likert scale items. Overall patient satisfaction served as the dependent variable, and patient perceptions of various aspects of the service were the independent variables. LASSO regression analysis was used to test the impact of the independent variables on overall patient satisfaction along with cluster analysis to examine the satisfaction ratings based upon patient characteristics.</p><p><strong>Results: </strong>Japanese patient perceptions of telemedicine health benefits were the most impactful driver of overall satisfaction. Cluster analysis indicated that males were generally more satisfied than females. The least satisfied patients were predominately female and those experiencing telemedicine for the first time. Patients receiving service from a specialist physician were least satisfied with the telemedicine financial costs.</p><p><strong>Discussion: </strong>Patient satisfaction levels were found to be highly impacted by perceptions of the health benefits received and the non-financial costs of service. These benefits could be highlighted by Japanese telemedicine providers to increase utilization of telemedicine services. Patient satisfaction was also found to be influenced by patient-centered care (ie, the \"soft skills\" of providers) to a lesser degree. Therefore, Japanese telemedicine providers may benefit from developing patient-centered communication skills.</p><p><strong>Conclusion: </strong>The model used provides nuanced understandings of telemedicine patient satisfaction, which highlights where targeted improvements in Japanese telemedicine patient satisfaction are likely to be most impactful.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284464","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}

{"title":"Factors Associated With Willingness to Pay for Primary Health Care Services in South Africa: A Cross-Sectional Survey of Medical Schemes Members.","authors":"Evelyn Thsehla, Charles Hongoro, Jacqui Miot, Kate Kgasi, Edmore Marinda, Esnath Maramba, Alister Chabi, Barry Childs, Olurotimi Modupe, Olufunke Alaba","doi":"10.1177/11786329241274479","DOIUrl":"https://doi.org/10.1177/11786329241274479","url":null,"abstract":"<p><p>The cost of healthcare is an issue of concern for both consumers and funders of healthcare in South Africa. The country spends approximately 8% of GDP on health care. Health care is financed through the public sector which covers 86% of the population and the private sector which covers 14% of the population. Medical schemes are the main source of healthcare financing in the private sector. Services covered by medical schemes include chronic diseases, emergencies, diagnosis, and treatment of a selected number of diseases. Primary health care services such as screening are limited. The aim of this study was to assess factors associated with members of medical schemes' willingness to pay for a primary health care package in the private sector. A cross-sectional survey was conducted amongst principal members of medical schemes between July and September 2020. All principal members with access to an online questionnaire were eligible to participate in this study. Logistic regression was used to identify factors associated with willingness to pay for primary health care services. A total of 6512 members of medical schemes participated in the study. Thirty-five percent of the participants were willing to pay for the primary health care package. Factors influencing willingness to pay included marital status, employment status, income and household size. The study highlights the need for policymakers to consider socioeconomic factors when designing health care policies.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11401016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284463","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}

{"title":"The Influencing Factors of Psychosocial Adaptation of Cancer Patients: A Systematic Review and Meta-Analysis.","authors":"Hanjing Zhu, Linning Yang, Hongfan Yin, Xia Yuan, Jia Gu, Yan Yang","doi":"10.1177/11786329241278814","DOIUrl":"https://doi.org/10.1177/11786329241278814","url":null,"abstract":"<p><strong>Purpose: </strong>The psycho-social adaptation of cancer patients is very important, which affects the treatment, rehabilitation process and prognosis of patients, and is closely related to the subjective well-being and quality of life of patients. However, the key factors affecting the psycho-social adjustment of cancer patients are not clear yet. This study aims to evaluate the psycho-social adaptation of cancer patients and its influencing factors based on a meta-analysis.</p><p><strong>Basic procedures: </strong>The Systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist and guided by the society-to-cell model framework. Literature retrieval was conducted from the construction of the library to December 2023.</p><p><strong>Main findings: </strong>Fourteen pieces of literature were included in this study, with a total sample size of 2922 cases. Among the 14 literatures included, 9 were in English and 5 were in Chinese, published between 1991 and 2021. All of the 14 literatures were cross-sectional studies. According to the society-to-cells model framework, the influencing factors are divided into 5 levels: society, community, family, individual, and physiology. However, studies related to the cellular level are lacking.</p><p><strong>Principal conclusions: </strong>The psychosocial adaptation of cancer patients is affected by physiology, individual, family, community and society, among which age, education level, disease uncertainty, hope level, psychological pain, self-efficacy, social support, coping styles (facing, avoidance, submission, and emotion-oriented) are the main factors affecting the psychosocial adaptation of cancer patients. However, studies related to the cellular level are lacking. This may be due to the fact that most of the factors from the individual to the society level are intervenable, and most studies focus more on the mining of these levels of factors. However, the biological basis is crucial to the occurrence and development of diseases, and needs to be paid attention to by nursing staff, and further research on this level needs to be strengthened in the future.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284465","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}

{"title":"Identifying Patient Subpopulations with Significant Race-Sex Differences in Emergency Department Disposition Decisions.","authors":"Peter Lin, Nilay T Argon, Qian Cheng, Christopher S Evans, Benjamin Linthicum, Yufeng Liu, Abhishek Mehrotra, Laura Murphy, Mehul D Patel, Serhan Ziya","doi":"10.1177/11786329241277724","DOIUrl":"10.1177/11786329241277724","url":null,"abstract":"<p><strong>Background/objectives: </strong>The race-sex differences in emergency department (ED) disposition decisions have been reported widely. Our objective is to identify demographic and clinical subgroups for which this difference is most pronounced, which will facilitate future targeted research on potential disparities and interventions.</p><p><strong>Methods: </strong>We performed a retrospective analysis of 93 987 White and African-American adults assigned an Emergency Severity Index of 3 at 3 large EDs from January 2019 to February 2020. Using random forests, we identified the Elixhauser comorbidity score, age, and insurance status as important variables to divide data into subpopulations. Logistic regression models were then fitted to test race-sex differences within each subpopulation while controlling for other patient characteristics and ED conditions.</p><p><strong>Results: </strong>In each subpopulation, African-American women were less likely to be admitted than White men with odds ratios as low as 0.304 (95% confidence interval (CI): [0.229, 0.404]). African-American men had smaller admission odds compared to White men in subpopulations of 41+ years of age or with very low/high Elixhauser scores, odds ratios being as low as 0.652 (CI: [0.590, 0.747]). White women were less likely to be admitted than White men in subpopulations of 18 to 40 or 41 to 64 years of age, with low Elixhauser scores, or with Self-Pay or Medicaid insurance status with odds ratios as low as 0.574 (CI: [0.421, 0.784]).</p><p><strong>Conclusions: </strong>While differences in likelihood of admission were lessened by younger age for African-American men, and by older age, higher Elixhauser score, and Medicare or Commercial insurance for White women, they persisted in all subgroups for African-American women. In general, patients of age 64 years or younger, with low comorbidity scores, or with Medicaid or no insurance appeared most prone to potential disparities in admissions.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153712","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}

{"title":"Exploring the Impact of COVID-19 on Cervical Cancer Screening Services: A Qualitative Study of Healthcare Providers' and Women's Perspectives and Experiences.","authors":"Fennie Mantula, Yoesrie Toefy","doi":"10.1177/11786329241275883","DOIUrl":"10.1177/11786329241275883","url":null,"abstract":"<p><p>A qualitative exploration was conducted to analyse the reasons behind the low utilisation of cervical cancer screening services in Gwanda district, Zimbabwe, focusing on the impact of the COVID-19 pandemic. The study involved 5 focus group discussions with 36 women, utilising maximum variation sampling to explore the effects of COVID-19 on screening coverage. Additionally, in-depth interviews were conducted with 25 health-care providers from primary health facilities and the provincial hospital offering screening services. The results suggest a decline in the progress of the cervical cancer screening programme due to the disruptions caused by COVID-19 which subsequently reduced women's access to screening and treatment services. It was anticipated that restoring women's confidence in adherence to screening would require time post-pandemic. Moreover, findings highlighted the potential progression of undetected precursor lesions to advanced cancer stages during non-screening periods, which may increase future cervical cancer morbidity and mortality. The findings underscore the importance of integrating cervical cancer screening messaging within broader health communication strategies to emphasise the significance of health interventions for overall well-being. This study recommends the adoption of more efficient screening methods, such as Human-Papillomavirus self-sampling to mitigate future disruptions in screening services, thereby guiding policymakers towards implementing best screening approaches.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132563","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}

{"title":"The Effects of Ghana's Free Maternal and Healthcare Policy on Maternal and Infant Healthcare: A Scoping Review.","authors":"Emefa Awo Adawudu, Kizito Aidam, Elisha Oduro, Dennis Miezah, Allison Vorderstrasse","doi":"10.1177/11786329241274481","DOIUrl":"10.1177/11786329241274481","url":null,"abstract":"<p><p>Ghana was the first sub-Saharan country to implement a National Health Insurance Scheme (NHIS). In furtherance of the nation's Universal Health Coverage (UHC) goals, in 2008, Ghana actualized plans for a Free Maternal Healthcare Policy (FMHCP) under the NHIS. The FMHCP was aimed at removing financial barriers to accessing maternal and neonatal health services. This scoping review was conducted to map out the literature on the effects of the FMHCP under the NHIS on the utilization of maternal and infant health care in Ghana. Six databases including CINAHL, PubMed, Sage Journals, Academic Search Premier, Science Direct, and Medline were searched in conducting this review with key terms. A total of 175 studies were retrieved after the search and finally, 23 articles were included in the study after various stages of elimination. The review followed the reporting guidelines stated in the Preferred Reporting Items for Systematic and Meta-analyses Extensions for Scoping Reviews (PRISMA-ScR). The results showed an overall increase in the utilization of antenatal care, facility-based delivery, and postnatal care services. However, certain systemic issues persist regarding access to maternal and infant healthcare. Socio-demographic inequalities such as maternal level of education, place of residence, and economic status likewise barriers such as the existence of out-of-pocket payments, long distance to health facilities, and poor distribution of resources in rural areas hindered the utilization of maternal and infant healthcare. The country faces significant work to eliminate existing barriers and inequalities to ensure that it achieves its UHC goals.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132564","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}

{"title":"Evaluating the Barriers and Facilitators to Implementing a Novel Referral System for Outpatient Geriatric Services: The Geri-Hub Quality Improvement Initiative.","authors":"Guillaume Lim Fat, Kristina M Kokorelias, Erica Foronda, Bindhu Sadasivan, Lindy Romanovsky","doi":"10.1177/11786329241274482","DOIUrl":"10.1177/11786329241274482","url":null,"abstract":"<p><strong>Background: </strong>In healthcare systems prioritizing care of older adults, resource limitations and escalating demand often impede access to outpatient specialized geriatric services.</p><p><strong>Objectives: </strong>This study, theoretically guided by the Consolidated Framework for Implementation Research (CFIR), aimed to explore barriers and facilitators in implementing a centralized \"Geri-Hub.\" The Geri-Hub is a centralized intake system established within 2 hospital systems to coordinate outpatient and community-based services for older adults, aiming to connect them with the most appropriate care in a timely manner.</p><p><strong>Methods: </strong>Qualitative insights were gathered from healthcare professionals at 2 academic institutions in the process of consolidating services. Through open-ended surveys and semi-structured interviews, we solicited feedback on referral management, waiting times, and overall work experiences.</p><p><strong>Results: </strong>Thirteen frequently referring providers and a cohort of 9 geriatricians, along with 4 administrators, contributed to the study. Geriatricians emphasized streamlined referrals, flexible scheduling for urgent cases, and a target wait time of 3 months. Administrators stressed standardized referral procedures, defined roles, and accessible referral information.</p><p><strong>Discussion: </strong>The findings underscored the need for straightforward referral processes, enhanced communication on referral statuses, and reduced wait times. Optimizing these processes could potentially mitigate resource utilization issues and improve patient outcomes in healthcare systems. This research highlights the critical role of timely access to geriatric services during transformative phases in healthcare delivery.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106748","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}

{"title":"Primary Healthcare Marketing: A Bibliometric Study and Research Agenda.","authors":"Piotr Rościszewski, Mariusz Stępień, Justyna Berniak-Woźny","doi":"10.1177/11786329241266648","DOIUrl":"https://doi.org/10.1177/11786329241266648","url":null,"abstract":"<p><p>The evolution of our lives has forced changes to the healthcare system and consequently established healthcare marketing as an essential element of health services, including primary health care (PHC). This article aims to analyze the size, structure, and dynamics of research on primary healthcare marketing to identify the main topics and research trends in this area. The authors conducted a bibliographic analysis based on the methods of performance analysis and scientific mapping. The bibliographical analysis covered 1981 publications selected from the Scopus database and was carried out with the use of the MS Excel and VOSviewer applications. The results were supplemented with an in-depth analysis of 34 publications selected based on bibliographic coupling analysis to determine key research trends and results, which increased the understanding of the research area. The conducted research proves that the issue of marketing in primary health care is rarely addressed by researchers, which translates into very limited research results and little impact on the decision-making process in this area. This research field requires much greater commitment, especially in the areas indicated in the future research agenda recommendations.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11359442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106749","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}