Public Health eJournal最新文献

{"title":"The Increasing Risk of Mortality in Breast Cancer: A Socioeconomic Analysis Between Countries","authors":"M. Coccia","doi":"10.1453/JSAS.V6I4.1972","DOIUrl":"https://doi.org/10.1453/JSAS.V6I4.1972","url":null,"abstract":"Abstract. The risk of mortality in breast cancer among women is a critical health issue worldwide. Scholars argue that breast cancer mortality rates have decreased in many advanced countries overall. However, about 50% of world population in 2017 was in poor and developing countries (more than 3,652 million with 50.24% female) and breast cancer mortality rates differ among nations also because of socioeconomic factors. This study investigates, at global level, breast cancer mortality in association with breast cancer incidence and some factors of socioeconomic ecosystem between poor and rich countries, to explain trends that can be used to gain insights into country-level “best practices” for health improvement. Global data regarding breast cancer incidence and mortality as the age standardized rate per 100,000 population in 78low-to-middle income countries (LMICs), 50 upper-to-middle-income countries (UMICs) and 63 high income countries (HCIs) were obtained from IARC/WHO for 2012 and 2018. Data regarding GDP per capita, population and mammography (MMG) were obtained from World Bank, United Nations and WHO. Data, transformed in log scale to have normal distribution, were analyzed with descriptive statistics, partial correlation, regression analyses and paired-Samples T Test procedure to assess the statistical significance of increase or decrease of mortality and incidence in breast cancer from 2012 to 2018.Results reveal that a 1% higher level of breast cancer incidence, increases the expected mortality by 0.79% ( p-value < .001) in LMICs, by 0.50% ( p-value <.001) in UMICs and by 0.31% ( p-value < .008) in HICs. These results, confirmed by other analyses here, seem to suggest that breast cancer mortality is increasing over time worldwide in rich and in particular developing countries. The global analysis here reveals that though an improvement of wealth and wellbeing worldwide, the risk of incidence and mortality in breast cancer is increasing. This result suggests that situational factors in the ecosystem of countries support the growing increase and mortality of breast cancer that improvement in healthcare and medicine of the last 40 years are not been sufficient to slowdown. These conclusions need for much more detailed research to investigate into the interaction between factors of socioeconomic systems, health improvement, and breast cancer causes. Keywords. Breast cancer, Wealth of nations, Epidemiology. JEL. I14, I15, I18, I39, O10, O3, O55, Q50.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115712138","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}

{"title":"Palliative Care in Solomon Islands","authors":"J. Spratt, G. Spencer","doi":"10.2139/ssrn.3299814","DOIUrl":"https://doi.org/10.2139/ssrn.3299814","url":null,"abstract":"This Discussion Paper presents the findings of initial research into palliative care in Solomon Islands. This research sought to explore the current palliative care policy and service landscape in Solomon Islands, existing strengths to expand upon, and opportunities for future action and research. The result here is the first published exploration of palliative care in Solomon Islands. Following a literature review, data collection involved documentary analysis and interviews with policy-makers, health professionals and other community stakeholders. All interviewees agreed that there is a need to pay more attention to palliative care in Solomon Islands. Key areas for future action include: supporting health professionals to have difficult conversations with people about their prognosis and what to expect during the dying process; training for health professionals in pain assessment and management; improving systems and guidelines, particularly referral systems and access to morphine; and expanding support for families caring for loved ones dying at home. Future research opportunities exist in understanding: families’ and patients’ needs; cultural approaches to care-giving, pain and death; the role of traditional healers; how to increase health literacy; the costs and savings associated with palliative care provision; and the knowledge, attitudes and behaviours of health professionals. An examination of the opiate analgesic system is a pressing research priority. We conclude with recommendations for donors regarding how they could support future action and research.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124046378","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}

{"title":"When Less Is More: Can Reduced Health Monitoring Improve Patient Behavior?","authors":"Fernanda Marquez-Padilla","doi":"10.2139/ssrn.3354745","DOIUrl":"https://doi.org/10.2139/ssrn.3354745","url":null,"abstract":"Mexico's largest healthcare provider recently began issuing automatic-re ll prescriptions to stable hypertensive patients, thus reducing the frequency of health monitoring from 30- to 90-day intervals. Exploiting this change, I find that lower monitoring implies no drawbacks in health outcomes and actually improves an important health behavior: medication adherence. The number of days when patients are out of medication between fillings falls by 2.6 days -- an improvement in adherence of 7.5%. Furthermore, patients appear to value being on a low-frequency regime as they improve adherence to remain on it, suggesting that lower monitoring could be used as a \"reward\" to promote healthy behaviors.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121141111","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}

{"title":"Implications of Outbound Medical Tourism on Public Health Care Development in Nigeria","authors":"Ibrahim Orekoya, O. Oduyoye","doi":"10.19044/ESJ.2018.V14N30P353","DOIUrl":"https://doi.org/10.19044/ESJ.2018.V14N30P353","url":null,"abstract":"Medical tourism is the practice of patients travelling out of their country of origin or residence for the purpose of getting access to medical care services abroad. Outbound medical tourism is a phenomenon in Nigeria thereby contributing to the growth of the health care industry in destination countries. The paper examines the implications of outbound medical tourism on public health care development in Nigeria and reinforces the need for the Federal Government of Nigeria to restructure and reposition the health sector in the country towards effective and efficient health service delivery. The study employs secondary source of data. Public administrators and health care practitioners concerned about transforming Nigeria into a centre of medical tourist attraction may find it suitable to start by examining the issues raised in this study to initiate a good policy framework for the health sector. The study concludes that huge investment in the health sector can drastically reduce outbound medical tourism, make health care services affordable to all Nigerians and utilising foreign exchange to develop other relevant sectors of the Nigerian economy.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133856917","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}

{"title":"Linking Dynamic Capabilities and Healthcare Innovations: A Case Study Approach","authors":"Saravana Govindasamy, S. Wattal","doi":"10.2139/ssrn.3242224","DOIUrl":"https://doi.org/10.2139/ssrn.3242224","url":null,"abstract":"This study explores the relationship between dynamic capabilities and different types of innovations in healthcare industry. It utilizes a case study approach by conducting semi-structured interviews with clinicians and hospital administrators from two types of hospitals—academic and community. The main findings are: 1) the learning, coordinating, and integrating capabilities are associated with product/service and process innovations in academic hospitals; 2) the learning and integrating capabilities are associated with product/service and process innovations in community hospitals; 3) the barrier internal resources contention act as a moderator between the dynamic capabilities and innovations. This paper concludes by outlining propositions for additional research that would contribute to a more complete understanding of relationship between dynamic capabilities and different types of innovations in hospitals setting.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130802676","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}

{"title":"Who Is an Efficient and Effective Physician? Evidence From Emergence Medicine","authors":"S. Saghafian, Raha Imanirad, S. Traub","doi":"10.2139/ssrn.3227873","DOIUrl":"https://doi.org/10.2139/ssrn.3227873","url":null,"abstract":"Improving the performance of the healthcare sector requires an understanding of the effectiveness and efficiency of care delivered by providers. Although this topic is of great interest to policymakers, researchers, and hospital managers, rigorous methods of measuring effectiveness and efficiency of care delivery have proven elusive. Through Data Envelopment Analysis (DEA), we make use of evidence from care delivered by emergency physicians, and develop scores that gauge physicians' performance in terms of effectiveness and efficiency. In order to validate our DEA scores, we independently use various Machine Learning (ML) algorithms, including Support Vector Machines (SVM), K-Nearest Neighbors (KNN), Classification and Regression Trees (CART), Random Forest (RF), a Generalized Linear Model (GLM), and Least Absolute Shrinkage and Selection Operator (LASSO). After validating our DEA scores via comparison with predictions made by these algorithms, we make use of them to identify the distinguishing behaviors of highly effective and efficient physicians. We find that highly effective physicians order less tests compared to their peers and maintain their effectiveness when working under high workloads. We also observe that highly efficient physicians order less tests on average and become even more efficient during high-volume shifts. Importantly, our results indicate a statistically significant positive relationship between a physician's effectiveness and efficiency scores suggesting that, contrary to conventional wisdom, effectiveness and efficiency in care delivery should be viewed as compliments not substitutes. In addition, we find that effectiveness is lower among physicians who have higher job tenure or average test order count. Efficiency, however, is lower among physicians with less experience (measured in number of years after graduation from medical school) or high average test order count. Furthermore, our results indicate an increase in a physician's average efficiency and a decrease in his/her average effectiveness when faced with high workloads. Finally, we find evidence of peer influence on a focal physician's effectiveness and efficiency, which suggests an opportunity to improve system performance by taking physician characteristics into account when determining the set of physicians that should be scheduled during the same shifts.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121291892","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}

{"title":"Cleaning for Your Life: How a Medical Revolution Swept Into Canadian Homes Between 1854 and 1898","authors":"N. Cooke","doi":"10.2139/ssrn.3203876","DOIUrl":"https://doi.org/10.2139/ssrn.3203876","url":null,"abstract":"The last half of the nineteenth century constituted a medical revolution as scientists identified agents of disease. This study looks specifically to Canadian household manuals, bookended by the watershed publications of Catharine Parr Traill in 1854 and Adelaide Hoodless in 1898, to identify what knowledge emerging from the medical revolution known as the construction of germ theory makes its way to Canadian cookbook authors and, in turn, to Canadian homes. In doing so, it also sheds first light on some of Canada's early cookbooks, which have to date received deserved bibliographical attention but not yet close analytical scrutiny.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"236 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114235527","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}

{"title":"The 19th Century Net Nutrition Transition from Free to Bound Labor: A Difference-in-Decompositions Approach","authors":"S. Carson","doi":"10.2139/ssrn.3172005","DOIUrl":"https://doi.org/10.2139/ssrn.3172005","url":null,"abstract":"The body mass index (BMI) reflects current net nutrition and health during economic development. This study introduces a difference-in-decompositions approach to show that although 19th century African-American current net nutrition was comparable to working class whites, it was made worse-off with the transition to free-labor. BMI reflects net nutrition over the life-course, and like stature, slave children’s BMIs increased more than whites as they approached entry into the adult slave labor force. Agricultural worker’s net nutrition was better than workers in other occupations but was worse-off under free-labor and industrialization. Within-group BMI variation was greater than across-group variation, and white within-group variation associated with socioeconomic status was greater than African-Americans.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130115498","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}

{"title":"Medical Malpractice: How Legal Liability Affects Medical Decisions","authors":"P. Bertoli, V. Grembi","doi":"10.2139/ssrn.3014555","DOIUrl":"https://doi.org/10.2139/ssrn.3014555","url":null,"abstract":"In health care, overuse and underuse of medical treatments represent equally dangerous deviations from an optimal use equilibrium and arouses concerns about possible implications for patients' health, and for the healthcare system in terms of both costs and access to medical care. Medical liability plays a dominant role among the elements that can affect these deviations. Therefore, a remarkable economic literature studies how medical decisions are influenced by different levels of liability. In particular, identifying the relation between liability and treatments selection, as well as disentangling the effect of liability from other incentives that might be in place, is a task for sound empirical research. Several studies have already tried to tackle this issue, but much more needs to be done. In the present chapter, we offer an overview of the state of the art in the study of the relation between liability and treatments selection. First, we reason on the theoretical mechanisms underpinning the relationship under investigation by presenting the main empirical predictions of the related literature. Second, we provide a comprehensive summary of the existing empirical evidence and its main weaknesses. Finally, we conclude by offering guidelines for further research.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129693608","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}

{"title":"A Study on Growth and Development of Health Insurance in India in the Post Privatization Era","authors":"J. Rath","doi":"10.29121/granthaalayah.v5.i3.2017.1783","DOIUrl":"https://doi.org/10.29121/granthaalayah.v5.i3.2017.1783","url":null,"abstract":"Health Insurance in India emerges in the year 1999 with the introduction of IRDA bill in the floor of Parliament. In the post-privatization era, health insurance segment developed slowly and steadily. The penetration of insurance sector in Non-Life insurance is kept on increasing since 2001. In order to portray the journey of health insurance sector in India, it is required to show the growth and development of this sector in the country. The present study is intended to evaluate the growth and development of the health insurance sector in India in the post-privatization era. Data are collected mainly from secondary sources. Such data are analyzed and represented suitable through the help of tables, diagrams and charts. From the study, it is concluded that there is a significant upward trend in the growth of health insurance industry in India both at public and private sector after privatization. If this trend continues by keeping other factors constant, then the health insurance business would touch to Rs 20000 crores in the financial year 2016-17 contributed at least 60% by public sector and rest 40% by both private insurers and standalone health insurers.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130545928","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}