Journal of the Formosan Medical Association最新文献_第3页

Loss of resilience in Taiwan's pediatric care system after the COVID-19 pandemic COVID-19大流行后台湾儿科护理系统的恢复能力丧失。

IF 2.6 3区医学

Journal of the Formosan Medical Association Pub Date : 2024-11-01 DOI: 10.1016/j.jfma.2024.09.013

Jien-Wen Chien , Chi-Hsin Sally Chen , Yi-Jung Chen

{"title":"Loss of resilience in Taiwan's pediatric care system after the COVID-19 pandemic","authors":"Jien-Wen Chien , Chi-Hsin Sally Chen , Yi-Jung Chen","doi":"10.1016/j.jfma.2024.09.013","DOIUrl":"10.1016/j.jfma.2024.09.013","url":null,"abstract":"<div><div>During the COVID-19 pandemic, Taiwan's pediatric healthcare system faced its most severe shortage of pediatric residents in history. This review investigates the causes, consequences, and potential solutions to this shortage. Between 2020 and 2023, the recruitment rate of pediatric residents dropped by 27.3%, increasing workloads for attending pediatricians and may worsening health outcomes for pediatric patients. Compared to South Korea and Japan, Taiwan has the highest neonatal mortality rates and lowest life expectancy at birth. Additionally, Taiwan's National Health Insurance (NHI) pays pediatricians in hospitals half of what it pays those in local clinics, hindering the attraction of pediatric hospitalists. To sustain the pediatric healthcare system, the government could consider directly compensating pediatricians at clinic rates and transitioning to a capitation payment system. Systemic recommendations include increasing health expenditure as a percentage of gross domestic production (GDP) and amending the NHI Act to eliminate the global budget payment system. Managing the resulting increase in financial responsibility could involve raising tax revenue as a percentage of GDP. Implementing these measures could strengthen the pediatric healthcare system and prevent a collapse of pediatric inpatient care.</div></div>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289953","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}

引用次数: 0

Challenges and resilience of Taiwan's oral health care system after Covid-19 pandemic 台湾口腔保健系统在 Covid-19 大流行后面临的挑战和复原力。

IF 2.6 3区医学

Journal of the Formosan Medical Association Pub Date : 2024-11-01 DOI: 10.1016/j.jfma.2024.09.039

Ting-Chen Chen , Eddie Hsiang-Hua Lai , Fang-Yu Lo , Li-Jin Wang , Wender Lin

{"title":"Challenges and resilience of Taiwan's oral health care system after Covid-19 pandemic","authors":"Ting-Chen Chen , Eddie Hsiang-Hua Lai , Fang-Yu Lo , Li-Jin Wang , Wender Lin","doi":"10.1016/j.jfma.2024.09.039","DOIUrl":"10.1016/j.jfma.2024.09.039","url":null,"abstract":"<div><div>This paper examines the resilience of Taiwan's oral healthcare system in response to COVID-19, focusing on pre-pandemic conditions, pandemic impacts, and policy recommendations for future resilience. In Taiwan, oral diseases were prevalent, with 80.48% of adults affected by periodontitis in 2016, and 65.43% of 5-year-old children experiencing dental caries. Taiwan's National Health Insurance (NHI) covers over 99% of the population, providing comprehensive dental care. The global budget (GB) payment system, implemented in 1998, ensured financial stability. During the pandemic, dental visits in Taiwan decreased by 5.1% in 2021 compared to 2019. Despite reduced visits, the GB system maintained financial stability, mitigating financial impacts on healthcare institutions. The pandemic generally negatively affected healthcare workers' well-being, increasing resignation intentions. However, the number of practicing dentists in Taiwan remained stable from 2016 to 2022, with slight increases. Urban-rural disparities persisted, and workplace transitions increased, indicating greater mobility among dental professionals. To enhance resilience, the following recommendations are proposed: 1. Strengthen hierarchy of oral healthcare system: Balance dental resources across regions, and improve referrals between hospital and clinics; 2. Provide integrated patient-centered care: Integrate oral health into disease prevention and offer comprehensive services across all stages of life; 3. Integrate digital technology: Promote teledentistry and leverage Taiwan's strengths in information and communication technology (ICT).</div></div>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381117","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}

引用次数: 0

Estimating Taiwan's QALY league table for catastrophic illnesses: Providing real-world evidence to integrate prevention with treatment for resources allocation 估算台湾灾难性疾病的 QALY 排行榜：提供真实世界的证据，将预防与治疗结合起来进行资源分配。

IF 2.6 3区医学

Journal of the Formosan Medical Association Pub Date : 2024-11-01 DOI: 10.1016/j.jfma.2024.05.011

{"title":"Estimating Taiwan's QALY league table for catastrophic illnesses: Providing real-world evidence to integrate prevention with treatment for resources allocation","authors":"","doi":"10.1016/j.jfma.2024.05.011","DOIUrl":"10.1016/j.jfma.2024.05.011","url":null,"abstract":"<div><h3>Background/purpose</h3><div>Curative technologies improve patient's survival and/or quality of life but increase financial burdens. Effective prevention benefits all three. We summarize estimation methods and provide examples of how much money is spent per quality-adjusted life year (QALY) or life year (LY) on treating a catastrophic illness under a lifetime horizon and how many QALYs/LYs and lifetime medical costs (LMC) could be potentially saved by prevention.</div></div><div><h3>Methods</h3><div>We established cohorts by interlinkages of Taiwan's nation-wide databases including National Health Insurance. We developed methods to estimate lifetime survival functions, which were multiplied with the medical costs and/or quality of life and summed up to estimate LMC, quality-adjusted life expectancy (QALE) and lifetime average cost per QALY/LY for catastrophic illnesses. By comparing with the age-, sex-, and calendar year-matched referents simulated from vital statistics, we obtained the loss-of-QALE and loss-of-life expectancy (LE).</div></div><div><h3>Results</h3><div>The lifetime cost-effectiveness ratios of ventilator-dependent comatose patients, dialysis, spinal cord injury, major trauma, and cancers were US$ 96,800, 16,200–20,000, 5500–5,900, 3400–3,600, and 2900–11,900 per QALY or LY, respectively. The successful prevention of lung, liver, oral, esophagus, stomach, nasopharynx, or ovary cancer would potentially save US$ 28,000–97,000 and > 10 QALYs; whereas those for end-stage kidney disease, stroke, spinal injury, or major trauma would be US$ 55,000–300,000 and 10–14 QALYs. Loss-of-QALE and loss-of-LE were less confounded indicators for comparing the lifetime health benefits of different technologies estimated from real-world data.</div></div><div><h3>Conclusions</h3><div>Integration of prevention with treatment for resources allocation seems feasible and would improve equity and efficiency.</div></div>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076150","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}

引用次数: 0

Strengthening resilience and patient safety in healthcare institutions during the COVID-19 pandemic: Experience from a quasi-medical center 在 COVID-19 大流行期间加强医疗机构的应变能力和患者安全：一家准医疗中心的经验。

IF 2.6 3区医学

Journal of the Formosan Medical Association Pub Date : 2024-11-01 DOI: 10.1016/j.jfma.2024.09.035

Szu-Ying Chen , Shih-Hao Wang , Yi-Ming Wang , Yu-Wei Huang , Shu-Ching Chi

{"title":"Strengthening resilience and patient safety in healthcare institutions during the COVID-19 pandemic: Experience from a quasi-medical center","authors":"Szu-Ying Chen , Shih-Hao Wang , Yi-Ming Wang , Yu-Wei Huang , Shu-Ching Chi","doi":"10.1016/j.jfma.2024.09.035","DOIUrl":"10.1016/j.jfma.2024.09.035","url":null,"abstract":"<div><div>The COVID-19 global pandemic exposed healthcare system vulnerabilities, further endangering patient safety. This article explores perspectives on resilience and patient safety among healthcare workers using data from the Taiwan Patient Safety Culture Survey (TPSCS) and implementing Patient Safety Leadership Walkrounds (PSLWs) at E-Da Hospital. In 2021 and 2022, 1340 and 1114 staff members from clinical departments completed TPSCS questionnaires, respectively. 89 leaders from clinical departments participated in PSLWs in 2022. Among the four job categories, scores of Safety Attitude Questionnaire (SAQ) were lower among nurses and medical technicians, while perceptions of resilience and work-life balance were lowest among nurses. Between the two-year surveys, nurses exhibited significant decreases in SAQ in 2022 compared to 2021, while perceptions of work condition and work-life balance significantly declined among pharmacists. Resilience perception significantly decreased among all job categories except physicians during the pandemic. Mediation analyses showed teamwork climate, job satisfaction, management, work condition, and work-life balance were directly associated with safety climate, while resilience acts as a mediator, indirectly potentiating these relationships. Through PSLWs, we identified concerns about patient safety, including workforce, systems, processes, equipment, and work environment. Among these, workforce shortages and unsatisfactory pay emerged as the most pressing challenges. Strong leadership was recognized as a crucial factor in enhancing resilience and patient safety. This study suggests that TPSCS and PSLWs are worth regularly promoting among hospital institutions. Additionally, our findings highlight the urgency of healthcare organizations and governmental agencies to undertake policy reforms to improve healthcare workers’ well-being.</div></div>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406562","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}

引用次数: 0

Highlights. 亮点

IF 2.6 3区医学

Journal of the Formosan Medical Association Pub Date : 2024-10-31 DOI: 10.1016/j.jfma.2024.10.026

Jia-Horng Kao

引用次数: 0

Correspondence to comment on "Abnormal sleep patterns are associated with depressive symptoms in Chinese community-dwelling older adults". Correspondence to comment on "Abnormal sleep patterns are associated with depressive symptoms in Chinese community-dwelling older adults".

IF 2.6 3区医学

Journal of the Formosan Medical Association Pub Date : 2024-10-29 DOI: 10.1016/j.jfma.2024.10.019

Chuanjun Huang, Qi Guo

引用次数: 0

Comprehensive assessment and management of hypertension in elderly patients: Addressing frailty and target organ damage. 全面评估和管理老年高血压患者：应对虚弱和靶器官损伤。

IF 2.6 3区医学

Journal of the Formosan Medical Association Pub Date : 2024-10-29 DOI: 10.1016/j.jfma.2024.10.023

Tzu-Chieh Lin, Ye-Hsu Lu, Chia-Ter Chao, Shin-Jing Lin, Po-Sheng Wu, Ding-Cheng Chan, Hsiang-Chun Lee

引用次数: 0

Comment on "Abnormal sleep patterns are associated with depressive symptoms in Chinese community-dwelling older adults". 关于 "异常睡眠模式与中国社区老年人抑郁症状有关 "的评论

IF 2.6 3区医学

Journal of the Formosan Medical Association Pub Date : 2024-10-27 DOI: 10.1016/j.jfma.2024.10.016

Shuying Li, Ping Rao

引用次数: 0

Reply to comment on "Dexmedetomidine for enhanced recovery after non-intubated video-assisted thoracoscopic surgery". 回复关于 "右美托咪定促进非插管视频辅助胸腔镜手术后的恢复 "的评论。

IF 2.6 3区医学

Journal of the Formosan Medical Association Pub Date : 2024-10-26 DOI: 10.1016/j.jfma.2024.10.013

Ting-Fang Kuo, Man-Ling Wang, Ya-Jung Cheng, Jin-Shing Chen

引用次数: 0

Trends in volatile anesthetic sevoflurane and desflurane usage and its impact on carbon emissions: A six-year audit at National Taiwan University Hospital (2018-2023). 挥发性麻醉剂七氟醚和地氟醚的使用趋势及其对碳排放的影响：台湾大学医院六年审计（2018-2023）。

IF 2.6 3区医学

Journal of the Formosan Medical Association Pub Date : 2024-10-26 DOI: 10.1016/j.jfma.2024.10.021

Kuang-Cheng Chan, Shu-Yueh Cheng, Wei-Jen Chang, Tzu-Wei Chiu, Shou-Zen Fan, Ming-Hui Hung

引用次数: 0