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Must the ICMJE and COPE guidelines and/or recommendations be interpreted (and used) as voluntary advice or as mandatory rules? ICMJE和COPE指南和/或建议是否必须被解释(和使用)为自愿建议或强制性规则?
IF 6 3区 医学
Health Policy and Technology Pub Date : 2023-10-12 DOI: 10.1016/j.hlpt.2023.100817
Jaime A. Teixeira da Silva
{"title":"Must the ICMJE and COPE guidelines and/or recommendations be interpreted (and used) as voluntary advice or as mandatory rules?","authors":"Jaime A. Teixeira da Silva","doi":"10.1016/j.hlpt.2023.100817","DOIUrl":"https://doi.org/10.1016/j.hlpt.2023.100817","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"12 4","pages":"Article 100817"},"PeriodicalIF":6.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50197904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors affecting the use of magnetic resonance imaging in a Southern European region: a qualitative study 影响南欧地区磁共振成像使用的因素:一项定性研究
IF 6 3区 医学
Health Policy and Technology Pub Date : 2023-10-08 DOI: 10.1016/j.hlpt.2023.100816
Yolanda González-Rábago , Erika Valero , Paola Bully , Pedro Latorre , Begoña Fernandez-Ruanova
{"title":"Factors affecting the use of magnetic resonance imaging in a Southern European region: a qualitative study","authors":"Yolanda González-Rábago ,&nbsp;Erika Valero ,&nbsp;Paola Bully ,&nbsp;Pedro Latorre ,&nbsp;Begoña Fernandez-Ruanova","doi":"10.1016/j.hlpt.2023.100816","DOIUrl":"https://doi.org/10.1016/j.hlpt.2023.100816","url":null,"abstract":"<div><h3>Objectives</h3><p>The use of Magnetic Resonance Imaging (MRI) has increased significantly in recent years. Superior diagnostic capability and extension of criteria for the performance of MRI may explain this increase, but there are also non-clinical factors that influence doctors’ decisions. We aim to describe the views of doctors in the Basque Country (Spain) regarding factors affecting MRI orders.</p></div><div><h3>Methods</h3><p>We conducted a qualitative study using semi-structured interviews with doctors based on intentional sampling to cover a diverse range of interviewees according to personal and professional characteristics (sex, workplace, post of responsibility). We analyzed transcript content using an inductive approach.</p></div><div><h3>Results</h3><p>Factors identified by doctors were classified into three themes: 1) superior diagnostic capability of the MRI compared to other imaging modalities has favoured MRI use and inclusion in Clinical Practice Guidelines; 2) patient demands, owing to lower trust and acceptance of doctors’ judgment than to technology-based medicine, leads to patient-doctor relationships that result unnecessary MRI test; 3) structural or contextual aspects of the health system, such as excessive rotation of doctors or a lack of time to carry out a thorough patient examination, which disempower doctors and favour overuse.</p></div><div><h3>Conclusions</h3><p>Doctors identified non-clinical factors that affect MRI use and that lead to unintended consequences both for the healthcare system and for patients. We recommend an organizational approach to give doctors enough resources to overcome non-clinical factors that lead to excessive MRI orders in order to optimize its use.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"12 4","pages":"Article 100816"},"PeriodicalIF":6.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50197903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The opportunities and challenges of women's digital health: A research agenda 女性数字健康的机遇与挑战:研究议程
IF 6 3区 医学
Health Policy and Technology Pub Date : 2023-10-05 DOI: 10.1016/j.hlpt.2023.100814
Caroline A Figueroa , Josephine Sundqvist , Sunjoy Mathieu , Nasim Farrokhnia , Diane Nevin , Sarah Wamala Andersson
{"title":"The opportunities and challenges of women's digital health: A research agenda","authors":"Caroline A Figueroa ,&nbsp;Josephine Sundqvist ,&nbsp;Sunjoy Mathieu ,&nbsp;Nasim Farrokhnia ,&nbsp;Diane Nevin ,&nbsp;Sarah Wamala Andersson","doi":"10.1016/j.hlpt.2023.100814","DOIUrl":"https://doi.org/10.1016/j.hlpt.2023.100814","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"12 4","pages":"Article 100814"},"PeriodicalIF":6.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50197901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
E-Prescription: A practical application of information and communications technology in perspective of Bangladesh 电子处方:从孟加拉国的角度看信息和通信技术的实际应用
3区 医学
Health Policy and Technology Pub Date : 2023-10-01 DOI: 10.1016/j.hlpt.2023.100810
M. A. Khan, Md. Rabiul Islam, Asif Rahman, Afsana Mim, Rasel Ahmmed
{"title":"E-Prescription: A practical application of information and communications technology in perspective of Bangladesh","authors":"M. A. Khan, Md. Rabiul Islam, Asif Rahman, Afsana Mim, Rasel Ahmmed","doi":"10.1016/j.hlpt.2023.100810","DOIUrl":"https://doi.org/10.1016/j.hlpt.2023.100810","url":null,"abstract":"The healthcare management authorities are responsible for delivering convenient services to the patients. The traditional healthcare management system is quite old and impractical in many cases, including a physical visit. Additionally, the COVID-19 epidemic makes the existing system unattainable, which creates an uncomfortable situation for visiting doctor's chambers that is risky both for doctors and patients. An electronic-prescription (e-prescription) management system can switch the existing one to the online appointment and doctor consulting system. Many developed countries have already adopted such e-prescription management systems, although low-and-middle-income countries (LMICs) like Bangladesh are apathetic. So implementing e-prescription management systems in all countries, including Bangladesh, is the demand of time, especially when information and communication technologies (ICT) are at hand. We design, develop and test an ICT-based online doctor and patient management system utilizing the latest software and web development tools. In the developed e-prescription management system, the patient can visit their profile to make an appointment according to their need and doctor's availability. After that, the patient consults with the doctor based on the appointment's approval by the admin panel. Finally, the patient receives an online e-prescription and collects the medicine from a registered pharmacy with access to the online e-prescription. The e-prescription management system records patient history, including e-prescription, making handling patients easy. The proper use of the developed e-prescription management system will solve many existing problems of the existing healthcare management system, including many concerns that arise due to the advent of COVID-19.","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134934267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
VALIDATE approach on medication adequacy clinical decision support systems: Holistic assessment for optimal technology adoption 药物充足性临床决策支持系统的有效方法:最佳技术采用的整体评估
IF 6 3区 医学
Health Policy and Technology Pub Date : 2023-09-27 DOI: 10.1016/j.hlpt.2023.100811
Carla Fernández-Barceló , Elena Calvo-Cidoncha , Laura Sampietro-Colom
{"title":"VALIDATE approach on medication adequacy clinical decision support systems: Holistic assessment for optimal technology adoption","authors":"Carla Fernández-Barceló ,&nbsp;Elena Calvo-Cidoncha ,&nbsp;Laura Sampietro-Colom","doi":"10.1016/j.hlpt.2023.100811","DOIUrl":"https://doi.org/10.1016/j.hlpt.2023.100811","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;p&gt;Lately, Health Technology Assessment (HTA) has narrowed its scope to analyses of mainly clinical and economic benefits. Recent challenges emphasize the need for holistic assessments to obtain accurate recommendations for decision-making considering empirical facts and stakeholder's values. VALIDATE approach considers stakeholder's views and empirical facts allowing for more comprehensive HTAs. This study frames the assessment for clinical decision support systems (CDSS) using VALIDATE.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;A systematic review of the literature was conducted to gather evidence on the CDSS's effectiveness and published stakeholder perspectives. Considering the retrieved information, semi-structured interviews with stakeholders were conducted to uncover issues around CDSSs such as problem definition regarding the occurrence of medication errors, judgement of existing preventive methods and previous experiences with CDSSs, background theories regarding thoughts on future impact and personal beliefs, and barriers/facilitators for implementation.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;When including multi-stakeholder views, reasons different from the literature are shown to interfere with CDSS acceptance/implementation, such as: i) Occurrence of ME (no traceability of medication taken/poor patient empowerment), ii) Technology as a tool to prevent ME (insufficient if only implemented at one point-of-care), iii) Previous experiences with CDSSs (low CDSSs development due to drug prescription being lastly digitalized in hospitals) and iv) CDSSs metrics (data inputted should be measured to control CDSSs performance).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;Including multi-stakeholders views in scoping technology evaluation brings added value and new information for the assessment, resulting in more comprehensive assessment; otherwise, it can lead to inaccurate information resulting in inaccurate decisions on if, when and how to adopt CDSS.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Public Interest Summary&lt;/h3&gt;&lt;p&gt;Including varied stakeholders into health technology assessment provides a deeper understanding of what value can a technology bring in. The present study develops a framework to assess clinical decision support systems (CDSS) considering different stakeholders. They were interviewed to understand their perspective on different parts of the problem CDSSs try to solve (medication errors) and the solution itself (CDSSs). Some reasons on the interviews were different from the literature published so far, that are shown to hinder CDSS acceptance/implementation, such as: no traceability of medication taken/poor patient empowerment, CDSSs being insufficient if only implemented at one point-of-care, low CDSSs development due to drug prescription being lastly digitalized in hospitals and CDSS metrics (data inputted should be measured to control CDSSs performance). This approach can improve both implementation chances and posterior assessment of CDSSs.","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"12 4","pages":"Article 100811"},"PeriodicalIF":6.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50197902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Future challenges and opportunities for cancer screening in the COVID-19 era COVID-19时代癌症筛查的未来挑战和机遇
IF 6 3区 医学
Health Policy and Technology Pub Date : 2023-09-17 DOI: 10.1016/j.hlpt.2023.100808
Mojtaba Nouhi , Leon Bijlmakers , Zahra Goudarzi , Samira Alipour , Seyyed Mostafa Hakimzadeh , Pedram Nazari , Reza Jahangiri , Majid Heydari
{"title":"Future challenges and opportunities for cancer screening in the COVID-19 era","authors":"Mojtaba Nouhi ,&nbsp;Leon Bijlmakers ,&nbsp;Zahra Goudarzi ,&nbsp;Samira Alipour ,&nbsp;Seyyed Mostafa Hakimzadeh ,&nbsp;Pedram Nazari ,&nbsp;Reza Jahangiri ,&nbsp;Majid Heydari","doi":"10.1016/j.hlpt.2023.100808","DOIUrl":"10.1016/j.hlpt.2023.100808","url":null,"abstract":"<div><h3>Objectives</h3><p>The COVID-19 pandemic undermines health service provision and poses threats to health systems in general. This study aims to investigate the early and long-term effects of COVID-19 on cancer screening.</p></div><div><h3>Method</h3><p>We conducted a scoping review, in which we nested the Futures Wheel (FW) method and the Future Polygon (FP) method. PubMed, SCOPUS, and Web of Sciences databases were searched electronically to identify relevant studies published between 1 January 2020 and 25 July 2023. The FW method was applied to identify the early and long-term effects; the FP was applied during a focus group discussion with a group of experts with a view to estimating the lag time between COVID-19 and its effects on cancer screening.</p></div><div><h3>Results</h3><p>A total of 79 studies met the inclusion criteria. We identified 31 early effects and 26 long-term effects of COVID-19, and divided them into four clusters: screening centers, at-risk persons, screening methods, and clinical staff. The first long-term effects of COVID-19 involve a tendency to shift from hospital-based to home-based screening, accompanied by an acceleration in the application of remote screening methods and emerging psychological problems among clinical staff. This may result in an increase in the number of people with serious oncological conditions, more intensive use of advanced therapeutic interventions, higher expenditure and worsening of treatment outcomes.</p></div><div><h3>Conclusion</h3><p>The effects of COVID-19 on cancer screening and its long-term effects on cancer treatment and its outcomes are ominous. A redesign of cancer screening programs may be required so as to make them more flexible and resilient to external shocks.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"12 4","pages":"Article 100808"},"PeriodicalIF":6.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135348048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adapting evidence-informed peri-discharge complex interventions in reducing 30-day hospital readmissions for heart failure and COPD 采用循证出院期复杂干预措施,减少心力衰竭和慢性阻塞性肺病患者30天再入院率
IF 6 3区 医学
Health Policy and Technology Pub Date : 2023-09-16 DOI: 10.1016/j.hlpt.2023.100804
Claire CW Zhong , Charlene HL Wong , Chi-tim Hung , Eng-kiong Yeoh , Eliza LY Wong , Vincent CH Chung
{"title":"Adapting evidence-informed peri-discharge complex interventions in reducing 30-day hospital readmissions for heart failure and COPD","authors":"Claire CW Zhong ,&nbsp;Charlene HL Wong ,&nbsp;Chi-tim Hung ,&nbsp;Eng-kiong Yeoh ,&nbsp;Eliza LY Wong ,&nbsp;Vincent CH Chung","doi":"10.1016/j.hlpt.2023.100804","DOIUrl":"10.1016/j.hlpt.2023.100804","url":null,"abstract":"<div><h3>Objective</h3><p>To select and refine evidence-informed peri-discharge complex interventions(abbrev. <em>Interventions</em><span>) for reducing 30-day hospital readmissions among Heart Failure(HF) and COPD patients in Hong Kong public healthcare system context using GRADE Evidence to Decision(EtD) framework.</span></p></div><div><h3>Methods</h3><p>Two 18-participant panels were recruited to carry out a two-step process for both conditions. In Step 1, participants were invited to prioritize <em>Interventions</em> and suggest important combinations of <em>Interventions</em>. In Step 2, based on the priority lists, participants were invited to conduct a two-round Delphi study for generating consensus-based <em>Interventions</em> for reducing 30-day hospital readmissions. GRADE EtD framework was used to guide the decision-making process, taking into consideration of benefits, harms, values and preferences, equity, acceptability, and feasibility.</p></div><div><h3>Results</h3><p>Five out of ten <em>Interventions</em> reached positive consensus for HF, while six reached positive consensus for COPD. Case management, discharge planning, patient education, self-management, and telephone follow-up were common components, and were considered as core elements for reducing 30-day hospital readmissions among HF and COPD patients in Hong Kong. Preliminary implementation issues mainly included governance and leadership, financing, health workforce development, service access and readiness, as well as empowerment of patients and caregivers.</p></div><div><h3>Conclusions</h3><p>This study successfully applied the GRADE EtD framework for starting the adaptation process of complex interventions and established a list of local stakeholders-endorsed <em>Interventions</em> for reducing 30-day hospital readmissions for HF and COPD in Hong Kong. Before implementing and maintaining these endorsed <em>Interventions</em> at scale in local context, further research to improve intervention-context fit as well as piloting and evaluation is necessary.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"12 4","pages":"Article 100804"},"PeriodicalIF":6.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135348909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current evidence on the use of mHealth approaches in Sub-Saharan Africa: A scoping review 撒哈拉以南非洲使用移动医疗方法的当前证据:范围审查
IF 6 3区 医学
Health Policy and Technology Pub Date : 2023-09-16 DOI: 10.1016/j.hlpt.2023.100806
Genet Tadese Aboye , Martijn Vande Walle , Gizeaddis Lamesgin Simegn , Jean-Marie Aerts
{"title":"Current evidence on the use of mHealth approaches in Sub-Saharan Africa: A scoping review","authors":"Genet Tadese Aboye ,&nbsp;Martijn Vande Walle ,&nbsp;Gizeaddis Lamesgin Simegn ,&nbsp;Jean-Marie Aerts","doi":"10.1016/j.hlpt.2023.100806","DOIUrl":"10.1016/j.hlpt.2023.100806","url":null,"abstract":"<div><h3>Background</h3><p>Mobile health (mHealth) approaches are especially beneficial to Sub-Saharan Africa (SSA), which has a disproportionate disease burden and a scarcity of healthcare workers.</p></div><div><h3>Objective</h3><p>This study aims to assess the availability, stage, and targeted health issues of mHealth interventions in SSA and to identify the gaps.</p></div><div><h3>Methods</h3><p>The study employed a scoping review guided by Arksey and O'Malley's framework to explore the use of mHealth in SSA. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to report the review in a transparent and comprehensive manner. Articles published from 2000 to 2021 were searched in PUBMED, IEEE, SCOPUS, and Web of Science and evaluated with set of inclusion criteria. Data from the included publications were retrieved and synthesized.</p></div><div><h3>Results</h3><p>A total of 1020 articles were found. 59 of these have met the criteria for inclusion. The results show the implementation of mHealth interventions in 21 SSA nations. Only 1 (2%) mHealth interventions used a wearable sensor-based approach. 13 (22%) were SMS text-based interventions, 17 (29%) were app-based mHealth approaches, 18 (30%) were telemedicine-based approaches, and 10 (17%) were mixed approaches. HIV, cancer, and maternal and child health problems are the most commonly discussed health issues. Proof of concept, design and development, a pilot test were the frequently documented stages of mHealth interventions.</p></div><div><h3>Conclusion</h3><p>Less than half of SSA countries incorporate mHealth platforms, highlighting the need for further development. Integrating wearable based platforms for real-time monitoring of physiological parameters demands careful consideration.</p></div><div><h3>Public Interest Summary</h3><p>Mobile health (mHealth) technology is believed to be very beneficial for Sub-Saharan Africa (SSA) nations where there is a high disease burden but  inadequate healthcare system. Evidence-based data on the use and implementation of mHealth systems is needed to trace implementation and fill existing gaps. We performed a scoping review to determine the current availability, use, and stage of mHealth interventions and targeted health services in SSA. 21 SSA nations made (few) attempts in designing and implementing of mHealth systems. HIV, cancer, and maternal and child health are some of the health services among others. Though few large-scale implementations were reported, most interventions are at an early stage. mHealth solution should be designed to be both economical and simple to use to increase its uptake and incorporate wearables for real-time monitoring of physiological parameters.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"12 4","pages":"Article 100806"},"PeriodicalIF":6.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883723000825/pdfft?md5=9370a35f12f646886dd0c8ab3ead2271&pid=1-s2.0-S2211883723000825-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135347253","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
Cost-of-illness and associated factors among persons with type 2 diabetes: Findings from a tertiary care center in South India 2型糖尿病患者的疾病费用和相关因素:来自印度南部三级保健中心的调查结果
IF 6 3区 医学
Health Policy and Technology Pub Date : 2023-09-15 DOI: 10.1016/j.hlpt.2023.100807
Jeby Jose Olickal , Palanivel Chinnakali , BS Suryanarayana , Ganesh Kumar Saya , Kalaiselvan Ganapathy , DKS Subrahmanyam
{"title":"Cost-of-illness and associated factors among persons with type 2 diabetes: Findings from a tertiary care center in South India","authors":"Jeby Jose Olickal ,&nbsp;Palanivel Chinnakali ,&nbsp;BS Suryanarayana ,&nbsp;Ganesh Kumar Saya ,&nbsp;Kalaiselvan Ganapathy ,&nbsp;DKS Subrahmanyam","doi":"10.1016/j.hlpt.2023.100807","DOIUrl":"10.1016/j.hlpt.2023.100807","url":null,"abstract":"<div><h3>Objective</h3><p>Our aim was to estimate the cost of illness (COI) from the patient's perspective among individuals with type 2 diabetes (PWDs) attending a public tertiary care center in southern India.</p></div><div><h3>Methods</h3><p>This cross-sectional analytical study included PWDs on treatment for at least one year. Interviews captured direct medical costs (hospitalization, tests, medications), direct non-medical costs (meals, travel), and indirect costs (wage loss). Median regression analyses examined factors associated with total COI.</p></div><div><h3>Results</h3><p>Of total 1002 PWDs included<strong>,</strong> the mean (SD) age was 56 (12) years. Majority were males and from rural areas. One-third had diabetes for more than ten years, half were on insulin therapy, and more than half had comorbidities. Median (IQR) reported household income was US$637 (US$318–US$1115)/year. The Median (IQR) annual COI was US$39 (US$20-US$67), of which 73% was direct costs with a median of US$28. Majority of the participants (<em>n</em>=818, 81.6%) spent on laboratory investigations as direct medical costs and travel (<em>n</em>=1000, 99.8%) as direct non-medical costs. Travel costs represented the largest share of total COI (41%), followed by wage loss. Median annual COI was higher for males, salaried PWDs, and PWDs on insulin.</p></div><div><h3>Conclusions</h3><p>Our findings highlight that PWDs attending a public tertiary care center bear significant out-of-pocket expenses for diabetes care, primarily due to direct costs. Particularly, travel costs were identified as the most substantial component of the total COI.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"12 4","pages":"Article 100807"},"PeriodicalIF":6.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135346696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enterprise architecture requirements for standardising digital health in Uganda's health system 乌干达卫生系统中数字健康标准化的企业架构要求
IF 6 3区 医学
Health Policy and Technology Pub Date : 2023-09-15 DOI: 10.1016/j.hlpt.2023.100805
Joseph Wamema, Andrew Alunyu, Mercy Amiyo, Josephine Nabukenya
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