Frontiers in Public Health最新文献

{"title":"Knowledge, attitudes, and practices among the general community population toward heatstroke","authors":"Yangfeng Xu, Jianping Chen, Jinkang Du, YunYing Jin","doi":"10.3389/fpubh.2024.1373025","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1373025","url":null,"abstract":"Heatstroke (HS) is a life-threatening condition resulting from thermal injury within the body, and it is associated with a significantly high mortality rate. This study aimed to assess the knowledge, attitudes and practices (KAP) among the general community population toward heatstroke.The web-based cross-sectional study was conducted between September 2023 and October 2023 at the Emergency Department of Dongyang People's Hospital. A self-designed questionnaire was developed to collect demographic information of the general community population and to assess their knowledge, attitudes and practices toward heatstroke.A total of 1,356 valid questionnaires were collected. Among the participants, 875 (64.53%) were female, and 496 (36.58%) had regular exercise. The mean knowledge, attitudes and practices scores were 12.73 ± 1.42 (possible range: 0–14), 33.74 ± 2.91 (possible range: 8–40) and 34.65 ± 5.30 (possible range: 8–40), respectively. The structural equation model demonstrated that education had direct effects on knowledge (β = 0.017, p < 0.001), attitudes (β = 0.123, p < 0.001), and practices (β = −0.094, p < 0.001). Moreover, knowledge had direct effects on attitudes (β = 1.920, p < 0.001), and attitudes had direct effects on practices (β = 0.642, p < 0.001).The findings revealed that the general community population have sufficient knowledge, active attitudes and proactive practices toward the heatstroke. However, there is still room for improvement and it is necessary to develop and implement educational initiatives and interventions designed to further enhance their KAP toward heatstroke.","PeriodicalId":510753,"journal":{"name":"Frontiers in Public Health","volume":"4 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099993","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":"Assessment of knowledge, attitudes, and practices regarding cardiovascular diseases (CVDs) among older individuals of rural Bangladesh: findings from a face-to-face interview","authors":"Abu Bakkar Siddique, Md. Shohag Hosen, Hasna Akter, Syed Mujakkir Hossain, Md. Al Mamun","doi":"10.3389/fpubh.2024.1336531","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1336531","url":null,"abstract":"Cardiovascular diseases (CVDs) stand as the foremost contributor to global mortality, claiming roughly 17.9 million lives each year, constituting 32.1% of total fatalities. Their impact is notably profound in economies such as Bangladesh, exacting a substantial economic burden. Consequently, grasping the landscape of knowledge, attitudes, and practices is essential for timely identification and prevention strategies.This cross-sectional study, carried out between January and May 2023 in the rural regions of Zirani, Savar Upazila, Dhaka, Bangladesh, utilized convenient sampling and conducted face-to-face interviews using a semi-structured questionnaire. It encompassed socio-demographic factors, as well as knowledge, attitudes, and practices concerning CVDs. Data analysis employed descriptive statistics, chi-square tests, and regression analyses, utilizing both the R programming language and SPSS (Version 26).A total of 424 participants aged 60 years and above were included. The majority were male (60.8%), and the mean age was 71.21 ± 9.21 years, 57.3% were between 60 and 70 years old. Factors such as education, monthly family income, high blood pressure, diabetes, and non-smoking. Were significantly associated with higher knowledge, attitudes and practices scores.This study illuminates CVD-related KAP among rural Older Individuals in Bangladesh, revealing significant associations between factors such as education, monthly family income, high blood pressure, and non-smoking, with higher scores in knowledge, attitudes, and practices regarding cardiovascular health. These insights underscore the importance of addressing socio-economic factors and health behaviors in developing targeted interventions for the prevention and management of cardiovascular diseases in this demographic.","PeriodicalId":510753,"journal":{"name":"Frontiers in Public Health","volume":"70 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101912","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":"Large language models in physical therapy: time to adapt and adept","authors":"Waqar M. Naqvi, Summaiya Zareen Shaikh, Gaurav V Mishra","doi":"10.3389/fpubh.2024.1364660","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1364660","url":null,"abstract":"Healthcare is experiencing a transformative phase, with artificial intelligence (AI) and machine learning (ML). Physical therapists (PTs) stand on the brink of a paradigm shift in education, practice, and research. Rather than visualizing AI as a threat, it presents an opportunity to revolutionize. This paper examines how large language models (LLMs), such as ChatGPT and BioMedLM, driven by deep ML can offer human-like performance but face challenges in accuracy due to vast data in PT and rehabilitation practice. PTs can benefit by developing and training an LLM specifically for streamlining administrative tasks, connecting globally, and customizing treatments using LLMs. However, human touch and creativity remain invaluable. This paper urges PTs to engage in learning and shaping AI models by highlighting the need for ethical use and human supervision to address potential biases. Embracing AI as a contributor, and not just a user, is crucial by integrating AI, fostering collaboration for a future in which AI enriches the PT field provided data accuracy, and the challenges associated with feeding the AI model are sensitively addressed.","PeriodicalId":510753,"journal":{"name":"Frontiers in Public Health","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100559","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":"Knowledge, attitude, and practice toward ultrasound screening for breast cancer among women","authors":"Shaozhong Liu, Shukai Zheng, Mengzhen Qin, Yifeng Xie, Kun Yang, Xiaozhen Liu","doi":"10.3389/fpubh.2024.1309797","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1309797","url":null,"abstract":"Several obstacles can hinder breast cancer screening. This study aimed to investigate the knowledge, attitude, and practice (KAP) toward ultrasound screening for breast cancer in women.This cross-sectional study recruited women who visited the breast specialist clinic of Zhongshan City People’s Hospital (a tertiary hospital) between August 2022 and April 2023 through convenience sampling. KAP scores ≥70% were considered adequate.This study enrolled 501 participants. The mean knowledge, attitude, and practice levels were 8.56 ± 1.81/12 (possible range 0–12, 71.33%), 29.80 ± 2.71 (possible range 8–40, 74.50%), and 32.04 ± 3.09 (possible range 8–40, 80.10%). Senior high school education (vs. junior high school and below, coefficient = 1.531, 95%CI: 1.013–2.312, p = 0.044), bachelor’s education and above (vs. junior high school and below, coefficient = 5.315, 95%CI: 3.546–7.966, p < 0.001), housewife or unemployed (vs. employed, coefficient = 0.671, 95%CI: 0.466–0.966, p = 0.032), and a history of breast ultrasound (vs. no, coefficient = 1.466, 95%CI: 1.121–1.917, p = 0.005) were independently and positively associated with knowledge. Knowledge (coefficient = 1.303, 95%CI: 1.100–1.544, p = 0.002) and monthly income >10,000 (vs. <5,000, coefficient = 4.364, 95%CI: 1.738–10.956, p = 0.002) were independently and positively associated with attitude. Only attitude (coefficient = 1.212, 95%CI: 1.096–1.340, p < 0.001) was independently and positively associated with the practice. A structural equation modeling (SEM) analysis was used to estimate causality among KAP dimensions, showing that knowledge directly influenced attitude (β = −1.090, p = 0.015), knowledge did not directly influence practice (β = −0.117, p = 0.681) but had an indirect influence (β = 0.826, p = 0.028), and attitude directly influenced practice (β = −0.757, p = 0.016).Women in Zhongshan City had good knowledge, favorable attitudes, and active practice toward breast ultrasound screening for breast cancer. Women’s characteristics associated with a poorer KAP were identified, allowing for more targeted interventions.","PeriodicalId":510753,"journal":{"name":"Frontiers in Public Health","volume":"1 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101088","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":"Association of prenatal and postnatal exposure to air pollution with clinically diagnosed attention deficit hyperactivity disorder: a systematic review","authors":"Jinzhu Zhao, Tianyi He, Feng Wang, Wei Liu","doi":"10.3389/fpubh.2024.1396251","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1396251","url":null,"abstract":"Attention deficit hyperactivity disorder (ADHD), a prevalent neurodevelopmental disorder in children, originates from a multifaceted interplay of genetic, neurological, and environmental factors. Recent studies have increasingly concentrated on environmental determinants, notably air pollution, and their impact on the risk of developing ADHD. Additionally, previous research has often conflated clinically diagnosed ADHD cases with instances of mere ADHD-like symptoms, a methodology that can introduce bias and obscure the true relationship between environmental factors and ADHD. To address this oversight, our systematic review meticulously investigates the relationship between both prenatal and postnatal exposures to particular air pollutants and strictly clinically diagnosed ADHD. Our comprehensive review encompassed 801 studies from PubMed, Cochrane Library, Web of Science, and Embase databases, out of which eight met our rigorous inclusion criteria. The Newcastle-Ottawa Scale (NOS) was utilized to gauge quality and bias. Our review found substantiated the connection between prenatal exposure to PM2.5 and NOx and a heightened risk of ADHD, while exposure to PM10 during the prenatal stage was not associated with ADHD. These findings hint at varied health impacts from different particulate matters and the prospect of gender-specific susceptibilities to such exposures. We also identified an association between postnatal exposure to PM2.5, PM10, and NO2 and an increased ADHD risk, underlining the potential neurodevelopmental harms from early exposure to these pollutants. These relationships, seemingly intricate and potentially dose-dependent, underscore the need for more detailed scrutiny. The unique value of our review is in its detailed exploration of the association between specific air pollution exposures and clinically diagnosed ADHD. Our findings offer much-needed clarity in this complex domain and emphasize the importance of future research to standardize exposure and outcome metrics, probe potential mechanisms, and reduce bias and heterogeneity.","PeriodicalId":510753,"journal":{"name":"Frontiers in Public Health","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102162","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 association between children’s exposure to pesticides and asthma, wheezing, and lower respiratory tract infections. A systematic review and meta-analysis","authors":"A. Keleb, Chala Daba, Lakew Asmare, Fekade Demeke Bayou, Mastewal Arefaynie, Anissa Mohammed, Abiyu Abadi Tareke, Natnael Kebede, Yawkal Tsega, Abel Endawkie, Shimels Derso Kebede, Kaleab Mesfin Abera, Eyob Tilahun Abeje, Ermias Bekele Enyew","doi":"10.3389/fpubh.2024.1402908","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1402908","url":null,"abstract":"Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children.A comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins I2 statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique.A total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14–1.35) with extreme heterogeneity (I2 = 81%, p < 0.001). Exposure to pesticides increased the odds of developing wheezing among children by 34% (OR = 1.34, 95% CI: 1.14–1.57), with high heterogeneity (I2 = 79%, p < 0.001) and also increased the risk of developing lower respiratory tract infection by 79% (OR = 1.79, 95% CI: 1.45–2.21) with nonsignificant low heterogeneity (I2 = 30%, p-value = 0.18).This meta-analysis provided valuable evidence supporting the association between childhood asthma, wheezing, and lower respiratory tract infection with pesticide exposure. The findings would contribute to a better understanding of the estimate of the effect of pesticide exposure on respiratory health in children and inform evidence-based preventive strategies and public health interventions.","PeriodicalId":510753,"journal":{"name":"Frontiers in Public Health","volume":"14 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099462","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":"Assessing the impact of annual health screenings in identifying noncommunicable disease risk factors within Qatar’s primary health care corporation Qatari registered population","authors":"S. Al-Abdulla, Ahmad Haj Bakri, Mariama Mansaray, M. Al-Kuwari","doi":"10.3389/fpubh.2024.1305636","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1305636","url":null,"abstract":"Noncommunicable diseases (NCDs) are a significant global health burden, including in Qatar, where cardiovascular diseases cause mortality. This study examines the outcomes of the annual health checkup implemented by the Primary Health Care Corporation (PHCC) in Qatar in detecting NCDs risk factors among Qataris aged 18+ years.A cross-sectional study design was implemented to calculate the prevalence of behavioural and metabolic NCDs risk factors among Qataris who underwent annual health checkups between 2017 and 2019. Data on age, gender, tobacco consumption, height, weight, blood pressure, glycated haemoglobin (HbA1c), and cholesterol levels were extracted from electronic medical records.In 2019, Qatar experienced an 80% rise in Annual Health checkups attendance compared to 2017. Tobacco use fluctuated between 11.79 and 12.91%, peaking at 35.67% among males in 2018. Qataris with elevated blood pressure dropped from 29.44% in 2017 to 18.52% in 2019. Obesity decreased from 48.32 to 42.29%, more prevalent in females. High HbA1c levels reduced from 13.33 to 8.52%, while pre-diabetic levels rose from 21.1 to 25.52%. High cholesterol ranged from 7.31 to 9.47%. In a regression analysis, males had 2.28 times higher odds of elevated blood pressure and 1.54 times higher odds of high HbA1c, with a 0.68 lower odds of obesity compared to females. Ages 36 and above had 2.61 times higher odds of high cholesterol compared to younger age groups.The annual health screening has shown promising results in detecting and addressing NCDs risk factors among Qataris. The attendance rate has increased over the three-year period, and there has been a decrease in the prevalence of elevated blood pressure, obesity, and high HbA1c levels. However, tobacco consumption and pre-diabetic levels remain significant concerns. These findings can guide the implementation of tailored preventative and curative services to improve the health and well-being of the Qatari population.","PeriodicalId":510753,"journal":{"name":"Frontiers in Public Health","volume":"29 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141107519","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":"Relationship between oral health literacy and oral health-related quality of life in patients with bladder cancer","authors":"Fatemeh Babadi, Ahmad Ahmadi, Mohsen Sarkarian, Maria Cheraghi","doi":"10.3389/fpubh.2024.1385443","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1385443","url":null,"abstract":"Bladder cancer is one of the most important diseases that threatens oral and dental health due to its nature and side effects of chemotherapy. Therefore, the present study was conducted to investigate the relationship between oral health literacy and oral health-related quality of life in patients with bladder cancer.This cross-sectional study was conducted on patients with bladder cancer in Ahvaz, 2023. Subjects were selected randomly from the patients those were registered in Cancer Registry Center in Ahvaz Jundishapur University of Medical sciences and invited to Golestan Hospital for data collection through clinical evaluation, the Oral Health Literacy Adult Questionnaire (OHL-AQ), and the Oral Health Impact Profile-14 (OHIP-14PER) questionnaire. The data were analyzed using Pearson correlation coefficient, independent t-test, and analysis of variance.The number of participants was 194. The mean oral health literacy in patients with bladder cancer was 9.74 ± 2.39, indicating insufficient oral health literacy. A significant association was observed between OHL-AQ and DMFT index, but no significant association was found between OHIP-14PER and DMFT index. Furthermore, a significant correlation was found between OHL-AQ and OHIP-14PER (r = −0.68) in patients with bladder cancer.Based on the findings of the present study, all dimensions of oral health literacy have correlation with the oral health-related quality of life in patients with bladder cancer. Therefore, adopting oral health behaviors and increasing oral health literacy can be the best way to improve the oral health-related quality of life to among patients with bladder cancer.","PeriodicalId":510753,"journal":{"name":"Frontiers in Public Health","volume":"40 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108001","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":"Psychological health status of Chinese university students: based on Psychological Resilience Dynamic System Model","authors":"Junqiang Fan, Yuxin Huang, Fei Yang, Yongjie Cheng, Jingjing Yu","doi":"10.3389/fpubh.2024.1382217","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1382217","url":null,"abstract":"The mental health of unverisity students is influenced by diverse factorsis multifaceted, requiring further investigation to evaluate its current status and determinants. The present study aims to address this gap by targeting Chinese university students and employing the Psychological Resilience Dynamic System model. Through a questionnaire survey, this research endeavors to explore the mental health status and influencing factors. Ultimately, the findings of this study aim to provide a theoretical basis and tailored practical guidance for the development of mental health intervention strategies for university students.Based on the Psychological Resilience Dynamic System Model, the mental health status of 3,390 Chinese university students from 15 universities was empirically investigated with the principle of stratified sampling and the geographical distribution and disciplinary diversity of universities. The questionnaires used included Kessler psychological distress scale, psychological resilience scale,positive psychological capital scale, family hardiness index and social support scale. Among the participants, 47.85% were male and 52.15% were female. Regarding the origin, 42.89% of the students were from rural areas, while 57.11% were from urban areas.Key findings unveil: (1) A prevalence of 24.54% in students has suboptimal mental health, with 18.70 and 5.84%, respectively, representing those with poor and relatively poor mental health conditions; (2) A noteworthy negative correlation (p < 0.01) between mental health scores of university students and nine pivotal factors, including psychological resilience, self-efficacy, optimism, hope, resilience, family resilience, objective support, subjective support, and support utilization; (3) Eight factors, including grade, family economic status, psychological resilience, self-efficacy, optimism, family resilience, objective support, and support utilization, emerge as significant predictors of university students’ mental health (p <0.001), collectively elucidating 57.9% of the total variance in mental health.The aforementioned research results, indicate that the influencing factors on the mental health of university students encompass four main aspects. These include individual demographic factors such as grade and family economic status, positive psychological capital factors such as psychological resilience, self-efficacy, optimism, hope, and resilience, family resilience factors including responsibility, control, and challenge, and societal support factors including objective support, subjective support, and support utilization. Based on this, this paper focuses on four recommendations: giving full play to the leading role of universities in mental health education and stress intervention, strengthening the educational power of positive family ideals and role modeling, building a support system for positive social atmosphere and psychological counseling, and improving the self-shaping ability o","PeriodicalId":510753,"journal":{"name":"Frontiers in Public Health","volume":"7 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141107023","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":"Beyond reducing direct medical cost: examining health outcomes in tuberculosis through a difference-in-differences analysis of South Korea’s out-of-pocket payment exception policy","authors":"Sarah Yu, Daseul Moon, D. Jeong, Young Ae Kang, Gyeong In Lee, Hongjo Choi","doi":"10.3389/fpubh.2024.1380807","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1380807","url":null,"abstract":"Universal health coverage and social protection are major global goals for tuberculosis. This study aimed to investigate the effects of an expanded policy to guarantee out-of-pocket costs on the treatment outcomes of patients with tuberculosis.By linking the national tuberculosis report and health insurance data and performing covariate-adjusted propensity-score matching, we constructed data on health insurance beneficiaries (treatment group) who benefited from the out-of-pocket payment exemption policy and medical aid beneficiaries as the control group. Using difference-in-differences analysis, we analyzed tuberculosis treatment completion rates and mortality in the treatment and control groups.A total of 41,219 persons (10,305 and 30,914 medical aid and health insurance beneficiaries, respectively) were included in the final analysis (men 59.6%, women 40.4%). Following the implementation of out-of-pocket payment exemption policy, treatment completion rates increased in both the treatment and control groups; however, there was no significant difference between the groups (coefficient, −0.01; standard error, 0.01). After the policy change, the difference in mortality between the groups increased, with mortality decreasing by approximately 3% more in the treatment group compared with in the control group (coefficient: −0.03, standard error, 0.01).There are limitations to improving treatment outcomes for tuberculosis with an out-of-pocket payment exemption policy alone. To improve treatment outcomes for tuberculosis and protect patients from financial distress due to the loss of income during treatment, it is essential to proactively implement complementary social protection policies.","PeriodicalId":510753,"journal":{"name":"Frontiers in Public Health","volume":"23 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141105030","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}