Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"Comparing Social Isolation in Older Adults With and Without Physical Health Challenges During COVID-19: Church and Church Friends Matter.","authors":"Tina R Kilaberia, Yuanyuan Hu, Edward R Ratner, Janice F Bell","doi":"10.1177/00469580241273277","DOIUrl":"10.1177/00469580241273277","url":null,"abstract":"<p><p>Older adults were disproportionately affected by COVID-19. The purpose of this study was to explore experiences of sudden-onset social isolation and factors that influenced it among social isolation in two groups of older adults. A qualitative thematic study with a survey component was conducted comparing 18 older adults in two groups: 12 reporting physical health challenges and 6 reporting no physical health challenges. Three qualitative themes describe experiences of (a) avoiding risk to personal health as the reason to postpone healthcare, (b) grieving church and church friends as a lost social connection, and (c) compound stress due to converging factors related to personal health, public health, racial justice movement and critical national events. Those with physical health challenges were less able to postpone seeking healthcare, suffered from compound stress, and were more likely to feel isolated when unable to participate in church activities. Religious, faith, or spiritual supports may be important buffers against social isolation during public health emergencies, especially for older adults with physical health challenges and when there is concurrent social unrest.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of COVID-19 on Mental Health and Sleep Function of Hospital Staff Working With COVID-19 Patients: A Cross-Sectional Nationwide Study.","authors":"Mohammad Al-Tamimi, Iman Aolymat, Rahaf Alkhateeb, Saba Alshurman, Esra'a Dauod, Farah Rawabde","doi":"10.1177/00469580241248124","DOIUrl":"10.1177/00469580241248124","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic has presented a globally challenging situation for human physical and mental health. Healthcare workers (HCWs) are affected by increased levels of anxiety, stress, and insomnia. This study aimed to evaluate the effect of COVID-19 on HCWs anxiety, stress, and insomnia levels. This cross-sectional study employed the Hospital Anxiety and Depression Scale, Perceived Stress Scale 10, and Insomnia Severity Index to assess anxiety, stress, and insomnia among HCWs at 10 COVID-19 isolation and treatment hospitals/centers after the first COVID-19 wave in Jordan. A web-based survey was used to collect data from 183 participants. Statistical analysis of factors affecting the mean scores of anxiety, stress, and insomnia was carried using student <i>t</i>-test or ANOVA while factors associated with differences in anxiety, stress, and insomnia frequencies were tested using Chi-square/Fisher exact test. Multivariate analysis was performed to determine the independent risk factors. Among participants, 97.3% reported moderate to severe levels of stress, 68% reported borderline to high abnormal levels of anxiety, and 32% had moderate to severe insomnia. The mean of anxiety total score was 9.8 ± 4.8, stress total score was 22.7 ± 4.5, and insomnia total score was 11.0 ± 7.1. Significant positive correlations were noted between anxiety, stress, and insomnia (<i>P</i> < .005). Female gender, migraine, less working years, increased time spent with patients, lower workforce, clinical insomnia and high stress were significant independent factors associated with anxiety (<i>P</i> < .05). Younger age, being single or divorced, heart disease, smoking, occupation (nurses), lower workforce, vaccination dose, and anxiety were significant independent factors associated with insomnia (<i>P</i> < .05). Increased time spent with patients, lower workforce, lower spouse and colleagues support, sadness due to isolation and anxiety were significant independent factors associated with stress. HCWs at COVID-19 centers had high levels of stress, anxiety, and insomnia. Appropriate interventions to maintain HCWs mental health are recommended.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11311156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Factors Related to Stillbirth.","authors":"Mohammad Torkashvand Moradabadi, Nahid Ardian, Seyed Saeed Mazloomy-Mahmoodabad, Tahmineh Farajkhoda, Nooshin Yoshani, Seyed Alireza Afshani, Deepak Paliwal","doi":"10.1177/00469580241236272","DOIUrl":"10.1177/00469580241236272","url":null,"abstract":"<p><p>The stillbirth rate is among the most important indicators of access to and quality of care during pregnancy. This study investigated the factors related to the stillbirth rate in the Yazd province, Iran. The current research is descriptive and cross-sectional and the results of Shahdieh city cohort study which was conducted on 4756 women were used. Data related to the history of stillbirth, demographic characteristics, fertility history and, various female diseases were extracted from the results of the cohort study. The result shows that 7.2% of studied women had a history of stillbirth. Among the multiple variables, predictor variables including education level, marriage age, age of the first conception, number of children, consanguineous marriage, Employment status, and diseases like diabetes, hypertension, and history of depression had a significant relationship with a history of stillbirth (<i>P</i> ≤ .05). The stillbirth rate in Shahedieh is high compared to the global stillbirth Rate, but it is comparable with the stillbirth Rate in Yazd province. Although Yazd province, as one of the industrial hubs of Iran, has relatively acceptable indicators of income, employment, and medical and health facilities and welfare compared to other provinces, this study showed that factors such as diabetes, hypertension, low level of women's education, consanguineous marriage, and women's employment status and social welfare can affect Stillbirth Rate.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10919122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating health systems' efficiency towards universal health coverage: A data envelopment analysis.","authors":"Paul Eze, Chidumebi Judith Idemili, Lucky Osaheni Lawani","doi":"10.1177/00469580241235759","DOIUrl":"10.1177/00469580241235759","url":null,"abstract":"<p><p>To estimate the technical efficiency of health systems toward achieving universal health coverage (UHC) in 191 countries. We applied an output-oriented data envelopment analysis approach to estimate the technical efficiency of the health systems, including the UHC index (a summary measure that captures both service coverage and financial protection) as the output variable and per capita health expenditure, doctors, nurses, and hospital bed density as input variables. We used a Tobit simple-censored regression with bootstrap analysis to observe the socioeconomic and environmental factors associated with efficiency estimates. The global UHC index improved from the 2019 estimates, ranged from 48.4 (Somalia) to 94.8 (Canada), with a mean of 76.9 (std. dev.: ±12.0). Approximately 78.5% (150 of 191) of the studied countries were inefficient (ϕ < 1.0) with respect to using health system resources toward achieving UHC. By improving health system efficiency, low-income, lower-middle-income, upper-middle-income, and high-income countries can improve their UHC indices by 4.6%, 5.5%, 6.8%, and 4.1%, respectively, by using their current resource levels. The percentage of health expenditure spent on primary health care (PHC), governance quality, and the passage of UHC legislation significantly influenced efficiency estimates. Our findings suggests health systems inefficiency toward achieving UHC persists across countries, regardless of their income classifications and WHO regions, as well as indicating that using current level of resources, most countries could boost their progress toward UHC by improving their health system efficiency by increasing investments in PHC, improving health system governance, and where applicable, enacting/implementing UHC legislation.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10924553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Disparities in Neurodegenerative Disease Mortality: A Population-Based Study among Belgian Men and Women Aged 65 or Older.","authors":"Janna Dinneweth, Sylvie Gadeyne","doi":"10.1177/00469580241237113","DOIUrl":"10.1177/00469580241237113","url":null,"abstract":"<p><p>This study investigates the association between socioeconomic position (SEP) - in terms of income and education - and mortality from neurodegenerative diseases, that is, dementia, parkinsonism, and motor neuron diseases (MNDs). We calculated age-standardized mortality rates and mortality rate ratios using log linear Poisson regression for different SEP groups, stratified by gender, age-group, and care home residency, utilizing the 2011 Belgian census linked to register data on cause-specific mortality for 2011 to 2016. Mortality was significantly higher in the lowest educational- and income groups. The largest disparities were found in dementia mortality. Income had a strong negative effect on parkinsonism mortality, education a positive effect. We found no significant association between SEP and MND. Our study provides evidence supporting the presence of socioeconomic disparities in mortality due to neurodegeneration. We found a strong negative association between SEP and NDD mortality, which varies between NDD, gender and care home residency.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Predisposing Emergency Medical Technicians to Workplace Violence: A Cross Sectional Study.","authors":"Tshikani Lewis Khoza, Maureen Nokuthula Sibiya, Nombeko Mshunqane","doi":"10.1177/00469580241233452","DOIUrl":"10.1177/00469580241233452","url":null,"abstract":"<p><p>Emergency medical technicians (EMT) are at high risk of workplace violence as they often care for patients in uncontrolled and often hostile emergency settings. Gauteng Province, the most populous province in South Africa, caters for 75% of the total population which is dependant on state funded health care. Public sector EMTs' have been robbed with aggravated circumstances, assaulted with intent to do grievous bodily harm, raped and even murdered whilst on duty. Despite this, comprehensive studies investigating the factors that predispose public sector EMTs' to workplace violence in Gauteng Province are lacking. Thus, the aim of this study was to investigate the factors that predispose public service EMTs' to workplace violence in Gauteng Province. Data were collected using questionnaires. A total of 413 questionnaires were returned by community members of Gauteng who met the inclusion criteria. Descriptive statistics and binomial tests were used to analyze data. The results of this study revealed that workplace violence toward public service EMTs' in Gauteng is attributed to the high rates of crime, the widening gap of inequality, economic deprivation of basic rights to previously disadvantaged communities by government, vulnerability of EMTs' when responding to the ill and injured within low- and middle-income communities and a lack of consequence for disorderly behavior within the communities. An understanding of the community factors that predispose EMTs' to workplace violence may improve the understanding of the phenomenon of workplace violence and developing prevention programs within the communities.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Price Transparency in United States' Health Care: A Narrative Policy Review of the Current State and Way Forward.","authors":"David N Bernstein, Jonathan R Crowe","doi":"10.1177/00469580241255823","DOIUrl":"10.1177/00469580241255823","url":null,"abstract":"<p><p>Health care price transparency is gaining momentum as a tangible policy intervention that can unleash market principles to increase competition, help begin to decrease U.S. health care expenditures, and provide Americans with access to affordable, high-quality health care. Indeed, pricing reform is required to facilitate patient shopping in health care. In this narrative policy review, we offer a brief history of health care price transparency efforts and an overview of the health care price transparency literature. Further, we highlight the current rules and legislative initiatives aimed at achieving the full potential of health care price transparency. Lastly, we offer key takeaways and highlight suggestions for future policy directions, including the need to ensure hospital and insurance compliance through more appropriate penalties and incentives, importance of reducing regulation to promote financial upside that can be obtained by both patients and providers who actively promote shopping for lower cost, higher quality health care goods and services, and the need for transparent and easily found quality metrics, including outcomes most important to patients, driven by physicians \"on the ground\" with patient input.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"The Simpler, the Better.\" A Qualitative Study on Digital Health Transformation in Early Adopter Rheumatology Outpatient Clinics.","authors":"Susann May, Robert Darkow, Johannes Knitza, Katharina Boy, Julian Schwarz, Martin Heinze, Johannes Hornig, Peer Aries, Martin Welcker, Felix Muehlensiepen","doi":"10.1177/00469580241247021","DOIUrl":"10.1177/00469580241247021","url":null,"abstract":"<p><p>Workforce shortage and the increasing burden of rheumatic and musculoskeletal diseases lead to extreme time constraints in rheumatology outpatient care. Digital services promise to facilitate care by relieving employees and unleash new capacities. This study aims to explore the perspectives of early adopter health care professionals (HCP) on digital transformation in outpatient rheumatology. In-depth qualitative interviews were conducted with rheumatology nurses and physicians in 3 German rheumatology outpatient clinics, each characterized by an advanced level of digital adaption. Qualitative data were subsequently analyzed using deductive-inductive qualitative content analysis. Interviews with 11 rheumatology nurses and 5 rheumatologists were completed. Three key themes emerged from the qualitative analysis: (i) Digital transformation of care; (ii) impact of digital transformation on health care delivery; and (iii) perceived drivers of successful digitalization. The interviews revealed that digital technologies are widely used throughout the complete patient pathway. Digitalization enables more continuity and flexibility in rheumatology care. Patient information can be electronically obtained in a standardized manner prior to planned visits, enabling an informed consultation and more time for in-depth patient discussion. Although digitalization restructures work, it can also increase the current workload. Improved accessibility for patient calls leads to more work for HCP. Important drivers of successful digital technology implementation are low-threshold and interoperable services, a medical team that is interested and educated in eHealth, and comprehensive patient information and onboarding. Digital transformation is increasingly redefining rheumatology care. While accelerating communication and workflows, improved service accessibility leads to more work for HCP.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Nurses in an Emergency Situation Look for a Medical Item But Fail to See It.","authors":"Riyadh Saleh H Almulhis, Modi Al-Moteri","doi":"10.1177/00469580241279811","DOIUrl":"10.1177/00469580241279811","url":null,"abstract":"<p><p>Emergency department nurses may fail to see medical items in emergency cart drawers, such as syringes and tubes, while handling emergency situations, which can often contribute to a delay in managing the case. This is a phenomenon known as Looked-but-failed-to-see (LBFTS) and occurs when the observer fails to detect a visible visual stimulus among various other stimuli. LBFTS is a group of human errors, including inattentional blindness (IB), satisfaction of search, and biased search processes, and is associated with constraints on human visual processing. LBFTS has been studied extensively in the fields of aviation, military, radiology, and road safety; however, the role of LBFTS in hospital ED has generally been overlooked. Hence, a key aim of this study was to investigate the possibility of the occurrence of LBFTS among ED nurses while searching for a particular medical item during a real-life emergency. An observational cross-sectional blinded study was conducted to determine the occurrence of LBFTS in a real-life visual search task during resuscitation cases in ED. The A-B-C (antecedent-behavior-consequence) observation and recording naturalistic observation technique was used. A total of 45 ED nurses who were assigned to either the crash cart or the intubation trolley at the time of data collection agreed to participate and were included in the analysis. The results revealed that LBFTS accounted for 66% of the cases where emergency items were brought from another location. Participants missed seeing an item, although the item was directly in front of their eyes. Factors such as the perception of cognitive workload at the time of data collection positively impacted the increase in LBFTS <i>(</i>P = .021). Taken together, the results of the present study and recent visual studies support the occurrence of LBFTS among nurses working in ED. Devising successful strategies to reduce this phenomenon could translate directly into saved lives.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Process Evaluation of Community-Based Nutrition Service for Under 2 Years Children in Degadamot District Using Qualitative Approach, Western Ethiopia, 2023.","authors":"Teshome Demis Nimani, Enyew Muluneh, Geta Asrade, Tesfahun Zemene, Feyisa Shasho Bayisa, Sara Debebe Jimma","doi":"10.1177/00469580241273244","DOIUrl":"10.1177/00469580241273244","url":null,"abstract":"<p><p>Malnutrition accounts for 45% of under-5 child morbidities in Ethiopia and is a more common issue in rural communities. In that regard, Ethiopia has implemented a CBN program at the community level to improve the nutrition status of children. Despite this, malnutrition still causes a significant rate of child morbidity and mortality. The implementation status of the CBN program is unknown. Thus, this evaluation aimed to evaluate the children under 2 years in Degadamot district health posts in northwest Ethiopia. A facility-based single-case study design with qualitative-method evaluation was employed from March 28 to April 28, 2023. The evaluation focused on the availability and compliance with multiple data sources. The qualitative data were transcribed, translated, and analyzed using thematic analysis with OPEN CODE version 4.02 software. Finally, the overall program implementation was determined based on predetermined judgmental criteria. According to the predetermined judgment parameter, the overall CBN program implementation level was 62.68%, measured by the availability of resources (71.36%) and compliance of service providers (54.0%). The overall community-based nutrition program implementation in the Degadamot district health post with 2 evaluation dimensions was judged as fair based on the presetting criteria. It is better to improve the service through training HEW and HDA, distributing nutritional supplies, providing regular support, and following up with HEWs for GMP performance in the Degadamot district.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}