Risk Management and Healthcare Policy最新文献

{"title":"Improving Patient Safety and Care Quality Through a \"Speaking-Up\" Climate: The Mediating Role of Situation Monitoring.","authors":"Ja Kyung Seo, Seung Eun Lee","doi":"10.2147/RMHP.S471043","DOIUrl":"10.2147/RMHP.S471043","url":null,"abstract":"<p><strong>Purpose: </strong>In healthcare settings, a climate that encourages speaking up among staff is believed to enhance patient safety and quality of care. However, the specific mechanisms of this relationship remain underexplored. Particularly, there is a need to understand how components of teamwork, such as situation monitoring, can be linked to the impact of a speaking-up climate on relevant outcomes. This study aimed to investigate the direct and indirect effects of a speaking-up climate on patient safety and quality of care using situation monitoring as a potential mediator.</p><p><strong>Patients and methods: </strong>This cross-sectional study used survey data from 380 staff nurses who provided direct patient care at three Korean hospitals. Structural equation modeling was utilized to test a hypothesized mediation model using Mplus 7.0.</p><p><strong>Results: </strong>Our data analysis confirmed the partial mediation model. As hypothesized, a speaking-up climate directly improved patient safety (β = 0.384, <i>p</i> < 0.001) and quality of care (β = 0.393, <i>p</i> < 0.001). Also, we found that indirect effects of a speaking-up climate on patient safety (β = 0.224, <i>p</i> < 0.001) and quality of care (β = 0.186, <i>p</i> = 0.005) through situation monitoring were significant. These results indicate that situation monitoring was found to significantly mediate the relationship between a speaking-up climate, patient safety, and quality of care.</p><p><strong>Conclusion: </strong>Our study demonstrates that the positive impact of a speaking-up climate extends beyond improving nurses' speaking up. Further, fostering a speaking-up climate can significantly improve patient safety and quality of care, and situation monitoring has a critical role in this relationship. These findings contribute to understanding how encouraging a speaking-up climate could benefit patient safety and care quality in healthcare organizations.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"2035-2043"},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115227","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":"Community Health Centers' Responsiveness and Its Associated Factors Among Outpatients in Southeast China: A Cross-Sectional Study.","authors":"Chi Zhou, Xu Li, Wenli Shen, Qunfang Huang, Xiaoling Lin, Gaofeng Zhang, Yin Dong","doi":"10.2147/RMHP.S475289","DOIUrl":"10.2147/RMHP.S475289","url":null,"abstract":"<p><strong>Background: </strong>The responsiveness of community health centers can reflect the soft capacity of medical institutions and is related to the improvement of health outcome indicators. This study is aimed at assessing the level and distribution of community health centers' responsiveness and its associated factors among outpatients under the health-oriented integrated healthcare system in China.</p><p><strong>Methods: </strong>A total of 634 outpatients were recruited from six community health centers in Zhejiang Province, China, in July 2022. SPSS software was used to conduct the analysis (version 23.0). Health system responsiveness was used as a measure of outpatient responsiveness to health care services through a self-administered questionnaire. Determinants of community health centers' responsiveness were determined by using a multiple linear regression model at a <i>p</i>-value <0.05.</p><p><strong>Results: </strong>The total score of community health centers responsiveness was 8.25±1.01, and the Gini coefficient is 0.027. Within these domains, social support and dignity received the highest scores, while choice of providers and autonomy scored the lowest. Age group between 60-74 years (β: 0.129; 95% CI: 0.042-0.529), ≥75 years (β: 0.095; 95% CI: 0.006-0.707), monthly income with 8000 RMB and above (β: 0.098; 95% CI: 0.035-0.653), having a family doctor (β: 0.124; 95% CI: 0.096-0.410), and satisficing with community health service (β: 0.298; 95% CI: 0.848-1.428) were significant predictors of community health centers' responsiveness.</p><p><strong>Conclusion: </strong>The Chinese community health centers show high responsiveness, indicating that the construction of a health-oriented integrated healthcare system has been effective. The family doctor contract service is important and should continually enhance both technical proficiency and health promotion capabilities. Encourage residents to actively participate in their treatment process is also essential.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"2023-2034"},"PeriodicalIF":2.7,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115226","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":"Trajectories of Treatment Burden Among Primary Care Patients with Long-Term Conditions in Southern China: A Latent Class Growth Analysis.","authors":"Zhihui Jia, Zimin Niu, Jia Ji Wang, Jose Hernandez, Yu Ting Li, Harry H X Wang","doi":"10.2147/RMHP.S464434","DOIUrl":"10.2147/RMHP.S464434","url":null,"abstract":"<p><strong>Background: </strong>Treatment burden is a patient-centred, dynamic concept. However, longitudinal data on the changing pattern of treatment burden among patients with one or more long-term conditions (LTCs) are relatively scanty. We aimed to explore the longitudinal trajectories of treatment burden and associated risk factors in a large, patient population in primary care settings.</p><p><strong>Methods: </strong>We analysed data from 5573 primary care patients with long-term conditions (LTCs) recruited using a multistage sampling method in Shenzhen, southern China. The treatment burden was assessed by the Mandarin Chinese version of the Treatment Burden Questionnaire (TBQ). We used latent class growth mixture modelling (LCGMM) to determine trajectories of treatment burden across four time points, ie, at baseline, and at 6, 12, and 18 months. Predictors of trajectory classes were explored using multivariable logistic regression analysis.</p><p><strong>Results: </strong>The mean TBQ scores of patients with a single LTC (n = 2756), 2 LTCs (n = 1871), 3 LTCs (n = 699), and ≥4 LTCs (n = 247) were 18.17, 20.28, 21.32, and 26.10, respectively, at baseline. LCGMM identified three discrete classes of treatment burden trajectories over time, ie, a high-increasing class, a low-stable class, and a high-decreasing class. When controlling for individual-level factors including age, education, monthly household income per head, smoking, alcohol consumption, and attendance in health education, patients who had a clinical diagnosis of 3 LTCs (adjusted odds ratio [aOR] = 1.49, 95% CI = 1.21-1.86, <i>P</i> < 0.001) or ≥4 LTCs (aOR = 1.97, 95% CI = 1.44-2.72, <i>P</i> < 0.001) were more likely to belong to the high-increasing class. Sensitivity analysis using propensity score methods obtained similar results.</p><p><strong>Conclusion: </strong>Our study revealed the presence of discrete patterns of treatment burden over time in Chinese primary care patients with LTCs, providing directions for tailored interventions to optimise disease management. Patients with 3 or more LTCs should receive close attention in healthcare delivery as they tend to experience a greater treatment burden.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"2009-2021"},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074634","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":"Multiple Long-Term Conditions and Disability are Independently Associated with Higher Risk of Fall Among Community Adults: A Cross-Sectional Study [Letter].","authors":"Rong Wang, Li Yao","doi":"10.2147/RMHP.S490307","DOIUrl":"10.2147/RMHP.S490307","url":null,"abstract":"","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"2007-2008"},"PeriodicalIF":2.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074633","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":"Trend and Equity in Maternal and Child Health Resource Allocation in China Since the New Health System Reform: A Nationwide Study from 2008 to 2020.","authors":"Yuanna Zhou, Lin Han, Wuxing Zhang, Yujun Fan, Wenjian Liu, Muzi Liu, Yishan Fan, Xiaoyuan Qu","doi":"10.2147/RMHP.S466680","DOIUrl":"10.2147/RMHP.S466680","url":null,"abstract":"<p><strong>Purpose: </strong>China has made considerable efforts to promote the development of maternal and child health (MCH) care since the new health system reform in 2009. This study aims to evaluate the trend and equity of MCH resources allocation in China from 2008 to 2020 and provide a reference for rational distribution of MCH resources.</p><p><strong>Methods: </strong>Data were collected from the China Health Statistics Yearbook and China Statistics Yearbook. The number of MCH hospitals, licensed (assistant) physicians, registered nurses and beds were selected for the measurement of the equity of MCH resources allocation. The Health Resource Agglomeration Degree and Theil index were used in evaluating MCH resource allocation equity and to compare differences among regions.</p><p><strong>Results: </strong>From 2008 to 2020, the average annual growth rates for MCH hospitals, beds, licensed (assistant) physicians, and registered nurses were 0.72%, 6.95%, 5.04%, and 9.57%, respectively. However, regional disparities in the equity of MCH resource allocation have been identified. Although the western region has shown growth in MCH resource allocation by geography, the agglomeration degree of the four indicators remains less than 1, significantly lower than the average value of greater than 2 in the eastern region. Additionally, the equity of human resource allocation in the western region is lower than the equity in the allocation of institutions. In the densely populated eastern region, the equity of MCH resource allocation by population is decreasing, with the agglomeration degree of all four indicators below 1 in 2020. The disparity in healthcare resource allocation within regions is the main cause of inequitable MCH resource allocation in China.</p><p><strong>Conclusion: </strong>The allocation of MCH resources in China has improved since 2009, however, geographic equity needs further improvement, particularly in densely populated regions. Population and geographic balances should be considered in the development and implementation of MCH resource allocation policies, and improving intraregional equity should be the focus.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"1987-2005"},"PeriodicalIF":2.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057408","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":"Evaluation of Vicarious Somatosensory Experience in Diabetes Mellitus: Bases for Empathy and Social Cognition.","authors":"Shaimaa Nasr Amin, Gehan El-Akabawy, Layth Baker Saleh, Alhawraa Salem Sulaiman, Abdulfattah Ahmed Alsharif, Mohammed Ahmed Qamoum, Mohammad Basheer Fahmawi, Alaa Al-Matrouk, Hana Taha, Ahmed A Ismail","doi":"10.2147/RMHP.S464113","DOIUrl":"10.2147/RMHP.S464113","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes Mellitus (DM) is a common metabolic disorder with negative impacts on brain functions. Social cognition and vicarious experience impairments are features of DM. This research aimed to estimate the social cognition and vicarious experience among Jordanian people with diabetes.</p><p><strong>Patients and methods: </strong>Cognitive abilities were assessed using the Vicarious Pain Questionnaire (VPQ) and the Mirror Touch Questionnaire (MTQ). Data on disease history, medications, routine laboratory measurements, and anthropometric indices.</p><p><strong>Results: </strong>Patients had lower pain responses and intensity scores, and higher unpleasantness scores than the control group (p < 0.05). Most of the VPQ and MTQ measures were mainly impaired among study participants who had higher education, were not practicing exercises, and were not consuming healthy diets (p < 0.05). The number of responses to the VPQ and average pain intensity were negatively correlated with age and positively correlated with both the serum aminotransferase (AST) concentration and the serum urea concentration (p < 0.05). The average unpleasantness score was positively correlated with the duration of therapy, serum creatinine, and albumin concentrations (p < 0.05). The final regression models for the number of pain responses and localized-generalized included group, practicing exercise, and AST, while the model for the average pain intensity included only the grouping variable. The model for average unpleasantness included grouping, AST, Albumin, consuming a healthy diet, and duration of therapy.</p><p><strong>Conclusion: </strong>The Jordanian diabetic patients who participated in the study had impaired social cognition and vicarious experience. A healthy lifestyle had a significant effect on the scores of the vicarious experience in addition to the level of education. Despite being the first study in Jordan to assess vicarious experience in DM, further studies are needed considering imaging and electrophysiological workup. Besides, further prospective studies are needed to determine the significance of the current study.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"1975-1986"},"PeriodicalIF":2.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006000","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":"Analysis of the Current Status of Nurses' Knowledge of Pressure Injuries and Factors Influencing It in Shaanxi Province, China: A Cross-Sectional Study [Letter].","authors":"Rong Wang, Li Yao","doi":"10.2147/RMHP.S489659","DOIUrl":"10.2147/RMHP.S489659","url":null,"abstract":"","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"1973-1974"},"PeriodicalIF":2.7,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005999","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":"Web-Based Dynamic Nomogram for Predicting Risk of Mortality in Heart Failure with Mildly Reduced Ejection Fraction.","authors":"Wei Guo, Jing Tian, Yajing Wang, Yajing Zhang, Jingjing Yan, Yutao Du, Yanbo Zhang, Qinghua Han","doi":"10.2147/RMHP.S474862","DOIUrl":"10.2147/RMHP.S474862","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop an integrative dynamic nomogram, including N-terminal pro-B type natural peptide (NT-proBNP) and estimated glomerular filtration rate (eGFR), for predicting the risk of all-cause mortality in HFmrEF patients.</p><p><strong>Patients and methods: </strong>790 HFmrEF patients were prospectively enrolled in the development cohort for the model. The least absolute shrinkage and selection operator (LASSO) regression and Random Survival Forest (RSF) were employed to select predictors for all-cause mortality. Develop a nomogram based on the Cox proportional hazard model for predicting long-term mortality (1-, 3-, and 5-year) in HFmrEF. Internal validation was conducted using Bootstrap, and the final model was validated in an external cohort of 338 consecutive adult patients. Discrimination and predictive performance were evaluated by calculating the time-dependent concordance index (C-index), area under the ROC curve (AUC), and calibration curve, with clinical value assessed via decision curve analysis (DCA). Integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to assess the contributions of NT-proBNP and eGFR to the nomogram. Finally, develop a dynamic nomogram using the \"Dynnom\" package.</p><p><strong>Results: </strong>The optimal independent predictors for all-cause mortality (<i>APSELNH: A: angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitor (ACEI/ARB/ARNI), P: percutaneous coronary intervention/coronary artery bypass graft (PCI/CABG), S: stroke, E: eGFR, L: lg of NT-proBNP</i>, <i>N: NYHA, H: healthcare</i>) were incorporated into the dynamic nomogram. The C-index in the development cohort and validation cohort were 0.858 and 0.826, respectively, with AUCs exceeding 0.8, indicating good discrimination and predictive ability. DCA curves and calibration curves demonstrated clinical applicability and good consistency of the nomogram. NT-proBNP and eGFR provided significant net benefits to the nomogram.</p><p><strong>Conclusion: </strong>In this study, the dynamic APSELNH nomogram developed serves as an accessible, functional, and effective clinical decision support calculator, offering accurate prognostic assessment for patients with HFmrEF.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"1959-1972"},"PeriodicalIF":2.7,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001444","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":"Physical, Functional, Psychological, and Social Effects of a Physical Activity Program in Adults and Older Adults During and/or After Hospitalization for COVID-19: A Systematic Review [Corrigendum]","authors":"Ilem D Rosero, Julieth Barreto, Carlos Cardona, Leidy T Ordoñez-Mora","doi":"10.2147/rmhp.s482743","DOIUrl":"https://doi.org/10.2147/rmhp.s482743","url":null,"abstract":"Corrigendum for the article Physical, Functional, Psychological, and Social Effects of a Physical Activity Program in Adults and Older Adults During and/or After Hospitalization for COVID-19: A Systematic Review","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"10 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141944496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamics and Efficacy: A Comprehensive Evaluation of the Advanced Dengue Fever Surveillance and Early Warning System in Ningbo City, 2023","authors":"Yanwu Zhang, Buasiyamu Abudunaibi, Yunkang Zhao, Dongliang Zhang, Yanru Chu, Song Lei, Xiaomin Gu, Xuying Lao, Xianhao Wu, Weitao Yao, Yi Chen, Feng Tong","doi":"10.2147/rmhp.s470237","DOIUrl":"https://doi.org/10.2147/rmhp.s470237","url":null,"abstract":"<strong>Objective:</strong> To conduct a comprehensive evaluation of the Dengue Fever Surveillance and Early Warning System deployed in Ningbo City during 2023, focusing on its capacity for timely identification and reporting of dengue fever cases, particularly imported cases from endemic regions.<br/><strong>Methods:</strong> A detailed data of patient clinical features and blood profile trends was collected from clinical records and surveillance reports, focusing on the rapid diagnostic processes and surveillance rigor. This study assessed the effectiveness of the system in identifying and reporting dengue cases and identified the limitations of the existing framework through a basic statistical approach.<br/><strong>Results:</strong> The system demonstrated timely identification and reporting of dengue fever cases, with a particular emphasis on imported cases. However, several limitations were identified, including the need for more precise monitoring criteria and improved coordination with medical entities.<br/><strong>Conclusion:</strong> The study underscores the critical role of public health bodies in managing disease outbreaks and advocates for enhanced methodologies to refine epidemic control efforts. The findings contribute to the advancement of early warning mechanisms and the improvement of proactive infectious disease monitoring in metropolitan environments, providing valuable insights for fortifying the Dengue Fever Surveillance and Early Warning System in Ningbo City.<br/><br/><strong>Keywords:</strong> Dengue fever, Imported, Surveillance, Early-warning<br/>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"26 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141944305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}