Risk Management and Healthcare Policy最新文献

{"title":"Public Awareness About Frailty Prevention and Possible Association Between Frailty and Disability: A Cross-Sectional Study in Saudi Arabia.","authors":"Ahmed M Ashour, Maan H Harbi, Nasser M Alorfi, Fahad S Alshehri, Saad M Wali, Mohammed M Aldurdunji","doi":"10.2147/RMHP.S516785","DOIUrl":"10.2147/RMHP.S516785","url":null,"abstract":"<p><strong>Background: </strong>Frailty, a condition characterized by diminished physiological reserves, is a significant public health concern globally, particularly due to its association with adverse outcomes such as hospitalization, dependence, and mortality. Despite the importance of early detection and prevention, public awareness about frailty remains insufficient, especially in Saudi Arabia.</p><p><strong>Objective: </strong>The purpose of this study was to assess public awareness of frailty and its association with disability, focusing on the socio-demographic factors that influence awareness.</p><p><strong>Methods: </strong>A cross-sectional study design was employed with 1000 participants from urban and rural regions of Saudi Arabia. Data was collected using a structured questionnaire to evaluate their knowledge, attitudes, and perceptions regarding frailty awareness, particularly around its prevention strategies.</p><p><strong>Results: </strong>A total of 1000 respondents participated in the survey. The majority of participants were males aged 18 to 39. The results indicated significant predictors of frailty awareness, including gender, education level, income, health status, and self-rated health. Frailty preventive techniques were more likely to be known by men, those with greater education, higher income, and better health.</p><p><strong>Conclusion: </strong>The findings highlight the need for targeted public health campaigns to improve awareness, especially among underrepresented groups. Addressing socio-demographic factors in future interventions may reduce frailty risks and support health promotion and prevention efforts in Saudi Arabia.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1713-1720"},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163866","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":"Predicting Postoperative Blood Transfusion in Elderly Patients Undergoing Total Hip and Knee Arthroplasty Using Machine Learning Models.","authors":"Dan Liang, Yiming Pang, Jingrui Huang, Xianda Che, Raorao Zhou, Xueting Ding, Chunfang Wang, Litao Zhao, Yichen Han, Xueqin Rong, Pengcui Li","doi":"10.2147/RMHP.S503286","DOIUrl":"10.2147/RMHP.S503286","url":null,"abstract":"<p><strong>Purpose: </strong>With the aging population, the demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA) has risen significantly. Elderly patients, especially those over 70 years, face a higher risk of perioperative bleeding and transfusion, increasing morbidity and mortality. Accurate transfusion risk prediction is vital for optimizing perioperative blood management. Traditional models often fail to capture complex factor interactions, whereas machine learning enhances predictive accuracy. This study aimed to develop predictive models for postoperative transfusion in elderly patients undergoing THA or TKA, identify key risk factors, and create an online prediction tool.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 1,520 elderly patients who underwent THA (659) or TKA (861). The Least Absolute Shrinkage and Selection Operator (LASSO) method was used for variable selection. The dataset was randomly split into training (70%) and testing (30%) sets. Five models-Logistic Regression (LR), Random Forest (RF), Support Vector Machines (SVM), K-Nearest Neighbors (KNN), and Naive Bayes (NB)-were developed and validated. Ten-fold cross-validation and grid search optimized model parameters. Model performance was evaluated using AUC, accuracy, precision, sensitivity, specificity, and F1 score. SHapley Additive exPlanations (SHAP) were applied to assess variable importance. An online tool was developed based on the models.</p><p><strong>Results: </strong>Nineteen variables were retained. RF, LR, and SVM showed superior performance with AUC values exceeding 0.90. RF achieved the best results, with an accuracy of 0.86, precision of 0.80, specificity of 0.91, F1-score of 0.78, and sensitivity of 0.76. SHAP analysis highlighted intraoperative blood loss, hypertension, and postoperative drainage volume as major predictors.</p><p><strong>Conclusion: </strong>The developed models and online tool support personalized transfusion risk assessment, optimizing perioperative management, optimizing blood utilization, and enhancing patient outcomes.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1697-1711"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144514","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":"Improving Nutritional Status in Chronic Heart Failure Patients: Effectiveness of a Transtheoretical Model-Based Stepwise Nutritional Management Program.","authors":"Dejing Yuan, Yuan Xue, Yuefei Zhou","doi":"10.2147/RMHP.S509402","DOIUrl":"10.2147/RMHP.S509402","url":null,"abstract":"<p><strong>Objective: </strong>To explore the nutritional status of chronic heart failure (CHF) patients and evaluate the effect of a transtheoretical model-based stepwise nutritional management program on nutritional improvement.</p><p><strong>Methods: </strong>This study conducted a retrospective analysis of 100 chronic heart failure (CHF) patients admitted to our hospital from March 2023 to May 2024. After applying inclusion and exclusion criteria, the patients were divided into an observation group and a control group. The observation group received a stepwise nutritional management program based on the transtheoretical model (TTM), while the control group received routine care. Nutritional improvement and clinical effects were compared between the two groups.</p><p><strong>Results: </strong>Among the 100 CHF patients, 27% had good nutritional status, 42% were at nutritional risk, and 31% had malnutrition. No significant differences in baseline data were found between the two groups (P > 0.05). After the intervention, the observation group showed significantly lower B-type natriuretic peptide (BNP) levels and higher left ventricular ejection fraction (LVEF) levels compared to the control group (P < 0.05). Psychological scores (Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS)) in the observation group were also significantly lower than those in the control group (P < 0.05). Additionally, serum total cholesterol (TC) and triglycerides (TG) levels were lower in the observation group (P < 0.05), and levels of prealbumin, transferrin, hemoglobin, and albumin were higher (P < 0.05). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores in the observation group were significantly lower than in the control group (P < 0.05).</p><p><strong>Conclusion: </strong>The nutritional status of CHF patients is generally poor, and the transtheoretical model-based stepwise nutritional management program can effectively improve their nutritional status, enhance cardiac function, improve quality of life, and alleviate psychological burden. This intervention is promising for clinical practice.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1683-1695"},"PeriodicalIF":2.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144497","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 Coupled Coordination of Digital Economy and Public Health Services in China and Its Influencing Factors.","authors":"Kunyu Chen, Zili Ding, Qunshan Tao, Rui Fu, Wangwang Zhu","doi":"10.2147/RMHP.S508245","DOIUrl":"10.2147/RMHP.S508245","url":null,"abstract":"<p><strong>Background: </strong>The coordinated development of the digital economy and public health services is essential for integrating the \"Digital China\" and \"Healthy China\" strategies and accelerating the modernization of the public health system. However, substantial regional disparities persist, necessitating a systematic evaluation of the coupling and coordination between these two domains, along with the identification of key influencing factors to support evidence-based policymaking.</p><p><strong>Methods: </strong>This study utilizes panel data from 30 Chinese provinces spanning 2012-2021. The entropy-weighted Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method is employed to quantify the levels of digital economy development and public health services. A coupling coordination model is employed to evaluate the degree of coordinated development between these sectors, whereas a panel Tobit model serves to identify the key influencing factors.</p><p><strong>Results: </strong>The overall trajectory of China's digital economy and public health services exhibits an upward yet fluctuating trend. The degree of coupling coordination has progressed from a state of near imbalance to a marginally coordinated phase, although it remains relatively low. Spatially, the eastern regions exhibit a higher degree of coordination, whereas the central and western regions primarily experience imbalances characterized by a lagging digital economy. Furthermore, the coupling coordination degree demonstrates a significant spatial positive correlation. Economic development is identified as the primary driver of improved coordination, whereas factors such as population density and health status exert inhibitory effects to some extent.</p><p><strong>Conclusion: </strong>To enhance overall coordination and achieve regional balance, policymakers should tailor development strategies to local resource endowments, optimize the synergy between the digital economy and public health services, and refine collaborative mechanisms.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1651-1668"},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144493","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":"Adenosine Triphosphate Bioluminescence Assay versus Microbiological Swab Culture in the Evaluation of Surface Sanitation in a Pediatric Hospital in Romania.","authors":"Alexandra Tudorica Sirmon, Luminița Mirela Bădițoiu, Mariana Anghel, Sorina Maria Denisa Laitin, Delia Muntean, Carmen Ana Kemper","doi":"10.2147/RMHP.S509274","DOIUrl":"10.2147/RMHP.S509274","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare two rapid testing methods - Adenosine Triphosphate (ATP) quantification and the total Aerobic Colony Count (ACC) by bioluminescence assay with the standard method - microbiological swab culture. The goal was to determine the advantages and limitations of these rapid alternative tests in assessing the sanitary condition of hospital surfaces.</p><p><strong>Methods: </strong>A total of 88 samples were collected from various surfaces (stainless steel, metal, plastic, Tarkett, ceramic, glass, textile) in medical and surgical wards of a pediatric hospital. For each tested area, one sample underwent standard microbiological culture (25 cm²), and two adjacent samples (each 100 cm²) were analyzed using the ENSURE^® TOUCH luminometer (Hygiena): one for ATP quantification (Ultrasnap) and one for ACC determination (Microsnap Total). Surfaces had been disinfected with commonly used agents-hydrogen peroxide, chlorinated products, or peracetic acid.</p><p><strong>Results: </strong>The Ultrasnap system identified 25 non-conforming samples; Microsnap Total found 13 non-conforming samples, while microbiological culture revealed one non-conforming sample and an additional 11 with low but detectable bacterial presence. The Ultrasnap method recorded a sensitivity of 100%, a specificity of 72.41% and an accuracy of 72.73%. In comparison, the Microsnap Total system showed higher specificity and accuracy (85.05% and 84.09%, respectively), but failed to identify the positive (non-conforming) test, resulting in a 0% positive predictive value.</p><p><strong>Conclusion: </strong>The study highlighted several advantages of rapid ATP tests, particularly their ease of use, their ability to provide results in just 10 seconds for Ultrasnap and approximately 7 hours for Microsnap Total, and their capacity to accurately identify well-sanitized surfaces. Additionally, Ultrasnap proved to be a sensitive indicator of residual organic matter, enhancing the capacity to distinguish between different sanitation levels and allowing cleaning and disinfection practices to be adjusted in real time, thereby reducing the risk of cross-transmission.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1669-1681"},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144454","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":"Innovative Training Strategies for Public Response to Out-of-Hospital Cardiac Arrest: A Scoping Review.","authors":"Heriyansyah Dalle, Yanny Trisyani, Aan Nur'aeni","doi":"10.2147/RMHP.S519931","DOIUrl":"10.2147/RMHP.S519931","url":null,"abstract":"<p><strong>Introduction: </strong>Out-of-hospital cardiac arrest (OHCA) is a critical medical emergency requiring immediate intervention to improve patient outcomes. Training the lay public in emergency intervention techniques has significantly enhanced survival rates. Easily accessible training programs are essential for equipping individuals with the necessary knowledge and skills. However, challenges such as standardized guidelines and cost-effective program delivery must be addressed. This study aimed to explore innovative practices in training and provide recommendations for enhancing emergency response capabilities in OHCA.</p><p><strong>Methods: </strong>The PRISMA Extension for Scoping Reviews (PRISMA-ScR) framework guided a comprehensive scoping review to identify relevant literature from PubMed, ScienceDirect, Scopus, EBSCOhost, and one search engine, Google Scholar. JBI tools were utilized to select high-quality articles, and thematic analysis was conducted to identify relevant innovations in OHCA training.</p><p><strong>Results: </strong>This review analyzed 13 articles discussing various methods of CPR training for the general public, considering cost, ease of use, and effectiveness. The findings highlight innovative approaches to improving the public's emergency response to OHCA. Smartphone apps significantly increase the likelihood of CPR and defibrillator use by laypersons. Low-cost DIY manikins are a viable alternative when resources are limited. Short CPR training videos and hands-only CPR training proved effective in training lay responders, while feedback devices and XR and VR-based training increased participants' confidence in CPR. Policy-based approaches, such as mandated CPR training, can broadly increase training coverage. Although advanced technologies offer high effectiveness, the cost and complexity of implementation remain significant challenges.</p><p><strong>Conclusion: </strong>The study provides valuable insights for developing innovative and effective training strategies to improve community emergency response to OHCA. However, further research should focus on long-term evaluation and integrating innovative technologies with low-cost training methods to develop more standardized and contextually appropriate training guidelines.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1635-1650"},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144500","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":"Nomogram Prediction Model of Thyroid Nodule in Healthcare Professionals: Based on Physical and Psychological Risk Factors.","authors":"Yuanling Tao, Chunyu Hu, Laixi Zhang, Zhen Cheng, Bing Zou, Mi Yan, Li Sun, Zongtao Chen","doi":"10.2147/RMHP.S517992","DOIUrl":"10.2147/RMHP.S517992","url":null,"abstract":"<p><strong>Background: </strong>Thyroid nodules are a common condition with a 7-15% likelihood of developing thyroid cancer. The prevalence of thyroid nodules in healthcare professionals is poorly understood, and how psychosomatic factors affect the occurrence of thyroid nodules is an interesting question. Therefore, the aims of this study are to explore the physiological and psychological aspects associated of thyroid nodules in healthcare professionals and establish a prediction model to provide a supportive basis for the primary prevention of thyroid nodules.</p><p><strong>Methods: </strong>A total of 738 healthcare professionals in a tertiary general hospital were selected by convenience sampling to complete an online psychological questionnaire and physical examination (biochemical indicators, ultrasound, etc.) from February to May 2023. Logistic regression was used to analyze risk factors, and the prediction model was established by nomogram.</p><p><strong>Results: </strong>A total of 406 of 738 healthcare professionals had thyroid nodules, the detection rate was 55.0%, among those detected, 24.1% were male and 75.9% were female. Multivariate logistic regression analysis showed: compared with ≤40 years old, aged 41-50 years old, or >50 years old were risk factors for thyroid nodules (OR=2.071/8.034); female (OR=1.873) was also risk factor for thyroid nodules relative to male; in addition, anxiety (OR=1.105), perceived stress (OR=1.045), fatty liver (OR=2.716), TSH abnormality (OR=1.944), and ALT abnormality (OR=2.252) were also risk factors. Based on the above seven influencing factors, a nomogram was drawn and verified internally. The results showed that the area AUC under the ROC curve of the model was 0.713, and the calibration curve indicated that the model consistency was acceptable.</p><p><strong>Conclusion: </strong>The detection rate of thyroid nodules is higher in healthcare professionals. A combination of psychological and physiological factors in TNs has a significant impact on thyroid nodules. Identifying risk factors for thyroid nodules and managing them promptly is important for the complete health of healthcare professionals.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1621-1633"},"PeriodicalIF":2.7,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129381","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":"Triaging Clients at Risk of Disengagement from HIV Care: Application of a Predictive Model to Clinical Trial Data in South Africa.","authors":"Mhairi Maskew, Shantelle Parrott, Lucien De Voux, Kieran Sharpey-Schafer, Thomas Crompton, Ashley Christopher Govender, Pedro Terrence Pisa, Sydney Rosen","doi":"10.2147/RMHP.S510666","DOIUrl":"10.2147/RMHP.S510666","url":null,"abstract":"<p><strong>Purpose: </strong>To reach South Africa's targets for HIV treatment and viral suppression, retention on antiretroviral therapy (ART) must increase. Here, we aim to successfully identify ART clients at risk of loss from care prior to disengagement.</p><p><strong>Patients and methods: </strong>We applied a previously developed machine learning and predictive modelling algorithm (PREDICT) to ART client data from SLATE I and II trials. The primary outcome was interruption in treatment (IIT), defined as missing the next scheduled clinic visit by >28 days. We tested two risk triaging approaches: 1) threshold approach classifying individuals into low, moderate, or high risk of IIT; and 2) archetype approach identifying subgroups with characteristics associated with risk of ITT. We report associations between risk category groups and subsequent IIT at the next scheduled visit using crude risk differences and relative risks with 95% confidence intervals.</p><p><strong>Results: </strong>SLATE datasets included 7199 client visits for 1193 clients over ≤14 months of follow-up. The threshold approach consistently and accurately assigned levels of IIT risk for multiple stages of the care cascade. The archetype approach identified several subgroups at increased risk of IIT, including those late to previous appointments, returning after a period of disengagement, living alone or without a treatment supporter. Behavioural elements of the archetypes tended to drive the risk of treatment interruption more consistently than demographics; eg adolescent boys/young men who attended visits on time experienced the lowest rates of treatment interruption (10% PREDICT datasets; 7% SLATE datasets), while adolescent boys/young men returning after previously disengaging had the highest rates of subsequent treatment interruption (31% PREDICT datasets; 40% SLATE datasets).</p><p><strong>Conclusion: </strong>Routinely collected medical record data can be combined with basic demographic and socioeconomic data to assess individual risk of future treatment disengagement. This approach offers an opportunity to prevent disengagement from HIV care, rather than responding only after it has occurred.</p><p><strong>Trial registration: </strong>SLATE I trial: Clinicaltrials.gov NCT02891135, registered September 1, 2016. First participant enrolled March 6, 2017, in South Africa and July 13, 2017, in Kenya. SLATE II trial: Clinicaltrials.gov NCT03315013, registered 19 October 2017. First participant enrolled 14 March 2018.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1601-1619"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112830","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 the Effectiveness of the WHO 6-Step Hand Hygiene Technique: Impact of Step Omission and Duration on Microbial Reduction.","authors":"Arkadii Vodianyk, Volodymyr Shyrobokov, Vadym Poniatovskyi","doi":"10.2147/RMHP.S506993","DOIUrl":"10.2147/RMHP.S506993","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization has proposed practical recommendations for hand hygiene, which include a six-step technique for hand washing and hand rubbing with antiseptic agents. Hand hygiene has become one of the five key elements of the patient safety program. However, adherence to all six steps of hygienic handrub among medical staff is quite low. In our study, we evaluated the effectiveness of reducing microbial load on the skin of hands depending on the number of steps performed and the duration of handrub.</p><p><strong>Methods: </strong>The preparation of the contamination fluid and the contamination of the volunteers' hand skin were carried out according to the European standard EN 1500. Subsequently handrub was performed using an alcohol-based antiseptic with various modifications of the six-step technique, either excluding certain elements or reducing the time spent on each step. After the handrub, swabs were performed, and the number of viable microorganisms in the obtained samples was determined.</p><p><strong>Results: </strong>Adherence to all stages of the WHO-recommended 6-step hand hygiene technique provided effective decontamination of hand skin. Using all six steps for 30 seconds resulted in a log reduction of microorganisms up to 2.82 (mean value of colony-forming unit (CFU) = 2.024×10³ (95% confidence interval (CI) ±0.545×10³). Reducing the duration of antiseptic use from 30 to 15 seconds did not decrease the effectiveness of the antiseptic action.</p><p><strong>Conclusion: </strong>Based on the conducted experimental studies, it can be concluded that following the WHO-recommended algorithm for hand hygiene significantly reduces the contamination of the skin surface with test cultures.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1591-1600"},"PeriodicalIF":2.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095888","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 Obesity on Readmission and Healthcare Costs in Patients with Skin and Subcutaneous Tissue Infections.","authors":"David Suh, Seung-Mi Lee","doi":"10.2147/RMHP.S516684","DOIUrl":"10.2147/RMHP.S516684","url":null,"abstract":"<p><strong>Purpose: </strong>Obesity is a global public health issue linked to worsened skin and subcutaneous tissue infections (SSTIs), complicating clinical management and increasing healthcare costs. This study aimed to evaluate obesity's influence on hospitalization duration, readmission rates, and healthcare costs among patients with SSTIs, with an emphasis on sex-specific patterns.</p><p><strong>Patients and methods: </strong>This retrospective cohort study analyzed data from South Korea's national healthcare database. The study population comprised adults hospitalized with SSTIs between 2015 and 2020. Obesity measures included body mass index (BMI) and waist circumference (WC), categorized by standard thresholds. Statistical analyses included Cox proportional hazards models for hospitalization duration, while multivariable logistic regression evaluated readmission risks. Healthcare costs were analyzed using generalized linear models, with sex-stratified analysis to examine clinical and economic outcome disparities.</p><p><strong>Results: </strong>Male patients demonstrated an inverse relationship between BMI and hospitalization duration and costs, with minimal WC influence. Conversely, female patients exhibited positive associations between both obesity measures and hospitalization outcomes. SSTI-related readmissions within two years increased with rising BMI and WC across both sexes (<i>p</i> < 0.001). Estimated readmission costs showed significant sex-specific variations, increasing 55% among males with WC ≥ 100 cm versus < 80 cm and 132% among females with WC ≥ 95 cm versus < 75 cm.</p><p><strong>Conclusion: </strong>Obesity substantially impacts SSTI clinical severity and economic costs, with distinct sex-specific disparities. Implementing tailored antimicrobial regimens, weight management strategies, and sex-specific treatment protocols is essential for outcome optimization and cost reduction. Future research should prioritize sex-specific interventions and resource allocation strategies in SSTI management.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1579-1590"},"PeriodicalIF":2.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095893","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}