Risk Management and Healthcare Policy最新文献

{"title":"Cleaning and Disinfecting Public Transportation Vehicles Against Respiratory Infectious Diseases in Lebanon: A Cross-Sectional Study.","authors":"Mahmoud Salam, Zahra Shan Bader, Abdul Rahman Itani, Abed Al Salam Balawi, Ali Al Hadi Assaf, Maha Mansour","doi":"10.2147/RMHP.S609392","DOIUrl":"10.2147/RMHP.S609392","url":null,"abstract":"<p><strong>Background: </strong>Public transportation involves a risk of transmitting various types of respiratory infectious diseases (RID), so it is essential to promote the safety of drivers, users, and the broader community. The aim of this study is to evaluate the cleaning and disinfecting (C&D) practices of public transportation vehicles in Lebanon.</p><p><strong>Methods: </strong>In this cross-sectional study, 394 drivers were surveyed between March and July 2025 from various regions in Lebanon. Using a face-to-face questionnaire, C&D practices were evaluated against the North American Transportation Services Association (NATSA) guidelines. Non-compliance rates were compared across sample characteristics using Pearson's Chi-square, Student's <i>t</i>-test, and Binary logistic regression analyses.</p><p><strong>Findings: </strong>Non-compliance rates with the frequencies of cleaning, disinfection, and deep cleaning (at washing stations) are 296 (75.1%), 321 (81.5%) and 161 (40.9%), respectively. Moreover, 251 (71.9%), 8 (3.4%) and 162 (51.3%) of drivers are not compliant with cleaning, disinfecting, and deep‑cleaning methods, respectively. Non-compliance with the frequency of changing HVAC filters was 387 (98.2%). Furthermore, 383 (97.2%) and 332 (89.7%) are not compliant with self-protective measures against RID while on duty or while C&D vehicles, respectively. Factors associated with non-compliance with C&D practices are reported.</p><p><strong>Interpretation: </strong>Non-compliance with the recommended C&D of public transportation vehicles in Lebanon is alarming. Disseminating an Arabic-language version of NATSA guidelines, providing affordable C&D kits, a fast‑pass deep‑cleaning service at washing stations, and waiving taxes on HVAC filters can contribute to safer public transportation service. FMs and hand sanitizers need to be available inside all public transportation vehicles. Both drivers and users are encouraged to use them. Stickers can be applied on the front shield of vehicles to remind drivers about precautionary measures against RID.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"609392"},"PeriodicalIF":2.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815052","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":"Shared Social Determinants and Aggregated Risk Behaviours Associated with Self-Rated Oral Health Among Schoolchildren in Jazan, Saudi Arabia.","authors":"Saba Kassim, Mosa A Shubayr, Samah Mourad, Doaa Felemban, Tahani Binaljadm, Sadeq Ali Al-Maweri, Hani T Fadel, Maha Alsharif, Reem K Alabbasi, Alla T Alsharif","doi":"10.2147/RMHP.S602386","DOIUrl":"10.2147/RMHP.S602386","url":null,"abstract":"<p><strong>Background: </strong>Dental and periodontal diseases share common social determinants and oral health-risk behaviours, yet these factors have not been thoroughly investigated across different contexts.</p><p><strong>Aim: </strong>This study aimed to examine the association between aggregated common oral health-risk behaviours and their determinants with self-rated dental and gingival health in Jazan, Saudi Arabia (SA).</p><p><strong>Methods: </strong>A cross-sectional study was conducted among a non-probability convenience sample of 687 school students in Jazan, SA. Participants completed an online questionnaire assessing behaviours related to oral hygiene, dental visits, dietary habits (sugar and fruit consumption), tobacco use, and sociodemographic and socioeconomic factors. Logistic regression modelling was performed to assess the determinants and aggregated behaviours associated with self-rated poor dental and gingival health.</p><p><strong>Results: </strong>The median age of participating students was 15 (interquartile range: 2) years, and 67% were female. The aggregate of oral health-risk behaviours score was significantly associated with self-rated poor dental and gingival health, with each additional risk behavior associated with higher odds of poor dental health (OR = 1.29, 95% CI: 1.17-1.42) and poor gingival health (OR = 1.34, 95% CI: 1.23-1.47). Rural residence was also significantly associated with both outcomes, including poor dental health (OR = 2.44, 95% CI: 1.56-3.83) and poor gingival health (OR = 2.02, 95% CI: 1.37-2.99).</p><p><strong>Conclusion: </strong>This study found a significant association between aggregated oral health-related risk behaviours and poor self-rated dental and gingival health among schoolchildren in Jazan region, SA. Notably, area of residence emerged as a key shared social determinant, with students living in rural areas disproportionately impacted. These findings support the shared role of oral health-risk behaviours and social factors in the development of both dental and gingival diseases.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"602386"},"PeriodicalIF":2.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809401","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":"Development and Validation of a Social Influence Scale for Antiviral Therapy Behavior of Patients with Chronic Hepatitis B.","authors":"Yuehua Chen, Ziyan Zhang, Junjie Jiang, Shiyin Wu, Wenbin Liu","doi":"10.2147/RMHP.S617195","DOIUrl":"10.2147/RMHP.S617195","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatitis B virus (HBV) infection remains a global health problem with widespread prevalence, yet treatment rates remain persistently low worldwide. Although the impact of social influence on health behaviors has been well confirmed and proven to play a prominent role, a standardized scale to measure its specific influence on treatment behavior among chronic hepatitis B (CHB) patients is still lacking. Therefore, this study aimed to develop a social influence scale to assess its role in patients' treatment decision-making.</p><p><strong>Patients and methods: </strong>The scale was developed through four steps. First, a preliminary scale was developed based on the literature review and internal discussion. Second, two rounds of Delphi expert consultation were conducted for item content validation. Third, a cross-sectional survey involving 611 participants was conducted from March to October 2023 in Fuqing, China, to test the reliability and validity of the preliminary scale. Finally, the scale was assessed by item analysis, internal consistency tests, and exploratory and confirmatory factor analysis.</p><p><strong>Results: </strong>The final scale consisted of five dimensions and 16 items that explained 90.5% of the total variance. Confirmative factor analysis model showed that the 5-factor model fits the data well (χ²/df=4.266, CFI=0.979, GFI=0.925, and RMSEA=0.073). The Cronbach alpha coefficient of the total scale and the five factors was 0.818 and 0.896-0.970. For convergent validity, AVE was 0.795-0.895, and CR was 0.918-0.971. The dimensions comprised descriptive norm, injunctive norm, social support, discrimination, and prototype.</p><p><strong>Conclusion: </strong>The scale is valid and reliable to evaluate the impact of social influence on treatment behaviors among CHB patients.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"617195"},"PeriodicalIF":2.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801740","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":"Cost-Effectiveness Analysis of Ivonescimab Plus Chemotherapy versus Tislelizumab Plus Chemotherapy as First-Line Treatment for Advanced Squamous Non-Small-Cell Lung Cancer in China Based on the HARMONi-6 Trial.","authors":"Feng Xuan, Minguang Huang, Yan Yang, Haoze Bian","doi":"10.2147/RMHP.S632004","DOIUrl":"10.2147/RMHP.S632004","url":null,"abstract":"<p><strong>Background: </strong>Ivonescimab plus chemotherapy improved survival compared with tislelizumab plus chemotherapy in the HARMONi-6 trial for first-line advanced squamous non-small-cell lung cancer (sq-NSCLC). However, its economic value in China remains unclear.</p><p><strong>Methods: </strong>From the perspective of the Chinese healthcare system, a partitioned survival model was developed to assess the cost-effectiveness of ivonescimab plus chemotherapy versus tislelizumab plus chemotherapy using efficacy and safety data from HARMONi-6. Analyses were conducted in the overall randomly assigned population and programmed death-ligand 1 tumor proportion score (PD-L1 TPS) subgroups. Outcomes included costs, life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), incremental net monetary benefits (INMBs), incremental net health benefits (INHBs), and cost-effectiveness probabilities. The willingness-to-pay (WTP) threshold was $27,906 per QALY. Sensitivity, scenario, subgroup, and price simulation analyses were performed.</p><p><strong>Results: </strong>In the overall population, ivonescimab plus chemotherapy increased costs compared with tislelizumab plus chemotherapy ($77,730.17 vs $40,088.29) and improved outcomes, with 3.5912 versus 2.3113 LYs and 2.9059 versus 1.8704 QALYs. The incremental cost was $37,641.88, with gains of 1.2799 LYs and 1.0355 QALYs, resulting in an ICER of $36,351.02 per QALY. Across PD-L1 TPS subgroups, all ICERs exceeded the WTP threshold. Probabilistic sensitivity analysis showed a 9.7% probability of cost-effectiveness at $27,906 per QALY, increasing to 87.5% at $41,859 per QALY. Price simulation indicated that ivonescimab would need to be priced at no more than $69.59 per 100 mg to be cost-effective at $27,906 per QALY.</p><p><strong>Conclusion: </strong>Ivonescimab plus chemotherapy provided greater survival benefits than tislelizumab plus chemotherapy but was unlikely to be cost-effective relative to tislelizumab plus chemotherapy in China at the current price.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"632004"},"PeriodicalIF":2.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815124","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":"A Risk Stratification Model for Unplanned Extubation a Chinese Tertiary Hospital Respiratory Intensive Care Unit: A Retrospective Study Based on Nursing-Related and Ventilation Characteristics.","authors":"Wenqing Xu, Ying Yang, Chen Wang, Hanhan Hong, Wenya Sun","doi":"10.2147/RMHP.S624397","DOIUrl":"https://doi.org/10.2147/RMHP.S624397","url":null,"abstract":"<p><strong>Aim: </strong>To develop a risk prediction model for unplanned extubation (UE) in invasively ventilated patients in the respiratory intensive care unit (RICU) using nursing-related and ventilation characteristics, and to perform risk stratification.</p><p><strong>Methods: </strong>This single-center retrospective study included adult patients receiving invasive mechanical ventilation in the RICU. Nursing-related variables (RASS score, delirium, physical restraint use, nurse-to-patient ratio) along with baseline and treatment data were collected. Univariate and multivariate logistic regression was employed to identify UE-associated factors and build a nomogram. Model performance was evaluated using ROC curve, Hosmer-Lemeshow test, calibration curve, decision curve analysis, and bootstrap internal validation. Risk stratification was performed based on predicted probability.</p><p><strong>Results: </strong>Among 1120 patients, 102 (9.11%) experienced UE. Multivariate analysis identified RASS category, nurse-to-patient ratio, and FiO₂ as independent factors. Compared with agitation, awake/mild sedation (<i>OR</i> = 0.262, <i>P</i> = 0.002) and deep sedation (<i>OR</i> = 0.071, <i>P</i> < 0.001) were protective. A nurse-to-patient ratio ≥ 1:4 was an independent risk factor (<i>OR</i> = 3.257, <i>P</i> = 0.001). FiO₂ was protective (<i>OR</i> = 0.037, <i>P</i> = 0.009). The model achieved an AUC of 0.781 (95% <i>CI</i>: 0.738-0.824), sensitivity 0.760, specificity 0.700, Brier score 0.076, Hosmer-Lemeshow <i>P</i> 0.301, and calibration slope 1.000. UE incidence in low-, medium-, and high-risk groups was 2.80%, 15.60%, and 25.00%, respectively.</p><p><strong>Conclusion: </strong>The UE risk prediction model based on nursing-related characteristics has good discrimination and calibration. RASS category, nurse-to-patient ratio, and FiO₂ are key independent factors. This model enables effective risk stratification and supports early identification of high-risk patients and optimized nursing management; however, its generalizability should be interpreted cautiously because of the single-center retrospective design and lack of external validation.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"624397"},"PeriodicalIF":2.6,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801739","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":"Sepsis in Autoimmune Rheumatic Diseases: Risk Factors, Pathophysiology, and Outcomes.","authors":"Meiyi Tian, Zhuo Sun, Yang Zhang, Jian Liu","doi":"10.2147/RMHP.S620940","DOIUrl":"https://doi.org/10.2147/RMHP.S620940","url":null,"abstract":"<p><p>Sepsis remains a leading cause of morbidity and mortality in patients with autoimmune rheumatic diseases (ARDs), with distinct time-dependent outcomes that differ across disease subtypes, sepsis definitions, immune phenotypes, and follow-up time horizons. Chronic immune dysregulation, disease-specific cytokine signatures, cumulative organ damage, and dose- and duration-dependent immunosuppressive therapies render this population particularly vulnerable to sepsis. Evidence indicates that ARDs and sepsis share overlapping immunopathological mechanisms, including cytokine dysregulation, disease-dependent neutrophil extracellular trap (NET) abnormalities, Treg/Th17 imbalance, endotoxin-related immune tolerance, and phenotype-specific immune suppression. However, the functional consequences of these shared pathways diverge substantially by ARD subtype and disease activity. Whether ARDs independently influence sepsis susceptibility and clinical outcomes remains controversial, largely due to heterogeneity in sepsis definitions, endpoint variability, and incomplete confounder control. In this systematic review with narrative synthesis, conducted in accordance with PRISMA 2020 guidance (87 studies included), we synthesize current epidemiological, genetic, and mechanistic evidence and discuss risk-management and healthcare-policy implications. We summarize disease-related, immune-related, treatment-related, demographic, and healthcare-system risk factors, stratified by evidence strength and specificity to ARDs, and critically evaluate the time-dependent mortality paradox: preserved or improved short-term survival in certain ARDs versus substantially elevated long-term mortality. A deeper understanding of these complex interactions, including pathogen spectra, vaccination status, and modifiable risk factors, may facilitate the development of clinically actionable risk stratification tools, inform personalized therapeutic decision-making, and improve both short- and long-term outcomes in this high-risk population.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"620940"},"PeriodicalIF":2.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13468303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759642","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":"Migraine Prevalence and QALY Loss in Serbia: A Population-Level Stratified Modeling Study.","authors":"Viktor Pasovski, Mark Parker, Tanja Novaković, Milica Krga Rastović, Katarina Katanić Pasovski, Ranko Raičević","doi":"10.2147/RMHP.S614644","DOIUrl":"10.2147/RMHP.S614644","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate age- and sex-specific migraine prevalence in Serbia and annual quality-adjusted life-year (QALY) loss among adults with definite or probable migraine using a population-level stratified model.</p><p><strong>Methods: </strong>Global Burden of Disease (GBD) 2023 prevalence estimates for definite migraine, probable migraine, and total medication-overuse headache (MOH) in Serbia were applied to final 2022 Serbian Census counts by single year of age and sex; 73.2% of total MOH was attributed to migraine. Epidemiological estimates included residents aged 5 years or older, whereas the primary one-year QALY analysis included adults aged 18 years or older with definite or probable migraine. Annual QALY loss equaled modeled case counts multiplied by the GBD 2023 proportion of time symptomatic and the paired EQ-5D-5L migraine-day utility decrement of 0.364. A 100,000-iteration probabilistic sensitivity analysis sampled 12 symptom-time parameters and one shared utility-decrement parameter from normal distributions truncated to [0,1], with prevalence fixed. No episodic/chronic split or attack-frequency assumptions were imposed.</p><p><strong>Results: </strong>The model estimated 952,369 residents aged 5 years or older with migraine (crude modeled prevalence, 15.0%). Among adults, 794,380 with definite or probable migraine were included in the primary QALY analysis, whereas 85,364 with MOH attributable to migraine were reported epidemiologically only. Deterministic annual QALY loss was 21,951, or 0.0276 QALY (10.1 full-health-equivalent days) per included adult. Across 100,000 probabilistic iterations, mean annual loss was 21,949 QALYs (95% uncertainty interval, 20,203-23,736).</p><p><strong>Conclusion: </strong>Migraine represents a substantial modeled population-health burden in Serbia. The primary estimate excluded pediatric, MOH-related, and additional interictal QALY loss. It provides a transparent national benchmark for migraine recognition, referral, health-related quality-of-life measurement, and evaluation of preventive-care access, but does not establish intervention effectiveness or cost-effectiveness.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"614644"},"PeriodicalIF":2.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714955","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":"Financial Heterogeneity During Early Diagnosis-Related Group Payment Reform: A Two-Year Hospital-Based Study.","authors":"Wei Shao, Lixin Shu, Xufang Wang, Fei Yu, Ting Zhou, Dan Han","doi":"10.2147/RMHP.S623418","DOIUrl":"https://doi.org/10.2147/RMHP.S623418","url":null,"abstract":"<p><strong>Introduction: </strong>China launched its national diagnosis-related group (DRG) reform to promote efficiency and improve financial risk alignment. However, empirical evidence from the early implementation period remains limited. This study aimed to assess financial heterogeneity across DRG categories and identify factors associated with financial loss during the early implementation of DRG-based payment.</p><p><strong>Methods: </strong>This retrospective study analyzed all DRG-classified inpatient encounters from a tertiary teaching hospital in Shanghai between 2023 and 2024. The study period corresponded to the early implementation phase of DRG-based payment in the study hospital. The same core definitions of actual total cost, DRG-predicted payment, and financial deviation were applied consistently across both years. Financial deviation was assessed using absolute and relative measures. DRG-level heterogeneity was examined among groups with at least 30 cases to identify those with the most pronounced improvement or deterioration. Multivariable logistic regression identified factors associated with financial loss, and linear regression was used as a sensitivity analysis.</p><p><strong>Results: </strong>Among 64,864 encounters with valid DRG-predicted payment, median absolute deviation shifted from -1615 CNY in 2023 to -1923 CNY in 2024 (p < 0.001), and the proportion of loss-making cases declined from 38.9% to 28.8%. Substantial heterogeneity existed across DRGs, with both improvement and deterioration observed among high-complexity and resource-intensive groups. Logistic regression showed that longer LOS increased the likelihood of financial loss (OR = 1.075, 95% CI 1.071 to 1.079), while older age decreased it (OR = 0.996, 95% CI 0.995 to 0.997). Financial loss was significantly less frequent in 2024 than in 2023 (OR = 0.623, 95% CI 0.603 to 0.644). Sensitivity analyses confirmed these findings.</p><p><strong>Conclusion: </strong>Financial alignment under DRG payment was better in 2024 than in 2023, although marked heterogeneity persisted across DRGs. LOS remained an important predictor of financial loss. These findings provide hospital-level evidence on financial risk variation during early DRG implementation. Because the analysis was based on a single tertiary teaching hospital, the results should not be generalized to other hospitals or interpreted as evidence of the broader effects of DRG payment reform in China.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"623418"},"PeriodicalIF":2.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760479","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":"Age and Gender Differences in the Association Between Risk Aversion and Risky Health Behaviors: Evidence from a Survey Experiment.","authors":"Panxu Yang","doi":"10.2147/RMHP.S600680","DOIUrl":"10.2147/RMHP.S600680","url":null,"abstract":"<p><strong>Background: </strong>Although studies have established a correlation between risk aversion and risky health behaviors, the heterogeneity of this relationship across age and gender groups remains underexplored.</p><p><strong>Methods: </strong>Data from 26,873 participants (aged 16 and above) from the 2018 wave of the China Family Panel Studies were analyzed using a five-round coin-toss experiment to measure risk aversion, with smoking and abnormal weight as risky health behaviors. Logistic regression examined the correlations.</p><p><strong>Results: </strong>Higher risk aversion was significantly associated with lower odds of smoking (OR = 0.979, p < 0.05) and abnormal body weight (OR = 0.972, p < 0.01). Age significantly moderated the association between risk aversion and smoking: the negative association was stronger among younger adults than older adults (risk aversion × age interaction OR = 1.001, p < 0.05), although the magnitude of this interaction is negligible. However, age did not significantly moderate the association between risk aversion and abnormal body weight (risk aversion × age interaction OR = 1.001, p > 0.1). Gender significantly moderated the association between risk aversion and abnormal body weight (risk aversion × male interaction OR = 1.032, p < 0.1) but did not significantly moderate the association between risk aversion and smoking. The negative association between risk aversion and abnormal body weight was more pronounced among females than males. Given the low explanatory power of the abnormal body weight model (Pseudo <i>R²</i> = 0.008), these findings should be interpreted with caution.</p><p><strong>Conclusion: </strong>Risk aversion is negatively associated with smoking and abnormal body weight, with the association being more pronounced for smoking. Age-related moderation is negligible, and policy implications are warranted only for smoking prevention, given the limited explanatory power of the body weight model.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"600680"},"PeriodicalIF":2.6,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703066","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":"Associated Factors of Pre-Anesthesia Blood Pressure Elevation in Elective Non-Cardiac Surgical Patients: A Case-Control Study Comparing Two Diagnostic Thresholds.","authors":"Xiao-Min Li, Yan Yang, Hao Pan, Wang Li, Ge-Yi Ai, Xi-Jiang Liu, Guang-Fen Zhang, Jie Guo","doi":"10.2147/RMHP.S612564","DOIUrl":"10.2147/RMHP.S612564","url":null,"abstract":"<p><strong>Background: </strong>Pre-anesthesia blood pressure (BP) elevation frequently occurs in normotensive elective surgical patients and may disrupt perioperative safety. This study adopted two mainstream diagnostic criteria (absolute and relative thresholds) to define BP elevation, and integrated physical, laboratory and psychological indicators to systematically explore relevant associated factors.</p><p><strong>Methods: </strong>This case-control study enrolling a total of 528 non-cardiac surgical patients. Patients were divided into case (elevated pre-anesthesia BP) and control (normal pre-anesthesia BP) groups. Pre-anesthesia BP elevation was defined as absolute threshold (systolic BP [SBP] ≥140 mmHg and/or diastolic BP [DBP] ≥90 mmHg), and relative threshold (≥20% increase from baseline). Multivariable logistic regression was used to screen associated factors.</p><p><strong>Results: </strong>The incidence of pre-anesthesia BP elevation was 35.6% (n=188) under the absolute threshold and 28.2% (n=149) under the relative threshold. Multivariable analysis revealed that increasing age (absolute threshold: odds ratio [OR] 1.08, 95% confidence interval [CI] 1.05-1.10, relative threshold: OR 1.03, 95% CI 1.01-1.04), hyperlipemia (absolute threshold: OR 2.66, 95% CI 1.84-3.86, relative threshold: OR 1.49, 95% CI 1.18-1.88) and anxiety (absolute threshold: OR 1.17, 95% CI 1.10-1.25, relative threshold: OR 1.07, 95% CI 1.02-1.13) were correlated with BP elevation under both definitions (all p < 0.01). Under the absolute threshold, body mass index (BMI) (OR 1.12, 95% CI 1.03-1.21) and alcohol drinking (OR 2.74, 95% CI 1.55-4.84) were positively correlated (both p < 0.01), whereas prolonged sleep duration (2-4 hours: OR 0.37, 95% CI 0.15-0.95, 4-6 hours: OR 0.14, 95% CI 0.06-0.35, 6-8 hours: OR 0.12, 95% CI 0.04-0.34) was negatively correlated (all p < 0.05).</p><p><strong>Conclusion: </strong>Increasing age, hyperlipemia and preoperative anxiety are consistently associated with transient pre-anesthesia BP elevation under both criteria. Further studies are required to confirm causal links and verify whether intervening on these correlates can reduce perioperative BP fluctuations.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"612564"},"PeriodicalIF":2.6,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702996","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}