Risk Management and Healthcare Policy最新文献

{"title":"Impact of the SARS-CoV-2 Pandemic on Hospitalizations in an Acute Psychiatric Ward.","authors":"Rosaria Di Lorenzo, Matteo Reami, Diego Dragone, Martina Morgante, Giulia Panini, Paola Ferri, Sergio Rovesti","doi":"10.2147/RMHP.S465858","DOIUrl":"10.2147/RMHP.S465858","url":null,"abstract":"<p><strong>Background: </strong>The Sars-CoV-2 pandemic imposed unprecedented and drastic changes in health care organizations all over the world.</p><p><strong>Purpose: </strong>To evaluate the impact of the pandemic on hospitalizations in an acute psychiatric ward.</p><p><strong>Patients and methods: </strong>We retrospectively identified and compared acute psychiatric hospitalizations in the Service for Psychiatric Diagnosis and Care (SPDC) of AUSL-Modena during the pre-pandemic (n = 1858) and pandemic period (n = 1095), from 01/01/2017 to 31/12/2022. Data were statistically analyzed using STATA12.</p><p><strong>Results: </strong>We collected 1858 hospitalizations in the pre-pandemic and 1095 in the pandemic. During the pandemic, we observed a progressively sharp reduction in voluntary hospitalizations, whereas involuntary ones remained stable with an increase in 2022 (p < 0.001), longer hospital stays (12.32 mean days vs 10.03; p < 0.001), longer periods of involuntary hospitalizations (8.45 mean days vs 5.72; p < 0.001), more frequent aggressive behaviour (16.10% vs 9.12%; p < 0.001) and referral to psychiatric communities at discharge (11.04% vs 6.13%; p < 0.001); non-Italians (p = 0.001), people with disability pension (p < 0.001) and Support Administrator (p < 0.001) were more frequently hospitalized.</p><p><strong>Conclusion: </strong>During the pandemic, voluntary psychiatric hospitalizations decreased, but not involuntary ones, and the most vulnerable people in serious clinical conditions were hospitalized.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141478030","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":"On the Association Between Demographic Structural Change and the Effectiveness of Nurse Staffing Policy for Inpatient Care: Evidence from Taiwan.","authors":"Yi-Ling Lai, Wen-Yi Chen, Shiuan-Shinn Lee, Yung-Po Liaw","doi":"10.2147/RMHP.S468178","DOIUrl":"10.2147/RMHP.S468178","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the influence of demographic changes on the effectiveness of hospital nurse staffing policy, measured by the cumulative response of inpatient care quality to adjustments in hospital nurse staffing levels in Taiwan.</p><p><strong>Methods: </strong>The research design utilized in this study aligns with the observational time-series methodology, and a total of 99 monthly time-series observations were collected from multiple databases administered by the Taiwan government over the period from January 2015 to March 2023. Specifically, the time-varying parameter vector autoregressive and autoregressive distributed lag models were employed to investigate the association between age distribution and nurse staffing policy effectiveness.</p><p><strong>Results: </strong>The time-varying impulse responses of the unplanned 14-day readmission rate after discharge to changes in nurse staffing levels indicate a positive association between patient-to-nurse ratios and unplanned 14-day readmission rates across various types of hospitals. Nevertheless, the effectiveness of hospitals' nurse staffing policy is observed to diminish with population aging, particularly evident in medical centers and regional hospitals.</p><p><strong>Conclusion: </strong>Policymakers should establish lower mandated patient-to-nurse ratios, grounded in practical nurse workforce planning, to address the needs of an aging society and enhance inpatient care quality through improved nurse staffing in hospitals.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141478031","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 Nomogram to Predict the Risk of Special Uterine Leiomyoma Pathological Types or Leiomyosarcoma in Postmenopausal Women: A Retrospective Study.","authors":"Yaping Wang, Yiyi Zhao, Chaolu Shi, Juanqing Li, Xiufeng Huang","doi":"10.2147/RMHP.S461773","DOIUrl":"10.2147/RMHP.S461773","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the risk factors of postmenopausal special uterine leiomyoma pathological types or leiomyosarcoma and to develop a nomogram for clinical risk assessment, ultimately to reduce unnecessary surgical interventions and corresponding economic expenses.</p><p><strong>Methods: </strong>A total of 707 patients with complete information were enrolled from 1 August 2012 to 1 August 2022. Univariate and multivariate logistic regression models were used to analyse the association between variables and special uterine leiomyoma pathological types or leiomyosarcoma in postmenopausal patients. A nomogram for special uterine leiomyoma pathological types or leiomyosarcoma in postmenopausal patients was developed and validated by bootstrap resampling. The calibration curve was used to assess the accuracy of the model and receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were compared with the clinical experience model.</p><p><strong>Results: </strong>The increasing trend after menopause, the diameter of the largest uterine fibroid, serum carcinoembryonic antigen 125 concentration, Serum neutrophil to lymphocyte ratio, and Serum phosphorus ion concentration were independent risk factors for special uterine leiomyoma pathological types or leiomyosarcoma in postmenopausal patients. We developed a user-friendly nomogram which showed good diagnostic performance (AUC=0.724). The model was consistent and the calibration curve of our cohort was close to the ideal diagonal line. DCA indicated that the model has potential value for clinical application. Furthermore, our model was superior to the previous clinical experience model in terms of ROC and DCA.</p><p><strong>Conclusion: </strong>We have developed a prediction nomogram for special uterine leiomyoma pathological types or leiomyosarcoma in postmenopausal patients. This nomogram could serve as an important warning signal and evaluation method for special uterine leiomyoma pathological types or leiomyosarcoma in postmenopausal patients.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11198023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452297","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":"Association Between Risk Perceptions of COVID-19, Political Ideology, and Mask-Wearing Behavior After the Outbreak: A Cross-Sectional Survey in South Korea.","authors":"Seung Yeon Lee, Ji Hye Ham, Hyun-Kyung Park, Deok Hyun Jang, Won Mo Jang","doi":"10.2147/RMHP.S463739","DOIUrl":"10.2147/RMHP.S463739","url":null,"abstract":"<p><strong>Purpose: </strong>After the declaration by the World Health Organization signaling the conclusion of the COVID-19 pandemic, most countries lifted mandatory mask-wearing regulations. This study aimed to investigate factors such as risk perception and political ideology associated with continued adherence to mask-wearing among specific populations, particularly when it is no longer deemed necessary.</p><p><strong>Methods: </strong>We conducted a cross-sectional study including a sample of 1001 respondents stratified by sex, age (≥ 18 years), and region from January 31 to February 2, 2023, after the mandatory mask regulation was lifted in South Korea. Multivariate logistic regression models were applied to estimate the relationships between risk perceptions, political ideology, and mask-wearing maintenance, adjusting for factors such as sex, age, occupation, and trust in the government.</p><p><strong>Results: </strong>Our results indicated significant associations between age, self-reported household economic status, political ideology, affective risk perception, and perceived effectiveness of the government's COVID-related measures with indoor mask-wearing. Specifically, liberals were more likely to keep mask-wearing indoors than conservatives (adjusted odds ratio [aOR]: 2.19; 95% confidence interval [CI]: 1.33-3.59); and those who perceived a greater affective risk of COVID-19 (aOR: 2.47; 95% CI: 1.96-3.10), along with those who perceived the government's countermeasures as inadequate, were more inclined to maintain the habit of wearing masks indoors (aOR: 1.90; 95% CI: 1.19-3.03).</p><p><strong>Conclusion: </strong>Our study highlighted the multifaceted factors influencing mask-wearing behavior in the post-COVID-19 era. Even after adjusting for various confounding factors, such as age, sex, and trust in the government, an association remained between affective risk perception, political ideology, and mask-wearing behavior. However, further research for psychological mechanisms is needed to foster a culture of preventive behaviors proportional to the risk of infection.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447686","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":"Sexual Harassment Among Chinese Psychiatrists and Its Impact on Quality of Life: A Cross-Sectional Survey [Response to Letter].","authors":"Yu Xiao, Liang Liu, Ting-Ting Chen, Zhou Zhang, Xiao-Hong Wu","doi":"10.2147/RMHP.S482718","DOIUrl":"10.2147/RMHP.S482718","url":null,"abstract":"","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443809","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":"Security Risk Assessment for Patient Portals of Hospitals: A Case Study of Taiwan.","authors":"Pei-Cheng Yeh, Kuen-Wei Yeh, Jiun-Lang Huang","doi":"10.2147/RMHP.S463408","DOIUrl":"10.2147/RMHP.S463408","url":null,"abstract":"<p><strong>Background: </strong>Growing cyberattacks have made it more challenging to maintain healthcare information system (HIS) security in medical institutes, especially for hospitals that provide patient portals to access patient information, such as electronic health record (EHR).</p><p><strong>Objective: </strong>This work aims to evaluate the patient portal security risk of Taiwan's EEC (EMR Exchange Center) member hospitals and analyze the association between patient portal security, hospital location, contract category and hospital type.</p><p><strong>Methods: </strong>We first collected the basic information of EEC member hospitals, including hospital location, contract category and hospital type. Then, the patient portal security of individual hospitals was evaluated by a well-known vulnerability scanner, UPGUARD, to assess website if vulnerable to high-level attacks such as denial of service attacks or ransomware attacks. Based on their UPSCAN scores, hospitals were classified into four security ratings: absolute low risk, low to medium risk, medium to high risk and high risk. Finally, the associations between security rating, contract category and hospital type were analyzed using chi-square tests.</p><p><strong>Results: </strong>We surveyed a total of 373 EEC member hospitals. Among them, 20 hospital patient portals were rated as \"absolute low risk\", 104 hospital patient portals as \"low to medium risk\", 99 hospital patient portals as \"medium to high risk\" and 150 hospital patient portals as \"high risk\". Further investigation revealed that the patient portal security of EEC member hospitals was significantly associated with the contract category and hospital type (<i>P</i><0.001).</p><p><strong>Conclusion: </strong>The analysis results showed that large-scale hospitals generally had higher security levels, implying that the security of low-tier and small-scale hospitals may warrant reinforcement or strengthening. We suggest that hospitals should pay attention to the security risk assessment of their patient portals to preserve patient information privacy.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11193402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443808","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":"Patient Safety Incidents in Operating Rooms Reported in the Past Five Years (2017-2021) in Korea.","authors":"Nam-Yi Kim, Hyonshik Ryu, Sungjung Kwak","doi":"10.2147/RMHP.S462485","DOIUrl":"10.2147/RMHP.S462485","url":null,"abstract":"<p><strong>Purpose: </strong>Patient safety incidents in the operating room require special attention because they can cause catastrophic and irreversible conditions in patients. Although patient safety incidents have different characteristics, there may be similarities and patterns of risk factors that may be common. Therefore, this study analyzed factors associated with the PSIs by analyzing data from the Korean Patient Safety Reports from 2017 to 2019.</p><p><strong>Methods: </strong>The \"Patient Safety Incidents Data from 2017 to 2021\" systematically collected by the Korea Institute for Healthcare Accreditation, include patient safety incident reports from medical institutions. Data on 1140 patient safety incidents in the operating room were analyzed. They included patients' gender and age, Hospital size, Incident seasons, incident time, Incident reporter, incident type, Medical department, and Incident severity. The Incident severity was analyzed by dividing it into three stages: near miss, adverse event, sentinel event, which are applied by domestic medical institutions.</p><p><strong>Results: </strong>The highest number of OR patient safety incidents were related to surgery and anesthesia. On analyzing the probability of adverse events based on near misses, the significant variables were patient gender, incident reporter, incident type, and Medical department. Additionally, the factors that were likely to precipitate sentinel events based on near misses were patient gender, incident time, reporter, and incident type.</p><p><strong>Conclusion: </strong>To prevent sentinel events in Patient safety incidents, female and during night shifts are required to pay close attention. Moreover, it is necessary to establish a patient safety reporting system in which not only all medical personnel, but also patients, generally, can actively participate in patient safety activities.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443807","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":"Erratum: Prevalence of Paternal Prenatal Depression and Its Associated Factors in Saudi Arabia [Corrigendum].","authors":"","doi":"10.2147/RMHP.S482256","DOIUrl":"https://doi.org/10.2147/RMHP.S482256","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/RMHP.S454926.].</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422020","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":"Alcohol Consumption Patterns for Excessive Drinkers in a Multi-Ethnic Society Short Running Title: Drinking Patterns and Health Education.","authors":"Ziting Wu, Jiangxia Yu, Beini Lyu, Haoxiang Lin, Shanshan Li, Gordon G Liu","doi":"10.2147/RMHP.S459188","DOIUrl":"10.2147/RMHP.S459188","url":null,"abstract":"<p><strong>Objective: </strong>Culture and eating habits, which vary greatly across different ethnic groups, have a substantial impact on drinking behavior. This study aimed to examine whether the drinking patterns and reasons differ by ethnic groups, and provide useful insights for multi-ethnic areas that seek to cut down alcohol intake.</p><p><strong>Methods: </strong>We recruited excessive drinkers and collected the drinking patterns and motivations by questionnaire in a multi-ethnic society. Multiple linear regressions were used to evaluate the variations in drinking characteristics among different ethnic groups.</p><p><strong>Results: </strong>We recruited 1287 participants through convenience sampling (a non-probability sampling technique used in research where the researcher selects participants or units for a study based on their accessibility and proximity), among whom 439 excessive drinkers were eligible. The mean age was 38 years for the 439 participants, 92.9% were men, 36.0% were Han, and 64.0% were minorities mainly composed of the Yi. The majority of the participants were married (75.9%) and did physical work (58.1%). Ethnic minorities consumed more alcohol on a single occasion than Han people did (47.3 vs 41.8g/session) while drinking less frequently. For the minority and Han participants, 67% and 42% were not used to drinking with food, respectively. Peer pressure and fostering a good atmosphere were the most common drinking reasons for the minority and Han, respectively.</p><p><strong>Conclusion: </strong>We found substantial differences in drinking patterns and reasons between ethnic minorities and Han ethnicity, attributable to their culture and customs. Findings highlight the importance of drinking habits and motivations in exploring alcohol control education strategies in the context of ethnic integration and population immigration.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11180439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332575","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":"Career Considerations in Nurse-Led Traditional Chinese Medicine Clinics: a Two-Center Qualitative Study.","authors":"Fei-Yi Zhao, Gerard A Kennedy, Julia Gilbert, Russell Conduit, Peijie Xu, Li-Ping Yue, Wen-Jing Zhang, Yan-Mei Wang, Yuen-Shan Ho, Qiang-Qiang Fu, Zhen Zheng","doi":"10.2147/RMHP.S465663","DOIUrl":"10.2147/RMHP.S465663","url":null,"abstract":"<p><strong>Background: </strong>Growing demand exists for high-quality Traditional Chinese Medicine (TCM) care, particularly through Nurse-led TCM clinics (TCM-NLCs). Nurses with extensive experience in TCM departments represent a potential workforce for this healthcare model. This qualitative study aims to investigate the willingness of these candidates to engage in TCM-NLCs, with a specific focus on their main concerns and apprehensions when facing new challenges.</p><p><strong>Methods: </strong>Individual semi-structured face to face interviews were conducted with senior nurses from two TCM hospitals in Shanghai. Each participant had a minimum of three years of work experience in a TCM related department. Conventional qualitative content analysis was utilized.</p><p><strong>Results: </strong>Fourteen participants were interviewed and data saturation was achieved. Nurses exhibited strong interest in practicing in TCM-NLCs. They believed that such innovative TCM nursing service model not only extends nursing role, provides greater empowerment and opportunities for professional development but also meets patients' diverse healthcare needs, reduces reliance on other healthcare providers such as doctors, and increases hospital revenue. However, challenges such as deficiencies in evidence-based TCM nursing education, the absence of standardized practice guidelines, and limited prescriptive privileges were identified as primary obstacles to engaging in TCM-NLCs practice, potentially undermining the specialization of this advanced nursing practice model.</p><p><strong>Conclusion: </strong>Although the nurses interviewed were highly motivated, they generally lacked confidence to practice independently in TCM-NLCs. A pressing priority is to address their concerns by providing appropriate resources as well as education and policy support to enhance their competency and ensure their practice autonomy, therefore building a more qualified pool of professionals for advanced TCM nursing practice.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332576","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}