Objective:To identify the group classification of discharged older adults’digital transition care demands and analyze its influencing factors.Methods:From July to August 2022,we used stratified random sampling to rec...Objective:To identify the group classification of discharged older adults’digital transition care demands and analyze its influencing factors.Methods:From July to August 2022,we used stratified random sampling to recruit older patients who were discharged between July 2021 and July 2022 from tertiary hospitals in Shanghai.We used latent profile analysis to classify the older patients into distinct groups based on their service demands:low,medium,and high.We use multiple logistic regression to explore the factors influencing the different demand levels.Results:The degree of discharged older patients’demand was classified as low(Category 1(C1),34.2%),medium(Category 2(C2),49.5%),high-demand levels(Category 3(C3),16.3%).Compared to those have C2,older adults in C1 are more likely to be male(Odds Ratio(OR)=2.81,P=0.02),have 2 chronic diseases(OR=3.91,P=0.03),and are less likely to be junior high and below(OR=0.09,P=0.00),hospitalized for 1–2 times in the past year(1 times:OR=0.19,P=0.07;2 times:OR=0.14,P=0.02),living with children(OR=0.32,P=0.05),have less insurance(OR=0.48,P=0.03),less understanding of digital transitional care(OR=0.47,P=0.01),have less eHealth literacy(OR=0.80,P=0.00),have less degree of importance attributed by family(OR=0.52,P=0.03);Compared to those have medium demand level,older adults in high demand level are more likely to have self and spouse as primary income(self:OR=26.35,P=0.00;spouse:OR=24.06,P=0.02),walking to the nearest health facility(self:6.74,P=0.03),have higher eHealth literacy(OR=1.88,P=0.00),degree of importance within the family(OR=5.19,P=0.01),higher self’s influence on medical decisions-making(OR=5.69.P=0.01).They are less likely to be in 60–79 years group(OR=0.00–0.37,P=0.00–0.03),Household Annual Income<5,000 CNY(OR=0.05,P=0.02).Conclusion:Digital transitional care demands of discharged older patients can be divided into three categories.Constructing a digital transitional care service system that aligns with the demands of discharged older patients is essential.Communication,care plan development,and follow-up are the most fundamental services.Additionally,it is essential to understand the characteristics of high-demand populations to provide tailored services and identify vulnerable populations from health and social perspectives to offer cost-effective transitional care services.展开更多
Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods （random-effect probit regression model and DID methods）, this study conducted an empirical analysis to estimate the impact of NCMS...Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods （random-effect probit regression model and DID methods）, this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization （outpatient and inpatient） of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization （both outpatient and inpatient） between the NCMS enrollment group and the non-enrollment group in both working age group （15-59） and the elderly group （60 and over）. Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior （visiting the hospital to receive a health examination） in the working age group, but the effect did not appear in the elderly group.展开更多
This study examined whether people who self-reported depression sought mental health treatment in the year after being interviewed, and how gender affected utilization. Depression data were obtained from the Canadian ...This study examined whether people who self-reported depression sought mental health treatment in the year after being interviewed, and how gender affected utilization. Depression data were obtained from the Canadian Community Health Survey (2000-01), and linked to medical records in Ontario (n = 24,677). Overall, women had higher rates of mental health service utilization, but there were no gender differences in rates of specialist care. The gender difference in mental health contact was greater for those without depression, as opposed to those with depression. Among those without depression, women were significantly more likely than men to use mental health services;however, rates were similar for women and men with depression. This finding suggests that men may be more likely than women to delay seeing a doctor for minor mental health concerns, but will seek help once a problem reaches a threshold.展开更多
Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Result...Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.展开更多
Introduction: Disaster damage to health systems is a human and health tragedy, results in huge economic losses, deals devastating blows to development goals, and shakes social confidence. Hospital disaster preparednes...Introduction: Disaster damage to health systems is a human and health tragedy, results in huge economic losses, deals devastating blows to development goals, and shakes social confidence. Hospital disaster preparedness presents complex clinical operation. It is difficult philosophical challenge. It is difficult to determine how much time, money, and effort should be spent in preparing for an event that may not occur. Health facilities whether hospitals or rural health clinics, should be a source of strength during emergencies and disasters. They should be ready to save lives and to continue providing essential emergencies and disasters. Jeddah has relatively a level of disaster risk which is attributable to its geographical location, climate variability, topography, etc. This study investigates the hospital disaster preparedness (HDP) in Jeddah. Methods: Questionnaire was designed according to five Likert scales. It was divided into eight fields of 33 indicators: structure, architectural and furnishings, lifeline facilities’ safety, hospital location, utilities maintenance, surge capacity, emergency and disaster plan, and control of communication and coordination. Sample of six hospitals participated in the study and rated to the extent of disaster preparedness for each hospital disaster preparedness indicators. Two hazard tools were used to find out the hazards for each hospital. An assessment tool was designed to monitor progress and effectiveness of the hospitals’ improvement. Weakness was found in HDP level in the surveyed hospitals. Disaster mitigation needs more action including: risk assessment, structural and non-structural prevention, and preparedness for contingency planning and warning and evacuation. Conclusion: The finding shows that hospitals included in this study have tools and indicators in hospital preparedness but with lack of training and management during disaster. So the research shed light on hospital disaster preparedness. Considering the importance of preparedness in disaster, it is necessary for hospitals to understand that most of hospital disaster preparedness is built in the hospital system.展开更多
Rationale: Medical treatment on short-term primary care medical service trips (MSTs) is generally symptom-based and supplemented by point-of-care testing. This pilot study contributes to the effective planning for suc...Rationale: Medical treatment on short-term primary care medical service trips (MSTs) is generally symptom-based and supplemented by point-of-care testing. This pilot study contributes to the effective planning for such austere settings based on predicted symptomology. Objective: We aimed to prospectively document the epidemiology of patients seen during two low-resource clinics on a MST in Honduras and apply predefined case definitions adapted from guidelines used by international healthcare organizations (e.g. World Health Organization). Methods: An observational design was used to track the epidemiology during two clinics on an MST in Limon, Honduras in March 2015. The QuickChart mobile electronic medical record (EMR) application was piloted to document diagnoses according to predefined case definitions. Results: The most commonly diagnosed syndromes were upper respiratory complaints (20.19%), nonspecific abdominal complaints (20.19%), general pain (15.38%), hypertension (9.62%), pruritus (6.73%), and asthma/ COPD (4.81%). The case definitions accounted for 94% of all complaints and diagnoses on the brigade. Discussion: The distribution of common patient diagnoses on this MST was similar to that which had been reported elsewhere. The use of broader symptom-based case definitions for epidemiologic surveillance could also facilitate the syndromic management of patients seen on MSTs, and improve the consistency of treatment offered. Conclusion: Case definitions for common syndromes on primary care MSTs may be a feasible method of standardizing patient management. Preliminary use of the QuickChart EMR was acceptable for documentation of epidemiology in the field. Further study is necessary to investigate the reliability of syndromic diagnostic criteria between different clinicians and in a variety of MST settings.展开更多
Can Romania have a sustainable health system,so that the population can choose medical services at a state hospital or at a private hospital?A healthy state,with a healthy population,can ensure a viable balance with a...Can Romania have a sustainable health system,so that the population can choose medical services at a state hospital or at a private hospital?A healthy state,with a healthy population,can ensure a viable balance with a secure future.Each country ensures its health system through levers,policies,and well-defined sources of funding,determined by demographics,geographical position,culture,nationality,has the necessary sources to implement its own health system,whether it is public or private.The programs that can be implemented in the health system start from the quality of medical services,which must be provided so that each patient can be sure that medical needs are achievable.We have a people with diverse traditions,a beautiful culture,specialized doctors and yet the medical system is still fragile.Funding programs must help us start this health system,build many private hospitals,so from prevention to services specialized,surgical,to be able to bring in the country specialized medical staff to us but gone to many states of the world.Any change can lead us to what we want,the health of our population in the village,the city,the majority of the population,the identification of possibilities to revive the health system.The market of private health systems,diversified by international players,bank brokers,manages to bring important changes in the health system.From a technical point of view,health insurance has its originality in the impossibility of being able to predict the insured’s illness and the costs necessary for recovery.Any risk related to personal injury,illness,temporary incapacity for work,can be identified,assessed in the form of medical expenses,loss of income,as a result,disability,borne by both the individual and the family,due to the inability to insure a normal activity,daily existence.Insurance can be considered as a method of controlling the health risk.The current situation regarding the disease of the population whit COVID often makes us understand that we must be prepared at all times.The situation of the pandemic SARS-COV 19 found a timely solution through the private health system.展开更多
文摘Objective:To identify the group classification of discharged older adults’digital transition care demands and analyze its influencing factors.Methods:From July to August 2022,we used stratified random sampling to recruit older patients who were discharged between July 2021 and July 2022 from tertiary hospitals in Shanghai.We used latent profile analysis to classify the older patients into distinct groups based on their service demands:low,medium,and high.We use multiple logistic regression to explore the factors influencing the different demand levels.Results:The degree of discharged older patients’demand was classified as low(Category 1(C1),34.2%),medium(Category 2(C2),49.5%),high-demand levels(Category 3(C3),16.3%).Compared to those have C2,older adults in C1 are more likely to be male(Odds Ratio(OR)=2.81,P=0.02),have 2 chronic diseases(OR=3.91,P=0.03),and are less likely to be junior high and below(OR=0.09,P=0.00),hospitalized for 1–2 times in the past year(1 times:OR=0.19,P=0.07;2 times:OR=0.14,P=0.02),living with children(OR=0.32,P=0.05),have less insurance(OR=0.48,P=0.03),less understanding of digital transitional care(OR=0.47,P=0.01),have less eHealth literacy(OR=0.80,P=0.00),have less degree of importance attributed by family(OR=0.52,P=0.03);Compared to those have medium demand level,older adults in high demand level are more likely to have self and spouse as primary income(self:OR=26.35,P=0.00;spouse:OR=24.06,P=0.02),walking to the nearest health facility(self:6.74,P=0.03),have higher eHealth literacy(OR=1.88,P=0.00),degree of importance within the family(OR=5.19,P=0.01),higher self’s influence on medical decisions-making(OR=5.69.P=0.01).They are less likely to be in 60–79 years group(OR=0.00–0.37,P=0.00–0.03),Household Annual Income<5,000 CNY(OR=0.05,P=0.02).Conclusion:Digital transitional care demands of discharged older patients can be divided into three categories.Constructing a digital transitional care service system that aligns with the demands of discharged older patients is essential.Communication,care plan development,and follow-up are the most fundamental services.Additionally,it is essential to understand the characteristics of high-demand populations to provide tailored services and identify vulnerable populations from health and social perspectives to offer cost-effective transitional care services.
文摘Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods （random-effect probit regression model and DID methods）, this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization （outpatient and inpatient） of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization （both outpatient and inpatient） between the NCMS enrollment group and the non-enrollment group in both working age group （15-59） and the elderly group （60 and over）. Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior （visiting the hospital to receive a health examination） in the working age group, but the effect did not appear in the elderly group.
文摘This study examined whether people who self-reported depression sought mental health treatment in the year after being interviewed, and how gender affected utilization. Depression data were obtained from the Canadian Community Health Survey (2000-01), and linked to medical records in Ontario (n = 24,677). Overall, women had higher rates of mental health service utilization, but there were no gender differences in rates of specialist care. The gender difference in mental health contact was greater for those without depression, as opposed to those with depression. Among those without depression, women were significantly more likely than men to use mental health services;however, rates were similar for women and men with depression. This finding suggests that men may be more likely than women to delay seeing a doctor for minor mental health concerns, but will seek help once a problem reaches a threshold.
基金Supported by Humanities and Social Science Research Project of the Ministry of Education in 2010 (10YJC840088)
文摘Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.
文摘Introduction: Disaster damage to health systems is a human and health tragedy, results in huge economic losses, deals devastating blows to development goals, and shakes social confidence. Hospital disaster preparedness presents complex clinical operation. It is difficult philosophical challenge. It is difficult to determine how much time, money, and effort should be spent in preparing for an event that may not occur. Health facilities whether hospitals or rural health clinics, should be a source of strength during emergencies and disasters. They should be ready to save lives and to continue providing essential emergencies and disasters. Jeddah has relatively a level of disaster risk which is attributable to its geographical location, climate variability, topography, etc. This study investigates the hospital disaster preparedness (HDP) in Jeddah. Methods: Questionnaire was designed according to five Likert scales. It was divided into eight fields of 33 indicators: structure, architectural and furnishings, lifeline facilities’ safety, hospital location, utilities maintenance, surge capacity, emergency and disaster plan, and control of communication and coordination. Sample of six hospitals participated in the study and rated to the extent of disaster preparedness for each hospital disaster preparedness indicators. Two hazard tools were used to find out the hazards for each hospital. An assessment tool was designed to monitor progress and effectiveness of the hospitals’ improvement. Weakness was found in HDP level in the surveyed hospitals. Disaster mitigation needs more action including: risk assessment, structural and non-structural prevention, and preparedness for contingency planning and warning and evacuation. Conclusion: The finding shows that hospitals included in this study have tools and indicators in hospital preparedness but with lack of training and management during disaster. So the research shed light on hospital disaster preparedness. Considering the importance of preparedness in disaster, it is necessary for hospitals to understand that most of hospital disaster preparedness is built in the hospital system.
文摘Rationale: Medical treatment on short-term primary care medical service trips (MSTs) is generally symptom-based and supplemented by point-of-care testing. This pilot study contributes to the effective planning for such austere settings based on predicted symptomology. Objective: We aimed to prospectively document the epidemiology of patients seen during two low-resource clinics on a MST in Honduras and apply predefined case definitions adapted from guidelines used by international healthcare organizations (e.g. World Health Organization). Methods: An observational design was used to track the epidemiology during two clinics on an MST in Limon, Honduras in March 2015. The QuickChart mobile electronic medical record (EMR) application was piloted to document diagnoses according to predefined case definitions. Results: The most commonly diagnosed syndromes were upper respiratory complaints (20.19%), nonspecific abdominal complaints (20.19%), general pain (15.38%), hypertension (9.62%), pruritus (6.73%), and asthma/ COPD (4.81%). The case definitions accounted for 94% of all complaints and diagnoses on the brigade. Discussion: The distribution of common patient diagnoses on this MST was similar to that which had been reported elsewhere. The use of broader symptom-based case definitions for epidemiologic surveillance could also facilitate the syndromic management of patients seen on MSTs, and improve the consistency of treatment offered. Conclusion: Case definitions for common syndromes on primary care MSTs may be a feasible method of standardizing patient management. Preliminary use of the QuickChart EMR was acceptable for documentation of epidemiology in the field. Further study is necessary to investigate the reliability of syndromic diagnostic criteria between different clinicians and in a variety of MST settings.
文摘Can Romania have a sustainable health system,so that the population can choose medical services at a state hospital or at a private hospital?A healthy state,with a healthy population,can ensure a viable balance with a secure future.Each country ensures its health system through levers,policies,and well-defined sources of funding,determined by demographics,geographical position,culture,nationality,has the necessary sources to implement its own health system,whether it is public or private.The programs that can be implemented in the health system start from the quality of medical services,which must be provided so that each patient can be sure that medical needs are achievable.We have a people with diverse traditions,a beautiful culture,specialized doctors and yet the medical system is still fragile.Funding programs must help us start this health system,build many private hospitals,so from prevention to services specialized,surgical,to be able to bring in the country specialized medical staff to us but gone to many states of the world.Any change can lead us to what we want,the health of our population in the village,the city,the majority of the population,the identification of possibilities to revive the health system.The market of private health systems,diversified by international players,bank brokers,manages to bring important changes in the health system.From a technical point of view,health insurance has its originality in the impossibility of being able to predict the insured’s illness and the costs necessary for recovery.Any risk related to personal injury,illness,temporary incapacity for work,can be identified,assessed in the form of medical expenses,loss of income,as a result,disability,borne by both the individual and the family,due to the inability to insure a normal activity,daily existence.Insurance can be considered as a method of controlling the health risk.The current situation regarding the disease of the population whit COVID often makes us understand that we must be prepared at all times.The situation of the pandemic SARS-COV 19 found a timely solution through the private health system.
