The optimal allocation of health resources needs to meet the trend of urbanization, the need of national health development and the growing demand of health care population. The allocation of health resources in our c...The optimal allocation of health resources needs to meet the trend of urbanization, the need of national health development and the growing demand of health care population. The allocation of health resources in our country is generally unbalanced, but it is currently showing an improvement trend. The acceleration of the aging population puts forward further requirements for deepening the medical reform and the construction of medical services. Through the analysis of the allocation of urban health resources under the background of the aging population, it provides the basis and feasible suggestions for actively coping with the aging population and optimizing the allocation of health resources. It considers that the investment in health resources is insufficient and the geographical distribution is poor. It puts forward some suggestions such as paying attention to the training of health personnel, increasing the investment in health human resources, introducing social capital and increasing the government financial investment.展开更多
This paper explores strategies to enhance the application ability of digital health resources among the elderly,addressing the challenges posed by the digital divide.As the global population ages,effective health mana...This paper explores strategies to enhance the application ability of digital health resources among the elderly,addressing the challenges posed by the digital divide.As the global population ages,effective health management for seniors becomes increasingly important.The study highlights the significance of technology training and education,social support networks,and design thinking in improving elderly individuals'digital health literacy.By implementing comprehensive training programs and fostering community support,seniors can gain the necessary skills and confidence to utilize digital health tools effectively.The paper also emphasizes the need for age-friendly technology that caters to the specific needs of older adults.Successful case studies,such as China's"Healthy China Action"and the U.S."Senior Tech"program,demonstrate the positive impact of these strategies.Ultimately,enhancing the elderly's capacity to use digital health resources is a collaborative effort that requires ongoing innovation,policy support,and community engagement,ensuring that seniors can enjoy the benefits of modern healthcare technologies while improving their quality of life。展开更多
Objective:Pancreatic cancer is a global health challenge,yet the Western Pacific Region(WPR)lacks comprehensive analysis of its burden and human resources for health(HRH)distribution.This study aims to assess trends i...Objective:Pancreatic cancer is a global health challenge,yet the Western Pacific Region(WPR)lacks comprehensive analysis of its burden and human resources for health(HRH)distribution.This study aims to assess trends in pancreatic cancer and HRH density in the WPR and investigate their relationship.Methods:Pancreatic cancer data from GBD 2021 and annual HRH density from GBD 2019 were analyzed.Joinpoint regression was used to analyze temporal trends of pancreatic cancer burden and HRH density across 31countries of the WPR.Spearman's rank correlation analysis and generalized linear models were applied to investigate the association between HRH density and pancreatic cancer burden.Results:From 1990 to 2021,pancreatic cancer incidence in the WPR increased by 209%,from 59,766 to184,612 cases,with a 201%rise in mortality and a 152%increase in disability-adjusted life years(DALYs).In 2021,smoking and high fasting plasma glucose were major risk factors,responsible for 16.43%and 23.29%of deaths,respectively.HRH density was positively correlated with the age-standardized incidence(P=0.767),death(P=0.752),and DALYs(P=0.726)rates of pancreatic cancer,and in 2019,most countries'HRH densities were below the Universal Health Coverage targets.Conclusions:Despite improvements in HRH,notable distribution inequalities and shortages persist,limiting capabilities in pancreatic cancer diagnosis and treatment.The positive association between burden and HRH density reflects improved diagnostics from HRH growth but persistent treatment insufficiency due to shortages,and suggests that targeted HRH investment,strengthened primary care,and integration of palliative care are crucial to alleviating the burden.展开更多
At the current stage,China’s medical and health industry is constantly developing,and it is essential to fully attach importance to the core role of Centers for Disease Control and Prevention(CDC).For tertiary hospit...At the current stage,China’s medical and health industry is constantly developing,and it is essential to fully attach importance to the core role of Centers for Disease Control and Prevention(CDC).For tertiary hospitals,one of their key work tasks is to carry out public health management.Based on this,this paper mainly expounds on some basic problems existing in the public health management of state-owned hospitals at the current stage,and puts forward corresponding countermeasures for the identified problems.These countermeasures include enhancing the emphasis on public health management,strengthening the intensity of medical management,effectively improving the allocation of medical management resources,and intensifying the training of relevant personnel.This paper aims to provide references for improving the level of hospital public health management.展开更多
Objectives:To measure the effect of social distancing on reducing daily deaths,infections and hospital resources needed for coronavirus disease 2019(COVID-19)patients during the first wave of the pandemic in Nordic co...Objectives:To measure the effect of social distancing on reducing daily deaths,infections and hospital resources needed for coronavirus disease 2019(COVID-19)patients during the first wave of the pandemic in Nordic countries.Methods:The observations of social distancing,daily deaths,infections along with the needed hospital resources for COVID-19 patient hospitalizations including the numbers of all hospital beds,beds needed in ICUs and infection wards,nursing staffs needed in ICUs and infection wards were collected from the Institute for Health Metrics and Evaluation(IHME)by the University of Washington.The observations of social distancing were based on the reduction in human contact relative to background levels for each location quantified by cell phone mobility data collected from IHME.The weighted data per 100,000 population gathered in a 40-day period of the first wave of the pandemic in Denmark,Finland,Iceland,Norway and Sweden.Statistical technique of panel data analysis is used to measure the associations between social distancing and COVID-19 indicators in long-run.Results:Results of dynamic long-run models confirm that a 1%rise in social distancing by reducing human contacts may decline daily deaths,daily infections,all hospital beds needed,beds/nurses needed in ICUs and beds/nurses needed in infection wards due COVID-19 pandemic by 1.13%,15.26%,1.10%,1.17%and 1.89%,respectively.Moreover,results of error correction models verify that if the equilibriums between these series are disrupted by a sudden change in social distancing,the lengths of restoring back to equilibrium are 67,62,40,22 and 49 days for daily deaths,daily infections,all hospital beds needed,nurses/beds needed in ICUs and nurses/beds needed in infection wards,respectively.Conclusion:Proper social distancing was a successful policy for tackling COVID-19 with falling mortality and infection rates as well as the needed hospital resources for patient hospitalizations in Nordic countries.The results alert governments of the need for continuously implementing social distancing policies while using vaccines to prevent national lockdowns and reduce the burden of patient hospitalizations.展开更多
Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Inc...Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Increasing age leads to health problems, often long-term or chronic, requiring investments in health care. Worse health and dissimilarities in pattern of morbidity/ mortality have been found in foreign-compared to Swedish-born persons, so it is reasonable to assume that this affects use of health care. The exploratory review focuses on elderly migrants’ (>65 years) use of healthcare. The databases Pub Med, EBSCO, CINAHL and ERIC were searched in 2000-2013. A limited number of studies were found;few had a comparative approach, most were from the USA, and focused on migrants from the former Soviet Union or countries in South-East Asia. A range of factors were identified that influence patterns of health care use: language fluency, ability to communicate, self-reported health status, prevalence of chronic disease, physical distance from care provision, availability of transport to reach care, cost of care, the health insurance system, cultural norms and values regarding different forms of care, level of education, and length of residence in the host country. Most studies treated health care from a general perspective and collected data from community and hospital settings, without analysing usage separately. Some studies indicated elderly migrants making use of health care less than other groups but the pattern is not unambiguous: other studies show that there is an overuse of health care. It is therefore difficult to show any particular pattern, or possible differences in use, regarding community versus in-patient care. Studies focusing on migrants’ actual use of health care are few and further research is needed, especially because elderly people form the largest group of users of health care and will be even larger in the future.展开更多
In recent years, the NCAA student athlete population in the United States has surpassed 500,000, and is continuing to rise each year [1]. These student athletes work their entire lives academically and athletically to...In recent years, the NCAA student athlete population in the United States has surpassed 500,000, and is continuing to rise each year [1]. These student athletes work their entire lives academically and athletically to reach the ultimate goal: competing in university athletics. However, when these athletes reach university, they are met with non-stop training, homework, exams, and evolving social lives. We have conducted a study at the University of Evansville evaluating how participation in university athletics may impact mental health status among these student athletes, as well as measuring players’ awareness of accessible mental health resources. Over fifty percent of participants reported experiencing at least one mental health condition while competing in their sport;eighty percent reported having knowledge of the mental health resources available to them on campus, however, nearly thirty percent of those knowledgeable reported not knowing how to access these resources. This has indicated a gap in awareness and utilization of mental health resources among student athletes at the University of Evansville.展开更多
The assessment of the fairness of health resource allocation is an important part of the study for the fairness of social development.The data used in most of the existing assessment methods comes from statistical yea...The assessment of the fairness of health resource allocation is an important part of the study for the fairness of social development.The data used in most of the existing assessment methods comes from statistical yearbooks or field survey sampling.These statistics are generally based on administrative areas and are difficult to support a fine-grained evaluation model.In response to these problems,the evaluation method proposed in this paper is based on the query statistics of the geographic grid of the target area,which are more accurate and efficient.Based on the query statistics of hot words in the geographic grids,this paper adopts the maximum likelihood estimation method to estimate the population in the grid region.Then,according to the statistical yearbook data of Hunan province,the estimated number and actual number of hospitals in each grid are analyzed and compared to measure the fairness of health resource allocation in the target region.Experiments show that the geographical grid population assessment based on hot words is more accurate and close to the actual value.The estimated average error is only about 17.8 percent.This method can assess the fairness of health resource allocation in any scale,and is innovative in data acquisition and evaluation methods.展开更多
AIM: To determine healthcare resource utilization and the economic burden associated with wet age-related macular degeneration(AMD) in Thailand ·METHODS: This study included patients diagnosed with wet AMD that w...AIM: To determine healthcare resource utilization and the economic burden associated with wet age-related macular degeneration(AMD) in Thailand ·METHODS: This study included patients diagnosed with wet AMD that were 60 years old or older,and had best corrected visual acuity(BCVA) measured at least two times during the follow-up period. We excluded patients having other eye diseases. Two separate sub-studies were conducted. The first sub-study was a retrospective cohort study; electronic medical charts were reviewed to estimate the direct medical costs. The second sub-study was a cross-sectional survey estimating the direct non-medical costs based on face-to-face interviews using a structured questionnaire. For the first sub-study,direct medical costs,including the cost of drugs,laboratory,procedures,and other treatments were obtained. For the second sub-study,direct non-medical costs,e.g. transportation,food,accessories,home renovation,and caregiver costs,were obtained from face-to-face interviews with patients and/ or caregivers. ·RESULTS: For the first sub-study,sixty-four medical records were reviewed. The annual average number of medical visits was 11.1 ±6.0. The average direct medical costs were $3 604 ±4 530 per year. No statistically-significant differences of the average direct medical costs among the BCVA groups were detected(P =0.98). Drug costs accounted for 77% of total direct medical costs. For direct non-medical costs,67 patients were included. Forty-eight patients(71.6%) required the accompaniment of a person during the out-patient visit. Seventeen patients(25.4%) required a caregiver at home. The average direct non-medical cost was $2 927 ±6 560 per year. There were no statistically-significant differences in the average costs among the BCVA groups(P =0.74). Care-giver cost accounted for 87% of direct non-medical costs.·CONCLUSION: Our study indicates that wet AMD is associated with a substantial economic burden,especially concerning drug and care-giver costs.展开更多
Background: Treatment non-adherence poses significant risks to health outcomes and impedes the health system’s efficiency, hence curtailing progress towards the end Tuberculosis (TB) strategy under SDG 3.3. Despite i...Background: Treatment non-adherence poses significant risks to health outcomes and impedes the health system’s efficiency, hence curtailing progress towards the end Tuberculosis (TB) strategy under SDG 3.3. Despite interventions to address TB treatment non-adherence, Kenya still reports high TB treatment non-adherence rates of 35% and consequently poor treatment outcome rates. Health Care Workers (HCWs) play a critical role in linking the population to health services, yet little is known of their influence on patients’ TB treatment non-adherence in Kenya. Objective: To analyze HCW-related factors associated with TB treatment non-adherence among patients in Kisumu East Sub-County. Methods: Health facility-based analytical cross-sectional mixed-method study. A Semi-structured questionnaire on treatment adherence and patients’ perceptions of HCWs during the clinic visit was administered to 102 consenting adult (out of a total census of 107 adults) drug-susceptible TB patients. 12 purposively selected HCWs by rank from 6 health facilities participated in Key Informant Interview sessions. Medication adherence was measured using the Morisky Medication Adherence Scale and then expressed as a dichotomous variable. Quantitative analysis utilized STATA version 15.1 while qualitative deductive thematic analysis was done using NVIVO version 14. Results: TB treatment non-adherence rate of 26% (CI: 18% - 36%) was recorded. Overall, patients who felt supported in dealing with the illness were 8 times more likely to adhere to treatment compared to those who were not (aOR = 7.947, 95% CI: 2.214 - 28.527, p = 0.001). Key HCW related factors influencing adherence to treatment included: friendliness (cOR = 4.31, 95% CI: 1.514 - 12.284, p = 0.006), respect (cOR = 6.679, 95% CI: 2.239 - 19.923, p = 0.001) and non-discriminatory service (cOR = 0.1478, 95% CI: 0.047 - 0.464, p = 0.001), communication [adequacy of consultation time (cOR = 6.563, 95% CI: 2.467 - 17.458, p = 0.001) and patients’ involvement in their health decisions (cOR = 3.02 95% CI: 1.061 - 8.592, p = 0.038)] and education and counselling (cOR = 4.371, 95% CI: 1.725 - 11.075, p = 0.002). Conclusion: The study results underline importance of patient-centered consultation for TB patients and targeted education and counselling for improved treatment adherence.展开更多
Background: Behind every great system is an organized team;this is especially true in the healthcare industry, where a dedicated human resources team can effectively recruit employees, train staff, and implement safet...Background: Behind every great system is an organized team;this is especially true in the healthcare industry, where a dedicated human resources team can effectively recruit employees, train staff, and implement safety measures in the workplace. The importance of human resources in the healthcare industry cannot be overstated, with benefits ranging from providing an orderly and effectively run facility to equipping staff with the most accurate and up-to-date training. Proper human resources management is critical in providing high-quality health care. A refocus on human resources management in healthcare requires more research to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes and access to health care worldwide. Methods: This study leveraged NOI Polls census data on Health Facility Assessment for Lagos State. One thousand two hundred fifty-six health care facilities were assessed in Lagos State;numbers of Health workers were documented alongside their area of specialization. Also, demographic characterizations of the facilities, such as LGA, Ownership type, Facility Level Care, and Category of the facility, were also documented. Descriptive statistics alongside cross tabulation was done to present the various area of specialization of the health workers. Multiple response analysis was done to understand the distribution of human resources across the health facilities. At the same time, Chi-square and correlation tests were conducted to test the independence of various categories recorded while understanding the relationships among selected specialties. Results: The study revealed that Nurses were the most common health specialist in the Lagos State health facilities. At the same time, Gynecologists and General surgeons are the two medical specialists mostly common in health facilities. Midwives are the second most common health specialist working full time, while Generalist medical doctors make up the top three health specialists working full time. Nurses and Midwives had the highest number in Lagos State, while Pulmonologists were currently the lowest human resource available in Lagos State health care system. It was also noted that health facility distribution across Lagos’s urban and rural areas was even. In contrast, distribution based on other factors such as ownership type, Facility level of care, and facility category was slightly skewed. Conclusion: The distribution of health workers in health facility across LGA in Lagos State depend on Ownership type, Facility level of care, and category of the facility.展开更多
Water resources health diagnosis is increasingly recognized as a critical tool.It should not only guide the preservation of water volume,quality,and ecological integrity but also assess the viability of carbon-neutral...Water resources health diagnosis is increasingly recognized as a critical tool.It should not only guide the preservation of water volume,quality,and ecological integrity but also assess the viability of carbon-neutral development pathways.But current research tends to consider water health assessment and carbon-neutrality planning as separate endeavors,which results in imprecise boundaries,disjointed metrics,and a weak linkage between diagnostic outcomes and testable management actions.This review brings together indicator systems,diagnostic systems,and environmental management systems architectures that make it possible to have integrated water-carbon governance.We define fundamental concepts and delimiting decisions followed by the examination of indicator designs across the hydrological regime,water quality,ecological integrity,service performance,resilience,and carbon-related measures,including intensity of energy/emissions,emissions caused by the watershed process of wastewater treatment,as well as the potential sink of the watershed.We compare diagnostic methods,such as composite indices and multi-criteria decision analysis,data-driven early-warning models,process-based and integrated simulations,as well as uncertainty-aware robustness models.Here,based on this synthesis,we suggest an environmental management systems(EMS)-based pathway,which connects the setting of the baseline,the diagnosis,the design of the intervention portfolio,and the measurement-reporting-verification into the closed-loop adaptive cycle.Digital enablement,comprising Internet of Things(IoT)monitoring,remote sensing,data fusion,optimization,and digital twins,is considered a viable way of scaling implementation,subject to interoperability,validation,and model governance.Among the major gaps,there are causal attribution to outcomes,cross-scale coupling of facility emissions and basin health,propagation of uncertainty in a coupled model,and credible Measurement,Reporting,and Verification(MRV)of non-CO_(2) gases and nature-based removals.The review gives a roadmap to normalize core metrics and fast-deployable systems to protect the health of the water resources and give verifiable progress towards carbon neutrality.展开更多
With the sustained growth of the economy and significant changes in social demographics,the issue of elderly-related diseases has increasingly drawn attention,particularly.Alzheimer’s disease(AD),as a representative ...With the sustained growth of the economy and significant changes in social demographics,the issue of elderly-related diseases has increasingly drawn attention,particularly.Alzheimer’s disease(AD),as a representative disease of neurodegenerative diseases,has become a major challenge,affecting the health and quality of life of the elderly population severely.In recent years,the incidence,prevalence and mortality rates of AD have increased in China,imposing substantial economic burdens on families,society and the entire healthcare system.To proactively address this challenge and respond to the national‘Healthy China Action’initiative,leading experts from authoritative institutions jointly authored the China Alzheimer Report 2025.Building on previous editions,this report updates epidemiological data on AD in China,thoroughly analyses the latest economic burdens of the disease and comprehensively evaluates the current status of AD diagnosis and treatment services,as well as the allocation of public health resources in our country.Its release reflects China’s progress in AD research and prevention,underscores societal concern for elderly health and aims to provide scientific guidance and data support for AD prevention,diagnosis and treatment.It also facilitates academic exchanges and cooperation,enhancing public awareness and promoting active participation in elderly healthcare,towards achieving‘healthy ageing’in China.展开更多
AIM: To determine the rate and yield of repeat esophagogastroduodenoscopy (EGD) for dyspepsia in clinical practice,whether second opinions drive its use,and whether it is performed at the expense of colorectal cancer ...AIM: To determine the rate and yield of repeat esophagogastroduodenoscopy (EGD) for dyspepsia in clinical practice,whether second opinions drive its use,and whether it is performed at the expense of colorectal cancer screening.METHODS: We performed a retrospective cohort study of all patients who underwent repeat EGD for dyspepsia from 1996 to 2006 at the University of California,San Francisco endoscopy service.RESULTS: Of 24 780 EGDs,5460 (22%) were performed for dyspepsia in 4873 patients.Of these,451 patients (9.3%) underwent repeat EGD for dyspepsia at a median 1.7 (interquartile range,0.8-3.1) years after initial EGD.Signif icant f indings possibly related to dyspepsia were more likely at initial (29%) vs repeat EGD (18%) [odds ratio (OR),1.45;95% confidence interval (CI): 1.20-1.75,P < 0.0001],and at repeat EGD if the initial EGD had reported such f indings (26%) than if it had not (14%) (OR,1.32;95% CI: 1.08-1.62,P = 0.0015).The same endoscopist performed the repeat and initial EGD in 77% of cases.Of patients aged 50 years or older,286/311 (92%) underwent lower endoscopy.CONCLUSION: Repeat EGD for dyspepsia occurred at a low but substantial rate,with lower yield than initial EGD.Optimizing endoscopy use remains a public health priority.展开更多
Chronic non-communicable diseases have become a significant threat to the health of middle-aged and older adults in urban areas.The allocation of health resources in urban communities is associated with the prevalence...Chronic non-communicable diseases have become a significant threat to the health of middle-aged and older adults in urban areas.The allocation of health resources in urban communities is associated with the prevalence of chronic diseases.This study conducts an empirical analysis using threshold regression methods based on data from the China Health and Retirement Longitudinal Study(CHARLS).It explores the nonlinear impact of community health resource allocation on chronic disease management among middle-aged and older adults across different age groups.The goal is to allocate health resources scientifically based on the health and activity needs of specific age groups.The results reveal staged differences across distinct age intervals.Specifically,the allocation of community health resources has a negative impact on the management of chronic diseases of respondents under 58 years old,an insignificant impact for those aged between 58 and 73 years,and a significant positive impact for those aged above 73 years old.The threshold effect of age is closely related to the health resource preference and activity pattern of different age groups.The alignment between health resource supply and demand within these groups determines their effectiveness in improving health outcomes.These findings could help optimize the spatial allocation of health resources,enhance planning standards,and address existing disparities across communities,thereby providing an evidence-based solution for urban planning decisions.展开更多
文摘The optimal allocation of health resources needs to meet the trend of urbanization, the need of national health development and the growing demand of health care population. The allocation of health resources in our country is generally unbalanced, but it is currently showing an improvement trend. The acceleration of the aging population puts forward further requirements for deepening the medical reform and the construction of medical services. Through the analysis of the allocation of urban health resources under the background of the aging population, it provides the basis and feasible suggestions for actively coping with the aging population and optimizing the allocation of health resources. It considers that the investment in health resources is insufficient and the geographical distribution is poor. It puts forward some suggestions such as paying attention to the training of health personnel, increasing the investment in health human resources, introducing social capital and increasing the government financial investment.
基金supported by the Research Project on Innovative Development of Social Sciences in Anhui Province(Grant Number:2022KD012)the Anhui Provincial University Philosophy and Social Science Key Project(Grant Number:2022AH051412).
文摘This paper explores strategies to enhance the application ability of digital health resources among the elderly,addressing the challenges posed by the digital divide.As the global population ages,effective health management for seniors becomes increasingly important.The study highlights the significance of technology training and education,social support networks,and design thinking in improving elderly individuals'digital health literacy.By implementing comprehensive training programs and fostering community support,seniors can gain the necessary skills and confidence to utilize digital health tools effectively.The paper also emphasizes the need for age-friendly technology that caters to the specific needs of older adults.Successful case studies,such as China's"Healthy China Action"and the U.S."Senior Tech"program,demonstrate the positive impact of these strategies.Ultimately,enhancing the elderly's capacity to use digital health resources is a collaborative effort that requires ongoing innovation,policy support,and community engagement,ensuring that seniors can enjoy the benefits of modern healthcare technologies while improving their quality of life。
基金supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2023ZD0510500)National Natural Science Foundation of China(No.82403392)。
文摘Objective:Pancreatic cancer is a global health challenge,yet the Western Pacific Region(WPR)lacks comprehensive analysis of its burden and human resources for health(HRH)distribution.This study aims to assess trends in pancreatic cancer and HRH density in the WPR and investigate their relationship.Methods:Pancreatic cancer data from GBD 2021 and annual HRH density from GBD 2019 were analyzed.Joinpoint regression was used to analyze temporal trends of pancreatic cancer burden and HRH density across 31countries of the WPR.Spearman's rank correlation analysis and generalized linear models were applied to investigate the association between HRH density and pancreatic cancer burden.Results:From 1990 to 2021,pancreatic cancer incidence in the WPR increased by 209%,from 59,766 to184,612 cases,with a 201%rise in mortality and a 152%increase in disability-adjusted life years(DALYs).In 2021,smoking and high fasting plasma glucose were major risk factors,responsible for 16.43%and 23.29%of deaths,respectively.HRH density was positively correlated with the age-standardized incidence(P=0.767),death(P=0.752),and DALYs(P=0.726)rates of pancreatic cancer,and in 2019,most countries'HRH densities were below the Universal Health Coverage targets.Conclusions:Despite improvements in HRH,notable distribution inequalities and shortages persist,limiting capabilities in pancreatic cancer diagnosis and treatment.The positive association between burden and HRH density reflects improved diagnostics from HRH growth but persistent treatment insufficiency due to shortages,and suggests that targeted HRH investment,strengthened primary care,and integration of palliative care are crucial to alleviating the burden.
文摘At the current stage,China’s medical and health industry is constantly developing,and it is essential to fully attach importance to the core role of Centers for Disease Control and Prevention(CDC).For tertiary hospitals,one of their key work tasks is to carry out public health management.Based on this,this paper mainly expounds on some basic problems existing in the public health management of state-owned hospitals at the current stage,and puts forward corresponding countermeasures for the identified problems.These countermeasures include enhancing the emphasis on public health management,strengthening the intensity of medical management,effectively improving the allocation of medical management resources,and intensifying the training of relevant personnel.This paper aims to provide references for improving the level of hospital public health management.
文摘Objectives:To measure the effect of social distancing on reducing daily deaths,infections and hospital resources needed for coronavirus disease 2019(COVID-19)patients during the first wave of the pandemic in Nordic countries.Methods:The observations of social distancing,daily deaths,infections along with the needed hospital resources for COVID-19 patient hospitalizations including the numbers of all hospital beds,beds needed in ICUs and infection wards,nursing staffs needed in ICUs and infection wards were collected from the Institute for Health Metrics and Evaluation(IHME)by the University of Washington.The observations of social distancing were based on the reduction in human contact relative to background levels for each location quantified by cell phone mobility data collected from IHME.The weighted data per 100,000 population gathered in a 40-day period of the first wave of the pandemic in Denmark,Finland,Iceland,Norway and Sweden.Statistical technique of panel data analysis is used to measure the associations between social distancing and COVID-19 indicators in long-run.Results:Results of dynamic long-run models confirm that a 1%rise in social distancing by reducing human contacts may decline daily deaths,daily infections,all hospital beds needed,beds/nurses needed in ICUs and beds/nurses needed in infection wards due COVID-19 pandemic by 1.13%,15.26%,1.10%,1.17%and 1.89%,respectively.Moreover,results of error correction models verify that if the equilibriums between these series are disrupted by a sudden change in social distancing,the lengths of restoring back to equilibrium are 67,62,40,22 and 49 days for daily deaths,daily infections,all hospital beds needed,nurses/beds needed in ICUs and nurses/beds needed in infection wards,respectively.Conclusion:Proper social distancing was a successful policy for tackling COVID-19 with falling mortality and infection rates as well as the needed hospital resources for patient hospitalizations in Nordic countries.The results alert governments of the need for continuously implementing social distancing policies while using vaccines to prevent national lockdowns and reduce the burden of patient hospitalizations.
文摘Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Increasing age leads to health problems, often long-term or chronic, requiring investments in health care. Worse health and dissimilarities in pattern of morbidity/ mortality have been found in foreign-compared to Swedish-born persons, so it is reasonable to assume that this affects use of health care. The exploratory review focuses on elderly migrants’ (>65 years) use of healthcare. The databases Pub Med, EBSCO, CINAHL and ERIC were searched in 2000-2013. A limited number of studies were found;few had a comparative approach, most were from the USA, and focused on migrants from the former Soviet Union or countries in South-East Asia. A range of factors were identified that influence patterns of health care use: language fluency, ability to communicate, self-reported health status, prevalence of chronic disease, physical distance from care provision, availability of transport to reach care, cost of care, the health insurance system, cultural norms and values regarding different forms of care, level of education, and length of residence in the host country. Most studies treated health care from a general perspective and collected data from community and hospital settings, without analysing usage separately. Some studies indicated elderly migrants making use of health care less than other groups but the pattern is not unambiguous: other studies show that there is an overuse of health care. It is therefore difficult to show any particular pattern, or possible differences in use, regarding community versus in-patient care. Studies focusing on migrants’ actual use of health care are few and further research is needed, especially because elderly people form the largest group of users of health care and will be even larger in the future.
文摘In recent years, the NCAA student athlete population in the United States has surpassed 500,000, and is continuing to rise each year [1]. These student athletes work their entire lives academically and athletically to reach the ultimate goal: competing in university athletics. However, when these athletes reach university, they are met with non-stop training, homework, exams, and evolving social lives. We have conducted a study at the University of Evansville evaluating how participation in university athletics may impact mental health status among these student athletes, as well as measuring players’ awareness of accessible mental health resources. Over fifty percent of participants reported experiencing at least one mental health condition while competing in their sport;eighty percent reported having knowledge of the mental health resources available to them on campus, however, nearly thirty percent of those knowledgeable reported not knowing how to access these resources. This has indicated a gap in awareness and utilization of mental health resources among student athletes at the University of Evansville.
文摘The assessment of the fairness of health resource allocation is an important part of the study for the fairness of social development.The data used in most of the existing assessment methods comes from statistical yearbooks or field survey sampling.These statistics are generally based on administrative areas and are difficult to support a fine-grained evaluation model.In response to these problems,the evaluation method proposed in this paper is based on the query statistics of the geographic grid of the target area,which are more accurate and efficient.Based on the query statistics of hot words in the geographic grids,this paper adopts the maximum likelihood estimation method to estimate the population in the grid region.Then,according to the statistical yearbook data of Hunan province,the estimated number and actual number of hospitals in each grid are analyzed and compared to measure the fairness of health resource allocation in the target region.Experiments show that the geographical grid population assessment based on hot words is more accurate and close to the actual value.The estimated average error is only about 17.8 percent.This method can assess the fairness of health resource allocation in any scale,and is innovative in data acquisition and evaluation methods.
基金Supported by Novartis(Thailand)Ltd.Thailand Research Fund through the Royal Golden Jubilee Ph.D.Program(grant No.PHD/0356/2550 to PD)
文摘AIM: To determine healthcare resource utilization and the economic burden associated with wet age-related macular degeneration(AMD) in Thailand ·METHODS: This study included patients diagnosed with wet AMD that were 60 years old or older,and had best corrected visual acuity(BCVA) measured at least two times during the follow-up period. We excluded patients having other eye diseases. Two separate sub-studies were conducted. The first sub-study was a retrospective cohort study; electronic medical charts were reviewed to estimate the direct medical costs. The second sub-study was a cross-sectional survey estimating the direct non-medical costs based on face-to-face interviews using a structured questionnaire. For the first sub-study,direct medical costs,including the cost of drugs,laboratory,procedures,and other treatments were obtained. For the second sub-study,direct non-medical costs,e.g. transportation,food,accessories,home renovation,and caregiver costs,were obtained from face-to-face interviews with patients and/ or caregivers. ·RESULTS: For the first sub-study,sixty-four medical records were reviewed. The annual average number of medical visits was 11.1 ±6.0. The average direct medical costs were $3 604 ±4 530 per year. No statistically-significant differences of the average direct medical costs among the BCVA groups were detected(P =0.98). Drug costs accounted for 77% of total direct medical costs. For direct non-medical costs,67 patients were included. Forty-eight patients(71.6%) required the accompaniment of a person during the out-patient visit. Seventeen patients(25.4%) required a caregiver at home. The average direct non-medical cost was $2 927 ±6 560 per year. There were no statistically-significant differences in the average costs among the BCVA groups(P =0.74). Care-giver cost accounted for 87% of direct non-medical costs.·CONCLUSION: Our study indicates that wet AMD is associated with a substantial economic burden,especially concerning drug and care-giver costs.
文摘Background: Treatment non-adherence poses significant risks to health outcomes and impedes the health system’s efficiency, hence curtailing progress towards the end Tuberculosis (TB) strategy under SDG 3.3. Despite interventions to address TB treatment non-adherence, Kenya still reports high TB treatment non-adherence rates of 35% and consequently poor treatment outcome rates. Health Care Workers (HCWs) play a critical role in linking the population to health services, yet little is known of their influence on patients’ TB treatment non-adherence in Kenya. Objective: To analyze HCW-related factors associated with TB treatment non-adherence among patients in Kisumu East Sub-County. Methods: Health facility-based analytical cross-sectional mixed-method study. A Semi-structured questionnaire on treatment adherence and patients’ perceptions of HCWs during the clinic visit was administered to 102 consenting adult (out of a total census of 107 adults) drug-susceptible TB patients. 12 purposively selected HCWs by rank from 6 health facilities participated in Key Informant Interview sessions. Medication adherence was measured using the Morisky Medication Adherence Scale and then expressed as a dichotomous variable. Quantitative analysis utilized STATA version 15.1 while qualitative deductive thematic analysis was done using NVIVO version 14. Results: TB treatment non-adherence rate of 26% (CI: 18% - 36%) was recorded. Overall, patients who felt supported in dealing with the illness were 8 times more likely to adhere to treatment compared to those who were not (aOR = 7.947, 95% CI: 2.214 - 28.527, p = 0.001). Key HCW related factors influencing adherence to treatment included: friendliness (cOR = 4.31, 95% CI: 1.514 - 12.284, p = 0.006), respect (cOR = 6.679, 95% CI: 2.239 - 19.923, p = 0.001) and non-discriminatory service (cOR = 0.1478, 95% CI: 0.047 - 0.464, p = 0.001), communication [adequacy of consultation time (cOR = 6.563, 95% CI: 2.467 - 17.458, p = 0.001) and patients’ involvement in their health decisions (cOR = 3.02 95% CI: 1.061 - 8.592, p = 0.038)] and education and counselling (cOR = 4.371, 95% CI: 1.725 - 11.075, p = 0.002). Conclusion: The study results underline importance of patient-centered consultation for TB patients and targeted education and counselling for improved treatment adherence.
文摘Background: Behind every great system is an organized team;this is especially true in the healthcare industry, where a dedicated human resources team can effectively recruit employees, train staff, and implement safety measures in the workplace. The importance of human resources in the healthcare industry cannot be overstated, with benefits ranging from providing an orderly and effectively run facility to equipping staff with the most accurate and up-to-date training. Proper human resources management is critical in providing high-quality health care. A refocus on human resources management in healthcare requires more research to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes and access to health care worldwide. Methods: This study leveraged NOI Polls census data on Health Facility Assessment for Lagos State. One thousand two hundred fifty-six health care facilities were assessed in Lagos State;numbers of Health workers were documented alongside their area of specialization. Also, demographic characterizations of the facilities, such as LGA, Ownership type, Facility Level Care, and Category of the facility, were also documented. Descriptive statistics alongside cross tabulation was done to present the various area of specialization of the health workers. Multiple response analysis was done to understand the distribution of human resources across the health facilities. At the same time, Chi-square and correlation tests were conducted to test the independence of various categories recorded while understanding the relationships among selected specialties. Results: The study revealed that Nurses were the most common health specialist in the Lagos State health facilities. At the same time, Gynecologists and General surgeons are the two medical specialists mostly common in health facilities. Midwives are the second most common health specialist working full time, while Generalist medical doctors make up the top three health specialists working full time. Nurses and Midwives had the highest number in Lagos State, while Pulmonologists were currently the lowest human resource available in Lagos State health care system. It was also noted that health facility distribution across Lagos’s urban and rural areas was even. In contrast, distribution based on other factors such as ownership type, Facility level of care, and facility category was slightly skewed. Conclusion: The distribution of health workers in health facility across LGA in Lagos State depend on Ownership type, Facility level of care, and category of the facility.
文摘Water resources health diagnosis is increasingly recognized as a critical tool.It should not only guide the preservation of water volume,quality,and ecological integrity but also assess the viability of carbon-neutral development pathways.But current research tends to consider water health assessment and carbon-neutrality planning as separate endeavors,which results in imprecise boundaries,disjointed metrics,and a weak linkage between diagnostic outcomes and testable management actions.This review brings together indicator systems,diagnostic systems,and environmental management systems architectures that make it possible to have integrated water-carbon governance.We define fundamental concepts and delimiting decisions followed by the examination of indicator designs across the hydrological regime,water quality,ecological integrity,service performance,resilience,and carbon-related measures,including intensity of energy/emissions,emissions caused by the watershed process of wastewater treatment,as well as the potential sink of the watershed.We compare diagnostic methods,such as composite indices and multi-criteria decision analysis,data-driven early-warning models,process-based and integrated simulations,as well as uncertainty-aware robustness models.Here,based on this synthesis,we suggest an environmental management systems(EMS)-based pathway,which connects the setting of the baseline,the diagnosis,the design of the intervention portfolio,and the measurement-reporting-verification into the closed-loop adaptive cycle.Digital enablement,comprising Internet of Things(IoT)monitoring,remote sensing,data fusion,optimization,and digital twins,is considered a viable way of scaling implementation,subject to interoperability,validation,and model governance.Among the major gaps,there are causal attribution to outcomes,cross-scale coupling of facility emissions and basin health,propagation of uncertainty in a coupled model,and credible Measurement,Reporting,and Verification(MRV)of non-CO_(2) gases and nature-based removals.The review gives a roadmap to normalize core metrics and fast-deployable systems to protect the health of the water resources and give verifiable progress towards carbon neutrality.
基金supported by a grant from Brain Science and BrainLike Intelligence Technology of the Ministry of Science and Technology of China(2021ZD0201804).
文摘With the sustained growth of the economy and significant changes in social demographics,the issue of elderly-related diseases has increasingly drawn attention,particularly.Alzheimer’s disease(AD),as a representative disease of neurodegenerative diseases,has become a major challenge,affecting the health and quality of life of the elderly population severely.In recent years,the incidence,prevalence and mortality rates of AD have increased in China,imposing substantial economic burdens on families,society and the entire healthcare system.To proactively address this challenge and respond to the national‘Healthy China Action’initiative,leading experts from authoritative institutions jointly authored the China Alzheimer Report 2025.Building on previous editions,this report updates epidemiological data on AD in China,thoroughly analyses the latest economic burdens of the disease and comprehensively evaluates the current status of AD diagnosis and treatment services,as well as the allocation of public health resources in our country.Its release reflects China’s progress in AD research and prevention,underscores societal concern for elderly health and aims to provide scientific guidance and data support for AD prevention,diagnosis and treatment.It also facilitates academic exchanges and cooperation,enhancing public awareness and promoting active participation in elderly healthcare,towards achieving‘healthy ageing’in China.
文摘AIM: To determine the rate and yield of repeat esophagogastroduodenoscopy (EGD) for dyspepsia in clinical practice,whether second opinions drive its use,and whether it is performed at the expense of colorectal cancer screening.METHODS: We performed a retrospective cohort study of all patients who underwent repeat EGD for dyspepsia from 1996 to 2006 at the University of California,San Francisco endoscopy service.RESULTS: Of 24 780 EGDs,5460 (22%) were performed for dyspepsia in 4873 patients.Of these,451 patients (9.3%) underwent repeat EGD for dyspepsia at a median 1.7 (interquartile range,0.8-3.1) years after initial EGD.Signif icant f indings possibly related to dyspepsia were more likely at initial (29%) vs repeat EGD (18%) [odds ratio (OR),1.45;95% confidence interval (CI): 1.20-1.75,P < 0.0001],and at repeat EGD if the initial EGD had reported such f indings (26%) than if it had not (14%) (OR,1.32;95% CI: 1.08-1.62,P = 0.0015).The same endoscopist performed the repeat and initial EGD in 77% of cases.Of patients aged 50 years or older,286/311 (92%) underwent lower endoscopy.CONCLUSION: Repeat EGD for dyspepsia occurred at a low but substantial rate,with lower yield than initial EGD.Optimizing endoscopy use remains a public health priority.
文摘Chronic non-communicable diseases have become a significant threat to the health of middle-aged and older adults in urban areas.The allocation of health resources in urban communities is associated with the prevalence of chronic diseases.This study conducts an empirical analysis using threshold regression methods based on data from the China Health and Retirement Longitudinal Study(CHARLS).It explores the nonlinear impact of community health resource allocation on chronic disease management among middle-aged and older adults across different age groups.The goal is to allocate health resources scientifically based on the health and activity needs of specific age groups.The results reveal staged differences across distinct age intervals.Specifically,the allocation of community health resources has a negative impact on the management of chronic diseases of respondents under 58 years old,an insignificant impact for those aged between 58 and 73 years,and a significant positive impact for those aged above 73 years old.The threshold effect of age is closely related to the health resource preference and activity pattern of different age groups.The alignment between health resource supply and demand within these groups determines their effectiveness in improving health outcomes.These findings could help optimize the spatial allocation of health resources,enhance planning standards,and address existing disparities across communities,thereby providing an evidence-based solution for urban planning decisions.
