Changes In Health Care System Research Articles

Biosimilars: A Critical Review of Development, Regulatory Landscape, and Clinical Implications.

The biopharmaceutical industry has witnessed significant growth in the development and approval of biosimilars. These biosimilars aim to provide cost-effective alternatives to expensive originator biosimilars, alleviating financial pressures within healthcare. The manufacturing of biosimilars is a highly complex process that involves several stages, each of which must meet strict regulatory standards to ensure that the final product is highly similar to the reference biologic. To gain regulatory approval, biosimilars must undergo rigorous analytical characterization including in vitro assays, bioanalytical evaluations, and clinical similarity studies like pharmacokinetic (PK), pharmacodynamic (PD) assessments-to demonstrate safety, efficacy, quality comparability with reference products. Leading regulatory agencies such as the European Medicines Agency (EMA), the World Health Organization (WHO), and the United States Food and Drug Administration (US FDA) have established stringent guidelines for biosimilar evaluation and post-marketing surveillance. Despite this regulatory clarity, challenges around interchangeability, market exclusivity, and patent protection often delay market access and limit adoption, particularly in regions where automatic substitution is restricted. Case studies of biosimilars such as rituximab, adalimumab, filgrastim, and trastuzab reveal both advancements and ongoing hurdles in achieving broader market integration. The introduction of biosimilars has shown potential to reduce healthcare costs; for example, a recent analysis indicates a 20-30% cost reduction in the U.S. due to biosimilar adoption. As the biosimilar market expands, collaborative efforts among regulatory bodies, industry stakeholders, and healthcare providers are essential to enhance access to biologic therapies. This collaboration is poised to improve patient outcomes and catalyse transformative change in global healthcare systems.

Preparing physiotherapists for the future: the development and evaluation of an innovative curriculum

BackgroundEducational innovation in health professional education is needed to keep up with rapidly changing healthcare systems and societal needs. This study evaluates the implementation of PACE, an innovative curriculum designed by the physiotherapy department of the HAN University of Applied Sciences in The Netherlands. The PACE concept features an integrated approach to learning and assessment based on pre-set learning outcomes, personalized learning goals, flexible learning routes, and programmatic assessment. PACE distinguishes itself from traditional education because of the flexible learning routes, vertical organization in learning communities, absence of pre-defined learning activities and class schedules, and a culture of continuous learning and development. PACE is based on three guiding principles: 1) flexible and varied, 2) self-directed and collaborative, 3) future-oriented. PACE was implemented in 2021 for first-year students. This study evaluates the implementation to inform future curriculum development.MethodsA sequential explanatory mixed methods design was used to evaluate the implementation of PACE using a questionnaire, focus groups, in-depth interviews, and a national progress test allowing for benchmarking results. Participants were undergraduate physiotherapy students of cohort 2021–2022, the first group who experienced PACE and teachers involved with this cohort. Questionnaire data were analyzed using descriptive statistics. To compare mean total scores of the national progress test between four different universities a one-way ANOVA was conducted including a post-hoc analysis. Reflexive thematic analysis guidelines were applied to analyze the interview data.ResultsIn total 82 first year students (44,6%) of cohort 2021–2022 and 36 teachers (60%) completed the questionnaire. Results show that the guiding principles were implemented as intended. Results of the national progress test on knowledge and clinical reasoning showed that students of the HAN University performed well compared to other universities. Thematic analysis of interviews and focus groups resulted in three themes and nine subthemes: 1) navigating a personalized curriculum, 2) caring and sharing, and 3) shaping professional identity. PACE contributed positively to students' intrinsic motivation, learning joy, identity development, and life-long learning skills. Areas for improvement were self-directed learning support, and teaching strategies to prompt deep learning.ConclusionThe evaluation showed that the guiding principles of PACE were implemented as intended and that the innovation positively contributed to student learning,

Changes in causes and outcomes of thoracic trauma cases during the COVID-19 pandemic: Literature review

Thoracic trauma refers to injuries affecting the chest area, which can lead to damage to the ribs, lungs, heart, and blood vessels. The most common cause of thoracic trauma is motor vehicle accidents. The COVID-19 pandemic has led to the implementation of various policies that have impacted multiple sectors, including healthcare systems and daily habits. Changes in healthcare systems are not limited to infectious cases but also extend to trauma cases. Various challenges have emerged alongside the increasing number of COVID-19 infections, such as shortages of personal protective equipment, ventilators, and hospital beds. The enforcement of pandemic-related policies has also resulted in alterations to daily routines. Lockdowns and social distancing measures have contributed to a decrease in traffic accidents due to reduced public mobility. Additionally, delays in seeking treatment for thoracic trauma due to fears of contracting COVID-19 have led to changes in outcomes. This literature review aims to identify the changes that occurred during the COVID-19 pandemic, particularly concerning the causes and outcomes of thoracic trauma cases.

Clinical and epidemiological aspects of the covid-19 coronavirus infection in pregnant women

The coronavirus infection caused by the SARS-CoV-2 virus remains one of the most significant global healthcare challenges [1-10]. COVID-19 has affected all aspects of modern society, from economic consequences to profound changes in healthcare systems and social structures. The rele­vance of studying the coronavirus infection is based on several important reasons. First, COVID-19 is characterized by its high transmission rate, leading to large outbreaks, which necessitates a detailed study of transmission methods and control measures. It should be noted that coronavirus infection affects various systems of the body, including the respi­ra­tory, cardiovascular, nervous, and immune systems. Second, the clinical manifestations of COVID-19 range from asymptomatic cases to severe forms with fatal outcomes, making it essential to thoroughly investigate both the pathogenesis and risk factors.

Development of primary health care in Moscow: New polyclinic standard

The increase in the number of chronic noncommunicable diseases, changes in the age structure of the population, and an increase in demand for medical services in the primary health care system determine the need for an adequate response of health systems to these requests. Standardization is one of the effective mechanisms for managing the quality and accessibility of medical care provided to the population. The development of the Moscow healthcare system today is focused on the redistribution of forces towards primary healthcare and large-scale digitalization. Aim. To evaluate the results of the implementation of standardized solutions in the primary health care management system provided in outpatient clinics subordinate to the Department of Health of the city of Moscow. Materials and methods. Statistical and analytical methods, the method of expert interviews and content analysis of literature sources of domestic authors, as well as normative legal acts for 2018-2023 were used in the work. The main performance indicators of the outpatient clinics of Moscow are analyzed. Results. Important purposes of the healthcare system have been achieved: the created modern framework of outpatient care provided the opportunity to ensure equal access to quality care; the introduction of a single standard of polyclinics contributes to the rationalization of territorial planning, improvement and development of infrastructure, the use of innovative medical technologies and solutions; managerial and reorganization changes in the structure of polyclinics allowed to build convenient and clear routing of patients to receive medical care in the required volume and shorter terms. Changes in the Moscow primary health care system affect both external and internal processes, are aimed at maximizing the coverage of the population with health services, improving the provision of modern equipment to Moscow polyclinics, and creating a digital polyclinic. Conclusion. Bringing Moscow polyclinics to a single standard required reengineering of existing processes, restructuring of procedures focused on managing the completed case. The quality and accessibility of medical care to the population of Moscow remains a top priority in the development of outpatient care.

Australian and Canadian clinicians’ views and application of ‘carbon health literacy’: a qualitative study

BackgroundClinical care contributes to at least 50% of the greenhouse gas (GHG) emissions of healthcare. This includes the 40% of healthcare that is harmful or low value, adding avoidable emissions without improving health or quality of care. Clinicians are well-placed to mitigate emissions associated with the provision of clinical care. This study aimed to explore clinicians’ views on a new construct we have termed ‘carbon health literacy’ to understand how knowledge, skills and capacities related to the emissions of clinical care has application in clinical practice.MethodsQualitative interviews were conducted between August 2022 and February 2023 with clinicians from Australia (n = 15) and Canada (n = 13). Clinicians with an interest in climate change and healthcare sustainability were sampled from a variety of clinical specialty areas, such as primary care, nursing, anaesthetics, and emergency. Clinicians were recruited through advertising on social media and via professional networks. A pre-piloted interview schedule was used to guide the interviews. Interviews were audio recorded, transcribed verbatim and analysed using framework analysis.ResultsParticipants viewed carbon health literacy as an increasingly important skill for clinicians to have or acquire, though they reported that the level of carbon health literacy and knowledge needed varies by job roles, clinical specialty areas, and individual capacity to generate healthcare system change. Many clinicians reported implementing strategies to mitigate their work-related GHG emissions, such as reducing waste or choosing lower carbon commuting options. There was limited awareness of reducing low-value care as a strategy to decrease emissions. All participants had encountered barriers to providing low-carbon care, including managing patient expectations, inadequate training and information, and limited capacity to generate system change in their organisational roles.ConclusionsTo support the delivery of high value low carbon healthcare, work is needed to build the carbon health literacy of clinicians and remove other barriers currently impeding their capacity to practice and promote sustainable clinical care.

Access points to different levels of health care over 13 years. Utilization behaviour in a changing health care system. Results of a three-wave cross-sectional series in Austria.

Providing health care is a balancing act among human resources, financial pressures and system-intrinsic factors. Understanding the utilization behaviour of primary and secondary care facilities [general practitioners (GPs) vs. specialists, as well as in- and outpatient hospital care] is crucial for a country like Austria, which has free access to all levels of care. The aim of this study was to reassess access point consultations in relation to sociodemographic variables over time. The databases used for this cross-sectional analysis were the Austrian Health Interview Surveys 2006/07, 2014, and 2019, with sample sizes of 15 474, 15 770, and 15 461 persons, respectively. Analyses included patterns of utilization behaviour, multivariable logistic regression models, and diff-in-diff analyses highlighting differences between the observation periods. GP and secondary care consultations increased from 2014 to 2019. While there were fewer GP visits in 2014 than in 2006/07, GP consultation rates grew by 3.2% between 2014 and 2019. Secondary care utilization increased by 5.4%-8.2% between 2006/07 and 2019, with the highest growth in older and less-educated persons. Secondary-level utilization without prior GP visits decreased again in 2019 after peaking in 2014. Utilization of all access points increased over the entire observation period, especially regarding secondary-level care. Higher GP visit rates do not seem to result in a drop in secondary-level consultations. These results emphasize the coordinator role of primary care in ongoing structural health reforms in European countries, such as Austria.

Whose Responsibility Is It? Implementing Patient-Prioritized Healthcare System Change in Oncology.

This brief commentary describes the reflections on a fundamental question by the Public Interest Group on Cancer Research, a successful academic-community partnership focused on cancer research, education, public engagement, and advocacy in Canada's Eastern province of Newfoundland and Labrador. Our Group has achieved some success in a short time with very limited funding. It has successfully created public spaces for conversations about cancer care and priorities for research and regularly advocated for health service change prioritized by input from patients and family members. However, we remain challenged in our understanding of how to truly implement change within oncology care contexts that is informed by patients and families affected by cancer. In this short reflection, we hope to raise awareness of this important issue and question whose responsibility it is to work with patients and families and follow through on prioritized healthcare issues and services. We suggest this may be a matter of integrated knowledge translation and a better understanding of where patients and families fit in this space. We hope to encourage reflection and conversation among all relevant stakeholders about how best to implement patient-prioritized change in oncology care and policy.

‘We listened and supported and depended on each other’: a qualitative study of how leadership influences implementation of QI interventions

BackgroundThere is growing recognition in the literature of the ‘Herculean’ efforts required to bring about change in healthcare processes and systems. Leadership is recognised as a critical lever for implementation...

An Integrated Rapid Response Model for Pediatric Patients Requiring In-Patient Medical Stabilization: Lessons Learned to Enable Regional Capacity Building.

There was an unprecedented surge in admissions for medical stabilization of pediatric patients with eating disorders during the COVID-19 pandemic in Ontario. Eleven hospitals established an integrated rapid response model to ensure timely in-patient access for these patients. This population was cared for in re-allocated community hospital beds as a result of engaging hospital leadership, strengthening partnerships, consulting experts, leveraging existing resources and developing regional bed access strategies. Innovative healthcare system changes were sustained, demonstrating how hospitals can partner to increase capacity and dynamically address crises. Our model can be applied to other populations requiring urgent and collaborative response.

Analysis of Indirect Costs of Absence Associated with Mental Disorders on the Basis of Social Security Data (2012-2023).

Mental and behavioral disorders significantly impair psychophysical functioning, leading to challenges in daily activities. The increasing recognition of the importance of mental health in global development goals has resulted in its inclusion in the United Nations' Sustainable Development Goals. The burden of mental disorders has grown worldwide due to demographic changes, with substantial economic and social impacts. This study aimed to examine the indirect costs of mental disorders in Poland by analyzing the expenditures by the Social Insurance Institution (ZUS) on work incapacity benefits and disability pensions from 2012 to 2023. The goal was to identify trends, dependencies, and the economic impact of policy changes. Data were collected from ZUS reports on annual expenditures for work incapacity benefits and disability pensions. Advanced statistical methods, including linear regression and Pearson correlation, were employed to analyze trends and relationships. Student's t-tests assessed the statistical significance of the observed trends. The expenditures on benefits for work incapacity due to mental disorders increased significantly over the past decade, particularly from 2020 to 2023, partly due to the COVID-19 pandemic. Short-term absenteeism due to mental disorders accounted for 10.5% of the total sick leave days. A strong positive correlation was found between years and benefit expenditures. Conversely, the disability pension expenditures exhibited a downward trend, potentially reflecting improvements in public health or policy changes. The significant increase in expenditures on benefits related to mental disorders may reflect greater awareness, improved diagnostics, and the impact of the COVID-19 pandemic. In contrast, the decline in disability pension expenditures could suggest improved mental health or effective policy measures. However, it is important to emphasize that the presented data are not the only factor influencing this situation. Multiple variables, including societal, economic, and healthcare system changes, contribute to these trends. Therefore, further research is necessary to fully understand the underlying causes and to guide effective policy development. Regular monitoring and continued investment in mental health are essential to managing indirect costs such as absenteeism and presenteeism efficiently.

Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemic

BackgroundThe Coronavirus disease 2019 (COVID-19) pandemic led to healthcare system changes aimed at minimizing disease transmission that impacted experiences with obstetric healthcare. ObjectiveTo explore experiences of clinicians providing obstetric care during the COVID-19 pandemic. Study DesignQualitative, in-depth, semi-structured interviews were conducted with five nurse practitioners and 16 obstetrical physicians providing a mix of outpatient and inpatient obstetric care during the COVID-19 pandemic in a mid-sized, Midwestern city in the United States. Interviews elucidated challenges and facilitators of obstetric care provision and vaccination of pregnant patients against COVID-19 during the pandemic. Transcripts were coded inductively then deductively using the Health Equity Implementation Framework (HEIF), which integrates a disparities framework and implementation framework to highlight multilevel factors that influence obstetric care. Thematic analysis was conducted, and thematic saturation was reached. ResultsWe interviewed 21 clinicians. Clinicians recounted personal challenges such as social isolation and burnout that could be countered by social support. Challenges within the clinical encounter included implementation of infection mitigation efforts, vaccine counseling, and limitations of telehealth. However, when successfully implemented, telehealth facilitated care and circumvented barriers. Clinicians cited challenges at the healthcare system level such as rapidly evolving knowledge and recommendations, restrictive visitor policies, personnel shortage, and inadequate institutional resources to support pandemic-related stressors. However, interdisciplinary care and guidelines available for clinicians facilitated care. Clinicians reported that challenges at the societal level included financial strain, lack of childcare, medical mistrust, politicization of medicine, misinformation, and racism. Societal-level facilitators included insurance access, community outreach, positive policy changes, and fostering trust in medicine. ConclusionThe pandemic produced unique stressors and exacerbated existing challenges for clinicians providing obstetric care. Applying the HEIF to the findings emphasizes the influence of societal factors on all other levels. Identified facilitators can inform interventions to address stressors in obstetric care that have resulted from the changed sociopolitical landscape of the pandemic.

Perception and Acceptance of Telemedicine Use in Health Care Among the General Public in China: Web-Based Cross-Sectional Survey.

The COVID-19 pandemic is bringing about substantial changes in health care systems, leading to a significant shift toward telemedicine for the delivery of health care services. This study aims to examine the relationship between perceived usefulness and ease of use of telemedicine services and their association with the behavioral intention to use telemedicine. An anonymous cross-sectional survey was conducted in China. Partial least squares structural equation modeling was used to determine significant predictors of intention to use telemedicine consultation. Types of illnesses that favored seeking telemedicine consultation, as well as the most preferred platform for conducting telemedicine consultations, were also investigated. In total, 1006 participants completed the survey. A total of 44.3% (n=446) reported being very likely and 49.3% (n=496) reported being likely to seek telemedicine consultation. Overall, the majority of participants expressed strong agreement or agreement regarding the perceived usefulness of telemedicine. Likewise, the majority indicated strong agreement or agreement when it came to their perception of the ease of using telemedicine. In the partial least squares structural equation modeling, perceived usefulness (β=0.322; P<.001) and perceived ease of use (β=0.118; P=.01) were significantly associated with a higher likelihood of seeking telemedicine consultation. A considerable number of participants expressed willingness to use telemedicine services for various medical conditions, particularly respiratory (n=340, 33.8%), skin (n=316, 31.4%), and musculoskeletal issues (n=316, 31.4%) while showing less interest in seeking telemedicine consultations for reproductive health (n=44, 4.4%) and cancer (n=64, 6.4%). The majority preferred video chat (n=443, 44%) and text chat (n=317, 31.5%) as their most preferred platforms for telemedicine consultation, while a smaller proportion preferred telephone (n=193, 19.2%) and email (n=53, 5.3%). Telemedicine has the potential to play a larger role in China's health care system. The preferences for certain platforms over others may influence service design and implementation.

The Use of COVID-19 Mobile Apps in Connecting Patients with Primary Healthcare in 30 Countries: Eurodata Study.

The COVID-19 pandemic has necessitated changes in European healthcare systems, with a significant proportion of COVID-19 cases being managed on an outpatient basis in primary healthcare (PHC). To alleviate the burden on healthcare facilities, many European countries developed contact-tracing apps and symptom checkers to identify potential cases. As the pandemic evolved, the European Union introduced the Digital COVID-19 Certificate for travel, which relies on vaccination, recent recovery, or negative test results. However, the integration between these apps and PHC has not been thoroughly explored in Europe. To describe if governmental COVID-19 apps allowed COVID-19 patients to connect with PHC through their apps in Europe and to examine how the Digital COVID-19 Certificate was obtained. Design and setting: Retrospective descriptive study in PHC in 30 European countries. An ad hoc, semi-structured questionnaire was developed to collect country-specific data on primary healthcare activity during the COVID-19 pandemic and the use of information technology tools to support medical care from 15 March 2020 to 31 August 2021. Key informants belong to the WONCA Europe network (World Organization of Family Doctors). The data were collected from relevant and reliable official sources, such as governmental websites and guidelines. Patient's first contact with health system, governmental COVID-19 app (name and function), Digital COVID-19 Certification, COVID-19 app connection with PHC. Primary care was the first point of care for suspected COVID-19 patients in 28 countries, and 24 countries developed apps to complement classical medical care. The most frequently developed app was for tracing COVID-19 cases (24 countries), followed by the Digital COVID-19 Certificate app (17 countries). Bulgaria, Italy, Serbia, North Macedonia, and Romania had interoperability between PHC and COVID-19 apps, and Poland and Romania's apps considered social needs. COVID-19 apps were widely created during the first pandemic year. Contact tracing was the most frequent function found in the registered apps. Connection with PHC was scarcely developed. In future pandemics, connections between health system levels should be guaranteed to develop and implement effective strategies for managing diseases.

Embarking on the era in new medicine: reshaping the systems of medical education and knowledge

Abstract Recent revolutions in science and technology have driven human civilisation to an unprecedented level and have promoted the rapid development of modern medicine. New Medicine (NM) is proposed in response to the recent technological revolution and higher requirements for health. The characteristics of NM have been summarised using systems, holistic, intelligent, and precision (SHIP) paradigms. The development of NM has led to substantial changes in healthcare systems and related human resources. However, information regarding how current medical talent cultivation goals adapt to the developments in the era of NM remains unclear. Such adaptations may require a systemic revamping of the current medical education. Recently, medical educators have proposed the construction of New Medical Education (NME), but no unified consensus on its connotation and roadmap exists. Systematically understanding the core essence of NM and identifying the matched strategies of NME are crucial and will benefit future reform strategies that attempt to tackle potential challenges and achieve sustainable goals for medical services. Here, we aim to summarise the changes that have emerged in the field of medicine, how these changes affect the development of medicine, and how the field should prepare for the future medical education.

Rethinking patient flows in a changing healthcare system: a unified approach.

The management of chronic diseases poses a challenge to the National Health Service (NHS), but it can also offer an opportunity for a radical renovation of healthcare provision. To improve the appropriateness of healthcare settings, it is essential to adopt integrated approach in all healthcare settings. This study was conducted at San Giovanni Bosco Hospital, in the area of the "Città di Torino" Local Health Authority, between June 2021 and December 2022. Its main goal was to manage hospital patient flows in an integrated manner in order to improve the efficiency of the entire healthcare system. The data were examined in terms of effectiveness in optimizing hospital flows. The data indicated that hospital outpatient activities can become more specialized by leveraging the greater technological potential that a hospital possesses. At San Giovanni Bosco Hospital, the hub of the "Città di Torino" Local Health Authority (ASL), differential patient pathways were established in order to enhance the efficiency of the entire system by deploying hospital staff in a community setting. Implementation of the Otorhinolaryngology pathway avoided the hospitalization of 249 patients, who would otherwise have added strain to the overall organization of the hub hospital, which is currently short of space. A significant effort is needed in order to build an integrated network that provides patients with reliable and stable references. The approach adopted at San Giovanni Bosco Hospital resulted in an improvement in the use of both hospital and territorial facilities.

Paramedics’ experiences of barriers to, and enablers of, responding to suspected or confirmed COVID-19 cases: a qualitative study

BackgroundParamedics’ work, even pre-pandemic, can be confronting and dangerous. As pandemics add extra stressors, the study explored paramedics’ lived experience of the barriers to, and enablers of, responding to suspected or confirmed Coronavirus Disease 2019 (COVID-19) cases.MethodsThis exploratory-descriptive qualitative study used semi-structured interviews to investigate Queensland metropolitan paramedics’ experiences of responding to cases during the COVID-19 pandemic. Interview transcripts were analysed using thematic analysis. Registered Paramedics were recruited by criterion sampling of staff who experienced the COVID-19 pandemic as active officers.ResultsNine registered paramedics participated. Five themes emerged: communication, fear and risk, work-related protective factors, leadership, and change. Unique barriers included impacts on effective communication due to the mobile nature of paramedicine, inconsistent policies/procedures between different healthcare facilities, dispatch of incorrect information to paramedics, assisting people to navigate the changing healthcare system, and wearing personal protective equipment in hot, humid environments. A lower perceived risk from COVID-19, and increased empathy after recovering from COVID-19 were unique enablers.ConclusionsThis study uncovered barriers and enablers to attending suspected or confirmed COVID-19 cases unique to paramedicine, often stemming from the mobile nature of prehospital care, and identifies the need for further research in paramedicine post-pandemic to better understand how paramedics can be supported during public health emergencies to ensure uninterrupted ambulance service delivery.

The changing health-care system in Ghana: forms of care within residential aged care facilities in urban Accra

PurposeThe emergence of residential aged care facilities (RACFs) within the Ghanaian health-care system has raised eyebrows because, hitherto, the concept of nursing homes had largely been perceived as an anomaly. The purpose of this study is to understand this emerging phenomenon and the activities of care provided within two facilities in the nation’s capital, Accra.Design/methodology/approachThe study draws on participant observations and in-depth interviews with purposively sampled 15 residents in the two facilities and eight caregivers. The data were analysed using thematic approach.FindingsThe study found that the daily forms of care mostly performed for the elderly were intimate and non-intimate physical, medical, emotional and spiritual and end-of-life care. The bulk of activities of care were performed in the morning.Originality/valueThe study reveals that the changing landscape of health-care facilities in Ghana to include RACFs indicates RACFs have come to stay to provide different forms of care to older persons who otherwise were cared for by the family.

Perception gaps of patient engagement for patient safety between healthcare professionals and the public in Korea

Background To ensure effective patient engagement, patients’ efforts, partnerships with healthcare professionals, and the organisation’s role in providing safe healthcare settings must be emphasised. Perception gaps regarding patient engagement between the public and healthcare professionals could prevent healthy partnerships from forming and hinder patient engagement activities. This study examined healthcare professionals’ perception of patient engagement and compared the findings with that determined for the public in a previous study. Methods An anonymous online survey was conducted in February 2020 among 1,007 healthcare professionals (physicians, nurses). The questionnaire comprised five parts regarding the perception of patient engagement. Descriptive analysis and Chi-squared/Fisher’s exact tests determined the frequency and significant differences among the public from previous study and healthcare professionals in this study. Results The perception of the importance of patient safety was high among healthcare professionals and the public. However, statistically significant differences in perceptions were observed among the public and healthcare professionals in all categories. The perception gaps were substantial between the groups in sub-categories of engagement for patient safety during medical treatment; 86% of physicians and 90% of nurses agreed that patients participate in the decision-making for the treatment process. Conversely, 58% of the public agreed. Only 22% of the public agreed with confirming healthcare professionals’ hand washing to prevent infection, versus 57% of physicians and 65% of nurses. More than 89% of healthcare professionals positively perceived medical dispute mediation versus only half of the public. In certain areas such as “medical dispute mediation and arbitration programs”, “fall prevention”, and “infection prevention”, there was a statistically significant difference in the perception of patient involvement among healthcare professionals, with nurses’ perception being particularly more positive than that of physicians. Conclusions The healthcare professionals’ perception of patient engagement was more positive than that of the public. To narrow the perception gaps and enhance the public’s perception, strategies involving changes in healthcare systems, promotional efforts, and educational initiatives should be developed. Additionally, strategies should be formulated for healthcare professionals to better engage as partners in patient care.

Nationwide epidemiology and health resource use among children with COVID-19 in Japan

BackgroundThe COVID-19 pandemic posed substantial challenges to healthcare systems. Understanding the responses of pediatric health services is crucial for future pandemic planning and preparedness, yet such data remains limited. MethodsIn this retrospective cohort study, we analyzed data from administrative databases developed by Japan Medical Data Center and DeSC Healthcare Inc. The dataset comprised records of 2,612,511 children, totaling 60,224,888 person-months, from January 2020 to May 2022. Multivariate generalized estimation equations were used to examine the incidence rates of COVID-19 and associated health resource use. ResultsOur analysis revealed that the incidence rates of COVID-19 gradually increased from Wave I (2.2 cases per 100,000 person-months) to Wave V (177.8cases per 100,000 person-months), with a notable elevation during Wave VI (2367.7 cases per 100,000 person-months). While nucleic acid amplification tests were primarily used during Waves I–V, the use of rapid antigen tests markedly increased in Wave VI. The hospitalization rates increased gradually from 0.2 in Wave I to 10.2 events per 100,000 person-months in Wave VI, and the case-hospitalization risk decreased from 14.9% in Wave II to 0.7% in Wave VI. Additionally, we observed decreasing trends in the use of antibiotics (Wave I, 31.8%; Wave VI, 9.0%), whereas antipyretic use rose from Wave I (56.1%) to Wave VI (86.6%). ConclusionsOur study highlighted essential changes in the nationwide pediatric healthcare system's response to the COVID-19 pandemic. These findings provide valuable insights into the future pandemic planning and preparedness.