Demand For Medical Treatment Research Articles

Nomogram for Predicting Viral Shedding Time of SARS-CoV-2 Delta Variant in Patients with COVID-19: A Retrospective Study

Abstract Background The coronavirus disease 2019 (COVID-19) cases continue to rise, and the demand for medical treatment and resources in healthcare systems surges. Assessing the viral shedding time (VST) of patients with COVID-19 can facilitate clinical decision making. Although some studies have been conducted on the factors affecting the VST of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), few prediction models are currently available. Methods This retrospective study included the consecutive patients with COVID-19 admitted to Xi’an Chest Hospital in Shaanxi, China, for treatment between December 19, 2021 and February 5, 2022. The clinical data of the patients were extracted from their electronic medical records. Combining significant factors affecting the VST, a nomogram was developed to predict the VST of the SARS-CoV-2 Delta variant in patients with COVID-19. Results We included 332 patients in this study. The average VST was 21 d. VST was significantly prolonged in patients with severe clinical symptoms, sore throat, old age, long time from onset to diagnosis, and an abnormal white blood cell count. Consequently, we developed a nomogram prediction model using these 5 variables. The concordance index (C-index) of this nomogram was 0.762, and after internal validation using bootstrapping (1000 resamples), the adjusted C-index was 0.762. The area under the nomogram’s receiver operator characteristic curve showed good discriminative ability (0.965). The calibration curve showed high consistency. The VST was prolonged in the group with lower model fitting scores according to the Kaplan-Meier curve (χ2=286, log-rank P < 0.001). Conclusions We developed a nomogram for predicting VST based on 5 easily accessible factors. It can effectively estimate the appropriate isolation period, control viral transmission, and optimize clinical strategies.

The Reimbursement Rate of New Rural Cooperative Medical Scheme and Self-Rated Health Among Rural Middle-Aged and Elderly.

ObjectivesThe ultimate goal of the New Rural Cooperative Medical Scheme (NRCMS) is to improve physical and psychological health and aim to provide equitable, affordable, cost-effective healthcare services for all rural people. One of our major concerns from the perspective of policy outcome is whether middle-aged and elderly can benefit from the insurance to improve self-rated health. The main objectives of this study are to answer the questions that the reimbursement rate of the NRCMS is a possible explanation of why and how rural middle-aged and elderly shift from non-medical service inputs to medical service to produce health based on a family production theory.MethodsData were obtained from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2018, which involved 1,030 rural adults aged 45 years and older, and ordinal logistic regression estimator and two-step regression were used to examine these assumptions. Our approach controlled for the health status of those people at the same administrative level of the hospital.ResultsOur study shows some interesting results. First, the reimbursement rate of NRCMS predicted a higher level of SRH among rural middle-aged and elderly, but that all of the indirect effect of it on SRH could be explained in total by satisfaction of local medical services utilization (ab = 0.0492). Second, the results further showed that the odds ratio of satisfaction from affordable, convenient, high-quality medical services is 2.402 times (p < 0.01) greater for those with higher reimbursement levels than for their counterparts with lower reimbursement. Third, the odds ratios of inpatient care visit, outpatient care visit, and physical examination among policyholders of NRCMS are also 1.116, 1.628, and 1.08 times greater, respectively, than their counterparts who are not satisfied with these local medical services.ConclusionsOur results concluded that generous insurance reimbursement can reduce the price of healthcare and costs of utilization that both had a dramatic effect on SRH among middle-aged and elderly when their demand for medical treatment is incurred. The government should focus on the healthcare cost, utilization, and health benefit calculations of health insurance policy options at the stage of rapid aging in rural China.

Relationship Between Emotional Intelligence, Self-Acceptance, and Positive Coping Styles Among Chinese Psychiatric Nurses in Shandong.

BackgroundNurses are facing increasing pressure due to the progressing of society, broadening of nursing service connotation, and increasing of the masses’ demand for medical treatment. Psychiatric nurses face suicides, violence, and lost along with other accidents involving patients with mental disorders under higher psychological pressure. A coping style, which is affected by individual emotions and cognition, is an essential psychological resource that allows individuals to regulate stress. The purpose of this study was to investigate the correlation between self-acceptance and the positive coping style of psychiatric nurses, and investigate the mediating role of emotional intelligence.MethodsA total of 813 psychiatric nurses from six natural regions in Shandong Province were investigated using the Self-Acceptance Questionnaire (SAQ), Emotional Intelligence Scale (EIS), Simplified Coping Style Questionnaire (SCSQ), and self-compiled general information questionnaire.ResultsThe total EIS score of psychiatric nurses was 3.848 ± 0.459. The highest score was for others’ emotional management (4.071 ± 0.548) and the lowest was for emotion perception (3.684 ± 0.483). EIS and positive coping style were statistically significant based on age, work experience, professional title, education level, and gender (p < 0.05, p < 0.01). Self-acceptance was statistically significant only for professional titles (F = 3.258, p = 0.021). Self-acceptance and emotional intelligence were positively correlated with positive coping style (r = 0.361, p < 0.01; r = 0.492, p < 0.01, respectively). The factors were also positively correlated with each other (r = 0.316, p < 0.01). Self-emotion management, others’ emotional management, emotion perception, self-acceptance, and education level jointly predicted positive coping styles (R2 = 0.305, F = 60.476, p = 0.000). Emotional intelligence partially mediated the relationship between self-acceptance and positive coping styles, with a mediating effect of 16.3%.ConclusionEmotional intelligence and self-acceptance can promote positive coping styles and improve psychiatric nurses’ mental health.

Ageing in Developing Societies: Issues and Challenges

Ageing has emerged as a major challenge in several developing societies. With falling fertility rates and increasing longevity as its main drivers, it is expected that by 2050, one in five people of the developing countries will be over 60 years of age. It is argued that on account of this, such societies would further encounter an increased demand for medical treatment, long-term care, financial and emotional support. They also are likely to face an enormous psychological burden. In the context of ageing, the article highlights some of the key issues and challenges encountered by the developing societies. Urbanisation, changing family structure and drifting intergenerational relationships are seen as factors that have led to a multitude of psychological problems like social isolation, loneliness, abuse and discrimination and depression in older adults. The article argues in support of health and other social protective measures and calls for the need to recognise the strengths of older adults with a view to integrate them into the mainstream.

Evaluation of the spatial equity of medical facilities based on improved potential model and map service API: A case study in Zhengzhou, China

By introducing an improved potential model and using the Internet map navigation service and GIS spatial analysis technology platform, this paper studies the spatial accessibility and equity of the medical treatment of residential buildings in the main urban area of Zhengzhou. The findings show that, overall, the spatial accessibility of medical treatment in the study area extends in the northeast and southwest directions, and presents a zonal spreading trend. There exist certain differences and imbalances in the medical facilities and services in each ring, reflect in a gradual deterioration from the first ring to the third ring. According to residents' demand for medical treatment and the distribution of medical resources, the medical spaces themselves can be roughly divided into three regions: “high enjoyment type” (ample resources and sparse population), “general type” (average amount of resources and concentrated population), and “lagging type” (few resources and sparse population). With regard to equity, and based on the Gini coefficient and Lorenz curve, the number of beds in medical facilities was found to be positively correlated with the population, and the total supply of resources to be balanced with population demand, whereas medical resources were seen to be scarce in the outskirts of Zhengzhou and far from the central area. The location entropy index suggests that accessibility to medical facilities in most residential areas is below the average level. While the total amount of hospital resources across the population was found to be relatively equitable, much room for improvement can be said to remain in terms of residents' accessibility when they arrive at hospitals for medical treatment. These research results provide new insights into equity evaluations of urban resource accessibility, as well as a scientific basis for the Chinese government to plan the distribution of medical resources.

Current situation and suggestions for ophthalmic medical work in a non-COVID-19 treatment hospital in later stages of epidemic

The epidemic of COVID-19 has exhibited the decline trend with the enhanced containment and mitigation strategies,The public's normal demand for medical treatment has increased sharply.The current focus is to ensure the daily medical services needed by non-COVID-19 patients while preventing and controlling the epidemic of COVID-19.Although ophthalmologists do not work on the front lines of the outbreak, due to their area of expertise, a variety of situations, such as infection consultations or ophthalmic emergency treatments, can lead to the exposure of ophthalmologists to high-risk environments. This paper mainly analyzes and studies the problems existing in work and life of ophthalmic medical staff in a Fixed-point Treatment hospital for non-COVID-19 patients in later stages of the epidemic,and make recommendations and responses,this assists in obtaining guarantee in both safety and quality of medical services provided, reduces cross-infection in clinical practice and reduces the infection risk of ophthalmic medical staff,but also helps in lessening the mental and spiritual stress for medical staffs. Key words: Coronavirus disease 2019 (COVID-19); Epidemic; Prevention and control of epidemic; Ophthalmology

Positively Aware? Conflicting Expert Reviews and Demand for Medical Treatment

We study the impact of expert reviews on the demand for HIV treatments. A novel feature of our study is that we observe two reviews for each HIV drug and focus attention on consumer responses when experts disagree. Reviews are provided by both a doctor and an activist in the HIV lifestyle magazine Positively Aware, which we merge with detailed panel data on HIV-positive men's treatment consumption and health outcomes. To establish a causal relationship between reviews and demand, we exploit the arrival of new drugs over time, which provides arguably random variation in reviews of existing drugs. We find that when doctors and activists agree, more positive reviews increase demand for HIV drugs. However, doctors and activists frequently disagree, most often over treatments that are effective, but have harsh side effects, in which case they are given low ratings by the activist, but not by the doctor. In such cases, relatively healthy consumers favor drugs with higher activist reviews, thus defying the doctor, which is consistent with a distaste for side effects. This pattern reverses for individuals who are in worse health and thus face stronger incentives to choose more effective medication despite side effects. Findings suggest that consumers demand information from experts according to the trade-offs they face when making health investments in the presence of adverse treatment side effects.

PLAYING GOD WITH HIV

It is generally understood that conflict can contribute to the spread of disease. This paper explains the reverse: how disease, as an accelerating factor, can result in serious conflict. While not a cause of war itself, HIV/AIDS exacerbates existing tensions: social, ethnic and political. Political constituencies concerned about HIV/AIDS will become frustrated if the state's leadership does not meet their demands. The demand for medical treatment of the disease is certain to exceed supply in all Southern African states. Projects to treat the disease are small and access is limited. The criteria for access, both real and perceived, will play a critical role in determining the level of conflict and disruption that HIV/AIDS will cause.

Counselling in a general practice surgery: results of a study

In ‘Counselling in General Practice: a Review’, Wyld (1981) concluded (p, 136) that some 75 per cent of clients can be expected to show some improvement after being counselled by non-medical workers in a GP setting, and that both GP contact and drug prescriptions are likely to be reduced. Wyld also quotes on the same page from what he calls the most informative paper about counsellors in GP practices, that by Anderson and Hasler (1979), which was a report on the service provided by a part-time counsellor in a GPs practice in Oxford. In this study which was initially of 80 patients, 35 out of 54 who responded to a questionnaire reported ‘general improvement’, and 35 out of 54 said they had reduced their demand for medical treatment. When the cost of prescriptions in the three months before counselling was compared with that for the three months after counselling, there was an estimated saving of £76.92 in the second three months. However, it is clear, as is common with questionnaire studies, that not all those seen responded to the questionnaire. It may also be difficult for patients who have had counselling, and who trouble to respond, to be other than supportive, particularly in view of the time they will have given up. Among the other studies mentioned by Wyld is one by Meacher (1977) in which, as well as patients estimating the help they had received, GPs also gave their estimates. Seventy five per cent of the patients said that counselling had helped and 82 per cent of the patients were said by the GPs to have improved after counselling.