Efficient Health Care System Research Articles

Utilization and benefits of point-of-care testing in primary healthcare⁠

Point-of-care testing (POCT) represents a transformative advancement in healthcare, enabling rapid and accurate diagnostics at or near the site of patient care. By reducing reliance on centralized laboratories, POCT expedites clinical decision-making and enhances healthcare delivery, particularly in underserved regions. Its application spans various medical fields, including infectious diseases, chronic disease management, and emergency care. Innovations such as molecular diagnostics, biosensors, and artificial intelligence (AI) integration have improved the precision, reliability, and accessibility of POCT devices, offering significant benefits for patient outcomes and healthcare efficiency. POCT has demonstrated its potential to reduce diagnostic delays, lower hospital admissions, and decrease the burden on overextended healthcare systems. Rapid diagnostics for conditions such as acute myocardial infarction, diabetes, and malaria have resulted in timely interventions, improving survival rates and reducing complications. In addition to clinical benefits, economic analyses highlight the cost-effectiveness of POCT, as it minimizes resource utilization and shortens patient treatment cycles. However, challenges persist in scaling POCT accessibility. Financial barriers, supply chain limitations, regulatory inconsistencies, and workforce training deficits impede its widespread adoption, particularly in low- and middle-income countries. Addressing these issues requires innovative funding models, global regulatory harmonization, and capacity-building initiatives to empower healthcare workers. Technological advancements continue to expand POCT's potential, integrating real-time diagnostics with digital health platforms and epidemiological surveillance systems. These developments promise not only to enhance healthcare delivery but also to improve public health responses to outbreaks and health crises. By bridging the gap between diagnostics and treatment, POCT offers a pathway to more equitable and efficient healthcare systems, transforming how and where care is delivered. Its integration into healthcare frameworks holds the potential to redefine patient care, fostering a future of accessible, high-quality healthcare for all.

BIG DATA AND MACHINE LEARNING FOR HEALTHCARE RESOURCE ALLOCATION AND OPTIMIZATION

Healthcare systems face increasing pressure to allocate limited resources effectively due to growing populations, rising healthcare costs, and the increasing complexity of medical needs. The advent of big data and machine learning (ML) technologies offers transformative potential for addressing these challenges. This paper explores the integration of big data and ML in healthcare resource allocation and optimization, focusing on how these technologies enable data-driven decision-making, improve operational efficiency, and enhance patient outcomes. We discuss applications such as predictive modeling for patient admissions, optimization of staffing, inventory management, and strategic planning. Additionally, challenges such as data privacy, interoperability, and algorithmic bias are analyzed, and potential solutions are proposed. This paper concludes with insights into future directions for research and practice in leveraging big data and ML to create more efficient and equitable healthcare systems.

MANAGEMENT ASPECTS OF THE INTEGRATION OF MEDICAL STATISTICS AND INFORMATION SYSTEMS FOR EFFECTIVE RESOURCE PLANNING IN THE HEALTHCARE SYSTEM

This article delves into the administrative aspects of integrating medical statistics and information systems, focusing on their role in enhancing the efficiency of resource planning within the healthcare system. It emphasizes the critical importance of medical statistics in the development and implementation of effective healthcare programs. These statistics provide essential data on the health status of the population, the distribution of diseases, the utilization of medical resources, and the effectiveness of healthcare services, all of which are crucial for making informed decisions at both the local and national levels. The article also identifies several barriers and challenges in the current medical data management processes, such as the lack of unified standards for data collection and the insufficient integration of information systems. These issues result in fragmented data and complicate the process of data analysis and interpretation, thereby hindering efficient decision-making and resource optimization. The study stresses the need to overcome these obstacles to ensure that medical statistics can be used more effectively to improve healthcare outcomes. In addition, the article explores the integration of various medical information systems, including the Ministry of Health's central database (CBD) and the medical institutions’ internal data management systems. It underlines the necessity for seamless data exchange between different levels of healthcare management to promote transparency, coordination, and accountability in healthcare services. Such integration is crucial for improving the overall quality of healthcare delivery and for making timely, evidence-based decisions. Furthermore, the paper addresses the need for modernizing reporting systems to ensure they align with the latest legal frameworks and to adapt to the evolving healthcare landscape. This is particularly important in the context of the ongoing war in Ukraine, where new challenges are emerging in healthcare management. The article highlights that the current systems of data reporting and collection often fail to meet the specific needs arising from the current socio-political situation, such as the monitoring of displaced persons and the need for rehabilitation services. By investigating these issues, the article aims to provide recommendations for enhancing the management of medical statistics and improving the overall functionality of healthcare systems. The ultimate goal is to create a more integrated and efficient healthcare system that can better respond to the challenges posed by both the ongoing conflict and the long-term health needs of the population.

The impact of informatization development on healthcare services in China

China faces substantial challenges in healthcare access and quality, marked by significant regional disparities. While the potential of informatization to enhance healthcare services is increasingly acknowledged, the specific mechanisms through which it impacts healthcare delivery remain underexplored. By employing provincial panel data and dynamic spatial panel models, we aim to uncover the mechanisms through which informatization impacts healthcare delivery. Our findings reveal notable regional differences, with the Eastern and Central regions leading in service levels, while the Western and Northeastern regions lag behind. Both informatization development and healthcare services demonstrate significant spatial interaction effects, indicating that improvements in informatization can positively influence healthcare services overall. However, the impact varies: while informatization benefits the Northeastern and Western regions, its effect in the Eastern region is not statistically significant, and the Central region experiences a negative impact. Furthermore, advancements in informatization in the Eastern and Central regions have the potential to enhance healthcare services in the Western and Northeastern regions. By providing empirical insights that identify key digital factors to enhance healthcare efficiency and quality, this study can assist policymakers in China and around the world in adopting more effective strategies to reduce the digital divide in healthcare and promote the development of more equitable and efficient healthcare systems.

HealthSphere: Integrated AI-Powered and Blockchain Based Health Management and Support System

The healthcare sector is undergoing a significant transformation as it embraces advanced technologies to address some of the most pressing challenges related to accessibility, data security, and operational efficiency. Among these innovations, Artificial Intelligence (AI) and Blockchain technology have emerged as key enablers of enhanced healthcare delivery. AI-powered chatbots are being increasingly utilized to provide immediate, real-time assistance to patients, helping them assess symptoms, obtain basic medical advice, and access information without the need for in-person consultations. These chatbots, powered by Natural Language Processing (NLP) and Machine Learning (ML) algorithms, can efficiently handle a wide range of patient inquiries, improving accessibility and reducing the burden on healthcare providers. On the other hand, Blockchain technology is revolutionizing the way health records are managed. It offers a decentralized, secure, and transparent method of storing and sharing health data, ensuring data integrity, and empowering patients with control over their own medical information. By enabling smart contracts and secure data transactions, Blockchain ensures that health records are easily shared among authorized entities, reducing the risks of unauthorized access and data breaches. This paper provides an in-depth survey of the integration of these technologies into a unified healthcare management system. It explores the practical applications of AI chatbots in improving patient engagement, symptom management, and appointment scheduling, while also discussing how Blockchain can enhance the security, transparency, and interoperability of health records. The paper further addresses the challenges that come with implementing these technologies, including issues related to scalability, data privacy, and regulatory compliance. Finally, it proposes a scalable, secure, and user-friendly platform that combines the strengths of both AI chatbots and Blockchain to create an efficient and reliable healthcare system, poised to improve the overall delivery of healthcare services..

Blockmedcare: Advancing Healthcare Through Blockchain Integration with AI and IOT

This research explores the integration of blockchain technology in healthcare, focusing on enhancing the security and efficiency of Electronic Health Record (EHR) management. We propose a novel Ethereumbased system that empowers patients with secure control over their medical data. Our approach addresses key challenges in healthcare blockchain implementation, including scalability, privacy, and regulatory compliance. The system incorporates digital signatures, Role-Based Access Control, and a multi-layered architecture to ensure secure, controlled access. We developed a decentralized application (dApp) with user-friendly interfaces for patients, doctors, and administrators, demonstrating the practical application of our solution. A survey among healthcare professionals and IT experts revealed strong interest in blockchain adoption, while also highlighting concerns about integration costs. The study explores future enhancements, including integration with IoT devices and AI-driven analytics, contributing to the evolution of secure, efficient, and interoperable healthcare systems that leverage cutting-edge technologies for improved patient care.

Ageing in China: Comparison of Healthcare Modes for the Elderly Population

Abstract: As China strives to meet the challenges of an ageing population, the need for an effective healthcare system for the elderly is becoming increasingly urgent. The traditional family-centred mode of care, deeply rooted in Chinese filial piety, has become inadequate in the face of modern social change. With a rapid ageing population and a rising incidence of chronic diseases, the demand for healthcare services is expected to grow significantly. This article explores the limitations of the current family-centred mode of ageing care, including the strain placed on families and the lack of adequate healthcare resources, especially in rural areas. The article argues for a shift to a community-based caring mode that provides more comprehensive and sustainable solutions by integrating specialised healthcare services in local communities. Comparing the situation in China to the community healthcare system successfully implemented in Japan, this paper highlights the potential benefits of adopting a similar strategy while taking into account China's unique demographic and regional challenges. Finally, the article argues for a more equitable and efficient healthcare system in China to meet the needs of its rapidly ageing population.

Transforming Patient Outcomes: Cutting-Edge Applications of AI and ML in Predictive Healthcare

The integration of Artificial Intelligence (AI) and Machine Learning (ML) in healthcare has emerged as a transformative force, offering unprecedented potential to enhance patient outcomes. This paper explores the cutting-edge applications of AI and ML in predictive healthcare, focusing on how these technologies are revolutionizing early detection, personalized treatment, and patient management. Through advanced algorithms and data-driven insights, AI and ML are enabling healthcare providers to predict disease progression, optimize therapeutic interventions, and improve patient monitoring in real-time. Key applications discussed include predictive modeling for chronic disease management, AI-powered diagnostic tools, and the use of machine learning in precision medicine. The paper also addresses the challenges associated with these technologies, including data privacy concerns, algorithmic bias, and the need for robust validation. By examining current case studies and future trends, this work aims to highlight the transformative impact of AI and ML on patient care, ultimately driving a shift toward more proactive, tailored, and efficient healthcare systems.

Harnessing the Butterfly Effect: Building an Efficient Healthcare System in Sri Lanka through Research and Clinical Audits

No abstract available

The impact of health insurance integration on patient choice of providers in China

ABSTRACT This paper utilizes a nationwide integration reform of two public health insurance programmes in China to examine the impact of health insurance integration on patient choice of medical providers. Using a dataset that combines longitudinal survey data and government regulations data, we find that the integration leads to an increasing probability of outpatients in nearby primary care facilities and decreased outpatient visits to public healthcare providers. Moreover, the effects of integration vary with patient demographics, the type of healthcare, and the model of insurance management. No significant evidence suggests that the integration affects health behaviours or health status in the short term. These findings provide empirical evidence on the effects of insurance integration and policy implications for building an efficient hierarchical healthcare system.

Home Healthcare Staffing, Routing, and Scheduling Problem With Multiple Shifts and Emergency Considerations

ABSTRACTEffective planning of human resources is critical in designing an efficient home healthcare system. In this study, we present a novel home healthcare staffing, routing, and scheduling problem inspired by a real‐world application. The proposed problem addresses a set of patients, with varying daily visit requirements, being served by a set of caregivers with different qualification levels over a multi‐day multi‐shift planning horizon. The problem aims to minimize the number of extra shifts for caregivers, maximize the allocation of caregivers to emergencies, and minimize the sum of route durations over the planning horizon. These objectives are optimized hierarchically while considering a set of restrictions, including time windows, skill matching, synchronization, care continuity, and labor regulations. To tackle the problem, we introduce a mixed‐integer linear programming model. The model is then extended and two sets of valid inequalities are incorporated to enhance its tightness. Computational experiments are conducted on a set of 20 instances. The results highlight the efficiency of the proposed extension in increasing both the number of instances that can be solved to optimality and the number of instances for which a feasible solution is found.

Hospital Medicare Spending per Beneficiary: A Longitudinal Study.

While studies have examined quality and health outcomes related to the Centers for Medicare & Medicaid Services' (CMS's) Hospital Value-Based Purchasing (HVBP) Program, a significant gap exists in the literature regarding the relationship between pay-for-performance initiatives and hospital financial performance in the program's Efficiency and Cost Reduction domain. This study examined the association between hospitals' cost inefficiency and participation in the HVBP Program by estimating the probability and magnitude of improvement or achievement in the program's Efficiency and Cost Reduction domain. The 2014-2019 Efficiency and Cost Reduction domain data were obtained from CMS and merged with the American Hospital Association's Annual Survey Database. We conducted a zero-inflated negative binomial regression to account for the excessive number of zeros in the data. The negative binomial component of the model assessed the magnitude of the impact on the Efficiency and Cost Reduction improvement from each covariate, while the zero-inflated component assessed the odds of being in the "certain-zero" group, meaning no chance to improve or achieve. Hospital ownership, location, size, safety-net status, percentage of Medicare patients, and the number of registered nurses per bed were statistically significant. Additionally, the Herfindahl-Hirschman Index and teaching status significantly influenced efficiency performance. Changes in hospital performance in this domain exist and have evolved. Hospitals might be at a disadvantage with this performance measure because of their inherent organizational structure. The HVBP Program may not provide clear enough direction or actionable incentive to address the needs of stakeholders influenced primarily by measures of Medicare spending per beneficiary. This study's findings hold practical value for policymakers, healthcare administrators, and researchers. Policymakers can use this information to tailor future pay-for-performance programs and effectively allocate resources. Healthcare administrators can identify areas for improvement and benchmark their performance against similar institutions. Researchers can explore the program's long-term sustainability and investigate cost drivers within different hospital groups. By understanding the link between hospital characteristics and cost reduction, all stakeholders can contribute to a more efficient healthcare system.

The attraction of medical workers to civil and administrative responsibility

The article considers actual issues of attraction of medical workers to juridical responsibility according to norms of civil and administrative law in the Russian Federation. The purpose of the study is to consider peculiarities of attraction of medical workers to civil and administrative responsibility in cases of violation of defense of life and health of citizen. The professionalism, ethics and responsibility for health of patients of medical workers are integral elements of efficient health care system. However, cases of improper implementation of professional responsibility, violation of ethical norms and legal acts occur in medical practice quite often. Because of this situation attraction of medical workers to civil and administrative responsibility becomes an actual issue. The conclusion is made that justified attraction of medical workers to responsibility is an integral part of health care system, targeted to support safety and quality of medical care. The combination of efforts to increase legal literacy, to intensify control and defense of rights of patients permits to develop responsible and efficient medical system ensuring safety and well-being of patients.

7.A. Skills building seminar: Is Behavioural Science Relevant for Public Health? A Quintuple Helix Lens

Abstract Background On 29 May 2023, the World Health Assembly adopted the first-ever global Behavioural Sciences for Better Health resolution (WHA76.7). This resolution requests the World Health Organization (WHO) to mainstream and support behavioural sciences in public health across the WHO and within Member States; including enhancing awareness, knowledge, and evidence and providing technical assistance, normative guidance, and capacity-building. But is behavioural science really relevant for public health? Why and how it can help us to improve people’s health? Rationale This workshop seeks to delve into the application of behavioural science in public health within the context of the quintuple helix framework - academia, industry, government, civil society, and the broader environment. Through collaborating across sectors, stakeholders can leverage behavioural science to design more effective strategies for promoting positive health behaviour change, preventing diseases, and addressing public health challenges. This workshop will feature discussions and case studies in various public health domains. Aim The main aim of this skills-building seminar is to explore the synergies between behavioural science and the quintuple helix, examining how these collaborations can drive innovation, enhance policy implementation, and foster sustainable health outcomes. By critically examining these intersections, we seek to stimulate dialogue, foster collaborations, and inspire innovative approaches for addressing complex health challenges in our society. Workshop structure This workshop will consist of three parts: - It will start with a short scene-setting presentation by Iveta Nagyova, EUPHA president, highlighting the innovation potential of behavioural science to improve people’s health (10 mins). - In the second part (30 mins), the panellists will discuss concrete examples of interconnections of behavioural science and public health within the quintuple helix framework. 1. Susan Michie will share her experience of interconnections between academia and government as a member of the UK SAGE - Scientific Advisory Group for Emergencies. 2. Simon Bacon will discuss the behavioural lens applied to the commercial determinant of health. 3. Tiina Likki will share WHO/Europe’s experience with developing and implementing the European regional action framework for behavioural and cultural insights for health, 2022-2027, 4. Kim Lavoie will speak about community involvement and social innovation within the context of more efficient healthcare systems. 5. Stefano Capalongo will show us examples of salutogenic design and architecture, applying neurobiobehavioural mechanisms. - The third part (20 mins) will be dedicated to a facilitated discussion with the audience to explore attendees’ opinions regarding the challenges and opportunities of applying behavioural sciences to improve people’s health and well-being, using the quintuple helix framework. Key messages • Integrating behavioural science within the quintuple helix framework cultivates partnerships advancing effective, inclusive and lasting public health initiatives. • Fostering cross-sector collaboration establishes an ecosystem driving innovative, equitable and sustainable solutions in public health. Speakers/Panelists Susan Michie University College London, London, UK Simon Bacon Concordia University, Montréal, Canada Kim Lavoie UQAM, Department of Psychology, Montreal, Canada Tiina Likki WHO/Europe, Hellerup, Denmark Stefano Capolongo Politecnico di Milano, Milan, Italy

Increased access to pediatric specialist healthcare using eConsult: A retrospective observational cohort and case–control study

ABSTRACT Objectives Primary care practitioners (PCPs) report that using the Champlain BASE™ eConsult service (eConsult) averts one-third of face-to-face (FTF) specialist referrals, however, there are concerns about duplication of services and adverse patient outcomes. Following an eConsult, we evaluated patient healthcare utilization and associated treatment costs. Methods Retrospective cohort study (2014 to 2018) of patients (<18 years old) for whom an eConsult visit averted a FTF specialist referral. Patients were linked to provincial health administrative databases and hospital electronic medical records for healthcare use for the same diagnosis and specialty for the 18 months following the eConsult. Concurrently, a retrospective case–control study compared utilization and costs between an eConsult versus a matched FTF visit for the same diagnosis. We also assessed PCP satisfaction. Results In follow-up, <5% of the study cohort of eConsult patients (n = 242) later accessed the healthcare system for the identical diagnosis and specialty type. FTF visits generate more frequent outpatient visits (12.6 times more [95% CI: 2.28 to 69.66, P = 0.002]) and higher costs compared to eConsult visits. There were no hospital admissions or deaths in patients with eConsult. PCPs (98%) described eConsult as an excellent service. Conclusions Using eConsult is associated with <5% of patients subsequently having a FTF visit for the same reason. Matched FTF visits generated more healthcare utilization and higher costs compared with eConsult. eConsult in pediatrics is safe and can minimize FTF specialist visits in elective cases and increase capacity, towards a more efficient and cost-effective healthcare system.

Block Medcare: Advancing Healthcare Through Blockchain Integration

In an era driven by information exchange, transparency and security hold crucial importance, particularly within the healthcare industry, where data integrity and confidentiality are paramount. This paper investigates the integration of blockchain technology in healthcare, focusing on its potential to revolutionize Electronic Health Records (EHR) management and data sharing. By leveraging Ethereum-based blockchain implementations and smart contracts, we propose a novel system that empowers patients to securely store and manage their medical data. Our research addresses critical challenges in implementing blockchain in healthcare, including scalability, user privacy, and regulatory compliance. We propose a solution that combines digital signatures, Role-Based Access Control, and a multi-layered architecture to enhance security and ensure controlled access. The system's key functions, including user registration, data append, and data retrieval, are facilitated through smart contracts, providing a secure and efficient mechanism for managing health information. To validate our approach, we developed a decentralized application (dApp) that demonstrates the practical implementation of our blockchain-based healthcare solution. The dApp incorporates user-friendly interfaces for patients, doctors, and administrators, showcasing the system's potential to streamline healthcare processes while maintaining data security and integrity. Additionally, we conducted a survey to gain insights into the perceived benefits and challenges of blockchain adoption in healthcare. The results indicate strong interest among healthcare professionals and IT experts, while also highlighting concerns about integration costs and technological complexity. Our findings underscore the transformative potential of blockchain technology in healthcare, pointing towards a new era of patient-centric and secure healthcare services. By addressing current limitations and exploring future enhancements, such as integration with IoT devices and AI-driven analytics, this research contributes to the ongoing evolution of secure, efficient, and interoperable healthcare systems.

Roles of different organizations in implementing patient-reported measures in routine maternity care in Finland

BackgroundThe integration of patient-centered care (PCC) and value-based healthcare (VBHC) principles, emphasizing personalized, responsive care and cost efficiency, is crucial in modern healthcare. Despite advocation from the International Consortium for Health Outcomes Measurement (ICHOM) for the global adoption of these principles through patient-reported measures (PRMs), their implementation, especially the pregnancy and childbirth (PCB) set, remains limited in maternity care. This study focuses on understanding the optimal organizational entity for integrating standard ICHOM-PCB-PRMs into routine maternity care in Finland. It aims to clarify the distribution of tasks among stakeholders and gather Finnish maternity healthcare professionals’ perspectives on organizational responsibility in PRM collection. The emphasis was on identifying the optimal organizational framework for managing PRMs in maternity care.ResultsA total of 66 maternity healthcare professionals participated in the study, reaching a consensus that public maternity care centers in Finland should be the primary entity responsible for managing PRMs in the maternity sector. Key aspects such as confidence with the role as a mother, maternal confidence with breastfeeding, and satisfaction with the result of care were identified as crucial and should be inquired about in both public maternity care centers and hospital maternity wards. The findings highlight the importance of comprehensive and consistent attention to these PRMs across public maternity care centers and hospital maternity settings to ensure holistic and effective maternal care.ConclusionsThe study highlights the central role of public maternity care centers in the collection and management of PRMs within Finnish maternity care, as agreed upon by the professional consensus. It underscores the importance of a consistent and holistic approach to PRM inquiry across different care settings to enhance the quality and effectiveness of maternity care. This finding is crucial for policymakers and healthcare practitioners, suggesting that reinforcing the collaborative efforts between public maternity care centers and hospital maternity wards is vital for a patient-centric, efficient healthcare system. Aligning with PCC and VBHC principles, this approach aims to improve healthcare outcomes for pregnant and postpartum women in Finland, emphasizing the need for a unified strategy in managing maternity care.

Revolutionizing healthcare and medicine: The impact of modern technologies for a healthier future-A comprehensive review.

The increasing integration of new technologies is driving a fundamental revolution in the healthcare sector. Developments in artificial intelligence (AI), machine learning, and big data analytics have completely transformed the diagnosis, treatment, and care of patients. AI-powered solutions are enhancing the efficiency and accuracy of healthcare delivery by demonstrating exceptional skills in personalized medicine, early disease detection, and predictive analytics. Furthermore, telemedicine and remote patient monitoring systems have overcome geographical constraints, offering easy and accessible healthcare services, particularly in underserved areas. Wearable technology, the Internet of Medical Things, and sensor technologies have empowered individuals to take an active role in tracking and managing their health. These devices facilitate real-time data collection, enabling preventive and personalized care. Additionally, the development of 3D printing technology has revolutionized the medical field by enabling the production of customized prosthetics, implants, and anatomical models, significantly impacting surgical planning and treatment strategies. Accepting these advancements holds the potential to create a more patient-centered, efficient healthcare system that emphasizes individualized care, preventive care, and better overall health outcomes. This review's novelty lies in exploring how these technologies are radically transforming the healthcare industry, paving the way for a more personalized and effective healthcare for all. It highlights the capacity of modern technology to revolutionize healthcare delivery by addressing long-standing challenges and improving health outcomes. Although the approval and use of digital technology and advanced data analysis face scientific and regulatory obstacles, they have the potential for transforming translational research. as these technologies continue to evolve, they are poised to significantly alter the healthcare environment, offering a more sustainable, efficient, and accessible healthcare ecosystem for future generations. Innovation across multiple fronts will shape the future of advanced healthcare technology, revolutionizing the provision of healthcare, enhancing patient outcomes, and equipping both patients and healthcare professionals with the tools to make better decisions and receive personalized treatment. As these technologies continue to develop and become integrated into standard healthcare practices, the future of healthcare will probably be more accessible, effective, and efficient than ever before.

Analysis of registered clinical trials in Italy regarding dermatology (2003-2022): a cross-sectional study on historical trend and prospects for industry investments.

This cross-sectional analysis intends to evaluate trend and outlook of industry clinical research in Italy regarding dermatology and its prospects for the next few years. A computerized search of ClinicalTrial.gov database was carried out considering the 20-year period 2003-2022 using the following string: "Skin Diseases OR Skin cancer OR Skin Neoplasms OR Skin Infection OR Skin Lesion OR Skin Ulcer OR Skin Laxity OR Skin toxicity OR Dermatologic Complication OR Skin abnormalities". During the last 20 years 690 Industry Clinical Trials (IndCTs) were conducted in Italy regarding dermatological investigations, almost entirely funded by non-Italian pharmaceutical companies, involving 4497 centers, and recruiting an average of 13.0 subjects per site. The number of controlled and randomized studies has grown quite regularly and in the last 5 years they represented 79.6% of IndCTs initiated. Countries most frequently sharing with Italy international protocols were Spain (75.0%), Germany (71.8%), France (68.5%), the USA (67.4%), and the UK (54.8%). These data point to a historical involvement of Italy in dermatology IndCTs lower than in the major European countries. However, the war in Ukraine has deprived IndCTs of the contribution of Russia, Ukraine, and Belarus, meaning a mean of about 40 new IndCTs per year in a population of 200 million inhabitants. In contrast, many indicators point to Italy as a country with potential in dermatology wider than used in the past: an efficient health care system accessible to any citizen or resident, 4.6 million dermatological interventions per year, low density of IndCTs concerning dermatology, good production of scientific papers in indexed medical journals, relatively low cost of services and labour and geopolitical stability. The European Clinical Trials Information System's (CTIS), mandatory for the EU member states since early 2023 allows common, simplified, and harmonized regulatory procedures over the life cycle of clinical trials in Europe (EMA, 2023) and plays in favor of Italy's greater competitiveness in clinical research.

Acceptance of the Internet-Based Sharing Nursing Service among caregivers of elderly with chronic diseases

BackgroundIn China, Internet-Based Sharing Nursing Service (IBSNS) is a new mode of nursing service delivery that has been in practice for over five years, which enables nurses to provide care at clients’ home. However, the acceptance and associated factors of IBSNS among caregivers of elderly with chronic diseases who are the major clients of the service were unclear.AimTo explore the acceptance of IBSNS and its associated factors among Chinese caregivers of elderly patient with chronic diseases based on the modified Technology Acceptance Model (mTAM).MethodsA cross-sectional study was conducted from February 2023 to March 2023. Caregivers of hospitalized elderly with chronic diseases were recruited using convenience sampling method from three hospitals in Beijing, China. Data were obtained from self-reports of participants. Structural equation modeling was used to analyze data.ResultsA total of 65.1% of the caregivers had neutral to weakly positive behavioral intention of IBSNS use. The mTAM model was supported with good model fit. Perceived ease of use was positively associated with perceived usefulness. Both perceived usefulness and perceived security were positively associated with attitude, consequently, attitude was associated with behavioral intention.ConclusionsImproving the ease of use, security, and usefulness may be helpful to increase the positive attitude towards IBSNS and behavioral intention of using IBSNS, which provides valuable insights that can help healthcare providers improve the integration of technology in patient care, ultimately leading to better health outcomes and more efficient healthcare systems.