General Reference Research Articles

Cardiovascular Mortality Risk among Patients with Liver Cancer: A SEER Database Study.

Data sourced from the Surveillance, Epidemiology, and End Results (SEER) database encompassing liver cancer diagnoses from 2000 to 2017 were utilized. The standardized mortality rate (SMR) was computed using general population reference data, and multivariate competing risk models were employed for analysis. Analysis of 70,733 liver cancer patient records revealed 1,954 instances of CVM. The overall CVM SMR for liver cancer patients was 12.01 (95% CI: 11.48-12.55). Various demographic and clinical factors, including sex, race, age, year of diagnosis, pathological type, general stage, treatment modalities, and matrimonial status, emerged as liver cancer pa-tients` independent predictors of CVM. Liver cancer patients have a notably heightened susceptibility to cardiovascular mortality (CVM) in contrast to the general populace. It is imperative to promptly recognize high-risk subcategories and execute tailored cardiovascular interventions as crucial measures to bolster survival rates within this cohort of patients.

Electrocardiographic abnormalities are frequently detected in healthy adult Borzoi with a normal echocardiogram.

Borzoi reportedly experience sudden death. The objective of this study was to report ECG intervals, amplitudes, and frequency of ECG abnormalities in clinically healthy Borzoi. 98 clinically healthy Borzoi were prospectively recruited and underwent echocardiogram, ECG, and cardiac troponin I testing between October 2020 and December 2022. Standard ECG measurements were obtained. Early repolarization notches and slurs were recorded. Of 82 Borzoi with a structurally normal echocardiogram, ventricular arrhythmias were documented in 8 (10%) dogs, all of which had normal cardiac troponin I concentrations. Median P wave duration was 55 milliseconds (range, 45 to 70 milliseconds). Median PR interval was 125 milliseconds (range, 80 to 175 milliseconds). Thirty-one (38%) Borzoi had first-degree atrioventricular block (PR interval > 130 milliseconds). Median QRS duration was 65 milliseconds (range, 48 to 90 milliseconds). Median QT interval was 235 milliseconds (range, 185 to 275 milliseconds). Twenty-nine (35%) and 15 (18%) of 82 Borzoi had QT intervals > 240 or > 250 milliseconds, respectively. Sixty-seven of 82 (82%) Borzoi had early repolarization notches or slurs. Seventeen of 82 (21%) Borzoi had an abnormality of the ST segment, most commonly convexity/doming. Convexity of the ST segment was intermittent (n = 9) or persistent (4). Ventricular arrhythmias, early repolarization, prolonged QT intervals, and ST segment abnormalities are not infrequent in clinically healthy Borzoi. P, PR, and QRS durations are commonly prolonged compared to general canine reference intervals. Future study into heritable channelopathies in Borzoi is warranted given the frequency of ventricular arrhythmias, repolarization abnormalities, and sudden death in the breed. Breed-specific ECG reference intervals are needed.

Evaluasi Penerapan Good Manufacturing Practices Produk Minuman Botanikal Jahe Siap Minum di PT XYZ

<p><strong>In improving the quality of food products as an effort to build a competitive UMKM economic structure, it’s necessary to implement Good Manufacturing Practices to produce the quality and suitable for consumption products. GMP is used as a general reference for food industries which is designed to prevent problems related to the quality and safety of food products. The aim of this research was to evaluated the implementation of GMP for Ginger Botanical Drink product which includes 18 aspects of assessment based on the Minister of Industry's regulation regarding GMP. This research was conducted in a qualitative descriptive. The 11 respondents were employees in the management and production departments with the instruments were field observation and interview on each aspect of GMP parameters. The result of this research showed that GMP implementation at PT XYZ is classified as Level 3 with some non-conformities, there were 2 points in the mayor category from the building aspect, 2 points in the mayor category from the sanitation facilities aspect, 1 point in the mayor category and 1 point in the critical category from the machine and equipment aspect, 1 point in the mayor category from the final product aspect, 1 point in the critical category from the employee aspect, and 1 point in the mayor category from the storage aspect. This proves that the implementation of GMP at PT XYZ is still not good enough, therefore, several improvement recommendations need to be given.</strong></p><p><strong><em>Keywords </em></strong>- <em>Evaluation, GMP, Improvement Recommendations, UMKM</em><em>.</em></p>

IDS-Neo2020+: A Novel Resource for New German Words in Use

Abstract Researching and recording new lexical items and senses holds a well-established position within German linguistics. The first corpus-based online dictionary (the Neologism Dictionary 2006ff.) was introduced in 2006 and focused on collecting and describing neologisms which had emerged and become established over the three decades from 1900 to 2020. In 2022, a new concept was developed to elevate lexicographic aspirations by integrating linguistic as well as encyclopaedic knowledge, and by introducing innovative presentational approaches. In this paper, the key changes and concepts of the new resource (published in platform OWID) will be highlighted, in particular its main aim, which is to merge an online dictionary with a dynamic informative dashboard. This combination offers headword-specific details for general reference and comprehensive information related to neologisms that transcends individual units, presented in various formats. Particular emphasis will be placed on the significant connection between neology and (critical) discourse, a facet that has previously played a minor role in lexicographic practices.

Current research status of virus-like particle vaccine

Virus-like particles (VLPs) are self-assembled protein nanoparticles with repetitive antigen epitopes, which can stimulate immune response and do not contain viral genetic materials. VLPs has important research value and application potential in vaccine development, targeted drug delivery and bioengineering materials. In this review, the mechanism of VLPs vaccine induced immune responses is discussed. The existing VLPs expression systems are summarized. The research progress of VLPs vaccine in prevention and treatment of virus infection are summarized. This review provides general reference and guidance for the design and development of antiviral VLPs vaccine.

Prevalence and associated factors of hypertension in adults in Lubumbashi, Democratic Republic of the Congo: A hospital cross-sectional study

Introduction: Hypertension is the leading cause of morbidity and mortality from cardiovascular disease worldwide. Knowledge of its prevalence and associated factors helps to prevent its complications. The objectives of this study were to determine the prevalence and associated factors of hypertension in hospitals in Lubumbashi, Democratic Republic of the Congo.Methods: A cross-sectional analytic study was conducted among 520 adults from February 6 to November 30, 2023 in 2 health facilities in the city of Lubumbashi (Afia Polyclinic - Don Bosco and Jason Sendwe Provincial General Reference Hospital). Participants were selected by systematic random sampling. Hypertension was defined when the subject had a blood pressure (BP) ≥ 135/85 mmHg on diurnal Ambulatory Blood Pressure Monitoring (ABPM) or ≥ 180/110 mmHg on clinic oscillometric BP measurement (OBPM), or when he/she had self-reported hypertension and/or was taking antihypertensive medication even if diurnal ABPM was normal. Factors associated with hypertension were determined using a logistic regression model at the 5% significance level.Results: The prevalence of hypertension was 32.8% (95% CI: 28.9%-37.0%). Factors significantly associated with hypertension included age ≥50 years (AOR = 4.0 [1.2-12.7]), dyslipidemia (AOR = 18.6 [3.2-107.4]), hypercalcemia (AOR = 171.6 [32.5-905.9]), hyperkalemia (AOR = 27.6 [7.1-107.8]), and hypernatremia (AOR = 948.1 [160.0-5619.3]).Conclusion: This study reveals the high hospital prevalence of hypertension and the factors associated with it, emphasizing the necessity for targeted interventions for at-risk populations, especially the elderly and those with electrolyte imbalances.

Experience of healthcare professionals at the Makiso General Reference Hospital on nursing-related accidents

Introduction: In our hospitals, nursing-related accidents are frequent. It is not uncommon for minor incidents and near misses to occur before a serious accident occurs. The main aims of this study are to explore the experience of healthcare professionals of nursing-related accidents; to determine what to do about nursing-related accidents; and to analyze the attitudes of healthcare professionals to nursing-related accidents. Methods: We conducted a qualitative, phenomenological study based on free, face-to-face interviews. It involved 3 care providers working at the Makiso General Referral Hospital from March 2 to 31, 2024. Results: In terms of experience, respondents identified risk factors, managing emotions during the accident and the consequences of a nursing-related accident. In terms of what to do in the event of a care-related accident, the subjects identified teamwork to prevent care-related accidents, taking precautions before administering care and ensuring patient safety. Finally, with regard to the attitude of nursing staff to accidents attributable to care, respondents expressed their views on reassuring patients that their health would be restored in the event of an accident attributable to nursing care, identifying problems linked to the accident and ways of preventing accidents attributable to care. Conclusion: To prevent nursing-related accidents, it is necessary to put into practice preventive measures that should be taken to reduce the frequency and severity of accidents attributable to nursing care. Nurses should regularly undergo medical training to prevent nursing-related accidents

Comparison of internal and external reference populations for occupational cancer surveillance in a cohort drawn from a diverse workforce.

Prior analyses of the Occupational Disease Surveillance System (ODSS) have compared cancer rates using internal referent groups. As an exploratory analysis, we sought to estimate cancer risk using general population reference rates to evaluate the impact that the comparison population has on findings from our surveillance program. A cohort of approximately 2.3 million workers in Ontario, Canada with an accepted lost-time workers' compensation claim were followed for all cancer diagnoses between 1983 and 2018. Standardized incidence ratios (SIRs) and 95% confidence intervals were calculated for workers in specific occupational groups using (1) all other workers in the ODSS cohort, and (2) the general population of Ontario. SIRs using the general population reference group were generally equal to or modestly lower compared to SIRs using the internal reference group. Within occupation groups, SIRs had a discordant direction of association (increased rate in the internal comparison and decreased in the external comparison) for some cancer sites including urinary, prostate, and colorectal. Findings emphasize the importance of the choice of reference group when evaluating cancer risks in large occupational surveillance cohorts. Importantly, the magnitude of confounding and the healthy worker hire bias may depend on the occupation group and cancer site of interest.

Design of Structures Subjected to Blast Loads: Analysis and Design Review

When designing structures to withstand explosions, the main goals are to minimize the number and extent of occupant injuries and to reduce the chance of catastrophic damage to structures. Although there is uncertainty in the source, extent, and location of explosions, the assessment of blast loading and structural performance is important when designing blast-resistant structures. This study is a review of the literature on the prediction of blast loads, structural modeling and analysis, and design criteria for structures to resist explosions. The paper provides in one concise document the general guidelines, references, and tools that structural engineers and researchers need to analyze and design structures subjected to blast loading. References on the topics discussed in this work are provided for more detail.

Why does one trust? A 360-degree perspective on the role of position power in weighting trustworthiness factors

ABSTRACT The purpose of the current paper is to explore the influence of the perceived trustworthiness factors of ability, benevolence and integrity on general and specific trust across supervisors, subordinates and peers with the same focal referent. This study used a 360-degree approach to examine how positional power asymmetries influence the relationship between trustworthiness and trust for a general and situation-specific referent. Data were obtained from military supervisors (N = 200), peers (N = 123), and subordinates (N = 85). Measures of trustworthiness and trust of a common military officer were obtained. Supervisors and subordinates differed in their relative weighting of trustworthiness factors (i.e. ability, benevolence, and integrity) when evaluating general and specific trust. Peers evidenced no difference in the relative weighting of trustworthiness factors. The relationship between benevolence and specific trust was stronger for subordinates than for supervisors. One implication of our findings is that trust can develop differently in bottom-up versus top-down organizational relationships. This study provides evidence that supervisors and subordinates emphasize different aspects of trustworthiness when evaluating their trust of a focal officer, and this process was different for general versus specific trust referents. The study also extends previous research by replicating previous findings across raters.

Facing multidimensional poverty in older adults: An artificial intelligence approach that reveals the variable relevance

Despite the rapid development in very recent years of Artificial Intelligence models to predict poverty risk, this problem still remains an unsolved open challenge, especially from a multidimensional perspective. One of the main challenges is related to the scarcity of labelled and high-quality data for training models coupled with the lack of a general reference model to build good predictors. This results in the proposal of a variety of approaches tailored to specific contexts. This paper presents our proposal to address multidimensional poverty prediction, starting from an unlabelled dataset. We focus on the case of a fragile population, the older adults; our approach is highly flexible and can be easily adapted to various scenarios. Firstly, starting from expert knowledge, we apply a stochastic method for estimating the probability of an individual being poor, and we use this probability to identify three levels of risk. Then, we train an XGBoost classification model and exploit its tree structure to define a ranking of feature relevance. This information is used to create a new set of aggregated features representative of different poverty dimensions. An explainable novel Naive Bayes model is then trained for predicting individuals’ deprivation level in our particular domain. The capacity to identify which variables are predominantly associated with poverty among older adults offers valuable insights for policymakers and decision-makers to address poverty effectively.

Plant–microbial fuel cell for electrical generation through living plants: an internal resistance insight into the plant species used

Abstract Climate change is a global threat, the presence of which has encouraged the development and implementation of renewable energies, including plant–microbial fuel cells, which could generate 6 629 568–33 147 840 MWh per year due to their large-scale applicability. One of the main challenges associated with microbial cells is internal resistance—a parameter whose magnitude is influenced by several factors. In the case of plant–microbial fuel cells, adding a plant positively affects the mitigation of internal resistance. However, the species employed is expected to play an important role. In the present study, the objective was to determine as a general reference the internal resistance of cells using various plant species, among which were tomato (Solanum lycopersicum), black beans (Phaseolus vulgaris), aloe vera (Aloe vera), corn (Zea mays), and moss (Dicranidae). For this purpose, an experimental procedure was carried out to compare the manual voltage measurements with a free cell concerning the voltage obtained by adding an external resistor in series. The internal resistance values were determined as a function of the measured voltage, obtaining 177, 179, 175, 324, and 233 kΩ for aloe vera, corn, tomato, black beans, and moss, respectively. From this, it was shown that the roots of the plants represent an essential addition to the internal resistance of the cell in the short term. In contrast, plants with a C4 photosynthetic metabolism are more favourable, while C3 plants can also benefit from internal resistance during a more extended period of rhizodeposition.

Identifying the dominant influencing factors of secondary lining cracking risk in an operating mountain tunnel

PurposeA risk-based method is proposed to identify the dominant influencing factors of secondary lining cracking in an operating mountain tunnel with weak surrounding rock.Design/methodology/approachBased on the inspection data from a mountain tunnel in Southwest China, a lognormal proportional hazard model is established to describe the statistical distribution of secondary lining cracks. Then, the model parameters are obtained by using the Bayesian regression method, and the importance of influencing factors can be sorted based on the absolute values of the parameters.FindingsThe results show that the order of importance of the influencing factors of secondary lining cracks is as follows: location of the crack on the tunnel profile, rock mass grade of the surrounding rock, time to completion of the secondary lining, and void behind the secondary lining. Accordingly, the location of the crack on the tunnel profile and rock mass grade of the surrounding rock are the two most important influencing factors of secondary lining cracks in the investigated mountain tunnel, and appropriate maintenance measures should be focused on these two aspects.Originality/valueThis study provides a general and effective reference for identifying the dominant influencing factors of secondary lining cracks to guide the targeted maintenance in mountain tunnels.

THE IMPACT OF HALLUX VALGUS ON FUNCTION AND QUALITY OF LIFE IN FEMALES

BackgroundThe effect of hallux valgus (HV) on health-related quality of life (HRQOL) and the relationship between radiographic severity of deformity and patient reported outcome measures (PROMs) is poorly understood. The aim of this study was to compare the HRQOL of female patients with HV to the UK population. The secondary aim was to assess the correlation between PROMs, including HRQOL, with radiographic severity of deformity.MethodsWeight bearing radiographic data (hallux valgus (HVA) angle; intermetatarsal (IM) angle) were measured in consecutive female patients presenting with HV. Each patient prospectively completed the Euroqol EQ-5D-5L questionnaire (EQ-5D), Visual Analogue Scale for Pain (VAS-Pain) and Manchester Oxford Foot Questionnaire (MOXFQ). Data were stratified into age ranges and compared with an EQ-5D United Kingdom general population reference dataset. Pearson R correlation values were calculated for the PROMs and radiographic deformity.ResultsBetween July 2015 and March 2020, 425 consecutive female patients presented with HV for consideration for surgery. EQ-5D-5L data were prospectively collected for 396 of these patients (93.2%). Females less than 65 years with HV had a statistically significantly worse quality of life compared with females of the same age group in the general population. Above the age of 65, there was no statistically significant difference in EQ-5D-5L Index score between the two groups. There was no correlation between radiographic HV deformity and HRQOL measures or MOXFQ scores.ConclusionFemale patients presenting with HV deformity have a significantly reduced quality of life compared with the UK general population. The radiographic severity of deformity did not correlate with HRQOL measures or foot and ankle specific PROMs. Foot and ankle specific clinical PROMs moderately correlate with HRQOL and may be a better marker of the negative effect of symptomatic hallux valgus deformity on quality of life.

Pulmonary embolism: Epidemiological and radiological aspects at the Niamey general reference hospital.

Introduction: Pulmonary Embolism is a diagnostic and therapeutic emergency. It is one of the clinical manifestations of venous thromboembolism (VTE) which is frequent and the most serious of the latter. The aim of our work is to study the characteristics of pulmonary embolism confirmed by chest CT angiography at the General Reference Hospital. More specifically, it is a question of describing the: epidemiological and radiological aspects of PE confirmed by chest CT angiography. Material and methods: This is a retrospective and prospective study, carried out at the Reference General Hospital over a period of 18 months: Retrospective over one (1) year from (July 2018 to June 2019), Prospective over six (6) months from July 2019 to December 2019. The study population included all patients referred to the radiology department for chest CT angiography with suspected pulmonary embolism and whose D-dimer dosage was greater than 500ng/ml. Chest x-ray and duplex ultrasound of the lower limbs were requested as additional basic examinations with the aim of exploring venous thromboembolic disease. Results: During this study, 84 chest CT angioscans were performed and 25 cases of pulmonary embolism were confirmed, representing a prevalence of 29.76%. The patients were classified according to the levels of clinical thromboembolic risk. Chest x-ray was performed in 16 patients or 64%. Cardiac Doppler ultrasound was performed in 16 patients (64%). Doppler ultrasound of the lower limbs was performed in only 3 patients. All patients had undergone chest CT angiography. Conclusion: The advent of chest CT angiography in the diagnostic approach allowed us to note an underestimation of the prevalence of PE in African countries. Thoracic CT angiography provided diagnostic confirmation.

Eosinophilic esophagitis and risk of incident major adverse cardiovascular events: a nationwide matched cohort study

BackgroundInflammatory diseases have been associated with an increased cardiovascular risk. However, data on incident major adverse cardiovascular events (MACE) from large population-based cohorts of patients with eosinophilic esophagitis (EoE) is lacking.MethodsThis study included all Swedish adults with EoE without a record of previous cardiovascular disease (CVD) (1990–2017, N = 1546) with follow-up until 2019. Individuals with EoE were identified from prospectively recorded histopathology reports from all Swedish pathology departments (n = 28). EoE patients were matched at index date for age, sex, calendar year and county with up to five general population reference individuals (N = 7281) without EoE or CVD. Multivariable-adjusted hazard ratios (aHRs) for MACE (ischemic heart disease, congestive heart failure, stroke and cardiovascular mortality) were calculated using Cox proportional hazards models. Full sibling comparisons and adjustment for cardiovascular medication were performed.ResultsDuring a median follow-up of 6.0 years, we observed 65 incident MACE in patients with EoE (6.4/1000 person-years (PY)) and 225 in reference individuals (4.7/1000 PY). EoE was not associated with a higher risk of MACE (aHR = 1.14, 95% CI = 0.86–1.51) or any of its components. No differences between age, sex and follow-up time were observed. The results remained stable in sensitivity analyses, including when adjusting for relevant cardiovascular medications and a full sibling comparison.ConclusionsIn this large population-based cohort study, patients with EoE had no increased risk of MACE compared to reference individuals and full siblings. The results are reassuring for patients with EoE.

Fertility and pregnancy outcomes in women with Turner syndrome: A single centre experience.

Many women with Turner syndrome (TS) will consider fertility options and pregnancy. We wished to examine the fertility and pregnancy outcomes in women with TS undergoing oocyte donation (OD) treatment or spontaneous pregnancy in a large single-centre cohort. General population reference dataor data from those with idiopathic premature ovarian insufficiencywere used as comparators. A retrospective single-centre cross-sectional study. Seventy-four women with TS underwent OD treatment with a total of 105 pregnancies, and 31 women with TS had 71 spontaneous conceptions. Fertility outcomes included clinical pregnancy and live birth rate. Pregnancy outcomes included miscarriage rate, prevalence of hypertension, gestational diabetes, lower segment caesarean section (LSCS), small for gestational age (SGA), prematurity and vertical transmission of TS. In those with TS, OD pregnancies were associated with increased rates of LSCS and SGA compared to spontaneous pregnancies; LSCS (OR: 4.19, 95% CI: 1.6-10.8,p = .003) and SGA (OR: 2.92, 95% CI: 1.02-8.38,p = .04). There were no recorded cardiac events but 5 (17.2%) cases of vertical transmissions of TS in daughters were identified. OD in those with TS was associated with a lower live birth rate per cycle started (OR: 0.53, 95% CI: 0.34-0.84,p = .008) and a higher rate of miscarriage compared to women with POI (40% vs. 26.2%,p = .04). We show that pregnancy in women with TS, whether OD or spontaneously conceived, carries obstetric risks, and therefore, women with TS, considering pregnancy, should receive comprehensive pre-pregnancy counselling and optimal obstetric care.

Risk of heart failure in inflammatory bowel disease: a Swedish population-based study.

Dysregulation of inflammatory and immune responses has been implicated in the pathogenesis of heart failure (HF). But even if inflammation is a prerequisite for inflammatory bowel disease (IBD), little is known about HF risk in IBD. In this Swedish nationwide cohort, patients with biopsy-confirmed IBD were identified between 1969 and 2017 [n = 81 749, Crohn's disease (CD, n = 24 303), ulcerative colitis (UC, n = 45 709), and IBD-unclassified (IBD-U, n = 11 737)]. Each patient was matched with up to five general population reference individuals (n = 382 190) and IBD-free full siblings (n = 95 239) and followed until 31 December 2019. Flexible parametric survival models estimated the adjusted hazard ratio (aHR) and standardized cumulative incidence for HF, with 95% confidence intervals (CI). There were 5582 incident HF identified in IBD patients (incidence rate [IR]: 50.3/10 000 person-years) and 20 343 in reference individuals (IR: 37.9) during a median follow-up of 12.4 years. IBD patients had a higher risk of HF than reference individuals (aHR 1.19, 95% CI 1.15-1.23). This increased risk remained significant ≥20 years after IBD diagnosis, leading to one extra HF case per 130 IBD patients until then. The increased risk was also observed across IBD subtypes: CD (IR: 46.9 vs. 34.4; aHR 1.28 [1.20-1.36]), UC (IR: 50.1 vs. 39.7; aHR 1.14 [1.09-1.19]), and IBD-U (IR: 60.9 vs. 39.0; aHR 1.28 [1.16-1.42]). Sibling-controlled analyses showed slightly attenuated association (IBD: aHR 1.10 [1.03-1.19]). Patients with IBD had a moderately higher risk of developing HF for ≥20 years after IBD diagnosis than the general population.

Judicial precedent in the Romano-Germanic legal family

The article is devoted to the study of the institution of judicial precedent in the Romano- Germanic legal family. It is established that the countries of the Romano-Germanic legal family, unlike the countries of the Anglo-Saxon legal family under the influence of Roman law, in the context of codification of law, have determined for themselves the priority source of law - law, not precedent. However, there is a gradual increase in the role of judicial precedent in continental law countries due to a number of factors that contribute to the intensification of judicial rulemaking. First, in these countries, there are still branches of law that, for various reasons, either do not have legal regulation or are regulated only by general reference rules or framework provisions. For objective reasons, the legislator cannot foresee the entire variety of real-life phenomena. This pushes the courts to adopt legal provisions that can fill in the gaps in the legal regulation of social relations. Secondly, there is a noticeable lag between legislation and dynamically changing social relations, resulting in the formation of large segments of social life regulated by legal acts that have lost their relevance. The current realities, which are largely full of unpredictable events, highlight the need for legal systems to adapt. All of this contributes to the use of judicial precedents, which serve not only as a tool for resolving specific disputes, but also as a means of developing law, allowing to fill existing «gaps in law». In the Romano-Germanic legal family, the real legal force of a judicial precedent is determined not so much by its formal enshrinement in legal acts as by actual life circumstances. Real-life situations, as well as the practical necessity and demand for precedent as a source of law, play a key role in determining its true legal status and legal force. Judicial precedent in continental law countries is becoming increasingly important, becoming an integral element of dynamic and adaptive legal regulation over time, and the rules establishing the generally binding force of precedents and the discretionary powers of authorized bodies are increasingly common in both public and private law in these countries. Judicial precedent in these countries should be considered as a source of law from a practical point of view, focusing on solving problems arising in the process of law enforcement.

Evaluation of pricing methods and its impact on accessibility to care in public hospitals: Cases of the Makiso and Mangobo General Reference Hospitals from 2019 to 2021

Introduction: In the Democratic Republic of Congo, there are two types of pricing for medical care in hospitals: Flat Rate Pricing and Pricing per Act. This study focuses on the evaluation of pricing methods and its impact on accessibility to care in public hospitals. This study specifically aims to determine the pricing method that allows the GRH/Makiso and the GRH/Mangobo to maximize revenue. Methodology: This is a retrospective analytical study, conducted over a period of three years, i.e. from 2019 to 2021, and which concerned the maximization of revenues in the General Reference Hospitals of Makiso and Mangobo. The documentary analysis allowed us to collect the data and the use of average and percentage calculations made it possible to analyze the data. The comparison of the results was certified by the Chi2 test at the threshold of 0.05. Results: The annual revenues produced by the Pricing per Act at the GRH/Mangobo from 2019 to 2021 are relatively lower than the annual revenues generated by the Flat Rate Pricing at the GRH/Makiso, i.e. respectively, 129,013,100.00 FC, compared to 706,501,460.00 FC. Finally, it is the Flat Rate Pricing which is advantageous for the hospital in being able to maximize revenue. Conclusion: The Congolese State is obliged to finance the health system accordingly to allow public hospitals to operate efficiently. It is therefore up to hospitals to choose the type of pricing that allows them to generate revenue.