Health Care Planning Research Articles

Evaluating Dentists' Understanding of Dry Mouth Management: An International Cross-Sectional Study.

Studying dentists' knowledge of dry mouth management is crucial for effective diagnosis and treatment, improving patient outcomes and oral health. This study aimed to evaluate their knowledge and awareness of dry mouth and its predictors. A pre-validated online survey was administered to a convenience sample of dentists across six countries. The questionnaire evaluated knowledge in various domains, including predisposing factors, diagnosis, clinical signs and symptoms, and management of dry mouth. A total of 884 dentists participated. Knowledge and awareness of dry mouth management varied significantly between countries (p < 0.05). Overall, 34.3% of participants demonstrated good knowledge, while 53.7% had moderate knowledge. Regarding management awareness, 55.4% had good awareness and 35.5% had moderate awareness. A majority (69.2%) showed good knowledge of common signs, symptoms, and consequences of dry mouth. Significant predictors of better knowledge and awareness included the country of practice and attendance at continuing education courses on dry mouth. The findings suggest that dentists in the surveyed countries require improved education on dry mouth and its management. Dental educators and healthcare planners can use this data to design targeted continuing education activities to enhance knowledge and awareness of dry mouth.

Nanofluidic Lab-On-A-Chip Systems for Biosensing in Healthcare.

Biosensing plays a vital role in healthcare monitoring, disease detection, and treatment planning. In recent years, nanofluidic technology has been increasingly explored to be developed into lab-on-a-chip biosensing systems. Given now the possibility of fabricating geometrically defined nanometric channels that are commensurate with the size of many biomolecules, nanofluidic-based devices are likely to become a key technology for the analysis of various clinical biomarkers, including DNA (deoxyribonucleic acid) and proteins in liquid biopsies. This review summarizes the fundamentals and technological advances of nanofluidics from the purview of single-molecule analysis, detection of low-abundance molecules, and single-cell analysis at the subcellular level. The extreme confinement and dominant surface charge effects in nanochannels provide unique advantages to nanofluidic devices for the manipulation and transport of target biomarkers. When coupled to a microfluidic network to facilitate sample introduction, integrated micro-nanofluidic biosensing devices are proving to be more sensitive and specific in molecular analysis compared to conventional assays in many cases. Based on recent progress in nanofluidics and current clinical trends, the review concludes with a discussion of near-term challenges and future directions for the development of nanofluidic-based biosensing systems toward enabling a new wave of lab-on-a-chip technology for personalized and preventive medicine.

Quantitative biomechanical analysis in validating a video-based model to remotely assess physical frailty: a potential solution to telehealth and globalized remote-patient monitoring.

Assessing physical frailty (PF) is vital for early risk detection, tailored interventions, preventive care, and efficient healthcare planning. However, traditional PF assessments are often impractical, requiring clinic visits and significant resources. We introduce a video-based frailty meter (vFM) that utilizes machine learning (ML) to assess PF indicators from a 20s exercise, facilitating remote and efficient healthcare planning. This study validates the vFM against a sensor-based frailty meter (sFM) through elbow flexion and extension exercises recorded via webcam and video conferencing app. We developed the vFM using Google's MediaPipe ML model to track elbow motion during a 20s elbow flexion and extension exercise, recorded via a standard webcam. To validate vFM, 65 participants aged 20-85 performed the exercise under single-task and dual-task conditions, the latter including counting backward from a random two-digit number. We analyzed elbow angular velocity to extract frailty indicators-slowness, weakness, rigidity, exhaustion, and unsteadiness-and compared these with sFM results using intraclass correlation coefficient analysis and Bland-Altman plots. The vFM results demonstrated high precision (0.00-7.14%) and low bias (0.00-0.09%), showing excellent agreement with sFM outcomes (ICC(2,1): 0.973-0.999), unaffected by clothing color or environmental factors. The vFM offers a quick, accurate method for remote PF assessment, surpassing previous video-based frailty assessments in accuracy and environmental robustness, particularly in estimating elbow motion as a surrogate for the 'rigidity' phenotype. This innovation simplifies PF assessments for telehealth applications, promising advancements in preventive care and healthcare planning without the need for sensors or specialized infrastructure.

Male partners’ involvement in antenatal care and its associated factors in West-central Ethiopia

BackgroundMale partner involvement in antenatal care is a key factor that cannot be ignored in the quest for improvement in maternal health and is recommended as an essential intervention to improve maternal and neonatal health outcomes. However, little attention has been given to male partners’ involvement in maternity care, particularly in developing countries.ObjectiveThis study aimed to assess male partners’ involvement in antenatal care and its associated factors among male partners whose wives gave birth within the last one-year in Bichena town, Westcentral, Ethiopia, 2019.MethodsA community-based cross-sectional study design was conducted from October 1/2018 to June 15/2019, in Bichena town, among 406 male partners. The data was collected by a simple random sampling technique and analyzed using the Statistical Package of the Social Science 23.0 version. Bivariate and multivariable logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of < 0.05 considered statistically significant.ResultsIn this study, 53.4% [95% CI: 48.3- 58.1%] of male partners had high involvement in antenatal care. The age group of 20–29 years [AOR = 2.14, 95% CI = 1.04–4.38], having primary, secondary, and diploma and above educational level [AOR = 2.04, 95% CI = 1.02–4.07], [AOR = 3.02, 95% CI = 1.49–6.11] and [AOR = 4.03, 95% CI = 2.06–7.89] respectively, ≤ 10 years marriage length [AOR = 2.92, 95% CI = 1.46–5.87], good knowledge of the services provided in antenatal care [AOR = 2.68, 95%, CI = 1.62–4.42], good awareness of the danger signs of pregnancy [AOR = 1.77, 95 CI = 1.10–2.85], favorable attitude towards antenatal care [AOR = 2.62, 95% CI = 1.64–4.19], travel less than 15 min to reach a nearby health facility [AOR = 3.43, 95% CI = 1.54–7.65] and making decision together to seek care in health facility [AOR = 2.44, 95% CI = 1.19–5.03] were associated with male partners involvement in antenatal care.ConclusionsMale partners' involvement in antenatal care was encouraging in the study area compared to previous studies done in Ethiopia. We suggest strengthening awareness among male partners about their shared responsibility during pregnancy. Male partners should be invited to attend the antenatal care. Policymakers and healthcare planners should design programs and plans that will encourage male partners’ involvement in maternal healthcare services utilization.

Gig Workers: A Comprehensive Analysis of the Rise, Challenges, and Future of the Gig Economy

The gig economy, defined by temporary contracts, freelance employment, and independent contracting, has seen substantial growth in the global labour market during the last twenty years. Gig workers function independently of conventional full-time employment, enjoying flexibility but sometimes missing access to benefits like job security, healthcare, and retirement plans. This study examines the evolution of the gig economy, analysing the many forms of gig employment, its catalysts, the influence of technology, and its consequences for both workers and employers. The analysis will address the issues encountered by gig workers, such as economic volatility, insufficient legal safeguards, and the ambiguity of employer-employee dynamics. The study will analyse worldwide reactions, regulatory patterns, and the future direction of gig employment considering governmental changes and technology improvements.

Individualized Healthcare Plans: A School Nurse Primer.

According to the 2017 U.S. Census, 74.3 million children younger than 18 years of age live in the United States. Of this group, 14.6 million children and adolescents have special health care needs or a chronic illness. Students who attend school with complex health conditions, including mental and physical diagnoses, require comprehensive planning by a professional school nurse. School nurses should write an individualized healthcare plan (IHP) for these students. An IHP is written by the school nurse in collaboration with the parent/guardians, student, and health care providers. This plan serves as a tool to guide health care for a student throughout the school day and in mandated school-sponsored events.

Sex-related differences in vitamin D testing in the Veneto Region, Italy: a retrospective analysis from 2005 to 2016

SummaryA retrospective analysis was performed to evaluate the frequency of vitamin D blood testing in individuals from the Padua province, Veneto, Italy from 2005 to 2016. A significant increase in the frequency of vitamin D blood tests, particularly in females was observed and in individuals with severe vitamin D deficiency (Class I).PurposeVitamin D deficiency has been linked to negative health outcomes that extend beyond bone-related conditions. The frequency of vitamin D blood testing in residents from the Padua province, (Veneto, Italy) from 2005 to 2016 was evaluated.MethodsData were retrospectively retrieved from blood test databases (Laboratory Medicine Unit, Padua University Hospital) and information on number of vitamin D blood tests performed on residents from 2005 to 2016 was collected. Data were stratified by sex and ten birth cohorts from 1901 to 2016. Blood tests were classified into five vitamin D classes: I < 50 nmol/L, II 50–74.9 nmol/L, III 75–149 nmol/L, IV 150–250 nmol/L, and V > 250–1000 nmol/L. Blood test trends were analyzed as blood test rate and vitamin D class rate/resident population. Population analysis was analyzed by incidence rates and stratified by vitamin D class.Results293,013 vitamin D blood tests were conducted between 2005 and 2016 across 10 birth cohorts. Females accounted for 75% of tests and fewer were conducted in the youngest and oldest birth cohorts. Sex differences in vitamin D blood test frequency were observed; adjusted rates ranging from 1.7 to 35.6% for males and 8 to 81% for females from 2005 to 2016. Crude incidence rates (per 1000 from 2005 to 2016) varied from 1.5 to 10.8‰ for males and 7 to 19.4‰ for females. Crude blood test rates for vitamin D deficiency (Class I) increased from 1.1 to 9.9‰ in 2016 for males and 5 to 17.3‰ for females. Crude incidence rates (from 2005 to 2016) for Class I were 9.7–57.1‰ in males and 43.6–92.4‰ in females.ConclusionsThese findings highlight sex-related differences in vitamin D testing, providing valuable insight for healthcare planning.

Management of Fracture-Related Infection in Conflict Zones: Lessons Learned from Medical Missions to Gaza

Background/Objectives: Fracture-related infections (FRIs) are a significant complication in conflict zones, where limited resources and damaged infrastructure complicate orthopedic care. Methods: This study retrospectively reviews the management of FRIs during medical missions to Gaza from April to July 2024. Results: Among 135 patients treated for war-related fractures, 30% were identified with suspected FRIs, which were primarily following explosive injuries. Contributing factors to the high incidence of infection included malnutrition, poor sanitation, and the scarcity of sterile surgical supplies. The absence of standard infection control measures further complicated treatment. Conclusions: These findings highlight the critical need for a comprehensive approach that incorporates infection prevention, sustainable healthcare planning, and quality assurance tailored to the realities of conflict zones. The study underscores the importance of international support to ensure the availability of essential medical supplies and to develop effective, context-specific strategies for infection management. By applying these insights, healthcare providers can improve patient outcomes and reduce the burden of FRIs in resource-limited settings affected by conflict.

A Qualitative Study of Patient and Interprofessional Healthcare Team Member Experiences of Bedside Interdisciplinary Rounds at a VA: Language, Teamwork, and Trust.

Patient and interprofessional healthcare team member experiences of bedside interdisciplinary rounds (BIDR) are generally positive. Overall, there is large heterogeneity in existingBIDR frameworks, and best practices have not been defined. Understand patients' and interprofessional healthcare team members' experiences of BIDR. Academic VA Medical Center (VAMC) with daily structured BIDR. Inpatients, nurses, pharmacists, and care coordinators who participated in BIDR. We conducted semi-structured qualitative interviews with study participants about their experiences with BIDR between January and June 2020. All interviews were recorded and professionally transcribed. We used thematic analysis to identify key themes. We interviewed 14 inpatients and 18 interprofessional healthcare team members, including nurses, pharmacists, and care coordinators. Patients participating in BIDR reported positive perceptions of being included in the discussion of their healthcare plans and increased trust in providers; patient discomfort resulted from physician use of technical language and frombeing presented with unclear, vague careplans. Interdisciplinary healthcare team members participating in BIDR reported an increased understanding, respect, and trust for other team members and improved patient care; challenges were posed by lack of supportive structural elements to interprofessional workflow and prolonged physician presentations. BIDR can build trust between patients andhealthcare providers and within the interprofessional team by creating a setting where teamwork interactions can be observed. Based on our findings, we recommend trust-building practices for BIDR, which include sharing BIDR goals with patients, using patient-centered language, creating structures for interprofessional inclusion, defining team roles, using standardized communication, and addressing interprofessional inputs in real time.

The Investigation of Machine Learning and Deep Learning Classification of Internet of Things (IoT) Enabled Medical Devices

The present cross-sectional, quantitative study investigates the classification capabilities of ML and DL in processing data from IoT-enabled medical devices: heart rate variability (HRV), blood pressure, blood glucose levels, and physical activity in patients with diabetes and cardiovascular diseases. Eight patients from AIIMS, New Delhi participated in this study. In the current investigation, two types of measurements are taken into consideration: cardiovascular measures and diabetes management metrics, which include BMI, blood pressure, blood glucose, physical activity, and HRV. The outcomes showed a positive association with blood glucose level and age (0.55), negative correlation between blood glucose and physical activity (-0.68), which had significant significance towards exercising importance in diabetes management. Blood glucose correlated moderately favorably with BMI with 0.45, while age and BMI correlated at 0.32. These results show how ML and DL techniques can improve the interpretation of complex health parameters from IoT-enabled devices to better manage patients and develop specific healthcare plans in chronic diseases.

Digital-twin co-simulation framework to support informed decision in healthcare planning and management

This manuscript aims to show the proof-of-concept for the integration of digital twin (DT) and discrete event co-simulation through its application to forward simulation of physical activities of care providers and robots in an intensive care unit (ICU). Co-simulation focuses on modular integration of heterogeneous simulation components to capture the complexity inherent in systems. Advancing this conception, the proposed co-simulation attempted to narrow gaps with real-world systems by using DT while simultaneously leveraging the forward simulation capacity of discrete event simulation (DES). In particular, we created a co-simulation for human–robot interactions in a simulated ICU facility, which modeled the hospital layout including the facility, robot, avatars for healthcare professionals, equipment, patient bed, and vital signs, which comprise physical twin (PT). In addition, specific patient-care scenarios were defined to drive PT for which the states of interest were represented in the DT, and then used for a dynamic input to the discrete event co-simulation. At the onset of the co-simulation, the parameters needed to run DES were manually configured to align the parameters with those of the DT. For internal validation, this DES was replicated under different work-system policies, and the co-simulation outcomes were interpreted in clinical context. Our co-simulation approach has potential for application to a broader class of problems in healthcare planning and management by supporting informed decision-making. Methodologically, timely information exchanges of PT with DT, and ensuing model updates in the Discrete Event System Specification (DEVS) is a promising approach for co-simulation, to maintain robustness against perturbations to real-world systems.

Prevalence and incidence of chronic wounds in Austria - a population-based real-world data analysis

Abstract Background Chronic wounds are associated with pain, odor, loss of mobility, an increased risk for infection and sepsis and a reduced quality of life. Treatment costs are rising due to the longevity of the population and increasing number of diabetes cases. For service planning in healthcare, it is thus necessary to describe patient characteristics and estimate the prevalence and incidence of chronic wounds. Currently, no data exists on this subject broken down by age group, gender, and province in Austria. Methods A retrospective analysis of real-world data was conducted using two merged datasets from an outpatient wound centre and the Austrian Health Insurance Fund. The study population consisted of people who resided in Austria and were covered by statutory health insurance from 2018 to 2022. We performed a descriptive, socio-demographic analysis of the data of patients, followed by a set of cluster analyses using the unsupervised K-means algorithm. From these clusters, we derived subgroup characteristics and patient trajectories and calculated prevalence and incidence rates for chronic wounds according to diagnoses, different age groups, gender, and different regions. Results Gender was almost evenly distributed in the wound centre’s data set (n = 4963; 49.6% female). The age distribution revealed the age group from 71-80 years being the largest group. In general, more women than men are affected by chronic wounds from the age of 81 onwards. 31% of chronic wound patients had diabetes as an underlying condition. More men were affected by peripheral arterial occlusive disease and diabetic foot syndrome and, conversely, more women by chronic venous insufficiency. These are preliminary results of the analyses. Conclusions Chronic wound patients were characterised by older age and multi-morbidity. Interestingly, gender differences appeared in the occurrence of comorbidities. Key messages • This study makes a crucial contribution in making routine data usable for the epidemiological study of chronic wounds, a cluster of diseases of complex aetiology. • It thus contributes to filling a knowledge gap. The prevalence estimate serves as a basis of knowledge for health care planning and a basis for the health economic assessment of the problem.

How advanced is your digital public health system? A qualitative analysis of suitable indicators

Abstract Background Revealing the full potential of digital public health (DiPH) systems necessitates a wide-ranging tool to assess their maturity. Essential domains that need to be considered include the literacy and interest in DiPH tool application by society and the workforce and the legal and ICT maturity of DiPH systems. No review has investigated indicators on these national DiPH system maturity (DiPHSM) domains yet. Our narrative review and qualitative analysis aimed to map the landscape of indicators related to DiPHSM measurement and rank them based on their importance for such assessments. Methods As original indicators were not published in scientific databases but as grey literature, we used DuckDuckGo to apply a pre-defined search strategy for 11 countries from all continents classified as having reached level 4 of 5 in the Global Digital Health Monitor. Of the 1484 identified references, 137 were included which named 15806 indicators. Consensus on importance was defined as at least 3 or 4 authors rating an indicator as important. Results We recognized 180 indicators on different constructs with importance for DiPHSM analysis, including the availability and use of Smartphones, computers, the Internet or the DiPH intervention, the existence of skilled workforce, infrastructure (investment), and interoperability between interventions, the secondary use of health data, a DiPH strategy and controlling agency, or the application of big data and artificial intelligence for health data collection, analysis, and sharing. Conclusions Our study holds the potential to develop more comprehensive tools for DiPHSM assessments. Further examination is required to analyze the suitability and applicability of all identified indicators for diverse healthcare settings. By working towards a uniform evaluation of DiPHSM, we foster informed decision-making among healthcare planners and practitioners, improve resource distribution, and continue to drive innovation in healthcare delivery. Key messages • Maturity assessment tools need to consider the complexity of DiPH systems. Thereby, DiPH system evaluations need to be accompanied by analyses of the legal, ICT, and literacy perspective maturities. • New methods are needed to systematically assess and use multidisciplinary grey literature for research.

The burden of psoriasis in Belgium, 2021

Abstract Psoriasis is a common, chronic, inflammatory skin disease with a great impact on healthcare systems. Given the limitations of the currently available burden estimates, estimates of the Belgian national burden of disease study are necessary in order to guide decision-making processes within the health sector. According to the Global Psoriasis Atlas, the prevalence of psoriasis is rising globally. The current study aims to estimate the burden of psoriasis in Belgium using national data. As there is no single comprehensive data source on prevalence of psoriasis in Belgium, a critical appraisal of existing local and national data sources was conducted. We estimated the non-fatal psoriasis burden in terms of years lived with disability (YLD). Estimated prevalence data were combined with disability weights to yield YLDs imposed by psoriasis. Mortality attributable to psoriasis was assumed to be zero, in line with the Global Burden of Disease study (GBD) 2019. We assessed three data sources containing information on existing cases with psoriasis in Belgium. Based on qualitative and quantitative appraisal, a widespread network of general practitioners was identified as the best available national data source. In 2021, the prevalence of psoriasis in Belgium was 2.1%, leading to 13084 DALYs (113 DALYs per 100 000). The burden of psoriasis was in line with national disease burden estimates for bipolar disorder, multiple myeloma, and hearing loss. Our prevalence, YLD, and DALY estimates for psoriasis in Belgium were however lower than those of the GBD study. Psoriasis imposes a non-negligible burden on population health in Belgium, despite it not being a cause of death. Along progression in psoriasis management, objective evaluation of psoriasis burden is critical to track the trends at the population level. Key messages • Psoriasis is a common skin disease with a relatively high morbidity burden. • Information on psoriasis prevalence and burden are crucial for disease management and appropriate health-care planning.

Assesing health needs of women with breast cancer in a Regula Hospital Dispensary in Crete, Greece

Abstract Background Understanding the health needs of women with breast cancer is essential for tailor-made care. Socio-economic factors impact care access and outcomes. Previous research has indicated variations in healthcare experiences based on factors such as education level, employment status, and income. However, specific insights into the health needs of women with breast cancer in Crete, Greece, remain limited. Purpose The current study aimed at assessing the health needs of women with breast cancer. Methods A total of 161 women were surveyed between June 2023 and December 2023 in a regular Hospital Dispensary at a General Hospital in Heraklion, Greece. Results The majority were married (46%) and had an average of 2 children. 16% were graduates of secondary education and 42 % graduates of higher education, 33% retired and 19% full-time employees. Most participants (45%) reported a family income between 10,001 to 20,000 €, 29% under 10000 € and 26 % between 20001 to 30000 €. The majority had received additional medical treatment (75%), with surgery being the most common (30.6%). Other treatment included radiation therapy (28%), chemotherapy (23%), and hormone therapy (18%). Prevalence of comorbidities was high, with hypertension (97%), coronary heart disease (92%), cholesterol issues (43.5%), arrhythmias (82%), thyroid disease (81%), diabetes mellitus (79.5%), and bleeding disorders (43.5%) being reported. Smoking was also prevalent among participants (79.5%). Conclusions This study highlights the complex health needs of women with breast cancer in Crete region, Greece and emphasizes the prevalence of comorbidities and the importance of tailored support services and comprehensive care approaches for this population. Key messages • Considering socio-economic factors is critical in healthcare planning and intervention strategies. • Emphasizing the importance of tailored support services and comprehensive care approaches for this population.

Long COVID prevalence differences across 27 European countries that participated in the 2021 Survey of Health, Ageing and Retirement in Europe

Abstract The COVID-19 pandemic caused a significant burden in Europe, with over 60% of infected individuals developing Long COVID symptoms. Variations in Long COVID prevalence across countries are linked to individual-level factors, but the influence of population-based country-level characteristics remains unclear. Thus, our objective was to assess how country-level characteristics related to: (i) the way European countries responded to the COVID-19 pandemic, (ii) their population-level health status, (iii) provision and access to healthcare services, (iv) human development, governance, and environmental risk factors, are associated with Long COVID. We used a sample of 4,004 middle-aged and older adults from 27 European countries who, in summer 2021, participated in Corona Survey 2 (from Survey of Health, Ageing and Retirement in Europe) and who reported COVID-19 infection one year prior to the survey. To assess the potential role of country-level characteristics, while controlling for key individual-level factors, we estimated three sequential multilevel random intercept logistic regression models. Approximately 70% of respondents who had COVID-19 also experienced Long COVID symptoms and there were significant cross-country differences in Long COVID rates, ranging from 32% to 89%. About 13% of the total variance in the risk of having Long COVID can be attributed to cross-country differences and the remaining 87% to individual-level factors. The individual-level characteristics also accounted for 6% of the observed cross-country differences in Long COVID rates (compositional effects) while the country-level characteristics further reduced this variance by over 50%. Both individual and country-level factors influence Long COVID occurrence, emphasizing the need for tailored recovery plans, healthcare planning and resource allocation at the national level to address this condition.

6.G. Scientific session: The importance of using country-specific severity distributions in burden of disease indicators

Abstract One of the most commonly used health gap summary measures in the field of public health is the Disability-adjusted life year (DALY). It has become the key metric for quantifying the burden of disease (BoD) and is used as an information source for setting priorities for health care and health service planning. The DALY metric quantifies gaps between a theoretical population in perfect health and the current health status related to both morbidity and mortality. It is the sum of the number of healthy life years lost due to disability (YLD) and death (YLL). The YLD summarises the loss of healthy life time using the frequency of diseases differentiated by severities or related health states (including sequelae). Depending on each health state, it converts the time spent with diseases into YLD by weighting each year with health limitation with so-called disability weights. This allows the two indicators YLL and YLD to be added to the DALY. Consequently, severity distributions are a means of describing the range of health loss along specific health states, which enables an accurate mapping with disability weights. For most of the diseases, these distributions are usually categorised as mild, moderate, severe, or no health loss (asymptomatic). Conditions with higher severity levels contribute more to the YLD and thus, to the overall disease specific BoD. The severity distributions are highly dependent on utilization at the individual level, but also on available health care services at the society level, which indicates that differences by settings are to be expected. Changes over time in the share of severe cases, for instance, may reflect the effectiveness of health interventions and policies. This underlines the importance of severity distributions, as they also reflect information about the quality of healthcare for those affected. The Global Burden of Disease (GBD) study applies for a significant proportion of their considered diseases uniform severity distributions across countries and broader regions. They acknowledge concerns over applying estimates of severity distributions based on limited data, noting that it is the only available information that they were able to use. As the YLD estimates are often utilized to develop and prioritize health policy interventions, there is a necessity for country-specific estimates that are evidence based and less susceptible to model assumptions. In most cases, the estimation of severity distributions involves complex methodology as data for such assessments are very limited or hardly reliable. In the following workshop, general concepts and country cases from Germany, Scotland, and Belgium will be presented covering a variety of diseases. The examples underline the importance of estimating national and even regional severity distributions when identifying the importance of diseases or comparing the health conditions of populations across time. Key messages • As the Burden of disease indicators are predominantly used to prioritize health interventions and allocate resources, it is crucial to use accurate information in the severity levels of disease. • Severity distributions reflect the health care services and vary across different settings. Utilising country-specific severity distributions when estimating Burden of Disease indicators is essential.

1.X.1. Achieving universal health coverage: international lessons from Irish policy implementation

Abstract Health systems all over the world are struggling to meet population health needs and provide timely access to universal healthcare in the context of the COVID-19 pandemic. COVID-19 occurred in Ireland in the early years of implementation of a national plan for universal healthcare, called Sláintecare. While many health systems are experiencing a retrenchment on universalism in the context of COVID-19, in Ireland despite tediously slow Sláintecare implementation, the pandemic provided a boost to reform implementation and universalism. The reason for this workshop is to draw on a publicly funded Health Research Board Applied Partnership Award, entitled ‘Foundations’, harnessing lessons from the Irish COVID-19 health system response to inform Sláintecare’s implementation https://hrbopenresearch.org/articles/3-70/v1 The objectives of the workshop are to 1) provide academic research evidence from the Irish experience of universal health system reform during and since COVID-19; 2) to give participants space to reflect on the implications of the Irish universal health system reform on international health systems and policy; 3) to actively involve workshop participants in an engaged discussion on implementing universal health coverage in the context of COVID-19. The added value of the workshop is to share learnings from an academic research programme, which is coproducing evidence in partnership with the Irish health system, in a worldwide context, providing relevant and thought-provoking discussion and analysis for an international audience. Four separate inter-related presentations will draw on aspects of the Foundations’ research project. Presentation 1, Prof Sara Burke will outline recent academic literature on universalism and the politics of reform implementation in the context of COVID-19 and present a timeline of universal healthcare reform implementation since 2018 when Sláintecare was adopted by the Irish government (14 mins). Presentation 2, Dr Sarah Parker will detail a specific study which set out to advance understanding of how and to what extent COVID-19 has highlighted opportunities for change that enabled better access to universal, integrated care in Ireland, with a view to informing universal health system reform and implementation (10 mins). Presentation 3, Dr Katharine Schulmann and Carlos Bruen will present findings on the governance of reform implementation and implications for all health systems (10 mins). Presentation 4, Dr Philip Crowley, Health Service Executive (HSE) National Director of Strategy and Research and Chair of the Foundations’ research steering group will reflect how research findings can inform implementing reform and their implications for all health systems (6 mins). There will be four presentations totalling 40 mins, followed by questions and discussion chaired by an international expert/academic on universal health systems. Key messages • COVID-10 has highlighted how universal health coverage is more important than ever, however the pandemic has resulted in some retrenchment on universalism. • While data and research drove health system decision making during the pandemic, embedding research evidence into health system and policy reform remains challenging and can be politically opposed.

Prevalence and social determinants of anxiety and depression among adults in Ghana systematic review

Abstract Background Anxiety and depression are major public health concerns, yet their prevalence and social determinants contributing to mental health disparities remain underexplored. This review, to our knowledge, is the first of its kind, aiming to examine the prevalence of anxiety and depression symptoms and disorders among adults in Ghana, along with social determinants associated with their occurrence. Methods A search of nine electronic databases and seven grey literature sources was conducted up to September 25, 2023. Two reviewers independently screened and appraised the studies. Forty-six studies were included. Prevalence estimates were pooled using a random-effects model. Subgroup analysis and meta-regression explored potential moderators. A narrative synthesis explored social determinants associated with anxiety and depression. Results Preliminary results showed a high prevalence of anxiety (43.7%, 95% CI: 35.6-54.4%) and depression (37.8%, 95% CI; 32.5% to 46%), with regional variations. There were significant differences in the prevalence of anxiety and depression across chronic physical conditions and method of condition assessment. Meta-regression showed significant association between average age and anxiety prevalence. Social determinants associated with anxiety included being female, non-Christian, low income, self-employed, limited social support, and basic education, while that for depression included being young (&amp;lt; 25yr), low income, government employed, childhood physical and sexual abuse, gender-based violence and urban residence. Protective factors for both were male gender, strong social support and higher education. Conclusions Preliminary results indicate a high prevalence of anxiety and depression linked to social determinants. While methodological limitations exist (eg, study heterogeneity), findings highlight a need for evidence-based interventions targeting social determinants to reduce the burden of anxiety and depression among adults in Ghana. Key messages • Our review suggests addressing the social determinants of mental health, aligned with sustainable developmental goals, may reduce the burden of anxiety and depression. • While Ghana is working towards improving mental health via its revised 12year Mental Health Policy launched in 2021, this review can facilitate planning and resource allocation for mental healthcare.

A healthcare workforce assessment model using reimbursement data in Luxembourg

Abstract Background The assessment of the healthcare professional (HCP) headcount and level of activity is a real challenge for policy makers. In Luxembourg, there is no uniform definition of practicing HCP. This work focused on identifying a method to assess HCP headcount and their level of activity in Luxembourg, while finding national consensus. Methods A thorough literature review was conducted to find methods that assess practicing HCP and identify their level of activity. Eligible were scientific papers or national reports discussing methods on employed and self-employed HCP. National reimbursement data were used for preliminary data explorations conducted alongside the ‘General Inspectorate of Social Security’ in Luxembourg and discussed with the ‘Institut national d’assurance maladie-invalidité (INAMI)’ in Belgium. Two working groups were planned with national stakeholders to discuss HCP assessment methodologies. Both the collaborations and the working groups led to a preliminary validated HCP assessment method. To reach national consensus, a Delphi study is planned in June 2024, using the eDelphi.org platform. Invited panelists include researchers, professionals, healthcare practitioners, decision makers and policy makers, patient representatives, and insurers. Results The literature review found 16 eligible papers on HCP headcount and HCP’ level of activity. Finally, the Belgian method, developed by experts from INAMI, using reimbursement data and establishing a median reimbursement for each medical specialty was retained for Luxembourg. The results of the Delphi study will inform on the level of agreement on relevance, clarity and completeness of the proposed methodology for Luxembourg. Discussion Finding national consensus represents a strong foundation for efforts to advance the use of the proposed methodology in healthcare workforce assessment and planning. Key messages • Counting something as simple as healthcare professionals requires a strong methodology that held the buy-in of all major stakeholder. • As working behavior of HCP evolves over time, it is crucial to not only count professionals but also full-time equivalents for policy makers to plan ahead in an accurate manner.