Improve Healthcare Services Research Articles

Mobile outreach clinics for improving health care services accessibility in vulnerable populations of the Diffa Region in Niger: a descriptive study

Mobile outreach clinics for improving health care services accessibility in vulnerable populations of the Diffa Region in Niger: a descriptive study

Exploring Clinical Documentation Practices among Healthcare Staff: A Clinical Audit of National Hospital Galle, Sri Lanka

Introduction: Valid and trustworthy clinical documentation improves patient outcomes, boosts hospital data accuracy, and enhances reflective action to improve healthcare service quality and safety. In Sri Lanka, the bedhead ticket (BHT) is the legal documentation record for inpatients. In 2022, the Ministry of Health (MoH) issued new rules for the correct maintenance of BHTs.Objective: This clinical audit's objective was to assess the in-patient clinical documenting practices at National Hospital Galle (NHG), Sri Lanka.Methodology: A total of 384 randomly selected BHTs from the record room, which belonged to patients who received inward care from April 2023 to September 2023, were included in this clinical audit. A checklist and a marking scheme were prepared according to MoH guidelines and filled out after going through each BHT.Results: The level of completeness of the first page was good in 96% of BHTs. Maintenance of continuation sheets was average in 82%of BHTs and good in only 2%. Around 67% of BHTs obtained good marks for the level of completeness of entries. Only 1% of BHTs had entries with a signature placed at the end. The date and time of the entry were recorded in 73.5% and 64.3% consecutively.Conclusion: Adherence to the MoH guidelines for clinical documentation practices was satisfactory at NHG, and regular audits and staff awareness and training are required to maintain the standards.

THE POTENTIAL OF ARTIFICIAL INTELLIGENCE IN MEDICINE

This article analyzes the prospects for using artificial intelligence (AI) in the medical field. It highlights that AI has already become an integral part of modern life and is actively utilized in various countries, particularly in diagnosis, treatment, and disease prognosis. AI enhances diagnostic accuracy, accelerates treatment processes, and optimizes medical resources significantly. Internationally, AI-based solutions are already widely implemented in countries like the USA, Japan, and China to improve healthcare services. These technologies allow doctors to process large amounts of data efficiently and perform complex procedures with reduced time and effort. However, in Ukraine, the development of AI technologies remains in its early stages, despite the approval of the “Concept for the Development of Artificial Intelligence” in 2020. The main challenges include the need to improve the legal framework, ensure data protection, and address ethical concerns. The use of AI can significantly enhance the quality of medical services while saving time and resources in healthcare institutions. In medical practice, AI is applied in several areas. For instance, AI accelerates diagnosis and improves accuracy, such as in the continuous monitoring of bone tissue in periodontal diseases; AI can analyze medical images with high speed and precision, identifying anomalies and leading to more accurate and timely diagnoses at early stages; AI algorithms can predict the deterioration of a patient’s condition by analyzing their medical data.

Perspectives of cancer consumer representatives on their involvement in healthcare service improvement: a qualitative study

BackgroundConsumer involvement in healthcare service organisation and policy development is recognised globally as a vital strategy in improving the quality and patient-centredness of care. There are significant gaps in knowledge about consumer involvement in practice, including consumers’ engagement in the process of enhancing cancer services. This study aimed to explore consumers’ perspectives on their involvement in cancer service improvement.MethodsCancer consumer representatives were recruited through Victorian Integrated Cancer Services, Australia. Eligible consumers were, or had been, a member of a health service improvement-related committee or project and attended at least one meeting with health professionals. Semi-structured qualitative interviews were conducted online and transcribed verbatim. Data were analysed using inductive thematic analysis.ResultsSix experienced consumer representatives were interviewed. Perspectives on their involvement in improving cancer services were categorised into three major topics. The first addressed personal aspects of involvement, in which participants described personal motivations (e.g., having lived experience of cancer themselves or in their family), challenges encountered in committee involvement, experiences of received support in their role as a consumer representative, concerns about narrow representation, and their evolving identity as a consumer representative. The second discussed practical contributions made by consumer representatives to improve systems and services. Participants detailed their active engagement with committees and consumer-led projects, contributing both their cancer experiences and general or professional skills. The third topic focused on directions for improving consumer involvement in the health system. Suggestions highlighted widening consumer representation to include often marginalised voices to inform decision-making at local committee and health system levels.ConclusionsThis study enhances the real-world understanding of the role that consumer representatives play in improving cancer health services. The strategies suggested in our research provide the opportunity to enhance consumer involvement and pave the way for more effective cancer service planning and implementation across diverse healthcare settings.

The Use of Mobile Health Care Among Medical Professionals in the Sichuan-Chongqing Region: Cross-Sectional Survey Study.

The emergence and integration of mobile health care technology have fundamentally transformed the health care industry, providing unprecedented opportunities to improve health care services and professional practice. Despite its immense potential, the adoption of mobile health care technology among health care professionals remains uneven, particularly in resource-limited regions. This study aims to explore the use and influencing factors of mobile health care among health care professionals in the Sichuan-Chongqing region of China and make recommendations. Convenience sampling was used in a cross-sectional study conducted from November 8 to November 14, 2023, to survey frontline clinical health care professionals at 5 district-level secondary public hospitals in the Sichuan-Chongqing region. A web-based questionnaire was used to investigate the use of mobile health care and its influencing factors among the participants. Descriptive analysis and logistic regression analysis were used in the study. A total of 550 valid questionnaires were completed. Among the surveyed health care professionals, only 18.7% (103/550) used mobile health care, with a satisfaction rate of only 50.5% (52/103). Around 81.3% (447/550) did not use any form of mobile health care. The age group of 30-39 years was found to be a significant factor influencing the use of mobile health care by health care professionals (P=.03). The main reasons for not using mobile health care among health care professionals were lack of appropriate technical training and support (266/447, 59.5%), lack of suitable management-specific apps (204/447, 45.6%), and concerns about increased workload (180/447, 40.3%). There were significant differences in the single-factor analysis of the reasons for the nonuse of mobile health care among health care professionals from different specialties (P=.04). Logistic regression analysis indicated that age was the only significant factor influencing the use of mobile health care by health care professionals (P=.04). The utilization rate of mobile health care among health care professionals in the Sichuan-Chongqing region is low. Age is a significant factor that influences whether health care professionals use mobile health care. Providing appropriate technical training and support may help improve the enthusiasm of health care professionals in using mobile health care.

Use and impact of clinical pathways across various healthcare settings: A protocol for an umbrella review of global evidence.

The proposed umbrella review aims to assess the use and impact of clinical pathways on professional practice, patient outcomes, length of hospital stay, hospital costs, patient satisfaction, and hospital staff satisfaction through a synthesis of existing systematic reviews and meta-analyses. Following PRIOR guidelines, a systematic search will be conducted in MEDLINE, Epistemonikos, and the Cochrane Library to identify relevant systematic reviews and meta-analyses, from inception till March 2024. Two reviewers will independently screen titles and abstracts, with a third resolving any disagreements. Full-text articles considered potentially relevant will be assessed for eligibility by the same process. The data extraction form will cover information about the review methods, characteristics of the included primary studies, the types of interventions evaluated, and the reported outcomes. This standardized data extraction form will be piloted by the review team on five to ten articles to ensure all relevant information is recorded. The quality of included systematic reviews and meta-analyses will be evaluated using AMSTAR 2. PROSPERO registration number is CRD42024529371. The study will present a narrative synthesis of the findings, addressing the clinical and methodological heterogeneity and assessing the impact of clinical pathways on various healthcare outcomes. This umbrella review will provide evidence-based insights into the effectiveness, challenges, and best practices of clinical pathways, guiding healthcare decision-making and identifying areas for future research. Results will be disseminated widely to inform policy and improve healthcare service delivery. No patient or public contribution, as this paper is a protocol of an umbrella review.

Primary health care as the main guarantor of a healthy population in the country and a global challenge in the world: a systematic review

Background Primary health care (PHC) is a fundamental aspect of healthcare systems globally, playing a crucial role in maintaining the health of the population. Despite its importance, there are still gaps in the delivery of PHC services. This study aims to analyze the healthcare system and the existing gaps to develop strategies for improving PHC services. Methods This study is a mixed method a combination of documentary analysis and narrative synthesis as an alternative to meta-analysis. For our systematic review, we primarily focused on articles published within the last 10 years. However, we also included some older articles (published between 2003 and 2009) that provided valuable insights into the historical context and evolution of primary healthcare systems. Data of each article reviewed during the review - Study, Article, Study setting, Study design, Study assessment, Study suggestions are presented in Table 1. A total of 38 articles were reviewed. The data sources include peer-reviewed articles and other relevant literature on PHC services. With appropriate keywords. Results The study identifies gaps in PHC services, including issues with access to care, affordability, and quality of care. It provides insights into the challenges faced by PHC systems worldwide, highlighting the need for strategies to address these issues. Conclusions The study contributes to a better understanding of the challenges faced by PHC systems worldwide and provides insights for policymakers and healthcare providers to improve healthcare services. The systematic review, which focuses on PHC, was conducted following the PRISMA guidelines. The PRISMA diagram of study selection was used to illustrate the process of article inclusion and exclusion. Table 1 provides a summary of the key information from the selected articles.

Defining, measuring and managing healthcare quality using unstructured physician review comments

PurposePhysician review websites (PRW) and Medicare requirements are pressing administrators to measure, monitor and improve healthcare service delivery. Healthcare service attributes linked to patient satisfaction have received increased attention. Text analysis provides an alternative methodology to capture contemporaneous data on service delivery attributes. A Kano analysis based on these service attributes can help administrators prioritize service delivery and ultimately improve patient satisfaction.Design/methodology/approachHealthcare service attributes were defined from 4,000+ comments on a PRW using latent content text analysis. The resulting 15 attributes were validated by medical professionals using a q-sort methodology and analyzed using a Kano methodology.FindingsThe 15 attributes cover three domains of healthcare service – clinic operations, competency and care. The Kano analysis yields a hierarchy, or pyramid, of healthcare service attributes: (1) must-be’s: establish service operational capabilities and benchmark peer performance; (2) satisfiers: establish and increase trust through: (a) clinical competence, (b) careful management of young patients and (c) delivery of appropriate care and treatment (3) delighters: use service-dominant logic to provide patient-centered care.Originality/valueThis research bridges the gap between the “what” and “how” that is frequently missing in text analysis of online reviews. We provide a methodology coupled with a Kano analysis, a widely used quality improvement tool, which results in a hierarchy of service attributes that can guide administrators and researchers.

Enhancing Healthcare Information Systems in Ethiopian Hospitals: Exploring Challenges and Prospects of a Cloud-based Model for Smart and Sustainable Information Services

Hospitals are the primary hubs for healthcare service providers in Ethiopia; however, hospitals face significant challenges in adopting digital health information systems solutions due to disparate, non-interoperable systems and limited access. Information technology, especially via cloud computing, is crucial in healthcare for efficient data management, secure storage, real-time access to critical information, seamless provider communication, enhanced collaboration, and scalable IT infrastructure. This study investigated the challenges to standardizing smart and green healthcare information services and proposed a cloud-based model for overcoming them. We conducted a mixed-methods study in 11 public hospitals, employing quantitative and qualitative approaches with diverse stakeholders (N = 103). The data was collected through surveys, interviews, and technical observations by purposive quota sampling with the Raosoft platform and analyzed using IBM SPSS. Findings revealed several shortcomings in existing information systems, including limited storage, scalability, and security; impaired data sharing and collaboration; accessibility issues; no interoperability; ownership ambiguity; unreliable data recovery; environmental concerns; affordability challenges; and inadequate policy enforcement. Notably, hospitals lacked a centralized data management system, cloud-enabled systems for remote access, and modern data recovery strategies. Despite these challenges, 90.3% of respondents expressed interest in adopting cloud-enabled data recovery systems. However, infrastructure limitations, inadequate cloud computing/IT knowledge, lack of top management support, digital illiteracy, limited innovation, and data security concerns were identified as challenges to cloud adoption. The study further identified three existing healthcare information systems: paper-based methods, electronic medical catalog systems, and district health information systems2. Limitations of the paper-based method include error-proneness, significant cost, data fragmentation, and restricted remote access. Growing hospital congestion and carbon footprint highlighted the need for sustainable solutions. Based on these findings, we proposed a cloud-based model tailored to the Ethiopian context. This six-layered model, delivered as a Software-as-a-Service within a community cloud deployment, aims to improve healthcare services through instant access, unified data management, and evidence-based medical practices. The model demonstrates high acceptability and potential for improving healthcare delivery, and implementation recommendations are suggested based on the proposed model.

Prevalence of Non-Communicable Diseases and Access to Healthcare Among Internally Displaced People During the Armed Conflict, Northern State (Sudan).

Non-communicable diseases emerge as major public health challenges with increasing prevalence and mortality. The armed conflict in Sudan has resulted in the displacement of 6.8 million people, putting a significant strain on the health sector in the displacement areas. This study aimed to explore the prevalence of non-communicable diseases and access to healthcare services among internally displaced people in Northern Sudan. A cross-sectional study was conducted among randomly selected internally displaced people in accommodation shelters at Dongola locality. Data were collected by face-to-face interviews using a questionnaire adapted from relevant studies. For data analysis descriptive statistics and chi-square tests were utilized using SPSS-27. 374 participated in the study with a 96.1% response rate. 70% of respondents were 18-49 years old. 70.9% of respondents were females, and 92.8% of them had no source of financial income. The prevalence of non-communicable diseases was 42.5%, with hypertension (44.7%), diabetes mellitus (24.7%), and thyroid disorders (15.2%) predominating. About 45.7% of patients interrupted their medication, and 38.6% could not access healthcare services, while 57.2% of respondents received free medical care. The study found a statistically significant association between the type of disease and age, gender, residence before displacement, and the Length of displacement. 42.5% of the internally displaced suffer from non-communicable diseases, with hypertension, diabetes mellitus, and thyroid disorders predominating. About 45.3 and 38.6% of them respectively have interrupted their medications and lost regular follow up. The urgent need for improved healthcare services is recommended.

Clinical Health Psychology Perspectives in Diabetes Care: A Retrospective Cohort Study Examining the Role of Depression in Adherence to Visits and Examinations in Type 2 Diabetes Management

Background: Depression in type 2 diabetes mellitus (T2DM) impacts glycemic control and complications. This study examines the influence of depression on compliance with recommended annual diabetes assessments in patients within the Local Healthcare Authority of Romagna. From a clinical health psychology perspective, understanding how depression influences patients’ engagement in managing their conditions is crucial. This insight can help improve healthcare services by ensuring they address mental health needs and thereby enhance treatment effectiveness and overall patient outcomes. Methods: This retrospective cohort study included residents of Romagna with incident T2DM from 2015 to 2017, followed from 1 January 2018 to 31 December 2022. Depression was identified via hospital discharge records or antidepressant prescriptions. Adherence to diabetes care guidelines was measured using the Guideline Composite Indicator (GCI). Results: The study included 13,285 patients, with a mean age of 61.1 years. Prevalence of post-diabetes depression increased from 3.0% in 2018 to 8.9% in 2022. Initial analyses showed higher GCI rates among patients with depression. However, propensity-score adjustment revealed that by 2021–2022, patients with pre-diabetes depression had 5% lower compliance rates (p-value ≤ 0.05). Older adults with depression had reduced adherence, while younger adults with post-diabetes depression had higher adherence rates. Conclusions: Depression significantly affects adherence to diabetes care guidelines in T2DM patients, particularly among older adults. Integrated care models addressing both diabetes and depression are crucial for improving health outcomes.

Characteristics of survivors enrolled in the World Trade Center Health Program

The World Trade Center (WTC) Health Program is a limited federal health care program that provides medical monitoring and treatment for WTC-related health conditions to responders and survivors impacted by the terrorist attacks on September 11, 2001.This study described the characteristics of the Program survivor members (who lived, worked, went to school, daycare or adult daycare or present in the New York City Disaster Area of 9/11/2001) to stimulate innovative ideas for improving healthcare services, generate new research interest, and serve as a reference for future research on this population. Administrative and medical claims data collected from the Program start date (07/01/2011) through 2022 were used. As of 12/31/2022, there were 37,384 enrolled survivors: 5.0% were aged ≤21 years on 9/11/2001, 45.9% females, and 31.2% non-Hispanic Whites. A total of 24,148 (64.6%) were certified for at least one WTC-related condition, including neoplasms (36.0%), aerodigestive disorders (35.6%) and mental health conditions (18.6%); 22.9% were certified for more than one category. Certification rates of some WTC-related conditions differed by sex, age and race/ethnicity. WTC survivor population is diverse in sex, age and race/ethnicity, with a high proportion certified for certain WTC-related health conditions, providing great opportunities for research in various areas.

Analyzing health service employees’ intention to use e-health systems in southwest Ethiopia: using UTAUT-2 model

BackgroundE-health systems have the potential to improve healthcare delivery and access to medical services in resource-constrained settings. Despite its impact, the system exhibits a low level of consumer acceptance and intention to use it. This research paper aims to analyze the intention of health service employees to use e-health systems in southwest Ethiopia using the UTAUT-2 model.MethodInstitutional-based cross-sectional studies were conducted at four referral hospitals (two private and two public) to examine the acceptance of e-health among consumers. Employees who had previous experience with diagnostic information systems and the health logistic information system were given structured questionnaires based on the UTAUT-2 model. The data were analyzed using the PLS-SEM method to identify the key factors that influence the intention to use e-health systems. The data were analyzed using SPSS version 20 and SmartPLS 3 software.ResultOut of the 400 surveyed employees, 225 (56.25%) valid questionnaires were collected. The findings indicate that three factors—effort expectancy (β = 0.276, t = 3.015, p = 0.001), habit (β = 0.309, t = 3.754, p = 0), and performance expectancy (β = 0.179, t = 1.905, p = 0.028)—had a significant positive impact on employees’ intention to use e-health systems. On the other hand, factors such as social influence, facilitating conditions, hedonic motivation, and price values did not appear as significant predictors of intention to use e-health. The study model was able to predict 63% of employees’ intentions to use e-health systems.ConclusionEffort expectancy, habit, and performance expectancy were significant predictors of employees’ intention to use e-health systems among health service employees in southwest Ethiopia. The study supports the ideas that ease of use, experience with information systems, and the role of the systems in improving job performance contribute to employees’ intention to use e-health. Policymakers and healthcare organizations in the region can use these findings to develop strategies for successful implementation and adoption of e-health systems, ultimately improving healthcare services and outcomes for the population.

The Impact of Kano State Rural Development Policy in Kano South Senatorial District since 2023: An Assessment of Community Empowerment Initiatives Since 2023

This study analyzes the impact of community empowerment initiatives on the socioeconomic landscape of the Kano south senatorial district. Over the years, successive Kano state government has been implementing series of the rural development initiatives. Significant efforts have been directed towards fostering community empowerment in the Kano South Senatorial District. Preliminary findings from this study suggest that the rural development policy has yielded notable improvements in the provision of livelihoods, social cohesion, and enhancing economic opportunities within the communities of Kano South. Infrastructure projects have enhanced accessibility and connectivity, while vocational training programs have equipped residents with skills to engage in various income- generating activities. Moreover, the provision of improved healthcare services has contributed to better health outcomes among residents, leading to a healthier and more productive population. Agricultural support initiatives have also played a crucial role in enhancing food security and promoting sustainable farming practices. However, some challenges and areas needing improvement have also been identified, including issues related to sustainability, scalability, and long-term impact assessment of the community empowerment initiatives. Overall, this research provides valuable insights into the effectiveness of the rural development policy in Kano State, shedding light on the successes achieved and areas for further enhancement in empowering rural communities in the Kano South Senatorial District. The recommendation made through this paper could inform policymakers, academics, and development practitioners on the strategies that can be employed to bolster community empowerment efforts in other districts. Ultimately, the paper could contribute towards sustainable development and improved well-being for residents in rural areas.

Do public governance and financial shocks effect public health? Empirical evidence from MENA region

Financial shocks have an incredible socioeconomic effect on both developed and developing countries. Various recent studies demonstrated that bad public governance impacted public health across all nations. In fact, this study aims to use panel data for 21 countries from the Middle East and North Africa (MENA) region over the period 2000–2020 to scrutinize the effect of both governance and financial crises on public health. We use the generalized method of moments (GMM) approach to carry out the empirical analysis. The objective of using this method is to deal with the issue of endogeneity between exogen variables. Results outline that there is a significant positive association between public governance indicators and public health. Moreover, we found a strong negative association between financial shocks and public health. Thus, the direct negative impact of financial crisis on public health could be mitigated by the indirect positive impacts via institutions and good public governance. This study gives insights to policymakers to take appropriate measures to decrease the severity of the financial shocks and improve healthcare services.

Causes of Pediatric Deaths in Lusaka, Zambia: A Quantitative Geographic Information Systems Approach.

While childhood mortality has been declining in Zambia, it remains high at 58 per 1000 live births. Importantly, many leading causes of mortality in Zambia are preventable. This study was conducted to identify clusters of childhood mortality, causes of death of recently deceased children, barriers to care, and risk factors for mortality in Lusaka, Zambia. This study was conducted as a prospective cohort study. Family members or lawfully authorized representatives (LARs) were interviewed when they came to pick up death certificates for recently deceased children from Lusaka Children's Hospital. Each interview included a verbal autopsy, determination of the child's location of residence, and collection of demographic information. Demographic data was also collected from a healthy control group. Quantitative Geographic Information Systems was used to visualize mortality and evaluate for clustering. Leading primary causes of death included malnutrition (21%), complications of chronic illnesses (16%), and central nervous system infections (13%), while the leading barriers to care were cost (58%) and difficulties with travel (53%). Compared to controls, recently deceased children came from families with significantly lower incomes (1905 Kwacha vs. 2412 Kwacha, p = 0.03) and were significantly more likely to have a history of malnutrition (16.7% vs. 1.4%, p = 0.005). Mortality was clustered in two high-population density, low-income neighborhoods in Lusaka. Systems to reduce financial barriers to care and improve access to transportation could reduce childhood mortality in Lusaka. The aforementioned neighborhoods are ideal locations for public health interventions or improved healthcare services.

Assessing pediatric antibiotic knowledge and practices among community pharmacists in Palestine: implications for antibiotic use and resistance

BackgroundAntibiotics are widely used in the pediatric population, and their inappropriate use contributes to antibiotic resistance, which is a growing concern in developing countries. Therefore, this national cross-sectional study aimed to assess community pharmacists’ knowledge, attitudes and practices regarding appropriate antibiotic use and dosing in pediatric patients and to explore the barriers to such use in Palestine.MethodsA questionnaire-based survey was conducted among community pharmacists on the West Bank, Palestine, from September 2022 to March 2023. The survey assessed the pharmacists’ sociodemographic characteristics; knowledge, practices, and attitudes toward antibiotic use; and understanding of antibiotic dosing. The data were analyzed using descriptive statistics, and the factors affecting pharmacists’ knowledge were evaluated.ResultsThe study included 301 community pharmacists, with an average age of 30.06 years, who were primarily female (75.1%). The majority of the pharmacists (80.1%) correctly believed that antibiotics are effective against bacterial infections. However, 18.3% believed that antibiotics are effective against viruses. While 61.8% knew that antibiotics kill germs, 32.0% were unaware that not all antibiotics require refrigeration. Furthermore, 67.8% were aware that antibiotics do not speed up recovery from diarrhea. Over 99% of the participants recognized that antibiotic resistance developed due to various resistant mechanisms. The majority (78.7%) believed that each infection needed a different antibiotic. Pharmacists demonstrated reasonable knowledge of antibiotic dosing in case scenarios. Knowledge was positively correlated with years of experience (P = 0.001).ConclusionsThis study revealed that community pharmacy professionals have a good understanding of antibiotic usage in pediatric patients. The findings suggest that professional expertise and quality training improve healthcare services. However, the results may not be universally applicable, as identifying knowledge gaps is necessary to help with the development of focused interventions. Therefore, ongoing educational initiatives, awareness campaigns and antibiotic stewardship programs are recommended.

Beyond the stethoscope: ageism in white coats and resident physicians' preferences for elderly patient care.

The global increase in life expectancy has significantly raised the elderly population. In Türkiye, the proportion of individuals aged 65 and over rose from 8.8% in 2018 to 10.2% in 2023. This demographic shift necessitates the planning of social and health services for the elderly. Ageism affects elderly health negatively and is prevalent in healthcare settings. This study aimed to determine the prevalence of ageism among resident physicians at Pamukkale University Hospital and identify factors influencing their preferences for providing healthcare to elderly patients. This cross-sectional study was conducted at Pamukkale University Hospital between 6 June and 16 June, 2024. A total of 448 resident physicians were selected through simple random sampling. Data were collected using a self-administered questionnaire, which included sociodemographic information, factors affecting ageism, and the Fraboni Scale of Ageism (FSA). Descriptive statistics, Chi-square tests, and logistic regression were used to evaluate factors influencing healthcare preferences. The FSA score averaged 71.89 ± 7.87, indicating a 20.1% (95% CI:16.48-24.10) prevalence of age discrimination among resident physicians. Logistic regression analysis revealed that male participants (odds ratio (OR) = 1.519, P = 0.042), those with moderate to very poor perceived knowledge of elderly health (OR = 2.418, P < 0.001), and higher FSA scores (OR = 1.046, P < 0.001) were more likely to prefer not providing healthcare services to elderly patients. Ageism among resident physicians is prevalent, impacting their willingness to provide care to elderly patients. Gender, perceived knowledge, and ageist attitudes influence their preferences for providing healthcare to elderly patients. Addressing these factors is crucial for improving healthcare services for the elderly.

DSEception: a noval neural networks architecture for enhancing pneumonia and tuberculosis diagnosis.

Pneumonia and tuberculosis are prevalent pulmonary diseases globally, each demanding specific care measures. However, distinguishing between these two conditions imposes challenges due to the high skill requirements for doctors, the impact of imaging positions and respiratory intensity of patients, and the associated high healthcare costs, emphasizing the imperative need for intelligent and efficient diagnostic methods. This study aims to develop a highly accurate automatic diagnosis and classification method for various lung diseases (Normal, Pneumonia, and Tuberculosis). We propose a hybrid model, which is based on the InceptionV3 architecture, enhanced by introducing Deepwise Separable Convolution after the Inception modules and incorporating the Squeeze-and-Excitation mechanism. This architecture successfully enables the model to extract richer features without significantly increasing the parameter count and computational workload, thereby markedly improving the performance in predicting and classifying lung diseases. To objectively assess the proposed model, external testing and five-fold cross-validation were conducted. Additionally, widely used baseline models in the scholarly community were constructed for comparison. In the external testing phase, the our model achieved an average accuracy (ACC) of 90.48% and an F1-score (F1) of 91.44%, which is an approximate 4% improvement over the best-performing baseline model, ResNet. In the five-fold cross-validation, our model's average ACC and F1 reached 88.27% ± 2.76% and 89.29% ± 2.69%, respectively, demonstrating exceptional predictive performance and stability. The results indicate that our model holds promise for deployment in clinical settings to assist in the diagnosis of lung diseases, potentially reducing misdiagnosis rates and patient losses. Utilizing deep learning for automatic assistance in the diagnosis of pneumonia and tuberculosis holds clinical significance by enhancing diagnostic accuracy, reducing healthcare costs, enabling rapid screening and large-scale detection, and facilitating personalized treatment approaches, thereby contributing to widespread accessibility and improved healthcare services in the future.

Social Services Provided to Patients Attending Primary Health Care Centers, Riyadh Saudi Arabia

Introduction: Social Services is an essential part of the PHC procedures. This work prescribes the diversity of services supplied to support quality in health care services at PHC, Riyadh, Saudi Arabia.Methods: The study comprised patients who got social services from the social services overflow unit at PHC in Riyadh, Saudi Arabia. Frequency distribution patient and par shard altered to describe the study population, and par shard produced to explain details of services provided.Results: The social services unit served 411 patients, with 60% married and 80% widowed, 17% illiterate, and 66% had a housing adaptation for the sick and his family. 46.22% average, family support 40.14% good, and connection with the surrounding environment 42.10%, Social Services' Health Status 51.6% chronic sickness and 49.% anxiety, 67% low income, treatment recommendations for social services. Financial aid was provided to 53.5% of patients, 68.6% for procedures, and 31% for other services such as guidance and support.Conclusion: The social service program in PHC is an essential component of primary health care services. It promotes quality improvement in healthcare services. Social services can improve the quality of health care services provided in primary health care. And the same time helping patients to get improved access to health care services through counseling and financial aid. Social services also have a role in improving the awareness of family members of patients' conditions and determinants. Social services in PHCs realize the social responsibility of primary health care services towards the families of patients in the community.