Type Of Healthcare Institution Research Articles

An Evaluation of Gastric Emptying Scintigraphy Protocols in Health Care Institutions When Compared with the Society of Nuclear Medicine and Molecular Imaging Procedure Guidelines.

This study aimed to analyze the compliance of health care institutions with the Society of Nuclear Medicine and Molecular Imaging (SNMMI) procedure guidelines for gastric emptying scintigraphy (GES). Methods: A 19-question survey on demographics and the GES protocol was conducted using a Google form. The demographic questions covered position, number of technologists in the department, location, type of health care institution, and number of GES studies per month. The protocol questions included patient preparation, meal preparation, withholding of scheduled medications, radiopharmaceutical type, and radiopharmaceutical dose. The survey was sent to 7 nuclear medicine Facebook groups and a list of clinical affiliates provided by the Indiana University School of Medicine Nuclear Medicine Program. Descriptive statistics were compiled for most questions. A Fisher exact test with a significance level of 0.05 was used to compare the type of health care institution with compliance with the SNMMI GES protocol regarding radiolabeling time, meal preparation, and meal components, as well as to compare the type of health care institution with the number of GES studies performed per institution. Results: In total, 240 people responded to the survey. Most were nonsupervisory nuclear medicine technologists (72%) in nonacademic institutions (72%) and groups with 4 or more technologists (62%). Of the respondents, 72% followed the SNMMI guideline of adding the radiopharmaceutical before cooking, but only 37% followed the meal component guideline. There was no significant association between the type of institution or the number of GES studies and compliance with radiolabeling time or with meal preparation or components. Most respondents asked patients to withhold medications per SNMMI guidelines and used the recommended radiopharmaceutical (99mTc-sulfur colloid, 95%) at the recommended dose (18.5-37 MBq, 84%). Conclusion: Although most respondents followed most aspects of the SNMMI guidelines for GES, more than half did not use the recommended meal of liquid egg whites. Compliance did not vary between academic and nonacademic institutions or between groups performing a large or a small number of GES studies.

Exploring factors for antibiotic over-prescription in children with acute upper respiratory tract infections in Assiut, Egypt: a qualitative study

BackgroundOver-prescription of antibiotics contributes to antibiotic resistance, which is a global health threat. Egypt has alarmingly high rates of antibiotic over-prescription for acute upper respiratory tract infections (URIs) in children. To effectively address this issue, it is important to understand the various factors that influence prescription behaviors. The Teixeira antibiotic prescription behavioral model (TAPBM) offers a comprehensive framework through which these factors can be explored. This qualitative study sought to investigate the perspectives of key stakeholders involved in pediatric healthcare in Egypt, with the primary goal of identifying the underlying determinants that contributed to this problem.MethodsThis qualitative study was conducted in Assiut City, Egypt, between January and March 2023. Purposive sampling was used to select participants, including consultant pediatricians, supervisors of pediatric training programs, and specialists in infection prevention and control. Thirteen semi-structured in-depth interviews (IDIs) were conducted, audio-recorded, and transcribed. Thematic analysis was performed using MAXQDA 2020 software.ResultsTwo main themes emerged from the analysis: intrinsic factors related to physicians, extrinsic factors related to patients, and nonphysician factors. Intrinsic factors encompass personal characteristics and attitudes. Prescribing decisions were influenced by factors such as fear of complications, limited follow-up visits, and competition. Knowledge and education also played a significant role. Moreover, diagnostic uncertainty in distinguishing between bacterial and viral infections posed a challenge. Extrinsic factors included patient and caregiver factors, such as parental expectations and demands for antibiotics, driven by the belief that they produced rapid results. Moreover, patients’ demographic factors, including socioeconomic status and living conditions, affected their prescribing behavior. Health system-related factors, such as the type of healthcare institution and the absence of formal national guidelines, were identified as influential factors. Additionally, this study highlighted the influence of the pharmaceutical industry. The potential impact of the COVID-19 pandemic on antibiotic prescriptions was addressed.ConclusionsThe study highlights the intricate interplay between intrinsic and extrinsic factors that shape antibiotic prescription decisions, underscoring the significance of addressing these factors in mitigating overprescribing.

Association Between Initiation of Rehabilitation and Length of Hospital Stay for Workers with Moderate to Severe Work-Related Traumatic Brain Injury

BackgroundIn workers with moderate to severe work-related traumatic brain injury (wrTBI), this study aimed to investigate the effect of the timing of rehabilitation therapy initiation on the length of hospital stay and the factors that can influence this timing. MethodsWe used data obtained from the Republic of Korea's nationwide Workers' Compensation Insurance. In the Republic of Korea, between the years 2010 and 2019, a total of 26,324 workers filed a claim for compensation for moderate to severe wrTBI. Multiple regression modeling was performed to compare the length of hospital stay according to the timing of rehabilitation therapy initiation following wrTBI. According to the timing of the initiation of rehabilitation therapy following TBI, the proportions of healthcare institutions that provided medical care during each admission step were compared. ResultsThe length of hospital stay for workers who started rehabilitation therapy within 90 days was significantly shorter than that for workers who started rehabilitationment were first admitted to tertiary hospitals. Approximately 39% of patients who received delayed rehabilitation treatment were first admitted to general hospitals, and 28.5% were first admitted to primary hospitals. ConclusionsOur findings demonstrate the importance of early rehabilitation initiation and that the type of healthcare institution that the patient is first admitted to after wrTBI may influence the timing of rehabilitation initiation. The results of this study also emphasize the need to establish a Worker’s Compensation Insurance–specialized rehabilitation healthcare delivery system.

HPR112 The Average Monthly Income of Full-Time Doctors Working in Hospitals by Type of Healthcare Institution in Hungary

In our research, we aimed to examine the average monthly income of full-time doctors employed in Hungary by type of healthcare institution, for the year 2020.

Comparison of Health Outcomes by Care Provider Type for Newly Diagnosed Mild Type 2 Diabetes Patients in South Korea: A Retrospective Cohort Study.

(1) Background: Although the beneficial impacts of primary care on patients’ health outcomes have been reported, it is still difficult to limit patients’ herd behavior in seeking tertiary or large hospital services in South Korea. The purpose of this study was to examine whether the use of primary care clinics was longitudinally beneficial for mild diabetes. (2) Methods: Using claims data from the National Health Insurance (NHI) program, this population-based retrospective cohort study compared health outcomes over a 4-year period from 2011 to 2015 by type of health care institution as a usual source of care in diabetic patients who were newly diagnosed in 2011, i.e., without any diagnosis between 2005 and 2010. (3) Results: Compared to those attending hospitals, general hospitals (GHs), or tertiary general hospitals (TGHs), patients who visited primary clinics were more likely to experience better health outcomes such as the lower risk of hospitalization and death. (4) Conclusions: These results provide additional evidence that higher-value from primary care clinics would be highly expected for early and mild type 2 diabetics. Promoting the Informed, patient-centered decision toward primary care clinics would contribute to improving the value of the healthcare delivery system.

Differences in beliefs on and implementation of evidence-based practice according to type of health care institution-A national cross-sectional study among Slovenian nurses.

To explore the differences in beliefs on and implementation of evidence-based practice in nurses working in different types of health care institutions. Optimal organizational context and knowledge are essential to support evidence-based practice and sustain the use of evidence in professional nursing practice. A cross-sectional study was conducted. A total of 1,014 nurses from 20 Slovenian hospitals and 29 primary health care centres participated. Variables included the following: Evidence-Based Practice Beliefs and Implementation Scale, educational and training activities, job satisfaction, job training, perceived research and evidence-based practice knowledge, and access to databases. Beliefs on evidence-based practice were explained by evidence-based practice (β=0.249) and research (β=0.162) knowledge, length of employment (β=0.124), job satisfaction (β=0.117), training in evidence-based practice (β=-0.092) and holding a master's degree (β=0.077). Implementation of evidence-based practice depended on beliefs (β=0.306) and the type of health care institution (β=0.132). The highest implementation result was seen in primary health care centres (<0.001). Training in evidence-based practice and perceived knowledge of evidence-based practice significantly influence the beliefs on and implementation of evidence-based practice. Nurses employed at primary health care centres who had completed a task-shifting training programme achieved significantly better results for implementation of evidence-based practice. The indirect effects of development training programmes for the implementation of EBP have not yet been studied. Development activities and change implementation processes in nursing foster education and training opportunities, which have significantly influenced the implementation of EBP.

National Trends in the Repair of Isolated Superior Labral Tear from Anterior to Posterior in Korea.

BackgroundThe optimal treatment for superior labral tear from anterior to posterior (SLAP) lesions is controversial. Thus, we aimed to investigate the national surgical trends in isolated SLAP repair in Korea.MethodsWe analyzed a nationwide database from the Korean Health Insurance Review and Assessment Service from 2008 to 2017. We investigated the trends in SLAP repair by time, sex, age, and the type of health care institution.ResultsFrom 2008 to 2017, 27,850 isolated SLAP repairs were identified. Age-adjusted incidence rate of isolated SLAP repair increased by 692% from 1.07/100,000 in 2008 to 8.48/100,000 in 2012 (P = 0.005). However, the incidence rate declined significantly after 2012 (P = 0.032) and was 5.28/100,000 in 2017. Sex-specific incidence rate of isolated SLAP repair was 2.3 times higher in men than in women. The decline since 2012 was most evident in patients aged ≥ 40 years (P = 0.01); however, the incidence rates of isolated SLAP repair during the study period were similar between patients aged ≥ 40 years and those aged < 40 years. Moreover, hospitals with 30–100 beds had the greatest change in the number of isolated SLAP repair cases.ConclusionIn Korea, the incidence of isolated SLAP repair increased dramatically until 2012; since then, it has declined. Although the decrease in isolated SLAP repair later in the study was evident in those aged ≥ 40 years, the incidence rate was still relatively high in patients aged ≥ 40 years.

Prevalence and Patterns of Sickle Cell Disease among Children Attending Tertiary and Non-Tertiary Health Care Institutions in a South Eastern State, Nigeria: A 10 year Survey

Background: Sickle cell disease (SCD) is a global lifelong but preventable genetic blood disorder and it is most prevalent in sub-Saharan Africa within populations of very similar geographic distribution to malaria. Objective: To determine the prevalence and patterns of sickle cell disease in children attending tertiary and non- tertiary hospitals in Imo State, Nigeria. Methods: The study was a hospital based retrospective cross sectional survey from year 2004 to 2013 that identified all children with sickle cell disease that attended hospital. Data was collected using a proforma from patients‟ medical records. Descriptive analyses were done with frequencies and summary statistics. Chi square statistics were computed to determine significant relationships with the p set at<0.05. Results: The prevalence rate of sickle cell disease was 5%. The most common symptom was fever (87.6%) followed by bone pain (45%) with the complaint of general body weakness appearing to be significantly associated with the type of health care institution attended. (p=0.000).The most common clinical sign was jaundice (59.8%), followed by pallor (51.1%); and the clinical complication experienced the most was infection (50.3%), followed by vaso-occlusive crises (36%). The occurrence of haemolytic crises appeared to be significantly associated with the type of health care institution attended (p=0.004). Conclusion: Infection appears to be a leading complication and a trigger to subsequent sickle cell events within our environment. Therefore the management intervention should emphasis on infection prevention strategies within a framework of a preventive- interventional approach. Keywords: Prevalence, Pattern, Sickle cell, hospital, survey

RIGHT TO DEVELOPMENT AND EMOTIONAL EXHAUSTION: THE CASE OF HEALTHCARE INSTITUTIONS IN TURKEY

Right to development covers economic, social, cultural, and political development. Encouraging its subjects to participate actively in economic, social, cultural, and political development, right to development has significant impact on each person. Although it is wide in scope, person, being the central subject of development, this study focuses on right to development of health care professionals limited to doctors and nurses. This paper assessed right to development of health care staff, considering their work conditions and other demographic characteristics. For the implementation of regulations regarding to right to development, a significant fieldwork covering 20 health care institutions in three cities of Turkey was successfully completed. In this fieldwork, Maslach Burnout Inventory (MBI) was used for data collection. This article assessed emotional exhaustion of 185 health workers via SPSS program. The analyse found that education status and type of health care institution have effect on emotional exhaustion while other demographic characteristics such as work experience, annual income or the city were found non-effective on emotional exhaustion of health care professionals. Considering results of this fieldwork, the correlation of emotional exhaustion with the right to development was discussed. The findings reveal that the fear of aggression, lack of sufficient trainings, defamation or mobbing by senior doctors are potential adverse effects causing emotional exhaustion of health workers. To decrease emotional exhaustion caused by work, institutions are suggested to provide ongoing training or a sustainable method for decrement of patient burden and workload. Last but not least, as a sustainable solution, a national wide precise legal monitoring mechanism covering both public and private, ordinary and university health care institutions is strictly offered to be created for prevention of infringement on right to development of medical staff.

Investigation and analysis of the health care seeking behaviour of caregivers of sick children in Xinjiang, China: a cross-sectional study

BackgroundThe Integrated Management of Childhood Illness (IMCI) strategy aims to reduce death, illness, and disability, and to promote improved growth and development among children younger than 5 years, especially through making the best use of the available health-care resources. The IMCI strategy has been introduced in Xinjiang, China, by Save the Children since 2014. The health care seeking behaviour of caregivers of children who are sick is identified as the primary factor affecting the project implementation. We thus aimed to study factors that might influence health care seeking behaviour of caregivers in Xinjiang. MethodsWe did a cross-sectional study in Xinjiang using a socioeconomic questionnaire and semi-structured interview with questions about health care seeking behaviour and its influencing factors in Chinese and Uighur. We recruited caregivers of sick children younger than 5 years from villages in townships of the Moyu County, Xinjiang, as the targeted project sites, using a stratified random cluster sampling method. We excluded caregivers with mental disorders, communicable diseases, and severe organic disease (ie, patients who could not finish the interview). The primary measure was the type of health-care institution that caregivers of sick children chose. We used descriptive statistics and a linear regression analysis. Ethical approval was obtained from the Peking University Health Science Center Ethics Committee. All participants provided written informed consent. FindingsBetween Jan 29, 2018, and April 28, 2018, 945 caregivers were recruited from 69 villages in eight township of the Moyu County. 877 caregivers completed the questionnaires, yielding a response rate of 93%. Although the public village clinics were strongly encouraged by the IMCI strategy, 347 (40%) of 877 caregivers regarded private clinics as their first choice, 299 (34%) chose the township health centres, and only 95 (11%) chose public village clinics. The cost (odds ratio [OR] 2·59, 95% CI 1·74–3·86; p<0·0001), distance (2·19, 1·55–3·10; p=0·0009), and attitudes of the medical staffs (1·46, 1·02–2·07; p=0·037) were considered as the facilitators that promote caregivers to choose the public village clinics, whereas the traditional values on health care seeking behaviour (OR 0·50, 95% CI 0·27–0·91; p=0·023) and inadequate medicines (0·33, 0·19–0·58; p=0·0004) were considered as the hindrances that impede caregivers to choose the public village clinics. InterpretationThe health care seeking behaviour of the caregivers of the children who are sick were not as expected compared with what the IMCI recommended. More attention needs to be given on the issue of the local culture's health care seeking behaviour. Besides enhancing the village doctors' competencies, adequate numbers and types of medicines are very important, which is also the key point of the strategies to promote children's health in the rural areas of Xinjiang and western China. FundingSave the Children (number CTXJ-2018-0148).

National Surgical Trends for Distal Radius Fractures in Korea.

The objective of this study was to investigate national surgical trends for distal radius fractures (DRFs) in Korea and analyze healthcare institution type-specific surgical trends. We analyzed a nationwide database acquired from the Korean Health Insurance Review and Assessment Service (HIRA) from 2011 to 2015. International Classification of Diseases, 10th revision (ICD-10) codes and procedure codes were used to identify patients aged ≥ 20 years with newly diagnosed DRFs. A total of 459,388 DRFs occurred from 2011 to 2015. The proportion of DRF cases treated by surgery tended to increase over time, from 32.6% in 2011 to 38.3% in 2015 (P < 0.001). Open reduction with internal fixation (ORIF) using a plate steadily gained in popularity each year, increasing from 39.2% of overall surgeries in 2011 to 60.9% in 2015. The type of surgery for DRFs differed depending on the type of healthcare institution. ORIF (91%) was the most popular procedure in tertiary hospitals, whereas percutaneous pinning (58%) was most popular in clinics. In addition, general hospitals and hospitals with 30–100 beds used external fixation more frequently than tertiary hospitals and clinics did. Overall, our findings indicate that surgical treatment of DRF, particularly ORIF, continues to increase, and that the component ratio of operation codes differed according to the healthcare institution type.

Prevalence of Psoriasis in Korea: A Population-Based Epidemiological Study Using the Korean National Health Insurance Database.

BackgroundAlthough psoriasis is universal in its occurrence worldwide, its prevalence varies by geographic location and race. A few hospital-based surveys have reported on the demographic characteristics in Korean patients with psoriasis. However, a nation-wide study on the prevalence of psoriasis in Korea remains uncompleted.ObjectiveThe purpose of this study was to determine the prevalence of psoriasis in Korea and to describe the demographic and social characteristics of afflicted individuals.MethodsWe identified patients with psoriasis using a relevant diagnostic code from the sixth revision of the Korean Standard Classification of Disease in the 2011~2015 claims database of the Health Insurance Review and Assessment Service of Korea. We estimated the annual prevalence of psoriasis and described the age and sex distribution of the patients, type and severity of psoriasis, comorbidities, type of health insurance, type of health-care institution and residence area. Patients with moderate-to-severe psoriasis were defined as those who had been treated with phototherapy, classical systemic agents, and/or biologic agents.ResultsThe standardized prevalence of psoriasis was 453 per 100,000 individuals of the database population in 2015. We found male preponderance with a 1.3:1 male-to-female ratio, and that the largest number of patients belonged to the age group of 50s. Of the patients diagnosed with psoriasis in 2015, 83.8% had plaque psoriasis and 22.6% had moderate-to-severe psoriasis.ConclusionThe annual standardized prevalence of psoriasis in Korea was 453 per 100,000 of the population in 2015.

Health Status and Health Service Utilization: Barriers and Facilitators for Korea Medicaid Beneficiaries

Purpose: This study compares beneficiaries of Korean Medicaid with those under the National Health Insurance program, seeking to understand how each group utilizes their healthcare. Methods: Data were obtained from a Health Promotion Survey in 2005. Health status was measured by the respondents’ perception of health. Health service utilization included the availability of healthcare services, the type of healthcare institution, and intent to revisit. Predisposing and enabling factors, as well as health care needs were used for this study. Results: Compared to National Health Insurance beneficiaries, Medicaid beneficiaries reported lower levels of health status and fewer enabling factors. They had more chronic diseases and disabilities. Education level, existence of chronic diseases, exercise patterns, and disabilities were associated with health status. Conclusion: We found that Medicaid beneficiaries had fewer resources and higher levels of health needs. As Medicaid is reformed, policy makers and administrators should understand healthcare utilization behaviors of Medicaid beneficiaries and the factors hindering access to care.

Utilization Patterns of Korean Medicine: An Analysis of the National Health Insurance Cohort Database from 2002 to 2013.

Although Korean Medicine (KM) is an important part of the Korean healthcare system and plays a significant role in chronic and incurable diseases, there is insufficient information about KM utilization. The aim of the study was to identify KM utilization patterns using a national representative sample data. KM users aged 0-80 years and older from the nationally representative sample in the National Health Insurance Service-National Sample Cohort of 778,506 KM users between 2002 and 2013 (were analyzed. Annual changes in utilization patterns were analyzed by sex, nine age groups, five income levels, and numbers of visits and hospitalizations. Utilization patterns by the type of healthcare institution and the top 10 major diseases were studied. Frequencies of KM use differed according to analyses of patients and claims. Women used KM 1.5 times more than did men. Patients in their 40s and 50s made up one third of KM users. In contrast to other studies, high-income groups used KM more than did low-income groups. More than 96% of ambulatory patients used mostly KM clinics, and more than 76% of inpatients used KM hospitals. Musculoskeletal disorders were the main disease treated, which conformed to the results of previous studies. The results suggest that women, people in their 40s and 50s, and people with a relatively high income use KM more often than other patients. Further comparison studies of both Western medicine in Korea and other countries should be conducted.

Abstract P6-09-14: Awareness of brest cancer risk factors among lay persons and physicians

Abstract Background The EDIFICE surveys have been conducted every three years since 2005. The aim of the surveys is to provide a better understanding of the participation of the French population in cancer screening programs. The breast cancer screening program is nowadays widely implemented throughout the female population aged 50-74 years; however, the question of whether it could be adapted according to breast cancer risk factors is currently under debate. This analysis focuses on awareness of the nature of breast cancer risk factors among the lay population and physicians. Methods This fourth nationwide observational survey, EDIFICE 4, was conducted by phone interviews using the quota method. A representative sample of 1602 individuals aged between 40 and 75 years old was interviewed between June 12 and July 10, 2014. A mirror survey on a representative sample of 201 general practitioners (adjusted for age and geographical area) and 100 oncologists (adjusted for type of healthcare institution and geographical area) was conducted between July 9 and August 8, 2014. Interviewees were all asked to cite five main risk factors for breast cancer. Results For lay persons (737 women with no history of cancer), the breast cancer risk factors reported were: for 54%, heredity and family history; for 29%, unhealthy lifestyle, including smoking, poor diet, stress, alcohol, physical inactivity; for 15%, exposure to exogenous hormone therapy; for 4%, air pollution; for 4%, sunburn on breasts; for 4%, late childbearing or no childbearing, and for 2%, overweight/obesity. Among physicians (70 female general practitioners and 35 female oncologists), the breast cancer risk factors reported were: for 98%, heredity and family history; for 51%, exposure to exogenous hormone therapy; for 39%, late childbearing or no childbearing; for 32%, unhealthy lifestyle, including smoking, poor diet, stress, alcohol, physical inactivity; for 22%, overweight/obesity; for 20%, age; for 22%, no breast feeding, and for 2%, air pollution. Conclusion We observed a relatively satisfactory level of understanding regarding the different risk factors for breast cancer despite the lack of indication of any qualitative ranking. Although overweight is a known risk factor for breast cancer, this fact is still not clearly understood among physicians and not widely known by the general public. On the other hand, both physicians and also half of the lay population were well aware of the fact that heredity is a risk factor for breast cancer. Citation Format: Morère J-F, Viguier J, Blay J-Y, Touboul C, Lhomel C, Eisinger F, Pivot X. Awareness of brest cancer risk factors among lay persons and physicians. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-09-14.

Assessment of medical resource utilization for Taiwanese children hospitalized for intracranial injuries

BackgroundCompared to adults, children and adolescents are at greater risk for traumatic brain injury (TBI), with increased severity and prolonged recovery when compared to adults. It is a challenge to provide care for those children who are at risk for complications of TBI under health care resource constraints. AimTo investigate hospitalization among children with intracranial injuries in terms of incidence and factors related to length of stay (LOS) and medical cost. MethodsData from the National Health Insurance Research Database from 2007–2009 were used. In total 8632 children aged <=18 years with acute traumatic intracranial injuries caused by accidents were discharged from hospitals in Taiwan. The associations between patient and hospital covariates (e.g., age, gender, accreditation level of hospital, surgical intervention, and number of comorbid conditions) and log-transferred hospitalization cost and length of stay (LOS) were examined with multivariable regression analysis and mediation analyses. ResultsThe incidence rate of hospitalization for acute intracranial injury was 63.3/100,000 per year. Motor vehicle crashes and falls accounted for 63.5% and 23.8% of intracranial injuries, respectively. The mean LOS for children was 5.0 days (median, 3 days), incurring a mean direct medical cost of $US 916.70 (median, $356.2). Boy sustained more injury (64.1%) and greater medicals cost ($965) occurred in boys. Patients with subarachnoid subdural and extradural haemorrhage tended to have a longer LOS and incur greater medical costs. Surgical intervention and type of healthcare institution were also significant predictors for medical costs. Additionally, LOS was the dominant mediator for the relationship between predictor and medical cost. ConclusionsAcute intracranial injuries among children incur a substantial health care burden. Therefore, health authorities need to optimally allocate medical resources in care.

Changes in Length of Stay for Neurological Geriatric Diseases in Korea between 2003 and 2007

Background and PurposeThe elderly population and the prevalence of stroke, dementia, and Parkinson's disease are increasing rapidly in Korea. The aim of this study was to establish the length of stay (LOS) for neurological geriatric diseases, and analyze this parameteraccording to healthcare institutions.MethodsWe used data from the Health Insurance Review and Assessment Service from 2003 to 2007. Nineteen neurological geriatric diseases were classified into four groups: dementia, cerebral hemorrhage, cerebral infarction, and Parkinson's disease. LOS was analyzed according to gender, age, insurance type, disease group, and type of healthcare institution.ResultsThe LOS for neurological geriatric diseases lengthened from 5,550,193 days (10.8% of the total National Health Insurance admission days) in 2003 to 14,749,671 days (19.7%) in 2007. The mean LOS was 40.8 days in 2003, and lengthened to 71.2 days in 2007. After stratification by disease group, the mean LOS for long-term-care hospitals lengthened by 1.43 times (from 81.7 to 116.6 days) in the cerebral infarction group, 1.35 times (from 85.6 to 115.2 days) in the cerebral hemorrhage group, and 1.28 times (from 82.7 to 105.7 days) in the Parkinson's disease group.ConclusionsThe LOS for neurological geriatric diseases has lengthened markedly, which isdue to an increasesin the number of hospitalized patients and the mean LOS, which have increased most rapidly in long-term-care hospitals. These results may be useful in developing geriatric health policies.

Back or neck-pain-related disability of nursing staff in hospitals, nursing homes and home care in seven countries—results from the European NEXT-Study

Background Musculoskeletal disorders are a widespread affliction in the nursing profession. Back or neck-pain-related disability of nursing staff is mainly attributed to physical and psychosocial risk factors. Objectives To investigate which—and to what extent—physical and psychosocial risk factors are associated with neck/back-pain-related disability in nursing, and to assess the role of the type of health care institution (hospitals, nursing homes and home care institutions) within different countries in this problem. Design Cross-sectional secondary analysis of multinational data of nurses and auxiliary staff in hospitals ( n=16,770), nursing homes ( n=2140) and home care institutions ( n=2606) in seven countries from the European NEXT-Study. Methods Multinomial logistic regression analysis with raw models for each factor and mutually adjusted with all analysed variables. Results Analysis of the pooled data revealed effort-reward imbalance as the predominant risk factor for disability in all settings (odds ratios for high disability by effort-reward ratio: hospital 5.05 [4.30–5.93]; nursing home 6.52 [4.04–10.52] and home care 6.4 [3.83–10.70] [after mutual adjustment of psychosocial and physical risk factors]). In contrast, physical exposure to lifting and bending showed only limited associations with odds ratios below 1.6; the availability and use of lifting aids was—after mutual adjustment—not or only marginally associated with disability. These findings were basically confirmed in separate analyses for all seven countries and types of institutions. Conclusions The findings show a pronounced association between psychosocial factors and back or neck-pain-related disability. Further research should consider psychosocial factors and should take the setting where nurses work into account.