Hospital Type Research Articles

IJCM_29A: Expenditure incurred by cancer patients covered under National Health Protection Scheme attending a tertiary care hospital in Mangalore

Background: Over the past decades, cancer has become the second leading cause of death and morbidities around the world, accounting for nearly 1 in 6 of the total global deaths. The cost of treatment depends on the type of cancer, the duration of treatment, the type of hospital, and whether they are covered under any health insurance. Objectives: 1. Cost of cancer treatment, before and after registration under VAS, among cancer patients attending an empanelled tertiary care hospital in South India 2. Pattern of OOPE incurred by households of cancer patients. 3. Proportion of expenditure spent on cancer treatment in comparison to the annual family income. Methodology: A hospital-based cross-sectional study was conducted in tertiary care centre among cancer patients covered under VAS, from April to May 2018. Patients who were not covered under the schemes were excluded from the study. Results: Out of the 150 cancer patients actively receiving cancer treatment, a majority, i.e., 65% of them were females. More than half of them (66%) were in the age group of 20-60 years. Only 9% of patients had additional health insurance to aid their expenditures while the rest were dependent only on VAS. The median (IQR) monthly income of the patient and family members was 153(83;293) USD. The overall median (IQR) cost was 525(230;980) in our patients. Costs before initiation of treatment under VAS constituted almost 90% of direct medical OOPE spent by the patient and his family. The overall mean OOPE in this study was 856 USD. 70% of the patients incurred a monthly cost of ≥40% of their monthly family income and 41% of the patient’s OOPE was more than 100% of their monthly family income. Conclusion: A monthly cost-to-income ratio of 240% is seen in 70% of the patients, Loans were taken and donations received to combat the expenditures. Hence VAS should reimburse the medical cost before enrolment under VAS. VAS can step up and protect its objectives by reimbursing the diagnostic costs and any long-term non-medical costs associated with the illness, as this would help reduce the OOPE by 1/3 making a huge difference to their financial status.

Assessment of the Level of Knowledge About Risk Factors, Prevention, and Treatment of Gestational Diabetes Mellitus in a Community Sample From Saudi Arabia.

Introduction Gestational diabetes mellitus (GDM) is a common disease affecting pregnant females, and it carries a major risk of short and long-term health problems for both mothers and their offspring. Multiple factors like advanced maternal age, obesity, and unhealthy lifestyle can increase the risk of GDM. The current guidelines recommend screening all pregnant females for risk factors during the first trimester with subsequent testing of the blood glucose level at 24 weeks gestation. Lack of awareness about GDM is a main contributing factor in the delay in screening and diagnosis of GDM with subsequent fetal and maternal complications. This study aims to identify the level of knowledge about GDM among the adult population in the Kingdom of Saudi Arabia (KSA). Material and methods A descriptive cross-sectional questionnaire-based study was conductedto identify the level of knowledge about risk factors, prevention, and treatment of GDM in a community sample from Saudi Arabia. A self-administered electronic questionnaire was designed, tested for validity and reliability, and distributed through social media platforms. It consisted of 18 questions asking about the socio-demographic characteristics, the type of hospital in which the participant receives their medical care, whether the participant heard about GDM or not, and if they knowsomeone with GDM, in addition to questions to assess the level of knowledge about risk factors, complications, prevention, and treatment of GDM. The total score of knowledge was calculated. The multivariate regression analysis test was employed to analyze the relationship between various demographic variables and the level of knowledge about GDM among the study population. A p-value of 0.05 or less was considered statistically significant. Results A total of 539 (100%) participants completed the questionnaire: 263 (48.8%) of them were in the age category (18-25 years), 440 (81.6%) of them were females, 307 (57%) had a bachelor's degree, 275 (51%) were single, 454 (84.2%) had heard about GDM, and 258 (47.9%) of them have or know someone with GDM. The total score of knowledge revealed excellent, good, fair, and poor levels among 334 (62%), 140 (26%), 49 (9%), and 16 (3%) of participants, respectively. The multivariable linear regression model revealed that participants who received health care from governmental hospitals heard about GDMand had or knew someone with GDM were positively associated with a higher level of knowledge. Conclusions The findings revealed that among participants, 62% showed excellent knowledge about GDM, although, the other 38% had non-optimal levels of knowledge. Awareness campaigns are recommended to improve the level of knowledge about this disease, its risk factors, treatment, and complications.

Factors influencing radiologic technologists’ commitment to radiation protective equipment utilization in fluoroscopy units: an analysis using the health belief model scale

Objective: This study aimed to assess the perceptions of radiologic technologists towards the use of radiation protective equipment (RPE) in fluoroscopy units and to identify the Health Belief Model constructs, “perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy”, that predict RPE utilization among radiologic technologists. Methods: A cross-sectional observational study was conducted among 228 radiologic technologists in Saudi Arabia. Data were collected using a self-administered questionnaire that included socio-demographic characteristics, frequency of RPE utilization, and the Health Belief Model. Logistic regression was used to identify the predictors of RPE utilization. Results: The findings indicate that 63% of radiologic technologists reported always being committed to using RPE, while 37% reported not fully committed. Perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy showed significant associations with RPE utilization between the two groups of radiologic technologists: those who always use RPE and those who are not fully committed (p < 0.05). Logistic regression showed that perceived benefits were a significant predictor of RPE utilization (AOR = 0.20, 95% CI: 0.60–0.67, p = 0.009), and type of hospital was also a significant predictor (AOR=0.09, 95% CI: 0.1–0.97, p = 0.047). Conclusion: The study highlights the need for interventions to improve the consistent use of RPE among radiologic technologists in fluoroscopy units. Emphasizing the importance of RPE usage, addressing barriers, and providing adequate cues to action can help enhance radiologic technologists’ commitment to using RPE and reduce radiation exposure risks. Tailoring interventions to the specific hospital setting and considering the perceived benefits of using RPE are crucial for promoting a culture of safety and accountability in different healthcare settings.

Duration of untreated psychosis and involuntary hospitalization in first-episode psychosis

IntroductionDuration of untreated psychosis (DUP) is defined as the time between the onset of psychotic symptoms and the initiation of appropriate treatment. DUP has been the subject of intensive research to understand how it is associated with a poorer prognosis in patients with first-episode psychosis (FEP). Involuntary treatment is often necessary in the context of FEP.ObjectivesTo characterize the relationship between the duration of untreated psychosis (DUP) and the type of hospitalization (voluntary versus involuntary) in patients admitted for FEP.MethodsWe conducted a retrospective observational study, collecting data from patients admitted between January 2019 and December 2022, in the psychiatric unit at our hospital in Bragança, Portugal. We used the information recorded in the clinical records and statistical analysis of the data was performed using the SPSS program.ResultsOver the 4-year study period, 81 patients with first-episode psychotic symptoms at admission were selected. The average age was 46.98 years, with a slight male predominance. 46.9% (n=38) were admitted involuntarily, and 53.1% (n=43) were admitted voluntarily. The average DUP was 73 days. DUP was 95.92 days for patients admitted involuntarily and 54.72 days for voluntary admission. This difference was not statistically significant.Conclusions There was a longer DUP in patients admitted involuntarily, although this association was not statistically significant. However, it is important to emphasize that involuntary hospitalization is frequently linked to more severe cases and poorer prognosis. Therefore, recognizing psychotic symptoms as early as possible is essential to facilitate prompt identification and effective treatment for patients experiencing their first episode of psychosis, ultimately leading to an improved prognosis.Disclosure of InterestNone Declared

Development of accreditation modules based on hospital types in Iran: Protocol for a mixed methods study.

Among different tools, accreditation is widely used worldwide to improve the quality and safety of hospital services. In Iran, as in many other countries, the same accreditation standards apply to all hospitals, regardless of their size and type of activity. This has given rise to many problems for hospitals. We will conduct this study in three phases: In the first phase, relevant individuals are interviewed to identify challenges caused to hospitals by applying the same standards for all types of hospitals and clarify issues that could be removed or changed in small hospitals. In the second phase, a scoping review is conducted on the literature about accreditation models worldwide. The first and second phases are conducted simultaneously, and a new accreditation model for Iran hospitals is derived by combining their results. In the final phase, using the Delphi technique, the obtained model and accreditation modules are verified during Delphi rounds. A more appropriate accreditation model that matches the characteristics of the target hospitals could be the output of this study. It is expected that the model could improve the process of evaluating the quality of hospital services through the accreditation tool.

Status and content of outpatient preoperative education for rectal cancer patients undergoing stoma surgery provided by Japanese wound, ostomy, and continence nurses: a cross-sectional study

BackgroundPreoperative education can improve postoperative quality of life in patients undergoing stoma surgery. However, the prevalence and when, where, and how preoperative education is implemented are unclear. Therefore, this study aimed to assess the current status of outpatient preoperative education for patients undergoing stoma surgery for rectal cancer as perceived by nurses. Additionally, it sought to identify the information provided by Japanese healthcare providers as a part of preoperative education.MethodsThis cross-sectional study included 1,716 wound, ostomy, and continence nurses (WOCNs) in charge of stoma clinics at Japanese hospitals. Unsigned self-administered survey forms were mailed to the participants, and paper- or web-based responses were obtained. The main questions included: overview of the participants and their facilities, provision of outpatient preoperative education, status of implementation, and preoperative education components. To examine the factors associated with preoperative education, the independent variable was the presence or absence of preoperative education in the clinic, and the explanatory variables were the years of experience as a nurse, years of experience as a WOCN, type of hospital, number of beds, and number of intestinal stoma surgeries per year. Regression analysis was performed.ResultsWe received 773 valid responses (valid response rate: 45%). Duration of experience as a nurse and as a WOCN were 24.6 and 10.9 years, respectively. Outpatient preoperative education was provided by 24% of the participants. Most preoperative education sessions were conducted for patients or caregivers. Preoperative education took 31–60 min per patient, and one to five patients received preoperative education each month. Booklets, ostomy appliances, and stoma models/dolls were used as supplementary materials for preoperative education. The most frequently mentioned components of preoperative education were stoma care, daily life, social security, stoma clinic, traveling and going out, quality of life after stoma surgery, and precautions for medical treatment. In addition, education on the use of restrooms on the go, disaster preparedness, defecation disorders after restorative proctectomy, and complications after stoma closure were considered necessary.ConclusionsThe implementation rate of outpatient preoperative education was low (24%). Future challenges include the development of specific educational content and procedures suitable for the Japanese medical environment and the establishment of preoperative medical care teams for stoma surgery to promote the provision of outpatient preoperative education.

Patient perceptions of healthcare service quality in Romania: Public versus private hospitals – Implications for developed and developing healthcare systems

Objective: Recent increases in per capita income and longevity in Central and Eastern European counties (CEECs), alongside a slow-changing soviet-era public healthcare system, has led to the emergence of private hospitals. This paper investigates the differential patient service quality perceptions for private versus public hospitals, as well as for three types of healthcare services: primary, ambulatory, and inpatient care.Methods: Data from 1,673 patients of private and public hospitals in the capital of Romania were collected in face-to-face interviews. Analysis of covariance and partial-least-squares techniques were used to examine the relationships between perceived service quality, hospital ownership status and the type of health service patients received.Results: Over 70% of women prefer private health facilities to public hospitals (compared to less than 30% of men). While private hospitals rank higher than public hospitals on most attributes, the interaction effect of gender and hospital type reveals that assurance and empathy are the only significant attributes in driving women to private hospitals. (Physical facilities and staff appearance) as well as intangible dimensions of service quality (assurance, responsiveness, reliability, and empathy) have a positive impact on perceived overall service quality of healthcare. Improvements in perceptions of hospital’s tangibles, staff’s responsiveness and empathy have the greatest potential to enhance perceived overall service quality.Conclusions: This paper demonstrates the importance of breaking down health services into various sub-categories both in terms of perceived healthcare attributes and in terms of tangible healthcare facilities, such as public and private hospitals.

Abstract 3426: Real-world biomarker testing rates and trends among patients with advanced non-small cell lung cancer in the US

Abstract Background: Broad biomarker profiling before treatment initiation for non-small cell lung cancer (NSCLC) is recommended. Patients may not receive or receive inadequate biomarker testing before treatment initiation. This study assesses rates and trends of biomarker testing in community and academic oncology practices in the US. Methods: A descriptive cohort study was conducted using electronic health records from an NSCLC registry. Patients who initiated NSCLC treatment following diagnosis of advanced NSCLC (stage IIIB/IIIC/IV) from 01/01/2015-12/31/2021 were identified. Patient demographics (age, gender, race, region) along with histology type (squamous/non-squamous) and hospital type (academic/community) were included. The percentage of patients receiving tests for any of the nine biomarkers before and during therapy was calculated and compared. Results: 8,769 patients were identified with advanced NSCLC; 65.9% having non-squamous cell carcinoma; 22.4% having squamous cell carcinoma; 11.7% unknown. 13.4% of patients were from academic centers, 78.7% from community hospitals, 8.0% unknown. The majority (59%) were 65+ years; 47.3% were female. Overall, 83.2% had biomarker testing at some point in treatment; only 66.3% before treatment initiation. Over time, biomarker testing rates prior to treatment initiation increased (46.9% in 2015 to 73.8% in 2021). The use of biomarker testing in non-squamous cell carcinoma was greater than in squamous cell carcinoma. The most frequent biomarker testing before treatment initiation were PD-L1 (52.2%), EGFR (51.6%), and ALK (50.7%), followed by ROS1 (46.9%), BRAF (39.5%), and KRAS (34.1%). Testing rates for the newest biomarkers NTRK, MET, and RET were 20.4%, 28.4%, and 28.0%, respectively. Testing rates were similar between academic centers and community-based hospitals, except for the newest biomarkers, where use in academic settings was greater. Biomarker testing rates were higher among female patients (χ2 P-value<0.001); rates by race were similar (χ2 P-value=0.83). Conclusion: While the use of biomarker testing in advanced NSCLC is growing, 26% of patients remained untested before treatment initiation. Biomarker testing in non-squamous cell carcinoma is higher than in squamous cell carcinoma, in keeping with the guideline emphasis on biomarker testing for that histology type. Results suggest that further dissemination of guideline recommendations to obtain biomarker test results prior to treatment initiation is important to optimize treatment decisions in the NSCLC landscape. Citation Format: Yiyu Chen, Angeline Carlson. Real-world biomarker testing rates and trends among patients with advanced non-small cell lung cancer in the US [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3426.

The Evaluation of Dermatological Disease Profiles of Neurosurgery Inpatients: A Tertiary Clinic Experience.

Both the skin and neuronal systems originate from the ectoderm. In patients hospitalized for neurosurgery, their skin may be affected by genetic and environmental factors. This study researched disease relationships by evaluating the profile of hospitalized neurosurgery patients who consulted with dermatologyin a tertiary clinic (Neurosurgery Clinic, Ankara Training and Research Hospital, Ankara). This study included hospitalized neurosurgery patients who consulted with dermatology. Age, gender, type of hospitalization, neurosurgical diseases, and dermatology diseases were selected as study variables. The medical health records of the patients were retrospectively scanned and analyzed. A total of 172 consultations were analyzed. The mean age of patients was 44.7 years oldranging from 1 year to99 years old. The percentage of male patients was 54.7%; 25.5% of the patients were hospitalized for cerebral vascular diseases, 30.2% for spinal diseases, 22.1% for tumors, 12.2% for infections, and 1.2% for other neurosurgical diseases. The most commonly diagnosed dermatological disease in patients was drug eruptions (18.6%), followed by seborrheic dermatitis (16.2%) and contact dermatitis (14.5%). According to this study, the most commonly diagnosed dermatological diseases in neurosurgery inpatients were drug eruption, contact dermatitis, and seborrheic dermatitis. The results of this study may be helpful in terms of neurosurgical training planning and treatment management.

Impact of hospital design on the psychological well-being of geriatric patients

PurposeThe study investigates the relationship between hospital environmental factors and the well-being of geriatric in-patients. It aims to identify the impact of architectural design on comfort, safety, privacy and stress levels experienced by elderly patients during their hospital stays.Design/methodology/approachEmploying a mixed-methods approach, the research assesses the experiences of 100 geriatric in-patients across various hospital types through surveys, observational checklists and state anxiety measurements. The methodology involves examining architectural features, patient perceptions and correlations among environmental variables and patient experiences. Statistical analyses, including correlations and chi-square tests, were employed to discern associations between environmental variables and patient experiences.FindingsThe research identified key architectural features significantly impacting geriatric patients' experiences. Factors such as sturdy beds, furniture quantity, lighting conditions, proximity to facilities and ward occupancy levels were found to influence spatial, sensory and social comfort. Notably, proximity to facilities and control over the immediate environment were crucial for self-control and safety perceptions. Privacy, highly valued by patients, correlated with the presence of curtains and ward occupancy. Moreover, patient stress levels exhibited correlations with autonomy, privacy and ward occupancy.Originality/valueThis research offers significant insights into the criticality of specific architectural elements in enhancing comfort and reducing stress for geriatric in-patients. These findings hold substantial value for healthcare facility design, emphasizing the need to prioritize certain design aspects to promote the well-being of elderly patients during hospitalization.

Analysis of the incidence and risk factors of blood transfusion in total knee revision: a retrospective nationwide inpatient sample database study

ObjectiveThis study sought to determine the incidence and risk factors of blood transfusion among patients undergoing total knee revision (TKR) using a nationwide database.MethodsA retrospective data analysis was conducted based on the Nationwide Inpatient Sample (NIS), enrolling patients who underwent TKR from 2010 to 2019 with complete information. The patients were divided into two groups based on whether they received blood transfusion or not. The demographic characteristics (race, sex, and age), length of stay (LOS), total charge of hospitalization, hospital characteristics (admission type, insurance type, bed size, teaching status, location, and region of hospital), hospital mortality, comorbidities, and perioperative complications were analyzed. Finally, we conducted univariate and multivariate logistic regression to identify factors that were associated with TKR patients to require blood transfusion.ResultsThe NIS database included 115,072 patients who underwent TKR. Among them, 14,899 patients received blood transfusion, and the incidence of blood transfusion was 13.0%. There was a dramatic decrease in the incidence over the years from 2010 to 2019, dropping from 20.4 to 6.5%. TKR patients requiring transfusions had experienced longer LOS, incurred higher total medical expenses, utilized Medicare more frequently, and had increased in-hospital mortality rates (all P < 0.001). Independent predictors for blood transfusion included advanced age, female gender, iron-deficiency anemia, rheumatoid disease, chronic blood loss anemia, congestive heart failure, coagulopathy, uncomplicated diabetes, lymphoma, fluid and electrolyte disorders, metastatic carcinoma, other neurological diseases, paralysis, peripheral vascular disorders, pulmonary circulation disorders, renal failure, valvular disease, and weight loss. In addition, risk factors for transfusion in TKR surgery included sepsis, acute myocardial infarction, deep vein thrombosis, pulmonary embolism, gastrointestinal bleeding, heart failure, renal insufficiency, pneumonia, wound infection, lower limb nerve injury, hemorrhage/seroma/hematoma, wound rupture/non healing, urinary tract infection, acute renal failure, and postoperative delirium.ConclusionsOur findings highlight the importance of recognizing the risk factors of blood transfusion in TKR to reduce the occurrence of adverse events.

Abstract P167: Association Between Obesity and New-Onset Heart Failure Among People With Hypertension in Thailand

Obesity establishes cardiovascular risk factors, including high blood pressure, hyperlipidemia, and high blood glucose, and also results in cardiovascular events. In Thailand, the epidemiological data on the relationship between obesity and heart failure (HF) among high-risk populations was limited. We assessed the hypothesis that increased body mass index (BMI) was associated with the new-onset HF among people with hypertension (HTN); we also assessed the effect modifier of uncontrolled HTN on this association. We conducted a retrospective cohort study in 2018. Thai people with HTN aged 20 years and older receiving continuous care at out patient clinic in the hospitals nationwide were included. While those with a history of HF before 12 months from the data collection date were excluded. The new-onset HF was defined regarding the ICD-10 as I50 in the medical records within 12 months. The information on the characteristics and BMI of participants was extracted from the medical records by well-trained registered nurses. Obesity was defined as BMI ≥25 kg/m 2 . We performed multivariable log-binomial regression analysis to determine the association between BMI and new-onset HF and presented as the adjusted risk ratio (aRR) and 95%CI. A total of 35,756 participants were included in the analysis. The mean age of participants was 64.5±0.1 years. In all, 61.4% were women, and 50.0% had controlled HTN (SBP&lt;140 mmHg and DBP &lt;90 mmHg) two visits consecutively. The mean BMI was 25.1±0.02 kg/m 2 . New-onset HF occurred in 75 participants (0.21%). Adjusting for age, sex, health schemes, geographic regions, hospital types, type 2 diabetes, dyslipidemia, renal insufficiency, history of ischemic heart disease, smoking status, alcohol use, uncontrolled HTN, and ACEI/ARB use, increased BMI per 1 kg/m 2 was significantly associated with new-onset HF (aRR 1.09 [95%CI: 1.05-1.14]). In comparison with participants with BMI of 18.5-22.9 kg/m 2 , the aRR for new-onset HF was 1.57 (95% CI:0.80-3.08), 3.69 (95%CI: 1.73-7.87), and 5.18 (95% CI: 1.81-14.81) in those with BMI 25.0-29.9, 30.0-34.9, and ≥35.0 kg/m 2 , respectively. For participants with obesity, aRR for new-onset HF was 2.05 (95% CI: 1.24-3.39) compared to non-obese participants. The effect modification of uncontrolled HTN on the association between obesity and new-onset HF was not observed ( p -value = 0.641). In conclusion, an increased BMI had a higher risk for new-onset HF among Thai people with HTN. Obesity was independently associated with new-onset HF among people with HT, regardless of uncontrolled HTN.

Job Satisfaction among the Nurses Working in Government and Private Hospital in Eastern Part of Nepal

Nursing is a profession which directly deals with the health of the human being. It requires competence, compassion and genuine commitment. So, job satisfaction among the nurses remains the matter of concern because it directly impacts the quality of patient care. The objective of the Study is to assess the level of satisfaction among the nurses.&#x0D; A descriptive Cross-Sectional study was conducted by using self-administered questionnaire among 200 nurses working in different Governmental and Private Hospital in Eastern Part of Nepal. Data was collected from 2080/1/1/ to 2080/6 30. Job Satisfaction was measured by using five-point Likert scale type questionnaire. Descriptive statistics; Mean, Standard Deviation, Percentage and inferential statistics co-relation analysis were utilized to examine data and draw meaningful insight. The findings of the study revealed that 54.5% (109) respondents were satisfied with their job and 45.5% (91) respondents were unsatisfied with their job. Based on the weighted mean score satisfaction level was assessed where the weighted mean was 3.105. Finding showed that there is significant relationship of job satisfaction with salary and type of hospital and there is no any relationship of job satisfaction with designation, age, qualification, marital status and work experience. Level of job satisfaction is more in government hospital than the private hospital. There is significant relationship between level of job satisfaction with its different components and there is significant differences in level of job satisfaction among nurses between government and private hospital.&#x0D; The study was aimed to find out the job satisfaction among nurses. Based on the findings more than half of the nurses were satisfied with their job and it is also showed that there is significant relationship of job satisfaction with salary and type of hospital. There are various factors where nurses are not satisfied such as; job security, self-growth and development, salary, working condition and hospital environment. If there are dissatisfied, they may stimulate the nurses to intend to leave their job/centers. For the quality care to the patient in hospital nurses’ source of job dissatisfaction must be addressed and managed.

The Effects of Workload Excess on Quality of Work Life in Third-Level Healthcare Workers: A Structural Equation Modeling Perspective.

Examining the workload and working conditions of healthcare workers is crucial regarding the quality of the work life of employees and the quality of services provided. This study aims to determine the effects of the perceptions of workload on the quality of work life of health personnel working in two different tertiary hospitals affiliated with the Ministry of Health and the Higher Education Institution in Türkiye with structural equation modeling. This study was conducted in two hospitals in Malatya province: İnönü University Turgut Özal Medical Center affiliated with the Higher Education Institution and Malatya Training and Research Hospital affiliated with the Ministry of Health. The mean score of the Individual Workload Perception Scale was 106.18 ± 16.5, and the mean score of the Work-related Quality of Life Scale was 66.39 ± 15.33. Total workload scores had a statistically significant positive effect on total quality of work life scores (β1 = 0.98; p = 0.001). It was concluded that there was a statistically significant relationship between workload and quality of work life and age, unit of employment, working time in the profession, and hospital type.

Knowledge, attitudes and practices among medical workers toward outpatient diabetes information platform

BackgroundThis study aimed to assess the knowledge, attitudes and practices among medical workers toward outpatient diabetes information platform.MethodsThis web-based cross-sectional study was conducted between May 2023 and June 2023 at the First Hospital of Zhangjiakou, China. A self-designed questionnaire was developed to collect demographic information of medical workers, and assess their knowledge, attitudes and practices toward outpatient diabetes information platform.ResultsA total of 685 questionnaires were collected. Among the participants, 603 (88.03%) were female, 432 (63.07%) work in a tertiary hospital, 548 (80.00%) have a bachelor degree, 270 (39.42%) of them work in the department of internal medicine and 315 (45.99%) of them received previous training on outpatient diabetes information platform. The mean knowledge, attitudes and practices scores were 4.32 ± 1.27 (possible range: 0–6), 56.76 ± 5.72 (possible range: 14–70), and 32.22 ± 8.42 (possible range: 9–45), respectively. 350 (51.09%) of them have sufficient knowledge, 168 (24.53%) have positive attitudes and 395 (57.66%) have active practices. Pearson correlation analysis showed that knowledge was positively correlated with attitudes (r = 0.397, P < 0.001), and attitudes were positively correlated with practices (r = 0.306, P < 0.001). Multivariate analysis showed that primary hospital (OR = 0.32, 95% CI: 0.14–0.71, P = 0.005), secondary hospital (OR = 0.48, 95% CI: 0.32–0.72, P < 0.001), doctor (OR = 2.44, 95% CI: 1.39–4.28, P = 0.002) were independently associated with sufficient knowledge. Knowledge (OR = 1.49, 95% CI: 1.29–1.73, P < 0.001), community hospital staff (OR = 0.21, 95% CI: 0.05–0.88, P = 0.032) were independently associated with positive attitudes. Attitudes (OR = 1.13, 95% CI: 1.09–1.17, P < 0.001), junior college (OR = 1.72, 95% CI: 1.07–2.77, P = 0.026) were independently associated with active practices. The structural equation model demonstrated that knowledge had a direct effect on attitudes (path coefficient = 0.521, P < 0.001), and attitudes had a direct effect on practices (path coefficient = 0.542, P < 0.001). Moreover, the type of hospital had a direct effect on knowledge (path coefficient = 0.085, P < 0.001). Additionally, previous training on the outpatient diabetes platform had direct effects on attitudes (path coefficient = 0.191, P < 0.001) and practices (path coefficient = 0.184, P < 0.001).ConclusionThese findings revealed that medical workers have insufficient knowledge, positive attitudes and inactive practices toward the outpatient diabetes information platform. Comprehensive training programs are needed to improve medical staff’s practices in this area.

Postoperative Complications of Surgery for Cervical Spondylotic Myelopathy with and Without Athetoid Cerebral Palsy.

Retrospective cohort study. With the aging of the Japanese population, patients with athetoid cerebral palsy (ACP) are getting older, and the rate of surgery for CSM is increasing in ACP patients. However, postoperative complications of such surgery among adult patients with ACP have not been reported yet. We investigated postoperative complications of surgery for CSM with ACP and compared them with those of surgery for CSM without ACP using a national inpatient database of Japan. Using the Diagnosis Procedure Combination database, we identified 61382 patients who underwent surgery for CSM from July 2010 to March 2018. We examined patient backgrounds, surgical procedures, and type of hospital, and a 4:1 propensity score matching was performed to compare the outcomes between the non-ACP and ACP groups. There were 60847 patients without ACP and 535 patients with ACP. The mean age was 68.5 years in the non-ACP group and 55 years in the ACP group. The percentages of patients who underwent fusion surgery were 21.6% and 68.8% in the non-ACP and ACP groups, respectively. The 4:1 propensity score matching selected 1858 in the non-ACP group and 465 in the ACP group. The ACP group was more likely to have postoperative urinary tract infection (.4% vs 2.8%, P < .001), postoperative pneumonia (.4% vs 2.4%, P < .001), and 90-day readmission for reoperation (1.9% vs 4.3%, P = .003). We found that ACP patients were more vulnerable to postoperative complications and reoperation after CSM than non-ACP patients.

Effect of the COVID-19 Pandemic on the Performance Indicators of Academic and Non-academic Hospitals in West Azerbaijan Province in 2020

Background: Hospitals are the most important pillar of the country›s health system, especially when faced with a crisis. One of the most important indicators in evaluating hospitals is performance indicators. This research was done to investigate the effect of the COVID-19 pandemic on the performance indicators of academic and non-academic hospitals in West Azerbaijan province in 2020. Methods: The present cross-sectional descriptive-analytical study was done on all academic and non-academic hospitals of West Azerbaijan province, which examined their performance indicators in 2019 and 2020. The data were analyzed using SPSS 16 software by repeated-measures analysis of variance (ANOVA). Results: The results of repeated-measures ANOVA demonstrated that the effect of time (coronavirus) on the index of bed occupancy ratio was significant (η2=0.24, P=0.006) so that it decreased this index in academic hospitals and had the opposite result in non-academic hospitals. The COVID-19 had a significant effect on the index of average patient stay (η2=0.47, P&lt;0.001) and this index in both types of hospitals increased. Also, the COVID-19 had a significant effect on bed turnover rate (η2=0.32, P=0.001) and it decreased in both types of hospitals. Conclusion: Since academic hospitals are more responsible in dealing with epidemics, it is suggested to pay more attention to their infrastructures. Considering the financial burden of some non-communicable diseases, academic hospitals should be prepared to accept and support them, especially in the early period of the epidemic.

ANALISIS GAP BIDANG SUMBER DAYA MANUSIA (SDM) RUMAH SAKIT PKU MUHAMMADIYAH YOGYAKARTA UNIT II MENUJU RS TIPE B

Background : Issues of ASEAN Free Trade Area ( AFTA ) and globalization of the world economy demands which is every profit and non-profit organizations to compete in marketing and resource. The changes, requires hospitals to survive among competitors that would appear at any moment. Therefore , Human Resources (HR) hospitals must be able to respond it. HR needs proper planning in accordance with the service requirements of each unit in accordance with the classification of hospitals based on the Regulation of the Minister of Health ( Permenkes ) number 56 of 2014 as well as national accreditation standard version of the Commission on Accreditation of Hospitals 2012 ( KARS ). So the RS PKU Muhammadiyah Yogyakarta Unit II will head the hospital type B and accreditation .Methods: The study design was qualitative used in-depth interviews and quantitative method for analyzing a plan about between condition HR today and the need for hospital accreditation of type B and KARS version 2012. While quantitative data obtained through questionnaires Need Assessment journal guidelines on Managerial Competency Development at Provincial and District HospitalsResults : Based on the research results, there is a shortage of human resources about the type and number according to hospital type B and for the accreditation of 99 elements document ratings are 96 % complete . As for performance assessment PKU Muhammadiyah Yogyakarta Unit II responsibility for the examination and treatment, training, science and research, issues of hospital management which is indispensable. To support the referral level, in terms of both treatment and prevention. As well as for international cooperation needs to be improved. While the assessment of training needs at the level of priority on the entire item, respondents give a high priority level assessment.Conclusion : There is a shortage of the type and quantity of human resources between the condition of human resources today and the provisions of hospital type B and there are some completeness of documents for the accreditation of qualifications assessment and education staff KARS 2012 version. Keywords : hospital type B, Permenkes 56/2014, accreditation of KARS version 2012, human resources.

ANALISIS DESKRIPTIF GAYA KEPEMIMPINAN SITUASIONAL KEPALA RUANGAN PERAWATAN RUMAH SAKIT PKU MUHAMMADIYAH YOGYAKARTA

The PKU Muhammadiyah HospitalOf Yogyakarta is referred Islamic hospital type B in Special Governmental State Yogyakarta and Central Java. In spite of being referred hospital, in giving service and nursing care has not been optimal. Head of nursing section has significant role in organizing associate nurse in effort of better service. A successful head section must be a good identifier and could appreciating the spirit of curiosity. Four situational leadership style such as, instructing, consulting, participating and delegating, will be analyze to see the tendency of leadership style that be used by the head of nursing section of PKU Muhammadiyah Hospital of Yogyakarta.This research is the quantitative-descriptive research. Measurement tools of this research using questioners that being distribute to 94 respondent. The subject of this research is vocational nurse on inpatient room of the PKU Muhammdiyah Hospital of Yogyakarta.Result of this research in the way of leadership assessed by associate nurse on head nursing section in patient room shows that ibnu shina room used consulting style 72,7%, marwah 56,3% consulting, roudhoh 63,3% consulting, arafah 53,8% participating, shofa-musdalifah 71,4% consulting, zam-zam 81,8% participating, and multazam 72,2% consulting.The style of situational leadership dominantly applied by the head nurse section of PKU based on the assessment of associate nurse is consulting leadership. The style of situational leadership not applied by the head nurse section is instructing.

Associations of U.S. hospital closure (2007-2018) with area socioeconomic disadvantage and racial/ethnic composition

PurposeTo examine whether hospital closure is associated with high levels of area socioeconomic disadvantage and racial/ethnic minority composition. MethodsPooled cross-sectional analysis (2007–2018) of 6467 U.S. hospitals from the American Hospital Association’s Annual Survey, comparing hospital population characteristics of closed hospitals to all remaining open hospitals. We used multilevel mixed-effects logistic regression models to assess closure as a function of population characteristics, including area deprivation index ([ADI], a composite measure of socioeconomic disadvantage), racial/ethnic composition, and rural classification, nesting hospitals within hospital service areas (HSAs) and hospital referral regions. Secondary analyses examined public or private hospital type. ResultsOverall, 326 (5.0%) of 6467 U.S. hospitals closed during the study period. In multivariable models, hospitals in HSAs with a higher burden of socioeconomic disadvantage (per 10% above median ADI ZIP codes, AOR 1.05; 95% CI, 1.01–1.09) and Black Non-Hispanic composition (highest quartile, AOR 4.03; 95% CI, 2.62–6.21) had higher odds of closure. We did not observe disparities in closure by Hispanic/Latino composition or rurality. Disparities persisted for Black Non-Hispanic communities, even among HSAs with the lowest burden of disadvantage. ConclusionsDisproportionate hospital closure in communities with higher socioeconomic disadvantage and Black racial composition raises concerns about unequal loss of healthcare resources in the U.S.