scholarly journals Regional disparities in access to assisted reproductive technology: assessment of patient satisfaction when employing modern technology to close the gap

Author(s):  
Sasha Mikhael ◽  
Anna Gaidis ◽  
Larisa Gavrilova-Jordan

Abstract Purpose Geographic disparities for assisted reproductive technology (ART) continue to exist. Travel cost and time off work may create additional barriers for patients living remotely. Implementing telehealth can alleviate these barriers by reducing office visits. The aim of this study was to evaluate patient satisfaction with telehealth during ART. Methods This was a cross-sectional survey and retrospective cohort study. Patients living remotely who underwent ART utilizing telehealth between 2015 and 2018 at a single institution were selected for the telehealth group. The non-telehealth control group included randomly selected patients who underwent IVF at the same institution between 2015 and 2018. Demographic variables and treatment outcomes were obtained for both groups. A patient satisfaction questionnaire was distributed to telehealth patients. Statistical analysis using χ2 test was performed to compare ART outcomes between both groups. Results Ninety-seven control and 97 telehealth patients were included. For telehealth patients, the mean number of office visits and distance traveled was 2.9 (± 0.8 SD) and 143.1 miles (± 49.2 SD) respectively. 58.8% of patients completed the survey. 44/57 participants had an oocyte retrieval and 42/44 underwent embryo transfer. For those who completed the survey, the clinical pregnancy rate was 31/44 and the live birth rate was 25/44. There was no difference in treatment outcomes between telehealth compared to controls. 73% of patients were highly satisfied with telehealth. Conclusions Telehealth can improve access to ART in underserved areas and results in high patient satisfaction. Reproductive health providers could consider telehealth as a safe and efficacious tool to ameliorate geographic disparities.

2010 ◽  
Vol 16 (2) ◽  
pp. 4 ◽  
Author(s):  
Bawo Onesirosan James ◽  
Joyce Ohiole Omoaregba ◽  
George Eze ◽  
Olufemi Morakinyo

<p><strong>Objectives.</strong> Depression is associated with diabetes mellitus and affects treatment goals negatively. We aimed to determine the prevalence of depression and identify its socio-demographic or clinical correlates among patients with diabetes mellitus attending an out-patient clinic in Nigeria.</p><p><strong>Methods.</strong> Two hundred consecutively recruited diabetes patients (index group) were compared with a similar number of apparently healthy controls in a cross-sectional survey. In both groups, in addition to obtaining socio-demographic details, depression was diagnosed using the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN), while the Beck Depression Inventory (BDI) was used to assess depression symptom severity. <strong></strong></p><p><strong>Results.</strong> Sixty (30%) diabetes patients met a SCAN diagnosis for clinical depression, compared with 19 (9.5%) in the control group. Having a smaller income and more children were significantly correlated with higher depression symptoms on the BDI.</p><p><strong>Conclusion.</strong> Depression is highly co-morbid with diabetes mellitus. The care of individuals with diabetes mellitus should include the screening and possible treatment for depression in order to achieve and sustain treatment goals.</p>


Author(s):  
Cokorda Istri Ariwidyastuti ◽  
P.P. Januraga ◽  
Dyah Pradnyaparamita Duarsa

Background and purpose: Patient satisfaction, including on radiography services, is an important component of health care provision. Surveys on patient satisfaction have been carried out particularly in government hospitals, but a more detailed study to determine the relationship between patient satisfaction with the responsiveness of service providers has yet to be carried out. This study aims to determine the relationship between the six domains of responsiveness of service providers and outpatient satisfaction at three conventional radiography facilities in Denpasar.Methods: Study was conducted by cross-sectional survey of 158 respondents selected consecutively in three conventional radiography services, namely a government hospital, a private hospital and a private radiology clinic. Data were collected through interviews using modified questionnaires on responsiveness from WHO. Data were analyzed by univariate, bivariate (chi-square test) and multivariate logistic regression method.Results: Univariate analysis indicated that patient satisfaction was 69% but still below the minimum service standards (>80,0%). Multivariate analysis showed that factors associated with satisfaction were the domain of attention (AOR= 3.77; 95%CI: 1.62-8.76), the quality of infrastructure (AOR=4.57; 95%CI: 1.61-12.93) and communication (AOR=6.30; 95%CI: 1.75-22.64).Conclusion: Patient satisfaction was generally still below the standard. Domains of responsiveness associated with patient satisfaction were the quality of infrastructure, level of attention and communication skills of service providers.


SAGE Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. 215824401880458
Author(s):  
Robert Kaba Alhassan ◽  
Bismark Appiah Adu-Gyamfi ◽  
Agbolosu Oliver ◽  
Bright Ayensu ◽  
Gbekor Awoenam ◽  
...  

Abuse of injections, particularly in resource poor countries, remains a challenge evident in the increasing preference for therapeutic injections over oral medication. Objective of this study is to explore factors associated with patients’ preference for therapeutic injection over oral medication in the Volta Regional Hospital, Ho in Ghana. The study is a cross-sectional survey conducted among 200 patients accessing care in Volta Regional Hospital. Data were analyzed using STATA statistical software for data analysis. Univariate probit regression was used to ascertain factors associated with patients’ preference for therapeutic injections over oral medication (main outcome variable of interest). It was found that 74% of the 200 respondents preferred injection to oral medication. More outpatients preferred injectable medication over oral ( p = .041); 86% of the respondents said they never experienced complication related to injectable medication. Patients who perceived injection as more efficacious were more likely to opt for it over oral medication (coefficient = 2.22; SE = 0.33; p < .05). It is concluded that patients’ preference for injectable medication over oral remains high in Ghana, and this preference is significantly associated with patients’ perceptions on superiority of injections over oral medication. There is the need to intensify health education for clients and in-service trainings for health providers to control abuse of therapeutic injections and promote patient safety.


2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Jing Zhao ◽  
Bin Xu ◽  
Xi Huang ◽  
Yi Yan ◽  
Yanping Li

Abstract Background Letrozole can significantly decrease the estrogen level, and has been administrated to prevent the incidence of early ovary hyperstimulation syndrome (OHSS). However, the effect of Letrozole on prevention of OHSS reached to controversial conclusions. The present meta-analysis aim to examine whether Letrozole could reduce the incidence of early OHSS after assisted reproductive technology (ART). Methods An exhaustive electronic literature search was conducted on MEDLINE, Google Scholar, CNKI and WANFANG MED ONLINE, from inception until May 2018. We include clinical trials that examined the effect of Letrozole on the prevention of early OHSS. The main outcome measures were the incidence of total early OHSS, mild early OHSS, moderate early OHSS, and severe early OHSS. Results Eight studies included in the review. Of these, five publications evaluated the effect of Letrozolel on the prevention of total, mild, moderate, and severe OHSS, respectively. The results indicated that there was a significantly decreased incidence of total OHSS with Letrozole compared with control group, and there were no significantly differences in the incidence of mild, moderate, and severe OHSS between study group with Letrozole and control group. Eight studies reported the incidence of moderate + severe OHSS. We found a significant decrease in incidence of moderate + severe OHSS in high-risk women with Letrozole. Conclusions Letrozole has no beneficial effect on the prevention of mild, moderate, and severe OHSS, individually; Letrozole should not be considered as the first-line treatment for prevention of OHSS. Further cohort studies are required to explore the effect of Letrozole on the prevention of OHSS. Plain English Summary This study aimed to examine whether Letrozole could reduce the incidence of early OHSS after assisted reproductive technology (ART). A meta-analysis including 8 studies was conducted. There were no significantly differences in the incidence of mild, moderate, and severe OHSS between study group with Letrozole and control group. Letrozole has no beneficial effect on the prevention of mild, moderate, and severe OHSS, individually.


2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii73-iii73
Author(s):  
A Z Fu ◽  
J P Hall ◽  
A Bailey ◽  
J Kemp ◽  
G J Thompson ◽  
...  

Abstract INTRODUCTION This study evaluated the relationship of MGMT status with first-line (1L) treatment outcomes of patients with newly-diagnosed GBM in France, Germany, Italy, Spain, the UK (EU5), and Canada. MATERIALS AND METHODS Medical oncologists and neuro-oncologists across EU5 and Canada completed a point in time, cross-sectional survey for the next 8 GBM patients seen between May and July 2016 within EU5 and Canada. All results apart from time to progression (TTP) were presented for patients receiving 1L active drug treatment. TTP was calculated from initiation of 1L treatment to initiation of second-line treatment. Results presented are statistically significant (p<0.05) unless otherwise specified. Bases vary depending on data availability. RESULTS A total of 241 physicians reported on 1747 patients with GBM. 875 were receiving 1L active drug treatment at time of survey. Mean age was 59.7 years (median=61) and 34.6% were women. Mean life expectancy was 14.9 months (median=12) at diagnosis and mean TTP was 8.5 months (median=7.3). Surgery was performed in 62% of patients (n=546) prior to 1L drug treatment; 38% of patients (n=329) had no surgery. Patients with surgery had a higher life expectancy at diagnosis vs patients with no surgery prior to 1L (mean=16.4 vs 12.2 months; median=15.0 vs 12.0). Patients who received corticosteroids (n=524) vs no corticosteroids during radiotherapy (n=64) had a shorter life expectancy at diagnosis (mean=15.0 vs 16.8 months, p=0.07; median=12.5 vs 13.9) and were more likely to have 8 or more inpatient days due to GBM (21% vs 8%, p=0.07) in the last 3 months prior to the survey. 62% of patients (n=541) had an MGMT-status recorded (tested: methylated or unmethylated), and 38% (n=334) were untested/ awaiting results (untested) at 1L. MGMT-tested patients had better life expectancy at diagnosis (mean=16.1 vs 12.9 months; median=15.0 vs 12.0) and longer TTP (mean=8.9 vs 7.8 months; median=7.8 vs 6.4) than untested patients. Among MGMT-tested patients, 58% were methylated and 42% were unmethylated. Methylated patients had similar life expectancy at diagnosis (mean=15.9 vs 16.3 months, p=0.85; median=15.0 vs 15.0) and TTP (mean=9.0 vs 8.8 months, p=0.42; median=8.0 vs 7.5) as unmethylated patients. CONCLUSIONS This analysis provides valuable insights into the 1L treatment outcomes of GBM patients in EU5 and Canada. Patients who did not undergo surgery had worse treatment outcomes. Steroid use appears to be associated with worse outcomes and higher healthcare resource utilization. Patient treatment outcomes varied depending on whether they are MGMT tested.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Haoran Zhang ◽  
Zhimin Liu

The study was to survey and assess the drug dependence and abuse potential of tramadol with no history of substance abuse. Subjects of tramadol dependence with no prior history of substance abuse were surveyed by interview. Physical dependence of tramadol was assessed using 10 items opiate withdrawal scale (OWS), and psychological dependence was assessed by Addiction Research Center Inventory—Chinese Version (ARCI-CV). Twenty-three male subjects (the median age was23.4±4.1years) referred to the addiction unit in Medical Hospital of Guangzhou with tramadol abuse problems were included in this cross-sectional study. The control group included 87 heroin addicts, 60 methamphetamine (MA) abusers, and 50 healthy men. The scores of OWS of tramadol were 0.83–2.30; the mean scores of identifying euphoric effects–MBG, sedative effects–PCAG, and psychotomimetic effects–LSD of ARCI were8.96±3.08,6.52±3.25, and6.65±2.50, respectively,F= 4.927,P<0.001. Scores of MBG scale in tramadol did not differ from those in heroin and MA groups (P>0.05) but were higher than those in healthy men (P<0.05). Tramadol with no history of substance abuse has a clear risk of producing high abuse potential under the long-term infrequent abuse and the high doses.


2008 ◽  
Vol 29 (3) ◽  
pp. 275-278 ◽  
Author(s):  
Leanne B. Gasink ◽  
Karyn Singer ◽  
Neil O. Fishman ◽  
William C. Holmes ◽  
Mark G. Weiner ◽  
...  

The effects of contact isolation on patient satisfaction are unknown. We performed a cross-sectional survey and found that most patients lack education and knowledge regarding isolation but feel that it improves their care. In multivariable analysis, isolated patients were not less satisfied with inpatient care than were nonisolated patients.


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