scholarly journals COVID-19 vaccine intentions and uptake in a tertiary care healthcare system: A longitudinal study

2021 ◽  
pp. 1-19
Author(s):  
Charlesnika T. Evans ◽  
Benjamin J. DeYoung ◽  
Elizabeth L. Gray ◽  
Amisha Wallia ◽  
Joyce Ho ◽  
...  
Keyword(s):  
Healthcare System ◽  
Tertiary Care ◽  
The Public ◽  
Factors Associated ◽  
Chicago Area ◽  
Clinical Procedures ◽  
System A ◽  
Serology Test ◽  
Vaccine Mandates

Abstract Objective Healthcare workers (HCWs) are a high priority group for COVID-19 vaccination and serve as sources for information for the public. This analysis assessed vaccine intentions, factors associated with intentions, and change in uptake over time in HCWs. Methods A prospective cohort study of COVID-19 seroprevalence was conducted with HCWs in a large healthcare system in the Chicago area. Participants completed surveys (November 25, 2020-January 9, 2021 and April 24-July 12, 2021) on COVID-19 exposures, diagnosis and symptoms, demographics, and vaccination status. Results Of 4,180 HCWs who responded to a survey, 77.1% indicated they intended to get the vaccine; in this group, 23.2% had already received at least one dose of the vaccine (23.2%), 17.4% were unsure, and 5.5% reported that they would not get the vaccine. Factors associated with intention or vaccination were being exposed to clinical procedures (vs no procedures) and having a negative serology test for COVID-19 (vs no test) (adjusted odds ratio (AOR)=1.39, 95% Confidence Interval (CI) 1.16-1.65, AOR=1.46, 95% CI 1.24-1.73, respectively). Nurses (vs physicians, AOR=0.24 95% CI 0.17-0.33), non-Hispanic Black (vs Asians, AOR=0.35, 95% CI 0.21-0.59), and women (vs men, AOR=0.38, 95% CI 0.30-0.50) had lower odds of intention to get vaccinated. By 6-months follow-up, over 90% of those who had previously been unsure were vaccinated, while 59.7% of those who previously reported no intention of getting vaccinated, were vaccinated. Conclusions COVID-19 vaccination in HCWs was high, but variability in vaccination intention exists. Targeted messaging coupled with vaccine mandates can support uptake.

scholarly journals PRS67 REAL WORLD TREATMENT PATTERNS OF COPD IN THE PUBLIC BRAZILIAN HEALTHCARE SYSTEM: A TREND ANALYSIS FROM 2010-2017

2019 ◽  
Vol 22 ◽  
pp. S362 ◽  
Author(s):  
G. Julian ◽  
C.R. Pinto ◽  
A. Izelli ◽  
A.C.M. Lemos ◽  
L. Assunção Costa ◽  
...  
Keyword(s):  
Trend Analysis ◽  
Healthcare System ◽  
Real World ◽  
Treatment Patterns ◽  
The Public ◽  
System A

Factors Associated With Outpatient Colonoscopy Appointment Non-Adherence at a Safety-Net Healthcare System: A Retrospective Review

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S611-S612
Author(s):  
Tarek I. Eid ◽  
Cris Jacob R. Molina ◽  
Victor Arce ◽  
Derek Murray ◽  
Paul Kang ◽  
...  
Keyword(s):  
Healthcare System ◽  
Retrospective Review ◽  
Safety Net ◽  
Factors Associated ◽  
System A

scholarly journals Performance Through Efficiency in the Public Healthcare System – A DEA Approach in an Emergent Country

2017 ◽  
Vol 62 (1) ◽  
pp. 31-49 ◽  
Author(s):  
Cristina Silvia Nistor ◽  
Cristina Alexandrina Ștefănescu ◽  
Andrei-Răzvan Crișan
Keyword(s):  
Data Envelopment Analysis ◽  
Public Sector ◽  
Healthcare System ◽  
Emerging Countries ◽  
Public Healthcare ◽  
Data Envelopment ◽  
Tobit Regression ◽  
The Public ◽  
System A ◽  
Analysis Technique

AbstractAiming to analyze the efficiency of the public sector, this paper enriches the literature by providing insights of the healthcare system for an emergent country - Romania. The empirical findings reached by applying the input orientated-variable return to scale (VRS) model of Data Envelopment Analysis (DEA) and Tobit regression method are determined on two key levels of the study. The Data Envelopment Analysis technique quantifies the efficiency within 20 representative hospitals located in the four administrative macro-regions, highlighting the ways of increasing efficiency, while the Tobit regression identifies the factors that influence the efficiency level. The results of the investigation allow for comparisons with other emerging countries, as efficiency has become an increasingly significant factor for public sector evolution.

scholarly journals Economic evaluation of the new oral anticoagulants for the prevention of thromboembolic events: a cost-minimization analysis

2016 ◽  
Vol 134 (4) ◽  
pp. 322-329 ◽  
Author(s):  
Milena Soriano Marcolino ◽  
Carisi Anne Polanczyk ◽  
Ana Carolina Caixeta Bovendorp ◽  
Naiara Silveira Marques ◽  
Lilian Azevedo da Silva ◽  
...  
Keyword(s):  
Healthcare System ◽  
Cost Minimization ◽  
Oral Anticoagulants ◽  
New Oral Anticoagulants ◽  
Public Healthcare ◽  
Thromboembolic Events ◽  
Public Healthcare System ◽  
The Public ◽  
Cost Minimization Analysis

ABSTRACT CONTEXT AND OBJECTIVE: Randomized clinical trials have shown that the new oral anticoagulants have at least similar impact regarding reduction of thromboembolic events, compared with warfarin, with similar or improved safety profiles. There is little data on real costs within clinical practice. Our aim here was to perform economic analysis on these strategies from the perspective of Brazilian society and the public healthcare system. DESIGN AND SETTING: Cost-minimization analysis; anticoagulation clinic of Hospital Municipal Odilon Behrens, Belo Horizonte, MG, Brazil. METHODS: Patients at the anticoagulation clinic were recruited between August and October 2011, with minimum follow-up of four weeks. Operational and non-operational costs were calculated and corrected to 2015. RESULTS: This study included 633 patients (59% women) of median age 62 years (interquartile range 49-73). The mean length of follow-up was 64 ± 28 days. The average cost per patient per month was $ 54.26 (US dollars). Direct costs accounted for 32.5% of the total cost. Of these, 69.5% were related to healthcare professionals. With regards to indirect costs, 52.4% were related to absence from work and 47.6% to transportation. Apixaban, dabigatran and rivaroxaban were being sold to Brazilian public institutions, on average, for $ 49.87, $ 51.40 and $ 52.16 per patient per month, respectively, which was lower than the costs relating to warfarin treatment. CONCLUSION: In the Brazilian context, from the perspective of society and the public healthcare system, the cumulative costs per patient using warfarin with follow-up in anticoagulation clinics is currently higher than the strategy of prescribing the new oral anticoagulants.

scholarly journals Epidemiological factors associated with Toxoplasma gondii infection in postpartum women treated in the public healthcare system of Goiânia, State of Goiás, Brazil

2018 ◽  
Vol 51 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Juliana Boaventura Avelar ◽  
Marcos Gontijo da Silva ◽  
Hanstter Hallison Alves Rezende ◽  
Heloisa Ribeiro Storchilo ◽  
Waldemar Naves do Amaral ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Healthcare System ◽  
Public Healthcare ◽  
Postpartum Women ◽  
Public Healthcare System ◽  
The Public ◽  
Factors Associated ◽  
Epidemiological Factors ◽  
Toxoplasma Gondii Infection

Factors Associated with Reoperation after Pyrocarbon Proximal Interphalangeal Joint Arthroplasty for the Arthritic Joint: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Bo J. W. Notermans ◽  
Jonathan Lans ◽  
Ryan P. Ponton ◽  
Jesse B. Jupiter ◽  
Neal C. Chen
Keyword(s):  
Reoperation Rate ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Factors Associated ◽  
System A ◽  
Initial Surgery ◽  
Younger Age ◽  
Pip Joint ◽  
Amount Of Knowledge

Abstract Introduction The rate of reoperation after pyrocarbon proximal interphalangeal (PIP) joint arthroplasty ranges from 5.9 to 37% and complications such as radiographic loosening, deformity, dislocation, and stiffness are common. Because of the limited amount of knowledge around these problems, we evaluated factors associated with reoperation after pyrocarbon PIP arthroplasty. Materials and Methods We retrospectively included all adult patients that underwent primary PIP pyrocarbon implant arthroplasty between 2002 and 2016 at one institutional system. A total of 45 patients, with a mean age of 55 (standard deviation: 14), underwent 66 PIP arthroplasties. To address for within individual correlations, we only included fingers treated at patients’ initial surgery (n = 54) in our statistical analysis. These patients were predominantly diagnosed with noninflammatory arthritis 73% (n = 33). Arthroplasty was performed upon 10 index, 22 middle, 20 ring, and 2 small fingers. Results The reoperation rate after pyrocarbon PIP arthroplasty was 30% over a median follow-up of 25 months (interquartile range: 8.7–54). Indications for reoperation consisted of subluxation (n = 6), stiffness (n = 5), swan-neck deformity (n = 3), and soft tissue complications (n = 2). Younger age (p = 0.025), male sex (p = 0.017), and noninflammatory arthritis (p = 0.038) were associated with a higher reoperation rate. Conclusion In this study, our reoperation rate after pyrocarbon PIP arthroplasty was 30%. This study suggested that younger patients, males, and patients with noninflammatory arthritis are at higher risk of reoperation. We recommend considering these factors when selecting candidates for pyrocarbon arthroplasty. Future studies should focus on prospectively researching these factors in comparison with other implants.

Congressional Recruitment and Representation

1966 ◽  
Vol 60 (3) ◽  
pp. 627-639 ◽  
Author(s):  
Leo M. Snowiss
Keyword(s):  
United States ◽  
House Of Representatives ◽  
Public Life ◽  
The United States ◽  
Political Organization ◽  
The Public ◽  
Factors Associated ◽  
Chicago Area ◽  
The Relationship

This is a study of the relationship between local political organization, candidate recruitment, and representation in the United States House of Representatives. It seeks to ascertain the effects which different systems of recruitment have upon the kinds of men who enter public life and the public policies they espouse. A case study of metropolitan Chicago is used to demonstrate the utility of this kind of analysis. The objective is to distinguish distinct systems of recruitment in the Chicago area, describe the factors associated with each, and note the consequences of each for representation in Congress.

scholarly journals The treatment gap for mental disorders in adults enrolled in HIV treatment programs in South Africa: A cohort study using linked electronic health records

2020 ◽  
Author(s):  
Yann Ruffieux ◽  
Orestis Efthimiou ◽  
Leigh L Van den Heuvel ◽  
John A Joska ◽  
Morna Cornell ◽  
...  
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Mental Disorders ◽  
Tertiary Care ◽  
Treatment Gap ◽  
Art Programs ◽  
Private Care ◽  
The Public ◽  
Factors Associated ◽  
Art Program

Background: Mental disorders are common in people living with HIV (PLWH) but often remain untreated. We aimed to explore the gap in access to treatment (treatment gap) for mental disorders in adults followed-up in antiretroviral therapy (ART) programs in South Africa and disparities in access to mental health services. Methods: We conducted a cohort study using ART program data and linked pharmacy and hospitalization data to estimate the 12-month prevalence of treatment for mental disorders (pharmacological or inpatient) and to examine factors associated with the rate of treatment for mental disorders among adults, aged 15-49 years, followed-up from January 1, 2012 to December 31, 2017 at one private care, two pubic primary care, and one public tertiary care ART programs in South Africa. We calculated the treatment gap for mental disorders as the discrepancy between the 12-month prevalence of mental disorders in PLWH (aged 15-49 years) in South Africa (estimated based on data from the Global Burden of Disease study) and the 12-month prevalence of treatment for mental disorders in ART programs. We calculated adjusted rate ratios (aRR) for factors associated with the rate of treatment of mental disorders using Poisson regression. Results: 182,285 ART patients were followed-up over 405,153 person-years. In 2017, the estimated treatment gap for mental disorders was 40.5% (95% CI 19.5%-52.9%) for patients followed-up in private care, 96.5% (95% CI 95.0%-97.5%) for patients followed-up in public primary care, and 65.0% (95% CI 36.5%-85.1%) for patients followed-up in public tertiary-care ART programs. Rates of treatment with antidepressants, anxiolytics and antipsychotics were 17 (aRR 0.06, 95% CI 0.06-0.07), 50 (aRR 0.02 95% CI 0.01-0.03), and 2.6 (aRR 0.39, 95% CI 0.35-0.43) times lower in public primary-care programs than in the private-sector ART program. Interpretation: There is a large treatment gap for mental disorders in PLWH in South Africa and substantial disparities in access to mental health service between patients receiving ART in the public vs. the private sector. In the public sector and especially in public primary care, PLWH with common mental disorders remain largely untreated.

scholarly journals Searching for underlying social determinants of health for thirty-day hospital readmissions

2019 ◽  
Vol 8 (6) ◽  
pp. 24
Author(s):  
Matthew Wilson ◽  
Kathleen Savoy ◽  
Jeff Dubin ◽  
Edward Floyd ◽  
Matthew Paik ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Determinants Of Health ◽  
Primary Care Doctor ◽  
Care Hospital ◽  
Factors Associated

Objective: An evaluation of social factors associated with 30-day readmission was undertaken at our institution to determine which factors would be significantly associated with time to hospital readmission.Methods: Prospective observational study at an academic tertiary care hospital in the mid-Atlantic region of patients who were readmitted within 30 days of their last inpatient discharge. The electronic health record in conjunction with the regional hospital information system was used to generate a daily report to identify a convenience sample of readmitted patients. Using a standardized interview, data on 117 patients were collected for an exploratory analysis of social factors associated with readmission.Results: Regression modeling demonstrated poor correlation with prediction of time to readmission (R-squared = 0.2189). No individual social variables were found to be significant for influencing time to readmission (all p-values > .05). Common social factors were seen within the population affecting their utilization and access of healthcare. Poly-pharmacy was found in the majority of patients. Self-reported medication adherence was good, except with regards to mental health medication compliance. 97% of patients reported filling their prescriptions. 36% of the patients went to their follow-up appointment within 7 days although the vast majority of patients (92%) reported having a primary care doctor. 23% of patients expressed difficulty getting to their follow up appointments.Conclusions: At one single-center tertiary care hospital, there were some common underlying social determinants of health that may be related to readmission; however, no factors in isolation were predictive of hospital readmission. While there are common themes among readmitted populations, particularly in regard to factors driven by poverty, it is likely that the complex interaction of social factors with health continues to limit attempted administrative modeling of these data.

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