scholarly journals P553 Factors related to steroid consumption in IBD patients: Evidence from a multicenter Study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S519-S520
Author(s):  
R Barkan ◽  
L Shpoker ◽  
R Abboud ◽  
S Nafrin ◽  
M Ganon ◽  
...  
Keyword(s):  
Side Effects ◽  
Assessment Tool ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Cross Sectional Study ◽  
Systemic Steroid ◽  
Cross Sectional ◽  
Systemic Steroids ◽  
Medical Centers ◽  
Systemic Steroid Therapy

Abstract Background Steroids are frequently used to induce remission in inflammatory bowel disease (IBD) but should not be used as maintenance treatment. Understanding the factors related to steroid consumption is essential in order to avoid over prescription of these drugs. Methods A cross-sectional study was conducted between 2019 and 2020 in six medical centers in Israel. Data was collected using a structured self-administered tool containing the following: socio demographic and clinical characteristics, knowledge of side effects and complications of steroid treatment, self-care and compliance with medical instructions, Steroid Assessment Tool (SAT) and objective physiological measures. Results The study included 402 IBD patients; 262 patients with Crohn’s disease (CD) (66%) and 135 patients with ulcerative colitis (UC) (34%). Most of the patients reported being monitored in the IBD unit in the medical centers (87.7%). A quarter of the patients (n=88) had been prescribed systemic steroids over the previous year, and 20 (23%) received 3 or more prescriptions for systemic steroids over the preceding year. Likewise, over 20% of patients were on systemic steroid therapy for over 4 months in the preceding year. Those patients were mostly men and ultra-orthodox. Patients with UC were prescribed steroids more often than CD patients. Knowledge levels regarding appropriate steroid consumption were significantly higher among women (F=40.24, p<.001) and lower among ultra-orthodox patients (X2=6.43, p<.05). Although most of the patients (85.9%) were routinely treated by gastroenterologist, the majority (80%) choose to visit the general practitioner when their disease had flared up. Conclusion Several factors were found to be related to inappropriateness use of steroids in IBD patients. Thus, tailored intervention for specific population should be developed to ensure that steroids are used correctly and that their side effects are minimized. Also, infrastructure and alignment of an integrated health care delivery system, with multidisciplinary team may provide the optimal environment for care coordination, especially during disease flare.

scholarly journals Physicians' Attitudes toward Unnecessary Tests and Processes in the Health Care Delivery System; a Cross-Sectional Study

2021 ◽  
Vol 6 (2) ◽  
pp. 115-124
Author(s):  
Fatemeh Farhadi ◽  
Rahim Khodayari ◽  
Zahra Mobarak ◽  
Morteza Arab-Zozani ◽  
◽  
...  
Keyword(s):  
Health Care ◽  
Delivery System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
System A

scholarly journals Patterns of antenatal care services utilization in rural Amroha, Uttar Pradesh: a community based cross sectional study

2019 ◽  
Vol 6 (9) ◽  
pp. 4048
Author(s):  
Bhaskar K. Watode ◽  
Anurag Srivastava ◽  
Rajeev Kumar
Keyword(s):  
Antenatal Care ◽  
Care Delivery ◽  
Economic Status ◽  
Uttar Pradesh ◽  
Health Care Delivery System ◽  
Cross Sectional Study ◽  
Family Type ◽  
World Health ◽  
Cross Sectional ◽  
Maternal Deaths

Background: Antenatal care (ANC) services are considered to be the crucial element in the primary health care delivery system of a country. World Health Organization (WHO) estimates suggested that almost all of the maternal deaths (99%) and child deaths (98%) occurred in developing countries. These maternal deaths could have been prevented if the pregnant women or adolescent girls had been able to access quality antenatal care. The objectives of the present study were conducted in rural parts of district Amroha, Uttar Pradesh for assessing the patterns of utilization of the ANC services and to ascertain the factors influencing utilization of ANC services.Methods: The present study was a cross sectional in nature. Recently delivered women were selected as study subject. A multi-stage stratified sampling design with random approaches had been used. Total 360 subjects included in the study.Results: Respondents age, education, occupation, socio economic status, family type and family size were the factors that influenced the utilization of the ANC services. With 100% ANC registration, sub centre was the most preferred place for registration. 76.9% of woman received more than 3 ANC visits. 315 (87.5%) and (71.9%) respondents received 2 doses to TT vaccine and more than 100 IFA tablets respectively.Conclusions: Utilization of ANC services are on rise in rural parts of Amroha, Uttar Pradesh. Still significant proportions of women are doesn’t return to health facility after the ANC registration. Intensification of efforts is needed to cater this left out group through improving community awareness and motivation.

scholarly journals Evaluating capacity at three government referral hospital emergency units in the Kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool

2020 ◽  
Author(s):  
Jennifer Pigoga ◽  
Anjni Patel Joiner ◽  
Phindile Chowa ◽  
Jennifer Luong ◽  
Masitsela Mhlanga ◽  
...  
Keyword(s):  
Emergency Care ◽  
Assessment Tool ◽  
Care Delivery ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Emergency Unit ◽  
Hospital Emergency ◽  
Cross Sectional ◽  
Middle Income ◽  
Entry Points

Abstract Background The Kingdom of Eswatini, a lower-middle income nation of 1.45 million in southern Africa, has recently identified emergency care as a key strategy to respond to the national disease burden. We aimed to evaluate the current capacity of hospital emergency care areas using the WHO Hospital Emergency Unit Assessment Tool (HEAT) at government referral hospitals in Eswatini. Methods We conducted a cross-sectional study of three government referral hospital emergency care areas using HEAT in May 2018. This standardised tool assists healthcare facilities to assess the emergency care delivery capacity in facilities and support in identifying gaps and targeting interventions to strengthen care delivery within emergency care areas. Senior-level emergency care area employees, including senior medical officers and nurse matrons, were interviewed using the HEAT. Results All sites provided some level of emergency care 24 hours a day, seven days a week, though most had multiple entry points for emergency care. Only one facility had a dedicated area for receiving emergencies and a dedicated resuscitation area; two had triage areas. Facilities had limited capacity to perform signal functions (life-saving procedures that require both skills and resources). Commonly reported barriers included training deficits and lack of access to supplies, medications, and equipment. Sites also lacked formal clinical management and process protocols (such as triage and clinical protocols). Conclusions The HEAT highlighted strengths and weaknesses of emergency care delivery within hospitals in Eswatini and identified specific causes of these system and service gaps. In order to improve emergency care outcomes, multiple interventions are needed, including training opportunities, improvement in supply chains, and implementation of clinical and process protocols for emergency care areas. We hope that these findings will allow hospital administrators and planners to develop effective change management plans.

scholarly journals Socio-demographic Characteristics of Depressive Illness Patients Attending a Selected Military Hospital

2020 ◽  
Vol 15 (2) ◽  
pp. 178-180
Author(s):  
Md Abdul Hamid ◽  
Md Mahbubur Rahman ◽  
Md Rafiqul Islam ◽  
Sheikh Shahidul Islam
Keyword(s):  
Gender Difference ◽  
Care Delivery ◽  
Public Health Problem ◽  
Health Care Delivery System ◽  
Cross Sectional Study ◽  
Depressive Illness ◽  
Child Rearing ◽  
Military Hospital ◽  
Important Public Health Problem ◽  
Cross Sectional

Introduction:Depressive illness is generally not perceived as an important public health problem and is not priority in health care delivery system in Bangladesh. It is the leading cause of disease-related disability in the country today. Gender differences in depression are likely to be result of certain risk factors. Objectives: To find out gender difference in epidemiological and socio-demographic features associated with depressive illness. Materials and Methods: This descriptive cross sectional study was carried out among 91 diagnosed depressive patients attending in the psychiatry department of CMH Dhaka from January to December 2014. The patients were interviewed through an interviewer-administered questionnaire. Data were analyzed by using SPSS version 20.  Chi-square test was used to see the level of significance. Results: In this study the mean age of the patients was 34.47±9.577 years. The study revealed that depressive illness appears to be  more in female during child bearing and child rearing period of 16-39 years and male of 40-63 years were more sufferer than female which was significantly different (p<0.05). In this study 63.74% of patients were female and 36.26% were male with ratio of 1.757:1. It was observed that the association of depression with residence in urban area in female (72.1%) was significantly (p<0.05) higher than male (27.9%) in the same area. This study revealed that the association of depression with history of financial hardship in female was statistically significant (p<0.05) over their male counter-part.The study also revealed that strenuous job was significantly (p<0.05) associated with depression in female than male. Conclusion:  The overall finding of the study indicates that possibility of gender difference in certain epidemiological and sociodemographic features of depressive illness is significantly present. As depressive illness has significant impact on burden of disease and quality of life, this issue needs to be addressed. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 178-180

scholarly journals Assessment of Oral Health Care Delivery System in Greater Noida Using Five A’s Model

2019 ◽  
Vol 3 (9) ◽  
pp. 303-313
Author(s):  
Insha Nissar ◽  
Bhuvandeep Gupta ◽  
Priyanka Kotia ◽  
Kirti Raina ◽  
Akansha Monga
Keyword(s):  
Family Income ◽  
Care Delivery ◽  
Dental Health ◽  
Health Care Delivery System ◽  
Cross Sectional Study ◽  
Dental Services ◽  
Cross Sectional ◽  
Services Utilization ◽  
Care Services ◽  
Study Population

BACKGROUND: Access to dental health services refers not only to utilization but also to the extent by which the utilization is judged as per the professional norms using five independent dimensions of accessibility, availability, accommodation, affordability and acceptability. AIM: The aim of the study is to assess the dental services utilization among population of Greater Noida using Five A’s model. MATERIALS AND METHOD: The study was conducted in Dental College in Greater Noida. This cross-sectional study was carried out on the 200 subjects using convenient sampling on the patients visiting dental OPD.A self-administered structured questionnaire in English and Hindi language was used. Data was entered in the Microsoft excel sheet and analysed using SPSS (version 20.0).RESULTS: Mean level of access to dental services in the study population was 60.3.Corresponding figures for affordability, availability, accessibility, accommodation and acceptability were 55.2 ± 12.1,57.1± 12.8,60.75 ± 14.7,61.75 ± 8.7,58.65± 11.4 respectively.CONCLUSION: According to the results of our study , the level of access to dental care services is not very good with family income, location and level of education being the determinants of this access.

scholarly journals Experiences of Patient-Centered Care Among Japanese and Australian Cancer Outpatients: Results of a Cross-Sectional Study

2021 ◽  
Vol 8 ◽  
pp. 237437352110076
Author(s):  
Mariko L Carey ◽  
Megumi Uchida ◽  
Alison C Zucca ◽  
Toru Okuyama ◽  
Tatsuo Akechi ◽  
...  
Keyword(s):  
Side Effects ◽  
Care Delivery ◽  
International Comparisons ◽  
Patient Centered Care ◽  
Cross Sectional Study ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care ◽  
Improvement Interventions ◽  
Quality Improvement Interventions

There have been few international comparisons of patient-centered cancer care delivery. This study aimed to compare the experiences of patient-centered care (PCC) of Japanese and Australian radiation oncology patients. Participants were adults with cancer attending a radiotherapy appointment at a Japanese or Australian clinic. Participants completed a survey asking about 10 indicators of PCC. Overall, 259 Japanese and 285 Australian patients participated. Compared with Japanese participants, Australian participants were significantly more likely to report receiving information about: what the treatment is, and the short-term and long-term side effects of treatment. A higher proportion of Australian participants reported being asked whether they wanted a friend or family member present at the consultation. There were no differences in the frequency with which Japanese and Australian participants were asked by their clinicians about whether they were experiencing physical side effects or emotional distress. International differences highlight the (1) need to exercise caution when generalizing from one country to another; and (2) the importance of context in understanding PCC delivery and the subsequent design of quality improvement interventions.

scholarly journals Teachers’ view about feminization of Medical Education in Bangladesh

2021 ◽  
Vol 12 (2) ◽  
pp. 4-9
Author(s):  
Muqbula Tasrin Aktar ◽  
Fuad Reajwan Kabir ◽  
M Kumrul Hasan ◽  
Md Rafiqul Islam
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Cross Sectional Study ◽  
Female Students ◽  
Working Environment ◽  
Medical Emergency ◽  
Cross Sectional ◽  
The Impact

This descriptive type of cross-sectional study was driven to explore the teachers’ view about feminization of medical education in Bangladesh. This study was carried out in 4 government and 4 non-government medical colleges of Bangladesh during the period of July 2019 to June 2020. From all four phases, total 104 teachers were respondents of this study to seek information regarding the factors affecting and effects of feminization of medical education in Bangladesh with a pretested self-administered questionnaire. The study revealed that high social respect, high marriage value, parental pressure, financial security are the factors for feminization of medical education in Bangladesh. Other factor that may influence female students to get admitted in the MBBS course is female students are more studious. There are limited better alternate profession for female students. This study also revealed that empathetic to patients are more satisfied with female doctors, they like some specific subspecialty as their career choice and feminization do not hamper quality of health care. 46 (44.2%) teachers were disagreed that female doctors like to work in rural area. and 49 (47.1%) teachers were disagreed that female doctors are efficient in medical emergency management during disaster. Study recommended establishment of female friendly working environment at all levels of the hospital. Study also recommended further long term and wider scale study with more participants to observe the impact of feminization of medical education on health care delivery system in Bangladesh Bangladesh Journal of Medical Education Vol.12(2) July 2021: 4-9

scholarly journals Utilization of Maternal Health Care Services in India: A Community Based Cross-sectional Study in Rural Belgaum

2019 ◽  
pp. 1-11
Author(s):  
Maginsh Dahal ◽  
Kushalata Baral ◽  
Mubashir Angolkar
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Delivery ◽  
Health Workers ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional

Introduction: Sub Centre (SC) is the peripheral unit of the existing health care delivery system under the allopathic system of medicine in India. These basically provide preventive, promotive and the curative services and are facilitated by Female Health Workers (ANM) and Male Health Workers (MHW). They are the integral part of health care delivery system. Also, key to achieve a goal of health for all and to promote the community people for their overall development. Methods: A community based descriptive cross-sectional study was conducted from August 2011 to February 2013 in all 9 sub centers of Kinaye PHC of Belgaum district, all 14 maternal health care workers were selected  and 272 beneficiaries were selected from catchments area of these sub-centers were interviewed by administering structured, pretested interview schedule. Data were analyzed by SPSS (20 Version). Results: Study revealed that (85%) of the workers had correct knowledge but could not transform it into practice completely. This is due to multiple problems that encounter such as include lack of equipments(85.71%), transport facilities (77.78%), delay in decision-making by community to seek care (77.78%), lack of supportive supervision (>20%). Besides these, they were lacking in career development opportunities. There are no promotional avenues and low remuneration and benefits. The acceptance of service provided through sub centers was satisfactory (>90%) among beneficiaries and ANMs (98%) were most accepted than MHW. Beneficiaries faced many problems to access services such as lack of need based services (60%), poor attention by health service provider towards the need of consumers (5.2%) and difficulty in reaching to sub health post (21%). Conclusion: The regular supply of necessary equipments and medicines needs to be ensured          at the sub centre and frequent in-service trainings and career development opportunities to be given to health workers to maintain the enthusiasm and devotion towards the profession.                Also there is a need to provide skill development opportunities and ensure the convenience of service at all sub centers and communication between health workers and beneficiaries to be emphasized.

scholarly journals Evaluating capacity at three government referral hospital emergency units in the Kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool

2020 ◽  
Author(s):  
Jennifer Pigoga ◽  
Anjni Patel Joiner ◽  
Phindile Chowa ◽  
Jennifer Luong ◽  
Masitsela Mhlanga ◽  
...  
Keyword(s):  
Emergency Care ◽  
Assessment Tool ◽  
Care Delivery ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Emergency Unit ◽  
Hospital Emergency ◽  
Cross Sectional ◽  
Middle Income ◽  
Entry Points

Abstract Background: The Kingdom of Eswatini, a lower-middle income nation of 1.45 million in southern Africa, has recently identified emergency care as a key strategy to respond to the national disease burden. We aimed to evaluate the current capacity of hospital emergency care areas using the WHO Hospital Emergency Unit Assessment Tool (HEAT) at government referral hospitals in Eswatini. Methods: We conducted a cross-sectional study of three government referral hospital emergency care areas using HEAT in May 2018. This standardised tool assists healthcare facilities to assess the emergency care delivery capacity in facilities and support in identifying gaps and targeting interventions to strengthen care delivery within emergency care areas. Senior-level emergency care area employees, including senior medical officers and nurse matrons, were interviewed using the HEAT. Results: All sites provided some level of emergency care 24 hours a day, seven days a week, though most had multiple entry points for emergency care. Only one facility had a dedicated area for receiving emergencies and a dedicated resuscitation area; two had triage areas. Facilities had limited capacity to perform signal functions (life-saving procedures that require both skills and resources). Commonly reported barriers included training deficits and lack of access to supplies, medications, and equipment. Sites also lacked formal clinical management and process protocols (such as triage and clinical protocols). Conclusions: The HEAT highlighted strengths and weaknesses of emergency care delivery within hospitals in Eswatini and identified specific causes of these system and service gaps. In order to improve emergency care outcomes, multiple interventions are needed, including training opportunities, improvement in supply chains, and implementation of clinical and process protocols for emergency care areas. We hope that these findings will allow hospital administrators and planners to develop effective change management plans.

scholarly journals Opportunities and Challenges of Nurses after Upgradation of Class 2 Status

2022 ◽  
Vol 13 (1) ◽  
pp. 20-26
Author(s):  
M Akter ◽  
MR Begum ◽  
R Begum ◽  
N Sultana
Keyword(s):  
Care Delivery ◽  
Group Discussion ◽  
Structured Interview ◽  
Health Care Delivery System ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Working Environment ◽  
Staff Nurse ◽  
Cross Sectional ◽  
Depth Interview

Nurse’s job facilities and challenges have emerged as a burning issue in health care delivery system in Bangladesh. This descriptive cross sectional study with a mixed quantitative and qualitative design aimed to explore the opportunities and challenges of nurses after upgradation of class 2 status. The study was carried out in two specialized public hospitals for one year duration among purposively selected 144 nurses with a semi structured interview administered questionnaire In depth interview and focus group discussion (FGD) were conducted among selected personnel. The study revealed that the mean age of nurses was 42.3 (±6.3) years, majority (86.1%) were female, most of them (79.1%) were senior staff nurse with 16.8 years mean working experience. The study explored the opportunities of nurses after upgradation of class 2 status like increased responsibilities and honor in working place, promotional opportunities mentioned by majority of respondents. On the other hand, the challenges were noted as not changing the physicians attitude, not changing the working environment, limited scope for utilization of professional skill, not having job security mentioned by majority of respondents. The study also found that most of the nurses (90.3%) were satisfied after upgradation, but a large portion were not satisfied regarding fringe benefits and current salary structure. From FGD and in depth interview some suggestions come forward for nursing profession empowerment like good salary package, medical incentive, residence and training facilities etc. Few opportunities increased in upgradation of nurses in class 2 status, however nurses were depriving from many of their facilities, which indicated that 2nd class status was partially implemented in professionally, socially and culturally. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 20-26

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