scholarly journals 290 The impact of ‘the medication non-adherence’ in patients with cardiovascular disease: causes, outcomes, and interventions. Review of the literature

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Vincenza Giordano ◽  
Luca Cardillo
Keyword(s):  
Health Care ◽  
Adverse Outcomes ◽  
Electronic Control ◽  
Inclusion Criteria ◽  
Mortality And Morbidity ◽  
Health Care Interventions ◽  
Outpatient Visits ◽  
Long Duration ◽  
Control Devices ◽  
The Impact

Abstract Aims The adherence of the pharmacological prescriptions, for patients affected by cardiovascular chronic diseases is one of the most difficult challenges and it’s very important for the clinical efficiency of the therapy. A weak medication adherence or the non-adherence is associated with an increase in health care interventions, an increase in mortality and morbidity, and they can negatively affect the citizens and the sustainability health care system. It’s very important to pay attention to this adhesion and it is a discussed topic in the cardiovascular field. Identify the causes of medication weak adherence and/or medication non-adherence used in cardiovascular diseases and determine the resulting unfavorable clinical outcomes and possible solutions to reduce this phenomenon. Methods and results A systematic search was carried out using databases such as PUBMED and CINAHL. The inclusion criteria established, so that an article could be used, was the relevance to the topic. From the studies analyzed for the preparation of the review, it is clear that the main causes of weak adherence and/or non-adherence to drug are the long duration of the therapies, the patient’s age, and the complexity of the therapy. All this leads to unfavorable outcomes for the patient, thus determining an increase in the number of outpatient visits with the risk of hospitalization or re-hospitalization, up to an increase in mortality and/or morbidity. Conclusions The medication weak adherence or the medication non-adherence is a crucial element in the cardiovascular field that requires intervention to reduce adverse outcomes. The methods to reduce this phenomenon include health education, the interaction between patient and professionals, medical deprescribing, and the use of electronic control devices which, in recent years, have proved to be perfect allies in adherence.

scholarly journals Pandemic Impact of Covid 19 on Compliance of Mother for Pregnancy Reviews

2021 ◽  
Vol 3 (1) ◽  
pp. 200-207
Author(s):  
Iin Octaviana Hutagaol ◽  
Arini Arini ◽  
Cicik Mujianti Mujianti
Keyword(s):  
Pregnant Women ◽  
Random Sampling ◽  
Sampling Technique ◽  
Government Policies ◽  
Stratified Random Sampling ◽  
Inclusion Criteria ◽  
Mortality And Morbidity ◽  
Trimester Pregnancy ◽  
Sample Count ◽  
The Impact

Maternal and neonatal services have not escaped the impact of the Covid 19 pandemic. It can indirectly increase the return of mortality and morbidity to both mother and baby. This study aims to assess the impact of the Covid 19 pandemic on the compliance of pregnant women to revisit antenatal care. The sampling technique used in this study was stratified random sampling, using the Lemeshow formula with a sample count of 126 people with the inclusion criteria set by the researcher. The design of this study was analytic observational. Data collection was carried out through observation questionnaire sheets that were collected offline and online (Google Form). The test used in this study was Mann Whitney. The results of the analysis show that the significance value is 0.003 at the 2nd-trimester pregnancy visit and 0.001 at the 3rd-trimester pregnancy visit, therefore, statistically p <0.05 there is a relationship between the impact of the pandemic and the 2nd and 3rd-trimester pregnancy visits. Mann Whitney with a higher ranking ratio (mean) between the affected groups (66.92) and those not affected (41.59). Thus, s who were affected by the pandemic were economically more likely to not attend pregnancy visits compared to those who were not economically affected by the pandemic. The results of the study show that there is a relationship between the impact of the COVID-19 pandemic and the unity of mothers carrying out pregnancy visits during the pandemic, this is due to government policies to limit and also anxiety of pregnant women.

scholarly journals How Online Reviews and Services Affect Physician Outpatient Visits: Content Analysis of Evidence From Two Online Health Care Communities (Preprint)

2019 ◽  
Author(s):  
Wei Lu ◽  
Hong Wu
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Empirical Work ◽  
Basic Research ◽  
Online Reviews ◽  
Difference In Difference ◽  
Online Services ◽  
Outpatient Visits ◽  
Channel Effects ◽  
The Impact

BACKGROUND Online healthcare communities are changing the ways of physician-patient communication and how patients choose outpatient care physicians. Although a majority of empirical work has examined the role of online reviews in consumer decisions, less research has been done in health care, and endogeneity of online reviews has not been fully considered. Moreover, the important factor of physician online services has been neglected in patient decisions. OBJECTIVE In this paper, we addressed the endogeneity of online reviews and examined the impact of online reviews and services on outpatient visits based on theories of reviews and channel effects. METHODS We used a difference-in-difference approach to account for physician- and website-specific effects by collecting information from 474 physician homepages on two online health care communities. RESULTS We found that the number of reviews was more effective in influencing patient decisions compared with the overall review rating. An improvement in reviews leads to a relative increase in physician outpatient visits on that website. There are channel effects in health care: online services complement offline services (outpatient care appointments). Results further indicate that online services moderate the relationship between online reviews and physician outpatient visits. CONCLUSIONS This study investigated the effect of reviews and channel effects in health care by conducting a difference-in-difference analysis on two online health care communities. Our findings provide basic research on online health care communities.

scholarly journals Challenges and Solutions for Keeping Maternity and Gynecology Services Functioning Comprehensively in Secondary Level Health Care Facility in COVID-19 Pandemic Situation Using a Clinical Spproach

2021 ◽  
pp. 1-7
Author(s):  
Jayanta Kumar Biswas ◽  
Pratistha Lall ◽  
Soumen Das Poddar ◽  
Vikas Srivastava ◽  
Ajith Nilakantan
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Secondary Level ◽  
Adverse Outcomes ◽  
World Health ◽  
Clinical Approach ◽  
Care Hospital ◽  
Hospital Data ◽  
Mortality And Morbidity ◽  
Study Results

OBJECTIVE: With the nationwide lockdown in India, and with a near-exclusive focus on the novel coronavirus disease (COVID-19) there has been a great deal of neglect in the management of other illnesses leading to significant mortality and morbidity. We aimed to assess the feasibility of keeping obstetrics & gynecology services in a secondary care hospital functioning (in terms of regional experiences and comprehensive patient care measures) in the COVID-19 pandemic situation using a clinical approach. STUDY DESIGN: All policies of the World Health Organization and other international obstetrics- gynecological recommendations or guidelines were followed in keeping the services functional. Hospital data of obstetrics and gynecology services were maintained and compared with the previous year’s data of the corresponding period (January to December) through a retrospective observational study. RESULTS: Compared to figures for 2019, in-patient admissions, surgeries, and daycare procedures performed, and deliveries conducted were reduced in total but almost approached previous levels. The number of out-patient attendance and gynecologic laparoscopic surgeries were significantly reduced mostly in the initial month of lockdown (April 2020) and thereafter. Only limited COVID-19 testing was done and there was no mortality in patients or health care workers (HCW) in the obstetrics and gynecological department. CONCLUSION: COVID-19 pandemic had caused an unprecedented global healthcare crisis. The experience and data collected from our hospital in the study period validate the ‘clinical’ working protocol that enables comprehensive maternity and gynecology care at secondary level care centers even in a pandemic situation without adverse outcomes on patients or the hospital staff.

scholarly journals How Online Reviews and Services Affect Physician Outpatient Visits: Content Analysis of Evidence From Two Online Health Care Communities

10.2196/16185 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e16185
Author(s):  
Wei Lu ◽  
Hong Wu
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Empirical Work ◽  
Basic Research ◽  
Online Reviews ◽  
Difference In Difference ◽  
Online Services ◽  
Outpatient Visits ◽  
Channel Effects ◽  
The Impact

Background Online healthcare communities are changing the ways of physician-patient communication and how patients choose outpatient care physicians. Although a majority of empirical work has examined the role of online reviews in consumer decisions, less research has been done in health care, and endogeneity of online reviews has not been fully considered. Moreover, the important factor of physician online services has been neglected in patient decisions. Objective In this paper, we addressed the endogeneity of online reviews and examined the impact of online reviews and services on outpatient visits based on theories of reviews and channel effects. Methods We used a difference-in-difference approach to account for physician- and website-specific effects by collecting information from 474 physician homepages on two online health care communities. Results We found that the number of reviews was more effective in influencing patient decisions compared with the overall review rating. An improvement in reviews leads to a relative increase in physician outpatient visits on that website. There are channel effects in health care: online services complement offline services (outpatient care appointments). Results further indicate that online services moderate the relationship between online reviews and physician outpatient visits. Conclusions This study investigated the effect of reviews and channel effects in health care by conducting a difference-in-difference analysis on two online health care communities. Our findings provide basic research on online health care communities.

COViD-19: We're All in This Together – Some More Than Others

2021 ◽  
Vol 36 (8) ◽  
pp. 358-360
Author(s):  
Chris Alderman
Keyword(s):  
United States ◽  
Health Care ◽  
Minority Groups ◽  
Premature Mortality ◽  
The United States ◽  
Adverse Outcomes ◽  
Developed Economies ◽  
Hospitalization Rates ◽  
The Impact ◽  
Significant Disease

It has long been apparent that gross disparities exist in health care in the United States, and, indeed, other nations with fully developed economies. All kinds of markers point to these inequities, with measures such as overall life expectancy, hospitalization rates, premature mortality, adverse outcomes associated with medical and surgical treatment, infant mortality, and the impact of many significant disease types higher and more impactful among minority groups and those of the most modest economic means. This is not new. Are there pointers to what might underpin the disparities in outcomes among the different minority groups?

THE IMPACT OF HEALTH TECHNOLOGY ASSESSMENT REPORTS ON DECISION MAKING IN AUSTRIA

2012 ◽  
Vol 28 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Ingrid Zechmeister ◽  
Ines Schumacher
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Care Expenditure ◽  
Health Technology ◽  
Decision Making Process ◽  
Inclusion Criteria ◽  
Distribution Of Resources ◽  
The Impact

Objectives: Health technology assessment (HTA) was established in Austria in the 1990s and, since then, it has gained considerable importance. In this study, we aim to analyze whether the HTA reports that have been produced at the Institute for Technology Assessment (ITA) and at the Ludwig Boltzmann Institute for HTA (LBI-HTA) have had an impact on decision making within the Austrian health care system.Methods: We selected all reports that were intended for supporting (i) reimbursement/investment or (ii) disinvestment decisions. Eleven full HTA reports and fifty-eight rapid assessments fulfilled the inclusion criteria. We used interview data and administrative data on volumes, tariffs and expenditure of products/services to analyze whether and how reports were in reality used in decision making and what the consequences for health care expenditure and resource distribution have been.Results: Five full HTA reports and fifty-six rapid technology assessments were used for reimbursement decisions. Four full HTA reports and two rapid assessments were used for disinvestment decisions and resulted in reduced volumes and expenditure. Two full HTA reports showed no impact on decision making. Impact was most evident for hospital technologies.Conclusions: HTA has played some role in reducing volumes of over-supplied hospital technologies, resulting in reduced expenditure for several hospital providers. Additionally, it has been increasingly included in prospective planning and reimbursement decisions of late, indicating re-distribution of resources toward evidence-based technologies. However, further factors may have influenced the decisions, and the impact could be considerably increased by systematically incorporating HTA into the decision-making process in Austria.

scholarly journals Geriatric syndromes and subsequent health-care utilization among older community dwellers in Stockholm

2021 ◽  
Author(s):  
Jette Möller ◽  
Christian Rausch ◽  
Lucie Laflamme ◽  
Yajun Liang
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Cox Regression ◽  
Baseline Survey ◽  
Care Utilization ◽  
Geriatric Syndromes ◽  
Outpatient Visits ◽  
The Impact ◽  
Community Dwellers

AbstractLittle is known about the long-term effect of geriatric syndromes on health-care utilization. This study aims to determine the association between geriatric syndromes and health-care utilization during a four-year period among older community dwellers. Based on the Stockholm Public Health Cohort study, a total number of 6700 community dwellers aged ≥65 years were included. From a baseline survey in 2006, geriatric syndromes were defined as having at least one of the following: insomnia, functional decline, urinary incontinence, depressive symptoms and vision impairment. Health-care utilization was identified by linkages at individual level with register data with a four-year follow-up. Cox regression was performed to estimate the associations. Compared to those without geriatric syndromes, participants with any geriatric syndromes had a higher prevalence of frequent hospitalizations, long hospital stays, frequent outpatient visits and polypharmacy in each of the follow-up years. After controlling for covariates, having any geriatric syndromes was associated with higher levels of utilization of inpatient and outpatient care as well as polypharmacy. The association was stable over time, and the fully adjusted hazard ratio (95% confidence interval) remained stable in frequent hospitalizations (from 1.89 [1.31, 2.73] in year 1 to 1.70 [1.23, 2.35] in year 4), long hospital stay (from 1.75 [1.41, 2.16] to 1.49 [1.24, 1.78]), frequent outpatient visits (from 1.40 [1.26, 1.54] to 1.33 [1.22, 1.46]) and polypharmacy (from 1.63 [1.46, 1.83] to 1.53 [1.37, 1.71]). Having any geriatric syndromes is associated with higher levels of health-care utilization among older community dwellers, and the impact of geriatric syndromes is stable over a four-year period.

scholarly journals An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration

2014 ◽  
Vol 2 (20) ◽  
pp. 1-196 ◽  
Author(s):  
Yvonne Birks ◽  
Reema Harrison ◽  
Kate Bosanquet ◽  
Jill Hall ◽  
Melissa Harden ◽  
...  
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Scoping Review ◽  
Current Evidence ◽  
Second Phase ◽  
Inclusion Criteria ◽  
Open Disclosure ◽  
Literature Reviews ◽  
The Uk ◽  
The Impact

BackgroundIn 2009 the UK National Patient Safety Agency relaunched its Being Open framework to facilitate the open disclosure of adverse events to patients in the NHS. The implementation of the framework has been, and remains, challenging in practice.AimThe aim of this work was to both critically evaluate and extend the current evidence base relating to open disclosure, with a view to supporting the implementation of a policy of open disclosure of adverse events in the NHS.MethodsThis work was conducted in three phases. The first phase comprised two focused systematic literature reviews, one summarising empirical research on the effectiveness of interventions to enhance open disclosure, and a second, broader scoping review, looking at reports of current opinion and practice and wider knowledge. The second phase involved primary qualitative research with the objective of generating new knowledge about UK-based stakeholders’ views on their role in and experiences of open disclosure. Stakeholder interviews were analysed using the framework approach. The third phase synthesised the findings from the first two phases to inform and develop a set of short pragmatic suggestions for NHS trust management, to facilitate the implementation and evaluation of open disclosure.ResultsA total of 610 papers met the inclusion criteria for the broad review. A large body of literature discussed open disclosure from a number of related, but sometimes conflicted, perspectives. Evidential gaps persist and current practice is based largely on expert consensus rather than evidence. There appears to be a tension between the existing pragmatic guidance and the more in-depth critiques of what being consistent and transparent in health care really means. Eleven papers met the inclusion criteria for the more focused review. There was little evidence for the effectiveness of disclosure alone on organisational or individual outcomes or of interventions to promote and support open disclosure. Interviews with stakeholders identified strong support for the basic principle of being honest with patients or relatives when someone was seriously harmed by health care. In practice however, the issues are complex and there is confusion about a number of issues relating to disclosure policies in the UK. The interviews generated insights into the difficulties perceived within health care at individual and institutional levels, in relation to fully implementing the Being Open guidance.ConclusionsThere are several clear strategies that the NHS could learn from to implement and sustain a policy of openness. Literature reviews and stakeholder accounts both identified the potential benefits of a culture that was generally more open (not just retrospectively open about serious harm). Future work could usefully evaluate the impact of disclosure on legal challenges within the NHS, best practice in models of support and training for open disclosure, embedding disclosure conversations in critical incident analysis and disclosure of less serious events.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals THE IMPACT OF HEALTH SUBSIDY ON HEALTH CARE UTILIZATION IN INDONESIA

2021 ◽  
Vol 3 (2) ◽  
pp. 16-37
Author(s):  
Renosa Tosca Zamaro
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Insurance Premium ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Care Utilization ◽  
Poor People ◽  
Outpatient Visits ◽  
Care Facilities ◽  
The Impact

Equal opportunity and access to health care services regardless of one’s socio-economic background is important for health equity. To achieve this, the Indonesian government introduced a national health insurance program named Jaminan Kesehatan Nasional in 2014 and provided insurance premium subsidies for poor people. The current study evaluates the health subsidy policy’s impact on the utilization of different kinds of health care facilities, both public and private. Two waves of Indonesian socio-economic surveys, namely 2013 and 2018, and two analysis methods, namely logistic regression, and difference-in-differences, were applied in this study. The results show that in first-level health care facilities, the health subsidy improves the probability of outpatient visits in public health centers and polyclinics but decreases the probability of outpatient visits in medical practices. Then, in secondary-level health care facilities, the health subsidy was found to increase the likelihood of outpatient visits in public hospitals; however, it lowers the probability of outpatient visits in private hospitals.

scholarly journals A Systematic Review of the Cardiovascular Manifestations and Outcomes in the Setting of Coronavirus-19 Disease

2020 ◽  
Author(s):  
Samarthkumar Thakkar ◽  
Shilpkumar Arora ◽  
Ashish Kumar ◽  
Rahul Jaswaney ◽  
Mohammed Faisaluddin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Inclusion Criteria ◽  
Mortality And Morbidity ◽  
Future Studies ◽  
Treatment And Prevention ◽  
Wide Range ◽  
Myocardial Infection ◽  
The Impact

The impact of coronavirus disease, 2019 (COVID-19), has been profound. Though COVID-19 primarily affects the respiratory system, it has also been associated with a wide range of cardiovascular (CV) manifestations portending extremely poor prognosis. The principal hypothesis for CV involvement is through direct myocardial infection and systemic inflammation. We conducted a systematic review of the current literature to provide a foundation for understanding the CV manifestations and outcomes of COVID-19. PubMed and EMBASE databases were electronically searched from the inception of the databases through April 27th, 2020. A second literature review was conducted to include major trials and guidelines that were published after the initial search but before submission. The inclusion criteria for studies to be eligible were case reports, case series, and observation studies reporting CV outcomes among patients with COVID-19 infection. This review of the current COVID-19 disease and CV outcomes literature revealed a myriad of CV manifestations with potential avenues for treatment and prevention. Future studies are required to understand on a more mechanistic level the effect of COVID-19 on the myocardium and thus provide avenues to improve mortality and morbidity.

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