scholarly journals Cancer Impacts on Out-of-Pocket Expenses, Income Loss, and Informal (Unpaid) Care: A Cross-Sectional Study of Patient Perspective

2021 ◽  
Vol 8 ◽  
pp. 237437352110496
Author(s):  
Sinaa Al-Aqeel ◽  
Lamya Alnaim ◽  
Jeelan Alghaith ◽  
Latifa Almosabhi
Keyword(s):  
Cross Sectional Study ◽  
Solid Cancer ◽  
Sectional Study ◽  
Income Loss ◽  
Cross Sectional ◽  
Unpaid Care ◽  
Median Distance ◽  
Out Of Pocket Expenses ◽  
To Receive ◽  
Median Amount

A paper-based questionnaire was used to measure out-of-pocket expenses, income loss, and informal (unpaid) care from the cancer patient’s perspective. A total of 181 adult solid cancer patients on chemotherapy for at least 3 months were recruited from 1 teaching hospital in Riyadh, Saudi Arabia. The majority were female (66%) and 41% were 60 years of age or older. A total of 107 respondents used their own car for transport to and from the hospital to receive chemotherapy (median distance 42 km). Over the last 4 weeks, 21% purchased medications, 18% visited a physician, and 8% visited a physiotherapist, spending a median amount of $47, $220, and $793, respectively. A total of 47 participants were employed at the time of their cancer diagnoses, and 32% of them reported some loss of income. A total of 85% of respondents were escorted by a carer during chemotherapy sessions. Approximately 64%, 31%, 61%, 43%, and 28% reported getting help from a carer for housework, child care, shopping, medicine taking, and personal care, respectively. The carer spent on average 50 h per week looking after the patient.

scholarly journals Processes of care and outcomes for homeless patients hospitalised for cardiovascular conditions at safety-net versus non-safety-net hospitals: cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046959
Author(s):  
Atsushi Miyawaki ◽  
Dhruv Khullar ◽  
Yusuke Tsugawa
Keyword(s):  
Hospital Mortality ◽  
Health Outcomes ◽  
Care Delivery ◽  
Bypass Graft ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Homeless Adults ◽  
To Receive

ObjectivesEvidence suggests that homeless patients experience worse quality of care and poorer health outcomes across a range of medical conditions. It remains unclear, however, whether differences in care delivery at safety-net versus non-safety-net hospitals explain these disparities. We aimed to investigate whether homeless versus non-homeless adults hospitalised for cardiovascular conditions (acute myocardial infarction (AMI) and stroke) experience differences in care delivery and health outcomes at safety-net versus non-safety-net hospitals.DesignCross-sectional study.SettingData including all hospital admissions in four states (Florida, Massachusetts, Maryland, and New York) in 2014.ParticipantsWe analysed 167 105 adults aged 18 years or older hospitalised for cardiovascular conditions (age mean=64.5 years; 75 361 (45.1%) women; 2123 (1.3%) homeless hospitalisations) discharged from 348 hospitals.Outcome measuresRisk-adjusted diagnostic and therapeutic procedure and in-hospital mortality, after adjusting for patient characteristics and state and quarter fixed effects.ResultsAt safety-net hospitals, homeless adults hospitalised for AMI were less likely to receive coronary angiogram (adjusted OR (aOR), 0.42; 95% CI, 0.36 to 0.50; p<0.001), percutaneous coronary intervention (aOR, 0.52; 95% CI, 0.44 to 0.62; p<0.001) and coronary artery bypass graft (aOR, 0.43; 95% CI, 0.26 to 0.71; p<0.01) compared with non-homeless adults. Homeless patients treated for strokes at safety-net hospitals were less likely to receive cerebral arteriography (aOR, 0.23; 95% CI, 0.16 to 0.34; p<0.001), but were as likely to receive thrombolysis therapy. At non-safety-net hospitals, we found no evidence that the probability of receiving these procedures differed between homeless and non-homeless adults hospitalised for AMI or stroke. Finally, there were no differences in in-hospital mortality rates for homeless versus non-homeless patients at either safety-net or non-safety-net hospitals.ConclusionDisparities in receipt of diagnostic and therapeutic procedures for homeless patients with cardiovascular conditions were observed only at safety-net hospitals. However, we found no evidence that these differences influenced in-hospital mortality markedly.

scholarly journals Exploration of COVID-19-Based Changes to Caregiver Burden and Caregiving Intensity among Informal Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 945-945
Author(s):  
Steven Cohen ◽  
Zachary Kunicki ◽  
Megan Drohan ◽  
Mary Greaney
Keyword(s):  
Caregiver Burden ◽  
Informal Caregivers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Multinomial Regression ◽  
Chi Square ◽  
Cross Sectional ◽  
Unpaid Care ◽  
Factors Associated ◽  
Amazon's Mechanical Turk

Abstract Individuals providing unpaid care of assistance to family members and friends (e.g. informal caregivers), may have been uniquely impacted by the COVID-19 pandemic. Research is needed to examine the pandemic’s effect on informal caregivers’ caregiving intensity and burden. Therefore, this cross-sectional study was conducted to explore self-reported changes in caregiver intensity (CI) and caregiver burden (CB) due to the pandemic to identify factors associated with changes in responsibilities and burdens. In June 2020, informal caregivers providing care to someone aged 50+ (n=835) reported their current and pre-pandemic caregiving intensity and burden. Data were collected via Amazon’s Mechanical Turk. Chi-square tests were used to examine bivariate associations between pandemic time (pre vs. post) differences in CI and CB. Multinomial regression was used to assess multivariate predictors of changes to CI and CB due to COVID-19. Results showed a significant U-shaped association between initial CB and CB change due to COVID-19. Higher levels of initial CB were associated with both a significant decrease in CB during COVID-19 (OR 1.33, 95%CI 1.06-1.67), and a significant increase in CB during COVID-19 (OR 1.22, 95%CI 1.05-1.43). There were no significant associations between initial CB and changes in CI due to COVID-19, although older caregivers were more likely to experience a decrease in CB due to caregiving (OR 1.02, 95%CI 1.00-1.05). These mixed results suggest that caregivers with high initial CB experienced the most extreme changes to CB due to COVID-19. Future planned analyses will focus on understanding the potential drivers behind these unexpected results.

scholarly journals COVID-19 Vaccine Hesitancy among Patients with Inflammatory Bowel Disease Receiving Biologic Therapies in Kuwait: A Cross-Sectional Study

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 55
Author(s):  
Mohammad Shehab ◽  
Yasmin Zurba ◽  
Ali Al Abdulsalam ◽  
Ahmad Alfadhli ◽  
Sara Elouali
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Cross Sectional Study ◽  
Biologic Therapies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Patients ◽  
Inflammatory Bowel ◽  
To Receive

Background: COVID-19 vaccinations have been shown to be effective in reducing risk of severe infection, hospitalization, and death. They have also been shown to be safe and effective in patients with inflammatory bowel disease (IBD) who are receiving biologic therapies. In this study, we aimed to evaluate the prevalence of vaccination among patients receiving biologic therapies for IBD. Methods: A single-center prospective cross-sectional study conducted at a tertiary care inflammatory bowel disease center in Kuwait. Data from patients with inflammatory bowel disease (IBD) who attended the gastroenterology infusion clinic from 1 June 2021 until 31 October 2021 were retrieved. Patients who received infliximab or vedolizumab at least six weeks before recruitment were included. The primary outcome was prevalence of COVID-19 vaccination. The secondary outcome was to assess whether prevalence of COVID-19 vaccination differed based on sex, age, type of biologic therapy and nationality. Results: The total number of inflammatory bowel disease (IBD) patients enrolled in the study was 280 (56.0% male and 44.0% female). Of the total, 112 (40.0%) patients were diagnosed with ulcerative colitis and 168 (60.0%) with Crohn’s disease. The number of ulcerative colitis patients who were vaccinated was 49 (43.8%) and the number of Crohn’s disease patients who were vaccinated was 68 (40.5%). The median age was 33.2 years and BMI was 24.8 kg/m2. With respect to the total number of patients, 117 (41.8%) were vaccinated with either BNT162b2 or ChAdOx1 nCoV-19 and 163 (58.2%) were not vaccinated. Female patients were more likely to receive the vaccine compared to male patients (83.0% vs. 63.8%, p < 0.001). In addition, patients above the age 50 were more likely to receive the vaccine than patients below the age of 50 (95.6% vs. 31.2% p < 0.001). Expatriates were more likely to receive the vaccine than citizens (84.8% vs. 25.0%, p < 0.001). There was no statistical difference between patients on infliximab and vedolizumab with regard to prevalence of vaccination (40.0% vs 48.0%, p = 0.34). Conclusion: The overall prevalence of COVID-19 vaccination among patients with inflammatory bowel disease (IBD) on biologic therapies was lower than that of the general population and world health organization (WHO) recom-mendation. Female patients, patients above the age of 50, and expatriates were more likely to receive the vaccine. Physicians should reinforce the safety and efficacy of COVID-19 vaccines among patients, especially IBD patients on biologic therapies, who express hesitancy towards them.

scholarly journals Willingness to Accept COVID-19 Vaccine and Its Determinants among Nigeria Citizens: A Web-based Cross-sectional Study

2021 ◽  
pp. 13-22
Author(s):  
Olanrewaju Davies Eniade ◽  
Abayomi Olarinmoye ◽  
Agofure Otovwe ◽  
Funke E. Akintunde ◽  
Omowumi O. Okedare ◽  
...  
Keyword(s):  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Outcome Variable ◽  
Willingness To Accept ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Other Information ◽  
Level Of Significance ◽  
To Receive

Background: The peculiarity in Nigerians’ demographic, socio-economic and cultural pattern necessitated the need to explore potential COVID-19 vaccine acceptance. This study investigated the determinants of willingness to receive COVID-19 vaccine in Nigeria. Methods: An online cross-sectional study among the general population in Nigeria. Data were collected using an electronic questionnaire.  A total of 368 individuals participated in the research. The outcome variable was willingness to accept COVID-19 vaccine coded as “Yes=1 and No=0.”  Basic socio-demographic information of participants and other information related to COVID-19 were obtained. Stata MP 14 was used for the statistical analysis. Descriptive statistics were presented, test of association were carried out using chi square and a binary logistic regression was used to assess the determinants of willingness to accept COVID-19 vaccine. All analyses were performed at 5% level of significance. Results: The mean age of the respondents was 29.4 + 9.65 years.  Majority of the study participants were female (58.9%), Yoruba (74.7%) and dwellers of urban area (68.5%). Also, 85.6% have attained tertiary level of education. Two-fifth (40.5%) of respondent reported their willingness to take the COVID-19 if made available. Majority (69.8%) of those that are willing to take the vaccine would prefer a live attenuated form and 39.6% would prefer the vaccine administered intramuscularly. Age group≥40 years (AOR: 5.20, CI: 1.02- 26.41), currently married (AOR: 2.81, CI: 1.05 – 7.53) and susceptibility to COVID 19 infection (AOR: 2.52, CI: 1.21 – 5.26) were associated with likelihood of willingness to accept COVID-19 vaccine. Conclusion: Despite the fact that majority were at risk of COVID-19 infection, willingness to receive COVID-19 vaccine was low among Nigerians. Level of maturity in terms of age and marriage as well as susceptibility to COVID-19 infection increased the likelihood of accepting COVID-19 infection. In Furtherance, younger ones, unmarried and non-susceptible individual may require more efforts tailored towards enrichment of understanding about the importance of COVID-19 vaccine in other to improve the acceptance of COVID-19 vaccine in Nigeria.

scholarly journals Engagement, not personal characteristics, was associated with the seriousness of regulatory adjudication decisions about physicians: a cross-sectional study

BMC Medicine ◽  
2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Javier A. Caballero ◽  
Steve P. Brown
Keyword(s):  
Personal Characteristics ◽  
Statistical Modelling ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Legal Representation ◽  
Apparent Relationship ◽  
The Uk ◽  
Relationship Of ◽  
To Receive

Abstract Background Outcomes of processes questioning a physician’s ability to practise —e.g. disciplinary or regulatory— may strongly impact their career and provided care. However, it is unclear what factors relate systematically to such outcomes. Methods In this cross-sectional study, we investigate this via multivariate, step-wise, statistical modelling of all 1049 physicians referred for regulatory adjudication at the UK medical tribunal, from June 2012 to May 2017, within a population of 310,659. In order of increasing seriousness, outcomes were: no impairment (of ability to practise), impairment, suspension (of right to practise), or erasure (its loss). This gave adjusted odds ratios (OR) for: age, race, sex, whether physicians first qualified domestically or internationally, area of practice (e.g. GP, specialist), source of initial referral, allegation type, whether physicians attended their outcome hearing, and whether they were legally represented for it. Results There was no systematic association between the seriousness of outcomes and the age, race, sex, domestic/international qualification, or the area of practice of physicians (ORs p≥0.05), except for specialists who tended to receive outcomes milder than suspension or erasure. Crucially, an apparent relationship of outcomes to age (Kruskal-Wallis, p=0.009) or domestic/international qualification (χ2,p=0.014) disappeared once controlling for hearing attendance (ORs p≥0.05). Both non-attendance and lack of legal representation were consistently related to more serious outcomes (ORs [95% confidence intervals], 5.28 [3.89, 7.18] and 1.87 [1.34, 2.60], respectively, p<0.001). Conclusions All else equal, personal characteristics or first qualification place were unrelated to the seriousness of regulatory outcomes in the UK. Instead, engagement (attendance and legal representation), allegation type, and referral source were importantly associated to outcomes. All this may generalize to other countries and professions.

Socioeconomic Status and Health Services Utilization for Children With Complex Chronic Conditions Liable to Receive Nurse‐Led Services: A Cross‐Sectional Study

2019 ◽  
Vol 51 (5) ◽  
pp. 518-525 ◽  
Author(s):  
Bibiana Pérez‐Ardanaz ◽  
José Miguel Morales‐Asencio ◽  
José Miguel García‐Piñero ◽  
Inmaculada Lupiáñez‐Pérez ◽  
Isabel María Morales‐Gil ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Health Services ◽  
Chronic Conditions ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Services Utilization ◽  
Complex Chronic Conditions ◽  
To Receive ◽  
Socioeconomic Status And Health

scholarly journals Is unhealthy substance use associated with failure to receive cancer screening and flu vaccination? A retrospective cross-sectional study

BMJ Open ◽  
2011 ◽  
Vol 1 (1) ◽  
pp. e000046-e000046 ◽  
Author(s):  
K. E. Lasser ◽  
T. W. Kim ◽  
D. P. Alford ◽  
H. Cabral ◽  
R. Saitz ◽  
...  
Keyword(s):  
Substance Use ◽  
Cancer Screening ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Flu Vaccination ◽  
To Receive

The Practice of Obtaining Informed Consent for Elective Surgery and Anesthesia from Patients’ Perspective: An Institutional based Cross-Sectional Study

2020 ◽  
Author(s):  
Tadese Tamire Negash ◽  
Aragaw Tesfaw
Keyword(s):  
Informed Consent ◽  
Elective Surgery ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Microsoft Excel ◽  
Cross Sectional ◽  
Risks And Benefits ◽  
To Receive ◽  
Patients Perspective ◽  
Structured Questionnaire

Abstract Background : Informed consent is a body of shared decision making process and voluntary authorization of patients to receive medical or surgical intervention. There are limited studies conducted so far to examine the practice of informed consent in Ethiopia. The aim of the study was to assess the practice of informed consent for surgery and Anesthesia from patients’ perspective.Method: An institutional-based cross-sectional study was conducted from March to May 2019. The data were collected using an interviewer-administered structured questionnaire and entered and analyzed using Microsoft Excel and SPSS version 23.Results: A total of 139 patients were interviewed in this study. Most 42(30.2%) of patients were in the age group of 29-38 years. The majority 74(53.2%) of the population were females and most 85 (61.2%) were from a rural residence. Nearly half 68 (48.9%) of the patients were informed of the benefits of the surgical procedure and 78(56.1%) of the patients were informed on the type of anesthesia to be administered while 65 (46.8% ) were not informed on any complications related to the anesthesia. About 66 (47.5%) of the patients interviewed were informed on alternatives to the surgery done. Of these patients, 39(59%) were not informed of any benefits and possible risks associated with the alternative modes of treatment. More than half 75 (54%) of the patients reported as they were understood the information provided during the pre-operative counseling and about 114 (82%) of the patients interviewed satisfied with the current process of obtaining informed consent.Conclusions and recommendation: The current practice of obtaining informed consent addressed only certain aspects of the informed consent component which reflects that patients were inadequately informed on complications related to surgery and anesthesia, alternative forms of treatment and their risks and benefits.

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