Impact of supplementary private health insurance on stomach cancer care in Korea: a cross-sectional study

ObjectivesTo determine if children attend the family physician (FP) or the FP/paediatrician for their surveillance medical appointments, as well as analyse the variables associated with the parents’ choice between the two physicians.DesignCross-sectional study.SettingPublic, semiprivate and private kindergartens in the city of Vila Nova de Famalicão (Portugal).ParticipantsParents of children aged 6 years or less without chronic diseases, enrolled in the selected kindergartens.Main outcome measuresProportion of children attending the FP or FP/paediatrician for their surveillance appointments; association between the chosen physician and sociodemographic and household variables (parents’ age, educational level, professional situation and marital status; household net income; number of children; the child’s age; presence of private health insurance), assessment of the parents’ perception of clinical knowledge and accessibility regarding the FP and the paediatrician.ResultsA total of 697 children were included in the analysis: 30.6% attended only the FP and 69.4% attended both the FP and the paediatrician. Using a Poisson regression, the mother’s age (PR=1.02, 95% CI 1.00 to 1.03), higher educational level (prevalence ratio (PR=1.15, 95% CI 1.00 to 1.33), private health insurance (PR=1.30, 95% CI 1.15 to 1.46), number of children (PR=0.86, 95% CI 0.78 to 0.94) and the child’s age (PR=0.95, 95% CI 0.91 to 0.98) were statistically associated with attending both the FP and the paediatrician; parents of children who attended only FP rated the FP with a higher accessibility and knowledge mean score than those who consulted both physicians (2.91vs2.38, P<0.001, and 4.11vs3.85, P<0.001).ConclusionsOur data show that 70% of our sample simultaneously attended an FP and a paediatrician. FPs are equally qualified to provide medical care to healthy children but this information is not properly transmitted to the general population.

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Awareness of Heart Disease Among Female College Students

American Journal of Health Studies ◽

10.47779/ajhs.2014.227 ◽

2020 ◽

Vol 29 (4) ◽

Author(s):

Ghadah Alshuwaiyer ◽

E. Laurette Taylor

Keyword(s):

Heart Disease ◽

Health Insurance ◽

Private Health Insurance ◽

Cross Sectional Study ◽

Female Students ◽

Educational Opportunities ◽

Female College Students ◽

Sectional Study ◽

Cross Sectional ◽

Preventive Methods

This cross-sectional study assessed the knowledge of female students about heart disease (HD). A sample of 334 students (age=18-64 years) completed a 43-item survey. Students (32%) considered themselves “not informed” about HD. Yet, HD was identified as a main health problem (30.5%) and a leading cause of death (60%; p < .05). Students with private health insurance (54%) visited the doctor regularly versus those without private or known type of insurance (6.4% and 2.1%, respectively; p < .05). Students identified exercise (73.8%) and aromatherapy (14.1%) as preventive methods for HD. To increase HD awareness among female students, educational opportunities should be incorporated into coursework.

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Healthcare utilisation, cancer screening and potential barriers to accessing cancer care in rural South West Nigeria: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-040352 ◽

2021 ◽

Vol 11 (7) ◽

pp. e040352

Author(s):

Avinash Sharma ◽

Olusegun Isaac Alatise ◽

Kelli O'Connell ◽

Samson Gbenga Ogunleye ◽

Adewale Abdulwasiu Aderounmu ◽

...

Keyword(s):

Cancer Screening ◽

Cancer Care ◽

Healthcare Utilisation ◽

Cross Sectional Study ◽

Personal Income ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Potential Barriers ◽

South West

Background/aimsCancer burden is predicted to double by 2030 in sub-Saharan Africa; access to healthcare services for cancer management is a priority in the region. In Nigeria, National Cancer Control Plan aims to ensure >50% cancer screening of eligible populations by 2022 for all Nigerians. We describe healthcare utilisation, cancer screening activities and potential barriers to accessing cancer care within an understudied rural community-based adult population in South West Nigeria.MethodsIn April 2018, we conducted a cross-sectional study of community-based adults (>18 years) ~130 km east of Ibadan, 250 km from Lagos in Osun State, South West Nigeria. Participants completed a face-to-face survey in local dialect. We used a questionnaire to assess demographics, health status, income, medical expenditures, doctor visits and cancer screening history.ResultsWe enrolled 346 individuals: with median age of 52 years and 75% women. Of the entire cohort, 4% had medical insurance. 46% reported a major medical cost in the last year. Cancer screening activities were infrequent in eligible participants: 1.5% reported having had cervical cancer screening, 3.3% mammogram and 5% colonoscopy screening. Cancer screening assessment was less frequent in those with less income and lower education levels. Using a multivariable logistic regression model including personal income, insurance status and education, higher personal income was associated with more cancer screening activity (OR 2.7, 95% CI 1.3 to 5.7, p<0.01). Despite this, most individuals had contact with a primary healthcare doctor (52% in the last year), and over 70% access to radio and TV suggesting the opportunity to expand community-based screening interventions and awareness exists.ConclusionsDespite national increases in cancer cases, we highlight a deficiency in cancer screening and universal healthcare coverage within a community-based adult Nigerian population. Subject to availability of governmental resources, increasing financial risk protection, awareness and targeted resource allocation may help expand access in Nigeria.

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Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database

BMC Pediatrics ◽

10.1186/s12887-020-02379-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shuichi Ito ◽

Tomoko Torii ◽

Akihiro Nakajima ◽

Takeshi Iijima ◽

Hiroshi Murano ◽

...

Keyword(s):

Uric Acid ◽

Health Insurance ◽

Pediatric Population ◽

Gouty Arthritis ◽

Cross Sectional Study ◽

Sectional Study ◽

Insurance Claims ◽

Cross Sectional ◽

Total Prevalence ◽

Health Insurance Claims

Abstract Background Although gout is rare in children, chronic sustained hyperuricemia can lead to monosodium urate deposits progressing to gout, just as in adults. This study assessed prevalence and characteristics of gout and asymptomatic hyperuricemia, and incidence of gouty arthritis in the pediatric population, using data from Japanese health insurance claims. The diagnosis and treatment of pediatric gout and hyperuricemia were analyzed, and specific characteristics of those patients were assessed. Since Japanese guidelines recommend treatment with uric acid lowering drugs for asymptomatic hyperuricemia as well as for gout, these data were also used to investigate the real-world use of uric acid lowering drugs in a pediatric population. Methods This cross-sectional study was based on a 2016–2017 Japanese health insurance claims database, one of the largest epidemiology claims databases available in Japan, which included 356,790 males and 339,487 females 0–18 years of age. Outcomes were measured for prevalence, patient characteristics, treatment with uric acid lowering drugs for gout and asymptomatic hyperuricemia, and prevalence and incidence of gouty arthritis. Because uric acid can be elevated by some forms of chemotherapy, data from patients under treatment for malignancies were excluded from consideration. Results Total prevalence of gout and asymptomatic hyperuricemia in 0–18 year-olds was 0.040% (276/696,277 patients), with gout prevalence at 0.007% (48/696,277) and asymptomatic hyperuricemia at 0.033% (228/696,277). Prevalence of gout and asymptomatic hyperuricemia was highest in adolescent males, at 0.135% (176/130,823). The most common comorbidities for gout and asymptomatic hyperuricemia were metabolic syndrome at 42.8% (118/276) and kidney disease at 34.8% (96/276). Of the patients diagnosed with gout or asymptomatic hyperuricemia, 35.1% (97/276) were treated with uric acid lowering drugs. Gouty arthritis developed in 43.8% (21/48) of gout patients during the study, at an incidence of 0.65 flares/person-year. Conclusions Even the pediatric population could be affected by asymptomatic hyperuricemia, gout, and gouty arthritis, and uric acid lowering drugs are being used in this population even though those drugs have not been approved for pediatric indications. Such off-label use may indicate a potential need for therapeutic agents in this population. Trial registration UMIN000036029.

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GPs’ assessment of cooperation with other health care providers involved in cancer care-a cross-sectional study

European Journal of Cancer Care ◽

10.1111/ecc.12751 ◽

2017 ◽

Vol 27 (1) ◽

pp. e12751 ◽

Cited By ~ 2

Author(s):

I. Koné ◽

G. Klein ◽

A. Siebenhofer ◽

A. Dahlhaus ◽

C. Güthlin

Keyword(s):

Health Care ◽

Health Care Providers ◽

Cancer Care ◽

Cross Sectional Study ◽

Care Providers ◽

Sectional Study ◽

Cross Sectional

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Protocol for the avatar acceptability study: a multiperspective cross-sectional study evaluating the acceptability of using patient-derived xenografts to guide personalised cancer care in Australia and New Zealand

BMJ Open ◽

10.1136/bmjopen-2018-024064 ◽

2018 ◽

Vol 8 (8) ◽

pp. e024064 ◽

Cited By ~ 1

Author(s):

Claire E Wakefield ◽

Emma L Doolan ◽

Joanna E Fardell ◽

Christina Signorelli ◽

Veronica F Quinn ◽

...

Keyword(s):

Cancer Survivors ◽

Cancer Care ◽

New Technologies ◽

Cross Sectional Study ◽

Decisional Balance ◽

Local Health ◽

Sectional Study ◽

Structured Interviews ◽

Cross Sectional ◽

Advantages And Disadvantages

IntroductionPatient-derived xenografts (PDXs) have the potential to transform personalised cancer care, however, little is known about the acceptability of using PDXs to guide treatment decision-making. Given that patient and community preferences can influence satisfaction with care as well as the success of new technologies, we will evaluate the acceptability of PDXs in individuals affected by cancer and community comparisons.Methods and analysisThis comparative cross-sectional study will recruit 323 individuals affected by cancer (cancer survivors (of childhood or adult cancer) and parents of childhood cancer survivors) and 323 community comparisons (adults and parents). We will collect data via structured interviews and questionnaires. To determine the acceptability of PDXs, we will assess five domains: willingness to use PDXs when/if diagnosed with cancer, perceived advantages and disadvantages of PDXs, maximum acceptable out-of-pocket costs per patient, maximum acceptable turnaround time to receive results and maximum acceptable number of mice sacrificed per patient. The primary endpoint will be participants’ decisional balance ratio (calculated as participants’ advantages ratings divided by perceived disadvantages ratings).Ethics and disseminationThe study protocol has been approved by the South Eastern Sydney Local Health District Human Research Ethics Committee (HREC:12/173) and UNSW Sydney (HC15773). The results will be disseminated in peer-reviewed journals and at scientific conferences. A lay summary will be published on the Behavioural Sciences Unit website.

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Does health insurance matter to the use of health services for the elderly in China? A multiyear, nationwide, cross-sectional study

The Lancet ◽

10.1016/s0140-6736(18)32682-5 ◽

2018 ◽

Vol 392 ◽

pp. S53 ◽

Cited By ~ 1

Author(s):

Yaoguang Zhang ◽

Wenhui Mao ◽

Ling Xu ◽

Zhiwen Miao ◽

Di Dong ◽

...

Keyword(s):

Health Insurance ◽

Health Services ◽

The Elderly ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Use Of Health Services

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Geographical variation in musculoskeletal surgical care in public hospitals in Ireland: a repeated cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-028037 ◽

2019 ◽

Vol 9 (5) ◽

pp. e028037 ◽

Cited By ~ 2

Author(s):

Mary E Walsh ◽

Fiona Boland ◽

John M O’Byrne ◽

Tom Fahey

Keyword(s):

Hip Fracture ◽

Hip Replacement ◽

Geographical Variation ◽

Private Health Insurance ◽

Knee Arthroscopy ◽

Cross Sectional Study ◽

Public Hospitals ◽

Sectional Study ◽

Cross Sectional ◽

Referral Hospitals

ObjectiveTo examine the extent of geographical variation across musculoskeletal surgical procedures and associated factors in Ireland.DesignRepeated cross-sectional study.Setting36 public hospitals in Ireland.ParticipantsAdult admissions for hip fracture, hip and knee replacement, knee arthroscopy and lumbar spine interventions over 5 years (2012–2016).Primary outcome measureStandardised discharge rate (SDR).AnalysisAge and sex SDRs were calculated for 21 geographical areas. Extremal quotients, coefficients of variation and systematic components of variance were calculated. Linear regression analyses were conducted exploring the relationship between SDRs and year, unemployment, % urban population, number of referral hospitals, % on waiting lists>6 months and % with private health insurance for each procedure.ResultsAcross 36 public hospitals, n=102 756 admissions were included. Hip fracture repair showed very low variation. Elective hip and knee procedures showed high variation in particular years, while variation for lumbar interventions was very high. Knee arthroscopy rates decreased over time. Higher unemployment was associated with knee and hip replacement rates and urban areas had lower hip replacement rates. Spinal procedure rates were associated with a lower number of referral hospitals in a region and spinal injection rates were associated with shorter waiting lists. A higher proportion of patients having private health insurance was associated with higher rates of hip and knee replacement and lumbar spinal procedures.ConclusionsVariation and factors associated with SDRs for publicly funded hip and knee procedures are consistent with similar international research in this field. Further research should explore reasons for high rates of spinal injections and the impact of private practice on musculoskeletal procedure variation.

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