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

192 Background: Financial distress has been established as a clinically relevant patient-reported outcome (PRO) associated with worse mortality and quality of life, but remains under-recognized by health care providers. Our goal was to define factors associated with financial toxicity (FT) in a public healthcare system. Methods: Patients with advanced lung cancer were recruited from outpatient clinics at the Princess Margaret Cancer Centre (Toronto, Canada). FT was measured with the validated Comprehensive Score for Financial Toxicity (COST) instrument, a 12-item survey scored from 0-44 with lower scores reflecting worse financial well-being. Data on patient and treatment characteristics, total out-of-pocket costs (OOP) and extended insurance coverage (EIC) were collected. Multivariable logistic regression models were fit for COST score and each variable, to determine factors associated with greater FT (COST < 21). Results: Of 251 patients approached, 200 (80%) participated. Median age of the cohort was 65 years; 56% were female, 64% immigrants and 77% employed or on pension. Median total OOP while on treatment ranged between $1000-5000 CAD. Median COST score was 21 (range 0-44). FT was associated with age, with patients < 65 years reporting greater FT than older patients (COST 18.0 vs. 24.0, p < 0.0001). In multivariable logistic regression analysis, younger age was associated with greater FT, when adjusting for income, employment status, OOP and EIC (OR 3.6, [95% CI, 1.5-9.1]; p < 0.0001). Total OOP > $1000 and EIC also were associated with greater FT (adjusted OR 5.0 [95% CI, 2.0-12.1] and 3.7 [95% CI, 1.5-9.1], respectively). Conclusions: Age is significantly associated with FT in the Canadian (Ontario) public healthcare system, with younger lung cancer patients reporting greater financial distress. This study highlights priority patient populations where FT should be routinely assessed and appropriate resources for support offered.

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Ongoing Initiatives to Improve the Quality and Efficiency of Medicine Use within the Public Healthcare System in South Africa; A Preliminary Study

Frontiers in Pharmacology ◽

10.3389/fphar.2017.00751 ◽

2017 ◽

Vol 8 ◽

Cited By ~ 53

Author(s):

Johanna C. Meyer ◽

Natalie Schellack ◽

Jacobus Stokes ◽

Ruth Lancaster ◽

Helecine Zeeman ◽

...

Keyword(s):

South Africa ◽

Healthcare System ◽

Public Healthcare ◽

Medicine Use ◽

Public Healthcare System ◽

The Public ◽

Preliminary Study

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Health services research in the public healthcare system in Hong Kong: An analysis of over 1 million antihypertensive prescriptions between 2004–2007 as an example of the potential and pitfalls of using routinely collected electronic patient data

BMC Health Services Research ◽

10.1186/1472-6963-8-138 ◽

2008 ◽

Vol 8 (1) ◽

Cited By ~ 50

Author(s):

Martin CS Wong ◽

Johnny Y Jiang ◽

Jin-ling Tang ◽

Augustine Lam ◽

Hong Fung ◽

...

Keyword(s):

Hong Kong ◽

Health Services Research ◽

Health Services ◽

Healthcare System ◽

Patient Data ◽

Public Healthcare ◽

Services Research ◽

Public Healthcare System ◽

The Public

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Telerehabilitation program for older adults on a waiting list for physical therapy after hospital discharge: study protocol for a pragmatic randomized trial protocol

10.21203/rs.3.rs-397821/v1 ◽

2021 ◽

Author(s):

Pollyana Ruggio Tristao Borges ◽

Renan Resende ◽

Jane Fonseca Dias ◽

Marisa Cotta Mancini ◽

Rosana Ferreira Sampaio

Keyword(s):

Older Adults ◽

Clinical Trial ◽

Cost Effectiveness ◽

Physical Therapy ◽

Hospital Discharge ◽

Healthcare System ◽

Economic Evaluations ◽

Public Healthcare ◽

Public Healthcare System ◽

The Public

Abstract Background: Delays in starting physical therapy after hospital discharge worsen deconditioning in older adults. Intervening quickly can minimize the negative effects of deconditioning. Telerehabilitation is a strategy that increases access to rehabilitation, improves clinical outcomes, and reduces costs. This paper presents the protocol for a pragmatic clinical trial that aims to determine the effectiveness and cost-effectiveness of a multi-component intervention offered by telerehabilitation for discharged older adults awaiting physical therapy for any specific medical condition.Methods: This is a pragmatic randomized controlled clinical trial with two groups: telerehabilitation and control. Participants (n=230) will be recruited among individuals discharged from hospitals who are in the public healthcare system physical therapy waiting lists. The telerehabilitation group will receive a smartphone app with a personalized program (based on individual’s functional ability) of resistance, balance, and daily activity training exercises. The intervention will be implemented at the individuals’ homes. This group will be monitored weekly by phone and monthly through a face-to-face meeting until they start physical therapy. The control group will adhere to the public healthcare system usual flow and will be monitored weekly by telephone until they start physical therapy. The primary outcome will be physical function (Timed Up and Go and 30-second Chair Stand Test). The measurements will take place in baseline, start, and discharge of outpatient physical therapy. The economic evaluations will be performed from the perspective of society and the Brazilian public healthcare system.Discussion: The study will produce evidence on the effectiveness and cost-effectiveness of multi-component telerehabilitation intervention for discharged older adult patients awaiting physical therapy, providing input that can aid implementation of similar proposals in other patient groups. Trial registration: Brazilian Clinical Trials Registry, RBR-9243v7. Registered on 24 August 2020.

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