scholarly journals Use of medicines and other products for therapeutic purposes among children in Brazil

2016 ◽  
Vol 50 (suppl 2) ◽  
Author(s):  
Tatiane da Silva Dal Pizzol ◽  
Noemia Urruth Leão Tavares ◽  
Andréa Dâmaso Bertoldi ◽  
Mareni Rocha Farias ◽  
Paulo Sergio Dourado Arrais ◽  
...  
Keyword(s):  
Health Insurance ◽  
Drug Use ◽  
Health Services ◽  
Chronic Diseases ◽  
Urban Areas ◽  
Pediatric Population ◽  
Medicine Use ◽  
Cross Sectional ◽  
Emergency Visits ◽  
Acute Conditions

ABSTRACT OBJECTIVE To assess the prevalence of the use of medicines and other products for therapeutic purposes in the Brazilian pediatric population and test whether demographic, socioeconomic and health factors are associated with use. METHODS A cross-sectional population-based study (National Survey on Access, Use and Promotion of Rational Use of Medicines – PNAUM), including 7,528 children aged 12 or younger, living in urban areas in Brazil. Medicine use to treat chronic or acute diseases was reported by the primary caregiver present at the household interview. Associations between independent variables and medicine use were investigated by Poisson regression. RESULTS The overall prevalence of medicine use was 30.7% (95%CI 28.3–33.1). The prevalence of medicine use for chronic diseases was 5.6% (95%CI 4.7–6.7) and for acute conditions, 27.1% (95%CI 24.8–29.4). The factors significantly associated with overall use were five years old or under, living in the Northeast region, having health insurance and using health services in the last 12 months (emergency visits and hospitalizations). The following were associated with drug use for chronic diseases: age ≥ 2 years, Southeast and South regions, and use of health services. For drug use in treating acute conditions, the following associated factors were identified: ≤ 5 years, North, Northeast or Midwest regions, health insurance, and one or more emergency visits. The most commonly used drugs among children under two years of age were paracetamol, ascorbic acid, and dipyrone; for children aged two years or over they were dipyrone, paracetamol, and amoxicillin. CONCLUSIONS The use of medicine by children is considerable, especially in treating acute medical conditions. Children using drugs for chronic diseases have a different demographic profile from those using drugs for acute conditions in relation to gender, age, and geographic region.

CONSULTATION OF MEDICINE USE IN OUTPATIENT

2021 ◽  
Vol 62 (6) ◽  
Author(s):  
Bui Dang Minh Tri ◽  
Bui Dang Phuong Chi ◽  
Nguyen Huu Nhan ◽  
Doan Ngoc Giang Lam
Keyword(s):  
Health Insurance ◽  
Drug Use ◽  
Descriptive Study ◽  
Medicine Use ◽  
Cross Sectional ◽  
Long Time

Objectives: To survey the patient’s counseling necesssary and counseling activities of medicine use in outpatients at Thong Nhat Hospital. Objects and methods: Cross-sectional descriptive study on 120 patients who were given health insurance drugs waiting to take drugs, before entering the counseling room and 60 counseling conversations about drug use by pharmacists for patients from September 1st, 2020 to December 1st, 2020 at Thong Nhat Hospital. Results: Patients wishing to be counseled about drug use (58.33%). The reason that patients did not want to be consulted about drug use was mainly treated for a long time of patients (79.49%) and consulted by their doctor (58.97%). The patients wanted to have advices on both their medicines and diseases, accounting for 61.43%. The majority of patients participating in the study were fully consulted about the drug contents and prescription (61.67%). Before pharmacists started consulting, most of the patients asked questions with general counseling content (55.0%). Conclusion: The proportion of patients wishing to be consulted about drug use was moderate. The main reason why patients did not want to be consulted about drug use was mainly treated for a long time of patients and consulted by their doctor. Mostly, patients wanted advices on both their medicines and diseases. The majority of patients were fully consulted about the drug contents and prescription.

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

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.

scholarly journals Exploring health literacy in Wuhan, China: a cross-sectional analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xin Mei ◽  
Qing Zhong ◽  
Gong Chen ◽  
Yuanxia Huang ◽  
Junlin Li
Keyword(s):  
Risk Factors ◽  
Health Literacy ◽  
Chronic Diseases ◽  
Urban Areas ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Education Levels ◽  
Chi Square Test

Abstract Background In recent years, research on health literacy has become increasingly focused on the health care system and public health. This cross-sectional study aimed to investigate health literacy and analyse the risk factors that affect health literacy in Wuhan, China. Methods Multistage stratified random sampling was used to select 5304 urban and rural residents aged 15 to 69 years from 204 monitoring points in 15 districts of Wuhan. Using the Chinese Citizen Health Literacy Questionnaire (HLQ) (2018 edition), a face-to-face survey was conducted from November to December 2018. Risk factors that may affect health literacy were assessed using the Chi-square test and multivariate logistic regression models. Results The knowledge rate of health literacy was relatively low (19.3%). The knowledge rate of health-related behaviour and lifestyle (BAL, 17.3%) was the lowest of the three aspects of health literacy, and the knowledge rate of chronic diseases (CD, 19.0%) was the lowest of the six dimensions of health literacy. Respondents who lived in urban areas, had higher education levels, worked as medical staff, had a higher household income and did not suffer from chronic diseases were likely to have higher health literacy. Conclusions The health literacy levels of citizens in Wuhan are insufficient and need to improve.

scholarly journals Factors determining access to oral health services among children aged less than 12 years in Peru

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1680 ◽  
Author(s):  
Diego Azañedo ◽  
Akram Hernández-Vásquez ◽  
Mixsi Casas-Bendezú ◽  
César Gutiérrez ◽  
Andrés A. Agudelo-Suárez ◽  
...  
Keyword(s):  
Health Insurance ◽  
Oral Health ◽  
Health Services ◽  
Educational Level ◽  
Urban Areas ◽  
Univariate Analysis ◽  
Enabling Factors ◽  
Natural Region ◽  
Region Of Residence ◽  
Oral Health Services

Background:Understanding problems of access to oral health services requires knowledge of factors that determine access. This study aimed to evaluate factors that determine access to oral health services among children aged <12 years in Peru between 2014 and 2015.Methods:We performed a secondary data analysis of 71,614 Peruvian children aged <12 years and their caregivers. Data were obtained from the Survey on Demography and Family Health 2014-2015 (Encuesta Demográfica y de Salud Familiar - ENDES). Children’s access to oral health services within the previous 6 months was used as the dependent variable (i.e. Yes/No), and the Andersen and col model was used to select independent variables. Predisposing (e.g., language spoken by  tutor or guardian, wealth level, caregivers’ educational level, area of residence, natural region of residence, age, and sex) and enabling factors (e.g. type of health insurance) were considered. Descriptive statistics were calculated, and multivariate analysis was performed using generalized linear models (Poisson family).Results:Of all the children, 51% were males, 56% were aged <5 years, and 62.6% lived in urban areas. The most common type of health insurance was Integral Health Insurance (57.8%), and most respondents were in the first quintile of wealth (31.6%). Regarding caregivers, the most common educational level was high school (43.02%) and the most frequently spoken language was Spanish (88.4%). Univariate analysis revealed that all variables, except sex and primary educational level, were statistically significant. After adjustment, sex, area of residence, and language were insignificant, whereas the remaining variables were statistically significant.Conclusions:Wealth index, caregivers’ education level, natural region of residence, age, and type of health insurance are factors that determine access to oral health services among children aged <12 years in Peru. These factors should be considered when devising strategies to mitigate against inequities in access to oral health services.

scholarly journals The Relationship of Ability to Pay and Ownership of Health Insurance towards Willingness to Pay Laboratory Services at Persahabatan Hospital, East Jakarta

2020 ◽  
Author(s):  
Siska Putri Utami ◽  
◽  
Yanti Harjono Hadiwiardjo ◽  
Kristina Simanjuntak ◽  
◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Willingness To Pay ◽  
Observational Research ◽  
Chi Square ◽  
Study Program ◽  
Cross Sectional ◽  
Ability To Pay ◽  
Laboratory Services ◽  
The Relationship

ABSTRACT Background: Limited cost of health services, especially in laboratory tests for diagnoses, causes doctors to consider patient’s willingness to pay so the costs are spent more efficiently. Some factors which supposedly affect the willingness to pay are ability to pay and health insurance ownership. This study aims to know the relationship between ability to pay and health insurance ownership with the willingness to pay for laboratory services in outpatients at RSUP Persahabatan. Method: This research was an analytical observational research with cross-sectional design. Samples consisted of 70 outpatients at RSUP Persahabatan laboratory collected by consecutive sampling. The dependent variable is willingness to pay and the independent variable are the ability to pay and insurance ownership measured using a questionnaire. The data was analyzed by Chi-square. Results: Chi-square test results showed relationship between the ability to pay and the willingness to pay for laboratory health services (OR= 13.14; 95% CI= 2.76 to 62.49; p< 0.001). There was no relationship between health insurance ownership and the willingness to pay for laboratory health services (OR= 2.82; 95% CI= 0.85 to 9.33; p= 0.083). Conclusion: High ability to pay will lead to high willingness to pay, since their need for food has been met and they will shift to the need for health. The health insurance ownership does not affect the willingness of patients in paying laboratory service. Keywords: Ability to Pay, Health Insurance, Hospital, Laboratory Services, Willingness to Pay. Correspondence: Siska Putri Utami. Medicine Study Program, Medicine Study Program, Faculty of Medicine, UPN “Veteran” Jakart. Jl. RS. Fatmawati Raya, Pd. Labu, Cilandak district, Depok, West Java, 12450. Email: [email protected]. Phone: (021) 7656971 DOI: https://doi.org/10.26911/the7thicph.04.18

scholarly journals Digital rectal examination and its associated factors in the early detection of prostate cancer: a cross-sectional population-based study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Samara Carollyne Mafra Soares ◽  
Marianna de Camargo Cancela ◽  
Arn Migowski ◽  
Dyego Leandro Bezerra de Souza
Keyword(s):  
Public Health ◽  
Prostate Cancer ◽  
Health Insurance ◽  
Early Detection ◽  
Health Services ◽  
Urban Areas ◽  
Private Health Insurance ◽  
Digital Rectal Examination ◽  
Positive Association ◽  
Population Based

Abstract Background Digital rectal examination (DRE) is one of the most common strategies for prostate cancer early detection. However, the use for screening purposes has a controversial benefit and potential harms can occur due to false-positive results, overdiagnosis and overtreatment. The objective of this study is to calculate the prevalence and identify factors associated with the receipt of DRE in Brazilian men. Methods We selected men older than 40 from a nationwide population-based survey (13,625 individuals) excluding those with prostate cancer diagnosis. Information was extracted from the most recent database of the Brazilian National Health Survey (PNS 2013). Statistical analysis was carried out to calculate incidence rate ratios, with 95% confidence intervals and p values, through multivariate analysis with Poisson regression and robust variance. Results Men having private health insurance (63.3%; CI = 60.5–66.0) presented higher prevalence of DRE than those in the public health system (41.6%; CI = 39.8–43.4). The results show a positive association between DRE and men having private health insurance, aged 60–69, living with a spouse, never smokers, and living in urban areas. Among public health services users, this positive association was observed among men aged 70–79, living with a spouse, having bad/very bad health self-perception, abstainers, ex-smokers, with undergraduate studies, presenting four or more comorbidities, and residing in urban areas. Conclusions Prostate cancer screening with DRE is quite frequent in Brazil, specially among men with private health plans and better access to health services, healthier lifestyle and at more advanced ages, characteristics which increase the risk of overdiagnosis and overtreatment.

scholarly journals Comorbidity associated with Severe Mental illness (The APNA study)

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
I Aguinaga-Ontoso ◽  
A Brugos-Larumbe ◽  
S Guillén-Aguinaga
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Chronic Disease ◽  
General Population ◽  
Health Services ◽  
Severe Mental Illness ◽  
Chronic Diseases ◽  
Poor Mental Health ◽  
Cross Sectional ◽  
Age And Sex

Abstract People with severe mental illness (SMI) that includes bipolar disorder or schizophrenia die on average 10-20 years sooner than the general population. Poor mental health can negatively affect quality of life and life expectancy more so than having multiple physical illnesses. The division between health services treating mental and physical health often means that patients suffering from both physical and mental conditions are at particular risk of poor care. Although more than 50 million people in the EU suffer multiple from more than one chronic disease, it is not well know the comorbidity associated with severe mental illness. Methods The study is a cross-sectional study within the APNA Study (Navarre primary health care prospective cohort) that included 470942 people over 18 years old in Navarre (Spain). Age, sex, chronic diseases diagnosis and SMI) that includes (bipolar disorder or schizophrenia were extracted. Lineal regression models for the number of chronic disease were computed. Logistic regression adjusted by sex and age, was computed for each chronic disease. Results Adjusting by age and sex, people with SMI have 1.47 (95% CI 1.44-1.50) more chronic diseases than people without SMI. Adjusting by age and sex, persons with SMI have a higher prevalence of comorbidity: OR = 13.29 (95% CI = 12.27-14.36). Patients with SMI have a higher prevalence of asthma OR = 1.41 (95% CI 1.21-1.64), COPD OR = 2.30 (95% CI 2.51-3.35), Type 2 DM OR = 1.50 (95% CI 1.31-1.70) hyperthyroidism OR = 1.63 (95% CI 1.26-2.10), Chronic kidney disease OR = 1.,43 (95% IC 1.10-1.88), Obesity OR = 1.68 (95% CI 1.47-1,92) and Hypothyroidism OR 1.63 (95% IC 1.43-1,85). Conclusions Patients with severe mental illness have a higher prevalence of comorbidity than the general population with an OR of 13.29. Health service should screen patient with severe mental illness for chronic diseases due to their high prevalence and mortality. Key messages Patients with severe mental illness die on average 10-20 years sooner than the general population this could be to a higher prevalence of comorbidity. Health services should screen patients with severe mental illness for chronic diseases due to their higher prevalence.

scholarly journals Access to prenatal care: inequalities in a region with high maternal mortality in southeastern Brazil

2016 ◽  
Vol 21 (5) ◽  
pp. 1647-1658 ◽  
Author(s):  
Katrini Guidolini Martinelli ◽  
Edson Theodoro dos Santos Neto ◽  
Silvana Granado Nogueira da Gama ◽  
Adauto Emmerich Oliveira
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Health Services ◽  
Pregnant Women ◽  
Minimum Wage ◽  
Urban Areas ◽  
Access To Health Care ◽  
Universal Access ◽  
Southeastern Brazil ◽  
Cross Sectional

Abstract Aim This article aims to evaluate access to prenatal care according to the dimensions of availability, affordability and acceptability in the SUS microregion of southeastern Brazil. Methods A cross-sectional study conducted in 2012-2013 that selected 742 postpartum women in seven hospitals in the region chosen for the research. The information was collected, processed and submitted to the chi-square test and the nonparametric Spearman’s test, with p-values less than 5% (p < 0.05). Results Although the SUS constitutionally guarantees universal access to health care, there are still inequalities between pregnant women from rural and urban areas in terms of the availability of health care and among families earning up to minimum wage and more than one minimum wage per month in terms of affordability; however, the acceptability of health care was equal, regardless of the modality of the health services. Conclusion The location, transport resources and financing of health services should be reorganised, and the training of health professionals should be enhanced to provide more equitable health care access to pregnant women.

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