scholarly journals Males tend to come earlier for eye care with the National Health Coverage Programme in private hospitals

2018 ◽  
Vol 37 (2) ◽  
pp. 127
Author(s):  
Gilbert WS Simanjuntak ◽  
Jannes F Tan ◽  
Reinne Natali Christine
Keyword(s):  
Logistic Regression ◽  
Health Insurance ◽  
Cataract Surgery ◽  
National Health ◽  
Social Intervention ◽  
Multiple Logistic Regression ◽  
Eye Care ◽  
Private Hospitals ◽  
To Come ◽  
Cataract Patients

Background<br />Cataract is the leading cause of blindness in Indonesia, and poverty is a major barrier to having cataract surgery. Increasing the proportion of adults that have regular, comprehensive eye examinations for cataract and other common eye health problems is one of the National Health Insurance (JKN) objectives. The objective of this study was to determine the impact of vision insurance on eye care utilization of cataract patients in private hospitals with the JKN system as social intervention. <br /><br />Methods<br />A cross-sectional study was conducted involving 230 cataract patients in a private hospital. Inclusion criteria were patients with cataract surgery, diagnosis and follow up visit minimally two months after surgery. A multiple logistic regression was used to analyse the data.<br /><br />Results<br />Initial visual acuity (VA) was 0.13 ± 0.15 and final VA was 0.91 ± 0.15. Two patients had final VA of 0.2 and 0.15, respectively, in which the first was associated with persistent corneal edema and diabetes mellitus, and the other with corneal scar. Age, gender, and level of education were not associated with VA at the first visit (p&gt;0.05). Further analysis using a multiple logistic regression model was found to be significant (p=0.0104), with gender being associated with preoperative vision, where males tend to come earlier to undergo cataract surgery/treatment.<br /><br />Conclusion<br />Males tend to come earlier than females for cataract surgery with the National Health Insurance (JKN) programme, despite the social intervention of the programme.

Development of an Algorithm for Stroke Prediction: A National Health Insurance Database Study in Korea

2018 ◽  
Vol 79 (3-4) ◽  
pp. 214-220 ◽  
Author(s):  
Seung Nam Min ◽  
Se Jin Park ◽  
Dong Joon Kim ◽  
Murali Subramaniyam ◽  
Kyung-Sun Lee
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Stroke Prevention ◽  
Normal Subjects ◽  
Control Group ◽  
Modifiable Risk Factors ◽  
Stroke Patients

Background: Stroke is the second leading cause of death worldwide and remains an important health burden both for the individuals and for the national healthcare systems. Potentially modifiable risk factors for stroke include hypertension, cardiac disease, diabetes, and dysregulation of glucose metabolism, atrial fibrillation, and lifestyle factors. Objects: We aimed to derive a model equation for developing a stroke pre-diagnosis algorithm with the potentially modifiable risk factors. Methods: We used logistic regression for model derivation, together with data from the database of the Korea National Health Insurance Service (NHIS). We reviewed the NHIS records of 500,000 enrollees. For the regression analysis, data regarding 367 stroke patients were selected. The control group consisted of 500 patients followed up for 2 consecutive years and with no history of stroke. Results: We developed a logistic regression model based on information regarding several well-known modifiable risk factors. The developed model could correctly discriminate between normal subjects and stroke patients in 65% of cases. Conclusion: The model developed in the present study can be applied in the clinical setting to estimate the probability of stroke in a year and thus improve the stroke prevention strategies in high-risk patients. The approach used to develop the stroke prevention algorithm can be applied for developing similar models for the pre-diagnosis of other diseases.

scholarly journals Proportion and Associated Factors of Low Vision among Adult Patients Attending at University of Gondar Tertiary Eye Care and Training Center, Gondar Town, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Melkamu Temeselew Tegegn ◽  
Gizachew Tilahun Belete ◽  
Ayanaw Tsega Ferede ◽  
Aragaw Kegne Assaye
Keyword(s):  
Logistic Regression ◽  
Cataract Surgery ◽  
Associated Factors ◽  
Low Vision ◽  
Binary Logistic Regression ◽  
Training Center ◽  
Eye Care ◽  
History Of ◽  
Study Participants ◽  
And Training

Introduction. Low vision is a worldwide health problem in both developing and developed countries. A national survey of low vision and blindness in Ethiopia showed that the prevalence of low vision was 3.7% and that of blindness was 1.6%, whereas there is no evidence in the study area. Purpose. The study was aimed to assess the proportion and associated factors of low vision at the University of Gondar tertiary eye care and training center. Methods. A hospital-based cross-sectional study was conducted on 727 study participants with a systematic random sampling technique from April 18 to May 16, 2019. Data were collected through the use of a structural questionnaire and physical eye examination. Data were entered into Epi Info version 7, and analysis was performed by using statistical package for social science (SPSS) version 20. The binary logistic regression model was fitted to identify factors associated with low vision, and variables with a P value of <0.05 in a multivariable binary logistic regression were considered as statistically significant. Results. A total of 715 study participants have participated in this study with a mean age of 49.39 ± 19.93 years. The prevalence of low vision was 35.7% (95% CI: 32.3, 39.3). Being female (AOR = 1.58; 95% CI: 1.10, 2.28), no formal educational level (AOR = 2.24; 95% CI: 1.25, 4.02), history of cataract surgery (AOR = 2.58; 95% CI: 1.53, 4.36), and age ≥ 70 years (AOR: 3.96; 95% CI: 2.21, 7.10) were significantly associated with low vision. Conclusion and Recommendation. The prevalence of low vision found in this study was high as compared with the national and global magnitude. Older age, being female, previous history of cataract surgery, and no formal education were independently and significantly associated with low vision. Cataract and uncorrected refractive errors were identified as the main causes of low vision. Therefore, it requires a plan to provide an eye care education to the community, increasing the quality of cataract surgery and refractive service for the community in the catchment area.

Exploring The Reasons for The Low Cataract Surgical Uptake Among Patients Detected in a Community Outreach Program in Cameroon: Focused Ethnographic Mixed-Method Study (Preprint)

2021 ◽  
Author(s):  
Mathew Mbwogge ◽  
Henry Nkumbe
Keyword(s):  
Cataract Surgery ◽  
Traditional Medicine ◽  
Cultural Beliefs ◽  
Sub Saharan Africa ◽  
Outreach Program ◽  
Eye Care ◽  
Major Barrier ◽  
Key Informants ◽  
People’S Perception ◽  
Cataract Patients

BACKGROUND Cataract, a leading cause of blindness in Sub-Saharan Africa is the clouding effect of the eye’s natural lens that can be treated through surgery. Given the many barriers surrounding cataract surgery, district eye care delivery was emphasized by Vision 2020: The Right to Sight, as one potential way to improve access to eye care. To this effect, the Magrabi ICO Cameroon Eye Institute has been involved in community eye care services since its inception, with more than 1000 sight-restoring cataract surgeries performed among patients referred from outreach camps. That notwithstanding, quite a good number of patients diagnosed with cataracts during community screening camps fail to present for surgery. This study sought to explore some of the challenges to accepting cataract surgery among community-diagnosed cataract patients. OBJECTIVE The objective of this study was five-fold including to (1) assess the level of awareness about cataract and available treatment, (2) explore barriers to cataract surgical uptake, (3) assess people’s perception about the outcome of cataract surgery, (4) understand people’s perception about free cataract surgery, and (5) explore reasons for outright refusal of cataract surgery. METHODS This was an ethnographic study from December 2018 through February 2019 in three different communities of the Lekié Division in Cameroon, in which cataract patients were diagnosed. The study sample was composed of operated cataract patients (identified through the hospital database), cataract blind patients, key informants, and community members identified through a purposeful snowball sampling technique. Focus group discussions, personalized in-depth interviews, and a short demographic questionnaire were used to collect data. Data were analyzed using an excel spreadsheet and Stata 14. Data was presented using tabular and graphical methods. RESULTS A total of 29 subjects (19 males) with a mean age of 54.5±14.5 years took part in the study. The most prominent barriers to cataract surgery were found to be cost (86.2%, 25/29) and fear of surgery (58.6%, 17/29). It was also found that 41.4% of those who do not take up cataract surgery turn to traditional medicine which itself turns out to be a major barrier to cataract surgery. Other barriers included the lack of awareness of available treatment (20.7%), no perceived need (17.24%), cultural beliefs and superstition (13.79%), and negligence (13.79%). CONCLUSIONS This study aimed at exploring the reasons for the low uptake of cataract surgery among community-diagnosed cataract patients. We found that cost (86.2%, 25/29) and fear (58.6%, 17/29) to be the main barriers. Belief in traditional medicine and superstition were the main drivers of fear. The implementation of a tiered pricing system, counselling training for Key Informants, incentives for referral of cataract patients, mass media engagement, advocacy, training and active involvement of traditional doctors as Key Informants, acquisition of a 4X4 outreach van, and motorbikes for camp organizers are some of the recommendations based on our results.

Abstract 241: Analysis of Characteristics and Mortality by the Level of Hospital in the Patients with Cardiac Arrest; A Nation-wide Population-based Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Sijin Lee ◽  
Su Jin Kim ◽  
Sung Woo Lee ◽  
Kap Su Han ◽  
Eui Jung Lee
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Regression Analysis ◽  
Health Insurance ◽  
National Health Insurance ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Hospital Level ◽  
Primary Groups ◽  
Level Hospital

Objectives: We intended to determine the association between hospital-level and mortality, and reveal differences in patient characteristics and potential resource utilization using the National health Insurance Service database. Methods: We selected adult patients (>20 years old) with non-traumatic cardiac arrest from 2006 to 2015 using the national database. The patients were categorized into ‘Tertiary’, ‘Secondary’ and ‘Primary’ groups by the level of hospital where they were treated. Demographics, insurance type, urbanization level, previous disease, medical therapies and hospital costs were analyzed among the groups. Primary end-points were mortality rate within 30 days, 6 months and 1 year. Multiple logistic regression analysis was utilized for determining the association between hospital-level and mortality (SAS ver 9.4). Results: Tertiary, Secondary and Primary groups accounted for 32.6%, 49.6% and 17.8% of total 337,042 patients. Tertiary and Secondary groups showed the higher proportion of younger age, male patients, coverage by national health insurance, urban residents and lower Charlson Comorbidity Index than Primary group. After adjusting characteristics and pre-existing diseases in multiple logistic regression analysis, the higher hospital level was negatively associated with mortality (Adjusted Odds ratio[aOR]: 0.372 and 0.419 at 30-days, aOR: 0.504 and 0.568 at 6-months, aOR: 0.538 and 0.604 at 1-year in Tertiary and Secondary groups). Advanced treatments like PCI, CABG, ECMO, EEG and therapeutic hypothermia were provided more in the higher level hospital. With regard to guideline change in 2010, there was a downturn in use of atropine and an increment in post-resuscitation care treatments in Tertiary and Secondary groups. Conclusions: Significant variability in cardiac arrest mortality exists across hospital levels, and this variation persists despite adjustment for measured patient factors. These findings suggest that higher level hospital provided more advanced procedures and post-resuscitation care, which leaded to higher hospital cost especially in acute period, and showed good adherence to guideline updates. (NRF-2017R1A2B100 5037)

Profile of Cataract Patients in the Eye, Ear, Nose and Throat Hospital, Rangoon

1989 ◽  
Vol 19 (4) ◽  
pp. 189-190 ◽  
Author(s):  
Le-Le-Win ◽  
Thein-Hlang ◽  
San-Shwe ◽  
Than-Htun-Oo ◽  
Ko-Ko-Tin
Keyword(s):  
Cataract Surgery ◽  
Operation Time ◽  
Average Period ◽  
Male Ratio ◽  
Complete Treatment ◽  
The Mean ◽  
To Come ◽  
Nose And Throat ◽  
Cataract Patients

We report on our experience of cataract surgery in the Eye, Ear, Nose and Throat Hospital (EENTH), Rangoon. Cataract patients constituted 52070 of all those admitted with eye diseases to the EENTH in a year. The mean number of cataract cases operated per month was 282. Among cataracts the senile form was the commonest. The female to male ratio for senile cataract patients was 1.2, and the average age at admission was 68 years. The mean duration of stay in hospital was 7 days with an operation time of 19min. The patients had to come to hospital for follow-up for an average period of 3.1 months to complete treatment. The need to consider cataract surgery as an outpatient procedure is discussed.

scholarly journals Studi Kasus : Kesiapan Rumah Sakit An – Nisa Tangerang Dalam Implementasi Program Jaminan Kesehatan Nasional

2019 ◽  
Vol 47 (4) ◽  
Author(s):  
Luh Putu Sinthya Ulandari
Keyword(s):  
Health Insurance ◽  
Human Resources ◽  
National Health Insurance ◽  
National Health ◽  
Thematic Analysis ◽  
Clinical Pathways ◽  
Qualitative Approach ◽  
Hospital Data ◽  
Private Hospitals ◽  
Depth Interviews

Abstract Health facilities play an important role in achieving the goals of National Health Insurance (JKN), to providing health services to all Indonesian people. The study aimed to determine the readiness of An - Nisa Hospital as one of the private hospitals in Tangerang in the implementation of the JKN. This research was conducted in March 2018 using a qualitative approach through in-depth interviews and documentation study. The sample was determined purposively, consisting of 7 internal informants from An - Nisa Hospital. Data were analyzed using thematic analysis. Various preparations have been made by An - Nisa Hospital before the hospital joined the BPJS Kesehatan provider, starting from casemix training, coding, costing, preparing clinical pathways, and learning about an information technology systems used in the JKN era. The addition of human resources, facilities and infrastructure was also carried out to support the implementation of JKN. An - Nisa Hospital formed a casemix team whose task was to compile claim documents and collect claims to BPJS Kesehatan. This study concludes that An - Nisa Hospital had prepared themselves before joining the BPJS Kesehatan provider, and the hospital is fully committed to successful the JKN Program. Keywords: preparation, implementation, national health insurance Abstrak Fasilitas kesehatan memegang peranan penting dalam tercapainya tujuan Jaminan Kesehatan Nasional (JKN) yaitu dalam memberikan pelayanan kesehatan kepada seluruh masyarakat Indonesia. Tujuan dari penelitian ini adalah untuk mengetahui kesiapan dari RS An – Nisa sebagai salah satu rumah sakit swasta di Tangerang dalam implementasi Program JKN. Penelitian dilakukan pada Maret 2018 dengan pendekatan kualitatif. Data dikumpulkan dengan wawancara mendalam dan studi dokumen. Sampel ditentukan secara purposive, yang terdiri dari 7 informan pihak internal RS An – Nisa. Data dianalisis secara deskriptif kualitatif. Berbagai persiapan telah dilakukan oleh RS An – Nisa sebelum mereka bergabung menjadi provider BPJS Kesehatan, mulai dari mengikuti pelatihan casemix, coding, costing, penyusunan clinical pathway, serta menikuti pembelajaran tentang sistem informasi teknologi yang digunakan di era JKN. Penambahan SDM, fasilitas sarana dan prasarana pun dilakukan guna mendukung penyelenggaraan JKN. RS An – Nisa membentuk sebuah tim casemix yang bertugas untuk menyusun dokumen klaim dan melakukan penagihan klaim kepada BPJS Kesehatan. Penelitian ini menyimpulkan bahwa RS An – Nisa telah mempersiapkan diri secara totalitas sebelum bergabung menjadi provider BPJS Kesehatan, serta berkomitmen penuh dalam menyukseskan program JKN. Kata kunci: Persiapan, implementasi, jaminan kesehatan nasional

scholarly journals BEST PRACTICE OF HOSPITAL MANAGEMENT STRATEGY TO THRIVE IN THE NATIONAL HEALTH INSURANCE (JKN) ERA

2021 ◽  
Vol 9 (1) ◽  
pp. 9
Author(s):  
Wahyu Pudji Nugraheni ◽  
Asri Hikmatuz Zahroh ◽  
Risky Kusuma Hartono
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
Customer Relationship Management ◽  
National Health ◽  
Management Strategy ◽  
Best Practice ◽  
Private Hospital ◽  
Customer Relationship ◽  
Government Hospital ◽  
Private Hospitals

Background: The implementation of the National Health Insurance (JKN) program has created a transformation in the health care system in Indonesia. Many hospitals were stuttering and unable to adapt to the new payment system. Some hospitals complained about INA-CBG rates that were lower than the real rates, so that hospitals suffered losses.Aims: This research aims to take the best practice from one government hospital and one private hospital that is able to thrive in the JKN era.Methods: This study used qualitative research methods through in-depth interviews.Results: The similarity of strategies carried out by the two best practice hospitals to thrive in JKN era are efficiency in business process, investment in human resources, customer relationship management, and stakeholders collaboration.Conclusion: The results of this study can be used as a reference for government and private hospitals in Indonesia to be able to thrive in the JKN era.Keywords: best practice, hospital, National Health Insurance, strategy

scholarly journals Targeting and Impact of National Health Insurance Program in Indonesia

2020 ◽  
Vol 9 (4) ◽  
pp. 468-481
Author(s):  
Galih Putri Yunistria
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Health Insurance ◽  
National Health Insurance ◽  
Logistic Regression Analysis ◽  
National Health ◽  
Health Care Facilities ◽  
National Health Insurance System ◽  
Care Facilities

National Health Insurance System (NHIS) program in Indonesia has been launched since 2014,and government spending to support the program has allocated nearly 40% of MoH budget,especially for the NHIS subsidies. This study examined the distribution of NHIS subsidizedbeneficiaries which associated with the household income distribution, and also studied about theutilization rate of health care facilities among the residents since the NHIS program has introducedto change citizens’ health seeking behaviour from traditional services to health facilities. Using the2016 Susenas data, this study employed the benefit incidence analysis method to measure thedistribution of NHIS-subsidized group, and logistic regression analysis to determine the health careseeking behavior. The result shows that households in higher income (quantile III-V) get benefitfrom government subsidy on NHIS program. It indicated there was a leakage on governmentbudget that not belong to the target (quantile I and II). Then, logistic regression analysis found thatpeople with higher income and having health insurance tend to visit health care facilities morefrequently than lower income group and uninsured people. This can be concluded that healthinsurance ownership is one of the important factors to influence people visiting health carefacilities.

scholarly journals An overview of the National Health Insurance and its possible impact on eye healthcare services in South Africa

2015 ◽  
Vol 74 (1) ◽  
Author(s):  
H. Lawrence Sithole
Keyword(s):  
South Africa ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
Public Healthcare ◽  
Health Coverage ◽  
Care Providers ◽  
Eye Care

The National Health Insurance (NHI) is an important development that underpins democracy in South Africa. It aims to redress the inequities of public healthcare delivery by implementing transformational policies towards establishing inclusive public healthcare coverage for the entire population of South Africa, with more emphasis on health promotion. The implementation of this initiative has created some hope amongst primary eye healthcare professionals, such as optometrists, that their profession may finally be given the recognition it deserves. Although the government is contemplating introducing a new directorate for eye healthcare and forming an advisory committee on eye healthcare reporting to the Minister of Health, the extent to which eye healthcare will be incorporated into the NHI is currently not clear. It is believed that the white paper on the NHI will shed some light on these issues. Unfortunately, current indications are that the initiative has serious challenges to overcome such as poor infrastructure, budgetary constraints and lack of interest from other healthcare professionals. Furthermore, corruption issues may also need to be addressed if the NHI is to be implemented successfully. Nevertheless, the NHI remains a positive proposition for universal health coverage for the people of South Africa, and there is hope that primary eye care providers, such as optometrists and other eye care professionals, will also play a greater role in the NHI than they currently do in the public healthcare system.

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