scholarly journals How the resource allocation and inpatient behavior affect the expenditures of terminal malignant tumor patients?

2019 ◽  
Author(s):  
Fen Li ◽  
Bifan Zhu ◽  
Peimin Sang ◽  
Chunlin JIN
Keyword(s):  
Resource Allocation ◽  
Influencing Factors ◽  
Malignant Tumor ◽  
Behavioral Model ◽  
Tumor Patients ◽  
Medical Resources ◽  
Terminal Stage ◽  
Inappropriate Use ◽  
Medical Institutions ◽  
Tertiary Hospitals

Abstract Background: The inappropriate use of medical resources and escalating health expenditures of severe diseases patients has been a great concern in China’s health system especially among terminal stage. This study aims to analyze how the resource allocation and hospitalization behavior affect the expenditures of terminal malignant tumor patients, and provide evidences on resource allocation and utilization. Methods: An analysis framework of influencing factors of medical expenses was built according to Andersen’s Behavioral Model. Hospitalization expenditures of malignant tumor patients who died in medical institutions were tracked in Shanghai in 2016. We use path analysis to analyze the influencing factors of hospitalization expenditures at terminal stage. Results: Results demonstrated that hospital services and expenditures during the terminal stage were primarily in tertiary hospitals. The top three influencing factors were length of stay, number of admissions and level of medical institutions. While the influence of demographic characteristics (age, gender, type of medical insurance, etc.) was relatively low. Conclusions: Data suggest that hospitalization expenditures and patients’ economic burden can be reduced through adjusting allocation of medical resources and service utilization, as well as reducing unnecessary hospitalization days.

scholarly journals Research progress of EMT in Cancer Metastasis

2021 ◽  
Vol 245 ◽  
pp. 03049
Author(s):  
Ruoyun Du
Keyword(s):  
Cancer Treatment ◽  
Influencing Factors ◽  
High Mortality ◽  
Malignant Tumor ◽  
Cancer Metastasis ◽  
Research Progress ◽  
Signal Pathways ◽  
Tumor Patients ◽  
Deadly Disease ◽  
To Receive

Cancer is still a deadly disease that haunts people. Once there is a malignant tumor, patients need to receive a series of expensive, complex and painful treatments. Even so, cancer still causes high mortality, for its ability to easily metastasizing to other organs, without effective cures for any kind of cancer so far. Therefore, researchers have been trying to explore its mechanism and find ways to inhibit its development and discover new cure from various aspects. The latest research found that Epithelial-Mesenchymal Transitions (EMT) may be related to cancer, especially in the metastasis. It can be a breakthrough finding that render cancer a curable disease. In this paper, we systematically introduce the definition, classification, mechanism, influencing factors of EMT and its relationship with cancer metastasis and provide new angles and ideas for further exploring all levels of signal pathways and cancer treatment.

Quality of Life and Resource Allocation

1988 ◽  
Vol 23 ◽  
pp. 33-55 ◽  
Author(s):  
Michael Lockwood
Keyword(s):  
Quality Of Life ◽  
Resource Allocation ◽  
Quality Adjusted Life Year ◽  
Medical Resources ◽  
Medical Vocabulary ◽  
Quality Adjusted Life

A new word has recently entered the British medical vocabulary. What it stands for is neither a disease nor a cure. At least, it is not a cure for a disease in the medical sense. But it could, perhaps, be thought of as an intended cure for a medicosociological disease: namely that of haphazard or otherwise ethically inappropriate allocation of scarce medical resources. What I have in mind is the term ‘QALY’, which is an acronym standing for quality adjusted life year. Just what this means and what it is intended to do I shall explain in due course. Let me first, however, set the scene.

scholarly journals Study on Influencing Factors to HIV Health Services Among Men Who Have Sex with Men (MSM) from 2013 to 2021

2021 ◽  
Author(s):  
Bing Lin ◽  
Jiaxiu Liu ◽  
Hong Pan ◽  
Yingjie Ma ◽  
Xiaoni Zhong
Keyword(s):  
Health Services ◽  
Condom Use ◽  
Hiv Testing ◽  
Influencing Factors ◽  
Behavioral Model ◽  
Consistent Condom ◽  
Hiv Knowledge ◽  
Consistent Condom Use ◽  
Predisposing Factor ◽  
Hiv Counseling

Abstract Background We assessed the utilization of HIV health services and its influencing factors on consistent condom use, HIV testing and HIV counseling among men who have sex with men (MSM) based on Andersen Behavioral Model, so as to provide a theoretical basis for future infectious disease prevention and control strategies and health services policy formulation.method This is a cross-sectional study from 2013 to 2021. A sample survey was conducted in southwest China including Chongqing, Sichuan, Xinjiang and Guangxi, and an anonymous self-administered questionnaire survey was conducted among MSM who met the requirements and were recruited. Based on Anderson Behavioral Model, the questionnaire divided the influencing factors into predisposing factor, enabling factor and need factor. There were 2908 valid questionnaires. Multivariate logistic regression analysis was used to explore the factors influencing the utilization of health services.Results In the survey of HIV health services, 36.49% of respondents consistently used condoms, 82.81% had HIV testing, and 65.61% had HIV counseling. It can be obtained that among the predisposing factor, older age is a factor that promotes HIV testing but is a hindrance to consistent condom use. Condom use was higher among MSM who were Ethnic Han and had an education level of "junior high or below". Among the enabling factor, not finding a sexual partner through the Internet, not having commercial sex were associated with consistent condom use. Urban and high income were enablers of HIV testing and HIV counseling. Among the need factor, improved HIV knowledge could promote HIV testing and HIV counseling among MSM.Conclusions For these groups, MSM with high-risk characteristics should be identified as a priority in the future public health services. HIV knowledge should be promoted in health education, and mental health diagnosis and treatment also should be strengthened.

scholarly journals Trend and Factors Associated with Repeat Computed Tomography Examinations in Tertiary Hospitals: Linked Health Administrative Data in Western Australia

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Ninh Ha
Keyword(s):  
Ct Scan ◽  
Western Australia ◽  
Age Groups ◽  
Ct Scanning ◽  
Major Surgery ◽  
Factors Associated ◽  
Inappropriate Use ◽  
Tertiary Hospitals ◽  
Picture Archiving And Communication ◽  
Hospital Morbidity

IntroductionComputed tomography (CT) has become an essential part of clinical practice. However, repeat CT scans has raised a concern about unnecessary exposure to ionising radiation and waste of health care resource. While substantial effort is underway to reduce inappropriate use of diagnostic imaging tests including CT, little evidence of any change in repeat CT use and its associated factors. Objectives and ApproachThis study aimed to measure trend in repeat CT use and identify factors associated with repeat CT use in tertiary hospitals in Western Australia (WA). This study used WA linked administrative records from hospital morbidity, emergency department presentations, and picture archiving and communication system datasets to capture all tertiary hospitalisations and number of CT use during the admission from 2003 to 2015. Multivariate logistic regression was used to examine trend and determine characteristics associated with repeat CT, for admissions with and without major surgery during hospitalisation. ResultsAmong 303,439 admissions with CT scan 11.9% had repeat CT scan in the same anatomic areas. While the probability of repeat CT among admission with surgery remained unchanged over the study period, its counterpart significantly reduced about 4% per year. Regardless of surgical status, repeat CT scanning was significantly lower among females, Indigenous and older age groups but higher among people living in rural and remote areas. We found that admissions for circulatory conditions, injuries, cancer or multimorbidity had significantly higher probability of having repeat CT. Conclusion / ImplicationsThis study indicates that clinical factors such as cancer, injury and multimorbidity are factors contributing to repeat CT. A reduction of repeat CT over the study period among admissions without surgical procedure suggests a potential reduction of unnecessary CT scan, although further study is needed to fully capture whether this is an actual change in practice.

Resource allocation

2021 ◽  
pp. 119-130
Author(s):  
Anna Smajdor ◽  
Jonathan Herring ◽  
Robert Wheeler
Keyword(s):  
Resource Allocation ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Quality Adjusted Life Years ◽  
Medical Resources ◽  
Life Years ◽  
Ethical Basis ◽  
Quality Adjusted Life

This chapter explores the issues around the rationing of medical resources. It considers the different ways in which restrictions are imposed on what treatments are available and the ethical basis on which these assessments are based. This includes the controversial 'quality adjusted life years' method which is used to determine a cost/benefit analysis of different treatments. The chapter also examines how rationing is consistent with broader themes of justice.

Is ROC analysis a tool that should replace probative analysis in studying lineups?

2016 ◽  
Vol 6 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Avraham Levi
Keyword(s):  
Malignant Tumor ◽  
Design Methodology ◽  
Roc Analysis ◽  
Roc Curves ◽  
Content Type ◽  
Inappropriate Use ◽  
Confidence Judgments ◽  
Innocent Suspect

Purpose – The purpose of this paper is to explain why ROC analysis is an inappropriate replacement for probative analysis in lineup research. Design/methodology/approach – Taking as the medical example comparing two methods to detect the presence of a malignant tumor (Mickes et al., 2012), and operationally defining ROC analysis: radiologists are shown the results from two methods. Their confidence judgments create a graph of correct identifications by mistaken ones. The author can compare the methods on radiologists’ ability to differentiate sick from healthy. Lineup researchers create two distinct lineups. In target-present lineups, witnesses differentiate between the target and the foils, not the target and the innocent suspect. In target-absent lineups, witnesses cannot even differentiate between innocent suspects and foils, having seen none. Findings – Eyewitness ROC curves are similar to probative analysis, but provide less useful information. Research limitations/implications – Researchers ware warned against using ROC when conducting lineup research. Originality/value – Preventing inappropriate use of ROC analysis.

scholarly journals Clinical Research of Acupuncture on Malignant Tumor Patients for Improving Depression and Sleep Quality

2011 ◽  
Vol 31 (3) ◽  
pp. 199-202 ◽  
Author(s):  
Yu FENG ◽  
Xin-yu WANG ◽  
Shao-dan LI ◽  
Yin ZHANG ◽  
Hai-ming WANG ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Clinical Research ◽  
Malignant Tumor ◽  
Tumor Patients

Survey of Preventable Disaster Deaths at Medical Institutions in Areas Affected by the Great East Japan Earthquake: Retrospective Survey of Medical Institutions in Miyagi Prefecture

2017 ◽  
Vol 32 (5) ◽  
pp. 515-522 ◽  
Author(s):  
Satoshi Yamanouchi ◽  
Hiroyuki Sasaki ◽  
Hisayoshi Kondo ◽  
Tomohiko Mase ◽  
Yasuhiro Otomo ◽  
...  
Keyword(s):  
Organizational Support ◽  
Environmental Conditions ◽  
Preliminary Investigation ◽  
Medical Intervention ◽  
Great East Japan Earthquake ◽  
Medical Resources ◽  
Retrospective Survey ◽  
Emergency Shelters ◽  
Medical Institutions ◽  
Miyagi Prefecture

AbstractIntroductionIn 2015, the authors reported the results of a preliminary investigation of preventable disaster deaths (PDDs) at medical institutions in areas affected by the Great East Japan Earthquake (2011). This initial survey considered only disaster base hospitals (DBHs) and hospitals that had experienced at least 20 patient deaths in Miyagi Prefecture (Japan); therefore, hospitals that experienced fewer than 20 patient deaths were not investigated. This was an additional study to the previous survey to better reflect PDD at hospitals across the entire prefecture.MethodOf the 147 hospitals in Miyagi Prefecture, the 14 DBHs and 82 non-DBHs that agreed to participate were included in an on-site survey. A database was created based on the medical records of 1,243 patient deaths that occurred between March 11, 2011 and April 1, 2011, followed by determination of their status as PDDs.ResultsA total of 125 cases of PDD were identified among the patients surveyed. The rate of PDD was significantly higher at coastal hospitals than inland hospitals (17.3% versus 6.3%; P<.001). Preventable disaster deaths in non-DBHs were most numerous in facilities with few general beds, especially among patients hospitalized before the disaster in hospitals with fewer than 100 beds. Categorized by area, the most frequent causes of PDD were: insufficient medical resources, disrupted lifelines, delayed medical intervention, and deteriorated environmental conditions in homes and emergency shelters in coastal areas; and were delayed medical intervention and disrupted lifelines in inland areas. Categorized by hospital function, the most frequent causes were: delayed medical intervention, deteriorated environmental conditions in homes and emergency shelters, and insufficient medical resources at DBHs; while those at non-DBHs were disrupted lifelines, insufficient medical resources, delayed medical intervention, and lack of capacity for transport within the area.Conclusion:Preventable disaster death at medical institutions in areas affected by the Great East Japan Earthquake occurred mainly at coastal hospitals with insufficient medical resources, disrupted lifelines, delayed medical intervention, and deteriorated environmental conditions in homes and emergency shelters constituting the main contributing factors. Preventing PDD, in addition to strengthening organizational support and functional enhancement of DBHs, calls for the development of business continuity plans (BCPs) for medical facilities in directly affected areas, including non-DBHs.YamanouchiS, SasakiH, KondoH, MaseT, OtomoY, KoidoY, KushimotoS. Survey of preventable disaster deaths at medical institutions in areas affected by the Great East Japan Earthquake: retrospective survey of medical institutions in Miyagi Prefecture. Prehosp Disaster Med. 2017;32(5):515–522.

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