scholarly journals The Effect of COVID-19 on Referral Time and Cost of Outpatient'S Services Amongst Insured of Iran Health Insurance, Fars, 2020

2021 ◽  
Author(s):  
Mitra Nowrouzpour ◽  
Farhad Lotfi ◽  
Zohre Foroozanfar ◽  
Hossein Mourdzadeh ◽  
Mostafa Iran nezhad parizi ◽  
...  
Keyword(s):  
Health Insurance ◽  
Diagnostic Tests ◽  
Cross Sectional Study ◽  
Test Results ◽  
Sectional Study ◽  
Outpatient Services ◽  
Cross Sectional ◽  
Registry System ◽  
Data Registry ◽  
Underutilization Of Services

Abstract Background This study aimed to investigate the effect of COVID-19 epidemic on the rate of referral and costs of outpatient services covered by Iran Health Insurance, Fars, Iran. Methods In this cross-sectional study, we used data registry system of Iran health insurance to compare cost of outpatient services and referral time after occurring COVID-19 epidemic with the same time before it. Extracted items included; outpatients’ and complementary services. Statistical analyses were performed with Graph Pad Prism software version 8.0, Wilcoxon and Mann-Whitney test. Results Costs paid for all outpatient and imaging services significantly decreased in 2020 compared to 2019. Also, the number of prescriptions in all outpatient services has significantly decreased, while the number of imaging diagnostic tests significantly increased. Conclusion Further studies are recommended to evaluate whether the reduction in cost of services and referral times are due to underutilization of services or not.

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.

Prevalence and Epidemiological Characteristics of Asymptomatic Malaria Based on Ultrasensitive Diagnostics: A Cross-sectional Study

2018 ◽  
Vol 69 (6) ◽  
pp. 1003-1010 ◽  
Author(s):  
Seble Girma ◽  
James Cheaveau ◽  
Abu Naser Mohon ◽  
Dewdunee Marasinghe ◽  
Ruth Legese ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Cross Sectional Study ◽  
Rapid Diagnostic Tests ◽  
World Health ◽  
Asymptomatic Malaria ◽  
Global Public Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Qrt Pcr ◽  
Epidemiological Characteristics

Abstract Background As the global public-health objectives for malaria evolve from malaria control towards malaria elimination, there is increasing interest in the significance of asymptomatic infections and the optimal diagnostic test to identify them. Method We conducted a cross-sectional study of asymptomatic individuals (N = 562) to determine the epidemiological characteristics associated with asymptomatic malaria. Participants were tested by rapid diagnostic tests (CareStart, Standard Diagnostics [SD] Bioline, and Alere ultrasensitive RDT [uRDT]), loop-mediated isothermal amplification (LAMP), and quantitative reverse transcription polymerase chain reaction (qRT-PCR) to determine malaria positivity. Hemoglobin values were recorded, and anemia was defined as a binary variable, according to World Health Organization guidelines. Results Compared to reference qRT-PCR, LAMP had the highest sensitivity (92.6%, 95% confidence interval [CI] 86.4–96.5), followed by uRDT Alere Malaria (33.9%, 95% CI 25.5–43.1), CareStart Malaria (14.1%, 95% CI 8.4–21.5), microscopy (5.0%, 95% CI 1.8–10.5), and SD Bioline (5.0%, 95% CI 1.8–10.5). For Plasmodium falciparum specimens only, the sensitivity for uRDT Alere Malaria was 50.0% (95% CI 38.8–61.3) and SD Bioline was 7.3% (95% CI 2.7–15.3). Based on multivariate regression analysis with qRT-PCR as the gold standard, for every 3.2% increase in the prevalence of asymptomatic malaria, hemoglobin decreased by 1 gram per deciliter (prevalence ratio 0.968, 95% CI 0.940–0.997; P = .032). Deletions (4.8%) in hrp2 were noted. Conclusions While uRDT Alere Malaria has superior sensitivity to rapid diagnostic tests and microscopy in detecting asymptomatic malaria, LAMP is superior still. Ultrasensitive diagnostics provide the accurate prevalence estimates of asymptomatic malaria required for elimination.

scholarly journals Analysis of Lifestyle, Advertising Effectiveness, and Instant Coffee Consumption among Peri-Urban Farmers

2021 ◽  
Vol 6 (2) ◽  
pp. 167-182
Author(s):  
Moh. Djemdjem Djamaludin ◽  
Dewi Mutia Silmie
Keyword(s):  
Sampling Method ◽  
Agricultural Land ◽  
Coffee Consumption ◽  
Cross Sectional Study ◽  
Advertising Effectiveness ◽  
Test Results ◽  
Sectional Study ◽  
Cross Sectional ◽  
Instant Coffee ◽  
The Public

Coffee consumption is increasing because many types of coffee are circulating, such as instant coffee among the public. The instant coffee studied in this study is the Iwan Fals edition of instant coffee. This study aimed to analyse the lifestyle and effectiveness of instant coffee advertising on instant coffee consumption among peri-urban farmers in Bogor Regency. This study used a cross-sectional study design located in Cibungbulang District, Bogor Regency. The location was chosen purposive because it is a peri-urban area that has more than 20% of agricultural land. A total of 100 respondents in this study were selected using a purposive sampling method with the criteria of a farmer and in the last 12 months consuming and viewing Iwan Fals edition coffee advertisements. The results of this study found that the maker's lifestyle is the most (32%) owned by the respondents. The effectiveness of instant coffee advertising in this study is included in the effective category (3.54). The results showed a relationship between gender, believing lifestyle, trying hard lifestyle with instant coffee consumption. The influence test results found an influence of male gender and lifestyle beliefs on instant coffee consumption. In general, respondents are classified as effective in consuming coffee because of their lifestyle and increase energy.

scholarly journals Degree of regional variation and effects of health insurance-related factors on the utilization of 24 diverse healthcare services - a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wenjia Wei ◽  
Agne Ulyte ◽  
Oliver Gruebner ◽  
Viktor von Wyl ◽  
Holger Dressel ◽  
...  
Keyword(s):  
Health Insurance ◽  
Managed Care ◽  
Influencing Factors ◽  
Healthcare Utilization ◽  
Regional Variation ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional

Abstract Background Regional variation in healthcare utilization could reflect unequal access to care, which may lead to detrimental consequences to quality of care and costs. The aims of this study were to a) describe the degree of regional variation in utilization of 24 diverse healthcare services in eligible populations in Switzerland, and b) identify potential drivers, especially health insurance-related factors, and explore the consistency of their effects across the services. Methods We conducted a cross-sectional study using health insurance claims data for the year of 2014. The studied 24 healthcare services were predominantly outpatient services, ranging from screening to secondary prevention. For each service, a target population was identified based on applicable clinical recommendations, and outcome variable was the use of the service. Possible influencing factors included patients’ socio-demographics, health insurance-related and clinical characteristics. For each service, we performed a comprehensive methodological approach including small area variation analysis, spatial autocorrelation analysis, and multilevel multivariable modelling using 106 mobilité spaciale regions as the higher level. We further calculated the median odds ratio in model residuals to assess the unexplained regional variation. Results Unadjusted utilization rates varied considerably across the 24 healthcare services, ranging from 3.5% (osteoporosis screening) to 76.1% (recommended thyroid disease screening sequence). The effects of health insurance-related characteristics were mostly consistent. A higher annual deductible level was mostly associated with lower utilization. Supplementary insurance, supplementary hospital insurance and having chosen a managed care model were associated with higher utilization of most services. Managed care models showed a tendency towards more recommended care. After adjusting for multiple influencing factors, the unexplained regional variation was generally small across the 24 services, with all MORs below 1.5. Conclusions The observed utilization rates seemed suboptimal for many of the selected services. For all of them, the unexplained regional variation was relatively small. Our findings confirmed the importance and consistency of effects of health insurance-related factors, indicating that healthcare utilization might be further optimized through adjustment of insurance scheme designs. Our comprehensive approach aids in the identification of regional variation and influencing factors of healthcare services use in Switzerland as well as comparable settings worldwide.

scholarly journals Recent trends in seroprevalence of rubella in Korean women of childbearing age: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e030873 ◽  
Author(s):  
Rihwa Choi ◽  
Yejin Oh ◽  
Youngju Oh ◽  
Sung Ho Kim ◽  
Sang Gon Lee ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Korean Women ◽  
Test Results ◽  
Women Of Childbearing Age ◽  
Sectional Study ◽  
Childbearing Age ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Specific Igg ◽  
Catch Up

ObjectivesThe aim of this study was to investigate the immunity against rubella using the serological status of rubella-specific IgG antibodies (antirubella IgG) in Korean women of childbearing age (15–49 years).DesignRetrospective cross-sectional study.SettingPopulation-based cross-sectional study in South Korea.ParticipantsBetween January 2010 and December 2017, test results from Korean women aged 15–49 years who had visited an obstetric private clinic (nationwide institutions) and had requested rubella-specific IgG antibody tests from Green Cross Laboratories were obtained from the laboratory information system.ResultsBetween 2010 and 2017, antirubella IgG test results from 328 426 Korean women aged 15–49 years who had visited private obstetric clinics (1438 institutions nationwide) were retrospectively analysed by tested year, age, cohort and geographic regions. Over the 8-year study period, the rate of unimmunised women ranged from 7.8% to 9.7%. Multivariable-adjusted logistic regression models showed that the odds of being immune to rubella (positive and equivocal results of antirubella IgG test) were lower in 2017 compared with 2010, in women in their 40s, in a pre-catch-up cohort and in women living in Incheon, Busan, South Gyeongsang, North and South Jeolla and Jeju provinces (p<0.0001).ConclusionsIn consideration of the factors associated with prevalence of women unimmunised to rubella, future public health efforts should be focused on catch-up activities. The results of this study could be used to strengthen disease control and prevent rubella, including a nationwide immunisation programme.

scholarly journals Sociodemographic determinants of health insurance enrolment and dropout in urban district of Ghana: a cross-sectional study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Eric Nsiah-Boateng ◽  
Justice Nonvignon ◽  
Genevieve Cecelia Aryeetey ◽  
Paola Salari ◽  
Fabrizio Tediosi ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cross Sectional Study ◽  
Determinants Of Health ◽  
Sectional Study ◽  
Urban District ◽  
Cross Sectional ◽  
Sociodemographic Determinants
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