scholarly journals Policy Spotlight Effect in Critical Time-Sensitive Diseases

2021 ◽  
Author(s):  
Chih-Yuan Lin ◽  
Li-Chuan Chang ◽  
Yue-Chune Lee
Keyword(s):  
Septic Shock ◽  
Health Insurance ◽  
Guideline Adherence ◽  
Major Trauma ◽  
Treatment Guideline ◽  
Critical Time ◽  
Process Quality ◽  
Medical Utilization ◽  
Diagnosis And Treatment ◽  
Spotlight Effect

Abstract Background: Categorization of hospital emergency capability (CHEC) is a policy implemented worldwide to regionalize critical emergent care. The CHEC policy mainly uses time-based indicators as emergency care quality measurements.Objectives: We aimed to explore the CHEC policy spotlight effect on critical time-sensitive diseases with and without the influence of time-based surveillance indicators and guidelines. Research Design: We conducted a nationwide retrospective cohort study between 2005–2011. Regarding critical time-sensitive diseases, our study targeted acute ischemic stroke (AIS), ST-segment elevation myocardial infarction (STEMI), septic shock, and major trauma. We selected diagnosis and treatment guideline adherence as process quality measures and defined medical utilization, upward transfer rate, and short-term mortality rate as outcome indicators. Subjects: The Taiwan National Health Insurance 2005 Longitudinal Health Insurance Database contains one million random cases, including medical records and hospital information. Results: During this 7-year study AIS, STEMI, septic shock, and major trauma, respectively. AIS and STEMI cohorts had significantly higher rates of guideline adherence and better process quality than those of septic shock and major trauma cohorts. Furthermore, AIS and STEMI cohorts had a significant increase in diagnosis costs. Conclusion: The CHEC policy spotlight effect exists in critical time-sensitive diseases with time-based quality indicators. Importantly, disease entities without these indicators may experience decreases in diagnosis and treatment guideline adherence, indirectly jeopardizing their outcomes.

scholarly journals Policy Spotlight Effect In Critical Time-Sensitive Diseases

2021 ◽  
Author(s):  
Chih-Yuan Lin ◽  
Li-Chuan Chang ◽  
Yue-Chune Lee
Keyword(s):  
Septic Shock ◽  
Health Insurance ◽  
Guideline Adherence ◽  
Major Trauma ◽  
Treatment Guideline ◽  
Critical Time ◽  
Process Quality ◽  
Medical Utilization ◽  
Diagnosis And Treatment ◽  
Spotlight Effect

Abstract Background: Categorization of hospital emergency capability (CHEC) is a policy implemented worldwide to regionalize critical emergent care. The CHEC policy mainly uses time-based indicators as emergency care quality measurements.Objectives: We aimed to explore the CHEC policy spotlight effect on critical time-sensitive diseases with and without the influence of time-based surveillance indicators and guidelines. Research Design: We conducted a nationwide retrospective cohort study between 2005–2011. Regarding critical time-sensitive diseases, our study targeted acute ischemic stroke (AIS), ST-segment elevation myocardial infarction (STEMI), septic shock, and major trauma. We selected diagnosis and treatment guideline adherence as process quality measures and defined medical utilization, upward transfer rate, and short-term mortality rate as outcome indicators. Subjects: The Taiwan National Health Insurance 2005 Longitudinal Health Insurance Database contains one million random cases, including medical records and hospital information. Results: During this 7-year study AIS, STEMI, septic shock, and major trauma, respectively. AIS and STEMI cohorts had significantly higher rates of guideline adherence and better process quality than those of septic shock and major trauma cohorts. Furthermore, AIS and STEMI cohorts had a significant increase in diagnosis costs. Conclusion: The CHEC policy spotlight effect exists in critical time-sensitive diseases with time-based quality indicators. Importantly, disease entities without these indicators may experience decreases in diagnosis and treatment guideline adherence, indirectly jeopardizing their outcomes.

scholarly journals Utilization Study of Antihypertensive Medicines Among Insured Patients at a Public Tertiary Healthcare Facility in Nigeria

2020 ◽  
Vol 7 (4) ◽  
pp. 174-180
Author(s):  
Roland Okoro ◽  
Chijioke Nmeka ◽  
Patrick O. Erah
Keyword(s):  
Health Insurance ◽  
Calcium Channel ◽  
National Health Insurance ◽  
National Health ◽  
Calcium Channel Blockers ◽  
Treatment Guideline ◽  
Prescribing Patterns ◽  
Channel Blockers ◽  
Defined Daily Dose ◽  
Medicines Use

Background: Access to essential medicines through health insurance contributes substantially towards achieving hypertension control in hypertensive sub-population of a nation. Objectives: This study aimed to estimate the gender-based antihypertensive medicines use, to describe utilization patterns, and to estimate prescribing adherence to the health insurance guideline. Methods: A descriptive, cross-sectional, retrospective review of paper-based prescriptions with at least an antihypertensive medicine written for insured outpatients from 1st January – 31st December 2013 at a Nigerian Federal Teaching Hospital was conducted. The prescription volume and Anatomic Therapeutic Chemical/Defined Daily Dose (DDD) methodology was used to estimate the extent of utilization of antihypertensive medicines among the study population. Drug utilization ninety percent (DU90%) was used to quantify the index of adherence to the National Health Insurance Scheme (NHIS) guideline. Differences in proportions were investigated with Pearson chi-square test (χ2). A p-value of less than 0.05 was considered statistically significant. Results: Females recorded significantly higher antihypertensive medicines use compared to their male counterparts (61.5% versus 38.5%, p < 0.05). Diuretics (32.1% and 9935.28 DDD) and calcium channel blockers (32.1% and 8286 DDD) were the most commonly prescribed and utilized antihypertensive medicine classes. The index of adherence to the NHIS standard treatment guideline is 80.7%. Conclusion: This study showed that diuretics (most frequently hydrochlorothiazide) and calcium channel blockers (most frequently amlodipine) were the most utilized antihypertensive medicine classes. Physicians’ prescribing patterns fell below the hundred percent benchmark of the country’s National Health Insurance programme guideline with respect to antihypertensive medicines.

scholarly journals SATISFACTION OF INSURED PATIENTS GETTING DIAGNOSIS AND TREATMENT SERVICES IN HOI AN HEALTH STATION, CHO MOI DISTRICT, AN GIANG PROVINCE IN 2020: STATUS AND SOME ASSOCIATED FACTORS.

2020 ◽  
Vol 62 (1) ◽  
Author(s):  
Thanh Hải Nguyễn ◽  
Thanh Hùng Phùng ◽  
Quỳnh Anh Phạm
Keyword(s):  
Health Insurance ◽  
Scientific Evidence ◽  
Diagnosis And Treatment ◽  
Treatment Service ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Research Results ◽  
Satisfaction Rate ◽  
The Board Of Directors ◽  
Insured Patients

Research was conducted with two objectives which are to describe and to analyze some factors affecting the satisfaction of insured patients getting diagnosis and treatment service in Hoi An health station, Cho Moi district, An Giang province. The research design is cross-sectional description, combining quantitative and qualitative. The research used SERQUAL questionaire, interviewed 288 inpatients. The research results show that 81.2% insured patients satisfied with diagnosis and treatment service in Hoi An health station, in which the overall satisfaction rate of insured patients with sympathy factor is 74.7%. Factor having lowest satisfaction rate of insured patient is trust factor (60.1%). Our study also found some factors related to patient satisfaction. They are occupation (OR = 2.1), number of visits per year (OR = 2.5), number of times using health insurance card (OR = 2.0), health insurance services counseling (OR = 2.6). The research results provide scientific evidence to advise the Board of Directors to propose solutions to improve the quality of medical examination and treatment and increase patient confidence.

scholarly journals Class-Modeling of Septic Shock With Hyperdimensional Computing

2021 ◽  
Author(s):  
Neftali D Watkinson ◽  
Tony Givargis ◽  
Victor Joe ◽  
Alexandru Nicolau ◽  
Alexander Veidenbaum
Keyword(s):  
Septic Shock ◽  
Immune System ◽  
Critical Time ◽  
Classification Approach ◽  
Acute Change ◽  
Patient State ◽  
Organ Tissue ◽  
Target Priority ◽  
One Class Classification ◽  
Sensitivity Increase

Sepsis arises when a patient's immune system has an extreme reaction to an infection. This is followed by septic shock if damage to organ tissue is so extensive that it causes a total systemic failure. Early detection of septic shock among septic patients could save critical time for preparation and prevention treatment. Due to the high variance in symptoms and patient state before shock, it is challenging to create a protocol that would be effective across patients. However, since septic shock is an acute change in patient state, modeling patient stability could be more effective in detecting a condition that departs from it. In this paper we present a one-class classification approach to septic shock using hyperdimensional computing. We built various models that consider different contexts and can be adapted according to a target priority. Among septic patients, the models can detect septic shock accurately with 90% sensitivity and overall accuracy of 60% of the cases up to three hours before the onset of septic shock, with the ability to adjust predictions according to incoming data. Additionally, the models can be easily adapted to prioritize sensitivity (increase true positives) or specificity (decrease false positives).

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