scholarly journals Internet Hospital in China during COVID-19: National Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Xingyan Xu ◽  
Yingying Cai ◽  
Jianhui Guo ◽  
Le Yang ◽  
Yi Sun ◽  
...  
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Virus Disease ◽  
Digital Health ◽  
Outpatient Service ◽  
Median Number ◽  
Smartphone App ◽  
Cross Sectional ◽  
Medical Needs ◽  
Mobile Medicine

BACKGROUND The Internet hospital is rapidly developing in China as an innovative approach to providing health services. The corona virus disease 2019 (COVID-19) outbreak has boost the process because Internet hospital has the ability to provide widespread accessible outpatient service delivery via Internet technologies for the public during the epidemic. To date, China's Internet hospitals during the COVID-19 pandemic have not been systematically investigated. OBJECTIVE The aim of this study is to understand the characteristics of China's Internet hospitals, and to assess their health service capacity. METHODS Using “Internet hospitals”, “Internet health”, “Internet medicine”, “mobile medicine”, “mobile health”, “Telehealth”, “digital medicine”, “digital health”, “Web hospitals”, and “Cloud hospitals” in Chinese as the search terms, the data of Internet hospitals were collected via official website, the WeChat platform, smartphone app and the Baidu search engine until July, 2020. RESULTS By July 2020, the number of Internet hospitals had expanded to 714 in 31 provinces. Of the 714 Internet hospitals, the half of Internet hospitals were established in 2019 (206, 28.85%) and 2020 (215, 30.11%). Especially, Internet hospitals set up in the beginning of 2020, as an emergency response to the COVID-19 epidemic, has a one-third weight in the final total. There are three different dominators—government-oriented, hospital-oriented, and enterprise-oriented internet hospitals—for which sponsors have different characters of supporting content and responsibilities. In the vast majority of Internet hospitals, traditional hospitals have dominant position (73.67%, 526/714). In addition, patients accessed outpatient service delivery via WeChat (224, 35.05%) most widely. 221 (46.14%) of Internet hospitals asked doctors to give health services at a specific Web clinic, while 258(53.86%) by smartphone app. The consulting methods included graphic message (96.84%), video (43.51%) and telephone (41.75%). Besides, 106(18.60%) Internet hospitals offered 3 ways to consult for patients at the same time. The median number of doctors available online was 43. The median consultation fee of fever clinic and other outpatient clinics except fever clinic per time were separately ¥0 and ¥6. Four-fifths(80.94%) of doctors were from local hospitals and medical union. Internet hospitals played various roles during COVID-19, such as medical prescription, drug delivery service, medical insurance, epidemic prevention and control information, fever clinic consultation, psychological counseling, myth busters of COVID-19, epidemic situation dynamic and donation. CONCLUSIONS Internet hospitals are booming in China. Internet hospital play an important role on preventing and controlling COVID-19, providing different and convenient types of medical services for people seeking medical needs.

Digital health services during COVID-19: A cross-sectional study among Chinese men who have sex with men (Preprint)

2021 ◽  
Author(s):  
Yuan Xiong ◽  
Yewei Xie ◽  
Hongbo Jiang ◽  
Guangquan Shen ◽  
Yi Zhou ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Online Survey ◽  
Digital Health ◽  
Cross Sectional Study ◽  
Health Problems ◽  
Medical Services ◽  
Health Seeking ◽  
Cross Sectional ◽  
Medical Needs

BACKGROUND In early 2020, many HIV and sexual health clinics shut down or only provided limited services because of COVID-19. How to ensure high-quality HIV and sexual health services for MSM during emergency responses is a critical challenge. This study evaluates Chinese MSM medical seeking behaviors before and during COVID-19 measures and explores the use of digital health (e.g., health information, online consultation, WeChat-based virtual hospitals) during the COVID-19 measures. OBJECTIVE MSM have sub-optimal healthcare seeking for health problems due to fear of unintentional disclosure of sexual orientation, fear of discrimination by healthcare workers. Digital health provides a comfortable alternative and is gaining popularity among MSM for both general and sexual health problems. This paper examines how MSM use digital health for common health issues and whether COVID-19 have any effects on their use of digital health. METHODS Data were collected from a nationwide online survey between 18 May to 2 June of 2020, a period when lockdown in China was easing. Men who ever had sex with another man, were 18 years or older, and assigned as male at birth were eligible. Survey collected information on health seeking behavior and use of digital health in three months before and during COVID-19 measures (23 January 2020). Variables that may associate with digital health use were evaluated. RESULTS Among 731 men (age: 29.2±7.3) recruited, most were never married (86.5%, 632/731), and identified as gay (81.7%, 597/731). The proportion of men who sought offline medical services at hospitals decreased from 49.1% (359 /731) before COVID-19 measures to 30.2% (221/731) during COVID-19 measures (P<0.001). Half (50.8%, 371/731) of the participants ever used digital health before COVID-19 and 35.6% (260/731) used it during the pandemic. Only 27% (197/731) reported that digital health services met their medical needs in general during the pandemic. Men living with HIV (AOR=1.92, 95%CI: 1.08-3.45) were more likely to use digital health during COVID-19 measures. CONCLUSIONS COVID-19 affected access to facility-based medical services. MSM were able to use some digital health services when facility-based services were not available. Further research is needed to optimize digital health services.

scholarly journals ANALISA TINGKAT KEPUASAN PASIEN RAWAT JALAN DI INSTALASI FARMASI BUDI SETIA LANGOWAN KABUPATEN MINAHASA

PHARMACON ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 888
Author(s):  
Gerald N. P. Tulung ◽  
Gayatri Citraningtyas ◽  
Imam Jayanto
Keyword(s):  
Health Services ◽  
Outpatient Service ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
A Value ◽  
Level Of Satisfaction ◽  
The Relationship

ABSTRACT The quality of health services is classified as good if the health services provided could cause satisfaction to each patient in accordance with the level of satisfaction of the average population who are the main target of the health service. The purpose of this study was to determine the level of satisfaction of outpatients with the quality of pharmacy services at the Pharmacy Installation at Budi Setia Langowan Hospital. This research is a cross-sectional study with the study sample determined using the accidental sampling method, which is a sampling technique by taking samples randomly. Data were taken by prospective way then analyzed using statistical methods with SPSS analysis program, using bivariate analysis to test the relationship between independent variables, namely the level of outpatient satisfaction with the dependent variable namely Outpatient Service Quality (Tangibles, Reliability, Responsiveness, Assurance, and Empathy) given by the hospital to outpatients. The results showed that the value of outpatient patient satisfaction was at a positive index with a value of 0.07 with a CSI value of 87.74, which was in the very satisfied range, thus stating overall of the patients receiving pharmaceutical services at the Budi Setia Langowan Pharmacy Installation, had felt very satisfied. Keywords: Analysis of the level of satisfaction of outpatients, Budi Setia Langowan. ABSTRAK Kualitas pelayanan kesehatan digolongkan baik jika pelayanan kesehatan yang diberikan dapat menimbulkan rasa puas pada setiap pasien yang sesuai dengan tingkat kepuasan rata-rata penduduk yang menjadi target utama dari pelayanan kesehatan tersebut. Tujuan penelitian ini untuk mengetahui tingkat kepuasan pasien rawat jalan terhadap kualitas pelayanan kefarmasian di Instalasi Farmasi Rumah Sakit Budi Setia Langowan. Penelitian ini merupakan penelitian cross-sectional dengan sampel penelitian ditetapkan menggunakan metode accidental sampling, yaitu teknik pengambilan sampel dengan mengambil sampel secara bebas. Data yang diambil secara prospektif  kemudian  dianalisis menggunakan metode statistik dengan program analisis SPSS, dengan menggunakan Analisis bivariat untuk melakukan uji hubungan antara variabel bebas yaitu tingkat kepuasan pasien rawat jalan dengan variabel terikat yaitu Mutu Pelayanan Rawat Jalan (Tangibles, Reliability, Responsiveness, Assurance, dan Emphaty) yang diberikan Rumah Sakit kepada pasien tawat jalan. Hasil penelitian menunjukan nilai Ikj kepuasan pasien  rawat jalan berada pada indeks positif dengan nilai 0,07 dengan nilai CSI sebesar 87,74 yang berada pada rentang sangat puas, sehingga menyatakan secara keseluruhan pasien yang menerima pelayanan kefarmasian di Instalasi Farmasi Budi Setia Langowan sudah merasa sanggat puas. Kata kunci : Analisa tingkat kepuasan pasien rawat jalan, Budi Setia Langowan.

scholarly journals HIV-Related Stigma and Discrimination (S&D) among Healthcare Workers (HCW) in Government Healthcare Facilities in Malaysia: Is It Real?

2021 ◽  
Vol 13 (11) ◽  
pp. 66
Author(s):  
Zailatul Hani Mohamad Yadzir ◽  
Mazliza Ramly ◽  
Anita Suleiman
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Significant Proportion ◽  
People Living With Hiv ◽  
Good Care ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Stigma And Discrimination ◽  
Stigmatizing Attitudes ◽  
Living With Hiv

Stigma and discrimination (S&amp;D) undermine quality of life of people living with HIV (PLHIV) and their access to health services. In this context, an understanding of current stigmatizing attitudes among HCW towards PLHIV from the perspective of Malaysia healthcare setting is crucial to plan for service delivery improvement that is non-stigmatizing and non-discriminatory. The objective of this study was to examine and measure the level of S&amp;D towards PLHIV among HCW in selected government facilities. A cross-sectional study was undertaken from July to August 2020 in five government hospitals and six government health clinics in Malaysia. Two sets of a validated self-administered questionnaires, one for HCW and another one for PLHIV were used to assess HIV-related S&amp;D. This survey was conducted via web-based platform. Overall, 3880 HCW and 1173 PLHIV participated in this study. This study found significant proportion of HCW were having stigmatizing attitudes towards PLHIV. This includes fear of taking blood from PLHIV (87%) and double gloving when attending PLHIV (64%) probably due to fear of contracting HIV. In addition, 45% of HCW agreed that women living with HIV (WLHIV) should be prohibited from having children. Although HCW have fears for contracting HIV, their consciences and integrity allowed them to display some positive attitudes towards PLHIV with the majority of HCW 84% and 79% stated that they having observed others in their facility expressed willingness to care and providing good care to PLHIV. On PLHIV experience, only 12% of them reported that they had ever experienced stigma when accessing health services. The findings of this study shared a worrying magnitude of stigma towards PLHIV among HCW in Malaysia. Nevertheless, ethics and professionalism are upheld through giving good care and services to PLHIV. However, stigma reduction intervention programmes are still needed for HCW to ensure continuous excellent service delivery.

scholarly journals Impact of Social and Relational Adversity on Access to Services among US Children with Autism Spectrum Disorder 2016–2019

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1099
Author(s):  
Sarah D. Ronis ◽  
Eunice Lee ◽  
Carrie Cuffman ◽  
Kimberly Burkhart
Keyword(s):  
Health Services ◽  
Childhood Adversity ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Medical Needs ◽  
Children With Asd ◽  
Us Children ◽  
The Impact

To explore the impact of social and relational adversity on access to key health services among US children with autism spectrum disorders (ASD), cross-sectional analyses of the 2016–2019 National Survey of Children’s Health assessed use of key health services by children with ASD, accounting for differences in demographic characteristics, medical needs, and experience of social and relational adversities. sUS children with ASD were more than twice as likely as peers without ASD to report two or more social adversities and more than three times as likely to report two or more relational adversities. In multivariable models, relational adversities were significantly associated with greater odds of medication use for ASD (OR 1.50, 95%CI:1.02, 2.17). Social adversities were neither associated with receipt of behavioral therapies nor prescription of medication to treat ASD. Screening for various forms of adversity among youth with ASD is of great importance; even one adverse experience may be enough to influence care of a child with ASD, with differences in effect according to the nature of the particular adversity. Further research should evaluate the role that childhood adversity plays in physical and mental health outcomes in ASD.

scholarly journals Potential Drug–Drug Interactions among Hospitalized COVID-19 Patients Admitted to Medical Wards of a Referral Hospital, North-East of Iran: A Cross Sectional Study

2021 ◽  
Author(s):  
Niloofar Saber-Moghaddam ◽  
Sepideh Hejazi ◽  
Sepideh Elyasi
Keyword(s):  
Drug Interaction ◽  
Virus Disease ◽  
Median Number ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
North East ◽  
East Of Iran ◽  
Drug Drug Interaction

Background: Hospitalized corona virus disease 2019 (COVID-19) patients are special population in term of drug-drug interaction (DDI), as they receive various experimental novel medications and also most of them are elderly with various comorbidities and consequently numerous medications. The aim of present study was to assess the prevalence and determinants of potential DDIs in hospitalized COVID-19 patients admitted to the medical ward of a Referral Hospital in North-East of Iran. Methods: A cross-sectional study was conducted among COVID-19 inpatients between March 2020 and April 2020. Prescribed medication being taken concurrently for at least 24 h were included and checked for DDI using Lexicomp® online drug reference. Data were analyzed using SPSS19. Results: A total of 88 patients were evaluated. The cardiovascular disease was the most common comorbidity (30.68%). The median number of medications prescribed for each patient was 5. Hydroxychloroquine was the most common prescribed medication for COVID-19 management (92.05%). About two-third (62.5 %) of patients were exposed to at least one potential C (84.09 %) or D (52.27%) DDI and no X DDIs were found. Patients with at least five prescribed medications were at higher risk of having DDI (P = 0.001). Conclusion: Drug–drug interaction in COVID-19 inpatients was common. Considering these DDIs, clinical pharmacist involvement can be helpful in minimizing the risk of these potentially harmful drug combinations.

scholarly journals Gambaran Faktor Penyebab Rujukan Di Puskesmas Kota Depok

2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Iin Nurlinawati ◽  
Rosita Rosita ◽  
Sefrina Werni
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Center ◽  
Health Workers ◽  
Health Centre ◽  
Health Centers ◽  
Cross Sectional ◽  
Medical Needs ◽  
Primary Health

Referral System for Individual Health Services states that health services are conducted in stages according to medical needs, starting from basic, second, and then third level health . The BPJS standard on the referral ratio limitation from health center to hospital is 15%. A total of 22 out of 32 health centers (69%) in Depok have referral ratios above 15%. This study was to identify factors infl uencing high referral ratios at health centers in Depok..This study was implemented from March to October 2017 by cross sectional design. The population was 32 health centers in Depok. Samples were health centers in Depok registered by BPJS as FKTP. There were 12 health centers, each 6 with high and low referrals. The sample of health workers were providers such as: doctors and dentist, heads of health centers and health offi ces. The results showed that the most referenced disease was a refraction disorder, unspecifi ed. Most primary health care with a high referral ratio (> 15%) did not have the required compulsory services at the primary health care, especially emergency and laboratory services (66.7%). The type of health personnel was less than that at Permenkes 75 of 2014 (83.3%). Facilities and infrastructure in health center were out of standards. Less drugs supplies also affected to referral. Suggestion: The government needs to provide more types of services, numbers of health workers and infrastructure in order to support the capacity of the health centre as well as better services . Abstrak Sistem Rujukan Pelayanan Kesehatan Perorangan menyebutkan bahwa pelayanan kesehatan dilaksanakan secara berjenjang sesuai kebutuhan medis, dimulai dari pelayanan dasar ke pelayanan kesehatan tingkat kedua berlanjut ke tingkat ketiga. Standar BPJS mengenai batasan rasio rujukan puskesmas ke pelayanan kesehatan tingkat lanjut maksimal 15%. Sebanyak 22 puskesmas (69%) dari 32 puskesmas di Kota Depok yang memiliki rasio rujukan diatas 15%. Penelitian ini bertujuan untuk memberikan gambaran faktor yang mempengaruhi rasio rujukan tinggi di puskesmas Kota Depok. Penelitian dilaksanakan pada bulan Maret sampai Oktober 2017. Metode yang digunakan adalah cross sectional (potong lintang). Populasi penelitian sebanyak 32 puskesmas di Kota Depok. Sampel yang diambil adalah puskesmas Kota Depok yang telah terdaftar pada BPJS sebagai FKTP sebanyak 12 puskesmas, 6 puskesmas dengan rujukan tinggi dan 6 puskesmas dengan rujukan rendah. Sampel tenaga kesehatan yang diwawancara meliputi pemberi pelayanan (dokter dan dokter gigi), kepala puskesmas dan Kepala Bidang Yankes Dinas Kesehatan. Hasil penelitian menunjukkan bahwa penyakit yang paling banyak dirujuk adalah disorder of refraction, unspecifi ed (kelainan refraksi mata). Sebagian besar puskesmas dengan rasio rujukannya tinggi (>15%) tidak memiliki kelengkapan pelayanan yang wajib ada di puskesmas terutama pelayanan gawat darurat dan laboratorium (66,7%). Jenis tenaga kesehatan kurang dari jumlah yang ada berdasarkan Permenkes 75 tahun 2014 (83,3%). Sarana dan prasarana belum sesuai dengan standar yang harus ada di puskesmas. Obat-obatan yang tidak tersedia di puskesmas menjadi salah satu alasan melakukan rujukan. Saran: Pemerintah harus selalu berupaya melengkapi jenis pelayanan, tenaga kesehatan dan sarana prasarana di puskesmas, agar kemampuan puskesmas dalam memberikan pelayanan menjadi lebih baik lagi.  

Collecting patient reported outcomes to facilitate prescription opioid management: Development and testing of the Opioid Management App (OM-App) (Preprint)

2020 ◽  
Author(s):  
Jessica Robinson-Papp ◽  
Gabriela Cedillo ◽  
Richa Deshpande ◽  
Mary Catherine George ◽  
Qiuchen Yang ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Risk Behaviors ◽  
Digital Health ◽  
Monitoring Program ◽  
Prescription Opioid ◽  
Research Database ◽  
Cross Sectional ◽  
Study Duration ◽  
Patient Reported

BACKGROUND Collecting patient-reported data needed by clinicians to adhere to opioid prescribing guidelines represents a significant time burden. OBJECTIVE We developed and tested an opioid management app (OM-App) to collect these data directly from patients. METHODS OM-App used a pre-existing digital health platform to deliver daily questions to patients via text-message and organize responses into a dashboard. We pilot tested OM-App over 9 months in 40 diverse participants with HIV who were prescribed opioids for chronic pain. Feasibility outcomes included: ability to export/integrate OM-App data with other research data; patient-reported barriers and adherence to OM-App use; capture of opioid-related harms, risk behaviors and pain intensity/interference; comparison of OM-App data to urine drug testing, prescription drug monitoring program data, and validated questionnaires. RESULTS OM-App data was exported/integrated into the research database after minor modifications. Thirty-nine of 40 participants were able to use OM-App, and over the study duration 70% of all OM-App questions were answered. Although the cross-sectional prevalence of opioid-related harms and risk behaviors reported via OM-App was low, some of these were not obtained via the other measures, and over the study duration all queried harms/risks were reported at least once via OM-App. Clinically meaningful changes in pain intensity/interference were captured. CONCLUSIONS OM-App was used by our diverse patient population to produce clinically relevant opioid- and pain-related data, which was successfully exported and integrated into a research database. These findings suggest that OM-App may be a useful tool for remote monitoring of patients prescribed opioids for chronic pain. CLINICALTRIAL NCT03669939 INTERNATIONAL REGISTERED REPORT RR2-doi:10.1016/j.conctc.2019.100468

The Impact of Social Mobilization on Health Service Delivery and Health Outcomes

2018 ◽  
Author(s):  
Xavier Giné ◽  
Salma Khalid ◽  
Mansuri Ghazala
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Health Outcomes ◽  
Health Workers ◽  
Health Service Delivery ◽  
Health Providers ◽  
Child Health Outcomes ◽  
Rural Pakistan ◽  
Post Natal Care ◽  
The Impact

This chapter uses a randomized community development programme in rural Pakistan to assess the impact of citizen engagement on public service delivery and maternal and child health outcomes. The programme had a strong emphasis on organizing women, who also identified health services as a development priority at baseline. At midline, we find that the mobilization effort alone had a significant impact on the performance of village-based health providers. We detect economically large improvements in pregnancy and well-baby visits by female health workers, as well as increased utilization of pre- and post-natal care by pregnant women. In contrast, the quality of supra-village health services did not improve, underscoring the importance of community enforcement and monitoring capacity for improving service delivery.

scholarly journals Drug therapy problems identified among older adults placed in a nursing home: the Croatian experience

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092879
Author(s):  
Katarina Fehir Šola ◽  
Iva Mucalo ◽  
Andrea Brajković ◽  
Ivona Jukić ◽  
Donatella Verbanac ◽  
...  
Keyword(s):  
Nursing Home ◽  
Drug Therapy ◽  
Medication Management ◽  
Institutional Care ◽  
Nursing Home Residents ◽  
Median Number ◽  
Cross Sectional ◽  
High Prevalence ◽  
Care Facilities ◽  
Drug Therapy Problems

Objective The aim of this study was to determine the frequency and type of drug therapy problems (DTPs) in older institutionalized adults. Method We conducted a cross-sectional observational study from February to June 2016 at a 150-bed public nursing home in Croatia, where comprehensive medication management (CMM) services were provided. A rational decision-making process, referred to as the Pharmacotherapy Workup method, was used to classify DTPs. Results Data were prospectively collected from 73 residents, among which 71% were age 75 years or older. The median number of prescribed medications per patient was 7 (2–16) and polypharmacy (> 4) was recorded for 54 (74.0%) patients. A total 313 DTPs were identified, with an average of 4.3 ± 2 DTPs per patient. The most frequent DTP was needing additional drug therapy (n = 118; 37.7%), followed by adverse drug reaction (n = 55; 17.6%). Lactulose (14.4%), tramadol (6.7%), and potassium (6.4%) were the medications most frequently related to DTPs. Conclusion The high prevalence of DTPs identified among older institutionalized adults strongly suggests the need to incorporate new pharmacist-led CMM services within existing institutional care facilities, to improve the care provided to nursing home residents.

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