scholarly journals Multimorbidity in Hospitalized Patients Admitted to General Practice Departments and Its Implications for the General Practice Healthcare System: A Four-Year Longitudinal Study in China

2021 ◽  
Vol 9 ◽  
Author(s):  
Zhihan Zhou ◽  
Meng Shi ◽  
Mengzhu Liu ◽  
Jianqin Gu ◽  
Clifford Silver Tarimo ◽  
...  
Keyword(s):  
Developing Countries ◽  
General Practice ◽  
Healthcare System ◽  
Human Body ◽  
Healthy Lifestyle ◽  
Circulatory System ◽  
Policy Implications ◽  
Body System ◽  
Gender Inequity ◽  
Epidemiological Characteristics

Objective: China and many developing countries has placed high expectations on the general practice healthcare system in terms of lowering medical costs and improving the health status of the multimorbid population in recent years. However, the prevalence of multimorbidity among inpatients attending the general practice department of hospitals and its policy implications are largely unknown. The current study aimed to analyze the prevalence of comorbidities among inpatients attending the general practice department of the tertiary Grade-A Hospitals in China, and put forward evidence-based policy recommendations.Methods: Between December 2016 and November 2020, 351 registered general practitioners from 27 tertiary hospitals were selected, and their direct admissions were evaluated. The rate and composition ratio were used for descriptive analysis of the clinical and epidemiological characteristics of multimorbidity. A backward stepwise algorithm was used to explore independent variables. The absence of multicollinearity and plausible interactions among variables were tested to ensure the robustness of the logistic regression model. The pyramid diagram was used to show the link between gender and the involved human body system in multimorbidity.Results: Multimorbidity was present in 93.1% of the 64, 395 patients who were admitted directly. Multimorbidity was significantly more prevalent in patients aged 45–59 years (OR=3.018, 95% CI=1.945–4.683), 60–74 years (OR = 4.349, 95% CI = 2.574–7.349), ≥75 years (OR = 7.804, 95% CI = 3.665–16.616), and those with body mass index (BMI) ≥ 28 kg/m2 (OR = 3.770, 95% CI = 1.453–9.785). The circulatory system was found to be the most commonly involved human body system in multimorbidity, accounting for 79.2% (95% CI = 78.8–79.5%) of all cases. Significant gender inequity was further observed in the involved human body system in multimorbidity.Conclusion: Multimorbidity is likely common among the inpatients attending the general practice department of hospitals in China and many developing countries, with significant gender inequity in the involved human body systems. Effective countermeasures include establishing a GP-PCIC multimorbidity prevention and control model and enhancing the multimorbidity of elderly and obese patients at both the clinical and healthy lifestyle levels. The diagnosis and treatment capabilities of GPs on the circulatory, endocrine, metabolic, digestive, and respiratory systems should be prioritized.

scholarly journals HEALTH CARE AS A SYSTEM-CREATING ELEMENT OF HUMAN CAPITAL: STRATEGIES OF ITS DEVELOPMENT BY THE CASE OF UKRAINE

2021 ◽  
Vol 7 (4) ◽  
pp. 176-181
Author(s):  
Yurii Safonov ◽  
Viktoriia Borshch ◽  
Oleksandr Rogachevskyi
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Human Capital ◽  
Healthcare System ◽  
Healthy Lifestyle ◽  
System Development ◽  
State Regulation ◽  
Healthcare Sector ◽  
Regulation System ◽  
Human Capital Index

The main purpose of the paper is to analyze the process of the health care development as the system-creating factor of human capital. Methodology. This study combines economic and managerial analysis of healthcare and human capital. The background for this analysis is the data of the 2020 Human Capital Index in Ukraine and other developed and developing countries. The method of historical and logical analysis of the literature was used. The functional and structural analysis was used with purpose to research the main tools of human capital’s development. Methods of comparative and statistical analysis and their synthesis were used to study dynamics of human capital. Method of summarization was used to make conclusions and recommendations for improving human capital in developing countries. Works of scientists in the sphere of human capital were used as the informational basis for the conducted study. Findings. In the paper it was analyzed the Human Capital Index in Ukraine and its components from the period of 2010-2020. The problems of the development of Ukrainian healthcare sector as the system-creating element of human capital are viewed. Formation of a new model for organizing medical care based on the development of the four P’s model of medicine (predicting, prevention, personalization, participation) is considered as the main basis for developing effective healthcare sector in Ukraine. The authors of the article see the following key areas of necessary actions in Ukrainian healthcare sector: technological breakthrough, strengthening a healthy lifestyle, ensuring the availability of high-quality medical services, developing human resources, creating a system of effective drug provision, increasing the efficiency of financing. Practical implications. The results of this study form the methodological and practical basis for improvement of the state regulation system of Ukrainian healthcare as a system-creating element of human capital. The results of conducted research could be a framework for formation of effective healthcare system in Ukraine, ensuring its constant development. The main proposals could be used by the Ministry of Healthcare of Ukraine while working out the Concept of national healthcare system development, they should be taken into consideration by state and municipal Health Departments for implement them during the process of Ukrainian healthcare sphere’s reformation.

scholarly journals Prevalence, Risk Factors, and Approach to Control of Comorbidities Among Hospitalized Patients: Evidence From A 4-Year Longitudinal Study in China

2021 ◽  
Author(s):  
Mengzhu Liu ◽  
Meng Shi ◽  
Jianqin Gu ◽  
Liuyi Wang ◽  
Clifford Silver Tarimo ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Practice ◽  
Quality Improvement ◽  
Prevention And Control ◽  
Circulatory System ◽  
Central China ◽  
Female Ratio ◽  
Metabolic Systems ◽  
And Control ◽  
Epidemiological Characteristics

Abstract Background: The disease burden of comorbidity is growing steadily in many developing countries, affecting residents' physical and mental health. General Practitioners are considered as the suitable service providers for the prevention and control of comorbidity. However, the current knowledge on the clinical and epidemiological characteristics of comorbidity among inpatients in the general practice departments of hospital is limited, which hinders the precise promotion of the service capacity and quality of GPs. Objective: The current study aimed to analyze the clinical prevalence of comorbidities in central China and to provide evidence-based policy recommendations for quality improvement in general medical services. Methods: The study was conducted at the general practice departments of all 27 tertiary grade-A hospitals of Henan Province, China. 3 registered GPs of each hospital were selected by random, and all direct admissions of the 81 GPs from December 2016 to November 2020 were followed up. The clinical epidemiological characteristics and influencing factors of comorbidity were evaluated using descriptive statistical analysis and logistic regression models. Results: Comorbidity was present in 93.1 percent of the 2385 direct admitted patients, with a male-to-female ratio of 1: 1. Comorbidity was significantly more prevalent in patients aged 45-59 years (OR=3.018, 95% CI=1.945-4.683), 60-74 years (OR=4.349, 95% CI=2.574-7.349), ≥75 years (OR=7.804, 95% CI=3.665-16.616), and those with body mass index (BMI) ≥28 kg/m2 (OR=3.770, 95% CI =1.453-9.785). The circulatory system is the most commonly involved human body system in comorbidity, accounting for 79% of all cases. The endocrine, nutritional, and metabolic systems, as well as the digestive and respiratory systems, were all significantly affected, with prevalence rates of 62 percent, 48 percent, and 37 percent, respectively. Conclusion: Comorbidity is common among the inpatients attending the provincial tertiary grade-A hospitals. Since old age and obesity are independent risk factors for comorbidity, healthy lifestyle interventions should be strengthened, as should the implementation of the patient-centered prevention and control model. Meanwhile, quality improvement priorities should be given to improving GPs' clinical diagnosis and treatment of the circulatory system, endocrine system, metabolic system, digestive system, and respiratory system.

scholarly journals Advances in Environmental Detection and Clinical Diagnostic Tests for Legionella Species

2021 ◽  
Author(s):  
Rajeshwari Vittal ◽  
Juliet Roshini Mohan Raj ◽  
Ballamoole Krishna Kumar ◽  
Indrani Karunasagar
Keyword(s):  
Developing Countries ◽  
Healthcare System ◽  
Diagnostic Tests ◽  
Clinical Manifestations ◽  
Cost Effective ◽  
Clinical Samples ◽  
Detection Techniques ◽  
Conventional Culture ◽  
Legionella Species ◽  
Mild Fever

Abstract Legionella is a fastidious organism that is difficult to culture in the lab but is widely distributed in environmental, domestic, and hospital settings. The clinical manifestations due to Legionella infections range from mild fever to fatal pneumonia and multiorgan pathologies. Legionella outbreaks though prevalent globally are not reported in developing countries due to difficulties in isolating this organism and the lack of simple diagnostic protocols. Here, we review the literature from across countries to present various methods used to detect Legionella from environmental and clinical samples. We compare the sensitivity and the specificity of the conventional culture-based assays with the recent methods and discuss approaches to develop better detection and diagnostic tests. With better cost-effective detection techniques and regular monitoring of the susceptible sites, which may harbor Legionella colonies, most of the Legionella infections can be prevented. As a result, considerable burden, caused by Legionella infections, on the healthcare system, in especially economically weaker countries, can be mitigated.

scholarly journals How Do Women Overcome Gender Inequality by Forming Small-Scale Cooperatives? The Case of the Agricultural Sector in Uganda

2021 ◽  
Vol 13 (4) ◽  
pp. 1797
Author(s):  
Amber Theeuwen ◽  
Valérie Duplat ◽  
Christopher Wickert ◽  
Brian Tjemkes
Keyword(s):  
Developing Countries ◽  
Gender Equality ◽  
Gender Inequality ◽  
Family Business ◽  
Agricultural Sector ◽  
Economic Benefits ◽  
Policy Implications ◽  
Small Scale ◽  
Business Relationships ◽  
Female Farmers

In Uganda, the agricultural sector contributes substantially to gross domestic product. Although the involvement of Ugandan women in this sector is extensive, female farmers face significant obstacles, caused by gendering that impedes their ability to expand their family business and to generate incomes. Gender refers to social or cultural categories by which women–men relationships are conceived. In this study, we aim to investigate how gendering influences the development of business relationships in the Ugandan agricultural sector. To do so, we employed a qualitative–inductive methodology to collect unique data on the rice and cassava sectors. Our findings reveal at first that, in the agricultural sector in Uganda, inter-organization business relationships (i.e., between non-family actors) are mostly developed by and between men, whereas intra-organization business relationships with family members are mostly developed by women. We learn that gendering impedes women from developing inter-organization business relationships. Impediments for female farmers include their restricted mobility, the lack of trust by men, their limited freedom in communication, household duties, and responsibilities for farming activities up until sales. Our findings also reveal that these impediments to developing inter-organization business relationships prevent female farmers from being empowered and from attainting economic benefits for the family business. In this context, the results of our study show that grouping in small-scale cooperatives offers female farmers an opportunity to overcome gender inequality and to become economically emancipated. Thanks to these cooperatives, women can develop inter-organization relationships with men and other women and gain easier access to financial resources. Small-scale cooperatives can alter gendering in the long run, in favor of more gender equality and less marginalization of women. Our study responds to calls for more research on the informal economy in developing countries and brings further understanding to the effect of gendering in the Ugandan agricultural sector. We propose a theoretical framework with eight propositions bridging gendering, business relationship development, and empowerment and economic benefits. Our framework serves as a springboard for policy implications aimed at fostering gender equality in informal sectors in developing countries.

THE BENEFITS OF PHYSICAL CULTURE AND THE NEED FOR ADVANCING A HEALTHY LIFESTYLE

2020 ◽  
Author(s):  
Olga Grigoryevna Unshikova ◽  
Keyword(s):  
Young People ◽  
Human Body ◽  
Healthy Lifestyle ◽  
Physical Culture

The article is devoted to the study of the influence of physical culture on the human body and the importance of sports education of young people.

Wealth and governance in unstable states : South Africa as a context for Mancur Olson's theory of collective action

2016 ◽  
Author(s):  
◽  
Pamela E. Kelrick
Keyword(s):  
South Africa ◽  
Developing Countries ◽  
Collective Action ◽  
Temporal Dynamics ◽  
Generalized Additive Models ◽  
Political Stability ◽  
Developed Countries ◽  
Additive Models ◽  
Policy Implications ◽  
Empirical Analyses

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] Mancur Olson's theory of collective action has primarily been construed and applied to developed countries with formal economies and (generally) socio-political stability. Yet, he asserted that his theory of collective action would apply in developing countries, even those which are far less stable. This study examined Olson's assertion that collective action applies in developing countries, using South Africa as a case study. The empirical analyses included canonical correlation analysis and generalized additive models, using attribute, spatial, and temporal data to understand the spatial and temporal dynamics between wealth and governance in South Africa. Geographic clustering by race and economic class remains persistent despite democratic reforms and improved governance engagement. In addition, findings of the empirical analyses were used to evaluate Olson's theory of collective action and frame the policy implications. Collective action is consistent with findings, but, in the context of developing countries, ought to include more prominent considerations of path dependency, increasing returns, and historical institutionalism.

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