scholarly journals Do Patients Residing in Provincial Areas Transport and Spend More on Cancer Treatment in Korea?

Author(s):  
Woorim Kim ◽  
Kyu-Tae Han ◽  
Seungju Kim

Background: With the increasing burden of cancer worldwide, a need exists to investigate patterns of healthcare utilization and costs. This study aimed to investigate whether the area of residence is associated with the likelihood of a patient receiving treatment at an institution located outside their residing region. This study also analyzed whether medical travel was related to levels of healthcare utilization and costs. Methods: This study used the 2007 to 2015 National Health Insurance (NHI) claims data. The residing area was categorized into capital area, metropolitan cities, and provincial area. Healthcare utilization was measured based on days of care and costs based on direct, covered medical costs. Chi-square test and analysis of variance (ANOVA) was conducted to investigate the general characteristics of the study population. The relationship between the dependent and independent variables were analyzed using the generalized estimating equation (GEE) model. Results: Of the 64,505 participants included in this study, 19,975 (31.0%) visited medical institutions located outside their residing area. Compared to individuals residing in the capital area, those living in provincial regions (OR 2.202, 95% CI 2.068–2.344) were more likely to visit medical institutions outside their residing area. Healthcare costs were higher in individuals receiving treatment at hospitals located elsewhere (RR 1.054, 95% CI 1.017–1.093). Conclusion: Cancer patients residing in provincial areas were likely to visit institutions located outside their residing area for treatment. Medical travel was associated with higher levels of spent healthcare costs. Policies should focus on preventing possible related regional cancer disparity and promoting optimal configuration of cancer services.

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuta Hirose ◽  
Kiyoshi Shikino ◽  
Yoshiyuki Ohira ◽  
Sumihide Matsuoka ◽  
Chihiro Mikami ◽  
...  

Abstract Background Patient awareness surveys on polypharmacy have been reported previously, but no previous study has examined the effects of sending feedback to health professionals on reducing medication use. Our study aimed to conduct a patient survey to examine factors contributing to polypharmacy, feedback the results to health professionals, and analyze the resulting changes in the number of polypharmacy patients and prescribed medications. Methods After conducting a questionnaire survey of patients in Study 1, we provided its results to the healthcare professionals, and then surveyed the number of polypharmacy patients and oral medications using a before-after comparative study design in Study 2. In Study 1, we examined polypharmacy and its contributing factors by performing logistic regression analysis. In Study 2, we performed a t-test and a chi-square test. Results In the questionnaire survey, significant differences were found in the following 3 items: age (odds ratio (OR) = 3.14; 95% confidence interval (CI) = 2.01–4.91), number of medical institutions (OR = 2.34; 95%CI = 1.50–3.64), and patients’ difficulty with asking their doctors to deprescribe their medications (OR = 2.21; 95%CI = 1.25–3.90). After the feedback, the number of polypharmacy patients decreased from 175 to 159 individuals and the mean number of prescribed medications per patient decreased from 8.2 to 7.7 (p < 0.001, respectively). Conclusions Providing feedback to health professionals on polypharmacy survey results may lead to a decrease in the number of polypharmacy patients. Factors contributing to polypharmacy included age (75 years or older), the number of medical institutions (2 or more institutions), and patients’ difficulty with asking their physicians to deprescribe their medications. Feedback to health professionals reduced the percentage of polypharmacy patients and the number of prescribed medications. Trial registration UMIN. Registered 21 June 2020 - Retrospectively registered, https://www.umin.ac.jp/ctr/index-j.htm


2021 ◽  
Author(s):  
Yuta Hirose ◽  
Kiyoshi Shikino ◽  
Yoshiyuki Ohira ◽  
Sumihide Matsuoka ◽  
Chihiro Mikami ◽  
...  

Abstract Background: Patient awareness surveys on polypharmacy have been reported previously, but no previous study has examined the effects of sending feedback to health professionals on reducing medication use. Our study aimed to conduct a patient survey to examine factors contributing to polypharmacy, feedback the results to health professionals, and analyze the resulting changes in the number of polypharmacy patients and prescribed medications. Methods: We conducted a questionnaire survey of patients in Study 1, while feedback of survey results health professionals, and before-after scrutiny of medical receipt data comprised polypharmacy in Study 2. In Study 1, we examined polypharmacy and its contributing factors by performing logistic regression analysis. In Study 2, we performe a t-test and a chi-square test. Results: In the questionnaire survey, significant differences were found in the following 3 items: age (odds ratio (OR)=3.14; 95% confidence interval (CI)=2.01-4.91), number of medical institutions (OR=2.34; 95%CI=1.50-3.64), and patients' difficulty with asking their doctors to deprescribe their medications (OR=2.21; 95%CI=1.25-3.90). After the feedback, the percentage of polypharmacy patients decreased from 21.5% to 20.1% and the mean number of prescribed medications per patient decreased from 8.2 to 7.7 (p<0.001, respectively). Conclusions: Providing feedback to health professionals on polypharmacy survey results may lead to a decrease in the number of polypharmacy patients. Factors contributing to polypharmacy included age (75 years or older), the number of medical institutions (2 or more institutions), and patients' difficulty with asking their physicians to deprescribe their medications. Feedback to health professionals reduced the percentage of polypharmacy patients and the number of prescribed medications.


PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7519
Author(s):  
Tao Yan ◽  
Kai Wang ◽  
Jichang Liu ◽  
Yukai Zeng ◽  
Fenglong Bie ◽  
...  

Background Medical institutions worldwide have not reached a consensus on what surgery is the most advisable for pulmonary typical carcinoid (TC) patients at the localized stage. This research focuses on exploring whether wedge resection or segmental resection is the superior option. Methods The demographic and clinical information of 1,887 TC patients diagnosed at the localized stage from 2004 to 2015 was collected from the Surveillance, Epidemiology, and End Results (SEER) Program. Patient prognosis was evaluated by KM curves. The chi-square test was used to examine the variation between different groups that would be eliminated by propensity score matching (PSM). Univariate and multivariate Cox proportional hazard model analyses were used to evaluate prognostic values of relative factors. Results The prognosis of TC was the most favorable for patients suffering from pulmonary squamous cell carcinoma (SCC), adenocarcinoma (ADC), and pulmonary carcinoids (PCs). The choice to have surgery, not the type of surgery chosen, was the most significant independent prognostic factor correlated with overall survival (OS) and lung cancer-special survival (LCSS). The prognostic result of the comparison between wedge resection and segmental resection was not statistically significant before or after PSM. In subgroup analysis, the inference still held.


2020 ◽  
Author(s):  
Yuta Hirose ◽  
Kiyoshi Shikino ◽  
Yoshiyuki Ohira ◽  
Sumihide Matsuoka ◽  
Chihiro Mikami ◽  
...  

Abstract Background: Patient awareness surveys on polypharmacy have been reported previously, but no previous study has examined the effects of sending feedback to health professionals on reducing medication use. Our study aimed to conduct a patient survey to examine factors contributing to polypharmacy, feedback the results to health professionals, and analyze the resulting changes in the number of polypharmacy patients and prescribed medications. Methods: Study 1: In July 2016, we conducted a questionnaire survey among adult patients receiving medical care at Minamihama clinic. We examined polypharmacy and its contributing factors by performing logistic regression analysis. Study 2: We sent feedback of survey results to 12 health professionals. Performing a t-test and a chi-square test on medical fee receipts, we analyzed changes in the percentage of polypharmacy patients and the number of prescribed medications during one month before and after the feedback. Results: In the questionnaire survey, significant differences were found in the following 3 items: age (odds ratio (OR)=3.14; 95% confidence interval (CI)=2.01-4.91), number of medical institutions (OR=2.34; 95%CI=1.50-3.64), and patients' difficulty with asking their doctors to deprescribe their medications (OR=2.21; 95%CI=1.25-3.90). After the feedback, the percentage of polypharmacy patients decreased from 21.5% to 20.1% and the mean number of prescribed medications per patient decreased from 8.2 to 7.7 (p<0.001, respectively).Conclusions: Providing feedback to health professionals on polypharmacy survey results may lead to a decrease in the number of polypharmacy patients. Factors contributing to polypharmacy included age (75 years or older), the number of medical institutions (2 or more institutions), and patients' difficulty with asking their physicians to deprescribe their medications. Feedback to health professionals reduced the percentage of polypharmacy patients and the number of prescribed medications. Trial registration: UMIN. Registered 21 June 2020 - Retrospectively registered, https://www.umin.ac.jp/ctr/index-j.htm


Pharmacy ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 157
Author(s):  
Prashant Sakharkar ◽  
Thanh Mai

The existing literature is limited on the prevalence of depression among people with respiratory conditions and person-level factors that are associated with increased healthcare utilization and expenditures. The aim of this study was to explore the prevalence, pattern of healthcare use, and expenditures in noninstitutionalized individuals having co-occurring depression with respiratory conditions. The Medical Expenditure Panel Survey (MEPS) data from 2011 to 2017 was used in this study. Our sample included individuals having respiratory conditions (asthma, emphysema, and chronic bronchitis) with and without depression. Healthcare use and expenditure data were analyzed using a chi-square test, t-tests, and multiple linear regression analyses. There were 8848 individuals in the study. The prevalence of comorbid depression was 20%. Individuals with co-occurring depression with respiratory conditions differed significantly from individuals without co-occurring depression for age ≥ 45 years, white, and with ≤2 chronic disease conditions. Depressed individuals with respiratory conditions had higher healthcare utilization and expenditures. The presence of co-occurring depression with respiratory conditions increases the treatment complexity, healthcare utilization, and expenditure. Better treatment and management of these patients may reduce healthcare use and expenditures in the future.


2020 ◽  
Author(s):  
Yuko Hirano ◽  
Kunio Tsubota ◽  
Shun Ohno

Abstract Background: Nurse migration under bilateral agreements is a recent global trend; though lack of consultation with health industries has led to challenges in the recruitment of foreign nurses by hospitals. To analyze the prevailing opinion of hospitals on the Economic Partnership Agreement (EPA), under which Japan officially recruits foreign nurses, we surveyed the hospitals that are yet to employ foreign nurses.Method: An anonymous questionnaire was developed and distributed to eligible hospitals; it requested the managers’ opinions on Japan’s policy on recruitment of foreign nurses and their intentions to hire foreign nurses. We randomly selected 1,879 hospitals, or 22% of the hospitals in Japan (n = 8,540) with more than 20 beds. We used descriptive statistics, a Chi-square test, and a logistic regression analysis to identify the predictors and developed a model to predict the likelihood of their intention to recruit foreign nurses in the future.Results: In total, 432 hospitals were eligible for further analysis (response rate: 22.9%). Half (50%) of the hospital managers were very/quite interested in Japan’s policy on recruiting foreign nurses, though only 20% intended to recruit under the EPA in the future. The likelihood of foreign nurse recruitment under the partnership agreement was associated with the degree of interest in the policy (OR 9.38; 95% CI 4.42–19.90) and managers’ perception of foreign nurses (OR 5.32, 95% CI 2.38–11.89).Conclusion: To attract more hospitals by reviewing the EPA policy, scrutinizing the needs of hospitals is key. EPA has challenges in accommodating the requests from the hospitals that urgently need foreign nurses, so it may render the new business model which effectively yields the eligible nurses from abroad. To review the EPA, it is essential to reflect upon the opinions of the medical institutions, including those who have yet to employ foreign nurses.


1970 ◽  
Vol 5 (2) ◽  
pp. 64
Author(s):  
Eny Sendra ◽  
Dewi Indriani

Breast feeding is giving milk to be drunk to the baby from the breast. Uterus involution is a process how the uterus return to the condition back, before pregnanting after bearing. At the moment of suckling, happens a stimulus and brings the hormones out, such as oksitosin uses not only to stimulate some muscles constraction but also to stimulate the uterus, so that the process of uterus involution happens foster. According to the explanations above, the research aimed to know about the correlation between breast feeding and uterus involution. This research’s design was, cross sectional by the population of all childbirth mothers approximately 50 persons / month. By using accidental sampling technique we got 21 sample respondents. The place of research in RSIA Aura Syifa in Kediri Regency on 16th until 22nd of June 2009. From this research’s result, we got 14 persons (66,67%) with normal uterus involution, suckled in a good way, one person (4,67%) with normal uterus involution, suckled in a wrong way, 2 persons (9,52%) with abnormal uterus involution, suckled in a good way and 4 persons (19,05%) with abnormal uterus involution, suckled in a wrong way. Statistic test which used chi-square test, counted the probability frequency in advance, from that we got 3 columns with the score, less than 5, so that chi-square can not be continued and by doing exact fisher test, the score was 0,001. Because P with the grade mistake 0,05 smaller, so the conclusion was “Ho” is rejected, it meant “there was correlation between suckling and uterus involution”. Key Word : Breast feeding, uterus involution


2020 ◽  
Vol 5 (3) ◽  
pp. 875
Author(s):  
Asfri Sri Rahmadeni

<p class="Normal1"><em>Commitment is the attitude or behavior of likes or dislikes shown by someone against the organization at work. Indonesia is recorded as a nurse who has a low organizational commitment (76%) so it harms services. This phenomenon in the hospital can be seen from the indicator of the high turnover rate of nurses which reaches 30.9% which exceeds the standard &lt;5%. Many factors affect organizational commitment. The purpose of this study was to analyze the Personal Factors Associated with Organizational Commitment of Hospital Nurses. This study is a cross-sectional analytic study and purposive sampling technique with a sample of 59 nurses. Chi-Square test results obtained personal factors that have a relationship with organizational commitment Nurse Hospital is age with p = 0,000 and education with p = 0,000, personal factors not related to organizational commitment are gender p = 1,053 and years of service with p = 1,147. Hospitals should conduct research/surveys on Organizational Commitment periodically as an evaluation material in the context of the organization's development and development in the future</em>.</p>


2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Abdurrakhman abdurrakhman Abdurrakhman

ABSTRACT : The House index and Container Index in the buffer area of ​​the working area of ​​Balikpapan Sepinggan Airport is still above 1%, so the potential for the spread of dengue disease. Mobilization of people, goods and transportation equipment will increasingly affect the transmission of disease in ports and airports, especially for vector-borne diseases. This study aims to analyze the risk factors associated with larvae density of Aedes aegypti and describe the larvae index in the buffer zone of the Sepinggan Balikpapan Airport This study was a descriptive study with a cross sectional design. The sample in this study was 121 houses with a proportionate stratified random sampling, the research location was in the buffer zone of Sepinggan Balikpapan Airport in November 2018. The variables studied were houses with positive larvae containers, breeding sites and PSN behavior and larvasidation. The data was analyzed using the chi square test. There was a relationship between houses with larvae positive Aedes aegypti, behavior of Mosquito Nest Eradication (PSN) and larvasidation with larvae density of Aedes aegypti but not for breeding sites (p = 0.00 and 95% CI = 0.64), and   (p = 0.00 and 95% CI = 0.34). The description of several Aedes aegypti larvae index, namely House Index (HI) = 57.02%, Container Index (CI) = 24.36%, Bruteau Index (BI) = 148.76, and Flick Free Numbers (ABJ) = 42.98 %. Houses with larvae of Aedes aegypti larvae and PSN and larvasidation behavior were associated with larvae density of Aedes aegypti. The index of HI, CI and BI larvae is of high value so there is a risk of DBD transmission


2019 ◽  
Vol 3 (2) ◽  

Radiographic Mandibular Indices serve as easy and relatively cheap tools for evaluating bone mineralization. Objectives: To examine the effect of age and gender on three mandibular indices: the panoramic mandibular index (PMI), the mandibular ratio (MR) and the mandibular cortical index (MCI), among Libyan population. Methods: The three indices were measured on 317 digital (OPGs) of adult humans (155 males, 162 females). The sample was divided into six age groups (from 18-25 years through 56-65 years). The measurements were analyzed for interactions with age and sex, using SPSS (Statistical Package for Social Studies) software version no. 22. The tests employed were two way ANOVA, the unpaired T-test and chi-square test. Results: The mean PMI fluctuated between 0.37 s.d. 0.012 and 0.38 s.d. 0.012. among the sixth age groups. One-way ANOVA statistical test revealed no significant of age on PMI. On the other hand gender variation has effect on PMI, since independent sample t-test disclosed that the difference between the male and female PMI means statistically significant. ANOVA test showed that the means of MR among age groups showed a negative correlation i.e. MR mean declined from 3.01 in 18-25 age groups to 2.7 in 55-65 age groups. In contrary, the gender showed no effect on MR according two sample t-test at p> 0.05. In regards with MCI, statistical analysis showed that it affected by age that is C1 was decreasing by age while C2 and C3 were increased by age. Using chi square test the result indicated that there is a significant difference among the different age group and the two genders in MCI readings. Conclusion: PMI was influenced significantly by age but minimally by the gender. MR is not affected by gender but has a negative correlation with age. MCI is affected by both age and gender


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