Incorporating Medical Supply and Demand into the Index of Physician Maldistribution Improves the Sensitivity to Healthcare Outcomes

Background: Since the association between disparity in physician distribution and specific healthcare outcomes is poorly documented, we aimed to clarify the association between physician maldistribution and cerebrovascular disease (CeVD), a high-priority health outcome in Japan. Methods: In this cross-sectional study, we conducted multivariable regression analysis with the Physician Uneven Distribution Index (PUDI), a recently developed and adopted policy index in Japan that uniquely incorporates the gap between medical supply and demand, as the independent variable and CeVD death rate as the dependent variable. Population density, mean annual income, and prevalence of hypertension were used as covariates. Results: The coefficient of the PUDI for the CeVD death rate was −0.34 (95%CI: −0.49–−0.19) before adjusting for covariates and was −0.19 (95%CI: −0.30–−0.07) after adjusting. The adjusted R squared of the analysis for the PUDI was 0.71 in the final model. However, the same multivariable regression model showed that the number of physicians per 100,000 people (NPPP) was not associated with the CeVD death rates before or after adjusting for the covariates. Conclusion: Incorporating the gap between the medical supply and demand in physician maldistribution indices could improve the responsiveness of the index for assessing the disparity in healthcare outcomes.

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Fatigue among children with a chronic disease: a cross-sectional study

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000958 ◽

2021 ◽

Vol 5 (1) ◽

pp. e000958

Author(s):

Merel M Nap-van der Vlist ◽

Geertje W Dalmeijer ◽

Martha A Grootenhuis ◽

Kors van der Ent ◽

Marry M van den Heuvel-Eibrink ◽

...

Keyword(s):

Chronic Disease ◽

Social Factors ◽

Participation Rate ◽

Cross Sectional Study ◽

Assessment Tools ◽

Sectional Study ◽

Cross Sectional ◽

Multivariable Regression Model ◽

Multivariable Regression ◽

Multidimensional Fatigue Scale

ObjectiveTo determine: (1) which biological/lifestyle, psychological and/or social factors are associated with fatigue among children with a chronic disease and (2) how much each of these factors contributes to explaining variance in fatigue.Design and settingThis was a cross-sectional study across two children’s hospitals.PatientsWe included children aged 8–18 years who visited the outpatient clinic with cystic fibrosis, an autoimmune disease or postcancer treatment.Main outcome measuresFatigue was assessed using the PedsQL Multidimensional Fatigue Scale. Generic biological/lifestyle, psychological and social factors were assessed using clinical assessment tools and questionnaires. Multiple linear regression analyses were used to test the associations between these factors and fatigue. Finally, a multivariable regression model was used to determine which factor(s) have the strongest effect on fatigue.ResultsA total of 434 out of 902 children were included (48% participation rate), with a median age of 14.5 years; 42% were male. Among these 434 children, 21.8% were severely fatigued. Together, all biopsychosocial factors explained 74.6% of the variance in fatigue. More fatigue was uniquely associated with poorer physical functioning, more depressive symptoms, more pressure at school, poorer social functioning and older age.ConclusionsFatigue among children with a chronic disease is multidimensional. Multiple generic biological/lifestyle, psychological and social factors were strongly associated with fatigue, explaining 58.4%; 65.8% and 50.0% of the variance in fatigue, respectively. Altogether, almost three-quarters of the variance in fatigue was explained by this biopsychosocial model. Thus, when assessing and treating fatigue, a transdiagnostic approach is preferred, taking into account biological, psychological and social factors.

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Culture And COVID-19 Related Mortality- A Cross Sectional Study of 53 Countries

10.21203/rs.3.rs-942150/v1 ◽

2021 ◽

Author(s):

Arnold Käffer ◽

Jörg Mahlich

Keyword(s):

Cross Sectional Study ◽

Global Health Security ◽

Cross Sectional ◽

Health Security ◽

Popular Narrative ◽

Multivariable Regression Model ◽

Health Related ◽

Multivariable Regression ◽

Tobacco Usage ◽

Related Mortality

Abstract The aim of this paper is to investigate the influence of culture on COVID-19 related mortality relying on Hofstede’s six dimensional concept of culture. Retrieving data from 53 countries a multivariable regression model was fitted that controls for health related, economic and policy related variables that have been found to be associated with mortality. In particular we included the percentage of population above 65 years of age, the prevalence of relevant co-morbidities (i.e. diabetes, hypertension, cancer. obesity), and tobacco usage as health related variables. Economic variables were GDP per capita and the connectedness of a country as measured by the number of international arrivals. As policy variables we included the Oxford stringency index as well as stringency speed, and the Global Health Security index. The results suggests that individualistic societies can navigate well through the pandemic when they are also characterized by low power distance which reflects a low acceptance of inequality within a society. This finding contradicts with previous studies that supported the popular narrative that autocratic societies with an obedient population are better positioned to manage the pandemic.

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Associciated factors of constipation among parkinson older patients

Tạp chí Nghiên cứu Y học ◽

10.52852/tcncyh.v141i5.188 ◽

2021 ◽

Vol 141 (5) ◽

pp. 75-80

Author(s):

Nguyen Ngoc Tam ◽

Nguyen Phuong Linh ◽

Nguyen Trung Anh

Keyword(s):

Daily Living ◽

Older Patients ◽

Vegetable Consumption ◽

Cross Sectional Study ◽

Cross Sectional ◽

Multivariable Regression Model ◽

Geriatric Hospital ◽

Multivariable Regression ◽

Reduce Risk ◽

Improve Health

This cross-sectional study aimed to investigate the factors associated with constipation among elderly patients with Parkinson’s disease (PD). The participants were recruited from the National Geriatric Hospital between July to September 2020. Constipation was diagnosed by using Bristol stool classification and Rome IV criteria. A total of 133 Parkinson older patients were enrolled in the study. In multivariable regression model, increased odds of constipation were significantly associated with low water consumption (adjusted OR 4.55), low vegetable consumption (adjusted OR 6.16) and dependent activities of daily living (ADL) (adjusted OR 3.98). ADL needs to be regularly assessed and water and vegetable consumption should be closely monitored in older PD patients in order to improve health and reduce risk of constipation.

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Oxygen saturations of medical inpatients in a Malawian hospital: cross-sectional study of oxygen supply and demand

Pneumonia ◽

10.15172/pneu.2012.1/208 ◽

2012 ◽

Vol 1 (1) ◽

pp. 3-6 ◽

Cited By ~ 6

Author(s):

Hywel-Gethin Tudur Evans ◽

Nadia Mahmood ◽

Duncan G. Fullerton ◽

Jamie Rylance ◽

Andrew Gonani ◽

...

Keyword(s):

Oxygen Supply ◽

Supply And Demand ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Medical Inpatients

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Stature is inversely associated with self-reported diabetes in middle-aged Mexican women

Revista Panamericana de Salud Pública ◽

10.26633/rpsp.2017.32 ◽

2017 ◽

Vol 41 ◽

pp. 1

Author(s):

Ruy Lopez-Ridaura ◽

Karl P Puchner ◽

Eduardo Ortiz-Panozo ◽

Isabel Vieitez ◽

Martín Lajous

Keyword(s):

Menopausal Status ◽

Urban Environments ◽

Urban Setting ◽

Mexican Women ◽

Inverse Association ◽

Middle Aged ◽

Cross Sectional ◽

Multivariable Regression Model ◽

Multivariable Regression ◽

Sectional Analysis

Objective. To investigate whether stature is associated with two highly prevalent cardiom- etabolic disorders—diabetes mellitus (DM) and high blood pressure (HBP) —in middle-aged Mexican women. Methods. We conducted a cross-sectional analysis of a sample of 93 481 middle-aged Mexican female teachers, all participating in the Mexican Teachers Cohort (MTC, or ESMaestras) study. We used a multivariable regression model to investigate the association of stature quintiles with the self-reported outcomes of DM and HBP. Results. After adjusting for birth cohort, ethnicity, family history, birthweight, occupation of household’s head during participant’s childhood, menopausal status, and geographical region of birthplace, stature was inversely associated with DM, with the odds for DM being 9% higher in the lowest stature quintile when compared to the highest stature quintile. Stratification for location of residence resulted in confirmation of the above-mentioned findings only in partici- pants living in urban environments. Conclusions. We found an inverse association of stature with DM but not with HBP. Our data suggest that urban setting might be an important effect modifier of this association, which merits further investigation since it might provide valuable insights into the epidemiological transition occurring in developing countries.

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Demand for Health Information on COVID-19 among Vietnamese

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124377 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4377 ◽

Cited By ~ 13

Author(s):

Huong Thi Le ◽

Diep Ngoc Nguyen ◽

Ahmed Sam Beydoun ◽

Xuan Thi Thanh Le ◽

Thao Thanh Nguyen ◽

...

Keyword(s):

Health Information ◽

Information Needs ◽

Sampling Technique ◽

Cross Sectional Study ◽

Snowball Sampling ◽

Cross Sectional ◽

Web Based ◽

Multivariable Regression ◽

Ethnic Factors ◽

Demand For Health

Due to the rapid spread of coronavirus, Vietnam introduced its first national partial lockdown on April 1st, 2020. The public relied on online sources, whether through official websites or phone-based applications, to acquire up-to-date health information, provide accurate instructions, and limit misinformation. This study aims to provide insight regarding the current level of awareness of the pandemic, and to identify associated factors in Vietnamese participants to recommend necessary interventions. A cross-sectional study was conducted using a web-based survey during the first week of the lockdown period. There were 341 observations collected using a snowball sampling technique. A Tobit multivariable regression model was used to identify factors associated with the demand for each category of health information. The most requested information was the latest updated news on the epidemic, followed by information about disease symptoms and updated news on the outbreak. The prevalence of diverse socioeconomic, demographic, and ethnic factors in Vietnam requires consideration of the specific health information needs of unique groups. Identifying group-specific demands would be helpful to provide proper information to fulfill each population group’s needs.

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Predicting blood supply and demand in the next 20 years with population ageing in China: a cross-sectional study

The Lancet ◽

10.1016/s0140-6736(18)32691-6 ◽

2018 ◽

Vol 392 ◽

pp. S62 ◽

Cited By ~ 1

Author(s):

Yubing Shen ◽

Wei Han ◽

Xiaochu Yu ◽

Zhong Liu ◽

Jingmei Jiang ◽

...

Keyword(s):

Blood Supply ◽

Supply And Demand ◽

Cross Sectional Study ◽

Population Ageing ◽

Sectional Study ◽

Cross Sectional

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Racial, Economic and Health Inequality and COVID-19 Infection in the United States

10.1101/2020.04.26.20079756 ◽

2020 ◽

Cited By ~ 11

Author(s):

Vida Abedi ◽

Oluwaseyi Olulana ◽

Venkatesh Avula ◽

Durgesh Chaudhary ◽

Ayesha Khan ◽

...

Keyword(s):

United States ◽

New York ◽

Health Care Access ◽

Urban Areas ◽

Death Rate ◽

The United States ◽

Preliminary Evidence ◽

Cross Sectional Study ◽

Cross Sectional ◽

The Impact

AbstractBackgroundThere is preliminary evidence of racial and social-economic disparities in the population infected by and dying from COVID-19. The goal of this study is to report the associations of COVID-19 with respect to race, health and economic inequality in the United States.MethodsWe performed a cross-sectional study of the associations between infection and mortality rate of COVID-19 and demographic, socioeconomic and mobility variables from 369 counties (total population: 102,178,117 [median: 73,447, IQR: 30,761-256,098]) from the seven most affected states (Michigan, New York, New Jersey, Pennsylvania, California, Louisiana, Massachusetts).FindingsThe risk factors for infection and mortality are different. Our analysis shows that counties with more diverse demographics, higher population, education, income levels, and lower disability rates were at a higher risk of COVID-19 infection. However, counties with higher disability and poverty rates had a higher death rate. African Americans were more vulnerable to COVID-19 than other ethnic groups (1,981 African American infected cases versus 658 Whites per million). Data on mobility changes corroborate the impact of social distancing.InterpretationThe observed inequality might be due to the workforce of essential services, poverty, and access to care. Counties in more urban areas are probably better equipped at providing care. The lower rate of infection, but a higher death rate in counties with higher poverty and disability could be due to lower levels of mobility, but a higher rate of comorbidities and health care access.

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Anxiety and media exposure during COVID-19 outbreak in Kuwait

10.1101/2020.08.24.20180745 ◽

2020 ◽

Author(s):

lulua falah alasousi ◽

sara alhammouri ◽

sara alabdulhadi

Keyword(s):

Online Survey ◽

Demographic Data ◽

Media Exposure ◽

Cross Sectional Study ◽

Sectional Study ◽

Exclusion Criteria ◽

Cross Sectional ◽

Result Show ◽

Multivariable Regression ◽

The Relationship

Background: Rising fear and panic among public during COVID19 pandemic increase concern regarding anxiety cases in Kuwait. Media capture our attention during this period looking for daily virus update lead to more fear . Our purpose of this study to examine the relationship between anxiety and media exposure among Kuwaiti during COVID19 outbreak Method: cross sectional study among Kuwaiti citizen between age23-55yrs old was conducted from April,21,2020 to May,15,2020 using online survey. Total of 1230 participants involve in the current study after exclusion criteria removed. Beside demographic data and media exposure anxiety was assessed using generalized anxiety disorder scale GAD-7. multivariable regression was used to identify the correlation between anxiety and media exposure Result: the result show that there is positive correlation between media exposure and anxiety during COVID19 outbreak in Kuwait (p<.001), furthermore it revealed that there is significant relationship between the frequency of exposure and anxiety(<.001) Conclusion: from this study we can understand that during COVID19 pandemic exposure to media can cause anxiety therefore measures should be taken by the governments to fight misinformation and physician should pay more attention to mental health disease during this period.

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Asthma and Keratoconus: An analysis of the risk factors association with the severity of keratoconus

10.21203/rs.3.rs-19388/v1 ◽

2020 ◽

Author(s):

Srujana Sahebjada ◽

Elsie Chan ◽

Jing Xie ◽

Grant Snibson ◽

Mark Daniel ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Risk Factor ◽

Significant Risk ◽

Significant Risk Factor ◽

Educational Background ◽

Cross Sectional Study ◽

Cross Sectional ◽

Wide Range ◽

Multivariable Regression

Abstract Background: A cross-sectional study was undertaken in Australia to explore a wide range of risk factors associated with keratoconus. A questionnaire addressing age, gender, educational background, ocular and medical history, smoking and alcohol consumption, and physical examination comprising anthropometric measurements was collected; eye examination was undertaken. The associations between a range of risk factors and keratoconus was determined using univariate and multivariable linear regression analyses.Main Text: A total of 260 keratoconus subjects were included in this study. Mean age of subject was 35.5 (SD= 14.8) years and the majority of the subjects were European 171 (68.2%). Initial univariate regression analysis identified the following risk factors at the p<0.1 level with keratoconus: higher body mass index, smoking cigarettes, diabetes, rheumatoid arthritis and asthma were associated with increased severity of keratoconus, whereas eczema was associated with less severe keratoconus. Following multivariable regression analysis, only asthma remained as a significant risk factor associated with 2.2 diopters (D) steeper average mean keratometry compared to keratoconus subjects having no asthma [p = 0.03; β= 2.18; 95% confidence intervals: 1.22, 4.14].Conclusion: Our study describes the comprehensive assessment of all the known risk factors in a large keratoconus cohort recruited in Australia. Our study has reported asthma as the only risk factor found to be significantly associated with keratoconus. The results of this study allow us to better understand the aetiology of keratoconus and such a knowledge could be useful in instigate systemic management of patients to slow or prevent keratoconus.

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