The Frequency and Causes of Unnecessary Medical Services in Urmia, Iran: Strategies and Control

Background: Unnecessary prescription, diagnosis, and medical services are increasing various health problems in the world. According to the World Health Organization (WHO), over-prescription and unnecessary services are the measures that cause significant damages rather than benefits. Objectives: The present study aimed to evaluate the perspective of Urmia medical system members regarding the frequency and causes of unnecessary medical services and their control and prevention strategies in Urmia, Iran. Methods: This descriptive-analytical, cross-sectional research was performed on 102 specialist physicians selected from the Urmia Medical Association, and the selected individuals participated in the survey online. Outcome measures included the percentage of unnecessary medical care and common causes of overtreatment. Data were collected using Johns Hopkins University Unnecessary medical services checklist. Data analysis was performed in SPSS version 22 using descriptive statistics (frequency and mean) and chi-square. Results: In total, 41% of the participants (n = 43) were family physicians, and 59% (n = 59) were specialists of other medical fields. In terms of gender, 53% were male, and the others were female. The main causes of unnecessary medical services at a national level included pressure from patients (66.7%; n = 68), fear of medical malpractice (54.9%; n = 56), pressure from colleagues (23.5%; n = 24), and achieving a high rank in a performance appraisal (40.2%; n = 41). According to the participants, the development of more guidelines and instructions (47.1%; n = 48) and training residents on the appropriate use of diagnostic criteria (50%; n = 51) could be effective approaches to preventing unnecessary medical services. In addition, significant differences were observed between the perspective of the family physicians and the specialists in terms of the fear of malpractice (P = 0.002), lack of medical history (P = 0.17), pressure from patients (P = 0.25), training of residents on the use of diagnostic criteria (P = 0.001), and easier access to medical files (P = 0.001). Conclusions: From the physicians’ perspective, overtreatment is highly common in Iran. In order to solve this problem, efforts should be dedicated to areas such as medical file availability, diminishing the fear of malpractice, and more training of residents. Moreover, it is recommended that patients’ awareness be raised regarding the damages caused by unnecessary prescriptions so that they would not request frequent visits.

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PENGARUH AKSES DAN MOTIVASI TERHADAP PERILAKU IBU HAMIL DALAM MELAKUKAN KUNJUNGAN ANTENATAL DI WILAYAH KERJA PUSKESMAS PANCUR BATU TAHUN 2015

Elisabeth Health Jurnal ◽

10.52317/ehj.v1i2.202 ◽

2016 ◽

Vol 1 (2) ◽

pp. 48-60

Author(s):

Oktafiana Manurung ◽

Ermawaty Arisandi Siallagan

Keyword(s):

Antenatal Care ◽

World Health Organization ◽

Univariate Analysis ◽

World Health ◽

Bivariate Analysis ◽

Antenatal Visit ◽

Chi Square ◽

Cross Sectional ◽

The World ◽

Health Organization

According to the World Health Organization (WHO) Indonesian women have According to the World Health Organization (WHO) Indonesian women have very bad criteria in terms of health, marriage, employment, education, equality with men. This condition is thought to lead to low maternal access to antenatal care. Goals : Antenatal care in accordance with antenatal care standards may decrease Maternal and Infant Mortality due to regular antenatal care can detect early problems that occur in the mother during pregnancy.Methods : The type of this research is analytical descriptive with cross sectional design which aims to analyze the influence of access and motivation of pregnant mother to mother behavior in doing antenatal visit. The research was conducted in Pancur Batu Puskesmas Working Area. The population is 181 people and the sample size is 61 people. Data analysis was performed using univariate analysis, bivariate analysis with Chi-Square test, and multivariate analysis with multiple logistic regression test.Result : The result of this research indicate that physical accessibility variable is the availability of unrelated officer (p = 0,461) to mother behavior in antenatal visit, social accessibility variable (p = 0,005) and attitude (p = 0,023), and for motivation variable is motive P = 0.005) and expectations (p = 0.019) had a significant effect on maternal behavior in antenatal visits.Conclution : Based on the results of research suggested Head of Pancur Batu Puskesmas to conduct training to officers especially midwives who provide services mainly about hospitality in providing services and to officers implementing services further improve the communication of information and education so that every pregnant women have a good understanding that can eventually cause attitude Positive, high motivation and expectation that can affect the mother in conducting standardized antenatal visits.

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Knowledge, Attitude, and Perception of COVID-19 Pandemic in Enugu, Southeast Nigeria- The Initial Experience

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2031101 ◽

2021 ◽

pp. 27-37

Author(s):

E. K. Mgbe ◽

C. G. Mgbe ◽

S. N. Ezeofor ◽

J. F. Etiki

Keyword(s):

Social Media ◽

Descriptive Analysis ◽

World Health ◽

Validity And Reliability ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

The World ◽

Enugu State ◽

Health Organization

Background: The world is experiencing a global corona virus (COVID-19) pandemic. As of 9th June 2020, over 7 million confirmed cases of coronavirus disease (COVID-19) and more than 400,000 deaths had been reported in more than 30 countries of the world according to World Health Organization. Aim: We aimed to assess the knowledge, attitudes, and vulnerability perception of Enugu state residents during the coronavirus outbreak in order to facilitate better health care outcomes. Methodology: A prospective Web-based cross-sectional survey was designed for this study which was conducted in March 2020 among Enugu state residents. The obtained data were coded, validated, and analyzed using Statistical Package for the Social Sciences SPSS software, version 24. Descriptive analysis was applied to calculate the frequencies and proportions and Chi-Square Test was also used. A preliminary phase was conducted to assess the validity and reliability of the questionnaire before its use. Results: The study showed that significant number (99.6%) of the respondents had heard about Covid-19 and the most stated source of knowledge was social media (57.6%), followed by Newspaper and television shows (50.2%) while the least was from General Practitioner (GP) (8.9%). There was over 75% agreement with, and practice, of all known covid precautionary measures and less than 35% responses for wrong claims and practices about covid -19. Conclusion: The overall knowledge, attitude, and perception are high in Enugu state population although few still has background combined superstitious believes. Social media and internet are the highest used facility for acquisition of knowledge and information in Enugu, Nigeria.

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Roles and challenges of family physicians in Uganda: A qualitative study

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v11i1.2009 ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Innocent K. Besigye ◽

Jude Onyango ◽

Fred Ndoboli ◽

Vincent Hunt ◽

Cynthia Haq ◽

...

Keyword(s):

Qualitative Study ◽

Teaching And Learning ◽

Clinical Care ◽

Family Physicians ◽

World Health ◽

World Health Report ◽

Cross Sectional ◽

Health Report ◽

Geographical Regions ◽

The World

Background: The World Health report (2008), the World Health Assembly (2009) and the Declaration of Astana (2018) acknowledge the significant contribution of family physicians (FPs) in clinical and primary healthcare. Given the lack of resources and low numbers of FPs coupled with the contextual nature of family medicine (FM), the scope of practice of African FPs is likely to differ from that of colleagues in America and Europe. Thus, this study explored the roles of Ugandan FPs and the challenges they face.Methods: This cross-sectional qualitative study was conducted through in-depth interviews with FPs who are working in Uganda. Participants who work in public and private healthcare systems including non-governmental organisations and in all geographical regions were purposively selected. Interviews were conducted from July 2016 to June 2017. Qualitative thematic content analysis of the transcripts was performed using a framework approach.Results: The study team identified three and six thematic roles and challenges, respectively, from the interview transcripts. The roles were clinician, leadership and teaching and learning. Challenges included lack of common identity, low numbers of FPs, conflicting roles, unrealistic expectations, poor organisational infrastructure and lack of incentives.Conclusion: The major roles of FPs in Uganda are similar to those of their counterparts in other parts of the world. Family physicians provide clinical care for patients, including preventive and curative services; providing leadership, management and mentorship to clinical teams; and teaching and learning. However, their roles are exercised differently as a result of lack of proper institutionalisation of FM within the Uganda health system. Family physicians in Uganda have found many opportunities to contribute to healthcare leadership, education and service, but have not yet found a stable niche within the healthcare system.

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HUBUNGAN USIA DAN JARAK KEHAMILAN DENGAN KEJADIAN ANEMIA KLINIS SELAMA KEHAMILAN

Jurnal Asuhan Ibu dan Anak ◽

10.33867/jaia.v5i1.155 ◽

2020 ◽

Vol 5 (1) ◽

pp. 35-40

Author(s):

Vevi Gusnidarsih

Keyword(s):

Public Health ◽

At Risk ◽

Health Center ◽

World Health ◽

Chi Square ◽

Cross Sectional ◽

Public Health Center ◽

The World ◽

Mother And Child ◽

Anemia During Pregnancy

ABSTRACT Pregnancy anemia called "potential denger to mother and child" (potentially harmful to mothers and children), because that is anemia requires serious attention from all related parties in health care. Data from the World Health Organizazion (WHO), globally the prevalence of anemia in pregnant women around the world was 41.8%, in 2018 increased to 48.9% (Rikesdas, 2018). One cause of occurrence and clinical anemia during pregnancy is the age and distance of pregnancy. The research methodology used in this study is an analytical survey using cross sectional methods. The population of this study includes all expectant mothers who are in the working area of Talang Randai public health center in south Bengkulu period of February-March 2018 amounted to 58 people. Data is analyzed using Chi-square. The results of the study obtained 53.4% of the respondents had anemia, 41.4% of the respondents with age at risk is < 20 and > 35 year, 37.5% of respondents with pregnancy distance at risk is < 2 years. The Chi-Square statistical shows the Î± value of < 0.005 meaning there is a meaningful relationship between the ages (P = 0,002) and the gestational distance (P = 0,003) with the incidence of clinical anemia during pregnancy in the working area of Talang Randai public health center in South Bengkulu Regency. Keywords: Anemia, age, pregnancy distance

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Knowledge, attitude and practice of secondary school students toward COVID-19 epidemic in Italy: a cross selectional study

10.1101/2020.05.08.084236 ◽

2020 ◽

Cited By ~ 2

Author(s):

Dafni Souli ◽

Maddalena Dilucca

Keyword(s):

Secondary School ◽

Virus Transmission ◽

Student Population ◽

World Health ◽

School Students ◽

Chi Square ◽

Cross Sectional ◽

Modes Of Transmission ◽

The World ◽

Level Of Knowledge

AbstractThe coronavirus disease (COVID-19) is a highly transmittable and pathogenic viral infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which emerges in December 2019 in Wuhan, China and spreads around the world at the beginning of 2020. The World Health Organization declares the outbreak a Public Health Emergency of International Concern on the 30th of January, and a pandemic on the 11th of March. On the 4th of March, the Italian government orders the full closure of all schools and universities nationwide.The aim of this study is to investigate the knowledge, practice and attitudes (KAP) of secondary school at the time of COVID-19 pandemic in Italy. In this cross-sectional, web-based survey, conducted among the high school student population with age ranging from 14 to 19 years old, a questionnaire with 19 items regarding the KAP toward COVID-19 is asked. Study participants are recruited from several secondary schools of different areas. Frequencies and histograms are computed for descriptive purposes. Statistical analysis is computed with Chi square test, utilized to depict relevant difference between geender. Among a total of 2380 students who answers the questionnaire, 40.7% are male and 59.3% are female.Level of knowledge about generical characteristics of COVID-19 is quite similar among gender. Students present a good level of knowledge about the clinical presentation of the disease, the basic hygiene principles, the modes of transmission and the method of protection against virus transmission. The knowledge about number of this pandemia and easy scientific correlation with COVID-19 is quite confused. The most frequently reported source of knowledge about COVID-19 is television, whereas the less is the school. Our findings suggest that student population shows appropriate practice, and positive attitude towards COVID-19 at the time of its outbreak.More emphasis should be placed on education of the student partecipants about biological meaning of this infection and relative preventive or future measures.

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factors related to the event of gastritis disease in kelurahan tanjung pinang, jambi city in 2018

Jurnal Formil (Forum Ilmiah) Kesmas Respati ◽

10.35842/formil.v4i1.233 ◽

2019 ◽

Vol 4 (1) ◽

pp. 99

Author(s):

Melda Yenni ◽

Sugiarto Sugiarto ◽

Rumiati Rumiati

Keyword(s):

Coffee Consumption ◽

Sampling Technique ◽

Total Sample ◽

World Health ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Major Health Problem ◽

The World ◽

Chi Square Test

Non-communicable diseases are a major health problem in developing countries that are experiencing a demographic transition and a decline in lifestyle in their communities. The WHO 2013 World Health Research Agency, conducted a review of several countries in the world, obtained a percentage of gastritis in the world, including Britain 22%, China 31%, Japan 14.5%, Canada 35%, and France 29.5%. Based on data from the Jambi City Health Office from 20 puskesmas the number of gastritis cases was 83.21% and the highest number of gastritis events was at tanjung pinang health center, which was 5.91%. This study was conducted to determine the factors associated with the incidence of gastritis in Tanjung Pinang Village, Jambi City. The research design used was quantitative with a cross sectional approach. The population in this study was the productive age community in the area of Tanjung Pinang which numbered 9,489 people. The sampling technique uses Random Sampling techniques with a total sample of 95 respondents. This research was conducted on September 28, October 16, 2018. Data obtained were analyzed by univariate and bivariate using the Chi-Square test. The results showed that there was a relationship between eating patterns with the incidence of gastritis p-value 0,000 (P-Value <0.05), coffee consumption with the incidence of gastritis p-value 0.027 (P-Value <0.05) and the relationship of stress levels with Gastritis incidence p-value 0,000 (P-Value <0.05). It is expected that respondents and the community will always maintain a regular diet, reduce or limit coffee consumption in a day, and exercise for one hour and relax regularly, recreation/refreshing, share or manage work time properly

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FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN DISMENOREA PADA SISWI SMAN 1 LOLAK

PREPOTIF : Jurnal Kesehatan Masyarakat ◽

10.31004/prepotif.v5i2.2094 ◽

2021 ◽

Vol 5 (2) ◽

pp. 804-813

Author(s):

Strahmawati Hamzah ◽

Hamzah B

Keyword(s):

Sampling Technique ◽

Cross Sectional Study ◽

World Health ◽

Chi Square ◽

Cross Sectional ◽

The World ◽

Chi Square Test ◽

Secondary Dysmenorrhea ◽

Health Organization ◽

Age Of Menarche

ABSTRACT Data from the World Health Organization shows that the incidence of dysmenorrhea is quite high throughout the world. The average incidence of dysmenorrhea in young women is between 16,8%-81%. The prevalence of adolescent girls in Indonesia is that the incidence of dysmenorrhea is 64,25%, consisting of 54,89% primary dysmenorrhea and 9,36% secondary dysmenorrhea. The purpose of this study was to analyze the factors associated with the incidence of dysmenorrhea in SMA Negeri 1 Lolak. This study used an analytic observational design with a cross sectional study design with a sample size of 68 respondents. The sampling technique used was total sampling. Data for each variable was collected using a questionnaire through interviews and then the data was then analyzed by univariate and bivariate with chi square test. The results of research conducted at SMAN 1 Lolak showed that there was a relationship between the age of menarche and the incidence of dysmenorrhea in class XI students (p = 0,030 < 0,05), there was a relationship between family history and the incidence of dysmenorrhea in class XI students (p = 0,039 < 0,05), and there is a relationship between exercise habits and the incidence of dysmenorrhea in class XI students (p=0,024

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Pengetahuan Remaja Putri Tentang Konsumsi Tablet FE Pada Saat Menstruasi Pengan Anemia

Jurnal Endurance ◽

10.22216/jen.v4i2.4100 ◽

2019 ◽

Vol 4 (2) ◽

pp. 343

Author(s):

Rizka Angrainy ◽

Lidia Fitri ◽

Vipit Wulandari

Keyword(s):

World Health Organization ◽

Univariate Analysis ◽

Public Health Problem ◽

World Health ◽

Deficiency Anemia ◽

Chi Square ◽

Cross Sectional ◽

Purposive Sampling ◽

The World ◽

Health Organization

Anemia is a public health problem in the world. According to the World Health Organization (WHO), anemia cases occur 24.8% of the population and an estimated 50-80% of anemia is caused by iron deficiency. Anemia most often occurs in adolescents during menstruation and can be prevented by consuming Fe tablets. Initial survey of 10 female students showed most do not know about consuming Fe tablets during menstruation and 3 of them have Hb below 12 g%. The purpose of research to know the relationship of the adolescent knowledge about consuming fe tablets when menstrual with anemia in Junior High School 20 Pekanbaru 2018. The research design is quantitative Analitic with Cross Sectional approach.The population in this research amounted to 148 people with sampling using technique is purposive sampling as many as 86 people. The data obtained from the questionnaire and Hb measurements on the respondents.The statistical analysis used chi-square. The result of univariate analysis showed that most of the respondents (59,3%) had good knowledge about consuming Fe tablets during menstruation and the majority of respondents (84,3%) is not anemic. Test result obtained P Value < α (0,001<0,05), and it can be concluded that there is a significant relationship between of the adolescent knowledge about consuming Fe tablets when menstrual with anemia. Anemia merupakan masalah kesehatan masyarakat diseluruh dunia. Menurut World Health Organization (WHO), kasus anemia terjadi 24,8% dari populasi dan diperkirakan sekitar 50-80% anemia disebabkan oleh defisiensi besi. Anemia paling sering terjadi pada remaja saat menstruasi dan dapat dicegah dengan mengonsumsi tablet Fe. Survei awal terhadap 10 siswi menunjukkan sebagian besar tidak mengetahui tentang konsumsi tablet Fe pada saat menstruasi dan 3 diantaranya memiliki Hb dibawah 12 gr%. Tujuan penelitian untuk mengetahui hubungan pengetahuan remaja putri tentang konsumsi tablet Fe pada saat menstruasi dengan anemia di SMP Negeri 20 Pekanbaru. Jenis penelitian Analitik Kuantitatif dengan desain Cross Sectional. Populasi sebanyak 148 orang dengan pengambilan sampel menggunakan purposive sampling sebanyak 86 orang. Data penelitian diperoleh dari kuesioner dan pengukuran Hb. Analisa data menggunakan uji chi-square. Hasil penelitian sebagian besar responden 59,3% memiliki pengetahuan baik tentang mengonsumsi tablet Fe pada saat menstruasi dan mayoritas responden 84,3% tidak anemia. Hasil uji diperoleh Pvalue < α (0,001<0,05) dan dapat disimpulkan bahwa ada hubungan yang bermakna antara pengetahuan remaja putri tentang konsumsi tablet Fe pada saat menstruasi dengan anemia.

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Obesity With Hypertension Events In Taccorong Village, Bulukumba District

Comprehensive Health Care ◽

10.37362/jch.v3i3.228 ◽

2019 ◽

Vol 3 (3) ◽

pp. 121-128

Author(s):

Wiwi Yuniarti ◽

Muriyati ◽

Hamdana

Keyword(s):

Sampling Technique ◽

Premature Death ◽

The Body ◽

World Health ◽

Chi Square ◽

Cross Sectional ◽

The World ◽

Health Organization ◽

The Relationship ◽

Experienced Grade

According to the world health organization 2015, says that hypertension is one of the main causes of premature death throughout and hypertension kills nearly 8 billion people every year in the world. Obesity is one of the risk factors for hypertension, because of the accumulation of fat in the body, the higher a person's body mass index, the higher the risk of developing hypertension. The purpose of this study is to know the relationship between obesity and the incidence of hypertension in the village of Taccorong caused Bulukumba district in 2018. The population in this study was the obese community in Taccorong village, Bulukumba regency, a population of 68 respondents, a sampling technique used by a purposive sampling technique. This type of research is analytic research with a cross-sectional approach. The test used for the relationship of obesity with the incidence of hypertension in Taccorong village Bulukumba district in 2018. Is the Pearson Chi-Square test, with the results of the study that obese respondents who experienced grade 1 hypertension were 18 respondents (85.7%) and obesity 1 respondents who had hypertension grade 2 were 3 respondents (14.3%). While the obese 2 respondents who experienced grade 1 hypertension were 6 respondents (31.6%) and obesity 2 respondents who experienced grade 2 hypertension as many as 13 respondents (68.4%). Based on the test results obtained values (p=0.000) then Ho is rejected and Ha is accepted. The conclusion of this study is that there is a correlation between obesity and the incidence of hypertension in Taccorong village, Bulukumba district in 2018. It is recommended for the Puskesmas Bonto Nyeleng Institution to pay attention to its working area to detect total obesity.

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Understanding of Development Emergency Medical Services in Laos Emergency Medicine Residents

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7333 ◽

2021 ◽

Vol 9 (E) ◽

pp. 1085-1091

Author(s):

Korakot Apiratwarakul ◽

Ismet Celebi ◽

Somsak Tiamkao ◽

Vajarabhongsa Bhudhisawasdi ◽

Chatkhane Pearkao ◽

...

Keyword(s):

Emergency Medicine ◽

Emergency Medical Services ◽

Human Resource Development ◽

Traffic Accidents ◽

National Policy ◽

World Health ◽

Medical Services ◽

Cross Sectional ◽

Emergency Medical ◽

The World

BACKGROUND: Rising death tolls from traffic accidents are quickly becoming an inescapable problem in almost all countries around the world. That being said, the World Health Organization has launched an ambitious campaign aimed at reducing the death rate from traffic accidents by 50% in the next 10 years. Development of emergency medical services (EMSs) was the tool to success the goals, especially in low- to middle-income countries including Laos. However, no studies regard perspective of training EMS in Laos emergency medicine residents. AIM: The aim of our work is to demonstrate the effect of EMS training for Laos emergency medicine residents to the development of the national policy in Lao’s EMS. METHODS: A cross-sectional study was conducted in two countries (Laos and Thailand) from January 2020. The project activities were establishment of a command-and-control center, development of EMS support system, and training for emergency care professionals. RESULTS: The eight Laos emergency medicine residents were enrolled between January and March 2020. After practicing as a dispatcher and emergency medical consultant in Thailand at Khon Kaen University, the participants from Laos found that all personnel gained experience and improved their knowledge of technology in EMS and organization management. This had a direct impact on improving confidence in their return to practice in Laos. CONCLUSIONS: The human resource development through international collaboration between Thailand and Laos is contributing the effective knowledge and expertise learning in Laos. Moreover, the result of this training may provide the most effective care system resulting in the much-needed drop in the mortality rate of traffic accidents in Laos.

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