Qualitative Investigation into the Mental Health of Healthcare Workers in Japan during the COVID-19 Pandemic

The COVID-19 pandemic has negatively impacted the mental health of healthcare workers in many countries including Japan. While many survey-based findings have reported the serious state of their wellbeing among healthcare workers, the first-hand experience of the mental health and coping in this population remains to be evaluated. Accordingly, this study aimed to appraise them using constructionist thematic analysis on semi-structured interviews attended by a purposive and snowball sample of 24 healthcare workers in Japan conducted in December 2020–January 2021. Four themes were identified: (1) increased stress and loneliness, (2) reduced coping strategies, (3) communication and acknowledgement as a mental health resource, and (4) understanding of self-care. Participants noted that the characteristics of Japanese work culture such as long hours, collectivism and hatarakigai (i.e., meaning in work) to explain these themes. These findings suggest that robust support at an organizational and individual level, capturing intrinsic values, are particularly important for this key workforce to cope with increased stress and loneliness, leading to better patient care.

Measuring the acceptability of EQ-5D-3L health states for different ages: a new adaptive survey methodology

Background Acceptable health and sufficientarianism are emerging concepts in health resource allocation. We defined acceptability as the proportion of the general population who consider a health state acceptable for a given age. Previous studies surveyed the acceptability of health problems separately per EQ-5D-3L domain, while the acceptability of health states with co-occurring problems was barely explored. Objective To quantify the acceptability of 243 EQ-5D-3L health states for six ages from 30 to 80 years: 1458 health state–age combinations (HAcs), denoted as the acceptability set of EQ-5D-3L. Methods In 2019, an online representative survey was conducted in the Hungarian general population. We developed a novel adaptive survey algorithm and a matching statistical measurement model. The acceptability of problems was evaluated separately per EQ-5D-3L domain, followed by joint evaluation of up to 15 HAcs. The selection of HAcs depended on respondents’ previous responses. We used an empirical Bayes measurement model to estimate the full acceptability set. Results 1375 respondents (female: 50.7%) were included with mean (SD) age of 46.7 (14.6) years. We demonstrated that single problems that were acceptable separately for a given age were less acceptable when co-occurring jointly (p < 0.001). For 30 years of age, EQ-5D-3L health states of ‘11112’ (11.9%) and ‘33333’ (1%), while for 80 years of age ‘21111’ (93.3%) and ‘33333’ (7.4%) had highest and lowest acceptability (% of population), respectively. Conclusion The acceptability set of EQ-5D-3L quantifies societal preferences concerning age and disease severity. Its measurement profiles and potential role in health resource allocation needs further exploration.

Ten years of China’s new healthcare reform: a longitudinal study on changes in health resources

Background China launched a new round of healthcare-system reform in 2009 and proposed the goal of equal and guaranteed essential medical and health services for all by 2020. We aimed to investigate the changes in China’s health resources over the past ten years after the healthcare reform. Methods Data were collected from the China Statistical Yearbook and China Health Statistics Yearbook from 2009 to 2018. Four categories and ten indicators of health resources were analyzed. A descriptive analysis was used to present the overall condition. The Health Resource Density Index was applied to showcase health-resource distribution in demographic and geographic dimensions. The global and local Moran’s I were used to assess the spatial autocorrelation of health resources. Concentration Index (CI) was used to quantify the equity of health-resource distribution. A Geo-Detector model and Geographic Weighted Regression (GWR) were applied to assess the association between gross domestic product (GDP) per capita and health resources. Results Health resources have increased over the past ten years. The global and local Moran’s I suggested spatial aggregation in the distribution of health resources. Hospital beds were concentrated in wealthier areas, but this inequity decreased yearly (from CI=0.0587 in 2009 to CI=0.0021 in 2018). Primary medical and health institutions (PMHI) and their beds were concentrated in poorer areas (CI remained negative). Healthcare employees were concentrated in wealthier areas (CI remained positive). In 2017, the q-statistics indicated that the explanatory power of GDP per capita to beds, health personnel, and health expenditure was 40.7%, 50.3%, and 42.5%, respectively. The coefficients of GWR remained positive with statistical significance, indicating the positive association between GDP per capita and health resources. Conclusions From 2009 to 2018, the total amount of health resources in China has increased substantially. Spatial aggregation existed in the health-resources distribution. Health resources tended to be concentrated in wealthier areas. When allocating health resources, the governments should take economic factors into account.

Optimism and Health: Resource or Delusion

There is a general, widely-held belief that optimism is always a good thing. While there is much previous research suggesting that optimists enjoy several health and wellness benefits, there is also a large body of research suggesting that optimism is not always advantageous. Examining how optimism develops and changes across the lifespan may give us insight into how we use optimism and allow us to determine if and when optimism is helpful or maladaptive. In this talk, I will review evidence debating the efficacy of optimism, as well as examine how optimism develops across the lifespan. I also discuss how life events may or may not impact the developmental trajectory of optimism. Lastly, I address currently unanswered questions and emphasize the contextual nature of optimism’s advantages. Ultimately, being persistently optimistic about the future is a nearly universal human trait. But the exact contexts in which this positive thinking is helpful--if ever--is an intriguing question that speaks to how we think about ourselves, how we think about others, and how we think about our many possible futures.

Margret M. and Paul B. Baltes Award Lecture: Optimism and Health: Resource or Delusion?

The lecture will be given by the 2020 Baltes Award recipient, William Chopik, PhD, of Michigan State University. The recipient of the 2021 Baltes Award is Laura B. Zahodne, PhD, of the University of Michigan. The Margret M. and Paul B. Baltes Foundation Award in Behavioral and Social Gerontology recognizes outstanding early-career contributions in behavioral and social gerontology. The award is generously funded by the Margret M. and Paul B. Baltes Foundation.

Fairness of the Distribution of Public Medical and Health Resources

The fairness of health services is an important indicator of the World Health Organization's performance evaluation of health services, and the fairness of health resource allocation is the prerequisite for the fairness of health services. The research in this article aims to explore how to use health and medical resources fairly and effectively to allocate health resources in different fields, populations and projects, in order to achieve the maximization of social and economic benefits of health and medical resources. In the study of the distribution and equity of public health and medical resources, we comprehensively apply Gini coefficient, Theil index, Lorentz curve and difference index, based on the theory of health resource allocation and the theory of health equity, the province's health service resources have been researched and evaluated, combined with regional health planning theories and public health theories, a variety of scientific methods were used to analyze community health service resources at all levels across the country. At the same time, we reviewed the journal literature about the treatment of patients and children, and analyzed the patients admitted to medical institutions in various regions. The research in this paper found that from 2016 to 2020, the Gini coefficient of the province's health institutions according to population distribution has been fluctuating between 0.14 and 0.17. During this 5-year period, the Gini coefficient of the distribution of medical and health expenditures by population shows a downward trend year by year. From 2019, reach below 0.1, this shows that the fairness of the allocation of health resources according to population has a clear trend of improvement.

Equity and Efficiency of Medical and Health Resource Allocation in Western China Based on Health Resources Agglomeration Degree and Malmquist Index

Background: There is unequal distribution and low utilization efficiency of medical and health resources among regions in China for regional inequality social and economic development. The social and economic development in western China is relatively backward nationwide. The quantity and quality of medical and health resources have become a social problem in western China. This study aims to evaluate the equity and efficiency of health resource allocation in western China. Methods: The research data are extracted from China Statistical Yearbook ( 2009 – 2019 ). We choose the health resource agglomeration degree ( HRAD ) theory and Malmquist index to evaluate the equity and efficiency of health resource allocation in western China. The HRAD shows the impact of demographic and geographic factors on health resource aggregation. Results: From the latest data in 2019, the equity of medical and health resources allocation based on geographical area in Inner Mongolia, Tibet, Qinghai and Xinjiang is poor. The equity of medical and health resources allocation based on population allocation in Yunnan, Tibet, Gansu, Qinghai, Ningxia and Xinjiang is poor. From 2009 to 2019, the equity of health resource allocation in western China are poor nationwide. The total factor productivity of Tibet, Qinghai, Ningxia and Xinjiang was less than 1, which were 0.994, 0.984, 0.974 and 0.994, respectively. The allocation of medical and health resources in western China is unfair. Conclusion: The government should pay attention to the horizontal flow of medical and health resources when investing in medical and health resources. Population and geographical factors should be taken into account when allocating health resources. The total factor productivity in the western region is greatly affected by the technological progress rate. We should increase investment in medical and health technology, and effectively optimize the equity and efficiency of medical and health resource allocation.