A Head-to-head Comparison of the EQ-5D-3L Index Scores Derived from the Two EQ-5D-3L Value Sets for China

Background: Two EQ-5D-3L (3L) value sets (developed in 2014 and 2018) co-exist in China. The study examined the level of agreement between index scores for all the 243 health states derived from them at both absolute and relative levels and compared the responsiveness of the two indices. Methods: Intraclass correlations coefficient (ICC) and Bland-Altman plot were adopted to assess the degree of agreement between the two indices at the absolute level. Health gains for 29,403 possible transitions between pairs of 3L health states were calculated to assess the agreement at the relative level. Their responsiveness for the transitions was assessed using Cohen effect size.Results：The mean (standard deviation, SD) value was 0.427 (0.206) and 0.649 (0.189) for the 3L2014 and 3L2018 index scores, respectively. Although the ICC value showed good agreement (i.e., 0.896), 88.9% (216/243) of the points were beyond the minimum important difference limit according to the Bland-Altman plot. The mean health gains for the 29,403 health transitions was 0.234 (3L2014 index score) and 0.216 (3L2018 index score). The two indices predicted consistent transitions in 23,720 (80.7%) of 29,403 pairs. For the consistent pairs, Cohen effective size value was 1.05 (3L2014 index score) or 1.06 (3L2018 index score); and the 3L2014 index score only yielded 0.007 more utility gains. However, the results based on the two measures varied substantially according to the direction and magnitude of health change. Conclusion：The 3L2014 and 3L2018 index scores are not interchangeable. The choice between them is likely to influence QALYs estimations.

Readiness of the Haji Abdoel Madjid Regional General Hospital Batanghari Jambi to Deal Disaster

Disasters are events caused by events or a series of events caused by natural or non-natural. During the period from January to May 2021, there were 1,185 disasters that occurred in Indonesia such as floods, tornadoes, landslides, forest and land fires, earthquakes, tidal waves and droughts. This study aimed to analyse the preparedness of the Haji Abdoel Madjid Batang Hari Regional General Hospital (RSUD HAMBA) Jambi (facing disasters and the COVID-19 pandemic). The research method uses a mix method approach, using the Hospital Safety Index (HSI) forms. The HAMBA Hospital included earthquakes, strong winds, fires, and the COVID-19 pandemic. The struktural safety assessment got an index score of 0.69, non-struktural safety was 0.67, and emergency and disaster management safety got an index score of o.63. Overall, HAMBA Hospital received a safety index of 0.67 which was included in the "A" classification which indicates that HAMBA Hospital is ready to face the COVID-19 disaster and pandemic. HAMBA Hospital is expected to strengthen emergency and disaster management, renovation and addition of rooms and facilities must follow applicable hospital building safety standards.

Electric and Manual Oral Hygiene Routines Affect Plaque Index Score Differently

This cross-sectional study aimed to examine the oral hygiene behaviors in the general population and identify factors affecting oral hygiene behaviors and plaque removal efficacy. A survey was distributed to patients through 11 dental practices in Japan, and each patient’s plaque index score (PIS) was recorded. In total, 1184 patients participated (521 women and 660 men), with 84.04% using manual toothbrushes (MTBs) and 15.96% using electric toothbrushes (ETBs). ETB users had a significantly lower PIS compared to MTB users (p = 0.0017). In addition, a statistically significant difference in the PIS was detected in relation to the frequency of brushing per day (≥2 times) and time spent on brushing (≥1 min). Some MTB users spent less than 1 min brushing, while all ETB users spent at least 1 min brushing, and extended brushing periods significantly improved the PIS for the MTB users. MTB users tend to replace brush heads more frequently than ETB users, and the frequency of replacement affected the PIS significantly (p < 0.01) for the MTB users. The status of dental treatment (first visit, in treatment versus recall) also significantly affected the PIS (p < 0.01). The ETB was more effective than the MTB in terms of better plaque removal and reduced frequency of brush head replacement.

A Comparative Evaluation between the Efficacy of Scaling & Root Planing (SRP) with Local Delivery of Chlorhexidine Gluconate and SRP Alone in Periodontal Pocket Reduction Therapy

Aim: The aim of the present study was to compare the efficacy of locally delivered chlorhexidine as an adjunct to scaling and root planning (SRP) & SRP alone in bringing reduction of pocket depth in the treatment of moderate to severe periodontitis patients. Materials and Methods: A total number of 15 patients both males and females in the age group of 30-55 years were selected with total number of 30 sites with periodontal probing pocket depth measuring 5-8mm in different quadrant of the mouth. A randomized, double blind, controlled clinical trial design was followed for the study. On one side scaling and root planning was done and on the other side scaling and root planning was done along with local delivery of chlorhexidine glugocate then the patient was examined after 0, 45, and 60 days using The clinical parameters the Plaque Index (PI), gingival index (GI), Bleeding on probing (BOP), Clinical attachment level (CAL) and Probing pocket depth (PPD). Statistical Analysis: Student paired T-test has been carried out for this present study. Results: The mean reduction of Plaque Index score between 0-45 day between control site and test site was 1.58±0.11 and the mean reduction of Plaque Index score between 0-60 day between control site and test site was 2.42±0.34 which is found not significant. At the Control site the mean plaque index score on 0 day was 2.2, on 45th day was 1.88 and on 60th day was 1.82. At the test site the mean plaque index score on 0 day was 2.6, on 45th day was 1.82 and on 60thday was 1.59. There was change from the base line values of mean plaque index between the control sites and test sites but was not significant. Conclusion: There was improvement in all the clinical parameters of the test sites in comparison to the control sites from base line to 60 days, but the adjunctive use of chlorhexidine showed a significant improvement only on the clinical attachment level.

Regulation of medicines advertisement in Zimbabwe: an assessment of the impact of pharmaceutical promotion on the prescribing behaviour of healthcare professionals

Background The pharmaceutical industry plays a key role in drug discovery and is considered useful regards to informing the health care workers health care workers about new medicines. Investigations concerning health care workers to industry interactions are less common. The objective of this study is to determine levels of knowledge, attitude and perception towards regulation of pharmaceutical promotion among healthcare practitioners in Zimbabwe. Methods A cross-sectional study was used and 330 healthcare practitioners were enrolled into the study. Data collection was done through combined face-to-face interviews and web-based online survey. The relative importance index score and used as a measure of knowledge, attitude and perception levels towards pharmaceutical promotion. Univariate and bivariate analysis was performed using STATA software package. Results Our study estimated that 95%, 67%, and 90% of the healthcare practitioners in Zimbabwe have a favourable (i.e. > 65%) relative importance index score of knowledge, attitudes, and perception, respectively, towards regulation of pharmaceutical promotion. Further exploration of the data indicated that the factors that had an association with the knowledge, attitude and perception levels towards regulation of pharmaceutical regulation at 5% level of significance include health care workers’ profession, gender, education level, the nature of the working institution and the number of prescriptions involved per week. Conclusion In conclusion, the findings of this study highlighted that in general the health care workers in Zimbabwe have higher levels of knowledge, attitude and perception towards regulation of pharmaceutical promotion, though the attitudes levels weres a bit lower compared to other domains.

Continuity of care, measurement and association with hospital admission and mortality: a registry-based longitudinal cohort study

ObjectiveTo assess whether continuity of care (COC) with a general practitioner (GP) is associated with mortality and hospital admissions for older patients We argue that the conventional continuity measure may overestimate these associations. To better reflect COC as a GP quality indicator, we present an alternative, service-based measure.DesignRegistry-based, population-level longitudinal cohort study.SettingLinked data from Norwegian administrative healthcare registries, including 3989 GPs.Participants757 873 patients aged 60–90 years with ≥2 contacts with a GP during 2016 and 2017.Main outcome measureAll-cause emergency hospital admissions, emergency admissions for ambulatory care sensitive conditions, and mortality, in 2018.ResultsWe assessed COC using the conventional usual provider of care index (UPCpatient) and an alternative/supplementary index (UPCGP list) based on the COC for all other patients enlisted with the same preferred GP.For both indices, the mean index score was 0.78. Our model controls for demographic and socioeconomic characteristics, prior healthcare use and municipality-fixed effects. Overall, UPCGP list shows a much weaker association between COC and the outcomes. For both indices, there is a negative relationship between COC and hospital admissions. A 0.2-point increase in the index score would reduce admissions for ambulatory care sensitive conditions by 8.1% (CI 7.1% to 9.1%) versus merely 1.9% (0.2% to 3.5%) according to UPCpatient and UPCGP list, respectively. Using UPCGP list, we find that mortality is no longer associated with COC. There was greater evidence for an association between COC and all-cause admissions among patients with low education.ConclusionsA continuity measure based on each patient’s contacts with own preferred GP may overestimate the importance of COC as a feature of the GP practice. An alternative, service-based measure of continuity could be suitable as a quality measure in primary healthcare. Facilitating continuity should be considered a health policy measure to reduce inequalities in health.

Measuring the capacity to combat illicit tobacco trade in 160 countries

Background Illicit trade of tobacco negatively affects countries’ tobacco control efforts. It leads to lower tobacco prices and makes tobacco products more accessible to vulnerable populations. In this study, we constructed an illicit tobacco trade index, which measures the structural and institutional capabilities of 160 countries in addressing illicit tobacco trade. We collected the most recent and best available data on general governance, tobacco control policies, and trade and customs practices. Results Singapore, New Zealand, Finland and Sweden lead countries with the most favorable illicit tobacco trade score. We observed a positive relationship between illicit tobacco trade scores and Gross National Income (GNI) per capita and a negative relationship with the share of illicit tobacco trade to total tobacco consumption. Conclusions The capability to combat illicit trade varies across countries. However, on average, low and middle-income countries (LMICs) are less capable of addressing illicit tobacco trade as suggested by the lower illicit tobacco trade index score. The lower index score in low and middle-income countries was mainly driven by low scores in tobacco control policies and trade and customs practices and conditions. Our study reinforces the importance for LMICs to adopt the WHO’s Protocol to Eliminate Illicit Tobacco Trade Products, particularly committing to treaty obligations and investing on track and trace system and other customs reforms.