Factors Influencing Intention to Use Mobility as a Service: Case Study of Gyeonggi Province, Korea

Mobility as a service (MaaS) integrates various transportation modalities and connects these modalities to enable users to travel from departure points to destination points. The objectives of this study were to analyze the factors influencing the intention to use MaaS and determine a direction for the implementation of this service. Hence, this study utilized an ordered probit model and marginal effect analysis. Specifically, a survey was conducted based on citizens living in Gyeonggi-do, South Korea, to prepare logical MaaS operation measures customized in this province. Subsequently, variables related to MaaS were classified, and statistical analysis was performed based on these variables. The need for integrated transportation service, intention to use shared mobility, gender, household income, and region are found to have significant effects. Moreover, demographic groups with high levels of intention to use MaaS were identified. Finally, the intention to use MaaS was found to be mainly affected by whether public transportation was the primary means of transportation or whether the subjects spent a comparatively long time commuting. It is expected that these findings will serve as the basis for MaaS implementation in the future and will also be used as fundamental data for transportation service planning.

The Nurse Practitioner Workforce in Western Canada: A Cross-Sectional Practice Analysis Comparison

Regular examination of health workforce data is essential given the pace of health system and legislative changes. Health workforce studies pertaining to nurse practitioner (NP) practice are needed to examine the gaps between work activities, policy, human resource supply, or for population needs. Jurisdictional comparison studies can provide essential information about NP practice for governments to respond to health workforce deficiencies or engage in service planning. In Canada, there is limited provincial-territorial jurisdictional NP workforce data to support health planning or policy change. This descriptive cross-sectional study was to examine the similarities and differences in practice patterns of Canadian NPs. In 2016 and 2017, an electronic survey was sent to all 852 registered NPs in three Canadian provinces, yielding a large convenience sample of 375 NP respondents. The results of this study underscore the value of NPs’ extensive registered nurse expertize as well as their ability to serve diverse patient populations, work in varied healthcare settings, and provide care to medically complex patients. The study findings also show that NPs in all three jurisdictions work to their full scope of practice, in both rural and urban settings. This study is the first to compare NP workforce data across multiple Canadian jurisdictions simultaneously. Studies of this type are valuable tools for understanding the demographics, education, integration, and employment activities of NPs and can aid governments in addressing workforce planning.

Predictors of health-related quality of life following injury in childhood and adolescence: a pooled analysis

BackgroundInjury is a leading contributor to the global disease burden in children and places children at risk for adverse and lasting impacts on their health-related quality of life (HRQoL) and development. This study aimed to identify key predictors of HRQoL following injury in childhood and adolescence.MethodsData from 2259 injury survivors (<18 years when injured) were pooled from four longitudinal cohort studies (Australia, Canada, UK, USA) from the paediatric Validating Injury Burden Estimates Study (VIBES-Junior). Outcomes were the Paediatric Quality of Life Inventory (PedsQL) total, physical, psychosocial functioning scores at 1, 3–4, 6, 12, 24 months postinjury.ResultsMean PedsQL total score increased with higher socioeconomic status and decreased with increasing age. It was lower for transport-related incidents, ≥1 comorbidities, intentional injuries, spinal cord injury, vertebral column fracture, moderate/severe traumatic brain injury and fracture of patella/tibia/fibula/ankle. Mean PedsQL physical score was lower for females, fracture of femur, fracture of pelvis and burns. Mean PedsQL psychosocial score was lower for asphyxiation/non-fatal submersion and muscle/tendon/dislocation injuries.ConclusionsPostinjury HRQoL was associated with survivors’ socioeconomic status, intent, mechanism of injury and comorbidity status. Patterns of physical and psychosocial functioning postinjury differed according to sex and nature of injury sustained. The findings improve understanding of the long-term individual and societal impacts of injury in the early part of life and guide the prioritisation of prevention efforts, inform health and social service planning to help reduce injury burden, and help guide future Global Burden of Disease estimates.

Prevalence and Incidence Rates of Dementia: A Nationwide Population-Based Study of Electronic Health Records in Israel1

Background: Data on the rate of dementia is essential for planning and developing appropriate services at the national level. Objective: We report the prevalence and incidence of dementia, based on electronic health records available for the whole population. Methods: This national dementia dataset was established as a part of the National Program to Address Alzheimer’s and Other Types of Dementia. Data from medical health records for all persons aged 45+ in Israel, for 2016, were extracted from the databases of the four health maintenance organizations. Dementia cases were identified based on either recorded dementia diagnosis, through International Classification of Diseases (ICD-9 and ICD-10) or dispensation of anti-dementia drugs. The date of first diagnosis was determined by the earliest recording. Results: A total of 65,951 persons with dementia, aged 45+, were identified from electronic health data. Based on both ICD codes and anti-dementia drugs, the prevalence rates of dementia among individuals aged 45+ and 65+ in 2016 were 2.5%and 6.4%, respectively, and the incidence rates were 0.49%and 1.3%, respectively. Based on ICD codes alone, the prevalence rates of dementia among individuals aged 45+ and 65+ in 2016 were 2.1%and 5.4%respectively, and the incidence rates were 0.36%and 0.96%respectively. The rates were higher among females compared to males and paradoxically lower in lower socioeconomic status compared to higher statuses. Conclusion: This data collection reflects the present access of dementia patients to medical care resources and provides the basis for service planning and future dementia policies.

Family Planning Unmet Need; Determinant Factors and Strategy Design through Health Management Approach and Fishbone Analysis in Riau Province, Indonesia

The high number of unmet needs for Family Planning (FP) in Indonesia has an effect on birth spacing and the number of parities so that there is a high risk of maternal and infant mortality. Based on data from the Family-Program Performance and Accountability Survey (PPAS) from the National Population and Family Planning Board (NPFPB) in 2019, 51% of Fertile Age Women (FAW) were not willing to use FP. This study aims to describe the determinant factors and strategies to reduce the incidence of unmet needs for FP. The method used was a quantitative descriptive study conducted in July-September 2021. The data collection technique analyzed the program performance and accountability survey report data from NPFPB in 2019 (secondary data). The result was that the determinant factors of the unmet need for FP include: age 30-49 years (60.1%), parity having 6 or more children (73.6%), reasons for fertility (32.89%), being against using (7.9%), lack of knowledge about 8 modern FP tools/methods (15.5%), reasons for FP tools/methods (34.65%). Meanwhile, the majority of information on FP was obtained through television (91.9%), direct information through midwives/nurses (77.5%). The strategy to reduce the number of unmet need for FP was through a health management approach with five stages, namely: 1. Assessment to identify the number of Fertile Age Couple (FAC) unmet need for FP, demographic characteristics, and reasons for not using contraceptive tools/methods: 2. Mapping step, case mapping per region, 3. Planning, service planning process, 4. action, service delivery based on planning, 5. Evaluation monitoring stage, monitoring process, and activity evaluation. Six management elements are used for fishbone analysis, namely: man, money, method, material, machine, and market. It requires a high commitment to all stakeholders so that the implementation of the strategy can be realized.

AMORE Project: Integrated knowledge translation and geospatial analysis to improve travel times to health services (accessibility) and health equity in Cali, Colombia: a proof of concept using mixed-methods research

Addressing accessibility to health services requires intersectoral multi-stakeholder action. There is not a lot of knowledge about the effects of traffic congestion on accessibility. The availability of new data allows putting forward simple metrics that all stakeholders can manage. This proof-of-concept reveals accessibility using a platform with intuitive heatmaps/choropleths, dials, and graphs. It uses filters and shows accessibility according to socio-demographic characteristics. It is dynamic, reflecting the impact of changes in traffic congestion. The platform (AMORE Platform) provides a situational analysis that can be updated as conditions or data changes. The Platform reveals and quantifies inequities of accessibility and allows maximizing accessibility by optimizing the location for new services. The proof-of-concept uses two scenarios (1) urgent care in a tertiary hospital; and (2) frequent care (hemodialysis and radiotherapy). The data generation component will be complemented with a participatory action research assessment with project collaborators involving different stakeholders (e.g., authorities, service providers and users, organized civil society and academia) who will use the platform and could determine its value and potential in service planning, urbanism, and intersectoral and multistakeholder collaboration. The platform can be updated and modified to cover other services within and beyond the health sector. The proof-of-concept is done in Cali, Colombia's third most populous city, with inputs from a broad range of stakeholders.

Diagnosed Incidence of Non-Affective Psychotic Disorders Amongst Adolescents in British Columbia and Sociodemographic Risk Factors: A Retrospective Cohort Study

Objectives To estimate the diagnosed incidence of non-affective psychotic disorder between the ages of 13 and 19 years in South-Western British Columbia (BC) and to examine variation in risk by sex, family and neighbourhood income, family migration background, parent mental health contact and birth year. Methods Linked individual-level administrative data were used to construct a cohort of individuals born in 1990–1998 and residing in South-Western BC ( n = 193,400). Cases were identified by either one hospitalization or two outpatient physician visits within 2 years with a primary diagnosis of a non-affective psychotic disorder (ICD-10: F20–29, ICD-9: 295, 297, 298). We estimated cumulative incidence, annual cumulative incidence and incidence rate between the ages of 13 and 19 years, and conducted Cox proportional hazards regression to estimate associations between sociodemographic factors and risk over the study period. Results We found that 0.64% of females and 0.88% of males were diagnosed with a non-affective psychotic disorder between the ages of 13 and 19 years, with increasing risk observed over the age range, especially amongst males. Incidence rate over the entire study period was 106 per 100,000 person-years for females and 145 per 100,000 person-years for males. Risk of diagnosis was elevated amongst those in low-income families and neighbourhoods, those with a parent who had a health service contact for a mental disorder, and more recent birth cohorts. Risk was reduced amongst children of immigrants compared to children of non-migrants. Conclusions Findings from this study provide important information for health service planning in South-Western BC. Future work should examine whether variations in diagnosed incidence is driven by differences in health service engagement or reflect genuine differences in risk.

Updating estimates of the number of UK stroke patients eligible for endovascular thrombectomy: incorporating recent evidence to facilitate service planning

Introduction Endovascular thrombectomy (EVT) is a highly effective treatment for acute ischaemic stroke due to large arterial occlusion (LAO). To support decisions about service provision, we previously estimated the annual UK population eligible for EVT as ∼10% of stroke admissions. Since then, several trials have produced evidence that could alter these figures. We update our estimates considering information from studies and trials reporting 2018–2021 on incidence, presentation time and stroke severity and consider the possible impact of predicted demographic changes in the next 10–20 years. Patients and Methods We produce an updated decision tree describing the EVT eligible population for UK stroke admissions. One-way sensitivity analyses (using upper and lower confidence intervals for estimates at each branch of our decision tree) were used to identify where further research evidence is necessary to increase certainty around estimates for numbers of EVT eligible patients. Results The updated estimate for the number of UK stroke patients eligible for EVT annually was between 10,020 (no advanced imaging in early presenting patients) and 9,580 (advanced imaging in all early presenting patients), which compared with our estimates in 2017 is a minimal reduction. One-way sensitivity analyses established that enhanced evidence about eligibility for milder strokes, ASPECTS scores and pre-stroke disability are offset by evidence regarding a lower incidence of LAO. Importantly, predicted increases in life expectancy by 2040 may increase thrombectomy need by 40%. Discussion Information from additional randomised trials published during 2018–2020 with updated estimates of LAO prevalence had a minimal impact on overall estimates of stroke patients eligible for EVT in the UK. Ongoing research into the benefits of EVT for patients with mild stroke or European Stroke Journal For Peer Review lower ASPECTS scores has the potential to increase the estimates of the eligible population; future need for EVT will increase with the ageing population. Conclusion Our updated analyses show overall numbers eligible little changed, but evidence from ongoing trials and demographic changes have the potential to increase the need for EVT significantly.