A273thousands. Descriptive analysis was applied to the data and related BMI payment policies were reviewed. Results: 1) Altogether there were 49.81 million insured persons who used medical services in 2014, among which 95.71% used outpatient medical services and 17.68% used inpatient medical services. 2) Most of the patients went to high-level hospitals to see doctors. 33.95% went to the third level hospitals and 22.33% went to the secondary level hospitals. 3) Averagely every 56 outpatient visits may result in 1 hospitalization. 4) The average annual medical expenditure was 5383 RMB for BMI participants, among which 1828 RMB (34%) was paid out-ofpocket. 5) The medical burden from hospitalization (55.09%) was higher than that from outpatient services. 6) The amount of total burden of employee participants (4825 RMB) was 2.4 times higher than that of urban residents, but the proportion of out-of-pocket (30.06%) was lower than the latter. ConClusions: Grading diagnosis and treatment should be promoted to guide the patients with commonly encountered diseases to be treated in basic level hospitals, which will control the irrational increase of medical expense and alleviate the total medical burden. At the same time, the medical service supervision should be enhanced to improve the rationality of medical services and decrease the unnecessary expenditures.
China has entered the post-epidemic era with the implementation of a general program for epidemic prevention and control of Category B infectious diseases. The number of sick people in the community will increase dramatically over a period of time, which will inevitably lead to a run on hospital medical resources. Schools, as one of the key institutions in epidemic disease prevention, will face a major test of their medical service system. The “Internet Medical” will be seen as a new way for students and teachers to access medical services, providing them with the convenience of remote consultation, interrogation, and treatment. However, there are many problems with its use on campus. In this regard, this paper aims to identify and evaluate the problems in the interface of the “Internet Medical” service model on campus, intending to improve the current level of medical services on campus and ensuring the safety of students and teachers on campus.
terms of observable characteristics such as age, gender, and comorbidities (pϽ0.001). Samples were balanced with nearest neighbor matching. Then segmented time-series models were applied. There was a significant association between the onset of intervention and the level of utilization of these drugs. CONCLUSIONS: To isolate the effects of guidelines, we need to control for three different factors: 1) baseline differences between the two groups; 2) stepwise differences at the intervention point; and 3) trend differences after the intervention. We showed that propensity score matching can be used for the first factor, and the latter two can be controlled with the interrupted time-series model. OBJECTIVES:The burden of caregiving is high. In 2009 there were an estimated 65.7 million caregivers in the U.S. (29% of the adult population) and these numbers are expected to swell in the coming years with the ageing population. Caregiving impacts on the health, wellbeing and work productivity of the caregiver, therefore research aimed at assessing and reducing the burden of caregiving is warranted. The objective of this study was to assess the status of current clinical research into the burden of caregiving. METHODS: Clinicaltrials.gov was searched for trials where caregiver burden (CB) was reportedly measured. Information on the carerecipient condition (CRC), the primary focus of the study, and the type of intervention being considered, was extracted from the included trials. RESULTS: 80 trials were identified that measured a reported outcome of CB. The most common CRC was Alzheimer's disease and related disorders (34 studies); followed by cancer (14), frail and elderly (8), mental health (7), Parkinson's disease (7), brain and spinal cord injury (5) and 'other' (5). A range of questionnaire-based instruments were reportedly used across studies to elucidate the physical, emotional (psychological), social and financial impacts of caregiving.The role or burden of the caregiver was a key focus in 55% of the studies; trials involving care of cancer patients had the highest proportion of caregiver-focused studies (12/14, 86%). Behavioural and drug interventions were the most frequently investigated intervention type (38% and 25% of trials, respectively), although no studies investigating a 'drug' intervention evaluated the effect on caregivers as a primary outcome. CONCLUSIONS: Current clinical research into the burden of informal caregiving is concentrated in age-related CRCs. Research interventions aimed at relieving CB are mostly behavioural in nature. The growing number of caregivers means that research into effective methods of reducing CB will be of ever increasing importance.
OBJECTIVES: Published 'Think Aloud' experiments on EQ-5D elicitation methods suggest that VAS and TTO may capture different constructs of preference. There has been some discussion concerning issues of so called implausible options and the possibility of non-trading in DCEs, the extent to which respondents may be 'aware' of their rationale for choices or valuations, and the use of heuristics in complex tasks. This qualitative study seeks to uncover how respondents think about EQ-5D elicitation tasks, and how they arrive at-and-interpret their responses to the extent that they are aware of these processes. METHODS: Forty respondents carried out a series of valuation exercises (ranking, VAS, TTO and DCE in randomized order) involving 6 EQ-5D states. In a variant of a 'Think Aloud' method, respondents were asked to explain their thought processes and decisions after each exercise. RESULTS: A 'Thurstone Effect' is suggested by Ranking-VAS preference reversals: 58% of respondents reported having 'changed their minds' about the order of preference among states when assigning VAS values to states that they had just ranked (novel task), and declared their VAS order as being 'correct'. Evidence of TTO non-trading thresholds, and inclusion of factors in TTO that are absent in VAS valuations were observed (68%). Differences between valuations are also observed because of the natural comparators in each elicitation method: 11,111 for TTO, one pair for DCE and all 6 states for ranking and VAS. Some evidence of the effect of one elicitation method on another was found. E.g. some respondents report that performing a TTO task in between a VAS and DCE influences the way they compare states in the DCE. Further insight into heuristics used by respondents was obtained using patterns of preference reversals and confidence ratings. CONCLUSIONS: These findings carry implications for the design of EQ-5D Valuation subsets.
artifacts. Since a previous literature review by San Martin-Rodriguez et al. in 2005, many more studies have examined organizational determinants, yet studies regarding systematic factors, such as health care systems, remain scarce. CONCLUSIONS: Interprofessional collaboration is influenced by systematic, organizational, and interactional factors. Policies targeting multi-level aspects may be helpful in enhancing interprofessional collaboration and ultimately improving patient care. Future studies are needed to examine factors beyond the interactional level and their relationships with patient outcomes. OBJECTIVES:To investigate the characteristics of clinical trials conducted in 5 Asian countries over the past 2 years with a focus on: disease conditions, funding sources and age groups. METHODS: ClinicalTrials.gov was searched for trials initiated after January 1, 2010 in the following countries: Indonesia, Korea, Malaysia, Taiwan and Thailand. The 10 most common conditions and trial sponsors were ranked and the percentage of trials in adults and children was calculated. These figures were compared between countries. RESULTS: During the time period, the following number of trials were identified (number; trials per 1,000,000 population): Taiwan (826; 35.6), Korea (1597; 32.7), Thailand (375; 5.4), Malaysia (132; 4.6) and Indonesia (47; 0.2). The most common trials in all countries were for chronic conditions. Trials on type 2 diabetes were the most common trials in Taiwan, Thailand, Malaysia and Indonesia (range: 3-18%), and were the 3 rd most common in Korea (2%). Breast cancer trials were also common in all 5 countries (range: 1-2%) and non-small cell lung cancer trials were common in 4 countries (range: 1-2%), except Indonesia. Funding for the trials was predominantly non-industry in Taiwan, Thailand and Korea (64%, 61% and 53% respectively), but predominantly industry in Malaysia and Indonesia (72% and 54% respectively). Over 40% of trials in Taiwan were sponsored by local medical institutions. Trials in adults alone were the most common in all countries: Korea (84%), Malaysia (84%), Taiwan (81%), Thailand (74%) and Indonesia (65%). CONCLUSIONS: The number of trials per 1,000,000 population was much higher in Taiwan and Korea than in Thailand, Malaysia and Indonesia. Trials conducted in all these countries, however, show strong similarities in terms of the conditions studied; although there are some differences (e.g. funding sources) between the countries that suggest other factors influence clinical trials in these countries. OBJECTIVES:To explore the perceptions of Malaysian community pharmacist towards locally manufactured generic medicines. METHODS: A cross-sectional descriptive study involving entire population (N ϭ 270) of practising community pharmacists in the State of Penang, Malaysia was undertaken using a self-completed anonymous mail questionnaire. RESULTS: Responses were received from 48 pharmacists (response rate 17.8%). Majority of the respondents (97.9%) actively dispensed generic medicines in...
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