BackgroundThe World Health Organization (WHO) incorporated well-being into its definition of health in 1948. The significance given to this concept is due to its role in the assessment of people’s quality of life and health.MethodsUsing the WHO Well-being Index, we estimated well-being among adults and identified selected associated factors in the occupied Palestinian territory (oPt) using data obtained from the National Time Use Survey conducted by the Palestinian Central Bureau of Statistics (PCBS) 2012–2013 on a representative sample of persons living in the West Bank and Gaza Strip. Univariate and bivariate analyses were conducted among participants 18 years old and above. Multivariate analysis (Regression) was performed with factors found significant in cross-tabulations, using SPSS® version 20.ResultsOverall, 33.8 % (2395) of respondents reported low levels of well-being (ill-being). Neither age, nor sex, nor region were found significant in regression analysis. People who were married, working 15 h or more, with a higher standard of living, who reported participating in community, cultural, and social events, or in religious activities reported high levels of well-being. Those who reported regularly following the mass media, or living in Palestinian refugee camps reported low levels of wellbeing.ConclusionsOverall, about one-third of adult Palestinians reported low levels of well-being (ill-being), a finding which in itself requires attention. Marriage, employment, high living standards, community participation, and religious activities were found to be protective against ill-being. Further investigations are required to determine additional causes of ill-being in the oPt, taking into consideration the possible effects of chronic exposure to political violence on subjective well-being.
The performance of general practitioners (GPs) is frequently assessed without considering the factors causing variability among general medical practices (GMPs). Our cross-sectional national-based study was performed in Hungary to evaluate the influence of GMP characteristics on performance indicators. The relationship between patient’s characteristics (age, gender, education) and GMP-specific parameters (practice size, vacancy of GP’s position, settlement type, and county of GMP) and the quality of care was assessed by multilevel logistic regression models. The variations attributable to physicians were small (from 0.77% to 17.95%). The education of patients was associated with 10 performance indicators. Practicing in an urban settlement mostly increased the quality of care for hypertension and diabetes care related performance indicators, while the county was identified as one of the major determinants of variability among GPs’ performance. Only a few indicators were affected by the vacancy and practice size. Thus, the observed variability in performance between GPs partially arose from demographic characteristics and education of patients, settlement type, and regional location of GMPs. Considering the real effect of these factors in evaluation would reflect better the personal performance of GPs.
Background: Primary nonadherence to prescribed medications occurs when patients do not fill or dispense prescriptions written by healthcare providers. Although it has become an important public health issue in recent years, little is known about its frequency, causes, and consequences. Moreover, the pattern of risk factors shows remarkable variability across countries according to the published results. Our study aimed to assess primary nonadherence to medications prescribed by general practitioners (GPs) and its associated factors among adults in Hungary for the period of 2012–2015. Methods: Data on all general medical practices (GMPs) of the country were obtained from the National Health Insurance Fund and the Central Statistical Office. The ratio of the number of dispensed medications to the number of prescriptions written by a GP for adults was used to determine the medication adherence, which was aggregated for GMPs. The effect of GMP characteristics (list size, GP vacancy, patients’ education provided by a GMP, settlement type [urban or rural], and geographical location [by county] of the center) on adherence, standardized for patients’ age, sex, and eligibility for an exemption certificate, were investigated through generalized linear regression modeling. Results: A total of 281,315,386 prescriptions were dispensed out of 438,614,000 written by a GP. Overall, 64.1% of prescriptions were filled. According to the generalized linear regression coefficients, there was a negative association between standardized adherence and urban settlement type (b = -0.099, 95%CI = -0.103 to -0.094), higher level of education (b = -0.440, 95%CI = -0.468 to -0.413), and vacancy of the general practices (b = -0.193, 95%CI = -0.204 to -0.182). The larger GMP size proved to be a risk factor, and there was a significant geographical inequality for counties as well. Conclusions: More than one-third of the written prescriptions of GPs for adults in Hungary were not dispensed. This high level of nonadherence had great variability across GMPs, and can be explained by structural characteristics of GMPs, the socioeconomic status of patients provided, and the quality of cooperation between patients and GPs. Moreover, our findings suggest that the use of the dispensed-to-prescribed medication ratio in routine monitoring of primary health care could effectively support the necessary interventions.
Background From the 2011 Palestinian Center Bureau of Statistics, disability is defined as long-term physical, mental, intellectual, or sensory impairment that can hinder full and effective participation in society; disability among elderly people has become a major public health concern in recent years. More than 1 billion people live with disability worldwide. In the occupied Palestinian territory, disability in elderly people is still not well understood. This study aims to assess the prevalence of disability among Palestinians aged 50 years or older and associated factors. Methods Data were obtained from the Palestinian Central Bureau of Statistics Disability-Survey of 2011, representing the Palestinian population. People aged 50 years or older were selected. We gathered descriptive statistics and used multivariate binary logistic regression to check for confounders. Data were analysed with SPSS17 software. Findings The total sample size was 8747 people aged 50 years or older. 71% of those had no disability and the remaining 29% reportedly had at least one disability, of which 53% represented problems with mobility, 26% vision, 11% hearing, 7% memory, 1% mental health, 1% communication, and 1% intellectual. Men were less likely to be disabled than women (odds ratio [OR] 0•75, 95% CI 0•64-0•89, p=0•001). The level of disability increased at age 70 and older (OR 1•96, 95% CI 1•67-2•31). The percentage of disabled elderly people increased among those who could not read compared with those educated (OR 2•93, 95% CI 2•36-3•63); decreased in those with large families compared with families of fewer than three people (for families of three to six people, OR 0•73, 95% CI 0•63-0•84; for families of seven to 27 people, 0•59, 0•50-0•70); increased in refugees compared with non-refugees (OR 1•26, 95% CI 1•07-1•47, p=0•005); increased in non-workers compared with workers (OR 2•96, 95% CI 2•50-3•49); and increased in those widowed and divorced compared with people who were married (OR 1•25, 95% CI 1•07-1•47, p=0•005). Compared with the centre of the West Bank, the number of people with disability was highest in the Gaza Strip (OR 2•23, 95% CI 1•89-2•63), followed by north West Bank (OR 2•60, 95% CI 2•22-3•05), and south West Bank (OR 1•95, 95% CI 1•63-2•33). Interpretation Disability is more prevalent in women, those not educated, refugees, non-workers, widowed and divorced individuals, and people in Gaza. Further investigations are needed to establish the main causes of disability in the occupied Palestinian territory, and associated factors. Funding None. Contributors JJBJ participated in the method, data analysis, interpretation, conclusion, writing, and overall work integration. NAYH participated in the introduction, data analysis, and in writing. LSAZ participated in data analysis. AA-MS participated in Abstract conclusion. RGh participated in data analysis, conclusion, and interpretation. RGi supervised all the work. All authors approved the final version of the Abstract for publication. Declaration of interests We d...
Background Disability poses an important challenge to countries all over the world since it affects more than 15% of the global population. The disability prevalence is higher in developing countries compared to developed ones. Disability has negative consequences on health, wellbeing, and quality of life. The goal of this study is to assess the prevalence of disability and to determine some of its associated factors among Palestinian elderly in the occupied Palestinian territory (oPt), a country marked by a chronic lack of political, economic, and social stability which affect various aspects of the population’s life. Methods We used data from the Palestinian Central Bureau of Statistics (PCBS) disability survey conducted in 2011 using a nationally representative sample of the Palestinians living in the West Bank (WB) and Gaza Strip (GS). Data were collected using a standardized questionnaire developed and adopted by the World Health Organization (WHO) and the Washington Group (WG) for Disability Statistics, adapted to satisfy the Palestinian context. Results Overall, 31.2% of the Palestinian elderly 60 years and above reported one or more type of disability. Binary logistic regression with disability as the dependent variable showed that older people [OR = 2.88, 95% CI: 2.31–3.60], women [OR = 1.65, 95% CI: 1.33–2.04], illiterate people [OR = 2.37, 95% CI: 1.83–3.06], people reporting small family sizes with 1 to 2 members [OR = 1.69, 95% CI: 1.34–2.14], people who reported that they were not working at the time of the survey [OR = 4.59, 95% CI: 3.13–6.73], and Palestinian refugees [OR = 1.22, 95% CI: 1.04–1.42] were more likely to have a disability. However, residents of the Centre of WB were less likely to have disability compared to residents of the GS [OR = 0.46, 95% CI: 0.37–0.58]. Conclusions The study found a high prevalence of disability among Palestinian elderly, as has been reported by the majority of studies performed in developing countries. However, results indicate that demographic and socioeconomic differences among the disabled should be taken into special consideration in setting policies and practices to improve the health and wellbeing of the disabled.
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