Inappropriate Rate of Admission and Hospitalization in the Iranian Hospitals: A Systematic Review and Meta-Analysis

Arab‐Zozani, Morteza; Pezeshki, Mohammad Zakaria; Khodayari‐Zarnaq, Rahim; Janati, Ali

doi:10.1016/j.vhri.2019.07.011

Cited by 19 publications

(16 citation statements)

References 47 publications

(48 reference statements)

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“…Each question has three options of “yes, no, not clear”, each of which accounts for 1 point, 0 point, and 0.5 point. After summarizing the scores obtained for each question, studies were considered to have a high risk of bias and low quality if the total score was less than 3 points; moderate risk of bias and moderate quality if the total score was 3 to <6 points; low risk of bias and high quality if the total score was 6–8 points [ 12 ]. Differences were resolved through discussions and consultations with a third researcher.…”

Section: Methodsmentioning

confidence: 99%

Knowledge, attitudes, and practices towards COVID-19 among college students in China: A systematic review and meta-analysis

Wang

Shui

et al. 2022

PLoS ONE

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Background Since the outbreak of the respiratory infectious disease caused by the novel coronavirus in 2019, the COVID-19 epidemic has posed a serious threat to the life and safety of the public, and has also seriously affected the normal study and life of college students in China. Although a series of studies have been conducted on college students’ knowledge, attitudes and practices of COVID-19, the results vary widely. This study aimed to evaluate the pooled estimated level of knowledge, attitudes, and practices (KAP) about COVID-19 among college students in China. Methods We conducted a comprehensive search on Scopus, ProQuest, PubMed, EMbase, Web of Science, the Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), VIP Database and Wanfang Database up to 13 February 2022. We then assessed the quality of included studies using a checklist developed by the Joanna Briggs Institute (JBI) for cross-sectional studies and analyzed using STATA.15 after two researchers independently extracted relevant data and entered them into Microsoft Excel. Funnel plots and Egger’s regression tests were used to check for publication bias, and sensitivity analysis was performed to assess the robustness of the results. A random-effects model was used for the meta-analysis, on the basis of which subgroup analyses were performed by time of investigation (study period) and by gender and major of the subjects. Result A total of 42 studies including 174,440 subjects were included in this review, and the quality of the included studies was mainly intermediate and advanced. The findings of the meta-analysis showed that the overall levels of Chinese college students’ knowledge, positive and negative attitudes, and practice of preventive measures towards COVID-19 were 74% (95%CI: 69%-79%), 84% (95%CI: 80%-88%), 31% (95%CI: 23%-38%) and 82% (95%CI: 77%-86%), respectively. The results of subgroup analysis showed that female and medical college students had higher levels of knowledge and practice on COVID-19. Conclusion The study findings showed that the overall KAP level of college students in China included in the study was relatively optimistic. Influenced by gender, major and time, there were differences in the KAP level of college students. In order to promote the effective prophylaxis and control of pandemic, we recommend implementing targeted measures to improve the awareness rate of COVID-19-related knowledge among this group and the implementation rate of COVID-19 preventive measures among male and non-medical college students.

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Section: Methodsmentioning

confidence: 99%

Knowledge, attitudes, and practices towards COVID-19 among college students in China: A systematic review and meta-analysis

Wang

Shui

et al. 2022

PLoS ONE

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“…COVID-19 pandemic has created a golden opportunity for addressing the drivers of unnecessary overuse of medical services by countries because of the three main reasons: 1) There is a shortage of healthcare resources for controlling COVID-19 pandemic and unnecessary services waste the resources 2) Overuses of healthcare services unnecessarily expose the patients and healthy individuals to the virus in outpatient clinics and hospitals, 3) Overuse of medications may suppress the immune response and predispose people to COVID-19 infection. Our preliminary search shows that the COVID-19 pandemic has decreased the use of several clinical interventions in countries 56,57 for example screening tests, 58 admission and hospitalization, 59 and elective surgeries. 60,61 Considerable proportions of these clinical interventions are unnecessary.…”

Section: Dovepressmentioning

confidence: 99%

<p>Medical Overuse in the Iranian Healthcare System: A Systematic Scoping Review and Practical Recommendations for Decreasing Medical Overuse During Unexpected COVID-19 Pandemic Opportunity</p>

Pezeshki¹,

Janati²,

Arab‐Zozani³

2020

RMHP

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Purpose: To perform an inclusive search for original studies that report medical overuse in the Iranian healthcare system and discovering the area of overuse. Patients and Methods: A systematic search of the literature is conducted in bibliographic databases including PubMed, Embase, Scopus, Web of Sciences, Cochrane and Scientific Information Database using a comprehensive search strategy without time limit until the end of 2018, updated by 1 July 2020, accomplished by reference tracking, author contacting and expert consultation to identify studies on the overuse of medical care. Results: We reviewed 4124 published articles based on predetermined inclusion criteria. The author's consensus included a total of 41 articles. Of these, 32 were in English and 9 in Farsi, published between 1975-2019. The result categorized into two distinct clinical areas: treatment (18 articles) and diagnostic (23 articles) services. Almost all of the studies only described the magnitude of unnecessary overuse. Unnecessary overuse of antibiotics, MRI, and CT-scan were the most reported topics. The ranges of their overuse proportion were as follows: antibiotic (31 to 97%); MRI (33 to 88%), and CT-scan (19 to 50%). Conclusion: Our review showed, even so, the magnitude of unnecessary overuse of medical services is high but there are only a few interventional studies in clinical and administrative level for finding effective methods for decreasing these unnecessary services. Researchers should be encouraged to conducting interventional studies. We suggest the ministry of health to use the golden opportunity of COVID-19 epidemic for designing Iran national policy and action plan for controlling and preventing unnecessary healthcare services and including a section for "Interventional Research" in the action plan.

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“…COVID-19 pandemic has created a golden opportunity for addressing the drivers of unnecessary overuse of medical services by countries because of the three main reasons: 1) There is shortage of health care resources for controlling COVID-19 pandemic and unnecessary services waste the resources 2) Overuses of health care services unnecessarily expose the patients and healthy individuals to the virus in outpatient clinics and hospitals, 3) Overuse of medications may suppress the immune response and predispose people to COVID-19 infection. Our preliminary search shows that COVID-19 pandemic has decreased the use of several clinical interventions in countries (55) for example screening tests (56), admission and hospitalization (57), and elective surgeries (58, 59). Considerable proportions of these clinical interventions are unnecessary.…”

Section: Discussionmentioning

confidence: 99%

Medical overuse in the Iranian healthcare system: a systematic scoping review and practical recommendations for decreasing medical overuse during unexpected COVID-19 pandemic opportunity

Pezeshki

Janati

Arab‐Zozani

2020

Preprint

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Background: Overuse of medical care is a major problem across health systems as well as in Iran. By our knowledge, this is the first scoping review in which medical overuse in the Iranian healthcare system was investigated.Objective: To perform an inclusive search for original studies that report medical overuse in the Iranian healthcare system. Methods: A systematic search of the literature conducted in bibliographic databasesincluding PubMed, Embase, Scopus, Web of Sciences, Cochrane and Scientific Information Database using a comprehensive search strategy without time limit until the end of 2018, accomplished by reference tracking, author contacting and expert consultation to identify studies on the overuse of medical care. Results:We reviewed 4124 published articles based on predetermined inclusion criteria. The author's consensus included a total of 40 articles. Of these, 31 were in English and 9 in Farsi, published between 19975-2018. The result categorized into two distinct clinical areas: treatment (17 articles), and diagnostic (23 articles) services. Almost all of the studies only described the magnitude of unnecessary overuse. Unnecessary overuse of Antibiotics, MRI, and CT-scan were the most reported topics. The ranges of their overuse proportion were as follows; Antibiotic (31 to 97%); MRI (33 to 88%), and CT-scan (19 to 50%). Conclusions:Our review showed, even so, the magnitude of unnecessary overuse of medical services is high but there are only a few interventional studies in clinical and administrative level for finding effective methods for decreasing these unnecessary services. Researchers should be encouraged to conducting interventional studies. We suggest the ministry of health to use the golden opportunity of COVID-19 epidemic for designing Iran national policy and All rights reserved. No reuse allowed without permission. : medRxiv preprint action plan for controlling and preventing unnecessary health care services and including a section for "Interventional Research" in the action plan.

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Inappropriate Rate of Admission and Hospitalization in the Iranian Hospitals: A Systematic Review and Meta-Analysis

Cited by 19 publications

References 47 publications

Knowledge, attitudes, and practices towards COVID-19 among college students in China: A systematic review and meta-analysis

Knowledge, attitudes, and practices towards COVID-19 among college students in China: A systematic review and meta-analysis

<p>Medical Overuse in the Iranian Healthcare System: A Systematic Scoping Review and Practical Recommendations for Decreasing Medical Overuse During Unexpected COVID-19 Pandemic Opportunity</p>

Medical overuse in the Iranian healthcare system: a systematic scoping review and practical recommendations for decreasing medical overuse during unexpected COVID-19 pandemic opportunity

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