healthcare sector

  • 文章类型: Journal Article
    目的:这项研究的目的是确定预期寿命与众多社会指标之间的相互依存关系,即,以确定促进预期寿命增加或减少的因素。
    方法:计算并分析了皮尔逊系数以及预期寿命的因变量与众多自变量之间的线性和对数趋势和相关性。计算是针对世界上所有可获得数据的国家进行的。根据预期寿命和众多指标之间的相关性,我们试图确定不同国家预期寿命价值不同的原因。
    结果:实现高预期寿命值的重要因素是经济发展和医疗保健支出,但“现代疾病”的传播比如肥胖或糖尿病,对预期寿命有显著的负面影响。预期寿命的其他重要限制因素是巨大的收入不平等,私人医疗保健支出在医疗保健总支出中所占份额较高,医疗保健总支出较低。较不发达的社会可以通过提供清洁水和安全的卫生设施以及与各种传染病(特别是艾滋病毒)作斗争来大大提高其预期寿命。
    结论:预期寿命是社会发展状况的有意义的指标,准确地反映了特定社会的总体状况。已经表明,人均GDP(PPP)是预期寿命的关键决定因素,而其他重要因素则起着进一步修饰的作用。
    OBJECTIVE: The aim of this study is to determine the interdependence between life expectancy and numerous social indicators, i.e., to determine the factors that encourage an increase or decrease in life expectancy.
    METHODS: Pearson coefficients as well as linear and logarithmic trends and correlations between the dependent variable of life expectancy and numerous independent variables were calculated and analysed. The calculations were carried out for all countries in the world for which data is available. Based on the strength of the correlations between life expectancy and numerous indicators, we have tried to determine the reasons for the different values of life expectancy in the various countries.
    RESULTS: Important factors for achieving high life expectancy values are economic development and healthcare spending but the spread of \"diseases of the modern era\", such as obesity or diabetes, have a significant negative impact on life expectancy. Other important limiting factors for life expectancy are large income inequalities, a higher share of private healthcare expenditure in total healthcare expenditure and lower total healthcare expenditure. Less developed societies can significantly increase their life expectancy by providing clean water and safe sanitation and by combating various infectious diseases (especially HIV).
    CONCLUSIONS: Life expectancy is a meaningful indicator of the state of social development and accurately reflects the general state of a particular society. It has been shown that GDP per capita (PPP) is a key determinant of life expectancy, while other important factors play the role of a further modifier.
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  • 文章类型: Journal Article
    医疗保健行业面临着几个挑战,比如成本上升,需求上升,以及对可持续性的需求。由于这些问题,医疗保健的一个新领域出现了,着眼于管理的长期改进,社会政策,和卫生经济学。这项研究探索了医疗保健的前沿,专注于管理的长期进步,社会政策,和卫生经济学。为了更好地了解影响医疗保健行业的问题,并确定最需要可持续解决方案的领域,我们对2000名医疗保健专业人员和政策制定者进行了调查.使用结构方程模型(SEM)分析数据,并建立了一个彻底的可持续医疗模式。根据调查结果,医疗保健行业现在面临三个重大挑战:不断上涨的价格,需求增加,以及对可持续性的需求。根据受访者的说法,最需要可持续创新的三个主要领域是管理,社会政策,和卫生经济学。这些结论得到了(SEM)分析的支持,这也表明,这些领域的可持续实践显著影响医疗保健系统的可持续性。这些发现导致这项研究得出结论,为了保证每个人的医疗保健的可及性和可负担性,迈向卫生经济学的可持续实践,社会政策,管理是需要的。医疗保健提供者之间的合作,政策制定者,和其他利益相关者需要创建创造性的解决方案,以支持医疗保健部门的可持续性。这项研究为可持续医疗保健提供了一个全面的框架,可以作为进一步研究和制定新法规的指南。
    The healthcare sector faces several challenges, such as rising costs, rising demand, and the need for sustainability. A new area of healthcare has emerged due to these problems, focusing on long-term improvements in management, social policy, and health economics. This research explores the cutting edge of healthcare, concentrating on long-term advancements in management, social policy, and health economics. To better understand the problems affecting the healthcare sector and to pinpoint the areas where sustainable solutions are most required, a survey of 2000 healthcare professionals and policymakers was performed. The data were analyzed using structural equation modeling (SEM), and a thorough sustainable healthcare model was created. According to the survey\'s findings, the healthcare sector now faces three significant challenges: growing prices, increased demand, and the need for sustainability. According to the respondents, the three main areas where sustainable innovations are most required are management, social policy, and health economics. These conclusions were supported by the (SEM) analysis, which also showed that sustainable practices in these fields significantly impact the sustainability of the healthcare system. These findings lead this research to conclude that to guarantee the accessibility and affordability of healthcare for everyone, a move towards sustainable practices in health economics, social policy, and management is needed. Cooperation between healthcare providers, policymakers, and other stakeholders is required to create creative solutions that support sustainability in the healthcare sector. This study offers a thorough framework for sustainable healthcare that may act as a guide for further research and the formulation of new regulations.
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  • 文章类型: Journal Article
    糖尿病发病率的急剧增长引发了关于意识的严肃辩论,早期诊断,和护理干预。这个观点旨在探索,从医疗保健行业代表的角度来看,他们在应对糖尿病时面临哪些挑战和困难,以及如何克服这些挑战和困难。我们应用了世界咖啡馆的方法进行小组讨论,这使我们能够将50个利益相关者聚集在一起。他们在意识概念下确定了机构和结构层面的挑战,数字化,和新形式的护理,并分享了他们对可行解决方案的建议。我们了解到,有必要绘制德国糖尿病地图,以确定风险人群,并且应该实施混合解决方案进行治疗,care,预防,早期诊断,考虑数字基础设施。此外,医疗保健系统对数字创新的需求引发了人们对信息透明度和数据管理的担忧。
    The dramatic growth in the rate of diabetes prompts serious debates about awareness, early diagnosis, and care interventions. This Viewpoint aims to explore, from the perspectives of healthcare sector representatives, what challenges and difficulties they face in dealing with diabetes and how these can be overcome. We applied the World Café method for group discussions, which enabled us to bring together 50 stakeholders. They identified challenges at institutional and structural levels under the concepts of awareness, digitalisation, and new forms of care and shared their suggestions for feasible solutions. We learned there is a need for a diabetes map of Germany to identify risk groups and that hybrid solutions should be implemented for treatment, care, prevention, and early diagnosis, considering digital infrastructure. Also, the demand for digital innovation in the healthcare system raised concerns about information transparency and data management.
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  • 文章类型: Journal Article
    背景:在许多先进的医疗保健系统中,患者倡导协会在医疗政策决策中发挥了更重要的作用.这些协会提供帮助,representation,并向患者和公民发声。然而,虽然他们的角色很重要,缺乏分析他们基础动态的研究,包括他们的组织决定,从管理的角度来看。为了填补这一知识空白,我们制定了两个研究问题,以调查患者倡导协会的基础动机,以及影响这些协会在整个演变过程中发生的变化的机构压力.
    方法:使用作为较大研究项目一部分开发的半结构化问卷,我们收集了意大利国家卫生服务局内31个患者倡导协会的数据.我们采用定性分析来检查关联\'出生和进化以及动机和影响驱动样本组织内的变化。
    结果:问卷答复提供了有关患者倡导协会历史的信息,并强调了他们与意大利国家卫生服务的密切联系。我们的结果表明,建立协会的动机可以分为五类:系统级别的支持,患者保护和支持,提高认识的行动,改善患者健康和生活质量的行动,和知识的传播。我们还确定了协会内部变化的频率和性质,并探讨了影响这些组织变化的机构压力。
    结论:可以考虑组织理论来解释结果,这些理论关注组织的建立决策以及外部压力如何影响组织的动态和演变。
    BACKGROUND: Within many advanced healthcare systems, patient advocacy associations are gaining a more relevant role in healthcare policy decisions. These associations provide help, representation, and voice to patients and citizens. However, although their role is important, a paucity of research exists analyzing their foundation dynamics, including their organizational decision, from a managerial perspective. To fill this knowledge gap, we formulated two research questions to investigate the motivations underlying the foundation of patient advocacy associations and the institutional pressures influencing the changes that have occurred in these associations throughout their evolution.
    METHODS: Using a semi-structured questionnaire developed as part of a larger research project, we collected data about 31 patient advocacy associations operating within the Italian National Health Service. We employed qualitative analysis to examine the associations\' birth and evolution as well as the motivations and influences driving change within the sampled organizations.
    RESULTS: Questionnaire responses provided information about the patient advocacy associations\' histories and highlighted their close links with the Italian National Health Service. Our results indicated the motivations for the associations\' establishment could be grouped into five categories: support at the system level, patient protection and support, actions to increase awareness, actions for improving patients\' health and quality of life, and dissemination of knowledge. We also identified the frequency and nature of the changes within the associations and explored the institutional pressures that influenced these organizational changes.
    CONCLUSIONS: The results can be interpreted considering the organizational theories that focus on organizations\' establishment decisions and how external pressures impact organizations\' dynamics and evolution.
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  • 文章类型: Journal Article
    背景:医疗保健行业对环境的影响约占全球二氧化碳排放量的4.6%,加剧了气候危机。然而,卫生部门的排放对人类健康的影响没有定期评估。我们的目标是估计欧盟(EU)内卫生部门的碳足迹的健康负担和相关成本。
    方法:我们通过考虑四种情况,根据人类健康损害因子(DALYs/kg-CO2e)计算了残疾调整生命年(DALYs)和相关成本。共享社会经济途径的三种情景(S1-高增长,S2-基线,和S3-低增长)代表了全球社会的变化,人口统计,和经济学,直到2100年。第四种情况(S4)考虑了当前欧盟55%的温室气体减排目标。2019年医疗保健行业的人均排放量(二氧化碳当量)是从《柳叶刀倒计时》中提取的,并从欧盟统计局检索了同年的人口数据。
    结果:在欧盟,365,047DALYs(95CI:194,692-535,403)预计将由卫生部门的基线排放(S2)引起。在S1场景中,负担将略有下降至316,374DALYs(95CI:170,355-462,393),而S3方案将增加486,730DALYs(95CI:243,365-681,422)。如果欧盟的碳排放目标得以实现,负担可以大大减少到164,271DALYs(95CI:87,611-240,931)。成本可能高达256亿欧元,当考虑DALYs货币化时。
    结论:卫生部门的二氧化碳排放预计将对人类健康产生重大影响。因此,重要的是要确保欧盟公共建筑的气候政策符合《巴黎协定》,增加对医疗保健部门气候缓解计划的资金,并审查当地的临床实践。
    BACKGROUND: The healthcare sector has an environmental impact of around 4.6% of global CO2 emissions, contributing to aggravating the climate crisis. However, the impact of the health sector\'s emissions on human health is not regularly assessed. We aim to estimate the health burden and associated costs of the health sector\'s carbon footprint within the European Union (EU).
    METHODS: We calculated disability-adjusted life years (DALYs) and associated costs based on human health damage factors (DALYs/kg-CO2e) by considering four scenarios. Three scenarios for shared socioeconomic pathways (S1 - high growth, S2 - baseline, and S3 - low growth) represented variations of global society, demographics, and economics until 2100. A fourth scenario (S4) considered the current EU\'s 55% reduction goal of greenhouse gas emissions. The healthcare sector\'s emissions per capita (in CO2-equivalent) in 2019 were extracted from the Lancet Countdown, and population data were retrieved from Eurostat for the same year.
    RESULTS: In the EU, 365,047 DALYs (95%CI: 194,692-535,403) are expected to be caused by the health sector\'s emissions at baseline (S2). In an S1 scenario, the burden would slightly decrease to 316,374 DALYs (95%CI: 170,355-462,393), whereas a S3 scenario would increase 486,730 DALYs (95%CI: 243,365-681,422). If EU\'s carbon goals are met, the burden could be substantially reduced to 164,271 DALYs (95%CI: 87,611-240,931). Costs can amount to 25.6 billion euros, when considering DALYs monetisation.
    CONCLUSIONS: CO2 emissions from the health sector are expected to significantly impact human health. Therefore, it is important to ensure that EU climate policies for public buildings are in line with the Paris Agreement, increase funding for climate mitigation programs within the healthcare sector, and review clinical practices at the local level.
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  • 文章类型: Journal Article
    这项研究的目的是调查2008年至2022年期间,医疗旅游收入对49个新兴和发达经济体医疗保健部门增长的影响。使用面板GMM和PMG/ARDL估计方法,结果显示,更高水平的医疗旅游收入促进了医疗保健部门的增长。这一发现在不同的样本时期仍然稳健,医疗保健行业绩效的替代衡量标准,和型号规格。
    The purpose of this study is to investigate the effect of medical tourism revenues on the growth of healthcare sector across 49 emerging and developed economies from 2008 to 2022. Using panel GMM and PMG/ARDL estimation methods, the results show that higher levels of medical tourism revenues promote growth in the healthcare sector. This finding remains robust across different sample periods, alternative measure of healthcare sector performance, and model specifications.
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  • 文章类型: Journal Article
    电子健康计划所体现的日益增长和无处不在的数字化趋势导致了数字解决方案在医疗保健领域的广泛采用。这些举措被认为是旨在改善医疗保健服务的强大变革力量,提高患者的治疗效果,提高医疗保健系统的效率。然而,尽管电子健康计划提供了巨大的潜力和可能性,这篇文章强调了批判性地研究它们的影响的重要性,并警告人们不要误解技术本身可以解决复杂的公共卫生问题和医疗保健挑战。它强调需要批判性地考虑社会文化背景,教育和培训,组织和体制方面,监管框架,用户参与和实施电子健康计划时的其他重要因素。忽视这些关键因素可能会使电子健康计划变得低效甚至适得其反。鉴于此,这篇文章指出了可能阻碍电子健康计划成功的失败和谬误,并强调了它们往往达不到不断上升和不合理期望的领域。为了应对这些挑战,文章建议采用更现实和基于证据的方法来规划和实施电子健康计划。它要求一致的研究议程,电子健康计划中适当的评估方法和战略方向。通过采用这种方法,eHealth倡议可以有助于实现社会目标,实现全球范围内医疗保健系统的关键卫生优先事项和发展要务。
    The growing and ubiquitous digitalization trends embodied in eHealth initiatives have led to the widespread adoption of digital solutions in the healthcare sector. These initiatives have been heralded as a potent transformative force aiming to improve healthcare delivery, enhance patient outcomes and increase the efficiency of healthcare systems. However, despite the significant potential and possibilities offered by eHealth initiatives, the article highlights the importance of critically examining their implications and cautions against the misconception that technology alone can solve complex public health concerns and healthcare challenges. It emphasizes the need to critically consider the sociocultural context, education and training, organizational and institutional aspects, regulatory frameworks, user involvement and other important factors when implementing eHealth initiatives. Disregarding these crucial elements can render eHealth initiatives inefficient or even counterproductive. In view of that, the article identifies failures and fallacies that can hinder the success of eHealth initiatives and highlights areas where they often fall short of meeting rising and unjustified expectations. To address these challenges, the article recommends a more realistic and evidence-based approach to planning and implementing eHealth initiatives. It calls for consistent research agendas, appropriate evaluation methodologies and strategic orientations within eHealth initiatives. By adopting this approach, eHealth initiatives can contribute to the achievement of societal goals and the realization of the key health priorities and development imperatives of healthcare systems on a global scale.
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  • 文章类型: Journal Article
    证据表明,常规职业安全与健康(OSH)培训对于在医疗机构保持良好的安全文化至关重要。然而,我们对医疗机构类型和常规OSH培训如何交互影响报告的组织安全文化认知数量的理解有限.
    本研究评估了医疗机构类型和OSH培训对加纳医护人员报告的组织安全文化认知数量的互动影响,其次,它评估了当考虑理论上相关因素(成分和上下文)时,这种关系是如何减弱的,最后检查预测因子与报告的组织安全文化认知数量之间的关联程度和顺序。
    横断面访谈研究。
    研究人员采访了加纳中部地区17个医疗机构的500名医护人员。
    将负二项回归模型拟合到加纳500名医护人员的横断面调查数据。
    在医疗中心工作的医护人员(24%,P<0.05)和医院(23%,P<0.05)与在未进行常规OSH培训的医疗中心工作的同行相比,进行常规OSH培训的员工更有可能报告良好的组织安全文化观念。39岁以上的个人(23%,与20-29年类别中的同行相比,P<0.05)更有可能报告良好的组织安全文化观念。女性医护人员(11%,与男性同行相比,P<0.05)更有可能报告良好的组织安全文化观念。
    这些发现为医疗保健部门的政策制定者和利益相关者提供了有价值的信息,以制定必要的干预措施,以改善医疗保健机构的安全文化。
    UNASSIGNED: Evidence shows that routine occupational safety and health (OSH) training is critical for maintaining good safety culture at healthcare facilities. However, our understanding of how healthcare facility type and routine OSH training interactively influence the number of reported organizational safety culture perceptions is limited.
    UNASSIGNED: This study assesses the interactive effect of healthcare facility type and OSH training on the number of reported organizational safety culture perceptions of healthcare workers in Ghana, secondly it evaluates how the relationship was attenuated when theoretically relevant factors (compositional and contextual) were considered, and lastly examines the magnitude and order of association between the predictors and the number of reported organizational safety culture perceptions.
    UNASSIGNED: Cross-sectional interview study.
    UNASSIGNED: The researchers interviewed 500 healthcare workers in seventeen healthcare facilities in the Central region of Ghana.
    UNASSIGNED: Negative binomial regression models were fitted to cross-sectional survey data on 500 healthcare workers in Ghana.
    UNASSIGNED: Healthcare workers who work in healthcare centers (24%, P<0.05) and hospitals (23%, P<0.05) where routine OSH training was conducted were more likely to report good organizational safety culture perceptions compared with their counterparts who work at healthcare centers where no routine OSH training was conducted. Individuals who were above 39 years (23%, P<0.05) were more likely to report good organizational safety culture perceptions compared with their counterparts in the 20-29-year category. Female healthcare workers (11%, P<0.05) were more likely to report good organizational safety culture perceptions compared with their male counterparts.
    UNASSIGNED: These findings provide valuable information for policymakers and stakeholders in the healthcare sector to develop interventions necessary for improving safety culture at healthcare facilities.
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  • 文章类型: Journal Article
    人工智能导致了医疗保健领域的重大发展,在其他部门和领域。鉴于其意义,本研究深入研究深度学习,人工智能的一个分支.
    在研究中,深度学习网络ResNet101,AlexNet,GoogLeNet,和Xception被考虑,它的目的是确定这些网络在疾病诊断中的成功。为此,利用了1680张胸部X射线图像的数据集,包括COVID-19、病毒性肺炎、和没有这些疾病的人。这些图像是通过使用旋转方法生成复制数据而获得的,其中采用70%和30%的分割进行训练和验证,分别。
    分析结果显示,深度学习网络成功地将COVID-19,病毒性肺炎,和正常(无病)图像。此外,对成功水平的检查显示,ResNet101深度学习网络比其他网络更成功,成功率为96.32%。
    在研究中,人们看到,深度学习可以用于疾病诊断,可以帮助相关领域的专家,最终为医疗保健组织和国家管理人员的做法做出贡献。
    Artificial intelligence has led to significant developments in the healthcare sector, as in other sectors and fields. In light of its significance, the present study delves into exploring deep learning, a branch of artificial intelligence.
    In the study, deep learning networks ResNet101, AlexNet, GoogLeNet, and Xception were considered, and it was aimed to determine the success of these networks in disease diagnosis. For this purpose, a dataset of 1,680 chest X-ray images was utilized, consisting of cases of COVID-19, viral pneumonia, and individuals without these diseases. These images were obtained by employing a rotation method to generate replicated data, wherein a split of 70 and 30% was adopted for training and validation, respectively.
    The analysis findings revealed that the deep learning networks were successful in classifying COVID-19, Viral Pneumonia, and Normal (disease-free) images. Moreover, an examination of the success levels revealed that the ResNet101 deep learning network was more successful than the others with a 96.32% success rate.
    In the study, it was seen that deep learning can be used in disease diagnosis and can help experts in the relevant field, ultimately contributing to healthcare organizations and the practices of country managers.
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  • 文章类型: Journal Article
    目标:在许多国家,门诊和住院护理是分开的。住院期间,因此,需要将门诊药物转换为医院处方集的药物。
    方法:我们在六个切换步骤(S0-S5)中新设计了一种切换算法,并在BundeswehrHamburg医院进行了一项研究(300张病床,80%平民)。我们进行了(i)药物核对以获取有关门诊药物的信息,以及(ii)药物审查以解决与药物相关的问题,例如,药物-药物相互作用。我们应用(iii)该算法将药物转换为医院处方集。
    结果:(i)我们确定了连续入院的100例患者(中位年龄:71岁;Q25/Q75:64/80岁)中的475种门诊药物(每位患者中位数:4;Q25/Q752/7)。在475种药物中,无法使用切换算法,因为产品名称缺失了23.9%,强度缺失了1.7%。在3.2%中,由于在住院期间未开药,因此不需要转换。(ii)在79名患者中有31名使用一种以上药物的患者中发现了药物-药物相互作用。在475种药物中,18.5%在医院处方集上,因此不需要切换(S0),0.2%在不允许切换的替换-排除列表中(S1),42.0%改用医院处方集(S2)的学名药,1.7%的治疗等效药物(S3),0.4%患者单独切换(S4),8.2%的患者不可能进行标准化/患者-个体转换(S5).
    结论:尽管进行了全面的药物和解,将药物转换为医院处方集的患者和药物相关信息经常缺失.一旦所有必要的信息可用,标准化的切换可以很容易地根据新开发的切换算法进行。
    OBJECTIVE: In many countries, outpatient and inpatient care are separated. During hospitalization, therefore, switching the outpatient medication to medication of the hospital formulary is required.
    METHODS: We newly designed a switching algorithm in six switching steps (S0-S5) and conducted a study at Bundeswehr Hospital Hamburg (300 beds, 80% civilians). We performed (i) a medication reconciliation to obtain information on outpatient medications and (ii) a medication review to solve drug-related-problems, e.g., drug-drug interactions. We applied (iii) the algorithm to switch medications to the hospital formulary.
    RESULTS: (i) We identified 475 outpatient medications (median per patient: 4; Q25/Q75 2/7) in 100 patients consecutively admitted to hospital (median age: 71; Q25/Q75: 64/80 years). Of 475 medications, the switching algorithm could not be used since product names were missing in 23.9% and strength in 1.7%. In 3.2%, switching was not required since medication was not prescribed during the hospital stay. (ii) Drug-drug interactions were identified in 31 of 79 patients with more than one medication. (iii) Of 475 medications, 18.5% were on the hospital formulary and therefore did not need to be  switched (S0), 0.2% were on a substitution-exclusion list not allowing switching (S1), 42.0% were switched to a generic medication of the hospital formulary (S2), 1.7% to a therapeutically equivalent medication (S3), 0.4% were patient-individually switched (S4), and for 8.2% a standardized/patient-individual switching was not possible (S5).
    CONCLUSIONS: Despite comprehensive medication reconciliation, patient- and medication-related information for switching medications to the hospital formulary was often missing. Once all the necessary information was available, standardized switching could be easily carried out according to a newly developed switching algorithm.
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