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Yang MY, Kim EJ, Nam D, Park Y, Ha IH, Kim D, Lee YJ. Trends of Korean medicine service utilization for lumbar disc herniation and spinal stenosis: A 10-year analysis of the 2010 to 2019 data. Medicine (Baltimore) 2024; 103:e38989. [PMID: 39058889 PMCID: PMC11272331 DOI: 10.1097/md.0000000000038989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
This retrospective, cross-sectional, and descriptive study aimed to analyze the trend of utilizing traditional Korean medicine services in patients with lumbar disc herniation (LDH) and/or lumbar spinal stenosis (LSS). In this study, based on the national patient sample data provided by Health Insurance Review and Assessment Service (HIRA), the trend of Korean medicine service utilization was investigated, including the following information: demographic characteristics of the patients, the total expenditure, number of claim statements per category, medical care expenditure per category, and routes of visiting traditional Korean medicine institutions. The study population comprised patients who visited Korean medicine institutions at least once from January 2010 to December 2019, with LSS and LDH as the primary diagnosis. LDH patients who used traditional Korean medicine services for treatment increased by about 1.36 times. LDH and LSS patients under 45 years of age were more likely to be males, but women accounted for a higher percentage among those over 45 years of age. Overall, women accounted for a slightly higher percentage than their counterparts for both diseases. From details of treatments received that were extracted from the claims data, acupuncture treatment accounted for the highest percentage for both disorders. Moreover, 50.7% of the patients who visited Korean medicine institutions to treat the two diseases also visited conventional Western medicine institutions. These patients, who were diagnosed with their condition at a Korean medicine institution, visited a conventional institution and then returned; the conventional institutions were primarily used for examination (40.5%). Increased utilization of traditional Korean medicine services was confirmed among patients with LDH and/or LSS; in particular, a sharp increase was noted among patients with LSS. The results of this study will be useful as basic research data for clinicians, researchers, and policy makers.
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Affiliation(s)
- Myeong Yeol Yang
- Department of Acupuncture & Moxibustion, Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Eun-Jung Kim
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Dongwoo Nam
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital, Dongdaemun-gu, Seoul, Republic of Korea
| | - Yeoncheol Park
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong 892 Dongnam-ro, Gangdong-gu, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
| | - Doori Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
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Cheng Y, Lai HR, Chen IH, Chiu YL, Lee PI, Peters K, Lee PH. Willingness of Patients With End-Stage Renal Disease to Accept a Kidney Transplant and Related Factors. J Nurs Res 2024; 32:e328. [PMID: 38814995 DOI: 10.1097/jnr.0000000000000616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The prevalence of end-stage renal disease (ESRD) in Taiwan is among the highest in the world. Although kidney transplant is the most effective treatment for ESRD, the willingness of patients with ESRD to undergo kidney transplantation is low in Taiwan. The factors associated with willingness to accept kidney transplantation remain unclear, and studies on kidney transplant willingness and associated factors among Taiwanese patients with ESRD are scarce. PURPOSE The aim of this study was to assess willingness to undergo a kidney transplant and related factors among patients with ESRD in Taiwan. METHODS A cross-sectional design was employed. Two hundred fourteen participants from a single medical center in Taiwan were recruited, and 209 valid questionnaires were collected (valid response rate: 97.7%). The study instruments included a kidney transplant knowledge scale, a kidney transplant attitude scale, and a kidney transplant willingness scale. Data were analyzed using Pearson's product-moment correlations, t tests, one-way analyses of variance, and multiple regressions. RESULTS The mean kidney transplant willingness in the sample was 13.23 (out of 20). Being male, younger, married, or employed; having a college education or above; and having a shorter dialysis duration were all associated with higher kidney transplant willingness. Sociodemographics, dialysis duration, knowledge, and attitudes explained 45.4% of the variance in kidney transplant willingness, with two of these, kidney transplant attitudes (β = .61, p < .001) and dialysis duration (β = -.11, p = .041), identified as significant. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The findings support the important role of cultivating positive attitudes in patients with ESRD to increasing willingness to undergo kidney transplantation interventions.
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Affiliation(s)
- Yin Cheng
- BSN, RN, Master Student, School of Nursing, College of Nursing, Taipei Medical University; and Supervisor, Department of Nursing, Far Eastern Memorial Hospital, Taiwan
| | - Hsiang-Ru Lai
- PhD, Professor, Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - I-Hui Chen
- PhD, Professor, School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yen-Ling Chiu
- PhD, MD, Associate Professor, Graduate Institute of Medicine, Yuan Ze University; and Attending Physician, Department of Medicine, Far Eastern Memorial Hospital, Taiwan
| | - Pei-I Lee
- RN, Doctoral Candidate, School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kath Peters
- PhD, RN, Professor, School of Nursing and Midwifery, Western Sydney University, New South Wales, Australia
| | - Pi-Hsia Lee
- EdD, RN, Professor, School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Fatma N, Ramamohan V. Healthcare seeking behavior among patients visiting public primary and secondary healthcare facilities in an urban Indian district: A cross-sectional quantitative analysis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001101. [PMID: 37669247 PMCID: PMC10479939 DOI: 10.1371/journal.pgph.0001101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 07/17/2023] [Indexed: 09/07/2023]
Abstract
In this work, we examined healthcare seeking behavior (HSB) of patients visiting public healthcare facilities in an urban context. We conducted a cross-sectional survey across twenty-two primary and secondary public healthcare facilities in the South-west Delhi district in India. The quantitative survey was designed to ascertain from patients at these facilities their HSB-i.e., on what basis patients decide the type of healthcare facility to visit, or which type of medical practitioner to consult. Based on responses from four hundred and forty-nine participants, we observed that factors such as wait time, prior experience with care providers, distance from the facility, and also socioeconomic and demographic factors such as annual income, educational qualification, and gender significantly influenced preferences of patients in choosing healthcare facilities. We used binomial and multinomial logistic regression to determine associations between HSB and socioeconomic and demographic attributes of patients at a 0.05 level of significance. Our statistical analyses revealed that patients in the lower income group preferred to seek treatment from public healthcare facilities (OR = 3.51, 95% CI = (1.65, 7.46)) irrespective of the perceived severity of their illness, while patients in the higher income group favored directly consulting specialized doctors (OR = 2.71, 95% CI = (1.34, 5.51)). Other factors such as having more than two children increased the probability of seeking care from public facilities. This work contributes to the literature by: (a) providing quantitative evidence regarding overall patient HSB, especially at primary and secondary public healthcare facilities, regardless of their presenting illness, (b) eliciting information regarding the pathways followed by patients visiting these facilities while seeking care, and (c) providing operational information regarding the surveyed facilities to facilitate characterizing their utilization. This work can inform policy designed to improve the utilization and quality of care at public primary and secondary healthcare facilities in India.
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Affiliation(s)
- Najiya Fatma
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Varun Ramamohan
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India
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Yoldi-Negrete M, Palacios-Cruz L, Tirado-Durán E, Jiménez-Rodríguez LI, Jiménez-Pavón J, Hernández S, Aguilar A, Morales-Cedillo IP, Jiménez-Tirado M, Fresán-Orellana A, Juárez García F, Becerra-Palars C, Camarena-Medellin B. Looking for factors affecting functioning in euthymic patients with bipolar I disorder: the importance of cognitive complaints and BDNF's Val66Met polymorphism. J Affect Disord 2022; 302:131-138. [PMID: 34990638 DOI: 10.1016/j.jad.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/14/2021] [Accepted: 01/01/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Functioning in Bipolar Disorder (BD) is affected in a substantial proportion of patients. The impact of demographic, clinical, cognitive, and genetic factors on functioning has been shown individually; however, as a complex phenomenon, a global approach to identify the most relevant as well as possible interactions is needed. METHODS 102 patients with type I BD in euthymia were invited for evaluation of demographic, clinical, and cognitive characteristics as well as genotype for Val66Met polymorphism of BDNF gene to determine those associated with poor functioning according to the FAST scale cut-off score. Clinical evaluation included assessment of residual affective symptoms and anxiety. Cognitive evaluation included the COBRA scale, verbal memory, and executive functions testing. RESULTS Residual depressive symptoms, anxiety, cognitive complaints and being a Met carrier were more frequent in the poor functioning group and were entered in a logistic regression model. Being a Met carrier (OR=4.46, CI=1.19-16.67) and cognitive complaints (OR=1.29, CI= 1.13-1.46) were the most important predictors of poor functioning in type I BD. LIMITATIONS Cross-sectional study, with select population limiting generalizability of findings. CONCLUSIONS A better understanding of underlying factors affecting cognition, including the possible involvement of BDNF Val66Met polymorphism, its systematic evaluation and a continued search for targeted treatment, along with recognition and attention of residual affective and anxious symptoms might improve psychosocial outcomes such as functioning in this population.
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Affiliation(s)
- María Yoldi-Negrete
- Laboratorio de Epidemiología Clínica, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Lino Palacios-Cruz
- Laboratorio de Epidemiología Clínica, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Elsa Tirado-Durán
- Departamento de Neuropsicología, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Laura Ivonne Jiménez-Rodríguez
- Departamento de Neuropsicología, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Joanna Jiménez-Pavón
- Clínica de Trastornos Afectivos, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Sandra Hernández
- Departamento de Farmacogenética, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Alejandro Aguilar
- Departamento de Farmacogenética, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Ingrid Pamela Morales-Cedillo
- Departamento de Farmacogenética, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | | | - Ana Fresán-Orellana
- Laboratorio de Epidemiología Clínica, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Francisco Juárez García
- Dirección de Investigaciones Epidemiológicas y Sociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Claudia Becerra-Palars
- Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Beatriz Camarena-Medellin
- Departamento de Farmacogenética, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico.
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Drøjdahl Ryg N, Gram J, Haghighi M, Juhl CB. Effects of Patient-Initiated Visits on Patient Satisfaction and Clinical Outcomes in a Type 1 Diabetes Outpatient Clinic: A 2-Year Randomized Controlled Study. Diabetes Care 2021; 44:dc203083. [PMID: 34301734 DOI: 10.2337/dc20-3083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/18/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We investigated the effects of replacing regular outpatient follow-up through prescheduled visits with patient-initiated visits on patient satisfaction and clinical variables of type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS A 24-month randomized controlled trial in which adults with T1D were allocated to either patient-initiated unlimited access to outpatient visits or usual care through regular prescheduled visits. The primary outcome was seven patient-reported experience measures of patient satisfaction focused on benefit of consultation and accessibility of the outpatient clinic. Secondary outcomes included clinical variables of diabetes and use of staff resources. RESULTS We enrolled 357 outpatients (intervention, n = 178; control, n = 179). After 24 months, participants in the intervention group experienced more benefit from consultations compared with baseline within groups (P < 0.05) and fewer unnecessary visits compared with control subjects (P < 0.05). Patient needs covered and satisfaction with the outpatient clinic were high and unchanged in both groups, and accessibility was increased (three questions, all P < 0.05). A calculated seven-item patient satisfaction sum score favored the intervention group over control subjects (P < 0.001). There were no significant changes in glycated hemoglobin (HbA1c), LDL, blood pressure, and complication status. The mean number of outpatient visits over 24 months (± SD) was lower in the intervention group compared with control subjects (4.4 ± 2.8 vs. 6.3 ± 2.7; P < 0.001), while the number of telephone contacts was higher (3.1 ±3.4 vs. 2.5 ± 3.2; P < 0.001). CONCLUSIONS Patient satisfaction remained high or improved with patient-initiated on-demand use of the diabetes outpatient clinic, with no decline in the quality of diabetes care, and a reduction in the use of staff resources.
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Affiliation(s)
- Nina Drøjdahl Ryg
- Medical Department, Endocrinology, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
- STENO Diabetes Center Odense, Odense, Denmark
| | - Jeppe Gram
- Medical Department, Endocrinology, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Maryam Haghighi
- Medical Department, Endocrinology, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Claus Bogh Juhl
- Medical Department, Endocrinology, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
- STENO Diabetes Center Odense, Odense, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
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Women, Patriarchy and Health Inequalities: The Urgent Need to Reorient Our Systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094472. [PMID: 33922437 PMCID: PMC8122806 DOI: 10.3390/ijerph18094472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/20/2021] [Indexed: 12/02/2022]
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