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Trip and mode choice decisions to out-patient health care facilities:A longitudinal analysis

Journal of Management Science and Engineering 2022年第2期7卷 173-196页

作者： Patrick McCarthy School of Economics Georgia Institute of TechnologyAtlanta30332USA Center for Economics Financeand ManagementHunan University Changsha410082China

This paper analyzes the impact of health indicators on an individual's trip and mode choices to out-patient care *** study's focus is an out-patient trip to a health care facility,and the source of data is the China Health and Retirement Longitudinal Study(CHARLS)for 2011.2013 and *** on a random utility framework,the study finds that making a rip to ureat an ilness or for a check-up increases the likelihood of an out-patient trip by 52 and 31 probability points,***-patient visits for which in-surance is not relevant,When the individual pays most of the out:of-pocket costs and when the facility is a public facility are also important *** and other per-sonal health factors have some but much more modest effects on one's trip *** analysis also identifies differential modal impacts of health indicators.A series of robustness tests generally confirm the results and identify areas for further *** a no-trip option,the biannual sunvey and infrequent out-patient trip-making mitigate endogeneity *** analysis has broad health policy and transportation implications for an ageing population whose share is increasing.

关键词： Health indicators Healthpolicy out-patient Tripchoice Modechoice Ageing Longitudinal Random utility model China CHARLS

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Infection Prevention Strategies in Cardiac Rehabilitation [1]—A Behavioral Intervention for patients [2]

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Health 2017年第9期9卷 1273-1284页

作者： Wendy Bjerke Sacred Heart University Fairfield USA

Background: Healthcare Acquired Infections (HAI) result in over 100 thousand deaths each year with one third of these deaths preventable via behaviors such as hand washing among health care providers in inpatient settings. Less research has been conducted in outpatient exercise settings such as cardiac rehabilitation (CR) among patients. Purpose: The purpose of this study was to examine the effectiveness of HAI prevention strategies in a CR setting among patients. Methods: Observations of the frequency of hand washing among CR patients pre and post four HAI strategies including provision of HAI education and signs, hand washing demonstrations, a HAI prevention video, and hand sanitizer samples. Washing hands prior to CR (WI) was observed as well as washing hands prior to leaving the CR center (WO). Methods included recording the frequency of WI and WO among all patients at baseline and after each of the four interventions. Mean frequencies of WI and WO were compared among a mean of 22 - 43 CR patient visits over 12 weeks using descriptive statistics and t-tests to determine if changes were significant pre and post intervention strategies. Results: At baseline, no patients WI or WO during an outpatient CR visit. Post interventions 1 - 4, the percentage of patients WI and WO was 33 and 34, 32 and 26, 32 and 29, 33 and 22 respectively. At a one-year follow up, the percentage of patients WI and WO was 40%. Conclusion: Increases in frequency and the percentage of WI and WO were observed among patients meriting continued examination of HAI prevention strategies among patients in outpatient exercise settings such as CR.

关键词： Healthcare Acquired Infections out-patient Settings Prevention Behavior Modification

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Predictors of hypoglycemia in insulin-treated patients with type 2 diabetes mellitus in Basrah

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World Journal of Diabetes 2016年第18期7卷 470-480页

作者： Dhuha Tarik Nassar Omran S Habib Abbas Ali Mansour Basrah Health Directorate Basrah 61013Iraq Department of Epidemiology Basrah College of Medicine Basrah 61013 Iraq Al-Faiha Specialized Diabetes Endocrine and Metabolism Center (FDEMC) Chair Diabetes Endocrine and Metabolism Division Department of Medicine Basrah College of Medicine Basrah 61013 Iraq

AIM To measure the incidence and determinants(predictors) of hypoglycemia among patients with type 2 diabetes mellitus(T2DM) who were on insulin treatment for at least one year. METHODS The present study is an out-patients based inquiry about the risk and predictors of hypoglycemia among patients with T2DM seeking care at the Al-Faiha Specialized Diabetes, Endocrine, and Metabolism Center, in Basrah over a period of 7 mo(from 15^(th) of April, 2013 to 15^(th) of October, 2013). The data used in the study were based on all detailed interview and selected laboratory investigations. A total of 336 patients could be included in the *** The incidence of overall hypoglycemia among the studied patients was 75.3% within the last 3 mo preceding the interview. The incidence of hypoglycemia subtypes were 10.2% for severe hypoglycemia requiring medical assistance in the hospital, 44.36% for severe hypoglycemia treated at home by family; this includes both confirmed severe hypoglycemia with an incidence rate of 14.6% and unconfirmed severe hypoglycemia for which incidence rate was 29.76%. Regarding mild self-treated hypoglycemia, the incidence of confirmed mild hypoglycemia was 21.42%, for unconfirmed mildhypoglycemia the incidence rate was 50.0% and for total mild hypoglycemia, the incidence rate was 71.42%. The most important predictors of hypoglycemia were a peripheral residence, increasing knowledge of hypoglycemia symptoms, in availability and increasing frequency of self-monitoring blood glucose, the presence of peripheral neuropathy, higher diastolic blood pressure, and lower Hemoglobin *** Hypoglycemia is very common among insulin-treated patients with T2DM in Basrah. It was possible to identify some important predictors of hypoglycemia.

关键词： Diabetes mellitus Insulin Hypoglycemia out-patient Type 2

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Reducing Paediatric outpatient Waitlists—A Proposed Allied Health Multidisciplinary Approach

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Open Journal of Preventive Medicine 2021年第2期11卷 63-70页

作者： Hsien-Jin Teoh Millie Darvell Redcliffe Hospital Metro North Hospital and Health Service Queensland Australia Private Practice Queensland Australia

Extremely long Australian paediatric outpatient waiting lists have resulted in large numbers of children waiting to see a paediatrician. Analyses of the patient referrals suggest that a large proportion of children may benefit from allied health input, in addition to being seen by the paediatrician. This paper provides an organisational strategy that involves streamlining Allied Health clinical services in an effort to assist with bringing down a Paediatric out-patient waitlist. The paper describes principles to guide the formation of a Paediatric Allied Health Multi-Disciplinary team that proposes assessment and brief interventions. The service would focus on supporting the paediatricians through the use of structured procedures, telephone intakes, multidisciplinary triage, shared and standardised assessments, collaborative formulations and reports, brief interventions, clinical-community linkages, and allied health student support. A variety of additional important organisational principles are proposed to facilitate patient flow from the perspective of streamlining administrative processes, having adequate administrative support, shared responsibilities, teamwork, flexibility, carrying out intake assessments, determining which referrals were appropriate for allied health, and working closely with medical staff.

关键词： Paediatric out-patient Allied Health Multi-Disciplinary Waiting Lists

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