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Objective To analyze the factors influencing the levels of occupational exposure in medical radiation workers in China, and to provide a scientific basis for determining the key points of radiation protection in the medical sector. Methods The individual monitoring data on occupational external exposure in medical radiation workers in 2021 were collected from the “National Individual Dose Registry”. The Chi-squared test and logistic regression were used to analyze the factors influencing the levels of occupational exposure in medical radiation workers. Results The Chi-squared test showed that gender, occupational category, medical institution category, region, number of radiation workers per thousand population, and regional per capita GDP were significantly associated with occupational exposure in medical radiation workers exceeding the annual effective dose of 5 mSv and an annual effective dose limit of 20 mSv (χ2 = 21.456−262.329, 7.601−78.650, P < 0.05). The logistic regression analysis further showed that gender, occupational category, region, and number of radiation workers per thousand population were factors influencing the occupational exposure in medical radiation workers exceeding the annual effective dose of 5 mSv (χ2 = 14.621−170.857, P < 0.05); gender, occupational category, region, and regional per capita GDP were factors influencing the occupational exposure in medical radiation workers exceeding the annual effective dose of 20 mSv (χ2 = 5.401−48.709, P < 0.05). Conclusion Male radiation workers in interventional radiology and in central China have high risks of exceeding annual effective doses of 5 and 20 mSv. Moreover, high number of radiation workers per thousand population and regional per capita GDP are associated with low risks. Medical institutions should maintain a sufficient number of radiation workers and strengthen training on radiation protection knowledge for male and interventional radiology workers to enhance their radiation protection awareness. Investigation of the factors contributing to the high occupational exposure in central China should be intensified, and targeted effective measures should be conducted to reduce the occupational exposure in medical radiation workers.
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Objective:To analyze the trend of medication use in patients with ulcerative colitis (UC) in recent ten years in at Xijing Hospital, Air Force Military Medical University.Methods:From 2010 to 2019, the clinical data of 1 425 patients diagnosed with UC in the Department of Gastroenterology at Xijing Hospital, Air Force Medical University, were retrospectively collected. According to the period of medication, the UC patients were divided into year 2010 to 2014 group and year 2015 to 2019 group. The general information and the medication trend of year 2010 to 2014 group and year 2015 to 2019 group were analyzed. And then according to gender and age (<40 years old and ≥40 years old), patients were divided into subgroups and analyzed. Independent sample t test and chi-square test were used for statistical analysis. Results:The number of UC patients of year 2010 to 2014 group and year 2015 to 2019 group was 369 and 1 056, respectively. The percentages of patients in remission of the two groups were 9.5% (35/369) and 12.0% (127/1 056), respectively; the percentages of mild patients were 40.4% (149/369) and 41.6% (439/1 056), respectively; the percentages of moderate patients were 37.4% (138/369) and 28.9% (305/1 056), respectively; the percentages of severe patients were 12.7% (47/369) and 17.5% (185/1 056), respectively. There was no significant difference in the proportion of UC patients with different degrees between year 2010 to 2014 group and year 2015 to 2019 group ( P>0.05). There were no significant differences in the age and proportion of female between the year 2010 to 2014 group and year 2015 to 2019 group ((46.2±15.3) years old vs. (44.6±30.6) years old; 45.8%, 169/369 vs. 44.8%, 473/1 056; both P>0.05). The utilization rates of 5-aminosalicylic acid (5-ASA), glucocorticoid, immunosuppressants, and biological agents of the year 2015 to 2019 group were all higher than those of the year 2010 to 2014 group (96.8%, 1 022/1 056 vs. 90.0%, 332/369; 29.9%, 316/1 056 vs. 14.6%, 54/369; 8.4%, 89/1 056 vs. 2.4%, 9/369; 4.8%, 51/1 056 vs. 0.5%, 2/369, respectively), and the differences were all statistically significant ( χ2=26.766, 33.256, 15.315 and 14.038, all P<0.01). Within each of the year 2010 to 2014 group and the year 2015 to 2019 group, there were no significant differences between the female and male in the age, utilization rates of 5-ASA, glucocorticoid, immunosuppressants and biological agents ((47.2±13.6) years old vs. (45.3±16.5) years old, (43.1±12.9) years old vs. (45.8±39.5) years old, 88.8%, 150/169 vs. 91.0%, 182/200; 96.8%, 458/473 vs. 96.7%, 564/583; 13.6%, 23/169 vs. 15.5%, 31/200; 28.3%, 134/473 vs. 31.2%, 182/583; 2.4%, 4/169 vs. 2.5%, 5/200; 7.0%, 33/473 vs. 9.6%, 56/583; 0 vs. 1.0%, 2/200; 5.3%, 25/473 vs. 4.5%, 26/583; all P>0.05). In the patients aged≥40 years old of the year 2010 to 2014 group, the proportion of females was higher than that of the patients aged <40 years old (50.2%, 121/241 vs. 37.5%, 48/128), and the utilization rate of 5-ASA in patients aged ≥40 years old was lower than that of patients aged <40 years old (85.9%, 207/241 vs. 97.7%, 125/128), and the differences were statistically significant ( χ2=5.438 and 12.824, P=0.020 and P<0.01). In the year 2010 to 2014 group, there were no statistically significant differences in the utilization rates of glucocorticoid, immunosuppressants and biological agents between patients aged ≥40 years old and patients aged <40 years old (13.7%, 33/241 vs. 16.4%, 21/128; 2.1%, 5/241 vs. 3.1%, 4/128; 0 vs. 1.6%, 2/128; all P>0.05). In the year 2015 to 2019 group, the utilization rate of biological agents in patients aged≥40 years old was lower than that in patients aged<40 years old (3.7%, 23/630 vs. 46.5%, 198/426), and the difference was statistically significant ( χ2=4.721, P=0.030). In the year 2015 to 2019 group, there were no statistically significant differences in female proportion, utilization rates of 5-ASA, glucocorticoid, immunosuppressants and biological agents between patients aged≥40 years old and patients aged <40 years old (43.7%, 275/630 vs. 46.5%, 198/426; 96.0%, 605/630 vs. 97.9%, 417/426; 29.7%, 187/630 vs. 30.3%, 129/426; 8.6%, 54/630 vs. 8.2%, 35/426; all P>0.05). Conclusions:Compared with year 2010 to 2014, the number of UC patients remarkably increased in the year 2015 to 2019 in the Department of Gastroenterology, Xijing Hospiatal, Air Force Medical University. The utilization rates of 5-ASA, glucocorticoid, immunosuppressants and biological agents all increased in UC patients. The medication trends of UC patients with different gender were almost the same. The medication trends of UC patients with different age were different.
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ABSTRACT Objective To measure lifetime, last-year and last-month prevalence of Non-Medical Use of Prescription Drugs (NMUPD) as well as the characteristics associated to last-month NMUPD among undergraduate students of a university in southern Brazil. Methods This was a cross-sectional study, with a sample that was selected through a clustered systematic sampling strategy. Multivariate analysis was conducted with Poisson regression according to a four-level hierarchical model of analysis. Fieldwork was conducted in 2015, and 1,423 students participated. Results Lifetime, last-year and last-month prevalence of NMUPD were 25.2%, 13.1% and 8.5%, respectively. Anxiolytics and barbiturates were the most prevalent. Variables independently associated were being female, having a family income lower than one or higher than six Brazilian minimum wages, being enrolled in a health sciences-related undergraduate course, and having reported lifetime NMUPD by a friend. Conclusions Based on these results, we suggest the development of prevention and promotion activities on this theme for students and professors, especially among those from health sciences-related courses. These interventions should focus on harmful effects of NMUPD, psychosocial coping strategies and socially established gender roles.
RESUMO Objetivo Medir a prevalência do Uso Não Médico de Medicamento Prescrito (UNMMP) na vida, no último ano e no último mês, bem como as características associadas ao UNMMP no último mês entre estudantes de graduação de uma universidade no sul do Brasil. Métodos O estudo teve delineamento transversal com amostragem aleatória sistemática por conglomerados. A análise multivariável foi conduzida por meio de regressão de Poisson com ajuste robusto da variância seguindo um modelo hierárquico de análise de quatro níveis. O estudo foi conduzido em 2015 e 1.423 estudantes participaram. Resultados As prevalências de UNMMP na vida, no último ano e no último mês foram de 25,2%, 13,1% e 8,5%, respectivamente. Ansiolíticos e barbitúricos foram os mais prevalentes. As variáveis associadas foram ser do sexo feminino, ter uma renda família menor que um ou maior que seis salários-mínimos, estar em um curso da área da saúde e ter algum amigo que já fez UNMMP. Conclusões A partir desses resultados, sugere-se o desenvolvimento de atividades de prevenção e promoção sobre este tema, especialmente para os alunos e professores dos cursos da área da saúde. Essas intervenções podem ser sobre efeitos adversos desse tipo de uso, bem como sobre estratégias psicossociais de enfrentamento e papéis de gênero socialmente estabelecidos.
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OBJECTIVES: In this preliminary study, we investigated the clinical characteristics of patients who were first diagnosed with psychotic disorder and explored the impact of the adherence to antipsychotics on long-term medical use. METHODS: All national health insurance claims related to psychotic disorders including gender, age, income, and drug compliance, from January 1, 2008 to December 31, 2015, were examined. With trend test using Medication Possession Ratio (MPR), we compared the medical use between the compliant group (MRP≥0.8) and the comparative non-compliant group (0.2≤MPR<0.8). RESULTS: Among 28,095 participants in total, 16,239 patients (57.8%) were diagnosed as schizophrenia; the 30s were the most common (n=7,151, 25.5%). Drug compliance was generally low regardless of the diagnosis and was the lowest among 20s with the 40–60% range of income. The compliant group showed lower psychiatric and medical use than the comparative group in the following years (p<0.0001). CONCLUSION: These findings suggest that patients in the 20s and 30s with the 40–60% range of income, who are diagnosed with schizophrenia at the first psychiatric visit, may need more clinical and political attention. The results also emphasize the importance of initial drug adherence to antipsychotics in reducing long-term psychiatric costs.
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Humans , Antipsychotic Agents , Compliance , Diagnosis , National Health Programs , Psychotic Disorders , SchizophreniaABSTRACT
BACKGROUND: The purpose of this study is to estimate empirically whether there is a difference in medical use among income groups, and if so, how much. This study applies econometric model to the most recent year of Korean Medical Panel, 2015. The model consists of outpatient service and inpatient service models. METHODS: The probit model is applied to the model which indicate whether or not the medical care has been used. Two step estimation method using maximum likelihood estimation is applied to the models of outpatient visits, hospital days, and outpatient and inpatient out-of-pocket cost models, with disconnected selection problems. RESULTS: The results show that there was the inequality favorable to the low income group in medical care use. However, after controlling basic medical needs, there were no inequities among income groups in the outpatient visit model and the model of probability of inpatient service use. However, there were inequities favorable to the upper income groups in the models of probability of outpatient service use and outpatient out-of-pocket cost and the models of the number of length of stay and inpatient out-of-pocket cost. In particular, it shows clearly how the difference in outpatient service and inpatient service utilizations by income groups when basic medical needs are controlled. CONCLUSION: This means that the income contributes significantly to the degree of inequality in outpatient and inpatient care services. Therefore, the existence of medical care use difference under the same medical needs among income groups is a problem in terms of equity of medical care use, so great efforts should be made to establish policies to improve equity among income groups.
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Humans , Health Expenditures , Inpatients , Korea , Length of Stay , Methods , Models, Econometric , Outpatients , Socioeconomic FactorsABSTRACT
Objective To fulfill the precise control of the liquid flow by a multifunctional medical flowmeter. Methods The flowmeter had a separated structure, and was composed of a liquid pipeline unit and a flow control unit. The flow control unit apprehended a velocity of liquid level changes in the sterile pipeline by ultrasonic sensing technique, and regulated fluid speed by a SCM-controlled electromagnetic valve. Results The requirements for sterile environment were fulfilled by the sterile liquid pipeline, and the flow control unit realized precision control of flow rate and achieved the expected effect. Conclusion The flowmeter has simple structure, low cost, convenient operation and use, can greatly reduce the workload of the nursing staff and the possible health risks, and thus is worthy promoting practically.
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PURPOSE: The purpose of the study was to compare recipients' health behavior, attitude to using medicaid, medication compliance, and the changes in hospital cost and visit-day of in-patient and out-patient care between tele-care regions (TCR) and general care regions (GCR) in Korean medicaid. METHOD: The design of the study was ex-post facto comparing recipients in TCR and GCR. The sample included 625 persons in TCR and 410 persons in GCR. To collect materials, the case manager interviewed recipients of medicaid and filled out questionnaires which were analyzed through SAS/PC 9.1. RESULTS: In studying health behavior and medication, compliance was not significant. However, the attitude to using medicaid was significantly more positive in TCR than in GCR. In out-patients, the change of hospital visit-day was not significant between TCR and GCR, but TCR showed a reduction in hospital cost compared to GCR. For in-patient recipients, GCR showed a greater reduction in changes in hospital cost and visit-day compared to TCR. CONCLUSIONS: The results of the study show that attitudes to using medicaid via telephone are positive and results are more effective than hospital visit consultation, and the cost of out-patient care could be reduced.
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Humans , Case Management , Compliance , Delivery of Health Care , Health Behavior , Hospital Costs , Medicaid , Medication Adherence , Outpatients , Surveys and Questionnaires , TelephoneABSTRACT
OBJECTIVES: In Korea, the top 10% of Medical Aid recipients represent nearly 60% of total payment, with the costs for those disabled for over 365 days representing approximately 30% of total payment. The purpose of this study was to compare Medical Aid use of the disabled with non-disabled recipients, and to identify contributing factors to the total payment in the top 2% of recipients identified as Medical Aid overusers. METHODS: Subjects (n=2,211) selected were > or =18-years-of-age and received >1000 days of co-payment-free type I Medical Aid. Case managers (n=200) conducted interviews in December 2006, and collected data from Health Insurance Review & Assessment Service. Amounts over the 9 months from January September 2006 were analyzed descriptively and using Chi-square, ANCOVA, and robust multiple linear regression. RESULTS: Disabled individuals (mean age 61.3 years) composed 36.6% of subjects; 44.8% of the disabled were male. On a monthly basis per capita, the disabled group averaged 10.5 outpatient days, total payment of 523,000 Korean Won(won), inpatient payment of 359,000won, and outpatient payment of 183,000won. All values exceeded the monthly average for non-disabled individuals. Contributing factors were identified as male gender (82,000won), elementary school or lower educational level (64,000won), residence in a small city (82,000won), lack of family support (61,000won), kidney disability (673,000won), intellectual disability (151,000won), and multiple disabilities (119,000won). CONCLUSIONS: The identification of contributing factors to Medical Aid use by those defined as disabled supports the adoption of comprehensive alternative policies such as strengthening of education and consultation services, provision of alternative facilities, and promotion of self-care.
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OBJECTIVE To study the results of medical antibiotic dressings-nanosilver using for the wound covering after circumcision for phimosis.METHODS Two hundred patients were randomly classified into two groups,test and control groups.For the patients of test group,the wounds were covered with nanosilver dressing moist with normal saline.For the patients of control one,the wounds were covered with vaseline dressings.The exudation,pain sensation and healing conditions were compared.RESULTS There was a decreased pain sensation in the test group.The nanosilver dressings were more easily to be removed from the wounds with little exudation and pain for the patients comparing with the controls(P
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Objective To analyse and solve the difficulties and countermeasures in continuously proving medical gas. Methods Aiming at the difficulties of continuously proving medical gas, oxygen produced are mostly canned by oxygen compressor, and are transported to every function module through connecting oxygen jars. Results Medical gas module was taken into full play to meet reasonable demand for continuously providing oxygen. Conclusion It is suitable for other field module hospital to use for reference in the action of medical succor of disaster.
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By applying Inquiries Management System for medical high-value consumables,we can rapidly and conveniently inquiry the specific name of one product,specification,price,supply channels,manufacturers and related products,doctor's name,patient's name,operation time etc,and protect the legitimate right and interests of both doctors and patients. Meanwhile,exoteric management helps to lay a good foundation for prevention of commercial bribery.