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Objective To analyze the causes of changes in the prevalence of respiratory diseases and the reason for changes in medical visit behavior of children in Zhejiang Province during the winter and spring seasons of 2019-2021, and to provide important reference for the allocation of hospital resources, implementation of hierarchical diagnosis and treatment, and epidemic prevention and control. Methods A retrospective study was conducted on 256 937 outpatient medical records from January 23rd to April 23rd of each year from 2019 to 2021 at the Children's Hospital Affiliated to Zhejiang University School of Medicine. Statistical methods were used for data analysis. Results A total of 256 937 cases were selected in the present study, including 157 000 cases in 2019, 22 192 cases in 2020, and 77 745 cases in 2021. The number of patients to the Children's Hospital of Zhejiang University School of Medicine from outside Hangzhou accounted for 41.74%, 14.36% , and 18.53% in 2019-2021, respectively. For 0~2 years old , 3~6 years old , and 7~14 years old groups , the percentages of patients with upper respiratory tract infections were 49.54%, 45.95%, and 46.74%, respectively ; with lower respiratory tract infections were 42.90% , 31.76% , and 22.95% ; with influenza were 2.23% , 3.15% and 4.09%; and with asthma were 1.37%, 5.08%, and 8.15%, respectively. Conclusion From 2019 to 2021, there have been significant changes in the total number of respiratory diseases in children, the proportion of disease types, and the proportion of children's geographical composition. It is necessary to continue to monitor children's respiratory diseases, grasp the dynamic changes in their medical visits in real time, adjust the hospital admission model , implement the graded treatment policy, and promote the prevention and control of respiratory diseases in children.
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Objective:To analyze the effect of the implementation of diagnosis-intervention packet (DIP) on the doctors′ diagnosis and treatment behavior of chronic diseases, so as to provide reference for further improving medical insurance payment related policies.Methods:The first page information of chronic disease patients admitted to hospitals with diabetes, hypertension and coronary atherosclerotic heart disease as the main conditions in 103 hospitals at all levels and township health centers in a city from 2016 to 2020 was collected, and the patients were divided into non-DIP group and DIP group according to the implementation time of DIP. After 1∶1 propensity score matching to balance the general conditions of the 2 groups, the diagnosis and treatment behaviors were analyzed from two dimensions: diagnostic behavior and treatment behavior. The grade A rate of medical record writing, admission and discharge diagnosis coincidence rate, and the average length of stay were used to evaluate the diagnostic behavior; the proportion of drugs and the degree of change in the cost structure were used as the evaluation indicators of treatment behavior.Results:After matching, 41 050 patients were included in both the non-DIP group and the DIP group.From the perspective of diagnostic behavior, the grade A rate of medical record writing in the non-DIP group and the DIP group was 99.40% and 99.83%, the coincidence rate of admission and discharge diagnosis was 58.42% and 61.79%, the average hospital stay was 8.03 days and 7.04 days respectively, and the difference between the groups was significant ( P<0.05). From the view of treatment behavior, the proportion of drugs decreased from 33.00% in the non-DIP group to 27.59% in the DIP group, with a significant difference ( P<0.05); the drug cost represented by Western medicine changed negatively, while the diagnostic cost showed a positive change. Conclusions:DIP has played a certain role in regulating doctors′ diagnosis and treatment behavior for chronic diseases. Among them, doctors have significantly improved their diagnostic behavior for chronic diseases, and the proportion of drugs in treatment behavior has been well controlled.
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Medical service pricing system is the basic system of health economics, which has a profound impact on physicians′ medical behavior and the running mode of hospital. Rui′an City, Wenzhou City, Zhejiang Province, freed up the cost space of drug and consumables based on the reasonable diagnosis and treatment behavior of doctors and selection of drug and consumables in the hospital procurement link. 68% of the free space was used to improve the price of medical services. 248 medical service items with obvious cost inversion were selected, such as nursing, traditional Chinese medicine, diagnosis, etc., and the price adjustment range was determined according to the agreed free space limit. Meanwhile, the credit mechanism of Alipay was applied to synchronously implement " vacating space and adjusting structure" , so as to solve the game problem between medical treatment and medical insurance, broaden the path of the " translation compensation method" of medical service price reform, and produce policy superposition and linkage effect with the reform of medical insurance payment mode.
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Objective @#To study patient-related information and factors altering their decision making in periodontal treatment and treatment behavior via big data analysis of the electronic medical records and to guide better dental care service and improve periodontal treatment. @*Methods@# A retrospective study was performed in patients with periodontitis who visited the Affiliated Stomatological Hospital of Tongji University from 2014 to 2016. Based on the periodontal sequence treatment procedure, the treatment types were divided into six groups and were analyzed using multivariable regression analysis. Chi-square test was performed according to gender and age.@*Results@#Age, payment method, disease severity, exhibited statistically significant differences regarding their effects on patients’ treatment behavior (P ＜ 0.05). Men were more likely to have severe periodontitis than women (male 41.04%; female 31.85%), and use medical insurance more often as payment method (male 86.14%; female 83.74%) (P ＜ 0.05). Compared with the population under 35 years old, moderate and severe periodontitis accounted for a larger proportion (84.58%) in the population over 35 years old. The compliance of the population over 35 years old was poor. Less follow-up reviews were conducted (17.10%) and medical insurance was less often used (49.65%) in this population. The differences were statistically significant (P ＜ 0.05).@*Conclusion@#Moderate and severe periodontitis accounted for a larger proportion in the population over 35 years old. Patients over 35 years old tend to choose simpler treatments with lower compliance and frequency of revisits. This situation may be related to the lower proportion of medicare use in this population. The awareness and compliance of periodontal treatment protocols in people over 35 years old needs to be improved.
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Objective To understand the status of sexually transmitted infection and seeking medical treatment behavior, and influencing factors of Vietnamese cross-border female sex workers (FSWs) in Hekou County, Yunnan, and to provide a basis for promoting reproductive health and preventing and controlling the spread of sexually transmitted diseases (STD) in Vietnamese cross-border FSWs. Methods The snowball sampling method was used to recruit research subjects in entertainment venues in Hekou County, Yunnan, to conduct a questionnaire survey and collect blood, vaginal secretions and cervical swab specimens for HIV/STD testing. Results A total of 262 Vietnamese cross-border FSWs were investigated. The total infection rate of sexually transmitted diseases and HIV was 35.8% (94/262). The positive rate of genital herpes simplex, fungal vaginitis, trichomoniasis, wet warts and chlamydia were 23.5%, 8.0%, 2.7%, 1.5% and 1.5%, respectively. The positive rate of HIV was 1.5%. In the past year, 116 Vietnamese cross-border FSWs had symptoms related to sexually transmitted diseases. Among them, 34.5% chose to go to the hospital or private outpatient clinic, 44.8% bought medicines by themselves, and 20.7% did not receive any treatment. The FSWs who reported having sexually transmitted diseases testing in the past year (OR=3.54, P<0.05), came from medium and high-end places (OR=3.94, P<0.05), had more than two symptoms (OR=3.88, P<0.05), and self-perceived high risk of sexually transmitted infection were more likely to seek medical treatment. Conclusion The Vietnamese cross-border FSW population in Hekou County of Yunnan Province had a high rate of sexually transmitted infections. The proportion of seeking medical treatment among FSWs having symptoms related to sexually transmitted diseases was low. It is necessary to guide the Vietnamese cross-border FSWs to seek formal medical treatment.
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Based on the international large-scale epidemiological research results, the Joint United Nations Programme on HIV and AIDS (UNAIDS) has proposed three 90%-90%-90% strategies for AIDS prevention and control, and the major countries in the world are actively promoting it. However there is a big gap in the strategy to promote the treatment of newly diagnosed HIV-positive people because of insufficient research on the acceptance and continuum care and treatment behavior of newly diagnosed person. Domestic and foreign studies have reported that diagnose outcome may cause psychological problems under pressure. Men who have sex with men with HIV infection are more stressed than the general population for their sexual orientation and HIV infections. Depression and anxiety are common mental problems which were present in 70.7% of the population, especially among newly diagnosed MSM. Unstable emotional state and unhealthy psychological condition may effect on their sleep, seeking treatment behavior and other aspects. The bi-directional affect between sleep and emotion has been proved, while the function of emotional state impact on HIV infection MSM ignition and retention ART is still unclear yet. This paper reviews treatment behavior status of men who have sex with men with HIV diagnosis, and both the effects of emotional state and sleep disorder on their treatment behavior, also analyzes and interprets the relationship between sleep disorder and emotion. This paper may contribute to provide new ideas and basis for HIV prevention and treatment among risky population and also for the care of HIV positive people.
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Background: The success of treatment in asthma requires long term commitment, adherence and a good self-management. Objectives: To study attitude and behavior related to adherence to medication by patients of asthma in a tertiary care institute and to assess their treatment seeking behavior. Study Settings: Tertiary care institute, Chest Medicine department, Design: Hospital based study. Materials and Methods: All the diagnosed asthma patients (N=100) were enrolled in the defined study period. Structured interviews were done of the diagnosed asthma patients using a predesigned questionnaire. The questions were related to the attitude and behavior towards medications, treatment seeking behavior of the patients and their adherence to treatment. Results: The study shows that out of 100 respondents, sixty (60%) of the respondents had experienced the symptoms for more than 6 weeks before going to hospital. About half (49%) had learned the use of inhaler from their doctor. Sixty-one (61%) had rated their asthma as “well controlled”. The commonest reason (n=79) for missing dose was “symptoms were relived & it was not necessary to continue treatment”. Conclusion: It could be seen that patient-side delays proved important determinant for treatment of Asthma. The commonest reason for missing dose was temporary relief of symptoms.
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Objective:It discussed the decision-making mechanism of medical market on supply side and how the hierarchical medical system help inhibiting the excessive medical behavior.Methods:Establishing medical behavior choice model based on the perspective of supply side and hierachy diagnosis Results and Conclusion:In the case of incomplete information and rigid demand hypothesis,the patient would accept all the supplies doctor offered and there was structural unbalance in both general medical market and advanced medical market which meant the excessive medical treatment existed.Under the hierarchical medical system,distinguishing by primary medical institution,both generalmedical market and advanced medical market reached equilibrium which improved the social resource allocation efficiency and the patients' welfare at the same time.
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Objective To observe the influence of the clinical pathway management intervention on medical service behaviors.Methods The clinical cases data in a grade A class 3 hospital of Zhangjiakou City,Hebei Province during 2011-2013 were retrospectively analyzed.The influence of implementing the clinical pathway management on the diagnosis results,medical records writing quality,clinical medication,operation,hospitalization time,medical costs,assisted examination items selection were observed and analyzed.Results The admission and discharge diagnosis coincidence rate and preoperative and postoperative diagnostic coincidence rate of 3 diseases entities in the two groups were 100%,the difference had no statistical significance (P>0.05);the medical record grade-A rate in the implementing clinical pathway group was significantly higher than that in the non-implementing clinical pathway group,the medical record grade-B rate was significantly lower than that in the non-implementing clinical pathway group,the difference was statistically significant (P0.05);the average hospitalization time,total costs,drug costs,laboratory fee and examination fee in the implementing clinical pathway group were lower than those in the non-implementing clinical pathway group,the difference was statistically significant (P<0.05);the operation fee,healthy material fee and nursing fee had no statistically significant difference was statistically significant(P<0.05).Conclusion Implementing the clinical pathway can standardize the doctor′s diagnosis and treatment behaviors and makes the medical work to develop to be more favorable for patients.
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Objective:To investigate the behaviors of the patients in clinic and analyze the behavior of the patients.Methods: To extract the basic information, diagnostic information, prescription information and so on from the 2013-2014 HIS database of Tai’an traditional Chinese medicine hospital to establish data model. The structure and flow of patients in the hospital had been analyzed by the data model.Results:Data analysis is the effective support of the hospital's continuous improvement service.Conclusion:Based on the HIS database to analyze the behaviors of the patients can let the manager from the perspective see a hospital running status, and this is the hospital management “precision decision-making” reference.
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Aims: Diarrhoea is a leading cause of mortality and morbidity among children under the age of five years. This study assessed diarrhea treatment behaviour among mothers of under-five attending Ibadan north local government Primary Health Care clinic, Oyo state. Study Design: The survey design was adopted for the study. Primary data was collected from the participants. Place and Duration of Study: The study was conducted in Ibadan north local government Primary Health Care clinic, Oyo state, Nigeria in 2015. Methodology: A structured questionnaire was used to gather data from 370 women randomly selected for the study. Data gathered included socio-demographic, knowledge, treatment behavior, home preparation and use of oral rehydration solution (ORS). Analysis of data was done using descriptive statistics and results presented in frequency tables. The statistical package for social sciences (SPSS version 17) was used for all analyses. Results: Results obtained from the study showed that the majority of the women were traders (35%), Christians (54%), between the ages of 20 and 30 (61%), married (67%) with children below 3 years of age (54%) and indicated that they have had previous births (51%). Most of the respondents had up to secondary education (75%) and indicated that they experience diarrhoea episodes with their children frequently (55%). almost all the women (98%) have heard of diarrhoea and the major source of information was the health workers. Knowledge analysis showed that the respondents have inadequate knowledge regarding causes and prevention measures for diarrhoea. However, 87% of the mothers knew that watery stool is a sign of diarrhea in children and 62% agreed that they gave their children ORS to drink each time they have episodes of diarrhoea. The most common treatment behaviour among the respondents (92% of respondents) was seeking medical attention from hospital during persistent diarrhoeal episode. Further results showed that respondents have inadequate knowledge of preparation and administration of ORS. Conclusion: In conclusion this research showed that there is still a knowledge gap as regards preventive healthcare behaviour in the study area. The need for corroborative post-natal child healthcare education to strengthen the efforts of the healthcare service providers in fighting diarrhoea is thus recommended.
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BACKGROUND: Analyzing the medical care utilization behavior and conception of disease treatment of dermatologic patients is important. However, the Korean literature has few studies reporting this information. OBJECTIVE: The aim of this study is to evaluate medical care utilization behavior and conception of disease treatment of dermatologic patients. METHODS: A written questionnaire concerning personal information, treatment behavior, treatment conception, patient satisfaction, and patient compliance was completed by 442 outpatients who visited the department of dermatology at a university hospital. RESULTS: According to the patients, satisfactory outpatient consultation time for dermatology was 14.2 minutes for the first-visit consultation, and 9.92 minutes for the second-visit consultation. Most (76.0%) patients initially sought the dermatologic clinics for dermatoses, but only 39.8% of patients knew how to distinguish dermatologists from other doctors. Among the participants, 26.7% of patients directly visited a tertiary medical center without visiting primary clinics. Before visiting the hospital, 52.3% of patients sought disease information, and 28.3% of patients obtained information about doctors. Some respondents (39.7%) had a negative attitude about dermatologic medicine because of lay referral. Men were highly satisfied with explanations of drugs and had more positivity towards drugs, but showed low compliance to applying topical medication. Patients of older age, lower education level, and lower economic status had lower satisfaction with explanations given during the examination. CONCLUSION: We advise dermatologists to play a major role in enlightening patients and constructing proper information delivery systems via diversified routes to prevent unreasonable medical care utilization behavior and groundless negative conceptions about dermatologic treatment.
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Humans , Male , Compliance , Surveys and Questionnaires , Dermatology , Education , Fertilization , Outpatients , Patient Compliance , Patient Satisfaction , Referral and Consultation , Skin Diseases , SkinABSTRACT
ObjectiveTo explore help-seeking behavior and treatment towards people with mental illness,so as to provide evidence for intervention measures.Methods 1988 mental disorders in outpatient were selected with a self-developed questionnaire randomly,and regression analysis was carried out.ResultsUnstable marriages and the lack of mental health knowledge were risk factors for actively professional help-seeking contact after first onset of a mental disorder.Median delays of seeking help and treatment in depression,schizophrenia,anxiety disorders and somatoform disorders were 113.5 days,34.0 days,86.5 days,309.0 days and 6.0 months,3.0 months,3.0 months,5.5 months orderly.There were notable difference for primary treatment contact between the four mental disorders ( x2 =46.317,P =0.029 ).No-professional recognition ratio was 17.8％.The ratio of correctly diagnosed and rationally cured with drugs ratio was 10.5％.89.5％ of outpatients had not been given rational drugs then they sought to psychiatry.ConclusionThe delay of help-seeking and treatment in mental illnesses are serious,so it should be taken effective measures to promote the popularization of mental health knowledge and train no-professional doctors in order to improve the behavior of seeking help and provide the ratio of recognition and treatment.