ABSTRACT
Background: Routine data have shown a stark increase in home mechanical ventilation (HMV) in Germany in recent years. However, the development of HMV in the first year of the COVID-19 pandemic is unknown. Methods: Case numbers of initiations, control examinations, and terminations of invasive and non-invasive HMV in 2017-2020 were analysed. ICD-10 diagnoses of cases with an initiation of invasive HMV in 2017- 2020 were examined (data from the German Federal Statistical Office). Expenses of the statutory health insurances for ambulatory intensive care in 2017-2020 were analysed (data from the German Federal Ministry of Health). Results: Contrary to the trend in recent years, HMV initiations declined by 14.9 % in 2020, from n = 17,958 (2019) to n = 15,279 (2020). This development was due to a 15.9 % decline in initiations of non-invasive HMV. In contrast, initiations of invasive HMV remained stable in 2020, despite regional differences. For invasive and non-invasive HMV, control examinations (-28 % and -24 %, respectively) and ventilation terminations (-45.3 % and -15.1 %, respectively) dropped in 2020. Patients for whom invasive HMV was initiated had numerous comorbidities and care needs. Expenses of statutory health insurances for ambulatory intensive care increased from EUR 1.52 billion (2017) to EUR 2.16 billion (2020;+42.3 %). Conclusions: After an increase in control examinations and terminations of HMV in recent years, we observe a trend reversal in 2020. Additionally, initiations of non-invasive HMV decreased in 2020. Future studies need to explore the association between this development and the COVID-19 pandemic.
ABSTRACT
Background: Advances in patient-facing health information technology (HIT) promise to improve health care delivery and patient outcomes. Low utilization of HIT suggests that the preferences of patients may not be adequately guiding the development of these technologies. This systematic review offers an assessment of published evidence regarding patient preferences for HIT. Methods: Articles addressing preferences for HIT from patient and other end-user groups published up through 2020 were identified from PubMed, Web of Science, Scopus and via hand searching. Articles that used quantitative stated-preference methods to explore preferences for HIT were eligible for inclusion. Studies that explored attitudes towards HIT without eliciting trade-offs were excluded. Critical appraisal of study quality was conducted using the PREFS checklist and quality criteria identified by the US Food and Drug Administration including heterogeneity analysis and patient engagement in study design. We conducted thematic analysis of the main preference findings from each study to synthesize patient and enduser preferences for HIT. The review was not registered and authors received no funding to conduct the review. Results: The search yielded 7,299 unique articles, 59 of which were ultimately included in the review. Studies explored preferences for telemedicine (n=30), patient portals (n=12), mHealth (n=9) or multiple HITs (n=8). Preference elicitation methods included direct elicitation (n=26), discrete-choice experiments (n=13), conjoint analysis (n=6), contingent valuation (n=5), and ranking exercises (n=9). Studies had a mean PREFS score of 3.51 out of 5. Forty-two studies conducted preference heterogeneity analysis and only 20 included patients in study design. Thematic meta-analysis indicated that patients prefer HIT that is convenient and lower cost, but does not sacrifice quality, and preferences varied by demographic features such as age as well as depending on the type of health information being communicated. Conclusions: Patient and end-users have distinct preferences for the use of HIT in their medical care. It is timely that researchers and healthcare administrators consider these preferences for HIT given its rapid uptake amidst the COVID-19 pandemic. Although this literature demonstrates that patients can be engaged as participants in preference studies to identify meaningful aspects of HIT, the field was limited in its inclusion of patients in the design of such studies. Future development of HIT should be guided by high-quality preference research that integrates patients in all stages in the design and implementation of HIT. © Journal of Hospital Management and Health Policy. All rights reserved.
ABSTRACT
Manufacturers need to be resilient to effectively mitigate substantial disruptions to manufacturing operations so they may remain competitive. Disruptions resulting from the coronavirus disease (COVID-19) global pandemic have caused manufacturers to experience new challenges, including (1) working with reduced in-person operations, (2) retasking workers into new roles, and (3) reconfiguring their equipment and processes to yield completely new product lines. Improved monitoring, diagnostic, and prognostic technologies and methods (collectively known as prognostics and health management [PHM]) can help address these challenges and potential future disruptions. © 2020 American Institute of Physics Inc.. All rights reserved.