Journal articles on the topic 'Aged care employee'
To see the other types of publications on this topic, follow the link: Aged care employee.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Aged care employee.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Cheng, Zhiming, Ingrid Nielsen, and Henry Cutler. "Perceived job quality, work-life interference and intention to stay." International Journal of Manpower 40, no. 1 (April 1, 2019): 17–35. http://dx.doi.org/10.1108/ijm-08-2017-0208.
Full textAbstract:
PurposeThe purpose of this paper is to examine the relationship between aged care employees’ perceived job quality and intention to stay in current aged care facilities, mediated by work-life interference.Design/methodology/approachThis paper uses the nationally representative employee–employer matched data from the 2012 National Aged Care Workforce Census and Survey in Australia. It applies the theoretical lens of the Job Characteristics Model and a mediation analytical model that controls for a rich set of employee, employer and regional characteristics.FindingsThis paper finds that higher perceived job quality positively correlates with greater intention to stay and that work-life interference mediates the relationship between perceived job quality and intention to stay.Research limitations/implicationsThis paper cannot make inference about causal relationship. Future studies on the aged care workforce should collect longitudinal data so that time-invariant unobservables can be eliminated in econometric modelling.Practical implicationsEfforts by the aged care sector to design quality jobs are likely to have significant positive correlation with the intention to stay, not only because employees are less likely to leave higher quality jobsper se, but also because higher quality jobs interfere less in the family lives of aged care workers, which itself is associated with greater intention to stay.Originality/valueThe results add to a small literature that has investigated how work-family variables can mediate between interventions that organisations put in place to improve work-life balance, and employee outcomes.
2
Kaine, Sarah. "Employee voice and regulation in the residential aged care sector." Human Resource Management Journal 22, no. 3 (June 16, 2011): 316–31. http://dx.doi.org/10.1111/j.1748-8583.2011.00170.x.
Full text
3
Clarke, Marilyn Alexandra, and Sally Rao Hill. "Promoting employee wellbeing and quality service outcomes: The role of HRM practices." Journal of Management & Organization 18, no. 5 (September 2012): 702–13. http://dx.doi.org/10.1017/s1833367200000626.
Full textAbstract:
AbstractAs a transformative service, aged care has the capacity to create uplifting changes and improvements to the quality of life for individuals and communities. Recent studies have, however, highlighted the pressures faced by aged care workers and the impact that these pressures have on employee wellbeing and quality of care. This paper explores the relationship between employee wellbeing and service quality. We present a model for the aged care sector which suggests that by identifying and implementing appropriate HRM strategies both employee wellbeing and service quality will be enhanced thus ensuring that this transformative service meets the needs of its many stakeholders. Essentially, we argue that employee wellbeing is directly linked to service delivery outcomes and overall business performance and that HR practices that address issues such as learning and development, employee voice and involvement and workplace health and safety play a significant role in enhancing and maintaining employee wellbeing.
4
Clarke, Marilyn Alexandra, and Sally Rao Hill. "Promoting employee wellbeing and quality service outcomes: The role of HRM practices." Journal of Management & Organization 18, no. 5 (September 2012): 702–13. http://dx.doi.org/10.5172/jmo.2012.18.5.702.
Full textAbstract:
AbstractAs a transformative service, aged care has the capacity to create uplifting changes and improvements to the quality of life for individuals and communities. Recent studies have, however, highlighted the pressures faced by aged care workers and the impact that these pressures have on employee wellbeing and quality of care. This paper explores the relationship between employee wellbeing and service quality. We present a model for the aged care sector which suggests that by identifying and implementing appropriate HRM strategies both employee wellbeing and service quality will be enhanced thus ensuring that this transformative service meets the needs of its many stakeholders. Essentially, we argue that employee wellbeing is directly linked to service delivery outcomes and overall business performance and that HR practices that address issues such as learning and development, employee voice and involvement and workplace health and safety play a significant role in enhancing and maintaining employee wellbeing.
5
Ngocha-Chaderopa, Nyemudzai Esther, and Bronwyn Boon. "Managing for quality aged residential care with a migrant workforce." Journal of Management & Organization 22, no. 1 (June 8, 2015): 32–48. http://dx.doi.org/10.1017/jmo.2015.17.
Full textAbstract:
AbstractGiven the growing demand for aged residential care facilities in Western industrialised economies, the adequate staffing of these facilities is a growing concern. Increasingly migrant care workers are being employed to fill the local labour shortfall. In this paper we present findings of a qualitative study exploring how managers of aged residential care facilities work to ensure consistent delivery of quality care through their migrant care workers. The issues raised by the 16 managers cluster around three themes: communication and language barriers; racism by residents, families and managers; and underemployment of tertiary qualified migrant care workers. In addition to issues of quality care delivery, concerns around migrant employee well-being are seen to be difficult to avoid.
6
Clarke, Marilyn. "To what extent a “bad” job? Employee perceptions of job quality in community aged care." Employee Relations 37, no. 2 (February 9, 2015): 192–208. http://dx.doi.org/10.1108/er-11-2013-0169.
Full textAbstract:
Purpose – The purpose of this paper is to explore how community aged care workers evaluate job quality using a job quality framework. Design/methodology/approach – The study uses a qualitative approach. Data were collected using semi-structured interviews and focus groups from a large aged care organisation. Findings – Perceptions of job quality are influenced by individual motivations, match between life-stage and work flexibility, as well as broader community views of the value of this type of work. Intrinsic factors (e.g. autonomy, job content) moderate the impact of extrinsic factors such as pay and job security. Research limitations/implications – The sample is relatively small and the study is based on data from one aged care organisation which may not reflect employment conditions in other organisations. Practical implications – Attraction and retention of community care workers can be improved by addressing factors associated with remuneration (including employment contracts and hours of work) and career structures. Skill and experience-based career structures would help build organisational capacity as well as making these jobs more attractive. Social implications – The demand for community care will continue to increase. Attracting, retaining and managing this workforce will be critical to meeting society’s expectations regarding the future care needs of older people. Originality/value – This research explores an under-researched workforce group in a critical area of aged care management. It highlights two key areas with the potential to improve employee perceptions of job quality and therefore address issues related to attraction, retention, job satisfaction and ultimately organisational performance.
7
Brooks, Jeff, and Janine Malcolm. "Strategies to address the gaps in employee influenza vaccination campaigns in residential aged care facilities." Infection, Disease & Health 21, no. 3 (November 2016): 139. http://dx.doi.org/10.1016/j.idh.2016.09.101.
Full text
8
Jepsen, Denise M., and Denise M. Rousseau. "Perceived evidence use: Measurement and construct validation of managerial evidence use as perceived by subordinates." PLOS ONE 17, no. 4 (April 26, 2022): e0266894. http://dx.doi.org/10.1371/journal.pone.0266894.
Full textAbstract:
Despite the promise of evidence-based management as a practice for improving decisions and their outcomes in organizations, little empirical study exists on the effects of evidence use in the workplace. The present research develops a scale to assess subordinate perceptions of managerial evidence use in decision making and provides empirical evidence of the relationships this measure has with established workplace and organizational phenomena. First, scale development studies in four samples, including a field site and MBA courses with students employed full time, show that perceived evidence use can be measured reliably and is distinct from other leadership measures. Second, a cross-sectional study of 308 employees in 18 aged care homes demonstrates a positive relationship between employee perceptions of managerial evidence use and commonly used measures of leader member exchange, trust in supervisor, work-based learning, and organizational performance ratings, and a negative relationship with employee distress. These results suggest implications for leadership and management practices in contemporary, information-rich environments and novel insights into how employees can be affected by managerial evidence use.
9
Jepsen, Denise M., and Denise M. Rousseau. "Perceived evidence use: Measurement and construct validation of managerial evidence use as perceived by subordinates." PLOS ONE 17, no. 4 (April 26, 2022): e0266894. http://dx.doi.org/10.1371/journal.pone.0266894.
Full textAbstract:
Despite the promise of evidence-based management as a practice for improving decisions and their outcomes in organizations, little empirical study exists on the effects of evidence use in the workplace. The present research develops a scale to assess subordinate perceptions of managerial evidence use in decision making and provides empirical evidence of the relationships this measure has with established workplace and organizational phenomena. First, scale development studies in four samples, including a field site and MBA courses with students employed full time, show that perceived evidence use can be measured reliably and is distinct from other leadership measures. Second, a cross-sectional study of 308 employees in 18 aged care homes demonstrates a positive relationship between employee perceptions of managerial evidence use and commonly used measures of leader member exchange, trust in supervisor, work-based learning, and organizational performance ratings, and a negative relationship with employee distress. These results suggest implications for leadership and management practices in contemporary, information-rich environments and novel insights into how employees can be affected by managerial evidence use.
10
Treuren, Gerrit J. M., and Beni Halvorsen. "The contribution of client embeddedness to an employee’s employment experience." International Journal of Manpower 37, no. 6 (September 5, 2016): 989–1003. http://dx.doi.org/10.1108/ijm-12-2015-0213.
Full textAbstract:
Purpose Does client embeddedness lead to improved employee quality of life, such as job satisfaction, affective commitment and employee engagement? If so, is this relationship affected by gender, age, tenure and psychological contract breach (PCB)? The paper aims to discuss these issues. Design/methodology/approach Regression and ANOVA analysis of a two-wave sample (n=121) of employees working for an aged care provider. Findings Client embeddedness at Time 1 predicts employee quality of life at Time 2. However, in this sample, this relationship is unaffected by gender, age and length of service. High levels of PCB weakens the relationship between client embeddedness and job satisfaction. Research limitations/implications The employee-client relationship directly improves quality of working life. However, it is unclear whether this finding is unique to this organisation, or whether client embeddedness can be cultivated over time or is a characteristic of an employee. Practical implications Organisations can substantially benefit from encouraging appropriate client-employee relationships. By adopting HR practices aimed at acquiring and cultivating client embeddedness through recruitment, performance management and training practices, organisations may increase employee quality of working life, and reduce employee turnover. Originality/value This paper substantially increases the understanding of client embeddedness by clarifying the direct effects of the client-employee relationship, and by identifying boundary conditions on the effect of client embeddedness. It also points to a distinct approach to recruiting and developing employees in client-facing industries.
11
Payne, Graeme Edward, and Greg Fisher. "Consumer-directed care and the relational triangle." Employee Relations: The International Journal 41, no. 3 (April 1, 2019): 436–53. http://dx.doi.org/10.1108/er-06-2017-0130.
Full textAbstract:
PurposeFollowing a recent government initiated change to a consumer-directed care model across the Australian community aged care sector, the purpose of this paper is to explore frontline home support workers’ perceptions of relational changes with clients in power and subordination within the triadic relationship between employer, employee and client.Design/methodology/approachContextual interviews were held with managers (n=4), coordinators (n=10) and semi-structured face-to-face interviews with support workers (n=17) in three organizations. Interview transcripts were analyzed.FindingsSome workers did not perceive a power change in their relationships with clients. Others perceived minimal change but were concerned about the incoming client generation (baby boomers) that were more aware of their rights. Others felt subordinated to the client, perceived a loss of control or that felt treated like an employee of the client. Consistent with the philosophy of consumer-directed care, senior staff encouraged clients to treat workers in this way.Research limitations/implicationsFurther research is recommended on worker and client perceptions of relationships within the context of a consumer or client focused model.Practical implicationsA clear and realistic understanding of the locus of power within a triadic relationship by all actors is important for positive workplace outcomes.Social implicationsThe increasing ageing population makes it essential that workers’ relationships with clients and with their organization are unambiguous.Originality/valueThis study makes a contribution to theories about change and power transfer in the implementation of consumer-directed care through the perceptions of support workers. Examination of power and subordination transfer through the perceptions of the actors of rather than through the prism of organizational policy deepens the understanding of frontline service work and relationships.
12
Harley, Bill, Belinda C. Allen, and Leisa D. Sargent. "High Performance Work Systems and Employee Experience of Work in the Service Sector: The Case of Aged Care." British Journal of Industrial Relations 45, no. 3 (September 2007): 607–33. http://dx.doi.org/10.1111/j.1467-8543.2007.00630.x.
Full text
13
McPhail, Ruth, and Liz Fulop. "Champions’ perspectives on implementing the National Lesbian, Gay, Bisexual, Transgender and Intersex Ageing and Aged Care Strategy in Queensland." Australian Health Review 40, no. 6 (2016): 633. http://dx.doi.org/10.1071/ah15185.
Full textAbstract:
Objective The National Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) Ageing and Aged Care Strategy was introduced by the Commonwealth Government in 2012. The present study explored perceptions of the first Aged Care Champions (trained employees) of the opportunities, challenges and barriers to implementing the Strategy in Queensland. Methods The present study was an exploratory study of Champions who were nominated by their providers to build capacity around the Strategy for introduction into their organisations. The Champions (n = 62) were surveyed before commencing their training programs. Quantitative and qualitative material was collected on how the Champions perceived the introduction of the six standards within their organisation. Results Champions perceived that there were opportunities to improve inclusivity, leverage organisational support and increase training and support to staff. Key challenges identified were internal attitudes and values, a lack of resources and a need for training and networking. Significant barriers included a lack of management support, resistant staff and pre-existing prejudicial values. Conclusions Providers and practitioners can leverage the opportunity to increase organisational levels of inclusivity, demonstrate organisational support to improve outcomes for clients and stakeholders and, importantly, provide staff training and development critical to the successful implementation of the Strategy. What is known about the topic? Many LGBTI elders have faced a lived history of oppression and discrimination and have special health care needs. As they age, their needs for greater levels of care increase, but for many so to do their concerns about receiving equitable treatment. What does this paper add? The National LGBTI Ageing and Aged Care Strategy was introduced to address the concerns and needs of LGBTI elders and ensure inclusive and supportive care. This study explores the opportunities, challenges and barriers as perceived by employees trained to introduce the Strategy into their services in Queensland. The present study is the first to explore the introduction of the Strategy from employees’ perspectives. What are the implications for practitioners? In the present study, the opportunity for increasing inclusivity, levels of support and training and development were explored from an employee perspective, giving voice to this group of practitioners. Challenges, including current attitudes and values of staff and management, as well as a lack of resources and making connections and networks, are identified. Finally, barriers to the implementation of the Strategy are outlined, including levels of support, staff resistance, values and past negative histories of many LGBTI elders.
14
Li, Xiangjun, Mingsheng Chen, Zhonghua Wang, and Lei Si. "Forgone care among middle aged and elderly with chronic diseases in China: evidence from the China Health and Retirement Longitudinal Study Baseline Survey." BMJ Open 8, no. 3 (March 2018): e019901. http://dx.doi.org/10.1136/bmjopen-2017-019901.
Full textAbstract:
ObjectiveIn general, published studies analyse healthcare utilisation, rather than foregone care, among different population groups. The assessment of forgone care as an aspect of healthcare system performance is important because it indicates the gap between perceived need and actual utilisation of healthcare services. This study focused on a specific vulnerable group, middle-aged and elderly people with chronic diseases, and evaluated the prevalence of foregone care and associated factors among this population in China.MethodsData were obtained from a nationally representative household survey of middle-aged and elderly individuals (≥45 years), the China Health and Retirement Longitudinal Study, which was conducted by the National School of Development of Peking University in 2013. Descriptive statistics were used to analyse sample characteristics and the prevalence of foregone care. Andersen’s healthcare utilisation and binary logistic models were used to evaluate the determinants of foregone care among middle-aged and elderly individuals with chronic diseases.ResultsThe prevalence of foregone outpatient and inpatient care among middle-aged and elderly people was 10.21% and 6.84%, respectively, whereas the prevalence of foregone care for physical examinations was relatively high (57.88%). Predisposing factors, including age, marital status, employment, education and family size, significantly affected foregone care in this population. Regarding enabling factors, individuals in the highest income group reported less foregone inpatient care or physical examinations compared with those in the lowest income group. Social healthcare insurance could significantly reduce foregone care in outpatient and inpatient situations; however, these schemes (except for urban employee medical insurance) did not appear to have a significant impact on foregone care involving physical examinations.ConclusionIn China, policy-makers may need to further adjust healthcare policies, such as health insurance schemes, and improve the hierarchical medical system, to promote reduction in foregone care and effective utilisation of health services.
15
Lin, Stephen, and Danièle Bélanger. "Negotiating the Social Family: Migrant Live-in Elder Care-workers in Taiwan." Asian Journal of Social Science 40, no. 3 (2012): 295–320. http://dx.doi.org/10.1163/156853112x650854.
Full textAbstract:
Abstract In response to difficulties faced by families in caring for the aged, the government of Taiwan launched a foreign live-in caregiver programme in 1992. This paper draws upon literature on family, domestic work and motives for caregiving to examine how the long-term co-residence of migrant live-in elder care-workers reconfigures Taiwanese families. Our analysis, based on in-depth interviews conducted in the summer of 2009 with 20 Vietnamese migrant live-in care-workers, uses the concept of ‘social family’ to document the close emotional and quasi-familial relationships between foreign care-workers and members of Taiwanese families. Narratives shed light on the dynamics of these relationships and show the limitations of the concept. The inherent asymmetrical employer-employee power relationship remains, while workers constantly negotiate contradictory feelings and positions in the intimate sphere of the employers’ private homes. This paper emphasizes the mutual dependency that migrants experience as both workers and members of a new family. Rather than being seen as cheap, disposable labour, migrants become indispensable to the families. It is this dependency and intimacy that make them part of the family, but also continues to make them vulnerable to abuse.
16
Fergie, Jaime, Tara Gonzales, Mina Suh, Xiaohui Jiang, Jon Fryzek, Ashley Howard, and Adam Bloomfield. "1513. Medically Attended Respiratory Syncytial Virus Hospitalizations (RSVH) and All-Cause Bronchiolitis Hospitalizations (BH) Among Children Aged ≤ 24 Months at RSV Season Start With Higher-Risk Congenital Heart Disease (CHD) Before and After the 2014 American Academy of Pediatrics (AAP) Policy." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S760. http://dx.doi.org/10.1093/ofid/ofaa439.1694.
Full textAbstract:
Abstract Background In 2014, the AAP stopped recommending palivizumab for use in children with hemodynamically significant CHD (hs-CHD) aged 12 to 24 months at the RSV season start. This analysis investigates the impact of the 2014 AAP policy on the contemporary burden of RSVH and BH in children with CHD for whom palivizumab immunoprophylaxis is no longer recommended. Methods All children with CHD aged ≤ 24 months at the start of the RSV season and hospitalized for RSV or BH during the 2010-2017 RSV seasons (November-March) were studied. RSVH and BH were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and ICD-10-CM codes. As there are no ICD codes for hs-CHD, we evaluated the effect of the guidance on higher-risk CHD as defined by ICD codes.1 Frequency and characteristics of RSVH and BH and disease severity (including intensive care unit [ICU] admission and mechincal ventilation) for these children before and after the 2014 AAP guidance using the Children’s Hospital Association’s Pediatric Health Information System® (PHIS) data set were described. SAS version 9.4 was used for statistical analysis of this data, with z-tests method used to determine statistical significance. Results RSVH significantly increased after 2014 for all higher-risk CHD children aged ≤ 24 months (3.4% [1992 RSVH CHD/59,217 RSVH] before the 2014 guidance and 4.0% [1798 RSVH CHD/45,470 RSVH] after; P< 0.0001) and for the subgroup of children aged 12 to 24 months at the start of the RSV season (0.5% before the guidance and 0.8% after; P< 0.0001). Disease severity as measured by ICU admissions in the 12 to 24 months subgroup also significantly increased after the 2014 guidance (0.2% before the guidance and 0.3% after; P< 0.0001). Mechanical ventilation usage was not statistically significantly increased after the 2014 guidance (P=0.188). A similar pattern of results was found for BH. Conclusion RSVH, BH, and associated disease severity significantly increased among higher-risk CHD children aged 12 to 24 months, within the PHIS health system, after the 3 RSV seasons following the 2014 AAP RSV immunoprophylaxis recommendations. Disclosures Jaime Fergie, MD, AstraZeneca (Speaker’s Bureau)Sobi, Inc. (Speaker’s Bureau) Tara Gonzales, MD, Sobi, Inc. (Employee) Mina Suh, MPH, International Health, EpidStrategies (Employee) Xiaohui Jiang, MS, EpidStrategies (Employee) Jon Fryzek, PhD, MPH, EpidStrategies (Employee) Adam Bloomfield, MD, FAAP, Sobi, Inc. (Employee)
17
Kozlov, Elissa, Meghan McDarby, Maximo Prescott, and Myra Altman. "Assessing the Care Modality Preferences and Predictors for Digital Mental Health Treatment Seekers in a Technology-Enabled Stepped Care Delivery System: Cross-sectional Study." JMIR Formative Research 5, no. 9 (September 15, 2021): e30162. http://dx.doi.org/10.2196/30162.
Full textAbstract:
Background Access to mental health services continues to be a systemic problem in the United States and around the world owing to a variety of barriers including the limited availability of skilled providers and lack of mental health literacy among patients. Individuals seeking mental health treatment may not be aware of the multiple modalities of digital mental health care available to address their problems (eg, self-guided and group modalities, or one-to-one care with a provider). In fact, one-to-one, in-person treatment is the dominant care model with a masters- or doctoral-level trained mental health provider, and it may or may not be the appropriate or preferred level of care for an individual. Technology-enabled mental health platforms may be one way to improve access to mental health care by offering stepped care, but more research is needed to understand the care modality preferences of digital mental health care seekers because additional modalities become increasingly validated as effective treatment options. Objective The purpose of this study was to describe and evaluate the predictors of care modality preferences among individuals enrolled in a technology-enabled stepped mental health care platform. Methods This exploratory, cross-sectional study used employee data from the 2021 Modern Health database, an employer-sponsored mental health benefit that uses a technology-enabled platform to optimize digital mental health care delivery. Chi-square tests and one-way analysis of variance (ANOVA) were conducted to evaluate associations among the categorical and continuous factors of interest and the preferred care modality. Bivariate logistic regression models were constructed to estimate the odds ratios (ORs) of preferring a one-on-one versus self-guided group, or no preference for digital mental health care modalities. Results Data were analyzed for 3661 employees. The most common modality preference was one-on-one care (1613/3661, 44.06%). Approximately one-fourth of the digital mental health care seekers (881/3661, 24.06%) expressed a preference for pursuing self-guided care, and others (294/3661, 8.03%) expressed a preference for group care. The ORs indicated that individuals aged 45 years and above were significantly more likely to express a preference for self-guided care compared to individuals aged between 18 and 24 years (OR 2.47, 95% CI 1.70-3.59; P<.001). Individuals screening positive for anxiety (OR 0.73, 95% CI 0.62-0.86; P<.001) or depression (OR 0.79, 95% CI 0.66-0.95; P=.02) were more likely to prefer one-on-one care. Conclusions Our findings elucidated that care modality preferences vary and are related to clinical severity factors and demographic variables among individuals seeking digital mental health care.
18
Shepherd, Martha E., Ashlee Lecorps, Jon Harris-Shapiro, and Lesley-Ann Miller-Wilson. "Evaluating Outreach Methods for Multi-Target Stool DNA Test for Colorectal Cancer Screening Among an Employer Population." Journal of Primary Care & Community Health 12 (January 2021): 215013272110378. http://dx.doi.org/10.1177/21501327211037892.
Full textAbstract:
Introduction/Objectives: Despite compelling evidence of clinical and economic benefits, adherence to colorectal cancer (CRC) screening remains low. Increasing public awareness through various outreach methods may improve screening uptake. The objective of this study was to evaluate the uptake of non-invasive multi-target stool DNA (mt-sDNA) by different outreach methods in an average-risk employer population. Methods: This retrospective observational study included CRC screening-eligible individuals aged ≥50 years insured by the Metropolitan Nashville Public Schools (MNPS) employee healthcare plan. The study intervention arms included population-based outreach and office visit-based interaction. The mt-sDNA completion rate (proportion of individuals who return the mt-sDNA kit after consenting to have it shipped to their home), proportion of patients who performed follow-up colonoscopy after a positive test, and time to follow-up colonoscopy were assessed. Results: A total of 167 mt-sDNA kits were shipped to eligible participants (aged 50-64 years) in the population-based outreach arm. In the office visit-based interaction arm, a total of 132 mt-sDNA kits were shipped to eligible participants (aged ≥50 years). The mt-sDNA completion rate was significantly higher for office visit-based interaction as compared to population-based outreach (76.8% vs 53.5%; P < .001) among those aged 50 to 64 years. While all patients aged 50 to 64 years with a positive mt-sDNA result received a follow-up colonoscopy in both arms, the median time to follow-up colonoscopy was shorter among the population-based outreach (55 vs 136 days; P < .05). Conclusions: Office visit-based interaction was associated with a higher mt-sDNA completion rate as compared to the population-based outreach among average-risk, CRC screening-eligible individuals aged 50 to 64 years old.
19
Zhang, Liangwen, Sijia Fu, and Ya Fang. "Prediction the Contribution Rate of Long-Term Care Insurance for the Aged in China Based on the Balance of Supply and Demand." Sustainability 12, no. 8 (April 14, 2020): 3144. http://dx.doi.org/10.3390/su12083144.
Full textAbstract:
There are a large number of disabled elderly people in China, which results in huge care and financial burdens to their families and society. However, China has not yet launched a unified long-term care insurance (LTCI) system. This study aims to predict the contribution rate of LTCI in China from 2020 to 2050 based on the long-term care (LTC) cost of the disabled elderly, aged 65 and over, in order to provide strong evidence for the establishment of a unified and sustainable national LTCI system in China. The simulations are based on data from the population census data, the Chinese statistical yearbook, and the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database. Based on the International Labor Organization (ILO) financing model from the perspective of fund balance, an overall simulation model and a Monte Carlo simulation are used to estimate the contribution rate of LTCI for disabled elderly from 2020 to 2050 in China. The total financial demands will increase sharply from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050. Of that total, 80.2% will be required in urban areas. In addition, the per capita financial demands of care in urban and rural areas in 2050 will be approximately six times and 11 times higher than in 2020, respectively. The predicted results show that the overall contribution rate of LTCI in China will increase sharply from 1.46% in 2020 to 5.14% in 2050, an increase of about 3.5 times. By comparison, the contribution rate in 2020 will be close to 1.33% in Japan in 2015 and 1.40% in Germany in 2010. According to the 1:1 payment proportion between employer and employee, each side bears 0.68% of the insurance premium. From 2020 to 2050, the financial demands of long-term care for disabled elderly in China will increase, especially in urban areas, and the burden of per capita financial demands in rural areas will increase significantly. The overall contribution rate of LTCI will increase linearly and the payment burden of policyholders will increase year by year. This study provides evidence of the need for the establishment of a sustainable financing mechanism for multiple financial supplies.
20
Timo, Nils. "Future directions for workplace bargaining and aged care under a post 2005 Howard government." Australian Health Review 29, no. 3 (2005): 274. http://dx.doi.org/10.1071/ah050274.
Full textAbstract:
ON THE 1ST OF JULY 2005, the Howard Government took control of both the House of Representatives and the Senate and substantial reform of the nation?s industrial relations framework is likely to proceed. In order to understand the implications of the proposed industrial relations (IR) reform agenda on aged care, it is necessary to briefly revisit the past. Historically, the ability of the Commonwealth Parliament to regulate industrial relations was construed in the context of Section 51 (xxxv) of the Australian Constitution Act 1900 (Cwlth) that enabled the Commonwealth to make laws concerning ?conciliation and arbitration and the prevention and settlement of industrial disputes extending beyond the limits of any one state?. Since 1904, the Commonwealth, with the states following shortly thereafter, established a regime of industrial tribunals responsible for third party independent conciliation and arbitration, overseeing a system of legally binding industrial awards covering wages and employment conditions. This system, in the words of one of its chief architects, Justice Higgins, ? . . . would substitute for the rude and barbarous processes of strike and lock-out?1 (page 2). By 1991, Australian wages policy gradually shifted from centralised arbitration, elevating workplace agreements to the status of government policy on both sides of politics.2 This process accelerated labour market deregulation, shifting industrial relations and human resource issues to the enterprise level.3 The shift towards workplace agreements post 1990?s was underpinned by a bold reinterpretation of Section 51 (xx) of the Constitution Act that enabled the Commonwealth to regulate the affairs of ?trading or financial corporations formed within the limits of the Commonwealth?, thus, by definition, including regulating employee relations of corporations. The use by the Commonwealth of these powers has extended the jurisdiction of the Australian Industrial Relations Commission (AIRC) to include the making and approving of certified agreements made by constitutional corporations or in settlement of an industrial dispute. Other types of employers such as sole traders, churches and charities, partnerships and unincorporated associations remained covered by state industrial jurisdictions. (On these powers of the Commonwealth, see State of
21
Lagacé, Martine, Francine Tougas, Joelle Laplante, and Jean-François Neveu. "La santé en péril: répercussions de la communication âgiste sur le désengagement psychologique et l'estime de soi des infirmiers de 45 ans et plus." Canadian Journal on Aging / La Revue canadienne du vieillissement 27, no. 3 (2008): 285–99. http://dx.doi.org/10.3138/cja.27.3.241.
Full textAbstract:
ABSTRACTThese two studies are designed to evaluate the reactions of male nurses aged 45 years and older toward ageism. The goal of the first study is to test the prestigious work domain model of psychological disengagement resulting from a previous study conducted among female nurses. This model has been confirmed through path analyses conducted on a sample of 236 male nurse technicians; by the same token, it has been shown to apply in the case of lower-status employees working in a prestigious field. In particular, the more a male nurse aged 45 and older experiences relative personal deprivation, the more he discredits feedback from his co-workers and superiors; such discrediting, in turn, leads to devaluation of the domain of work, which in turn lowers self-esteem. The goal of the second study is three-fold, namely: (a) testing the disengagement model among 419 male nurse clinicians; (b) extending this model through the addition of ageist communication as a variable triggering personal relative deprivation; and (c) constructing a scale of ageist communication. Path analyses have again confirmed that the way a domain is appreciated influences the negative impact that devaluation can produce on self-esteem, regardless of the gender or status of the employee working in that field. In addition, these results demonstrate the central role played by communication in the workplace as a vehicle of ageism and as a precursor of ageing employees' discomfort. The discussion covers the implications of ageing employees' reactions toward ageism as well as the consequences of depreciatory language and exclusionary communication practices in the workplace.
22
Chambers, Georgina M., Christopher Harrison, James Raymer, Ann Kristin Petersen Raymer, Helena Britt, Michael Chapman, William Ledger, and Robert J. Norman. "Infertility management in women and men attending primary care—patient characteristics, management actions and referrals." Human Reproduction 34, no. 11 (November 1, 2019): 2173–83. http://dx.doi.org/10.1093/humrep/dez172.
Full textAbstract:
Abstract STUDY QUESTION How did general practitioners (GPs) (family physicians) manage infertility in females and males in primary care between 2000 and 2016? SUMMARY ANSWER The number of GP infertility consultations for females increased 1.6 folds during the study period, with 42.9% of consultations resulting in a referral to a fertility clinic or specialist, compared to a 3-fold increase in the number of consultations for men, with 21.5% of consultations resulting in a referral. WHAT IS KNOWN ALREADY Infertility affects one in six couples and is expected to increase with the trend to later childbearing and reports of declining sperm counts. Despite GPs often being the first contact for infertile people, very limited information is available on the management of infertility in primary care. STUDY DESIGN, SIZE, DURATION Data from the Bettering the Evaluation and Care of Health programme were used, which is a national study of Australian primary care (general practice) clinical activity based on 1000 ever-changing, randomly selected GPs involved in 100 000 GP–patient consultations per year between 2000 and 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS Females and males aged 18–49 years attending GPs for the management of infertility were included in the study. Details recorded by GPs included patient characteristics, problems managed and management actions (including counselling/education, imaging, pathology, medications and referrals to specialists and fertility clinics). Analyses included trends in the rates of infertility consultations by sex of patient, descriptive and univariate analyses of patient characteristics and management actions and multivariate logistic regression to determine which patient and GP characteristics were independently associated with increased rates of infertility management and referrals. MAIN RESULTS AND THE ROLE OF CHANCE The rate of infertility consultations per capita increased 1.6 folds for women (17.7–28.3 per 1000 women aged 18–49 years) and 3 folds for men over the time period (3.4–10.2 per 1000 men aged 18–49 years). Referral to a fertility clinic or relevant specialist occurred in 42.9% of female infertility consultations and 21.5% of male infertility consultations. After controlling for age and other patient characteristics, being aged in their 30s, not having income assistance, attending primary care in later years of the study and coming from a non-English-speaking background, were associated with an increased likelihood of infertility being managed in primary care. In female patients, holding a Commonwealth concession card (indicating low income), living in a remote area and having a female GP all indicated a lower adjusted odds of referral to a fertility clinic or specialist. LIMITATIONS, REASONS FOR CAUTION Data are lacking for the period of infertility and infertility diagnosis, which would provide a more complete picture of the epidemiology of treatment-seeking behaviour for infertility. Australia’s universal insurance scheme provides residents with access to a GP, and therefore these findings may not be generalizable to other settings. WIDER IMPLICATIONS OF THE FINDINGS This study informs public policy on how infertility is managed in primary care in different patient groups. Whether the management actions taken and rates of secondary referral to a fertility clinic or specialist are appropriate warrants further investigation. The development of clinical practice guidelines for the management of infertility would provide a standardized approach to advice, investigations, treatment and referral pathways in primary care. STUDY FUNDING/COMPETING INTEREST(S) This paper is part of a study being funded by an Australian National Health and Medical Research Council project grant APP1104543. G.C. reports that she is an employee of The University of New South Wales (UNSW) and Director of the National Perinatal Epidemiology and Statistics Unit (NPESU), UNSW. The NPESU manages the Australian and New Zealand Assisted Reproductive Technology Database on behalf of the Fertility Society of Australia. W.L. reports being a part-time paid employee and minor shareholder of Virtus Health, a fertility company. R.N. reports being a small unitholder in a fertility company, receiving grants for research from Merck and Ferring and speaker travel grants from Merck. TRIAL REGISTRATION NUMBER NA
23
Samnaliev, M., V. Barut, S. Weir, J. Langham, S. Langham, X. Wang, B. Desta, and E. R. Hammond. "THU0550 HEALTH CARE UTILIZATION AND COSTS IN ADULTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS IN THE UNITED KINGDOM: A REAL-WORLD OBSERVATIONAL RETROSPECTIVE COHORT STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 515–16. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3765.
Full textAbstract:
Background:There is limited real-world evidence demonstrating the long-term direct costs associated with systemic lupus erythematosus (SLE) in the United Kingdom (UK).Objectives:To describe health care resource utilization and costs in adults with SLE in the UK over time and document costs by disease severity and type of encounter, including primary care, hospitalizations, outpatient visits, and prescription drugs.Methods:Patients aged ≥18 years with SLE were identified in the linked Clinical Practice Research Datalink – Hospital Episode Statistics database from January 1, 2005, to December 31, 2017. Patients were required to have data from ≥12 months before and after the index date, defined as the date of earliest diagnosis available in the data set. Patients were classified as having mild, moderate, or severe disease using an adapted claims-based algorithm.1Costs were calculated in 2017 UK pounds from the UK national health care system perspective. We estimated all-cause health care costs and incremental costs associated with each year of follow-up compared with a baseline year (3 years before index) using each patient as his or her own control and adjusting for age, sex, disease severity, and comorbid conditions.Results:Of the 802 patients identified, 369 (46.0%) had mild SLE, 345 (43.0%) had moderate SLE, and 88 (11.0%) had severe SLE. The mean all-cause cost increased in the 3 years before diagnosis and, in the first year after diagnosis, amounted to £7532 (standard deviation [SD] £9634). This cost varied by disease severity: mild SLE, £5221 (£8064); moderate SLE, £8323 (£9846); and severe SLE, £14,125 (£11,267) (Figure 1). Adjusted total mean annual increase in costs per patient in the overall study population was £4476 (95% confidence interval £3809–5143) greater in the year of diagnosis compared with the baseline year (P<0.0001), adjusted for age, sex, disease severity, and comorbid conditions. Primary care utilization was the leading component of costs during the first year after diagnosis, followed by prescriptions, outpatient care, and inpatient care (Figure 2). Information on biologic use in hospitals is unavailable in these data.Conclusion:The direct costs of health care for patients with SLE in the UK are substantial and persist over the years after diagnosis. Patients with moderate or severe SLE have higher all-cause costs over time compared with patients with mild SLE. Earlier diagnosis and treatment may reduce disease severity and occurrence of comorbidities, and the associated high health care costs.References:[1]Garris C, et al.J Med Econ. 2013;16:667–677.[2]Department of Health. NHS reference costs 2017/18.https://improvement.nhs.uk/resources/reference-costs/#rc1718;2018 [accessed May 11, 2019].Disclosure of Interests:Mihail Samnaliev Consultant of: AstraZeneca, Volkan Barut Employee of: AstraZeneca, Sharada Weir Consultant of: AstraZeneca, Julia Langham Consultant of: AstraZeneca, Sue Langham Consultant of: AstraZeneca, Xia Wang Employee of: AstraZeneca, Barnabas Desta Employee of: AstraZeneca, Edward R. Hammond Employee of: AstraZeneca
24
Sada, K. E., Y. Kojo, J. Fairburn-Beech, K. Sato, E. Hayashi, S. Akiyama, and M. Van-Dyke. "FRI0218 PREVALENCE, BURDEN OF DISEASE AND HEALTHCARE UTILIZATION AMONG PATIENTS WITH EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS (EGPA) IN JAPAN 2005-2017." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 692.1–693. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1658.
Full textAbstract:
Background:EGPA is a rare vasculitis condition with very limited data available from real-world settings on burden and health care utilization (HCU), particularly in Japan.Objectives:To estimate the prevalence (overall and age, gender stratified) and describe HCU and treatment patterns among Japanese EGPA patients.Methods:This was a retrospective descriptive cohort study using a large administrative claims database covering up to more than 5 million corporate employees and their dependents (JMDC claim database) in Japan. Annual prevalence from 2005-2017 was estimated using two EGPA case definitions: a) patients with ≥1 ICD-10 code (2003 version) for EGPA (M30.1), b) patients with ≥2 ICD-10 codes for EGPA (M30.1) during the year in which prevalence was calculated. Among newly identified EGPA patients with no EGPA code in at least 12 months before, clinical burden, comorbidities, after hour visiting (AHV), all cause hospitalization, and treatment with drugs, including oral corticosteroid (OCS) use was described. OCS dose was expressed as prednisone equivalent.Results:The total number of newly identified patients in 2006-2016 was 45 persons and the mean (SD) age was 42.3 years (SD 14.7 years). The prevalence (per 1,000,000 patients) of EGPA with case definition a) in Japan in 2017 was estimated to be 38.0. The stratified prevalence (per 1,000,000) by age was: 2.3 in the group aged <18 years, 34.0 in those aged 18-50 years, and 91.1 in those aged ≥50 years, respectively. The prevalence in females (50.0) was approximately 1.7-fold higher than that in male (28.7). The prevalence, including stratified results, with definition b) was similar to that with definition a). In the newly identified patients, 60% of patients had at least one hospitalization and 55.6% had AHV, in the year after the first observed EGPA code during the study period. Following index date, new patients were treated: 77.8% with OCS, 11.1% with Azathioprine, 8.9% with intravenous immunoglobulin, 6.7% with Cyclophosphamide, 4.4% with Methotrexate, and 2.2% with Rituximab (non mutually exclusive). The mean (SD) maximum recorded daily dose of OCS in the 12 months follow up period was 53.5 (39.9) mg in new patients. The average dose (SD) of OCS in first month and last month in new patients was 39.1 (29.0) and 9.8 mg (4.8), respectively. Among those with at least a 14-day supply of OCS, 73.1% could be classified as adherent (≥80%) based on their 1-year proportion of days covered. 6.7% of EGPA patients experienced a potentially worsening with an increase of ≥10 mg daily OCS dose prescription following a previous prescription of <10mg.Conclusion:Analysis of the burden of disease and the use of medical resources in newly identified EGPA patients revealed that EGPA patients require hospitalizations and AHV, in addition to exposure to high doses of OCS. The appropriate medication for the treatment of EGPA to reduce burden on patients may need consider the pathophysiological state of EGPA patients.Disclosure of Interests:KEN-EI SADA Speakers bureau: I received speaker’s fee from GSK and Astra Zeneca K.K., Yoshiki Kojo Shareholder of: GSK, Employee of: GSK, Jolyon Fairburn-Beech Shareholder of: GSK, Employee of: GSK, Keiko Sato Shareholder of: GSK, Employee of: GSK, Etsuko Hayashi Shareholder of: GSK, Employee of: GSK, Shoko Akiyama Shareholder of: GSK, Employee of: GSK, melissa van-dyke Shareholder of: GSK, Employee of: GSK
25
Thompson, Jeffrey, Alen Marijam, Fanny S. Mitrani-Gold, Jonathon Wright, and Ashish V. Joshi. "1227. A Survey Study of Healthcare Resource Use, and Direct and Indirect Costs, Among Females with an Uncomplicated Urinary Tract Infection in the United States." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S702—S703. http://dx.doi.org/10.1093/ofid/ofab466.1419.
Full textAbstract:
Abstract Background Uncomplicated urinary tract infections (uUTI) account for a large proportion of primary care antibiotic (AB) prescriptions. This study assessed uUTI-related healthcare resource use (HRU) and costs in US females with a self-reported uUTI. Methods We surveyed US females aged ≥ 18 years who participated in web-based surveys (fielded August 28–September 28, 2020 by Dynata, EMI, Lucid/Federated, and Kantar Profiles). Participants had a self-reported uUTI ≤ 60 days prior, and took ≥ 1 oral AB for their uUTI. Those reporting signs of complicated UTI were excluded. HRU was measured via self-reported primary care provider (PCP), specialist, urgent care, emergency room (ER) visits, and hospitalizations. Direct costs were calculated as sum of self-reported and HRU monetized with Medical Expenditure Panel Survey estimates. Indirect costs were calculated via Work Productivity and Impairment metrics monetized with Bureau of Labor Statistics estimates. Participants were stratified by number of oral ABs prescribed (1/2/3+) and therapy appropriateness (1 AB [1st line/2nd line]/multiple [any line] AB) for most recent uUTI. Multivariable regression modeling was used to compare strata; 1:1 propensity score matching assessed uUTI burden vs matched population (derived from the 2020 National Health and Wellness Survey [NHWS]). Results In total, 375 participants were eligible for this analysis. PCP visits (68.8%) were the most common HRU. Across participants, there were an average of 1.46 PCP, 0.31 obstetrician/gynecologist, 0.41 urgent care and 0.08 ER visits, and 0.01 hospitalizations for most recent uUTI (Table 1). Total mean uUTI-related direct and indirect costs were &1289 and &515, respectively (Table 1). Adjusted mean total direct costs were significantly higher (Table 2) for participants in the ‘2 AB’ cohort vs the ‘1 AB’ cohort (&2090 vs &776, p < 0.0001), and for the ‘multiple AB’ vs ‘1 AB, 1st line’ cohorts (&1642 vs &875, p=0.002). Participants in the uUTI cohort reported worse absenteeism (+15.3%), presenteeism (+46.5%), overall work impairment (+52.4%), and impact on daily activities (+50.7%) vs NHWS cohort (p < 0.0001, Table 3). Table 1. Overall mean uUTI-related healthcare resource use, direct, and indirect cost data Table 2. Estimated uUTI-related direct costs stratified by (A) number of AB and (B) appropriateness of AB therapy used to treat last uUTI Table 3. Mean Work Productivity and Activity Impairment data for uUTI and NHWS cohorts Conclusion Inadequate treatment response, evident by multiple AB use, was associated with an increase in uUTI-related costs, including productivity loss. Disclosures Jeffrey Thompson, PhD, Kantar Health (Employee, Employee of Kantar Health, which received funding from GlaxoSmithKline plc. to conduct this study) Alen Marijam, MSc, GlaxoSmithKline plc. (Employee, Shareholder) Fanny S. Mitrani-Gold, MPH, GlaxoSmithKline plc. (Employee, Shareholder) Jonathon Wright, BSc, Kantar Health (Employee, Employee of Kantar Health, which received funding from GlaxoSmithKline plc. to conduct this study) Ashish V. Joshi, PhD, GlaxoSmithKline plc. (Employee, Shareholder)
26
ZAVGORODNIY, Alexander Vasilyevich, Ilya Alexandrovich VASILYEV, Nelli Ivanovna DIVEEVA, Marina Valentinovna FILIPPOVA, and Mikhail Mikhailovich KHARITONOV. "Russian Court Interpretation of Legislative Measuresfor Advanced Training and (or) Professional Training of the Selected Employed Population Aged from 25 to 65 Years." Journal of Advanced Research in Law and Economics 9, no. 1 (September 27, 2018): 342. http://dx.doi.org/10.14505//jarle.v9.1(31).40.
Full textAbstract:
In this article, we present the first generalization and analysis of decisions made by Russian courts of general jurisdiction from 2009 to 2016 for the application of provisions of the Labor Code of the Russian Federation, the Federal Law of November 21, 2011 No. 323-FZ ʼOn the fundamentals of protecting the health of citizens in the Russian Federationʼ, the Federal Law of July 3, 2016 No. 238-FZ ʼOn independent qualification assessmentʼ, the Federal Law of December 29, 2013 No. 273-FZ ʼOn education in the Russian Federationʼ, the Decree of the Government of the Russian Federation of October 28, 2013 No. 966 ʼOn licensing educational activitiesʼ adopted to fulfill the Decree of the President of the Russian Federation of May 7, 2012 No. 599 ʼAbout measures to implement the state policy in the sphere of education and scienceʼ in the field of advanced training and (or) professional training of employed population aged from 25 to 65 years. As a result, we have made several conclusions. Firstly, if periodical advanced training is a mandatory condition for admission to work (for example, for medical workers), then courts using separate methods of protecting rights of citizens (in particular, health care), should understand the consequences of these decisions. Secondly, the imposition of administrative sanctions in accordance with Part 3 of Article 19.20 of the Code of Administrative Offences due to the non-systematic increase in the professional level of educators recommends improving the algorithm for substantiating the gross violation of license requirements. Thirdly, the legal status of a person who has concluded an agreement on advanced training differs from that of an apprenticeship contract, and the guarantees for this person are not established by Articles 203-205 but rather Article 187 of the Labor Code of the Russian Federation. Therefore, courts should not qualify a contract on advanced training as an apprenticeship contract. Fourthly, if advanced training is not designated for employees as additional qualification and an employer does not have the duty to pay for this training, then the resolution of a possible dispute should be based on whether the employer's interest is realized or not. Fifthly, the impossibility of an employee to work should be objective and compulsory, which is assessed by the law enforcer based on the balance of rights and interests of both parties of the corresponding employment contract. Sixthly, the legal regulation of the independent assessment of working qualification requires its improvement and alignment with norms of the labor legislation of the Russian Federation.
27
Fergie, Jaime, Tara Gonzales, Mina Suh, Xiaohui Jiang, Jon Fryzek, Ashley Howard, and Adam Bloomfield. "1520. Respiratory Syncytial Virus Hospitalizations (RSVH) and All-Cause Bronchiolitis Hospitalizations (BH) Among Children Aged ≤ 24 Months at the Start of RSV Season With Bronchopulmonary Dysplasia/Chronic Lung Disease of Prematurity (BPD/CLDP) Before and After the 2014 American Academy of Pediatrics (AAP) Policy." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S762. http://dx.doi.org/10.1093/ofid/ofaa439.1701.
Full textAbstract:
Abstract Background The AAP, in 2014, stopped endorsing palivizumab for use in children with BPD/CLDP born at < 32 weeks’ gestational age (wGA) between the ages of 12 to 24 months not requiring medical support during the 6 months before the start of RSV season and all children with BPD/CLDP born at > 32 wGA. We sought to understand the impact of the guidance change on RSVH and BH in children no longer advised for RSV immunoprophylaxis with palivizumab. Methods Children with BPD/CLDP aged ≤ 24 months at the RSV season start and hospitalized for RSV or bronchiolitis during the 2010-2017 RSV seasons (November-March) were studied. RSVH, BH, and BPD/CLDP were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and ICD-10-CM codes. ICD-9 codes for wGA combine 31 and 32 wGA into one code. Therefore, for BPD/CLDP, we classified group 1 as children aged 12 to 24 months who were born at < 31 wGA and group 2 as those born at ≥ 31 wGA. The Children’s Hospital Association’s Pediatric Health Information System® (PHIS) data set was used to describe frequency and characteristics of RSVH and BH and disease severity (including intensive care unit [ICU] admission and mechanical ventilation [MV]) before and after the 2014 AAP policy. Statistical analyses were done using z-tests; SAS version 9.4. Results Among children with BPD/CLDP, RSVH rates were 1.7% (1035/59,217) before 2014 and 2.1% (973/45,470) after 2014 (P< 0.0001). RSVH rose after the policy change vs before among children with BPD/CLDP in both group 1 (0.40% vs 0.26%; P< 0.0001) and group 2 (0.22% vs 0.14%; P=0.002). Similarly, BH also increased for both group 1 (P< 0.0001) and group 2 (P=0.002) after the guidance change vs before. Although ICU admissions increased significantly for children with BPD/CLDP in both group 1 (P< 0.0001) and group 2 (P=0.0004), use of MV (P=0.002) increased after 2014 for children with BPD/CLDP in group 1 only. Similar results were observed for BH. Conclusion This analysis highlights the increase in RSVH, BH, and associated severity among BPD/CLDP subgroups within the PHIS health system after 2014. Further study of long-term complications associated with RSVH in these children is warranted. Disclosures Jaime Fergie, MD, AstraZeneca (Speaker’s Bureau)Sobi, Inc. (Speaker’s Bureau) Tara Gonzales, MD, Sobi, Inc. (Employee) Mina Suh, MPH, International Health, EpidStrategies (Employee) Xiaohui Jiang, MS, EpidStrategies (Employee) Jon Fryzek, PhD, MPH, EpidStrategies (Employee) Adam Bloomfield, MD, FAAP, Sobi, Inc. (Employee)
28
Patterson, Brandon J., Philip O. Buck, Justin Carrico, Katherine A. Hicks, Desmond Curran, Desiree Van Oorschot, John E. Pawlowski, Bruce Y. Lee, and Barbara P. Yawn. "Assessment of the Potential Herpes Zoster and Post Herpetic Neuralgia Case Avoidance with Vaccination in the United States." Open Forum Infectious Diseases 4, suppl_1 (2017): S413. http://dx.doi.org/10.1093/ofid/ofx163.1034.
Full textAbstract:
Abstract Background Herpes zoster (HZ), commonly referred to as shingles, is a reactivation of latent varicella zoster virus in patients previously infected. Clinical characteristics of HZ include painful rash with potential complications, including post herpetic neuralgia (PHN). Care for HZ and PHN incurs significant costs and vaccination is beneficial. The aim of this study was to compare the impact on HZ and PHN case avoidance of two HZ vaccines, an available live-attenuated zoster vaccine (zoster vaccine live [ZVL]) vs. a candidate non-live adjuvanted HZ subunit vaccine (HZ/su), in the US population. Methods A Markov model called ZONA (ZOster ecoNomic Analyses) was developed following two age cohorts (≥60 years to represent the current ACIP recommendation and ≥65 years to represent the Medicare population) over their lifetimes from the year of vaccination. Demographic data were obtained from the US Census, whereas HZ incidence and the proportion of HZ individuals developing PHN were derived from published US-specific sources. Age-specific vaccine efficacy and waning rates were based on published clinical trial data. Vaccine coverage for both vaccines was assumed to be 30.6% and 34.2% in the two age cohorts, respectively, based on CDC data; compliance of the second dose of the HZ/su vaccine was 69%, based on data from clinical trials and Hepatitis B seconddose completion. Sensitivity analyses demonstrated robustness of the base analysis findings. Results In the US, for cohorts of 66.83 million (M) persons aged 60+ and 47.76M aged 65+ it was estimated that the HZ/su vaccine would reduce the number of HZ cases by 2.12M and 1.55M in the two age cohorts, respectively, compared with 0.65M and 0.45M using the ZVL. Furthermore, the HZ/su vaccine would reduce the number of PHN cases by 0.23M and 0.18M in the two age cohorts, respectively, compared with 0.10M and 0.09 using the ZVL. The number needed to vaccinate to prevent one HZ case were 10 and 11, in the respective cohorts, using the HZ/su vaccine compared with 31 and 37, in the respective cohorts, using the ZVL. Conclusion Due to higher and sustained vaccine efficacy, the candidate HZ/su vaccine demonstrated superior public health impact in the US compared with the currently available ZVL. Disclosures B. J. Patterson, GSK: Employee and Shareholder, GSK stock options or restricted shares and Salary; Pennsylvania Pharmacists Association: Scientific Advisor, stipend; P. O. Buck, GSK: Employee and Shareholder, GSK stock options or restricted shares and Salary; J. Carrico, RTI Health Solutions: Employee, Salary GSK: Research Contractor, Research support; K. A. Hicks, RTI: Employee, Salary GSK: Research Contractor, Research support; D. Curran, GSK: Employee and Shareholder, GSK stock options or restricted shares and Salary; D. Van Oorschot, GSK: Employee, Salary; J. E. Pawlowski, GSK: Employee and Shareholder, GSK stock options or restricted shares and Salary; B. Y. Lee, GSK: Consultant, Consulting fee; B. P. Yawn, GSK: Consultant and Scientific Advisor, Consulting fee
29
Han, Chengming. "Oral Health Disparities Among Chinese Older Adults: Evidence From CHARLS." Innovation in Aging 4, Supplement_1 (December 1, 2020): 80. http://dx.doi.org/10.1093/geroni/igaa057.262.
Full textAbstract:
Abstract This paper explored the effect of the type of health insurance on dentist visits among older adults in China. The data were drawn from the CHARLS-II (2013). The sample included older adults aged 60 and older (N= 6767, n(urban)=3272, n(rural)=3495). Multivariate logistic regression models indicated that in urban and rural places, respondents with a governmental/civil servants’ insurance and those with an urban-employee insurance are more likely to visit a dentist in the survey year. Household registration status (hukou) does not play a significant role in dentist visits when insurance types are adjusted for. In other words, employment status, and the coverage of health insurance presented more significant effects on dentist visits. Differing from previous studies about urban-rural health disparities, this study disclosed substantial institutional influences on dental care access among older adults.
30
Scott, Frank A., Mark C. Berger, and John E. Garen. "Do Health Insurance and Pension Costs Reduce the Job Opportunities of Older Workers?" ILR Review 48, no. 4 (July 1995): 775–91. http://dx.doi.org/10.1177/001979399504800411.
Full textAbstract:
Using a 1991 nationwide survey of employers and 1979, 1983, 1988, and 1993 data from the Employee Benefits Supplement of the Current Population Survey, the authors examine the effects of fringe benefit provision on the decision to hire older workers. They find that higher health insurance costs, in the presence of prohibitions against age discrimination and discrimination in the provision of fringe benefits, adversely affected older workers' employment opportunities. In all five data sets over a fourteen-year period, the probability that a new hire was aged 55–64 was significantly lower in firms with health care plans than in those without, and was also significantly lower in firms with relatively costly plans than in those with less costly plans. On the other hand, neither the cost nor the presence of a defined contribution or defined benefit pension plan significantly affected that probability.
31
Md Abdullah, Syed Abul Hassan, Nushrat Tamanna, and Ishrat Jahan. "Employees’ Job Satisfaction in Tertiary Level Hospitals." Journal of Armed Forces Medical College, Bangladesh 11, no. 2 (January 16, 2019): 14–19. http://dx.doi.org/10.3329/jafmc.v11i2.39816.
Full textAbstract:
Introduction: In a resource-limited and high burden disease setting, satisfied human resource is an asset in terms of high productivity, efficiency and quality care.
Objective: To evaluate and analyze the employees’ job satisfaction at tertiary level hospitals and identify the important determinants for job satisfaction.
Materials and Methods: This descriptive study was done in two leading specialized private owned hospitals of Bangladesh during January 2011 to April 2011. A group of 200 employees were selected from both clinical (60%) and non-clinical (40%) staffs through systematic sampling method. Self-administered structured questionnaire was used keeping focus on organizational supportive activities, management employee relationship, gender discrimination and overall job satisfaction.
Results: Male and female participants were nearly equal, 75% female respondent was satisfied/highly satisfied on their job which was higher than male (55%)(P<0.005). Married participants and employees aged 31-40 years showed higher level of job satisfaction (P<0.005). Forty Four percent respondent considered that salary was not at expected level and 47% opined that they could participate very often in decision making process. Two third respondents considered that they enjoyed freedom in their job and majority (55%) admitted that they received praise for good work. All the respondents opined that they did not have any experience of sexual harassment. Univariate analysis was done to see the association between job satisfaction and other variables. Authority valued respondent's contribution (P<0.005), satisfaction with salary and other benefits (P<0.005), superiors encourage employees about carrier development (p<0.005), make feeling about importance of job (P<0.005), receive praise for good work (P<0.05), superior looks after the personal welfare (P<0.05) and organization helps employee in their problem (P<0.005) were found significantly associated with Job satisfaction.
Conclusion: To provide optimum health service by a health centre, all the staffs at all level, should be valued as an asset of the organization and their salary, participation and welfare should be properly looked after.
Journal of Armed Forces Medical College Bangladesh Vol.11(2) 2015: 14-19
32
Carias, Cristina, Susanne Hartwig, M. Nabi Kanibir, and Ya-Ting Chen. "1381. Rotavirus Gastroenteritis among older adults: discussion based on a systematic literature review." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S700—S701. http://dx.doi.org/10.1093/ofid/ofaa439.1563.
Full textAbstract:
Abstract Background While the burden of Rotavirus Gastroenteritis (RGE) is well recognized in young children, it is less so in older adults. However, older adults are also at high-risk of Acute Gastroenteritis (AGE) severe outcomes. In this review, we thus aimed to comprehensively assess RGE burden and vaccination impact in older individuals. Methods We performed a systematic literature review with PubMed and Scopus, from 2000 to 2019, using MESH and free-range terms. We included only studies that reported the incidence, and/or RV vaccination impact, in adults aged 60 and above and using regional specific data-sources. Results We analyzed 11 manuscripts for individuals aged 60 and above (Figure 1). Studies spanned Australia, Sweden, Netherlands, Canada (2), Germany (2), UK (2), and the US (2). Yearly inpatient RV incidence varied between 1.6 per 100,000 in Australia for those 65+ (retrospective database analyses, pre-vaccine); and 26 per 100,000 for those 85+ in Canada (modeling estimates for 2006-10, pre-vaccine). The incidence rate ratio for inpatient RGE between the post and pre-vaccine periods for those 65+ was 0.57 [95% CI: 0.10 – 3.15] in Canada, but 2.24 [95%CI: 1.78-2.83] in Australia, which may be due to increased testing for RV in the elderly post-vaccine. Reductions in the post-vaccination burden of RV and AGE among 60+ were reported in the UK (2 studies), and the US (2 studies) via retrospective database analyses In the UK, post-vaccine reductions in AGE health care-utilization were reported in the Emergency Department (21%), and outpatient centers (walk-in centers: 47%; general practice consultations: 36%). Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Conclusion While the burden of RGE mainly falls on young children, it also affects older adults. Retrospective database analyses reveal that, likely due to indirect vaccination benefits, increases in RV vaccination coverage have had an impact on lowering RGE, and AGE cases and healthcare utilization in older adults, a group at high-risk of severe outcomes for AGE. Disclosures Cristina Carias, PhD, Merck (Employee, Shareholder) Susanne Hartwig, n/a, MSD Vaccins (Employee) M.Nabi Kanibir, MD, Merck/MSD (Employee, Shareholder) Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder)
33
Chen, Sha, Zhiye Lin, Xiaoru Fan, Jushuang Li, Yao-Jie Xie, and Chun Hao. "The Comparison of Various Types of Health Insurance in the Healthcare Utilization, Costs and Catastrophic Health Expenditures among Middle-Aged and Older Chinese Adults." International Journal of Environmental Research and Public Health 19, no. 10 (May 13, 2022): 5956. http://dx.doi.org/10.3390/ijerph19105956.
Full textAbstract:
Rapid aging in China is increasing the number of older people who tend to require health services for their poor perceived health. Drawing on the China Health and Retirement Longitudinal Study (CHARLS) 2018 data, we used two-part model and binary logistic regression to compare various types of health insurance in the healthcare utilization, costs and catastrophic health expenditures (CHE) among the middle-aged and older adults in China. Compared with uninsured, all types of health insurance promoted hospital utilization rate (ranged from 8.6% to 12.2%) and reduced out-of-pocket (OOP) costs (ranged from 64.9% to 123.6%), but had no significant association with total costs. In contrast, the association of health insurance and outpatient care was less significant. When Urban Employee Medical Insurance (UEMI) as reference, other types of insurance did not show a significant difference. Health insurance could not reduce the risk of CHE. The equity in healthcare utilization improved and healthcare costs had been effectively controlled among the elderly, but health insurance did not protect against CHE risks. Policy efforts should further focus on optimizing healthcare resource allocation and inclining toward the lower socio-economic and poor-health groups.
34
La, Elizabeth M., Desmond Curran, Ahmed Salem, David Singer, Nicolas Lecrenier, and Sara Poston. "12. Modeled Impact of the COVID-19 Pandemic and Associated Reduced Adult Vaccinations on Herpes Zoster in the United States." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S130. http://dx.doi.org/10.1093/ofid/ofab466.214.
Full textAbstract:
Abstract Background During the COVID-19 pandemic, adult vaccination in the United States (US) decreased substantially in 2020. Unlike other vaccine-preventable diseases where individuals may have experienced reduced risk due to COVID-related mitigation efforts (e.g., lockdown restrictions, use of face masks), individuals remained at risk of herpes zoster (HZ). This study projects the impact of reduced recombinant zoster vaccine (RZV) use on HZ cases and complications in the US. Methods A multi-cohort Markov model estimated the impact of missed RZV vaccinations, by comparing scenarios with and without missed vaccinations between Apr-Dec 2020, on cases of HZ, postherpetic neuralgia (PHN), and quality-adjusted life-years (QALYs) among US adults aged ≥ 50 years. Epidemiology, RZV efficacy, and utility inputs were obtained from standard US sources, clinical trial data, and published literature. Missed doses were estimated using data on RZV doses and an assumed 43% reduction in RZV vaccinations during the pandemic, based on publicly available data. Deterministic sensitivity and scenario analyses were conducted. Results In 2020, approximately 21 million (M) RZV distributed doses were expected, including an estimated 9.2M RZV series initiations in Apr-Dec. An estimated 3.9M RZV series initiations were missed, resulting in 31,945 projected HZ cases, 2,714 PHN cases, and 610 lost QALYs projected over a 1-year follow up. If individuals with missed RZV initiations remain unvaccinated in 2021, avoidable HZ cases will increase to 63,117 over 2 years. Further, if the same number of RZV initiations are missed in 2021, 95,062 avoidable HZ cases are expected. In a sensitivity analysis assuming 30% RZV reduction, 18,020 avoidable HZ cases and 1,531 PHN cases were observed over 1 year. Conclusion Adding to the substantial COVID-19 infection-related morbidity and mortality, reduced RZV use during the pandemic resulted in further burden from avoidable HZ cases. Health care providers should continue to emphasize the importance of vaccination against HZ and other preventable diseases during the pandemic. Funding GlaxoSmithKline Biologicals SA (GSK study identifier: [VEO-000222]). Acknowledgement Business & Decision Life Sciences c/o GSK (Coordination: Quentin Rayée). Disclosures Elizabeth M. La, PhD, The GSK group of companies (Employee, Shareholder) Desmond Curran, PhD, The GSK group of companies (Employee, Shareholder) Ahmed Salem, MSc, The GSK group of companies (Employee) David Singer, PharmD, MS, The GSK group of companies (Employee) Nicolas Lecrenier, Ing, PhD, The GSK group of companies (Employee, Shareholder) Sara Poston, PharmD, The GSK group of companies (Employee, Shareholder)
35
Vojtek, Ivo, Vanessa Palsenbarg, and Joe Smyser. "65. Vaccine Confidence, COVID19, and the Influence of Peer Networks." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S164. http://dx.doi.org/10.1093/ofid/ofaa439.375.
Full textAbstract:
Abstract Background An increased appreciation for vaccines could be expected due to COVID-19. However, surveys show a polarization in opinions with about 20% of Americans preemptively rejecting any COVID-19 vaccine, partly due to inconsistent risk communication. While Health Care Professionals (HCPs) will be heavily relied upon to encourage uptake of a COVID-19 vaccine and 70% of Americans receive their vaccine information from HCPs, 84% also rely on peer networks. Understanding that HCPs have an important, but not exclusive, influence on health decision making can signal a new approach. This study provides data on where women, the main decision-makers regarding immunization in most families access information about vaccination. Methods Through an online survey conducted in UK, Brazil, Germany, Italy and Canada from 10 to 19-March 2020, we collected data on where, and from whom, women aged 25–54 years access information about vaccination. We set 1000 respondents/country quotas to reflect regional differences with data weighted as necessary. Results 5,036 women who met inclusion criteria responded: from the UK (1,003), Brazil (1,002), Germany (1,008), Italy (1,007), and Canada (1,016). Though most likely to receive vaccination info via their HCP: in Germany, women are least likely to be influenced by HCPs, with those aged 25–34 years more likely to turn to family members or online sources; in the UK, they are more likely to find info via a health authority’s website; and in Brazil, they are more likely to see info in traditional media and on Facebook. Only 50% ranked vaccine efficacy and disease risk in the Top 5 factors influencing their vaccine decisions, alongside the opinion of an HCP, recommendation of a Public Health Authority and impact of the disease. Conclusion HCPs, families and peers are important sources of info regarding vaccination. COVID-19 is unlikely to improve vaccine confidence as the issue becomes increasingly polarized and communications more inconsistent. We can respond by investing in health promotion and harmonized communications through peer networks. Since caregivers, their families and peers have increased weight in vaccination decisions, then they should have increased weight in preventive health strategies. Disclosures Ivo Vojtek, PharmD, PhD, MSc, FRSM, RPh, GSK Vaccines (Employee, Shareholder) Vanessa Palsenbarg, MA, GSK Vaccines (Employee, Shareholder) Joe Smyser, PhD, Public Good Project (Board Member, Employee)
36
Curran, Desmond, Ahmed Salem, Stéphane Lorenc, Brandon Patterson, Justin Carrico, Katherine A. Hicks, Elizabeth M. La, Sara Poston, and Christopher F. Carpenter. "20. Cost-Effectiveness of Recombinant Zoster Vaccine for Vaccinating Immunocompromised Adults Against Herpes Zoster in the United States." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S134. http://dx.doi.org/10.1093/ofid/ofab466.222.
Full textAbstract:
Abstract Background Individuals who are immunocompromised (IC) due to disease or therapy are at increased risk of herpes zoster (HZ), with HZ cases in IC populations also resulting in increased health care resource use and costs as compared with the immunocompetent population. This study assesses the cost-effectiveness of recombinant zoster vaccine (RZV) versus no vaccine for the prevention of HZ in IC adults aged ≥ 18 years in the United States (US). Methods A Markov model with a one-year cycle length was developed to follow a hypothetical cohort of one million IC individuals for a 30-year time horizon. The model estimates health and cost outcomes associated with RZV versus no vaccine. The base-case analysis considered hematopoietic stem cell transplant (HSCT) recipients who were assumed to remain IC for five years post-transplant. Second-dose compliance was assumed to be 100%, with efficacy and waning inputs based on clinical trial data. Epidemiological, cost, and utility inputs were obtained from standard US sources and published literature. Costs and quality-adjusted life-years (QALYs) were discounted at 3% per year. Sensitivity, threshold, and scenario analyses were conducted, including scenarios of four other IC conditions. Results In the modeled hypothetical cohort of one million HSCT recipients, RZV resulted in 116,790 fewer HZ cases and 21,446 fewer postherpetic neuralgia cases versus no vaccine, 5,545 fewer QALYs lost and a societal cost-savings of &5.4 million. The number needed to vaccinate to prevent one HZ case was estimated to be 9. HSCT population results were shown to be robust in sensitivity and threshold analyses. In scenario analyses, RZV was cost saving for renal transplant recipients. Incremental cost-effectiveness ratios for other IC populations were &33,268 per QALY gained for human immunodeficiency virus, &67,682 for breast cancer, and &95,972 for Hodgkin lymphoma. Conclusion Results suggest that RZV is a cost-effective option for vaccinating US IC adults for the prevention of HZ and associated complications. Disclosures Desmond Curran, PhD, The GSK group of companies (Employee, Shareholder) Ahmed Salem, MSc, The GSK group of companies (Employee) Stéphane Lorenc, NA, GSK group of companies (Consultant) Brandon Patterson, PharmD, PhD, GSK group of companies (Shareholder) Justin Carrico, BS, GSK group of companies (Consultant)RTI Health Solutions (Employee) Katherine A. Hicks, MS, BSPH, GSK group of companies (Consultant)RTI Health Solutions (Employee) Elizabeth M. La, PhD, The GSK group of companies (Employee, Shareholder) Sara Poston, PharmD, The GSK group of companies (Employee, Shareholder) Christopher F. Carpenter, MD, MHSA, GSK group of companies (Consultant)
37
Torres, Gretchen Williams, Juliet Yonek, Jeremy Pickreign, Heidi Whitmore, and Romana Hasnain-Wynia. "HIV Testing and Referral to Care in U.S. Hospitals Prior to 2006: Results from a National Survey." Public Health Reports 124, no. 3 (May 2009): 400–408. http://dx.doi.org/10.1177/003335490912400309.
Full textAbstract:
Objectives. We sought to provide a benchmark for human immunodeficiency virus (HIV) testing availability and practices in U.S. hospitals prior to the Centers for Disease Control and Prevention's (CDC's) 2006 revised recommendations. Methods. We conducted a survey of nonfederal general hospitals in the U.S. in 2004. Chi-square tests detected significant associations with hospital characteristics. Questionnaires were completed electronically via a secure Internet site or on paper. Nonresponse analysis was conducted and data were weighted to adjust for nonresponse. Results. HIV testing (on the basis of clinical symptoms or behavioral risk factors) was available in more than half of hospital inpatient units (62%), employee health departments (58%), and emergency departments (57%). Twenty-three percent offered routine screening (testing for people in a defined population regardless of clinical symptoms or behavioral risk), most commonly in labor and delivery. Teaching status, region, size, and type of metropolitan area were associated with the availability of HIV testing and routine screening ( p<0.01). Hospitals used a variety of methods to link patients to care: referral to a hospital-based clinic (36%); on-site, same-day evaluation (35%); and referral to an unaffiliated HIV or community clinic (42%). Conclusions. Hospitals offered HIV testing on the basis of clinical suspicion or risk, but were far from meeting CDC's current recommendation to routinely test all patients aged 13 to 64. Hospital size, teaching status, and geographic location were associated with HIV testing availability and testing practices. Our understanding of current practice identifies opportunities for public health action at the practitioner, organization, and systems levels.
38
Priest, Julie, Erin Hulbert, Bruce L. Gilliam, and Tanya Burton. "1019. Healthcare Resource Utilization and Cost of People Living with HIV (PLWH) in US Commercial and Medicare Advantage Health Plans." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S539. http://dx.doi.org/10.1093/ofid/ofaa439.1205.
Full textAbstract:
Abstract Background The goal of HIV treatment is to achieve and maintain virologic suppression to prevent disease progression. Patients with uncontrolled HIV and decreasing CD4 counts can experience more health problems and increased health care resource utilization (HCRU) and cost. The objectives were to describe the clinical characteristics, HCRU and cost of PLWH in US Commercial and Medicare Advantage health plans by CD4 count. Methods A retrospective cohort study of PLWH aged 18+ between 01/01/2014-03/31/2018 in the Optum Research Database was conducted. Patients were continuously enrolled 6 months before (baseline) and 12 months after (unless evidence of death) the first identified antiretroviral (ARV) therapy (follow-up). Patients were classified as heavily treatment-experienced (HTE) if their regimen indicated an ARV therapy used to treat multi-drug resistant (MDR) virus, Non-HTE if treatment did not include an HTE regimen, or Treatment-Naïve if they were not treated with any ARV medication during baseline. All variables were summarized descriptively by the CD4 count closest to the first ARV regimen and compared using chi-square or F-test/ANOVA. Results 5,522 patients met the inclusion criteria including 18% with a CD4 count < 200, 70% 200-500, and 12% > 500 cells/mm3. Patients in the lowest CD4 group were more likely to be HTE or Naïve, African-American, female, living in the South, earn less and have at least one AIDS defining condition (Table 1). Patients in the lowest CD4 group also had the highest mortality rate, (6% in the < 200, 2% 200-500, 1% in the > 500 group; p-value < 0.001) and the highest rates of emergency room visits and inpatient stays (Figure 1). All-cause total cost among patients with CD4 counts < 200 was 51% higher than those with CD4 > 500, and medical cost was 207% higher driven primarily by inpatient health care cost. Similar trends were seen for HIV-related care. Among the lowest CD4 group, average total cost was highest in the HTE group followed by Naïve patients. Table 1. Baseline Characteristics by CD4 count group, cells/mm3 Figure 1. Percentage of Patients with All-cause and HIV-related Healthcare Utilization by CD4 Group Conclusion There are still PLWH with CD4 counts < 200 cells/mm3 which can result in more AIDS defining conditions, higher mortality risk, and higher HCRU and cost. These results suggest interventions may be needed to diagnose and treat patients sooner and closely monitor the health of more advanced patients for worsening outcomes. Disclosures Julie Priest, MSPH, GlaxoSmithKline (Employee, Shareholder) Erin Hulbert, MS, Optum (Employee)ViiV (Grant/Research Support) Bruce L. Gilliam, MD, ViiV Healthcare (Employee)
39
Rao, Suchitra, Molly Lamb, Angela Moss, Emad Yanni, Rafik Bekkat-Berkani, Anne Schuind, Bruce Innis, Jillian Cotter, Rakesh Mistry, and Edwin J. Asturias. "986. Evaluation of Moderate-to-Severe Influenza Disease in Children 6 Months to 8 Years of Age in Colorado." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S291—S292. http://dx.doi.org/10.1093/ofid/ofy210.823.
Full textAbstract:
Abstract Background A clinical endpoint of moderate-to-severe (M/S) influenza has been proposed in children, defined as fever >39°C, otitis media, lower respiratory tract infection, or serious extrapulmonary manifestations. This definition has not been evaluated against clinically relevant outcomes like hospitalization, emergency room care, antimicrobial use, and child/parental absenteeism. Methods We conducted a prospective observational study of children aged 6 months–8 years with influenza at the Children’s Hospital Colorado Emergency Department (ED) and its affiliates during two influenza seasons (2016–2017 and 2017–2018). Children with influenza-like-illness (ILI) were enrolled and tested for influenza by polymerase chain reaction (PCR). Parents of influenza cases and matched influenza-negative controls were contacted 2 weeks later for follow-up. The primary outcome was hospitalization for M/S influenza vs. mild influenza. Secondary outcomes included recurrent ED visits, antimicrobial use, child/parental absenteeism. Interim analyses were conducted using SAS v9.4. Results Among the 1,480 enrolled children with ILI, 410 (28%) tested positive for influenza by PCR. The median age of influenza cases was 4.0 years (IQR 2.2–6.1), and 20% were considered high-risk for influenza complications. Of influenza cases, 284 (69%) met the definition for M/S influenza. Among M/S influenza subjects, 8.4% were hospitalized, compared with 1.6% with mild influenza (risk difference (RD) 6.9%; 95% CI: 3.0–10.8, P < 0.01). Subjects with M/S influenza were more likely to receive antibiotics (RD 12.0%, 95% CI: 3.4–20.6, P < 0.01) with a trend to higher antiviral use (RD 6.9%, 95% CI: −0.7–14.5, P = 0.09). There was no significant difference for recurrent ED visits nor child/parental absenteeism. After adjusting for comorbidities, age, and influenza strain, the relative risk (RR) of hospitalization or recurrent ED visits was higher among those with M/S influenza vs. mild influenza (RR 2.18, 95% CI: 1.02–4.64, P = 0.04). Conclusion Children with M/S influenza have a higher risk of hospitalization compared with mild disease. This proposed definition is a useful clinical endpoint to study the public health and clinical impact of influenza interventions in children. Disclosures S. Rao, GSK: Investigator, Research grant. E. Yanni, GSK: Employee, Salary. R. Bekkat-Berkani, GSK: Employee, Salary. A. Schuind, GSK: Employee, Salary. B. Innis, GSK: Employee, Salary. R. Mistry, GSK: Investigator, Research support. E. J. Asturias, GSK: Investigator, Research grant and Research support.
40
Krilov, Leonard R., Jaime Fergie, Mitchell Goldstein, Christopher Rizzo, Lance Brannman, Jeffrey McPheeters, Stephanie Korrer, Tanya Burton, and Lucie Sharpsten. "743. Severity and Costs of Respiratory Syncytial Virus and Bronchiolitis Hospitalization in Commercially Insured Preterm and Term Infants Before and After the 2014 American Academy of Pediatrics Guidance Change on Immunoprophylaxis." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S267. http://dx.doi.org/10.1093/ofid/ofy210.750.
Full textAbstract:
Abstract Background In 2014, the American Academy of Pediatrics (AAP) stopped recommending respiratory syncytial virus (RSV) immunoprophylaxis in infants 29–34 weeks gestational age (wGA) without chronic lung disease (CLD) or congenital heart disease (CHD). This study examined the impact of this guidance change on the severity and costs of first year of life RSV hospitalizations (RSVH) and all-cause bronchiolitis hospitalizations (BH) among preterm (PT) vs. term infants in the 2014–2016 seasonal years relative to the 2011–2014 seasonal years. Methods Infants aged <1 year between July 1, 2011 and June 31, 2016 were identified from commercial insurance claims in the Optum Research Database. Diagnosis codes identified births of term and 29–34 wGA infants without CLD, CHD, or other health problems, RSVH, and BH. Length of stay (LOS), admission to the intensive care unit (ICU), and use of mechanical ventilation (MV) captured RSVH and BH severity. Costs were adjusted to 2015 USD. Results A total of 362,382 births (29–34 wGA and term without major health problems) were identified, of which 13,666 (3.8%) were PT. RSVH and BH were more severe among PT infants in 2014–2016 vs. 2011–2014, with a greater mean LOS (RSVH: 6.8 vs. 4.7 days, P = 0.008; BH: 7.2 vs. 4.6, P = 0.021), a higher proportion of infants admitted to the ICU (RSVH: 42.4% vs. 25.3%, P = 0.014; BH: 39.1% vs. 23.7%, P = 0.009), and increased use of MV (RSVH: 14.1% vs. 6.1%, P = 0.067; BH: 14.8% vs. 5.3%, P = 0.013). Among term infants, LOS and ICU admissions were similar between 2014–2016 and 2011–2014 (P > 0.05), but there was an increased use of MV in the 2014–2016 season (RSVH: 6.9% vs. 4.2%, P = 0.009; BH: 6.3% vs. 3.7%, P = 0.003). Mean costs per hospitalization were greater for PT infants in 2014–2016 compared with 2011–2014 (RSVH: $29,382 vs. $16,572, P = 0.059; BH: $26,101 vs. $15,896, P = 0.047), whereas mean term hospitalization costs were similar (RSVH: $15,011 vs. $15,472, P = 0.705; BH: $14,555 vs. $14,603, P = 0.957). Conclusion RSVH and BH severity and per-hospitalization costs (higher among PT infants relative to term infants) increased following the 2014 AAP immunoprophylaxis guidance change. The increases are likely explained by more frequent RSV hospitalizations among higher-risk 29–34 wGA infants in 2014–2016. Funded by AstraZeneca Disclosures L. R. Krilov, AstraZeneca/MedImmune: Consultant, Research grant and Research support. J. Fergie, AstraZeneca/MedImmune: Consultant and Speaker’s Bureau, Research grant and Research support. M. Goldstein, AstraZeneca/MedImmune: Consultant, Research grant and Research support. C. Rizzo, AstraZeneca: Employee, Salary and Stocks. L. Brannman, AstraZeneca: Employee, Salary and Stocks. J. McPheeters, Optum: Employee, Salary. AstraZeneca: Research Contractor, Consulting fee. S. Korrer, Optum: Employee, Salary. AstraZeneca: Research Contractor, Consulting fee. T. Burton, Optum: Consultant and Employee, Salary. AstraZeneca: Research Contractor, Consulting fee. L. Sharpsten, Optum: Employee, Salary. AstraZeneca: Research Contractor, Consulting fee.
41
Qu, Xiaomin, Xiang Qi, and Bei Wu. "Disparities in Dental Service Utilization among Adults in Chinese Megacities: Do Health Insurance and City of Residence Matter?" International Journal of Environmental Research and Public Health 17, no. 18 (September 19, 2020): 6851. http://dx.doi.org/10.3390/ijerph17186851.
Full textAbstract:
The aims of the study were to present the prevalence of dental service utilization among adults (age between 18 and 65) in Chinese megacities and to examine the associations of health insurance and city of residence with dental visits. This study was a cross-sectional analysis of the 2019 New Era and Living Conditions in Megacities Survey data with a sample of 4835 participants aged 18–65 from 10 different megacities in China. The data including gross domestic product (GDP) per capita of each megacity obtained from the National Bureau of Statistics of China as a city-level characteristic. After adjusting sampling weights, approximately 24.28% of the participants had at least one dental visit per year. Findings from multilevel mixed-effects linear models showed that participants residing in megacities with higher GDP per capita (β = 0.07, p < 0.001) who had Urban Employee Basic Medical Insurance (β = 0.25, p < 0.001) or Urban Resident Basic Medical Insurance (β = 0.19, p < 0.01) had more frequent dental visits after adjusting demographic characteristics, socioeconomic status, health status, health behavior and attitude, and oral health indicators. Margins post-estimation model results demonstrated disparities in the predicted probability of having never visited a dentist by types of health insurance and city of residence. In conclusion, the prevalence of dental visits in China was found to be low. This study highlights socioeconomic inequalities in dental service utilization. There is a great need to develop more dental care programs and services and expand health insurance to cover dental care in China.
42
Rodwell, John. "Managing employees in aged care: live the principles." Public Money & Management 38, no. 6 (July 27, 2018): 463–70. http://dx.doi.org/10.1080/09540962.2018.1455970.
Full text
43
Kumar, Mithilesh, Shipra Saini, Lokesh Parashar, Rajesh Chetiwal, Tanisha Kalra, and Nikhita Kalra. "Clinical profile of hemodialysis patients attending a tertiary care hospital in Delhi, India." International Journal Of Community Medicine And Public Health 8, no. 12 (November 24, 2021): 6000. http://dx.doi.org/10.18203/2394-6040.ijcmph20214604.
Full textAbstract:
Background: CKD (chronic kidney disease) is one of the major complications of diabetes and hypertension. With increase in prevalence of non-communicable diseases, the patients presenting with the symptoms of CKD are also rising. Most of the patients suffering from CKD eventually land up on renal replacement therapy, putting extra burden economically as well as psychologically to the self and their family. The aim of the study is to find out the socio demographic and clinical profile of the patients suffering from CKD attending a tertiary care hospital in Delhi.Methods: It was a record based descriptive analysis, conducted between January 2019 and June 2019 in one of the ESIC (Employee State Insurance Corporation) hospital of Delhi. Medical Records of the only those patients were considered whose complete data were present in the record file. Data about Socio demographic profiles , clinical data, duration of CKD, duration of haemodialysis, viral markers, number of blood transfusions, vascular access, number of failed AV fistula etc. were entered in MS Excel and analysed through SPSS 11.Results: Hospital records of 473 CKD patients undergoing hemodialysis were analyzed. It was found that 315 (67%) were males and 158 (33%) were females. Majority of the patients i.e. 245 were in the age group of 41-60 years followed by 166 who were in the age group of 21 to 40. Out of total patients, 195 (41.2%) participants were undergoing hemodialysis twice a week, 276 (58.4%) thrice a week, 2 (0.4) patients were undergoing hemodialysis session four times a week. Majority of the participants i.e. 414 (88%) were Hindu. Out of total 473 participants, 439 (93%) participants had sero negative for viral marker (i.e. HbsAg, HCV, HIV I and II) and 33 (7%) participants were sero positive for viral marker. Most common etiology of CKD was found to be hypertension in our study followed by diabetes.Conclusions: Patients suffering from chronic kidney diseases are increasing day by day with increasing prevalence of hypertension. Most of the patients of CKD patients were middle aged males. Most of the patients have to visit 3 times a week to any health care institution for hemodialysis. Many of the patients are getting infected with viral hepatitis during course of the illness.
44
Teti Rahmawati, Sri Rahayu,. "KARAKTERISTIK DAN KESEDIAAN CAREGIVERS KELUARGA DARI PASIEN DENGAN PENYAKIT KRONIS TENTANG PEMBENTUKAN SUPPORT GROUP." JURNAL ILMIAH KEPERAWATAN ALTRUISTIK 2, no. 2 (October 14, 2019): 53–62. http://dx.doi.org/10.48079/vol2.iss2.42.
Full textAbstract:
Family caregivers have a crucial role in patients with chronic diseases. During caregiving care, they might have various experiences, successes, failures, problems, and also obstacles in caring the patients. Surely, they might feel stressed, anxious, frustrated, depressed, feel alone, and health problems. Subsequently, they need public attention to by finding solutions such as the idea of creating a group. The purpose of this study was to identify the characteristics and willingness of family caregivers of patients with chronic diseases related to creating support groups. Quantitative research with cross-sectional study design was used. A total of 97 family caregivers of patients with chronic diseases were involved in this study with inclusion and exclusion criteria. The results showed that family caregivers aged an average of 45.71 ± 13.94 years with a minimum age of 20 years and a maximum age of 83 years, 69 people (71.1%) were female, 46 people (47.4%) had high school education level, 58 people (59.8%) was employee, 41 people (42.3%) have a relationship with patients as housewife, and 69 people (71.1%) are willing to build a support group. The conclusion of this study is expected to be the foundation in creating a support group in the family caregivers of patients with chronic diseases.
45
Martins, Jo M., and Godfrey Isouard. "Managers of Aged Care Residential Services: 2006-2016." Asia Pacific Journal of Health Management 14, no. 1 (April 15, 2019): 68. http://dx.doi.org/10.24083/apjhm.v14i1.213.
Full textAbstract:
Purpose : Aged care Australia is going through a transformation reform to respond to the growing number of aged people in need of support in daily living. In this context, this article provides analyses of the number and characteristics of managers of aged care residential services in relation to number of aged people, residents of aged care facilities and people employed in them.
Methodology/Design: Design of the analyses follows specifications provided by the authors for tabulations prepared by the Australian Bureau of Statistics (ABS) from the censuses of population conducted by ABS in 2006 and 2016.
Analysis : Analysis of changes of the number of managers of aged care residential facilities against the number of aged people, residents of aged care facilities, and people employed in them. Further, the analyses examine changes in the age and sex of managers, their category, field and level of education, weekly income, hours worked, marital status, country of birth and indigenous status.
Findings: There was a large increase in the number of employees and managers per resident, and a stable ratio of managers per employees. While the proportion of female managers declined, the average age of managers increased slightly. Both the fields and level of education remained similar in the decade. The average income of managers was similar as that in all industries in 2016, with a larger increase during the decade than in all industries. Average hours worked remained about the same. The same applied to marital status. The proportion of Australia-born managers declined while that of managers born in Asia rose substantially. The proportion of indigenous managers about doubled during the decade.
Implications: Relevance to those concerned with the evolving transformation of aged care in Australia and those interested with management training of the growing number of managers of aged care residential services.
46
Chen, Ya-Ting, Xinyi Ng, Tanaz Petigara, Jyoti Aggarwal, Jenna Bhaloo, Michelle Goveia, David Johnson, and Gary S. Marshall. "1400. Physician Attitudes towards Combination Vaccine Use in Infants up to 24 months of age in the United States (US)." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S708—S709. http://dx.doi.org/10.1093/ofid/ofaa439.1582.
Full textAbstract:
Abstract Background Combination vaccines reduce the number of injections and improve the timeliness of vaccination coverage. US Advisory Committee on Immunization Practices (ACIP) recommendations state that combination vaccines are generally preferred over equivalent individual component vaccines. Healthcare providers strongly influence parental decisions about vaccination. We sought a contemporary understanding of physician’s attitudes towards combination vaccine use in infants. Methods We conducted an online survey of US physicians (70 pediatricians and 30 family practitioners) who administer vaccines to infants aged 0-24 months and spend at least 2 days a week providing patient care. Information was collected on attitudes towards combination vaccines and factors that influence the choice of combination vaccine used in clinical practice. Descriptive analyses were performed. Results Physicians (mean age=50.2 years, range 30.0-70.0; 66% white; 37% women) reported a median of 4 injections (range 2-9) as the maximum that parents would accept at a single visit, and 71% routinely explained what combination vaccines are to parents. When deciding which pentavalent vaccine to use, physicians considered how the brand fits into the current vaccine schedule (71%); upfront purchase costs (64%); and availability as a prefilled syringe (61%). The main reasons for using combination vaccines were to reduce the number of injections (96%); ensure the infant is up-to-date with vaccinations (86%); and reduce the pain that the infant experiences with multiple injections (68%). More than half reported that their institution or practice has a program to incentivize infant vaccination according to schedule. If a hexavalent vaccine-based schedule was available, 76% of physicians said they would choose it over their current schedule comprising pentavalent or equivalent component vaccines. Conclusion Choice of pentavalent combination vaccine among pediatricians and family practitioners was largely dependent on convenience and cost-related factors. Over three-quarters would be inclined to use a hexavalent vaccine schedule if available. Disclosures Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder) Xinyi Ng, PhD, Merck & Co., Inc. (Consultant) Tanaz Petigara, PhD, Merck & Co., Inc. (Employee, Shareholder) Jyoti Aggarwal, MHS, Merck & Co., Inc. (Consultant) Jenna Bhaloo, MPH, Merck & Co., Inc. (Consultant) Michelle Goveia, MD, Merck & Co., Inc (Employee, Shareholder) David Johnson, MD, MPH, Sanofi Pasteur (Employee, Shareholder) Gary S. Marshall, MD, GlaxoSmithKline (Consultant, Scientific Research Study Investigator)Merck (Consultant, Scientific Research Study Investigator)Pfizer (Consultant, Scientific Research Study Investigator)Sanofi Pasteur (Consultant, Grant/Research Support, Scientific Research Study Investigator, Honorarium for conference lecture)Seqirus (Consultant, Scientific Research Study Investigator)
47
Callhoff, J., K. Albrecht, U. Marschall, and F. Hoffmann. "POS0162 HOW ACCURATELY CAN WE IDENTIFY RHEUMATOID ARTHRITIS BY ICD-10 CODES? A LINKAGE OF CROSS-SECTIONAL SURVEY DATA WITH CLAIMS DATA." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 310.1–310. http://dx.doi.org/10.1136/annrheumdis-2022-eular.1133.
Full textAbstract:
BackgroundClaims data from health insurance companies are a valuable source in health services research to provide insights on health care provision for an unselected patient collective. However, the available ICD-10 diagnoses have been collected for billing purposes and their validity is not clear.ObjectivesThe aim of this analysis was to assess the positive predictive values (PPV) of a ICD-10 diagnosis of rheumatoid arthritis (RA) and additional criteria (specific medication, measurement of inflammatory markers, contact to a rheumatologist) in German claims data using patient-reported confirmed diagnosis as reference/gold standard.MethodsWithin the PROCLAIR project (Linking Patient-Reported Outcomes with CLAims data for health services research In Rheumatology), data from a large German statutory health insurance with 6.6 million persons aged 18 to 79 were used. We identified a random sample of persons for which an ICD-10 code for RA (M05/M06) was available in at least two quarters in outpatient care. The sample was stratified for age (18 to 49, 50 to 64, 65 to 79 years), sex and seropositive (M05)/ seronegative RA (M06). Persons were asked to confirm their RA diagnosis (“What does your attending physician call the disease you are suffering from?”) with answer options “chronic polyarthritis”, “rheumatoid arthritis”, “rheumatism of the joints” “other (please specify)”. The answer was used as the gold standard for RA diagnosis. Analyses were weighted to represent the total RA population of the database. Patient-reported information was linked to the claims data given patient consent. PPVs (% of confirmed RA diagnosis) were calculated for ICD-10-diagnosis or additional examination of inflammatory markers (erythrocyte sedimentation rate/C-reactive protein), prescription of specific medication (disease-modifying anti-rheumatic drugs, non-steroidal anti-rheumatic drugs and glucocorticoids) and contact to a rheumatologist, in the respective year.ResultsWe contacted 6,193 persons with a claims diagnosis of RA. Of these 3,184 responding (51%), N=2,535 (81%) confirmed that they had RA. PPVs were 81% for ICD-10 only, 94% in M05 and 76% in M06. When additional criteria were taken into account, PPVs increased to 82% (measure of inflammatory markers), 85% (rheumatologist) and 89% (medication), respectively (Figure 1). However, PPVs ranged from 72% to 76% even if the additional criteria were not fulfilled. PPVs were lowest in men aged 18-49 years and relatively stable among women of all age groups.Figure 1.ConclusionThe ICD-10 codes M05 and (less optimal) M06 have high PPVs and are therefore feasible to identify RA in claims data. The prerequisite of specific medication seems to be the most useful one in identifying RA.AcknowledgementsSupported by the Federal Ministry of Education and Research (grants 01EC1405 and 01EC1902A).Disclosure of InterestsJohanna Callhoff Paid instructor for: Rheumatologische Fortbildungsakademie GmbH, Grant/research support from: Abbvie, AstraZeneca, BMS, GSK, Galapagos, Lilly, Medac, MSD, Pfizer, Sanofi, UCB, Katinka Albrecht: None declared, Ursula Marschall Employee of: Employee of BARMER, Falk Hoffmann: None declared
48
Magrey, M., J. A. Walsh, S. Flierl, R. Calheiros, D. Wei, and M. A. Khan. "AB0788 The International Map of Axial Spondyloarthritis (IMAS): a US patient perspective on diagnosis and burden of disease." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1521.1–1521. http://dx.doi.org/10.1136/annrheumdis-2022-eular.1282.
Full textAbstract:
BackgroundAxial spondyloarthritis (axSpA) is a chronic inflammatory disease encompassing radiographic (traditionally known as ankylosing spondylitis) and non-radiographic forms that lead to chronic pain, structural damage, and disability.1 The International Map of Axial Spondyloarthritis (IMAS) survey is an initiative developed to generate insights into the real-life experiences of people living with axSpA to ultimately improve quality of life.2ObjectivesTo assess the burden and daily experience of patients with axSpA in the United States.MethodsThe IMAS survey generates a report on patient-reported aspects of disease burden and experience with axSpA using adaptations of the original Atlas of axSpA questionnaire developed in collaboration with patients, the Axial Spondyloarthritis International Federation, and clinical academic experts. In this US adaptation of the IMAS survey, a 30-minute quantitative online survey was administered to US patients aged ≥18 years who completed screening questions, self-reported having been diagnosed with axSpA by a healthcare provider, and were under the care of a healthcare provider between July 22, 2021, and November 10, 2021. Survey questions were tailored to reflect differences in the US healthcare systems and the availability of treatments. This analysis presents a portion of the US data describing patient demographics, clinical characteristics, journey to axSpA diagnosis, and the emotional impact and overall burden of disease on quality of life using the General Health Questionnaire 12 (GHQ-12), the Assessment of SpondyloArthritis international Society – Health Index (ASAS-HI), and a global limitation index of 18 activities of daily living. All results were reported descriptively using summary statistics.ResultsSurvey data from 228 US patients with axSpA were collected in this analysis. The mean age was 45 years, 60% of patients were female, and the mean BMI was 27.7 kg/m2 (Table 1). Participating patients had an average of 5.6 comorbidities, with anxiety (43%), depression (41%), and hypertension (32%) as the most commonly reported comorbidities. Among all patients, the mean age at onset of first symptoms was 26 years and the mean age at diagnosis was 35 years; overall, mean diagnostic delay was greater in female than in male patients (11.2 vs 5.2 years; Figure 1A). According to the validated GHQ-12, over half of the patients (57%) were at risk for psychological distress (GHQ-12 score ≥3; Figure 1B). Patients who were older (>40 years old), physically inactive, or who had active disease (BASDAI ≥4) were at risk for psychological distress. Most patients (82%) suffered from a high degree of impairment (ASAS-HI ≥6), 47% had a medium or high limitation in activities of daily living, and 46% of patients were not employed at the time of the survey.Table 1.Patient Demographic and Clinical CharacteristicsCharacteristicPatients with axSpA(N=228)Mean age, years45Female, %60White, %86Mean body mass index, kg/m227.7Nonsmoker, %62Alcohol consumption behavior, %Never19Every day9Mean number of comorbidities5.6Common comorbidities (≥20% of patients), %aAnxiety43Depression41Hypertension32Obesity/overweight31Sleep disorders30Hypercholesterolemia29Uveitis24Psoriatic arthritis23Fibromyalgia20Spinal or other fractures20Psoriasis20Employed, %54axSpA, axial spondyloarthritis.aRespondents could have selected ≥1 answer.ConclusionThis study showed that a high proportion of US patients with axSpA report impaired function and are at risk for psychological distress. Patients also experienced a substantial delay in the time to axSpA diagnosis, with longer delays than those reported in the European Union. Delays were twice as long in women compared to men. These findings highlight the large impact of disease on daily activities and mental distress in US patients with axSpA.References[1]Sieper J, Poddubnyy D. Lancet. 2017;390:73-84.[2]Garrido-Cumbrera M, et al. Curr Rheumatol Rep. 2019;21:19.AcknowledgementsThis study was funded by Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA. Medical writing support was provided by Charli Dominguez, PhD, of Health Interactions, Inc, Hamilton, NJ, USA, and was funded by Novartis Pharmaceuticals Corporation. This abstract was developed in accordance with Good Publication Practice (GPP3) guidelines. Authors had full control of the content and made the final decision on all aspects of this publication.Disclosure of InterestsMarina Magrey Consultant of: Received consulting fees from Eli Lilly and Novartis, Grant/research support from: Received research grants from AbbVie, Amgen, and UCB, Jessica A. Walsh Consultant of: Received consulting fees from Amgen, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Grant/research support from: Received research funding from AbbVie, Merck, and Pfizer, Sandra Flierl Employee of: Employee of Ipsos, Renato Calheiros Employee of: Employee of Novartis, David Wei Employee of: Employee of Novartis, Muhammad Asim Khan Consultant of: Has served as a consultant for Novartis
49
Setiyawati, Nanik, and Niken Meilani. "FACTORS AFFECTING HOUSEWIVES’ ATTITUDES TO HIV AND AIDS TEST IN YOGYAKARTA, INDONESIA." Malaysian Journal of Public Health Medicine 21, no. 2 (August 28, 2021): 434–39. http://dx.doi.org/10.37268/mjphm/vol.21/no.2/art.1118.
Full textAbstract:
HIV testing becomes one of the standard components of mother and child health and family planning services at every level of health care. Increase case oh HIV among Housewives. There are 67% of pregnant women supported HIV test, but only 24% who tested HIV. This study aims to know the factors that influence the housewife attitude toward HIV testing in Yogyakarta which includes knowledge, mother’s belief in HIV testing, belief the attitude of her husband, friend and community leaders. This research is correlational analytic with cross sectional design. The sample are 350 housewives in Yogya City and Sleman district that already implemented Prevention Mother to Child Transmission for HIV program. Analysis data use chi square and logistic regression. The result is majority of respondents: mothers aged >35 years, secundipara, education level is middle, husband's work as an employee and family income above the regional minimum income standard. Majority respondents have a good knowledge of HIV/AIDS and HIV testing, supportive attitudes toward HIV testing and have high belief in HIV testing from husband's attitudes and community leader’s attitude. Respondents’ belief that the attitude of friends did not support HIV testing for them. The majority have a supportive attitude to HIV testing are have a good knowledge of HIV/AIDS, have high belief in HIV testing, have high belief in the attitudes of husbands, friends and community leaders. The most factors influence on mother's attitude toward HIV testing is mother belief in her husband's attitude
50
Quock, Tiffany P., Eunice Chang, Katalin Bognar, Anita D'Souza, and Michael S. Broder. "Healthcare Resource Utilization and Costs of Patients with AL Amyloidosis: An Analysis of Hospitalizations in the Premier Database." Blood 138, Supplement 1 (November 5, 2021): 4724. http://dx.doi.org/10.1182/blood-2021-146983.
Full textAbstract:
Abstract INTRODUCTION: The amyloidoses are a group of protein-folding disorders characterized by extracellular tissue deposition of aggregated proteins as ß-pleated sheet fibrils. One of the most common and severe types is immunoglobulin light chain (AL), or "primary", amyloidosis. Prior studies of healthcare cost and resource use were hampered by the absence of an International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code specific to AL amyloidosis. Since 10/1/2017, the ICD-10-CM has included a diagnosis code for AL amyloidosis (E85.81). We believe the current study is the first to report healthcare cost and resource use using this new code. METHODS: To understand characteristics, healthcare resource utilization, costs, and clinical outcomes associated with AL amyloidosis for patients treated in US hospitals, this retrospective analysis used 2017-2020 data from the Premier Perspective® Database. The study population comprised of hospitalized patients aged ≥18 years with ≥1 inpatient claim consistent with AL amyloidosis (ICD-10-CM: E85.81) in any diagnosis field; the first qualifying hospitalization during the study period was included. Study outcomes included APR-DRG severity of illness subclass (a measure of disease burden based on the extent of organ system loss of function or physiologic decompensation), length of stay (LOS), intensive care unit (ICU) use, mortality and hospitalization costs and charges as reported in the database (inflated to 2020 USD). To provide context, we compared costs and charges to most recent national averages calculated from the 2018 National Impatient Sample (NIS). We will also tabulate NT-proBNP, troponin and differential free light chain values and report Mayo stage when possible. RESULTS: 1,341 patients were admitted to the hospital with a diagnosis of AL amyloidosis; mean (SD) age was 67.2 (11.2) years, 44.1% were female, 64.3% were White, and 62.4% had Medicare coverage. The mean (SD) Charlson Comorbidity Index was 3.9 (2.3), and 90.9% of patients had cardiac and/or renal impairment (Table 1). More than 80% of patients had either major or extreme disease according to the APR-DRG severity of illness measure. 87.6% of admissions were urgent or emergent, and 8.0% (95% CI [6.5%,9.4%]) of admitted patients died in the hospital. The mean (SD) LOS was 9.5 (9.7) days (Figure 1); during the hospital stay, 20.1% of patients were admitted to the ICU, with a mean (SD) ICU LOS of 6.5 (7.6) days (Table 2). The mean (SD) total hospitalization costs were $27,099 ($34,849) and total charges were $111,234 ($144,853) for hospitalized patients with AL amyloidosis while similar measures for all US hospital stays were $13,702 ($121) and $57,991 ($694), respectively (Figure 2). CONCLUSIONS: Disease burden and hospital costs associated with AL amyloidosis are high, particularly within this group of patients who have advanced disease as indicated by the APR-DRG classification. Mean hospitalization costs were above $27,000 per patient and many patients were admitted to the ICU. New therapies aimed at improving survival and providing clinical benefits have the potential to reduce disease burden and to yield substantial cost savings. Figure 1 Figure 1. Disclosures Quock: Prothena Biosciences, Inc: Current Employment. Chang: Dompe US, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Dompe US, Inc. to conduct research; Mirum Pharmaceuticals, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Mirum Pharmaceuticals, Inc. to conduct research; Greenwich Biosciences, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Greenwich Biosciences to conduct research; Genentech, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Genentech to conduct research; Verde Technologies: Other: I am an employee of PHAR, LLC, which was paid by Verde Technologies to conduct research; Sage: Other: I am an employee of PHAR, LLC, which was paid by Sage to conduct research; Prothena: Other: I am an employee of PHAR, LLC, which was paid by Prothena to conduct research; Pathnostics: Other: I am an employee of PHAR, LLC, which was paid by Pathnostics to conduct research; Otsuka: Other: I am an employee of PHAR, LLC, which was paid by Otsuka to conduct research; Novartis: Other: I am an employee of PHAR, LLC, which was paid by Novartis to conduct research; Kite: Other: I am an employee of PHAR, LLC, which was paid by Kite to conduct research; Jazz: Other: I am an employee of PHAR, LLC, which was paid by Jazz to conduct research; Ionis: Other: I am an employee of PHAR, LLC, which was paid by Ionis to conduct research; Illumina: Other: I am an employee of PHAR, LLC, which was paid by Illumina to conduct research; Helsinn: Other: I am an employee of PHAR, LLC, which was paid by Helsinn to conduct research; GRAIL: Other: I am an employee of PHAR, LLC, which was paid by GRAIL to conduct research; Ethicon: Other: I am an employee of PHAR, LLC, which was paid by Ethicon to conduct research; Eisai: Other: I am an employee of PHAR, LLC, which was paid by Eisai to conduct research; Celgene: Other: I am an employee of PHAR, LLC, which was paid by Celgene to conduct research; Boston Scientific Corporation: Other: I am an employee of PHAR, LLC, which was paid by Boston Scientific Corporation to conduct research; Bristol Myers Squibb: Other: I am an employee of PHAR, LLC, which was paid by BMS to conduct research; AstraZeneca: Other: I am an employee of PHAR, LLC, which was paid by AstraZeneca to conduct research; Amgen: Other: I am an employee of PHAR, LLC, which was paid by Amgen to conduct research; Akcea: Other: I am an employee of PHAR, LLC, which was paid by Akcea to conduct research; AbbVie: Other: I am an employee of PHAR, LLC, which was paid by AbbVie to conduct research; Partnership for Health Analytic Research (PHAR), LLC: Current Employment, Other; Sanofi US Services, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Sanofi US Services Inc. to conduct research; Sunovion Pharmaceuticals, Inc.: Other: I am an employee of PHAR, LLC which was paid by Sunovion Pharmaceuticals, Inc. to conduct research. ; BioMarin Pharmaceuticals Inc.: Other: I am an employee of PHAR, LLC which was paid by BioMarin Pharmaceuticals, Inc. to conduct research. ; Takeda Pharmaceuticals U.S.A., Inc.: Other: I am an employee of PHAR, LLC which was paid by Takeda Pharmaceuticals U.S.A., Inc., to conduct research. ; Exact Sciences Corporation: Other: I am an employee of PHAR, LLC which was paid by Exact Sciences Corporation to conduct research. . Bognar: Prothena Biosciences, Inc: Other: I am an employee at Partnership for Health Analytic Research LLC which received funding from Prothena Biosciences, Inc. to conduct the research described in this abstract.; Akcea: Other: I am an employee of PHAR, LLC, which was paid by Akcea to conduct research; Amgen: Other: I am an employee of PHAR, LLC, which was paid by Amgen to conduct research; AstraZeneca: Other: I am an employee of PHAR, LLC, which was paid by AstraZeneca to conduct research; BMS: Other: I am an employee of PHAR, LLC, which was paid by BMS to conduct research; Boston Scientific Corporation: Other: I am an employee of PHAR, LLC, which was paid by Boston Scientific Corporation to conduct research; Celgene: Other: I am an employee of PHAR, LLC, which was paid by Celgene to conduct research; Eisai: Other: I am an employee of PHAR, LLC, which was paid by Eisai to conduct research; Ethicon: Other: I am an employee of PHAR, LLC, which was paid by Ethicon to conduct research; GRAIL: Other: I am an employee of PHAR, LLC, which was paid by GRAIL to conduct research; Helsinn: Other: I am an employee of PHAR, LLC, which was paid by Helsinn to conduct research; Illumina: Other: I am an employee of PHAR, LLC, which was paid by Illumina to conduct research; Ionis: Other: I am an employee of PHAR, LLC, which was paid by Ionis to conduct research; Jazz: Other: I am an employee of PHAR, LLC, which was paid by Jazz to conduct research; Kite: Other: I am an employee of PHAR, LLC, which was paid by Kite to conduct research; Novartis: Other: I am an employee of PHAR, LLC, which was paid by Novartis to conduct research; Otsuka: Other: I am an employee of PHAR, LLC, which was paid by Otsuka to conduct research; Pathnostics: Other: I am an employee of PHAR, LLC, which was paid by Pathnostics to conduct research; Sage: Other: I am an employee of PHAR, LLC, which was paid by Sage to conduct research; Verde Technologies: Other: I am an employee of PHAR, LLC, which was paid by Verde Technologies to conduct research; Genentech, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Genentech to conduct research; Greenwich Biosciences, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Greenwich Biosciences to conduct research; Mirum Pharmaceuticals, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Mirum Pharmaceuticals to conduct research; Dompe US, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Dompe US to conduct research; Sanofi US Services, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Sanofi US to conduct research; Sunovion Pharmaceuticals, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Sunovian to conduct research; BioMarin Pharmaceuticals Inc.: Other: I am an employee of PHAR, LLC, which was paid by BioMarin to conduct research; Takeda Pharmaceuticals U.S.A., Inc.: Other: I am an employee of PHAR, LLC, which was paid by Takeda to conduct research; Exact Sciences Corporation: Other: I am an employee of PHAR, LLC, which was paid by Exact Sciences to conduct research. D'Souza: Sanofi, Takeda, Teneobio, CAELUM, Prothena: Research Funding; Janssen, Prothena: Consultancy; Imbrium, Pfizer, BMS: Membership on an entity's Board of Directors or advisory committees. Broder: Prothena Biosciences, Inc: Other: I am an employee at Partnership for Health Analytic Research LLC which received funding from Prothena Biosciences, Inc. to conduct the research described in this abstract.; Akcea: Other: I am an employee of PHAR, LLC, which was paid by Akcea to conduct research; Amgen: Other: I am an employee of PHAR, LLC, which was paid by Amgen to conduct research; AstraZeneca: Other: I am an employee of PHAR, LLC, which was paid by AstraZeneca to conduct research; BMS: Other: I am an employee of PHAR, LLC, which was paid by BMS to conduct research; Boston Scientific Corporation: Other: I am an employee of PHAR, LLC, which was paid by Boston Scientific Corporation to conduct research; Celgene: Other: I am an employee of PHAR, LLC, which was paid by Celgene to conduct research; Eisai: Other: I am an employee of PHAR, LLC, which was paid by Eisai to conduct research; Ethicon: Other: I am an employee of PHAR, LLC, which was paid by Ethicon to conduct research; GRAIL: Other: I am an employee of PHAR, LLC, which was paid by GRAIL to conduct research; Helsinn: Other: I am an employee of PHAR, LLC, which was paid by Helsinn to conduct research; Illumina: Other: I am an employee of PHAR, LLC, which was paid by Illumina to conduct research; Ionis: Other: I am an employee of PHAR, LLC, which was paid by Ionis to conduct research; Jazz: Other: I am an employee of PHAR, LLC, which was paid by Jazz to conduct research; Kite: Other: I am an employee of PHAR, LLC, which was paid by Kite to conduct research; Novartis: Other: I am an employee of PHAR, LLC, which was paid by Novartis to conduct research; Otsuka: Other: I am an employee of PHAR, LLC, which was paid by Otsuka to conduct research; Pathnostics: Other: I am an employee of PHAR, LLC, which was paid by Pathnostics to conduct research; Prothena: Other: I am an employee of PHAR, LLC, which was paid by Prothena to conduct research; Sage: Other: I am an employee of PHAR, LLC, which was paid by Sage to conduct research; Verde Technologies: Other: I am an employee of PHAR, LLC, which was paid by Verde Technologies to conduct research; Genentech, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Genentech to conduct research; Greenwich Biosciences, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Greenwich Biosciences to conduct research; Mirum Pharmaceuticals, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Mirum Pharmaceuticals, Inc. to conduct research; Dompe US, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Dompe US, Inc. to conduct research; Sanofi US Services, Inc.: Other: I am an employee of PHAR, LLC, which was paid by Sanofi US Services Inc. to conduct research; Sunovion Pharmaceuticals, Inc.: Other: I am an employee of PHAR, LLC which was paid by Sunovion Pharmaceuticals, Inc. to conduct research. ; BioMarin Pharmaceuticals Inc.: Other: I am an employee of PHAR, LLC which was paid by BioMarin Pharmaceuticals, Inc. to conduct research. ; Takeda Pharmaceuticals U.S.A., Inc.: Other: I am an employee of PHAR, LLC which was paid by Takeda Pharmaceuticals U.S.A., Inc., to conduct research. ; Exact Sciences Corporation: Other: I am an employee of PHAR, LLC which was paid by Exact Sciences Corporation to conduct research. .