scholarly journals Study of the impact of available healthcare resources on the population’s mortality rate using the hierarchical linear modelling

2021 ◽  
Vol 65 (6) ◽  
pp. 540-548
Author(s):  
Irina A. Lakman ◽  
Venera Maratovna Timiryanova ◽  
Galiya Timergazievna Zakiryanova
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Resource Availability ◽  
Healthcare Resource ◽  
Healthcare Resources ◽  
Hierarchical Linear Modelling ◽  
Linear Modelling ◽  
The Russian Federation ◽  
Population Mortality ◽  
The Impact

Introduction. The uneven development of the medical material and technical base and resources is observed worldwide. At the same time, healthcare resource availability is associated with the territorial characteristics of the population’s mortality rate. In order to reduce mortality, a better understanding of this relationship is needed. The purpose of the study is to assess the impact of healthcare resource availability on mortality, taking into account the hierarchical nesting of municipalities in subjects of the Russian Federation with further funding for health care and demographic indicators. Material and methods. For these purposes, hierarchical linear modelling is used. The assessment was carried out on the data of 265 municipalities attributed to 6 constituent entities of the Russian Federation. The data sources are the Territorial Bodies of the Federal State Statistics Service and the Unified Interdepartmental Information and Statistical System (www.fedstat.ru). Results. As a result of modelling, the health care resources (doctors, medical personnel, beds) at the municipal level were determined to reduce the population mortality rate positively. At the same time, an ambiguous influence of the actual cost of the territorial compulsory medical insurance program was revealed at the regional level. Conclusion. The results obtained correspond to studies devoted to the regional diversity of the population mortality rate and the available healthcare resources. However, they make it possible to determine the influence of factors taking into account the level of their formation (regional, municipal). The proposed models make it possible to improve the quality of managerial decision-making in the health care system since, taking into account the hierarchical nesting, they share the influence of regional and local factors on the variation of municipalities in terms of the mortality rate of the population.

The Effect of Health Expenditure and Immunisation on Under-Five Mortality Rate in Selected African Countries.

2021 ◽  
Author(s):  
Alfred EBOH ◽  
Steve METIBOBA
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Health Expenditure ◽  
Health Care Systems ◽  
Health Care Expenditure ◽  
African Countries ◽  
Under Five ◽  
Significant Negative Effect ◽  
Negative Effect ◽  
The Impact

Abstract Background: As a way of tackling child mortality, many countries in the world depend on their respective health-care system. But governments of most countries in Africa are yet to provide robust funding of their health-care systems as many people still depend on the out-of-pocket payment to receive health services. Against this backdrop, this study used annual panel data to assess the effect of health-care expenditure and immunisation on the under-five mortality rate in 30 selected African countries for the period 2000-2017. Methods: Multiple regression technique was adopted for the data analysis and the robust fixed regression estimator was preferred to the random effects as determined by Hausman test.Results: The findings indicated that domestic government general health expenditure had a significant negative effect on the under-five mortality rate. However, the effect of domestic private health expenditure on under-five mortality was not significant while external health expenditure had a significant negative effect on under-five mortality rate. The impact of diphtheria immunisation on under-five mortality was significant. Conclusions: Except domestic private health expenditure, government and external forms of health expenditure coupled with diphtheria immunisation were significant factors for the reduction of the under-five mortality in the selected countries.

scholarly journals A Comprehensive Analysis of COVID-19 Transmission and Fatality Rates at the County level in the United States considering Socio-Demographics, Health Indicators, Mobility Trends and Health Care Infrastructure Attributes

2020 ◽  
Author(s):  
Tanmoy Bhowmik ◽  
Sudipta Dey Tirtha ◽  
Naveen Chandra Iraganaboina ◽  
Naveen Eluru
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Health Indicators ◽  
Mortality Rates ◽  
County Level ◽  
Model Framework ◽  
Transmission Rates ◽  
Health Care Infrastructure ◽  
The Impact ◽  
At Home

Background: Several research efforts have evaluated the impact of various factors including a) socio-demographics, (b) health indicators, (c) mobility trends, and (d) health care infrastructure attributes on COVID-19 transmission and mortality rate. However, earlier research focused only on a subset of variable groups (predominantly one or two) that can contribute to the COVID-19 transmission/mortality rate. The current study effort is designed to remedy this by analyzing COVID-19 transmission/mortality rates considering a comprehensive set of factors in a unified framework. Method: We study two per capita dependent variables: (1) daily COVID-19 transmission rates and (2) total COVID-19 mortality rates. The first variable is modeled using a linear mixed model while the later dimension is analyzed using a linear regression approach. The model results are augmented with a sensitivity analysis to predict the impact of mobility restrictions at a county level. Findings: Several county level factors including proportion of African-Americans, income inequality, health indicators associated with Asthma, Cancer, HIV and heart disease, percentage of stay at home individuals, testing infrastructure and Intensive Care Unit capacity impact transmission and/or mortality rates. From the policy analysis, we find that enforcing a stay at home order that can ensure a 50% stay at home rate can result in a potential reduction of about 30% in daily cases. Interpretation: The model framework developed can be employed by government agencies to evaluate the influence of reduced mobility on transmission rates at a county level while accommodating for various county specific factors. Based on our policy analysis, the study findings support a county level stay at home order for regions currently experiencing a surge in transmission. The model framework can also be employed to identify vulnerable counties that need to be prioritized based on health indicators for current support and/or preferential vaccination plans (when available). Funding: None.

Amendments to the Constitution of the Russian Federation: Dictated Necessity and Consequences in the Conditions of the Modern World

2021 ◽  
Author(s):  
V.V. Chuksina ◽  
◽  
K.A. Mirvoda ◽  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Local Governments ◽  
Health Care Systems ◽  
Modern World ◽  
Depth Analysis ◽  
Care Systems ◽  
The Russian Federation ◽  
The Impact

The subject of this article is Law of the Russian Federation on Amendments to the Constitution of the Russian Federation (14.03.2020 No. 1-Federal Constitutional Law) «On improving the regulation of certain issues of the public power organization and functioning», namely, aspects of «coordination of health care» and «protection of the family, motherhood and childhood». The authors analyzed the issues of the medical care provision centralization, the impact of these amendments on the legal capacity of citizens. For a more in-depth analysis, the experience of foreign countries (Canada and Germany) was used. Despite the fact that the health care systems of the countries cited as an example differ in their essence and organization, nevertheless, they influence the formation of the availability of medicine for the population. As a result of the study of this experience, it was concluded that the delegation of freedom in the provision of medical care to lower levels of government allows to provide to the population affordable and high-quality medical care. It is noted that at present it is necessary to review the degree of participation of local governments in ensuring the availability of medical care in accordance with the federal law.

The Impact of Neighborhood Characteristics on Housing Prices-An Application of Hierarchical Linear Modeling

2012 ◽  
Vol 1 (2) ◽  
pp. 31-44
Author(s):  
Lee Chun Chang ◽  
Hui-Yu Lin
Keyword(s):  
Empirical Study ◽  
Hierarchical Linear Modeling ◽  
House Prices ◽  
Housing Prices ◽  
Neighborhood Characteristics ◽  
Linear Modeling ◽  
Hierarchical Linear Modelling ◽  
Neighborhood Characteristic ◽  
Linear Modelling ◽  
The Impact

Housing data are of a nested nature as houses are nested in a village, a town, or a county. This study thus applies HLM (hierarchical linear modelling) in an empirical study by adding neighborhood characteristic variables into the model for consideration. Using the housing data of 31 neighborhoods in the Taipei area as analysis samples and three HLM sub-models, this study discusses the impact of neighborhood characteristics on house prices. The empirical results indicate that the impact of various neighborhood characteristics on average housing prices is different and that the impact of house characteristics on house prices is also moderated by neighborhood characteristics.

THE ECONOMICS OF HEALTH CARE DURING A PANDEMIC

Vestnik ◽  
2021 ◽  
pp. 286-289
Author(s):  
Л.Т. Каракетова
Keyword(s):  
Health Care ◽  
Negative Impact ◽  
Health Economy ◽  
Economic Downturn ◽  
Difficult Situation ◽  
Regulatory Documents ◽  
Economics Of Health ◽  
The Russian Federation ◽  
And Control ◽  
The Impact

В данной статье представлен обзор данных об экономике здравоохранения в сложной сложившейся ситуации, и рассматривается влияние пандемии на экономику здравоохранения, в частности, проведён анализ негативного последствия пандемии и изменений, которые привели не только к спаду экономики, но и возникновению новых проблем касаемо финансирования и контроля экономики здравоохранения. В статье приведены законодательные акты и нормативные документов Российской Федерации. This article provides an overview of data on the economy of healthcare in the current difficult situation. It examines the impact of the pandemic on the health economy, analyzing, in particular, the negative impact of the pandemic and changes that have led not only to the economic downturn, but also to the emergence of new problems regarding the financing and control of the health economy. Furthermore, the article presents the legislative acts and regulatory documents of the Russian Federation.

808 Sleep and Fatigue Mitigation: Paving The Way For Training Health Care Trainees

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A315-A315
Author(s):  
Zara Fatima ◽  
Sharez Haider ◽  
Kaz Nelson ◽  
Muna Irfan
Keyword(s):  
Health Care ◽  
Sleep Deprivation ◽  
Resource Availability ◽  
Clinical Performance ◽  
Training Session ◽  
Well Being ◽  
Self Awareness ◽  
Cumulative Score ◽  
The Impact ◽  
The Way

Abstract Introduction The health care workforce is undoubtedly prone to fatigue and sleep deprivation due to extensive hours, shift work and intense demands of the training. The physical and behavioral effects of sleep deprivation can compromise well being and also negatively impact clinical performance. ACGME has been actively engaged in efforts to promote protection of health care trainees from the deleterious effects of sleep deprivation but the grass root level educational efforts towards teaching trainees to mitigate sleep deprivation are lacking. Methods We conducted a 60 minute long “Sleep and Fatigue Training Session” with the goals of increasing the understanding of effects of sleep deprivation and training in countermeasures. The session was conducted as a part of the annual GME orientation session for all the incoming learners. 274 trainees (residents & fellows) participating from all the departments were divided into 25 small groups of 7–12 members each. Clinical vignettes, brief presentation and moderator facilitated interactive discussion were utilized as teaching tools. Handouts with strategies and resources for the trainees were disseminated. Pre and post session surveys were designed to assess trainees baseline understanding of sleep impairment, impact on performance, recognition of impact, possible countermeasures and the impact of module on the aforementioned parameters after the intervention. Results Based on the cumulative trend of participant’s responses obtained on a Likert scale of 1 to 5, results showed improvement in all the parameters including access to training (3.67 to 4.44), awareness (4.31 to 4.46), recognition (4.04 to 4.36), strategies (3.6 to 4.36), and resource availability (3.24 to 4.33). Attendees reported a cumulative score of 4.23/5 in terms of beneficial impact of the module. The resource availability parameter demonstrated the highest average increase (33.6%) after the intervention. The lowest increase in the cumulative trend was displayed (3.5%) in the self-awareness parameter. Conclusion The feedback from learners demonstrated that the interactive model of sleep training session was very favorably received with improved scores in all the parameters assessed. Our model paves the way for other institutes to adopt similar training sessions for learners. Support (if any):

Social Characteristics, Health, and Mortality Among Male Centenarians Using Veterans Affairs (VA) Health Care

2021 ◽  
pp. 016402752110007
Author(s):  
Lien T. Quach ◽  
Kelly Cho ◽  
Jane A. Driver ◽  
Rachel Ward ◽  
Avron Spiro ◽  
...  
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Marital Status ◽  
Military Service ◽  
Health Conditions ◽  
Social Characteristics ◽  
Electronic Health Record Data ◽  
Diagnosis Of Dementia ◽  
The Impact ◽  
Annual Mortality

We studied male centenarian Veterans using VA health care to understand the impact of social characteristics on their annual mortality rate, adjusting for prevalent health conditions. This longitudinal study used VA Electronic Health Record data from 1997 to 2012 ( n = 1,858). Covariates included age, race, marital status, and periods of military service. The mean age was 100.4 ± 1.4 years, 76% were white, and 49% were married. The average annual mortality rate was 32 per 100 person-years. The annual mortality rate was stable and not affected by race but did vary by marital status. Divorced or separated centenarians had a 21% higher rate of death than married centenarians. A diagnosis of dementia or of congestive heart failure each increased the mortality risk by 37%. Providers should consider prevalent health conditions, as well as marital status, in managing care of centenarian Veterans.

scholarly journals Certain issues of paid medical services analytics in the Russian Federation

2019 ◽  
pp. 231-235
Author(s):  
T. Yu. Bykovskaya ◽  
A. V. Panov
Keyword(s):  
Health Care ◽  
Russian Federation ◽  
Health Financing ◽  
Medical Services ◽  
The Russian Federation ◽  
The Government ◽  
State Financing ◽  
Vladimir Putin ◽  
The Impact ◽  
Socio Economic Factors

Today, there is an ambiguous dynamics of state financing of health care. Up to 2017, the Government of the Russian Federation gradually reduced the amount of allocations for health care. For example, in 2017 expenses decreased by 33% compared with 2016. Constantly observed adjustment of budget lists and their differentiated interpretation. Nevertheless, Vladimir Putin, in his message to the Federal Assembly in 2018, announced an increase in health care spending to 4.1% of GDP. Therefore, every year there is a growing need to explore the market for paid medical services. The article discusses the dynamics of paid medical services and the impact on them of various socio-economic factors, focusing on the development of the institute of public-private partnership as one of the tools for solving problems of health financing. The authors propose a series of comprehensive measures at the federal and regional levels that allow them to optimize the interaction of participants in the medical services market.

scholarly journals The impact of accreditation on health care quality in hospitals

2018 ◽  
Vol 75 (8) ◽  
pp. 803-808 ◽  
Author(s):  
Gordana Markovic-Petrovic ◽  
Mira Vukovic ◽  
Aleksandra Jovic-Vranes
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Mortality Rate ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Average Rate ◽  
Accreditation Process ◽  
Care Quality ◽  
Hospital Days ◽  
The Impact

Background/Aim. Accreditation is considered to be the oldest and most widespread mechanism of independent external evaluation of health care quality and is implemented in over 70 countries worldwide. Despite numerous studies in this field, there is still no solid evidence about its impact on health care quality and patient safety. The goal of this paper was to investigate if the accreditation process has an effect on the difference in values of health care quality indicators. Methods. The study was conducted in two tertiary level health care hospitals, one accredited, the other non-accredited. Values of seven quality indicators in the period before, during and immediately after the completion of accreditation (from 2007?2015), which measure health care quality, patient safety, the efficiency and productivity of the institution, were compared. Results. Of the seven monitored quality indicators, a positive effect of the accreditation process can be attributed to a shorter length of waiting for the first scheduled health check at the institution, shorter length of waiting for the first scheduled surgical check, lower rate of patients with decubitus as well as a decrease of the rate of hospital days per patient with acute myocardial infarction. No effect of accreditation was found on the mortality rate, mortality rate within the first 48 hours of hospitalization, and the average rate of hospital days per patient at the level of the institution. Conclusion. The process of accreditation undoubtedly intensifies activities that contribute to improving health care quality, which results in better health outcomes. Additional research in this field and new evidence about the relationship between accreditation and quality upgrading in health care institutions are required because this could motivate their managers to decide more easily to enter into this process and implement it, despite the additional efforts and financial investments associated with accreditation.

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