Journal Description
Healthcare
Healthcare
is an international, scientific, peer-reviewed, open access journal on health care systems, industry, technology, policy, and regulation, and is published semimonthly online by MDPI. Ocular Wellness & Nutrition Society (OWNS) is affiliated with Healthcare and its members receive discounts on article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE and SSCI (Web of Science), PubMed, PMC, and other databases.
- Journal Rank: JCR - Q2 (Health Policy & Services ) / CiteScore - Q2 (Leadership and Management)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 19.5 days after submission; acceptance to publication is undertaken in 2.4 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journals for Healthcare include: Trauma Care and European Burn Journal.
Impact Factor:
2.8 (2022);
5-Year Impact Factor:
3.0 (2022)
Latest Articles
Patient Opinions about Virtual Consultations in Saudi Arabia: A Nationwide Cross-Sectional Study
Healthcare 2024, 12(10), 1001; https://doi.org/10.3390/healthcare12101001 (registering DOI) - 13 May 2024
Abstract
There have been no nationwide studies of patient opinions regarding telehealth in Saudi Arabia to identify the factors that might influence patients’ perceptions and satisfaction. This was a prospective cross-sectional study of adults in the general population who last engaged with a healthcare
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There have been no nationwide studies of patient opinions regarding telehealth in Saudi Arabia to identify the factors that might influence patients’ perceptions and satisfaction. This was a prospective cross-sectional study of adults in the general population who last engaged with a healthcare practitioner via a virtual appointment. The participants were recruited by convenience sampling across Saudi Arabia between November 2023 and January 2024, completing a questionnaire that gathered data on (i) basic demographic and virtual consultation information and (ii) telehealth service delivery and technology based on the Telehealth Usability Questionnaire. Of the 916 participants, 53.7% were female, with a mean age of 47.2 (14.1) years. Nearly half attended primary care appointments, with the remainder attending a range of hospital specialties. Over 90% preferred having a virtual appointment over an in-person visit. About half had telephone consultations, while about a third had video calls through hospital-provided platforms; >90% found virtual appointments useful and convenient, easy to use, effective, reliable, and produced a favorable clinical interaction; and 97.4% were satisfied with their remote consultation experience despite the technical interruptions. The individuals who were less happy with their virtual consultation were significantly younger, lived in urban areas, attended specialty clinics, were seen by a psychologist, preferred in-person appointments, and had consultations by telephone. These data provide momentum to continue with and expand telehealth, especially through video calls, supported by educational initiatives.
Full article
(This article belongs to the Section TeleHealth and Digital Healthcare)
Open AccessArticle
The Precision and Safety of Ultrasound-Guided versus Palpation-Guided Needle Placement on the Plantar Fascia and Flexor Digitorum Brevis Interface: An Anatomical Study
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Miguel Malo-Urriés, Sergio Borrella-Andrés, Carlos López-de-Celis, César Fernández-de-las-Peñas, Albert Pérez-Bellmunt, José L. Arias-Buría, Isabel Albarova-Corral and Jacobo Rodríguez-Sanz
Healthcare 2024, 12(10), 1000; https://doi.org/10.3390/healthcare12101000 (registering DOI) - 13 May 2024
Abstract
Background: Evidence suggests the plantar fascia and its interphase with the flexor digitorum brevis muscle can play a relevant role in plantar heel pain. Needling interventions could offer an appropriate treatment strategy to addressing this interface. Objective: We compared the accuracy and safety
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Background: Evidence suggests the plantar fascia and its interphase with the flexor digitorum brevis muscle can play a relevant role in plantar heel pain. Needling interventions could offer an appropriate treatment strategy to addressing this interface. Objective: We compared the accuracy and safety of ultrasound-guided versus palpation-guided procedures for the proper targeting of the interface between the plantar fascia and the flexor digitorum brevis with a solid needle. Methods: A crossover cadaveric study was conducted. Five experienced therapists performed a series of 20 needle insertions each (n = 100 in total, 10 landmark-guided and 10 ultrasound-guided) on 10 anatomical samples. The therapists were instructed to accurately place the needle on the interface between the plantar fascia and the flexor digitorum brevis muscle. The distance of the tip of the needle to the identified target (accuracy), the surrounding sensitive structures targeted (safety), the time needed for the procedure, the number of needle passes, and the needle length outside the skin were assessed. Results: The ultrasound-guided technique was associated with a significantly higher accuracy (p < 0.001) but without differences in safety (p = 0.249) as compared to the palpation-guided procedure. Conclusion: Our results suggest that ultrasound-guided insertion exhibits greater accuracy but not greater safety than palpation-guided insertion when targeting the interface between the plantar fascia and the flexor digitorum brevis.
Full article
(This article belongs to the Special Issue New Approaches in Invasive and Non-invasive Rehabilitation: From Basic Science to Clinical Intervention)
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Open AccessCorrection
Correction: Sousa et al. Physical Activity, Readiness, and Cardiovascular Risk Stratification in the Polytechnics Communities of the Northern Region of Portugal Integrated in Mobility as a Service Concept. Healthcare 2023, 11, 3145
by
Andreia S. P. Sousa, Diana C. Guedes, José Félix, Soraia Pereira and Rubim Santos
Healthcare 2024, 12(10), 999; https://doi.org/10.3390/healthcare12100999 (registering DOI) - 13 May 2024
Abstract
In the published article [...]
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Open AccessArticle
Mental Healthcare Needs and Experiences of LGBT+ Individuals in Malaysia: Utility, Enablers, and Barriers
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Sheau Huey Ho, Amirul Hakim Shamsudin, Jun Wei Liow, Johan Ariff Juhari, Sai Ang Ling and Kyle Tan
Healthcare 2024, 12(10), 998; https://doi.org/10.3390/healthcare12100998 (registering DOI) - 13 May 2024
Abstract
Access to mental healthcare is undoubtedly of major importance for LGBT+ people worldwide, given the high prevalence of mental health difficulties due to minority stress exposures. This study drew mixed-method survey data from the community-based KAMI Survey (n = 696) to examine
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Access to mental healthcare is undoubtedly of major importance for LGBT+ people worldwide, given the high prevalence of mental health difficulties due to minority stress exposures. This study drew mixed-method survey data from the community-based KAMI Survey (n = 696) to examine the enablers, barriers, and unmet needs experiences of LGBT+ individuals in accessing mental healthcare services in Malaysia. First, we present findings from a series of descriptive analyses for sociodemographic differences in unmet needs for mental healthcare, barriers, and satisfaction levels with different types of mental healthcare. Next, we conducted an inductive thematic analysis of open-text comments (n = 273), with relevance drawn to Andersen’s Behavioural Model of Healthcare. More than a quarter (29.5%) reported an unmet need for mental healthcare, and some groups (younger, asexual or queer, or participants living in non-major cities) reported higher unmet needs. More than three-fifths (60.5%) reported not knowing where to find culturally safe mental health professionals. The thematic analysis uncovered key contextual (e.g., mental health practitioners’ stance, stigma, collaborative client-care) and individual (e.g., positive expectation of mental health services and anticipated stigma) attributes that influence healthcare experiences. Participants also identified resources that facilitate healthcare utilisation, such as affordability, availability of suitable professionals, and geographical considerations. The implications of our findings for the mental healthcare practices in Malaysia were outlined.
Full article
Open AccessArticle
Associations between Social Capital and Self-Rated Health among Men Who Have Sex with Men in Japan
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Adam O. Hill, Noriyo Kaneko, Carl M. Page, Natalie Amos, Kohta Iwahashi, Adam Bourne and Stuart Gilmour
Healthcare 2024, 12(10), 997; https://doi.org/10.3390/healthcare12100997 (registering DOI) - 13 May 2024
Abstract
Men who have sex with men (MSM) are significantly more likely to report poor health compared to the general population in Japan and internationally. Social capital has been observed as an important component of positive health and well-being outcomes among MSM. However, there
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Men who have sex with men (MSM) are significantly more likely to report poor health compared to the general population in Japan and internationally. Social capital has been observed as an important component of positive health and well-being outcomes among MSM. However, there is limited research investigating how alter sexuality (possessors of actual resources embedded in social capital networks) mitigates health outcomes. In an online survey of 1564 MSM in Japan, we investigated social correlates of poor self-rated health among MSM, including MSM and heterosexual social networks. Multiple logistic regression revealed that poor health was associated with older age, lower education, and part-time and unemployment. Poor health was inversely correlated with bisexual behavior and high MSM or heterosexual social capital. In order to decrease health disparities among MSM in Japan, interventions focusing on increasing social capital among deprived groups, such as those with lower socio-economic status, older MSM, and those whose sex partners are exclusively male, may be effective.
Full article
Open AccessArticle
Quality of Life, Family Support, Spirometry, and 6-Minute Walking Distance Differences between COVID-19 and Non-COVID-19 Intensive Care Unit Patients in One Year following Hospital Discharge
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Konstantina Avgeri, Konstantinos Mantzarlis, Effrosyni Gerovasileiou, Konstantina Deskata, Maria Chatzi, George Fotakopoulos, Markos Sgantzos, Vasiliki Tsolaki, Epaminondas Zakynthinos and Demosthenes Makris
Healthcare 2024, 12(10), 996; https://doi.org/10.3390/healthcare12100996 (registering DOI) - 13 May 2024
Abstract
Background: Critically ill patients after Intensive Care Unit (ICU) discharge may present disability in their cognitive and physical functions. Objectives: To investigate the quality of life (QoL) of both COVID-19 and non-COVID-19 patients following ICU discharge, lung function, and physical performance of
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Background: Critically ill patients after Intensive Care Unit (ICU) discharge may present disability in their cognitive and physical functions. Objectives: To investigate the quality of life (QoL) of both COVID-19 and non-COVID-19 patients following ICU discharge, lung function, and physical performance of participants. Methods: This study was prospective and conducted between 2020 and 2021 in the “X” hospital. If patients were Mechanically-Ventilated (MV) > 48 h, they were included. Results: Fifty COVID-19 and seventy-two non-COVID-19 participants were included in this study. The mean (SD) of the total SF-36 scores at COVID-19 patients at hospital discharge and 3 and 12 months were 46.5 (14.5), 68.6 (17.8), and 82.3 (8.9) (p < 0.05), while non-COVID-19 participants were 48.5 (12.1), 72.2 (9.9), and 82.7 (5.4) (p < 0.05). The forced expiratory volume in one second (FEV1) and 6-minute walking distance (6MWD) were assessed at 3 and 12 months and significantly improved over 12 months. Conclusion: The QoL of COVID-19 patients improved significantly over time as FEV1 and 6MWD.
Full article
(This article belongs to the Special Issue Pulmonary and Critical Care Medicine)
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Open AccessArticle
Effect of Verbal Encouragement on Postural Balance in Individuals with Intellectual Disabilities
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Ghada Jouira, Dan Iulian Alexe, Cristina Ioana Alexe, Haithem Rebai, Alina Ionela Cucui, Ana-Maria Vulpe, Gheorghe Gabriel Cucui and Sonia Sahli
Healthcare 2024, 12(10), 995; https://doi.org/10.3390/healthcare12100995 (registering DOI) - 12 May 2024
Abstract
This study investigated the effect of verbal encouragement (VE) on static and dynamic balance in individuals with intellectual disabilities (IDs). A total of 13 mild IDs and 12 moderate IDs participants underwent static balance tests (bipedal stance on firm surface, under open eyes
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This study investigated the effect of verbal encouragement (VE) on static and dynamic balance in individuals with intellectual disabilities (IDs). A total of 13 mild IDs and 12 moderate IDs participants underwent static balance tests (bipedal stance on firm surface, under open eyes (OEs) and closed eyes (CEs), and foam surface, unipedal stance on firm surface) and dynamic balance assessments (Y Balance Test (YBT) and Expanded Timed Up-and-Go Test (ETUGT)) under VE and no VE (NO/VE) conditions. VE significantly reduced center of pressure mean velocity (CoPVm) values for mild IDs in firm bipedal CEs conditions. The mild IDs group exhibited improved YBT scores and enhanced ETUGT performances for both groups under VE. Incorporating VE as a motivational strategy in balance training interventions can positively impact static and dynamic balance in individuals with mild IDs, especially in challenging conditions like unipedal stances on firm surfaces.
Full article
(This article belongs to the Special Issue Physical and Rehabilitation Medicine)
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Open AccessArticle
Convolutional Neural Network to Classify Infrared Thermal Images of Fractured Wrists in Pediatrics
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Olamilekan Shobayo, Reza Saatchi and Shammi Ramlakhan
Healthcare 2024, 12(10), 994; https://doi.org/10.3390/healthcare12100994 (registering DOI) - 11 May 2024
Abstract
Convolutional neural network (CNN) models were devised and evaluated to classify infrared thermal (IRT) images of pediatric wrist fractures. The images were recorded from 19 participants with a wrist fracture and 21 without a fracture (sprain). The injury diagnosis was by X-ray radiography.
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Convolutional neural network (CNN) models were devised and evaluated to classify infrared thermal (IRT) images of pediatric wrist fractures. The images were recorded from 19 participants with a wrist fracture and 21 without a fracture (sprain). The injury diagnosis was by X-ray radiography. For each participant, 299 IRT images of their wrists were recorded. These generated 11,960 images (40 participants × 299 images). For each image, the wrist region of interest (ROI) was selected and fast Fourier transformed (FFT) to obtain a magnitude frequency spectrum. The spectrum was resized to 100 × 100 pixels from its center as this region represented the main frequency components. Image augmentations of rotation, translation and shearing were applied to the 11,960 magnitude frequency spectra to assist with the CNN generalization during training. The CNN had 34 layers associated with convolution, batch normalization, rectified linear unit, maximum pooling and SoftMax and classification. The ratio of images for the training and test was 70:30, respectively. The effects of augmentation and dropout on CNN performance were explored. Wrist fracture identification sensitivity and accuracy of 88% and 76%, respectively, were achieved. The CNN model was able to identify wrist fractures; however, a larger sample size would improve accuracy.
Full article
(This article belongs to the Special Issue Artificial Intelligence Innovations and Applications in Trauma, Urgent and Emergency Care: Current and Prospects)
Open AccessReview
Promotion of Healthy Habits in University Students: Literature Review
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Sara Puente-Hidalgo, Camino Prada-García, José Alberto Benítez-Andrades and Elena Fernández-Martínez
Healthcare 2024, 12(10), 993; https://doi.org/10.3390/healthcare12100993 (registering DOI) - 11 May 2024
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The increase in responsibilities, together with the multiple challenges that students face in the university period, has a direct impact on their healthy lifestyles. This literature review describes the benefits of promoting healthy habits in college, highlighting the fundamental role of prevention and
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The increase in responsibilities, together with the multiple challenges that students face in the university period, has a direct impact on their healthy lifestyles. This literature review describes the benefits of promoting healthy habits in college, highlighting the fundamental role of prevention and promotion. A systematic review was carried out following the PRISMA recommendations, searching for information in the WOS and Scopus databases. On the other hand, a search was carried out within the existing and available grey literature. The review focused on finding information about physical activity, nutrition, and stress (with an emphasis on resilience and academic burnout) in university students. This bibliographic review includes 32 articles and six web pages, containing information on the benefits of physical activity, healthy habits, and health prevention. The information collected in this study shows that university students are exposed to multiple changes during this period, increasing as the academic years progress. At that time, their habits worsen, with low adherence to the Mediterranean diet, low physical activity, and high levels of stress, specifically increasing cases of academic burnout. The establishment of healthy habits during the university period is necessary, observing an improvement in all the variables studied. Prevention has played a fundamental role.
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Open AccessSystematic Review
Systematic Review: HIV, Aging, and Housing—A North American Perspective, 2012–2023
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Arthur S. Chaminuka, Gayle Prybutok, Victor R. Prybutok and William D. Senn
Healthcare 2024, 12(10), 992; https://doi.org/10.3390/healthcare12100992 (registering DOI) - 11 May 2024
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Advances in anti-retroviral therapy (ART) have decreased mortality rates and subsequently led to a rise in the number of HIV-positive people living longer. The housing experiences of this new population of interest—older adults (50 years and older) living with HIV—are under-researched. Understanding the
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Advances in anti-retroviral therapy (ART) have decreased mortality rates and subsequently led to a rise in the number of HIV-positive people living longer. The housing experiences of this new population of interest—older adults (50 years and older) living with HIV—are under-researched. Understanding the housing experiences and unmet needs of older people with HIV can better provide comprehensive care services for them. This study’s systematic review evaluated the peer-reviewed literature reporting housing access/insecurity/assistance/options, housing impact, and unmet needs of older individuals living with HIV in North America from 2012 to 2023. Furthermore, Latent Semantic Analysis (LSA), a text-mining technique, and Singular Value Decomposition (SVD) for text clustering were utilized to examine unstructured data from the abstracts selected from the review. The goal was to allow for a better understanding of the relationships between terms in the articles and the identification of emerging public health key themes affecting older adults living with HIV. The results of text clustering yielded two clusters focusing on (1) improvements to housing and healthcare services access and policies and (2) unmet needs—social support, mental health, finance, food, and sexuality insecurities. Topic modeling demonstrated four topics, which we themed to represent (1) a holistic care approach; (2) insecurities—food, financial, sexuality, and other basic needs; (3) access to housing and treatment/care; and (4) homelessness and HIV-related health outcomes. Stable housing, food, and healthcare services access and availability are critical elements to incorporating comprehensive, holistic healthcare for older adults living with HIV. The aging population requires high-priority policies for accessible and equitable healthcare. Clinicians and policymakers should address individual barriers, adopt a patient-centered approach, increase doctor visits, provide competency training, ensure long-term follow-up, involve families, and improve patient education in care management, contributing to HIV/AIDS geriatric care models.
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Open AccessArticle
Value-Based Health Care for Prostate Cancer Centers by Implementing Specific Key Performance Indicators Using a Balanced Score Card
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Jan Philipp Radtke, Peter Albers, Boris A. Hadaschik, Markus Graefen, Christian P. Meyer, Björn Behr and Stephan Nüesch
Healthcare 2024, 12(10), 991; https://doi.org/10.3390/healthcare12100991 (registering DOI) - 11 May 2024
Abstract
Background: Prostate cancer (PC) is the most common cancer in men in 112 countries, and accounts for 15% of cancers. Because it cannot be prevented, the rise in cases is inevitable, and improvements in diagnostic pathways and treatments are needed, as there is
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Background: Prostate cancer (PC) is the most common cancer in men in 112 countries, and accounts for 15% of cancers. Because it cannot be prevented, the rise in cases is inevitable, and improvements in diagnostic pathways and treatments are needed, as there is still a shortage of cost-effective diagnostics and widespread oncologically safe treatment options with measurable quality. As part of the implementation of a Full Cycle of Care, instruments have been developed to achieve value-based medicine, such as consistent commitment to measurability. One of these instruments is the Balanced Scorecard (BSC). Here, we propose the first BSC for prostate cancer (PC) treatment. Methods: BSCs are used to assess performance in healthcare organizations across four dimensions: financial, patient and referrer, process, and learning and development. This study aimed to identify Key Performance Indicators (KPIs) for each perspective. A systematic literature search was conducted according to PRISMA guidelines using multiple databases and specific search terms to identify KPIs for PC care, excluding case reports and conference abstracts. In total, 44 reports were included in analyses and development of the PC-specific BSC. Results: In the present study, a PC-specific BSC and KPIs were defined for the four classic perspectives, as well as for a newly developed PC-Specific Disease and Outcome perspective, including patient-related parameters from the German Cancer Society and the International Consortium for Health Outcomes Measurement. In addition, the Process perspective includes KPIs of fulfillment of continuing education of residents and the metrics of structured training of the radical prostatectomy procedure in the Learning and Development perspective. Conclusions: The developed BSC provides a comprehensive set of perspectives for an Integrated Practice Unit or center in PC care, ensuring that the indicators remain manageable and applicable. The BSC facilitates value creation in line with Porter’s Full Cycle of Care by systematically collecting and providing economic, personnel, and medical results, actions, and indicators. In particular, this BSC includes KPIs of structured training of practitioners and metrics of the German Cancer Society, that recently proved to improve PC patients outcomes.
Full article
(This article belongs to the Section Health Assessments)
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Open AccessArticle
The Collaboration of Private Hospitals with the Public Health Service: The Case of La Rioja, Spain (1986–2019)
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María Teresa Jiménez-Buñuales, Pilar León-Sanz, Paulino González-Diego and Leonor González-Menorca
Healthcare 2024, 12(10), 990; https://doi.org/10.3390/healthcare12100990 (registering DOI) - 11 May 2024
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In Spain, the public National Health Service provides care to Spaniards and other residents and is tailored for a decentralized state of autonomies. Each Autonomous Community has legislative capacity in its organization and management. We study the case of the collaboration between private
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In Spain, the public National Health Service provides care to Spaniards and other residents and is tailored for a decentralized state of autonomies. Each Autonomous Community has legislative capacity in its organization and management. We study the case of the collaboration between private hospitals and the public health service in La Rioja, an Autonomous Community of Spain located in the North of the Iberian Peninsula, due to the importance that this relationship has in health systems, in general. We applied the case study method as a methodological tool in a long-term local study. The interpretation was carried out within a national context, which allows us to understand its meaning and the historical keys to hospital development in this region. Primary sources have been reviewed (mainly reports, catalogs, and censuses of hospitals from the Ministry of Health and the Government of La Rioja) and other secondary sources, located in archives, libraries, Institute of Rioja Studies, and Department of Health. The hospital system in La Rioja was characterized by a predominance of public beds compared with private ones, although there has been a growing trend in the number of private beds from 2013 onwards due to the incorporation of health and social care convalescent hospitals (two). La Rioja has been promoting public–private collaboration (seen as a strategic alliance) and focusing on agreements in the socio-health space, particularly using the management service agreement and the concession of work formulas. The development of the public health service in La Rioja, from 1986 to 2019, has been determined by a progressive lower dependence on specialized hospitals from other health services of neighboring Autonomous Communities and by a mixed public–private hospital system.
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Open AccessArticle
Assessing Non-Laboratory Healthcare Professionals’ Attitude towards the Importance of Patient Preparation for Laboratory Tests
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Ričardas Stonys and Dalius Vitkus
Healthcare 2024, 12(10), 989; https://doi.org/10.3390/healthcare12100989 (registering DOI) - 10 May 2024
Abstract
(1) Background: Various guidelines address patient preparation and its importance for venous blood sampling, such as the GP41 guideline issued by the Clinical Laboratory Standards Institute (CLSI) and the blood collection guidelines published by the World Health Organisation. Recommendations provided by national societies
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(1) Background: Various guidelines address patient preparation and its importance for venous blood sampling, such as the GP41 guideline issued by the Clinical Laboratory Standards Institute (CLSI) and the blood collection guidelines published by the World Health Organisation. Recommendations provided by national societies or international organisations in the field of radiology, such as The Contrast Media Safety Committee of the European Society of Urogenital Radiology, or in the field of laboratory medicine, such as the Working Group for Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and the Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin American Confederation of Clinical Biochemistry (COLABIOCLI), also guide this practice. There is a notable lack of understanding regarding the viewpoints held by non-laboratory healthcare professionals concerning the significance of patient preparation for laboratory testing and the impact of typical factors associated with patient preparation. This study endeavours to bridge this gap by assessing the attitude of non-laboratory healthcare professionals in Lithuania regarding these pivotal aspects. (2) Methods: A self-designed anonymous questionnaire was disseminated among 141 public healthcare institutions in Lithuania. The internal consistency of the questionnaire was evaluated by computing Cronbach’s alpha. Descriptive statistics were utilised for the variables, while comparisons of attitude among groups were conducted using Mann–Whitney U (for two groups) or Kruskal–Wallis (for more than two groups) for categorical and discrete indicators. The Kruskal–Wallis post-hoc test was employed for pairwise comparisons. A significance level of p-Value < 0.05 was applied to establish statistical significance. (3) Results: A total of 158 respondents constituted two distinct groups of healthcare professionals: nurses and physicians. Most of the participants either agreed or strongly agreed that patient preparation could introduce bias into laboratory test results. Professionals with less than 20 years of work experience or those who attended training in patient preparation for sampling within a 5-year timeframe exhibited stronger agreement regarding different preanalytical factors in patient preparation and their impact on laboratory test results compared to their counterparts. (4) Conclusions: Non-laboratory healthcare professionals who participated in this survey consider proper patient preparation for laboratory testing to be a significant step towards obtaining accurate test results. They also recognize the commonly acknowledged preanalytical factors as important for ensuring reliable test results. However, attitudes towards the importance of several preanalytical factors vary depending on whether non-laboratory healthcare professionals have more or less than 20 years of work experience, as well as whether they have attended any training on this topic within the last five years or have never attended such training.
Full article
(This article belongs to the Section Healthcare Quality and Patient Safety)
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Open AccessCase Report
Prenatal Detection and Conservative Management of Uterine Scar Dehiscence in Patient with Previous Uterine Rupture and Multiple Surgeries—A Case Report
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Silvia Zermano, Giuseppina Seminara, Nadia Parisi, Valentina Serantoni, Martina Arcieri, Anna Biasioli, Monica Della Martina, Stefano Restaino, Giuseppe Vizzielli and Lorenza Driul
Healthcare 2024, 12(10), 988; https://doi.org/10.3390/healthcare12100988 (registering DOI) - 10 May 2024
Abstract
Uterine rupture is a rare and life-threatening condition. It usually occurs in patients with uterine scars (most commonly for a previous myomectomy or caesarean section), but it can also affect an unharmed uterus. This complication is more frequent in the third trimester and
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Uterine rupture is a rare and life-threatening condition. It usually occurs in patients with uterine scars (most commonly for a previous myomectomy or caesarean section), but it can also affect an unharmed uterus. This complication is more frequent in the third trimester and during delivery. There is not yet a recognised method of prediction of uterine rupture and the ultrasound features still need a consensus. In this article, we have reported a case of uterine dehiscence diagnosed by a pelvic ultrasound and magnetic resonance (MRI) at 24 weeks of gestation. The finding was confirmed intraoperatively at the caesarean section at 29 weeks of gestation. The 40-year-old patient has had a previous pregnancy complicated by uterine rupture at 22 weeks of gestation, following six previous abdominal surgeries for stage IV endometriosis, diffuse and nodular adenomyosis, and pelvic adhesion syndrome. The early detection of uterine dehiscence allowed us to prolong the pregnancy and perform a subsequent fertility-sparing surgery, reducing maternal and neonatal morbidity and mortality. Our case report proves that women with severe endometriosis/adenomyosis are at a high risk of uterine rupture and scar dehiscence. The antenatal ultrasound can describe a uterine dehiscence (even in asymptomatic patients) and prevent complications.
Full article
(This article belongs to the Special Issue Examination and Treatment of Gynecological Diseases)
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Open AccessArticle
Burnout and Satisfaction with Work–Life Balance among General Practitioners in Bulgaria during the COVID-19 Pandemic
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Kristina Kilova, Rumyana Stoyanova, Stanislava Harizanova and Marin Baltov
Healthcare 2024, 12(10), 987; https://doi.org/10.3390/healthcare12100987 (registering DOI) - 10 May 2024
Abstract
The objective of the present study is to analyze the link between the degree of professional burnout among general practitioners in Bulgaria during a pandemic and their satisfaction with the balance between their personal lives and professional lives. A cross-sectional study was conducted
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The objective of the present study is to analyze the link between the degree of professional burnout among general practitioners in Bulgaria during a pandemic and their satisfaction with the balance between their personal lives and professional lives. A cross-sectional study was conducted during the fourth wave of the COVID-19 pandemic from December 2021 to January 2022 among 377 general practitioners. We identified the presence and level of burnout syndrome among GPs using V. Boyko’s method for diagnostics of the severity of symptoms and the phases of formation and completion of the ‘occupational burnout’ process. Descriptive statistics and parametric and non-parametric tests were used for the analysis. For the significance level of the null hypothesis, we assumed that p < 0.05 at a 95% confidence interval. A total of 96.3% of the GPs had a high level of burnout during the COVID-19 pandemic. They worked more than 8 h a day (74.8%) and more than 5 days a week (69.0%). A total of 86.3% of them were not satisfied with the spare time they had and stated that they could not balance their work and personal lives (67.1%) since the pandemic was announced. A link was found between the level of professional burnout and long working hours (p = 0.022), dissatisfaction with free time (p = 0.028), and the inability to balance work and personal life (p = 0.000), as well as concerns related to safety during the pandemic (p = 0.048). Unrealistically high levels of burnout during the COVID-19 pandemic due to a disturbed work–life balance is a reason to re-evaluate health policies and involve more hospital care doctors at the frontlines to fight against severe infectious diseases. The results of this study could be used to inform policy makers, healthcare managers, and other stakeholders about the factors that have had profound impacts on GPs’ stress levels during the COVID-19 pandemic.
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Open AccessArticle
The Prevalence and Risk Factors of Postpartum Depression among Mothers in Najran City, Saudi Arabia
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Majed Alshahrani, Nisreen Oudah Tami Alqarni, Sarah Saeed Aldughar, Shuruq Talea Asiri and Ruba Ibrahim Alharbi
Healthcare 2024, 12(10), 986; https://doi.org/10.3390/healthcare12100986 (registering DOI) - 10 May 2024
Abstract
Background: Postpartum depression (PPD) is a significant mental health concern affecting mothers globally. However, research on PPD prevalence and risk factors in Najran City, Saudi Arabia, is limited. Study Aim: this cross-sectional study aimed to determine the prevalence and risk factors associated with
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Background: Postpartum depression (PPD) is a significant mental health concern affecting mothers globally. However, research on PPD prevalence and risk factors in Najran City, Saudi Arabia, is limited. Study Aim: this cross-sectional study aimed to determine the prevalence and risk factors associated with PPD among mothers in Najran City. Methodology: A questionnaire-based study was conducted from September 2023 to January 2024, involving 420 mothers aged 16–50 years with newborns (2–10 weeks after delivery). The questionnaire included demographic information and the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS). Statistical analysis utilized SPSS software v. 26, including descriptive statistics, Mann–Whitney U test, Kruskal–Wallis H test, and logistic regression. Results: The majority of participants were aged 20–35 years (61.4%), Saudi nationals (87.6%), and had university education (51.4%). EPDS scores indicated that 66.7% of mothers screened positive for possible depression. Significant associations were found between higher EPDS scores and factors such as unemployment (p = 0.004), younger age (p = 0.003), caesarean delivery (p = 0.043), mental illness (p = 0.0001), lack of adequate family support (p = 0.0001), and higher stress levels (p = 0.0001). Conclusion: The study revealed a high prevalence of PPD among mothers in Najran City, with sociodemographic, obstetric, and psychosocial factors significantly influencing PPD risk. These findings emphasize the need for targeted interventions and support systems to address maternal mental health needs effectively.
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The Role of Homogeneous Waiting Group Criteria in Patient Referrals: Views of General Practitioners and Specialists in South Tyrol, Italy
by
Giuliano Piccoliori, Christian J. Wiedermann, Verena Barbieri and Adolf Engl
Healthcare 2024, 12(10), 985; https://doi.org/10.3390/healthcare12100985 (registering DOI) - 10 May 2024
Abstract
Homogeneous waiting group (HWG) criteria are central to the patient referral process, guiding primary care physicians and hospitalists in directing patient care to specialists. This cross-sectional observational study, conducted in South Tyrol, Italy, in 2023, aimed to assess the implementation and impact of
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Homogeneous waiting group (HWG) criteria are central to the patient referral process, guiding primary care physicians and hospitalists in directing patient care to specialists. This cross-sectional observational study, conducted in South Tyrol, Italy, in 2023, aimed to assess the implementation and impact of HWG criteria on healthcare from the perspective of general practitioners and hospital physicians. A questionnaire was developed to gain knowledge about referral practices as perceived by general practitioners and specialists. The survey included 313 participants (82 general practitioners and 231 hospital physicians) and was designed to capture a range of factors influencing the application of HWG criteria, including communication and collaboration practices. The results showed moderate levels of familiarity with HWG criteria and opinions about the need for criteria refinement among hospitalists, indicating that further education and refinement of these criteria are warranted. Both general practitioners and hospital physicians expressed dissatisfaction with the current specialist referral system, highlighting the significant gaps in effective communication and collaboration. The survey also demonstrated the influence of patient demands and waiting times on referral practices, and the need for streamlined and accessible specialist care. This study highlights the need for improvement and adaptation of HWG criteria to better meet the needs of healthcare providers and patients in South Tyrol. By addressing the identified gaps in communication, collaboration, and education related to the HWG system, the efficiency, effectiveness, and patient-centeredness of the referral process can be improved, ultimately leading to better health outcomes.
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(This article belongs to the Special Issue Health Professional Education and Primary Health Care)
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Open AccessBrief Report
Targeted Tick-Borne Disease Recognition: Assessing Risk for Improved Public Health
by
Pyung Kim, Sarah Maxwell, Nabila Parijat, Dohyeong Kim and Connie L. McNeely
Healthcare 2024, 12(10), 984; https://doi.org/10.3390/healthcare12100984 - 10 May 2024
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Tick-borne diseases (TBDs) pose a rapidly growing threat to public health. The incidence of TBDs is on the rise, necessitating a comprehensive understanding of the risk factors beyond demographic considerations. This brief report combines a preliminary review of the literature with geographical case
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Tick-borne diseases (TBDs) pose a rapidly growing threat to public health. The incidence of TBDs is on the rise, necessitating a comprehensive understanding of the risk factors beyond demographic considerations. This brief report combines a preliminary review of the literature with geographical case mapping to identify the various factors influencing TBD risk. The report highlights the vulnerability of outdoor workers, the importance of outdoor activities, and the role of education in adopting preventive behaviors. Pet ownership and interactions with animals are also associated with an increased risk. The state of Illinois is used as a case study for this report, revealing regional variations in TBD incidence, and linking them to agricultural practices, forested areas, and park accessibility. These findings inform recommendations for targeted prevention strategies, emphasizing the need for detailed geographical data to enhance public health efforts in curbing TBD incidence and risk.
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Open AccessArticle
A Data-Driven Approach to Defining Risk-Adjusted Coding Specificity Metrics for a Large U.S. Dementia Patient Cohort
by
Kaylla Richardson, Sankari Penumaka, Jaleesa Smoot, Mansi Reddy Panaganti, Indu Radha Chinta, Devi Priya Guduri, Sucharitha Reddy Tiyyagura, John Martin, Michael Korvink and Laura H. Gunn
Healthcare 2024, 12(10), 983; https://doi.org/10.3390/healthcare12100983 - 10 May 2024
Abstract
Medical coding impacts patient care quality, payor reimbursement, and system reliability through the precision of patient information documentation. Inadequate coding specificity can have significant consequences at administrative and patient levels. Models to identify and/or enhance coding specificity practices are needed. Clinical records are
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Medical coding impacts patient care quality, payor reimbursement, and system reliability through the precision of patient information documentation. Inadequate coding specificity can have significant consequences at administrative and patient levels. Models to identify and/or enhance coding specificity practices are needed. Clinical records are not always available, complete, or homogeneous, and clinically driven metrics to assess medical practices are not logistically feasible at the population level, particularly in non-centralized healthcare delivery systems and/or for those who only have access to claims data. Data-driven approaches that incorporate all available information are needed to explore coding specificity practices. Using N = 487,775 hospitalization records of individuals diagnosed with dementia and discharged in 2022 from a large all-payor administrative claims dataset, we fitted logistic regression models using patient and facility characteristics to explain the coding specificity of principal and secondary diagnoses of dementia. A two-step approach was produced to allow for the flexible clustering of patient-level outcomes. Model outcomes were then used within a Poisson binomial model to identify facilities that over- or under-specify dementia diagnoses against healthcare industry standards across hospitalizations. The results indicate that multiple factors are significantly associated with dementia coding specificity, especially for principal diagnoses of dementia (AUC = 0.727). The practical use of this novel risk-adjusted metric is demonstrated for a sample of facilities and geospatially via a U.S. map. This study’s findings provide healthcare facilities with a benchmark for assessing coding specificity practices and developing quality enhancements to align with healthcare industry standards, ultimately contributing to better patient care and healthcare system reliability.
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(This article belongs to the Special Issue Data Driven Insights in Healthcare)
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Caregiver Knowledge, Attitude, and Behavior toward Care of Children with Cerebral Palsy: A Saudi Arabian Perspective
by
Abdulaziz Almosallam, Ahmad Zaheer Qureshi, Bashayer Alzahrani, Sultanh AlSultan, Waad Ibrahim Alzubaidi and Alanoud Alsanad
Healthcare 2024, 12(10), 982; https://doi.org/10.3390/healthcare12100982 - 10 May 2024
Abstract
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The care of children with cerebral palsy (CP) requires a complex system of care that is not only dependent on health care resources, but is also strongly influenced by social and cultural attributes. Hence, it is important to explore the understanding and practices
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The care of children with cerebral palsy (CP) requires a complex system of care that is not only dependent on health care resources, but is also strongly influenced by social and cultural attributes. Hence, it is important to explore the understanding and practices of caregivers within a regional perspective. This study was conducted to investigate the knowledge, attitude, and behavior (KAB) of parents with children diagnosed with CP in Saudi Arabia. A cross sectional survey was conducted on the caregivers of children with CP admitted for inpatient rehabilitation between October 2023 to January 2024. A total of 216 caregivers participated in this survey. About 82.9% of caregivers were the mothers of CP children, half (50.5%) were ≤36 years old, 53.7% were highly educated, and 89.2% lived in urban areas. More than half of the participants (57.7%) owned their homes. Regarding children, spastic quadriplegia was the most common type (46.3% of cases). Overall, the participants recorded good values for all variables for KAB. The mean value for attitude was higher (2.67 ± 0.20) when compared to behavior (2.49 ± 0.36) and knowledge (2.46 ± 0.25). Participants who had children with spastic quadriplegia CP reported lower behavior scores than their peers. Strategies with a special emphasis on improving the behaviors of caregivers for children with quadriplegia need to be adapted. Similarly, the living situations of families need to be taken into consideration given its significant association with the attitude of caregivers. A considerable lack of knowledge in handling emergency situations by caregivers signifies a gap in care, which could have potentially life-threatening consequences.
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