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Psychosocial and Economic Evaluation of Stroke Management in the Elderly: A Prospective Study at the Neurology Department in a Hospital in Dakar, Senegal
Diop Cheikh Tacko,
Gueye Boubacar,
Ba Massamba,
Coume Mamadou,
Ka Ousseynou,
Acray Petronille,
Faye Adama
Issue:
Volume 6, Issue 2, June 2021
Pages:
38-43
Received:
5 April 2021
Accepted:
19 April 2021
Published:
29 April 2021
Abstract: Stroke is the second leading cause of death worldwide and the leading cause of physical disability in the elderly. The objective of the study was to evaluate the psychosocial and economic aspects of its management. We conducted a cross-sectional, descriptive and evaluative study at the neuroscience clinic of FANN National University Hospital from May 8 to August 8, 2019. It involved 60 people aged 60 years and over received in consultation as well as 59 family caregivers who gave their consent. The caregivers' suffering was evaluated using the MINI ZARIT grid consisting of 5 items for a total score ranging from 0 to 7. The psychological impact of the disease was evaluated by the Geriatric Depression Scale in its short version (GDS); composed of 15 items scored from 0 to 1. The direct and indirect financial cost was evaluated on two items: The estimated financial loss associated with the work stoppage estimated by the daily earnings of the primary caregiver. Travel costs related to transportation from home to the neurovascular consultation unit. The mean age of our patients was 71.46 years (standard deviation 7.79 years). Females predominated with a sex ratio of 0.71. Most of our patients were polygamous (38.30%), followed by widowers (35%). Most of the patients had attended Koranic school (38.30%) and 31.70% were illiterate. They were unemployed for 55%. Caregiver burden was absent to mild in 32.20%, mild to moderate in 45.80% and moderate to severe in 22%. Signs of depression were present in 10% of patients, the 30% had a high probability of depression while 60% of patients had no depression. The average length of time the main caregiver was off work was 23.86 days (standard deviation 64.53 days). The average cost of financial losses related to this work stoppage was 200.38 USD (standard deviation 564.72 USD). The average cost of travel was $139.24 (SD $321.03). The average total cost was $339.62 (SD $650.97). The indirect cost of stroke remains quite high and represents a heavy burden for a population where the majority is unemployed, so it is important to propose a psychological support program more adapted to the Senegalese population. The establishment of low-cost home help services and a training program in neuropsychology for clinicians will be useful.
Abstract: Stroke is the second leading cause of death worldwide and the leading cause of physical disability in the elderly. The objective of the study was to evaluate the psychosocial and economic aspects of its management. We conducted a cross-sectional, descriptive and evaluative study at the neuroscience clinic of FANN National University Hospital from M...
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Work Stress and Obesity in the Bamenda Municipality, Cameroon
Kinga Bertila Mayin,
Promise Aseh Munteh,
Mercy A. Mbacham Tah-Monunde,
Fomba Louisette Naah
Issue:
Volume 6, Issue 2, June 2021
Pages:
44-48
Received:
29 March 2021
Accepted:
14 April 2021
Published:
29 April 2021
Abstract: This study investigated the effect of work stress on obesity in the Bamenda Municipality. We administered work stress test to 1,052 individuals aged 20 and above resident in the Bamenda Municipality. The model was estimated using the multiple regression analysis while the ANOVA and Correlation analysis were used to confirm the findings. From the analysis, it was realized that work stress level had a negative and statistical significant influence on obesity. It was thus concluded that, work stress statistically significantly influenced obesity in the Bamenda Municipality. From this finding, workers especially those who sit while working were advised to make out time for physical exercises and use standing desks when and where possible. Workers were also advised to make sure that, their work schedules did not leave them eating junk food especially at the wrong time. The wrong time here referred to eating while working and/or eating heavy meals late at night because they did not eat all day. Many small meals were found to be healthier than one heavy meal worse of all eating it late at night. Eating late gave individuals no time to be able to use the energy gotten from the food before sleeping. This thus forced their body to convert the food to fat and store thus adding their body weight in the long term. Lastly, we recommended that, the government of Cameroon should institute one compulsory day of the week for workers sports.
Abstract: This study investigated the effect of work stress on obesity in the Bamenda Municipality. We administered work stress test to 1,052 individuals aged 20 and above resident in the Bamenda Municipality. The model was estimated using the multiple regression analysis while the ANOVA and Correlation analysis were used to confirm the findings. From the an...
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Unit Costs and Its Drivers for Hypertension Treatment in Emergency Department of Muhimbili National Referral Hospital in Dar Es Salaam, Tanzania
Mujinja Phares,
Ringo Millen Charles
Issue:
Volume 6, Issue 2, June 2021
Pages:
49-55
Received:
20 November 2020
Accepted:
7 December 2020
Published:
8 May 2021
Abstract: Importance of economic evaluations in public sectors cannot be over emphasized as now when funding is scarce especially the health sector which is regarded as a consumer. Objective was to evaluate the unit costs of Hypertension and treatment and their drivers in Muhimbili National Hospital (MNH), Tanzania A cross-sectional descriptive hospital-based (direct cost-provider perspective) study was carried out from July to Sept 2020 in Emergency Department of MNH. The study horizon and analytical horizon were both one year (January to December 2019). Costing of materials, diagnosis and invested time were estimated from patient’s electronic files. Treatment information and analysis were done using Microsoft excel for quantitative data. Bottom up approach was used to arrive at the total and unit cost of the health conditions. Estimated unit cost for treating hypertension was TZS 165,465 where main cost driver was length of stay, which drove the providers cost. Sensitivity analysis showed that, cost of health personnels is the driver of unit cost for hypertension treatment. Furthermore the high cost was due to higher waiting times patients spend while seeking treatment and that reduction of the average length of stay by 50% resulted in 50% reduction in the unit cost of treating hypertension. Unit cost for providing treatment to hypertensive patients is high. Annual unit cost studies should precede budgeting and pricing for services offered by the department so as to optimize cost of providing services. Prioritizing preventive services especially annual health checks could lower curative services costs
Abstract: Importance of economic evaluations in public sectors cannot be over emphasized as now when funding is scarce especially the health sector which is regarded as a consumer. Objective was to evaluate the unit costs of Hypertension and treatment and their drivers in Muhimbili National Hospital (MNH), Tanzania A cross-sectional descriptive hospital-base...
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Spatial Variability of Typhoid Disease Incidences in Uganda Using Geographically Weighted Regression Approach
Kamukama Ismail,
Maiga Gilbert,
Ssebuggwaawo Denis,
Nabende Peter,
Ali Mansourian
Issue:
Volume 6, Issue 2, June 2021
Pages:
56-64
Received:
8 April 2021
Accepted:
21 April 2021
Published:
8 May 2021
Abstract: The spatial variability of typhoid disease incidences has not been accounted for, most especially in developing countries, which makes its surveillance inefficient and expensive. This research aimed at (i) exploring possible risk factors of typhoid disease and (ii) accounting for spatial variability of typhoid disease incidences using GWR approach. The research first explored possible risk factors of typhoid disease using global regression-Ordinary Least Squares (OLS). Geographically Weighted Regression (GWR) model was used to account for spatial variability of typhoid disease incidences. Moran’s Index was used to confirm spatial patterns in the data. The research revealed that; poor handwashing practice, rainfall and poor drainage (floods effect) were responsible for spatial variability of typhoid disease locally (P<0.05). GWR model revealed that poor handwashing practice was mainly responsible for typhoid disease occurrences in Northern, Northwestern and Mid-central parts of the country while excessive rainfall was mainly responsible for occurrence of the disease in the Eastern and Western regions. Poor drainage was mainly influencing disease occurrences in Eastern and Southwestern parts of the country. In the analysis, GWR model performed better than global OLS model (R-squared=0.37, R-squared=0.25 respectively). A combination of poor handwashing practice, excessive rainfall and poor drainage accounts for spatial variability of typhoid disease incidences in Uganda. This knowledge is very essential for surveillance teams to (i) enforce preventive measures, (ii) prepare for outbreaks and (iii) make targeted interventions to eventually reduce operational costs.
Abstract: The spatial variability of typhoid disease incidences has not been accounted for, most especially in developing countries, which makes its surveillance inefficient and expensive. This research aimed at (i) exploring possible risk factors of typhoid disease and (ii) accounting for spatial variability of typhoid disease incidences using GWR approach....
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An Analysis of Performance Management Reform in Public Hospitals Based on Orientation Mechanism
Xiaoli Yang,
Hongpeng Zhang
Issue:
Volume 6, Issue 2, June 2021
Pages:
65-71
Received:
21 April 2021
Accepted:
8 May 2021
Published:
26 May 2021
Abstract: The public welfare attributes of public hospitals have been criticized, and the performance management of hospitals has also been questioned. Is our public hospitals "sick"? How to "treat" profit-only "symptoms" so that public hospitals can return to the mission of public welfare? This also starts with performance appraisal. This article analyzes the essence of performance management, deconstructs the system and process of performance management, and discusses the reform of performance management in public hospital management from three aspects: establishing a hospital performance management system, introducing a balanced score card, and formulating a hierarchical organizational performance management system. This enables public hospitals to weaken their profit-seeking motives, highlight the public welfare nature of public hospitals, and meet the requirements of residents' medical services. At the same time, this also preserves the operating efficiency and economic efficiency indicators of public hospitals, organically combines service quality with efficient operation, and maximizes social well-being.
Abstract: The public welfare attributes of public hospitals have been criticized, and the performance management of hospitals has also been questioned. Is our public hospitals "sick"? How to "treat" profit-only "symptoms" so that public hospitals can return to the mission of public welfare? This also starts with performance appraisal. This article analyzes t...
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Fostering Loyalty as Repurchase Intention: The Role of Relationship Marketing and Word-of-mouth
Issue:
Volume 6, Issue 2, June 2021
Pages:
72-78
Received:
6 May 2021
Accepted:
27 May 2021
Published:
4 June 2021
Abstract: Thi Le Ha Nguyen. University of Medicine and Pharmacy, Vietnam National University, Hanoi City, Vietnam. She worked as a medical doctor in Vietnam for 21 years. She was awarded the Master of Primary Healthcare Management by Mahidol University, Thailand, and she holds a Ph. D. degree from the Graduate School of Medical Sciences, Kanazawa University, Japan in Healthcare Management. Fostering loyalty as repurchase intention: the role of relationship marketing and word-of-mouth Objective: Relationship marketing is a tool directed at word-of-mouth communication and customer loyalty and measured by repurchase intention. This study examines the effect of relationship marketing on word-of-mouth and repurchase intention. Method: The study instrument was a self-administered questionnaire distributed to inpatients who used health services at a tertiary-level hospital in Vietnam during June 2019. The data were analyzed using SPSS 25.0 for descriptive analyses and Amos 25.0 for the structural equation modeling to test the proposed hypotheses. Results: The findings showed that relationship marketing has a positive effect on word-of-mouth and repurchase intention, while word-of-mouth plays a mediating role between relationship marketing and repurchase intention. Implications: Our findings have implications for managers and policymakers when crafting strategic plans that aim to improve relationship marketing. They should consider factors that directly influence repurchase intention by enhancing word-of-mouth to maintain loyalty.
Abstract: Thi Le Ha Nguyen. University of Medicine and Pharmacy, Vietnam National University, Hanoi City, Vietnam. She worked as a medical doctor in Vietnam for 21 years. She was awarded the Master of Primary Healthcare Management by Mahidol University, Thailand, and she holds a Ph. D. degree from the Graduate School of Medical Sciences, Kanazawa University,...
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