Understanding the Effects of Iatrogenic Management on Population Health:A Medical Innovation Perspective

In this paper,we introduce an iatrogenesis intervention framework guided by medical innovation,which encompasses the objectives,influences of medical innovation on iatrogenesis,factors affecting various types of iatrogenesis,and strategies for controlling iatrogenesis.Advancements in medical innovation across various domains can bridge the patient safety implementation gap by uncovering,characterizing,refining,accelerating,scaling,extending,and mobilizing the external and internal conditions and factors that influence the control and elimination of iatrogenesis.

Factors associated with the utilization of diagnostic tools among countries with different income levels during the COVID-19 pandemic

Background Disparities in the utilization of essential medical products are a key factor contributing to inequality in health outcomes.We aimed to analyze the trends and influencing factors in using Coronavirus disease 2019(COVID-19)diagnostic tools and disparities in countries with different income levels.Methods We conducted a cross-sectional study using open and publicly available data sources.Data were mainly collected from the Foundation for Innovative New Diagnostics,"Our World in Data,"and the Global Burden of Disease databases.Negative binomial regression model and generalized linear mixed model were employed to investigate into five sets of factors associated with the usage of diagnostics:severity of COVID-19,socioeconomic status,health status,medical service capacity,and rigidity of response.Dominance analysis was utilized to compare the relative importance of these factors.The Blinder-Oaxaca decomposition was used to decompose the difference in the usage of diagnostics between countries.Results The total COVID-19 testing rate ranged from 5.13 to 22,386.63 per 1000 people from March 2020 to October 2022 and the monthly testing rate declined dramatically from January 2022 to October 2022(52.37/1000 vs 5.91/1000)..The total testing rate was primarily associated with socioeconomic status(37.84%),with every 1 standard deviation(SD)increase in Gross Domestic Product per capita and the proportion of people aged≥70,the total testing rate increased by 88%and 31%.And so is the medical service capacity(33.66%),with every 1 SD increase in health workforce density,the number increased by 38%.The monthly testing rate was primarily associated with socioeconomic status(34.72%)and medical service capacity(28.67%),and the severity of COVID-19(21.09%).The average difference in the total testing rates between high-income and low-income countries was 2726.59 per 1000 people,and 2493.43(91.45%)of the differences could be explained through the five sets of factors.Conclusions Redoubling the efforts,such as local manufacturing,regulatory reliance,and strengthening the community health workforce and laboratory capacity in low-and middle-income countries(LMICs)cannot be more significant for ensuring sustainable and equitable access to diagnostic tools during pandemic.

Evolving market-shaping strategies to boost access to essential medical products in developing countries with HIV self-testing as a case study

The COVID-19 pandemic has exacerbated health inequities among countries in the Global South with limited access to essential medical products,leading to a higher infection and mortality rate,especially among vulnerable populations.Despite tremendous progress in global health financing,the estimated annual financing gap in developing countries is projected to reach US$371 billion per year by 2030.Therefore,developing market-shaping strategies is of great importance in ensuring adequate supply,affordable prices,and equitable access to essential medical products in low-and middle-income countries.We propose a strategic and appropriate market-shaping intervention framework for governments,international organizations,and NGOs to maximize access to essential medical products in developing countries.In the health field,we believe that market shaping strategy could be defined as a set of purposeful activities that market forces may intervene with to advance the development,production,supply,and distribution of global goods for health,making essential medical products more affordable,accessible,innovative,sustainable and quality assured.We argue that when designing a market-shaping strategy,policy or decisionmakers must take full advantage of the key drivers to keep the market dynamic,interactive,and constantly evolving to meet the unmet medical needs.In addition,different forms of market-shaping interventions are determined by objectives and specific issues to be addressed.More comprehensive market shaping strategies,including the strategic use of market expansion,market disruption,market maintenance,and market contraction alone or together,deserve to be explored and key stakeholders are also expected to join forces to make the intervention more efficient and productive.