Surgical treatment of liver cancer and pancreatic cancer under the China Healthcare Security Diagnosis Related Groups payment system

BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers accounted for the highest number of new cases.Real-world data(RWD)is now widely preferred to traditional clinical trials in various fields of medicine and healthcare,as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated.Additionally,research results from the RWD match global reality better than those from traditional clinical trials.AIM To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors.METHODS This study analyzed RWD 1137 cases within the HB1 group(patients who underwent pancreatectomy,hepatectomy,and/or shunt surgery)in 2023.It distinguished different expenditure categories,including medical,nursing,technical,management,drug,and consumable costs.Additionally,it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal–Wallis test.This study used the Steel–Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables.RESULTS The study found that in HB11 and HB13,the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy.Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy,both were significantly longer than those who underwent liver resection.In HB15,no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy;however,both were significantly higher than those in hepatectomy.Additionally,the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection.CONCLUSION China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs.Further research could refine this grouping system and ensure continuous effectiveness and sustainability.

Smart Healthcare Activity Recognition Using Statistical Regression and Intelligent Learning

In this present time,Human Activity Recognition(HAR)has been of considerable aid in the case of health monitoring and recovery.The exploitation of machine learning with an intelligent agent in the area of health informatics gathered using HAR augments the decision-making quality and significance.Although many research works conducted on Smart Healthcare Monitoring,there remain a certain number of pitfalls such as time,overhead,and falsification involved during analysis.Therefore,this paper proposes a Statistical Partial Regression and Support Vector Intelligent Agent Learning(SPR-SVIAL)for Smart Healthcare Monitoring.At first,the Statistical Partial Regression Feature Extraction model is used for data preprocessing along with the dimensionality-reduced features extraction process.Here,the input dataset the continuous beat-to-beat heart data,triaxial accelerometer data,and psychological characteristics were acquired from IoT wearable devices.To attain highly accurate Smart Healthcare Monitoring with less time,Partial Least Square helps extract the dimensionality-reduced features.After that,with these resulting features,SVIAL is proposed for Smart Healthcare Monitoring with the help of Machine Learning and Intelligent Agents to minimize both analysis falsification and overhead.Experimental evaluation is carried out for factors such as time,overhead,and false positive rate accuracy concerning several instances.The quantitatively analyzed results indicate the better performance of our proposed SPR-SVIAL method when compared with two state-of-the-art methods.

Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

Continuity of Care in Primary Health Care Affecting Control of Diabetes

Background: Continuity of care is a distinguishing feature of primary care. Better continuity of care program showed a significant effect in controlling diabetes and it is complications. This study explores the effect of continuity of care on control of diabetes mellites in primary health care centres. Objectives: 1) To assess the effect of Continuity of care on controlling haemoglobin (Hb A1C) and fasting blood Sugar (FBS);2) To compare the control of Diabetes by using (Hb A1C and FBS) indices on same patient before and after application of chronic illness clinic;3) To identify the relation between age and gender affecting continuity of care in diabetic patient. Methods: It is a Prospective cohort study design. Included both gender and diabetic patient age above 24 years old. The data extracted from health care specialty center (HCSC) clinics in National guard hospital at Riyadh, through HCSC data base on three phases: 1) Phase 1: the data extracted of diabetic patients from October to November 2022 including MRN, diabetic patient, age, Hb A1C, Fasting blood glucose. 2) Phase 2: the same MRN extracted from phase 1 was extracted again retrospectively for six months from April to September 2022, to compare the indices before implanting the chronic illness clinic including Hb A1C, Fasting blood glucose. 3) Phase 3: prospectively from December 2022 to September 2023. Results: Among diabetic patients aged 60 years old and above showed better control of HbA1C and FBS comparing to these patients below age of 60 years old, with significant improvement of HbA1C after implanting chronic illness clinic. Conclusion: The significant improvement in the control of diabetic patients followed in primary health care centers reinforce the evidence of the importance of continuity of care.

Ozone Sterilizer for Treatment and Health Care

Ozone is a green broad-spectrum bactericidal disinfectant, and a trace amount of ozone in the atmosphere makes many viruses and bacteria lose their biochemical activity and infectivity. Nature produces trace amounts of ozone in the air through lightning to purify the ecological environment. The product of ozone decomposition is oxygen, without secondary pollution. Ozone sterilizer is widely used in the epidemic prevention and control of intensive breeding farms and achieved remarkable results. If the concentration and action time of ozone can be accurately controlled, then ozone can quickly eliminate pathogens, without harming the normal cells in the human body. How to use medical ozone for epidemic prevention, treatment and health care is a subject worthy of serious study, which should arouse the attention of the experts in the field.

Impact of the emigration of nurses on health care delivery system in selected hospitals,Benin‑City,Edo State,Nigeria

Background:Globally,there is a high demand for nurses,resulting in migration from low‑to high‑income countries.The emigration of nurses is the act of leaving one's own country to settle permanently in another country,leading to a shortage in the number of nurses in their home countries.Consequently,this study aims to assess the impact of the emigration of nurses on the health‑care delivery system in Nigeria.Materials and Methods:A descriptive cross‑sectional survey was conducted with a stratified sampling technique to select 270 nurses from three selected hospitals in Benin‑city Edo state.A self‑structured questionnaire with open and Likert scale questions were used as an instrument to assess the Impact of the Emigration of nurses on the Health Care Delivery System.Data collected were analyzed using tables,percentages,means,standard deviation and t‑test.Results:The result showed a mean score of 1.59±0.92 impacts of the emigration of nurses on health‑care delivery system and identified how to reduce it.The study also showed that there is no significant difference between gender and reason for emigration among nurses(t=3.84,P≤0.001).Conclusion:The emigration of nurses is severely affecting the health care delivery system in the country.Recently,the Nursing and Midwifery Council of Nigeria gave the directive for training schools to increase their training capacity and number of students’intake to cushion the effect,and this study shows that this palliative can only be a short time measure,and however will encourage more nurses traveling abroad on the long run.Therefore,the hospital managers and government should provide a conducive working environment,better remuneration,attractive retirement benefit,and other incentives as a push in factor for nurses to stay back in their home countries.

Affordability, Accessibility, and Quality of Maternal Health Care Services and Level of Satisfaction of Mothers in Rural Areas in China

Objective:This study aimed to understand the affordability,accessibility,and quality of maternal and child health services for postpartum mothers,and their impact on satisfaction.Methods:The study utilized the Anderson model and revised the Maternal Pregnancy and Perinatal Health Service Questionnaire.A survey was conducted among 289 mothers aged 20–49 in Feicheng City.Results:Regarding accessibility,most respondents(133)reported that travel time to healthcare services exceeded 60 minutes,while 99 respondents indicated a travel time of 16–30 minutes.The issue of affordability was highlighted,with 86.85%of participants perceiving maternal healthcare services as costly,indicating a significant financial burden.More than 50%of respondents were satisfied with two specific dimensions(P<0.05)regarding the quality of maternal healthcare services.Conclusion:The study found that accessibility,affordability,and quality significantly affect mothers’satisfaction with maternal health services.Future research should focus on developing more suitable service pathways for rural mothers.

The effect of high-fidelity simulation in medical nursing based on the healthcare simulation standards of best practice

Background:High-fidelity simulation has been demonstrated to make great progress in learning.However,there is still ongoing exploration on how to fully harness the advantages of this teaching method and enhance its effectiveness.This study conducted high-fidelity simulation in medical nursing based on the Healthcare Simulation Standards of Best Practice and evaluated its effect.Methods:The study was conducted from September 2019 to June 2020.A total of 82 undergraduate nursing students from a university in Shanghai participated in the high-fidelity simulation in medical nursing.The simulation design scale,educational practices in simulation scale,and students’satisfaction and self-confidence were used to evaluate the effect.Results:The mean score of simulation design scale was 4.06±0.63 with the mean scores of all dimensions being over 3.0.The mean score of educational practices in simulation scale was 4.14±0.56 with the mean scores of all dimensions being over 4.0.The mean scores of students’satisfaction and self-confidence were 4.07±0.72 and 3.89±0.58,respectively.Conclusion:Students reported high levels of simulation design and educational practices in simulation.They were also satisfied with learning and reported high levels of self-confidence.Some key points need to be considered so that the learning effects might be optimized.

Downsizing Health Care in the Community

This study reviewed recent changes in health care utilization in the health care providers of Syracuse, New York. The data indicated the largest decline in the numbers of inpatient volumes involved adult surgery and orthopedics. Numbers of inpatient discharges for this service declined by more than 2900 discharges for the combined Syracuse hospitals. The data also indicated that adult medicine discharges declined by more than 2600 during this time. For Diagnosis Related Groups with discharge differences of 30 or more, adult medicine discharges declined by 451 in neurology, 943 in respiratory medicine, and 625 in circulatory medicine. It was estimated that the value of the inpatient discharges amounted to approximately $1,740,000 in adult surgery and more than $1,560,000 for adult medicine. The savings that were achieved in this process related to staffing, pharmaceuticals, and testing.

Estimating the Future of Health Care at the Community Level

Developments in health care in the United States are changing the delivery of services for providers and payors. This study focused on inpatient hospital discharges in the Syracuse hospitals and other services. It demonstrated that, during the past five years, numbers of inpatient adult medicine discharges had increased while adult surgery discharges had declined. This information suggested that adult medicine discharges could be expected to increase and approach levels of five years ago. It also suggested adult surgery discharges could be expected to remain at previous levels or decline. This information indicated that the combined emergency department visits declined from 238,000 to 202,000 between 2019 and 2020, then increased from 218,000 to 228,000 visits between 2021 and 2023. These developments will probably result in greater efficiency at the community level. With a decline in numbers of inpatient beds, providers will be able to focus on the more efficient management by reducing numbers of staff as well as fewer pharmaceuticals and testing.

An Efficient Blockchain-Based Healthcare System Using Artificial Intelligence

Personal health records and electronic health records are considered as the most sensitive information in the healthcare domain.Several solutions have been provided for implementing the digital health system using blockchain,but there are several challenges,such as secure access control and privacy is one of the prominent issues.Hence,we propose a novel framework and implemented an attribute-based access control system using blockchain.Moreover,we have also integrated artificial intelligence(AI)based approach to identify the behavior and activity for security reasons.The current methods only focus on the related clinical records received from a medical diagnosis.Moreover,existing methods are too inflexible to resourcefully sustenance metadata changes.A secure patient data access framework is proposed in this research,integrating blockchain,trust chain,and blockchain methods to overcome these problems in the literature for sharing and accessing digital healthcare data.We have used a neural network and classifier to categorize the user access to our proposed system.Our proposed scheme provides an intelligent and secure blockchain-based access control system in the digital healthcare system.Experimental results surpass the existing solutions by collecting attributes such as the number of transactions,number of nodes,transaction delay,block creation,and signature verification time.

Advance IoT Intelligent Healthcare System for Lung Disease Classification Using Ensemble Techniques

In healthcare systems,the Internet of Things(IoT)innovation and development approached new ways to evaluate patient data.A cloud-based platform tends to process data generated by IoT medical devices instead of high storage,and computational hardware.In this paper,an intelligent healthcare system has been proposed for the prediction and severity analysis of lung disease from chest computer tomography(CT)images of patients with pneumonia,Covid-19,tuberculosis(TB),and cancer.Firstly,the CT images are captured and transmitted to the fog node through IoT devices.In the fog node,the image gets modified into a convenient and efficient format for further processing.advanced encryption Standard(AES)algorithm serves a substantial role in IoT and fog nodes for preventing data from being accessed by other operating systems.Finally,the preprocessed image can be classified automatically in the cloud by using various transfer and ensemble learning models.Herein different pre-trained deep learning architectures(Inception-ResNet-v2,VGG-19,ResNet-50)used transfer learning is adopted for feature extraction.The softmax of heterogeneous base classifiers assists to make individual predictions.As a meta-classifier,the ensemble approach is employed to obtain final optimal results.Disease predicted image is consigned to the recurrent neural network with long short-term memory(RNN-LSTM)for severity analysis,and the patient is directed to seek therapy based on the outcome.The proposed method achieved 98.6%accuracy,0.978 precision,0.982 recalls,and 0.974 F1-score on five class classifications.The experimental findings reveal that the proposed framework assists medical experts with lung disease screening and provides a valuable second perspective.

Understanding Health Care Professional-Patient Interactions in Multiple Sclerosis: A Systematic Review and Thematic Synthesis

Aim: To examine the experiences of health care professional (HCP)-patient interactions in Multiple Sclerosis (MS), identifying factors that can influence these interactions. Methods: A three-stage systematic review and thematic synthesis of qualitative and quantitative research was undertaken. Stage 1: the systematic literature search;Stage 2: methodological appraisal of the qualitative papers;Stage 3: thematic synthesis of all qualitative papers and the integration of quantitative findings into the synthesis. Results: Forty-nine qualitative studies were identified. This included 1014 individuals with MS (244 male, 755 female and 15 unknown) and 106 carers and 86 HCPs. Seventeen quantitative studies were identified which included 7680 (2008 male, 5812 females, and 40 unknown) participants as well as 224 carers. Two themes are discussed: 1) The expectations, experiences and perceptions of interactions with HCPs, and 2) The factors that influenced interactions and relationships. Discussion: There is need for improvement in the content and provision of information to patients with MS from HCPs. Specific strategies are suggested and implications for patients and health care providers are considered.

Primary Healthcare System of Pakistan: Challenges to Self-Management of Type 2 Diabetes

This review article is aimed at describing the primary healthcare system of Pakistan and its challenges in the face of epidemic of type 2 diabetes, focusing particularly on the middle-aged population of rural area of Pakistan. The main concern in Pakistan is that its middle-aged population is facing the onslaught of obesity and overweight due to lack of physical activity. In addition unhealthy eating habits making it more difficult for this population to control their weight. All these factors are contributing to a high risk of type 2 diabetes for the population of Pakistan. This article provides insight into the primary health care system of Pakistan and highlights its deficiencies by identifying that its primary healthcare system has a poor utilization of health care services, the poor accessibility to health system and poor management of diabetes by the healthcare system, gender disparity and inequity in the health care system. The primary objective of this study is to provide an overview of self-management of diabetes among the middle-aged population of Pakistan and to identify the overall deficiencies in the primary healthcare system, its delivery and access to the system, barriers to self-management of diabetes and quality of life in that region.

Use of systems change and health information technology to integrate comprehensive tobacco cessation services in a statewide system for delivery of healthcare

Despite the availability of effective treatments and recommendations for systems change, full application of the USPublic Health Service clinical practice guideline for the treatment of tobacco use is seldom achieved. The present report describes a comprehensive, structured approach used to implement the guideline and to integrate evidence-based cessation services into a system for delivery of health care. The PRECEDE-PROCEDE model and systems strategies were employed to design and implement the Tobacco Control Initiative (TCI), which provides evidence-based cessation services for the patients of a statewide public hospital system. For the TCI, multi-level assessments, pilot programs, electronic data collection, and performance feedback were needed to produce system-wide changes in workflow and in the quality of care for tobacco users. Although there are advances in health information technology (HIT), systems approaches are required for responding effectively to the Health Information Technology for Economic and Clinical Health (HI-TECH) Act and to standards governing use of electronic data related to treatment of tobacco use and dependence.

Performance Evaluation of Healthcare Monitoring System over Heterogeneous Wireless Networks

The wide diffusion of healthcare monitoring systems allows continuous patient to be remotely monitored and diagnosed by doctors. The problem of congestion, namely due to the uncontrolled increase of traffic with respect to the network capacity, is one of the most common phenomena affecting the reliability of transmission of information in any network. The aim of the paper is to build a realistic simulation environment for healthcare system including some of the main vital signs model, wireless sensor and mesh network protocols implementation. The simulator environment is an efficient mean to analyze and evaluate in a realistic scenario the healthcare system performance in terms of reliability and efficiency.

Determining Requirements for an Optimal Ad-Hoc Multicast Protocol in Mobile Health Care Training Systems

Nowadays, Health Care Training-based System (HCTS) is a vital component in the education and training of health care in 3D Virtual Environment (VE). The practice of HCTS continues to grow at rapid pace throughout all of the healthcare disciplines, however research in this field is still in its early stage. Increasingly, decision makers and developers look forward to offer more sophisticated, much larger, and more complex HCTS to serve the desired outcome and improve the quality and safety of patient care. Due to the rapidly increasing usage of personal mobile devices and the need of executing HCTS applications in environments that have no previous network infrastructure available, Mobile Health Care Training-based System (MHCTS) is an expected future trend. In such systems, medical staff will share and collaborate in a 3D virtual environment through their mobile devices in an ad-hoc network (MANET) in order to accomplish specific missions’ typically surgical emergency room. Users are organized into various groups (Radiologists, Maternity departments, and General surgery etc...), and need to be managed by a multicast scheme to save network bandwidth and offer immersive sense. MHCTS is sensitive to networking issues, since interactive 3D graphics requires additional load due to the use of mobile devices. Therefore, we need to emphasize on the importance and the improvement of multicast techniques for the effectiveness of MHCTS and the management of collaborative group interaction. Research so far has devoted little attention to the network communication protocols design of such systems which is crucial to preserve the sense of immersion for participating users. In this paper, we investigate the effect of multicast routing protocol in advancing the field of Health care Training-based System to the benefit of patient’s safety, and health care professional. Also, we address the issue of selecting a multicast protocol to provide the best performance for a particular e-health system at any time. Previous work has demonstrated that multicast operates at least as efficiently as traditional MAODV. A comprehensive analysis about various ad-hoc multicast routing protocols is proposed. The selection key factors for the right protocol for MHCTS applications were safety and robustness. To the best of our knowledge, this work will be the first initiative involving systematic literature reviews to identify a research gate for the use of multicast protocol in health care simulation learning community.

Health Care System in Portugal for People with Motor Problems

Purpose: From a social and labor inclusion perspective, the article presents a digital prototype conceptualized to provide a “Diagnostic Page”, which delivers various prescribers and suppliers of support products that mitigate the problems of the respective patients. It also provides a “Patient Card Page”, where all the information about financing the respective products is placed, as well as all the documents likely to be needed for the commercial transactions to be carried out by all the parties involved. It also aims to provide a digital medium to grow a community in this niche market. In the action research methodology approach, the prototype was taken to funding competitions and conferences, where interviews and surveys were carried out, and a number of suggestions were collected on the type of platform to consider in order to respond to the concerns and needs of end users, such as patients, prescribers, suppliers and associations. Methods: The digital platform where the system is hosted uses algorithms that, on the diagnostic page, consider keywords used by patients and return a series of prescribers and suppliers of support products, in which the corresponding percentage of attenuation is taken into account and the best solution found to overcome the level of difficulty presented by the respective patients is delivered. Results and Conclusions: It is hoped that, with this platform, people with motor problems will be able to obtain their diagnosis instantly, through the algorithm implemented, and that they will immediately be provided with a series of prescribers, suppliers and support products best suited to their needs, as well as all the information or conditions necessary to purchase or finance them. On the other hand, prescribers, suppliers and associations have an online platform where they can offer their consultations, products and other support as freelancers who are part of a community.

The Precautions Efficacy Taken among Health Care Workers While Performing Tracheostomies on COVID-19 Patients: Systematic Review

Background & objectives: Coronavirus disease 19 (COVID-19) has been declared by World Health Organization as a global pandemic disease in March 2020. Acute respiratory distress syndrome is frequent complication of COVID-19 disease. Tracheostomy is needed in cases of prolonged mechanical ventilation (7 - 10 days) in patients with acute respiratory distress syndrome. Tracheostomies are highly aerosol generating procedures, Otorhinolaryngologists and Health Care Workers (HCWs) are at high risk of virus exposure. The aim of this review is to evaluate the risk of transmission of COVID-19 during tracheostomy procedure, and to review the practical recommendation and scope of the timing to reduce risk of transmission to HCW. Methods: PubMed database was searched between April 2020 to Jan 2021 using the terms “Tracheostomy AND COVID-19 AND Health Care Workers”. All the articles that shared the same aim were screened which resulted in 243 references without duplicates. The title and abstract screening excluded further 202 studies. Eventually 9 full-text studies were included. Results: Five hundred and two COVID-19 patients underwent tracheostomies during the study period. Sixty-three percent of the procedure were done through open technique, while 37% of them were done through percutaneous technique. Seventy-eight percent of them used full Personal Protective Equipment (PPE) and 44.4% used Powered Air Purifying Respirator (PAPR). Negative Pressure Rooms (NPR) were used in 67%. Conclusion: The studies showed similar negative results on HCW infection despite much variance in using PPE. However, there should be global unified recommendations and guidelines regarding tracheostomies in COVID-19 patients to prevent future HCW infection.