Diabetic retinopathy (DR) is a leading cause of visual impairment and blindness worldwide, with a growing global burden, particularly in low- and middle-income countries. This study aimed to evaluate the cost-effectiveness of panretinal photocoagulation (PRP) alone compared with PRP combined with intravitreal anti–vascular endothelial growth factor (anti-VEGF) therapy in a real-world hospital setting in Indonesia. Methods: A retrospective cost-effectiveness analysis was conducted using medical record data from 171 patients with diabetic retinopathy treated in 2021 at a private eye hospital in Surabaya. The analysis was performed from a societal perspective over a one-year time horizon using a Markov model with 6-month cycles. Costs included direct medical and indirect costs. Health outcomes were measured using Disability-Adjusted Life Years (DALYs). The incremental cost-effectiveness ratio (ICER) was calculated, and one-way sensitivity analysis was performed to assess uncertainty. Results: The total cost of PRP combined with anti-VEGF therapy was higher than PRP alone (IDR 16,771,000 vs IDR 14,171,000). However, the combination therapy resulted in substantially greater health benefits, with 12.793 DALYs averted compared to 0.932 DALYs for PRP alone. The ICER was IDR 173,960,796 per DALY averted, which falls within the WHO-CHOICE cost-effectiveness threshold for Indonesia (2.86 times GDP per capita). Sensitivity analysis confirmed the robustness of these findings. Conclusion: PRP combined with intravitreal anti-VEGF therapy is a cost-effective strategy for managing diabetic retinopathy in Indonesia. These findings support its consideration in clinical practice and health policy to reduce the burden of visual impairment.
Objective: To review evidence on the efficacy and safety of tyrosine kinase inhibitors (TKIs) for myeloid/lymphoid neoplasms with FGFR1 rearrangement (MLN-FGFR1). Methods: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) databases, clinical trial registries, and major oncology and haematology conference proceedings were systematically searched. Data were collected through November 14, 2025. Results: Among 229 identified records, 15 studies met the inclusion criteria: four single-arm clinical trials, one observational study, and ten case reports or case series. No randomized controlled trials were identified. In total, outcomes were reported for 85 patients. Pemigatinib demonstrated the highest clinical activity, with rapid and durable responses and a safety profile consistent with FGFR inhibitors. Olverembatinib induced high rates of complete remission or complete haematologic remission and sustained disease control in most cases. However, interpretation is limited by the small cohort and short follow-up. Treatment with olverembatinib was generally well tolerated. Evidence for other agents was confined to a small observational cohort and individual reports, showing heterogeneous, mostly short-lived responses, with long-term remissions occurring mainly after allogeneic haematopoietic stem cell transplantation (HSCT). Overall, selective FGFR1 inhibitors, particularly pemigatinib, demonstrated superior therapeutic activity, whereas data for multi-target TKIs remained sparse and inconsistent. Methodological heterogeneity and population diversity precluded quantitative synthesis. Conclusion: Current evidence supports pemigatinib as the TKI with the most consistent clinical activity in MLN-FGFR1, while data for alternative agents remain limited and heterogeneous. Further prospective studies are required to inform treatment sequencing and long-term management.
Objective Adverse drug reactions (ADRs) pose a significant challenge to patient safety, and the effectiveness of pharmacovigilance systems depends to a large extent on patient engagement in reporting. The aim of this study was to compare the level of knowledge about ADRs and reporting behaviour among respondents, including patients and their caregivers, from Poland and the Netherlands. Methods A cross-sectional study was conducted using an anonymous online questionnaire incorporating skip logic. Participants were recruited using a non-probability sampling approach and, depending on their responses, completed between 11 and 17 questions. Results The results showed that Polish respondents demonstrated greater knowledge of ADRs and reporting procedures, which was reflected in higher self-reported reporting rates compared to respondents from the Netherlands. However, the proportion of individuals who declared that they had experienced ADRs in the past two years was similar in both countries. In contrast, official pharmacovigilance data indicate substantially higher reporting levels in the Netherlands, with approximately five times more reports submitted in 2024 compared to Poland. This discrepancy may suggest a gap between self-reported and actual reporting behaviour, as well as a potential overestimation of reporting activity in survey responses. Conclusion These findings indicate that although higher levels of knowledge and reporting were observed among Polish respondents, no statistically significant association between knowledge and ADR reporting was identified. This suggests that factors other than knowledge, including systemic and socio-cultural influences, may play a key role in real-world pharmacovigilance outcomes. Strengthening reporting systems and increasing patient awareness and engagement may help bridge the gap between awareness and actual reporting practices.
Background: Outpatient facilities in Aceh face significant challenges regarding long patient waiting times, exacerbated by variations in patient flow and data quality issues from the Electronic Medical Record (EMR) system. This problem has a negative impact on patient experience and operational efficiency. Objective: This study aims to gain a comprehensive understanding of patient flow dynamics and to develop effective management strategies to reduce patient waiting times. Methods: This study employed a retrospective observational design, analysing EMR data from 1 March 2025 to 16 July 2025. Kernel Density Estimation (KDE) was used to estimate the distribution of waiting times; the estimated distribution was then used to draw synthetic samples (simulations) to replicate waiting time patterns. Survival analysis using the Kaplan-Meier estimator and the Cox Proportional Hazards model was employed to evaluate factors influencing the duration of waiting times. Results: Waiting times varied between units; the Andrology unit recorded the highest average waiting time (130.71 minutes), followed by Dentistry & Oral Health (107.26 minutes) and Plastic Surgery (65.23 minutes). Factors such as the number of doctors and patient arrival time were identified as significant predictors of waiting time duration, with differing directions of influence across units. Conclusion: This multi-method approach provides further insight into the dynamics of patient waiting times and highlights the importance of accurate data for operational analysis. These findings may assist management in resource planning to improve efficiency and the patient experience.
Background: Artificial Intelligence (AI) is transforming clinical decision-making through enhanced diagnostic accuracy, predictive analytics, and personalised treatment planning. However, its rapid integration into healthcare systems introduces complex ethical and governance challenges. Despite growing literature, a critical gap persists between high-level ethical principles and their operational implementation in clinical practice. Methods: This study conducted a systematic literature review (2018–2026) across PubMed, Scopus, Web of Science, supplemented by analysis of two major 2026 policy reports: the World Economic Forum's Abu Dhabi intelligent health system case study [8] and the WHO European Region's survey of all 27 EU Member States [7] (94% response rate). Thematic analysis identified five ethical domains, and governance gaps were triangulated across peer-reviewed literature, cross-national survey data, and an in-depth case exemplar. Results: Analysis of peer-reviewed literature and policy reports revealed five interconnected ethical domains: algorithmic bias, physician autonomy, informed consent, accountability, and the patient–provider relationship. Cross-country evidence from the WHO Europe survey [7] identifies critical governance gaps: only 11% of EU Member States have health-specific AI strategies, 7% have health-specific ethical guidelines, and just 11% have dedicated AI liability frameworks. Only 26% offer in-service AI training for health professionals, and only 18% consult the broader public on AI governance. The Abu Dhabi case [8] demonstrates that advanced intelligent health systems can successfully integrate large-scale population health intelligence, real-time analytics, and preventive strategies at national level. At the same time, as digital health ecosystems continue to evolve, opportunities remain to further strengthen governance mechanisms through formalised clinician override protocols, transparent patient communication frameworks, and structured bias auditing processes. Conclusion: This paper proposes a three-level ethical governance framework (system, organisational, and clinical) incorporating mechanisms such as AI ethics committees, structured bias auditing, human-in-the-loop oversight, and transparent patient communication protocols. The framework aims to bridge the gap between ethical principles and accountable implementation in clinical practice, informed by both a high-performing intelligent health system exemplar (Abu Dhabi) and cross-national empirical evidence from 27 EU Member States.
Artificial Intelligence (AI) is rapidly transforming the healthcare sector, offering innovative solutions to longstanding challenges in patient care, diagnosis, and treatment. This study aims to provide a comprehensive overview of AI applications in healthcare, focusing on its role in diagnosis and treatment, the use of AI-powered robotics, implementation in the UAE's healthcare system, and its potential benefits from a business perspective. A systematic literature review methodology is employed, analyzing peer-reviewed articles from 2015 to 2024 sourced from databases. The research utilizes a standardized data extraction form and thematic analysis to identify key trends and insights. Findings indicate that AI technologies, including machine learning and natural language processing, are enhancing diagnostic accuracy, personalizing treatment plans, and improving patient monitoring systems. The integration of AI-powered robotics is shown to streamline surgical procedures and patient care. In the UAE, AI adoption in healthcare is accelerating, with initiatives aimed at improving healthcare delivery and outcomes. From a business standpoint, AI demonstrates potential for optimizing resource allocation, reducing operational costs, and enhancing overall healthcare system efficiency. This study contributes to the growing body of knowledge on AI in healthcare, offering valuable insights for healthcare providers, policymakers, and researchers. It underscores the transformative potential of AI while also acknowledging the need for careful consideration of ethical implications and implementation challenges.
The aim of this paper is to analyze the health care system in Estonia, with particular emphasis on financing mechanisms, organization of services, reforms, and the drug reimbursement system. Estonia, being one of the leaders in the digitalization of public services, has implemented a number of innovative solutions in the field of e-health, which have contributed to improved efficiency and accessibility of medical care. The paper presents key demographic and epidemiological indicators that shape the challenges for the Estonian health care system, such as population aging, negative natural growth, and the increasing burden of chronic diseases. The structure of health care financing is discussed, in which the Estonian Health Insurance Fund plays a dominant role, financed mainly from salary contributions and budget transfers. The growing share of out-of-pocket expenses by patients is highlighted, especially in the area of dental care and the purchase of medicines. The analysis also covers the most important reforms of recent years, including the strengthening of primary health care, the expansion of dental services, and the implementation of the Pharmaceutical Policy 2030. The drug reimbursement process is described in detail, including the role of the State Agency of Medicines and the Committee for Medicinal Products, as well as the mechanisms for setting reference prices and limiting patient co-payments. Attention is drawn to the challenges related to the availability of innovative therapies, including oncological and orphan drugs, and to the relatively long waiting time for their reimbursement compared to the EU average. Despite limited resources and demographic challenges, the Estonian health care system is characterized by high efficiency, transparency of decision-making processes, and openness to digital innovation. Further challenges include ensuring long-term financial stability, improving access to services for vulnerable groups, and further integration of health and social care.
Abstract Objective: The aim of this publication is to compare the costs of therapies used in the first-line treatment of chronic lymphocytic leukaemia (CLL) and funded under the B.79 drug program in Poland. Methods: The cost analysis of treatment was presented in two variants: cost analysis of therapy until disease progression and cost analysis of continuous treatment (without considering therapy discontinuation). For the second variant, estimated costs were presented for a two-year and three-year time horizon. The drug dosing was based on the records of the B.79 drug program. Results: The average treatment cost for time-limited therapies ranges from PLN 62,611 for OBI + CLB to PLN 238,803 for VEN + IBR. For therapies used continuously until progression, the average treatment cost ranges from PLN 421,178 for IBR to PLN 478,071 for ZAN. The total cost parity between VEN + OBI and therapies requiring continuous treatment until disease progression occurs around the 80th to 91st week, while for IBR + VEN, the total costs equalize around the 119th to 134th week of treatment. After these time points, there is a potential cost saving for the public payer. Conclusions: The limited duration of treatment allows for cost control within the drug program. Even in the short-term time horizon, the use of time-limited therapies enables savings for the public payer.
Background: Vitamins and minerals are vital for normal physiological and metabolic functions of the body. These micronutrients are not synthesized within the body; hence, they are commonly prescribed as dietary supplements in medical practice. Children aged <5 years suffer due to malnutrition. They experience micronutrient deficiency and subsequent complications. The aim of this study was to understand drug use patterns and Pharmacoeconomics of multivitamin prescriptions in pediatric patients in a tertiary care hospital setting. Materials and Methods: This was a single-center, prospective, observational study conducted in patients admitted to the pediatric ward of a tertiary care hospital. Patients of either gender, aged <5 years, and who were receiving any vitamin supplements during their treatment were included in the study. Data for demographics, medical records, and medicines prescribed were recorded in a case report form and analyzed descriptively. Pharmacoeconomic aspects of multivitamin use were also studied. Descriptive data were reported as numbers, percentages, and means. Demographic variables were assessed using the Chi-square test, and a P value of 0.05 was considered significant. Results: A total of 57 patients who met the inclusion criteria were included in the study. The majority of the patients were male (64.9%), and the mean age was 9.3 months. Vitamin D was prescribed to 70.2% of patients. Other vitamins prescribed were vitamin B6, B7, B complex, vitamin K, vitamin C, vitamin E, and leucoverine. The cost of vitamins prescribed for patients accounted for 8.3% of the total cost of the prescribed medications (₹9904 out of ₹119636). Conclusions: We were able to understand the drug utilization patterns and Pharmacoeconomics of multivitamin prescriptions in pediatric patients in a tertiary care hospital setting. We found out that multivitamins were prescribed rationally, and the cost of multivitamins was less than 1/10th of the total cost of the prescribed medications.
Objective: Rituximab, a chimeric monoclonal antibody targeting CD20 on B lymphocytes, has revolutionized hematologic malignancy treatment since its FDA and EMA approvals in 1997 and 1998. For a long time, rituximab treatment has been the standard for follicular lymphoma (FL), diffuse large B-cell lymphoma, and chronic lymphocytic leukemia (CLL), significantly improving survival rates and quality of life. Rapid intravenous infusions, approved by the FDA in 2012 and EMA in 2023, reduce infusion times to 90 minutes, offering similar safety profiles to standard infusions with significant cost savings and reduced strain on healthcare resources. This analysis evaluates the benefits of rapid rituximab administration in Poland using Hospital-Based Health Technology Assessment (HB-HTA) methodology. Methods: Conducted from December 2023 to January 2024, the study involved 155 observations of standard infusions across 14 centers in Poland. Medical personnel completed forms detailing rituximab administration stages and patient information. Data were used to develop an economic model assessing the benefits of 90-minute infusions, replacing the observed standard delivery, considering setup time, medical personnel involvement, and hospital savings. Supplementary qualitative data were collected through 9 in-depth telephone interviews with medical personnel and patients. Results: The study included 155 patients with an average age of 61 years and an average infusion duration of 3 hours and 46 minutes. It is estimated that replacement of standard delivery with rapid infusions could save 21.47 PLN labor costs per infusion for CLL patients and 25.04 PLN for NHL patients, as well as would reduce bed occupancy and free up medical staff time. This is expected to allow the increased number of infusions to be performed monthly and allow for resource reallocation. Nurses expressed positive opinions on the benefits of rapid infusions, highlighting, among other things, reduced patient wait times and improved operational efficiency in ward operations Conclusions: Rapid rituximab infusions potentially would enhance patient convenience, healthcare resource efficacy, and reduce costs in the Polish healthcare sector setting. They also could improve patient quality of life by minimizing time in medical facilities. The adoption of rapid administration protocols can transform oncology practice, making it more efficient and patient-oriented. To fully realize these benefits, modifications to the NHF catalogue and public procurement criteria are recommended, along with developing outpatient care to reduce administrative burdens and relieve hospital resources. Abbreviations: CHP - cyclophosphamide, doxorubicin, and prednisone regimen; CLL - chronic lymphocytic leukemia; EMA - European Medicines Agency; FDA - US Food and Drug Administration; FL - follicular lymphoma; FTE - full-time equivalent; HB-HTA - Hospital-Based Health Technology Assessment; IRRs - Infusion-related reactions; NHF - National Health Fund; NHL - non-Hodgkin lymphoma.
Objectives The aim is to analyse the health and systemic effects of effective therapy for bronchial asthma and status asthmaticus in Poland for the purpose of assessing the possibility of introducing a model of coordinated care for patients with bronchial asthma and analysing the limitations resulting from the introduction of a coordinated care model. Methods The analysis was carried out based on actual data from the National Health Fund (NFZ) from 2013-2023 in the scope of the medical problem of bronchial asthma, defined by the codes of the main diagnosis ICD-10: asthma J45 and status asthmaticus J46. Results After the introduction of the first medicinal products for financing under the drug program for asthma treatment in 2013, a decrease in the number of patients registered for hospital treatment was observed at the level of: -2.79%, including, negative dynamics are observed in AOS and POZ. This means better disease control in patients, this conclusion is confirmedy the stable and maintained similar level of the distribution of the number of patients, taking into account the mode of admission to the hospital. Conclusions The introduction of the drug program for the treatment of bronchial asthma and the financing of medicinal product reduces the number of hospitalizations. After the introduction of the drug program, the number of benefits provided for incapacity for work due to bronchial asthma and the number of medical certificates have remained at a constant level. The number of days of sickness absence due to bronchial asthma has decreased.
Background COVID-19's emergence created a worldwide disaster, hitting nations of all income levels and causing catastrophic health and socioeconomic destruction. Due to differences in healthcare systems, demography, and containment measures, low and lower-middle-income nations (LMICs) had distinct problems in coping with the epidemic. Objectives This review synthesizes the existing evidence on the cost of treating COVID-19 in low and middle-income countries, including direct and indirect expenses and the methods employed in cost assessment. Methodology The review includes studies published after 2019, concentrating on COVID-19 patients in low and lower middle-income countries. Four studies complied to the inclusion criteria, demonstrating various methodological approaches, perspectives, cost components and regional variation across the healthcare system. Results Four studies from Iran, Kenya, Ghana and Ethiopia were included. Average direct medical costs per inpatient ranged from $321 to $3,755, with ICU care consistently 2–4 times more expensive than general ward care. Key cost drivers included ICU services (up to 41%), staffing (up to 46%), medications (up to 35%), and PPE (up to 79%). Indirect costs, where reported, added substantially to the total burden. Conclusion COVID-19 imposed a significant economic burden in low- and lower-middle-income countries, with costs escalating sharply in severe and critical cases. ICU care, staffing, medications, and PPE are the primary cost drivers. These findings emphasized the need for cost-efficient strategies—such as early detection, home-based care, and targeted ICU use—to optimize resource allocation and reduce financial strain on health systems.
Common Position of Scientific Societies: Polish Society of Dermatology (PTD), Polish Society for Fundamental and Clinical Immunology (PTiDiK), Polish Society of Paediatric Oncology and Haematology (PTOHD) Background and Objectives This paper aims to analyse, assess and appraise appropriate use of Normal Polyvalent Immunoglobulins (IgGs) across multiple indications, wherever these therapies are known to be used and have been proven to be an effective therapeutic modality. This assessment is based on a framework proposed by a group of international experts in the recent Green Paper „Appropriate Use of Immunoglobulins in Europe”.1 Based on a systematic application of the framework’s criteria to all IgG conditions and diseases, this paper presents a short-list of indications, where IgG use is appropriate, together with a guidance on optimal therapeutic paradigms. As such, this paper is aimed to assist the clinical community and policy makers in navigating the extremely complex clinical landscape of rare and ultra-rare diseases and conditions, which are either immune-mediated or stem from deficient, dysregulated or dysfunctional immune system. Some of the indications considered in this study are currently not registered for IgG use in Poland or, if registered, not fully covered with reimbursement. In cases where IgG use in such conditions or diseases is found to be appropriate, this study may be also considered by the relevant regulatory and/or HTA bodies as a contribution towards reassessment or reappraisal.
Objective: The study aims to examine the progress in menstrual hygiene management in the Empowered Action Group (EAG) states, India between 2015-16 and 2019-21 and identify its correlates in terms of household characteristics, women’s characteristics, and quality of governance at the state level. Methods: The National Family Health Survey (NFHS) is the primary data source for state-wise data on hygienic methods of menstrual protection (HMMP) and its potential correlates, namely household-level and women-specific characteristics. To assess the role of the quality of governance in the adoption of HMMP practices, the Governance Index is constructed using data on eleven variables from various secondary sources. The method of principal component analysis is used to construct the Women Empowerment Index and the Governance Index. The statistical methods also include computation of Karl Pearson’s bivariate correlation coefficients between the percent of women adopting HMMP practices and the covariates namely, household and women’s characteristics and the governance index as well as testing the statistical significance of the estimated correlation coefficients. Results: The study finds that the use of HMMP is positively correlated with household characteristics namely household wealth and general caste; women’s characteristics namely women’s education, empowerment, and exposure to the internet; and governance factors at the state-level. The study, however, does not find religion and exposure to mass media as exhibiting a statistically significant relationship with menstrual hygiene practices. Among the EAG states, Bihar and Madhya Pradesh exhibit the worst performance in HMMP, while Uttarakhand is the best performer and is an outlier with its exemplary performance in HMMP as well as in socio-economic indicators. Odisha and Rajasthan, despite mediocre performance in some of the socio-economic characteristics, show considerable improvements in menstrual hygiene largely due to successful government initiatives. Conclusion: The interplay of household, women’s characteristics and governance contributes to the poor performance of EAG states of Uttar Pradesh, Madhya Pradesh, Bihar and Chhattisgarh as compared to other states. The experience of EAG states highlights the importance of targeted state interventions and governance along with a supportive socio-economic environment in achieving the menstrual health of women. In addition to ensuring adequate income support, reducing social disparities, dispelling myths and taboos regarding menstrual health, and empowering women; the allocation of adequate funds and trained personnel can contribute significantly to the effective implementation of government schemes for improvements in menstrual hygiene. Keywords: Menstrual hygiene, Socio-economic factors, Women empowerment, Governance, EAG states, India
Objective: Soldiers forming Polish Military Contingents (PMCs) serving outside of Poland are exposed to a number of risk factors, which increase the probability of contracting intestinal parasitic infections (IPIs). This is primarily associated with poor sanitation in most areas of troops deployment and also with the ease of transmission via the oral-faecal route. The aim of the present article was to discuss the prevalence of IPIs in Polish soldiers deployed to Kosovo (the Balkans), Lebanon and Iraq (the Middle East). Methods: Parasitological exams were performed on stool samples collected from 2759 Polish soldiers who were serving in Iraq (n=766), Lebanon (n=970), and Kosovo (n=1023) between 2020 and 2023. Stool samples were transported to the Military Institute of Medicine – National Research Institute in Poland. Light microscopy examinations of the samples were performed using three different diagnostic methods (direct smear, decantation with distilled water, and Fülleborn’s flotation). Results: 16.2% of the examined soldiers were infected with at least one species of intestinal parasites (16.0% in Kosovo, 15.3% in Lebanon, 17.6% in Iraq). The examinations found only two cases of helminthic infections and three cases of infections with the pathogenic Giardia intestinalis protozoa. Most of the identified IPIs were potentially pathogenic Blastocystis spp. stramenopiles (12.0%). Conclusions: The results showed a low prevalence of IPIs among the study participants, despite harsh environmental conditions in all three areas of deployment (the Balkans and the Middle East). Low rates of IPIs suggest compliance with food and drinking water precautions and good hygiene practices of the soldiers involved in the study.
Objectives The quest of delivering improvement in health care quality always remain a tough war and this is mainly because of the intricate nature of health care systems which often require interventions that will spur improvement in all aspects of organizational performance. Among these factors, healthcare workers emerge as the most critical component that influence the quality of care. Their satisfaction and well being has a great link towards the efficiency of healthcare. The publication objectives are to: Identify key factors influencing employee satisfaction in U.S. hospitals, such as leadership quality, career growth, and workplace culture. Examine workplace stressors like excessive workloads and poor management that lead to dissatisfaction and burnout. Highlight the role of leadership in shaping positive employee experiences and organizational outcomes. Link employee satisfaction to improved patient care and overall organizational performance. Provide actionable insights for enhancing retention, reducing turnover, and fostering a supportive work environment. Methods The research was conducted based on a thorough analysis of 6,900 employee reviews published on Glassdoor. The reviews considered were published between January 2023 and April 2024. This study used a mixed methods research approach, integrating qualitative and quantitative elements to provide a comprehensive analysis. Results The study results indicate that job satisfaction is deeply dependent on factors such as management's attitude and professionalism, interpersonal relationships, effective workload management, and career development opportunities. Additionally, stressors such as high patient-to-staff ratios, lack of flexible work scheduling solutions, and unprofessional administrative support are significant factors contributing to job dissatisfaction and burnout. Conclusion The study emphasizes the crucial role of overall leadership quality in shaping employee satisfaction and the destructive impact of toxic managerial behaviors. It also highlights the need for systematic encouragement of management to improve their skills in using soft management tools.
Objective This study aims to scrutinize the determinants of acceptance non-communicable disease prevention and control policies among adolescents. Method This research employed an analytic observational method with a cross-sectional approach. It was conducted in Semarang and involved 1396 adolescents selected through simple random sampling. Respondents are from the Semarang area, Central Java. The distribution of questionnaires in this study was carried out using google form which was distributed on the WhatsApp social media platform. The endogenous variable focused on the education and acceptance of non-communicable disease prevention and control policies among adolescents, with exogenous variables, including age, sex, and economic status. The inclusion criteria were adolescents of 18–24 years of age in Semarang and willing to be a respondent. The exclusion criteria in this study were respondents who did not fill out the questionnaire completely. The data was collected through a questionnaire and analyzed using chi-square to explore the relationship between the endogenous and exogenous variables. To identify both direct and indirect factors linked to the acceptance of non-communicable disease prevention and control policies, Stata 13 was utilized. Results There is a statistically significant correlation between age (OR= 1.68, CI 95% = 1.23 to 2.30, p= 0.001), education (OR= 1.55, CI 95% = 1.17 to 2.06, p= 0.003), sex (OR= 1.50, CI 95% = 1.13 to 1.97, p= 0.005), and economic status (OR= 1.37, CI 95% = 1.00 to 1.87, p= 0.045) and the acceptance of non-communicable disease prevention and control policies among adolescents. The path analysis model demonstrates that age, education, sex, and economic status have a direct impact on the acceptance of these policies. Simultaneously, it indicates that age, sex, and economic status indirectly influence the endorsement of policies for preventing and controlling non-communicable diseases. Conclusion Age, education, sex, and economic status are key factors influencing the acceptance of non-communicable disease prevention and control policies among adolescents. To address the challenges posed by non-communicable diseases, it is crucial to implement comprehensive and holistic intervention efforts, encompassing promotive, preventive, curative, and rehabilitative measures as a unified continuum of care.
Objective: The aim of this article is to collect and compare lipodystrophy assessment and severity grading methods. Electronic databases, bibliographies, and specialist publications were reviewed. Methods: Medical databases and repositories of scientific articles were reviewed, including PubMed, Scopus, PMC-NCBI, Science.gov, and Google Scholar. Specialized publication sources were also searched. Based on the collected material, a list of available cellulite assessment and severity grading methods was prepared. Results: The article presents all available scales for examining the advancement of cellulite changes. Based on available data and scales, it is possible to estimate the actual severity of GLD. Due to the multifactorial pathogenesis of the changes, the selection of appropriate treatment and prevention methods depends on good diagnostics. Conclusions: The conducted literature research allowed us to select papers published in the selected databases concerning comparative lipodystrophy assessment and severity grading methods. The obtained material will facilitate the selection of proper therapy and contribute to appropriate diagnostics, prevention, and treatment of changes. It will also facilitate understanding the pathophysiology and genesis of GLD.
Objective Understanding the determinants of informal payments can help policymakers identify appropriate policies and increase the effectiveness of health systems. However, very few studies address this topic in Türkiye. This paper aims to identify and prioritize the causes of informal payments for healthcare to provide accurate information for policymaking and resource allocations. Methods 21 sub-factors were determined and divided into four main factors. Analytical Hierarchy Process was used to determine the relative importance of the factors and sub-factors. Pair-wise comparisons were carried out by eight participants, which consisted of scholars, medical doctors, and health managers. Results The most important cause of informal payments was found to be “healthcare provision-related factors”. The overall weights of other sub-factors provide evidence that the monopoly power of some doctors, insufficient payment to providers, search for more quality healthcare by patients, and public belief that informal payment is inevitable are prominent determinants of the burden of informal payments. Seeking quality of healthcare and a common belief that informal payment is required to receive desired services are important causes of informal payments. Conclusion Policymakers and managers must reconsider the quality and effectiveness of healthcare provision and improve the payments to health staff. Public awareness should be increased to make individuals adopt their health-related rights.
Objective: The aim of this study is to assess the Knowledge, Attitude, and Perception (KAP) of hospital staff regarding the Casemix System in Developing countries. Methods: A cross-sectional study was carried among the hospital staffs in Indonesia and Malaysia. The study hospitals and respondents were selected via random and purposive sampling, respectively. Data was collected via self-administered questionnaires. Results: Total 350 hospital staffs participated, out of this 58.6% of participants were from Indonesia. Most of the respondents (58.0%) had a moderate level of knowledge score, medium level of perception score (84.9%) and negative attitude (90.0%) on Casemix. The study found that years of working experience, type of occupation, hospital type, country, and those with training in Casemix were significantly related to knowledge score. No independent variable except for country was related to perception score. It was also found that majority (66.7%) of the participating hospitals (N=36) completely captured the demographic data in their HIS, 47.2% completely implementing the coding module as per Casemix requirement and 27.8% of the hospitals recorded the Activity Daily Living (ADL) score in their system. Conclusion: Among the participants, only 2.3% demonstrated a high level of knowledge about Casemix. When it comes to attitudes, majority of respondents expressed a negative view towards Casemix. Regarding perceptions, only 11.4% of respondents had a high perception of Casemix, while the majority, 84.9%, had a medium perception.
