BACKGROUNDChina has achieved universal health insurance coverage. This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes.

METHODSThe sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing. We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives.

RESULTSPatients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates. Under plans with an annual ceiling for insurance coverage, patients spent significantly more in the second half of the year than in the first half of the year. The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider.

CONCLUSIONSOur results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers. Reformation is necessary to reduce those incentives, and improve equity and efficiency in healthcare use.

China ; Female ; Health Personnel ; statistics & numerical data ; Humans ; Insurance, Health ; statistics & numerical data ; Male ; Motivation ; Patients ; statistics & numerical data

COVID-19/psychology* ; Global Health/statistics & numerical data* ; Health Personnel/statistics & numerical data* ; Humans ; Mental Disorders/etiology* ; Mental Health/statistics & numerical data* ; Occupational Diseases/psychology*

PURPOSE: Health care delivery systems in rural areas face numerous challenges in meeting the community's needs. There is a lack of adequate attention for this problem. This study aims to explore the challenges of the health care process in rural Iran according to health care providers' experiences. METHODS: This was a qualitative study that used the content analysis method. We selected a total of 21 health care providers based on purposive sampling. Data collection consisted of semi-structured individual interviews that were analyzed by qualitative content analysis. RESULTS: Data analysis led to the formation of one main category, the challenges of process of health care in rural society. Within this main category, we created the following subcategories: change in characteristics of the rural society, increase in complexity of the health care process, decrease in workforce efficiency, and decrease in propensity of people's care. CONCLUSION: The findings of this study indicate that the process of health care in Iranian rural society is changing rapidly with community health workers encountering new challenges. There is diminished efficiency in responding to the changing care process in Iran's rural society. Considering this change in process of care, therefore, the health care system should respond to these new challenges by establishing new health care models.
Community Health Workers ; Data Collection ; Delivery of Health Care ; Health Personnel ; Humans ; Iran ; Nursing Care ; Rural Health ; Rural Population ; Statistics as Topic

OBJECTIVETo conduct a study on attitudes, knowledge, and use of complementary and alternative medicine (CAM) therapies in Serbia. Available data about CAM therapies in the region are scarce, opinions lacking from health sector. Balkan region countries had a delay in issuing national policies on CAM therapies.

METHODSThe questionnaire used was based on previously validated CAM Health Belief Questionnaire (CHBQ), formulated as 5-item Likert type scale, adjusted for local environment. Health care students and professionals were evaluated. The questionnaire comprehended 10 closed questions on attitudes, knowledge and use of CAM therapies. This survey was conducted in eight cities of Serbia, January 2010-July 2011. A total of 797 participants was included. The second group of participants was 145 healthcare professionals (50 academic staff, 64 clinical staff, 19 pharmacists, 6 other clinical branch specialists and 6 nurses). Data were collected by an interview. Examinees could acquire maximum of 70 points, 35 representing neutral attitude.

RESULTSStudents of dentistry (54.65±6.07) were better informed on CAM therapies than medicine students (50.26±7.92). Pharmacy students (51.16±7.10) accepted low-scientific CAM. Pharmacists scored better than university professors (55.12±6.55 vs. 50.29±9.50). Primary health care professionals had better awareness than pharmacists in dispensing pharmacies. Both groups of participants preferred use of vitamins over any other CAM therapy.

CONCLUSIONThese pioneering efforts in the region exposed weaknesses in CAM attitudes of current and future health care professionals. Nevertheless, awareness on alternative medicine treatment choices is growing among Balkan prescribers. Supportive legal framework would facilitate dissemination of CAM medical practices.

Attitude of Health Personnel ; Complementary Therapies ; utilization ; Cross-Sectional Studies ; Delivery of Health Care ; statistics & numerical data ; Health Knowledge, Attitudes, Practice ; Health Personnel ; Humans ; Serbia ; Students ; Surveys and Questionnaires

Health Personnel ; psychology ; Humans ; Logistic Models ; Multivariate Analysis ; Professional Competence ; statistics & numerical data ; Stress, Psychological ; epidemiology

Cardiovascular Diseases ; epidemiology ; Female ; Health Personnel ; statistics & numerical data ; Humans ; Male

COVID-19/virology* ; China ; Disease Outbreaks ; Health Personnel/statistics & numerical data* ; Humans ; SARS-CoV-2/pathogenicity*

BACKGROUND: Occupational contact with blood and body fluids poses a significant risk to healthcare workers. The aim of this systematic review is to investigate the epidemiology and risk factors affecting needlestick injuries (NSI) in healthcare personnel in Iran. METHODS: In March 2020, researchers studied six international databases such as Medline/PubMed, ProQuest, ISI/WOS, Scopus, Embase, and Google Scholar for English papers and two Iranian databases (MagIran and SID) for Persian papers. Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess quality of studies. The method of reporting was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. RESULTS: A total of 43 articles were included in the analysis. Results showed that females (OR = 1.30, 95 % CI 1.06-1.58, P value = 0.009), younger age (OR = 2.75, 95 % CI 2.27-3.33, P value < 0.001, rotated shift workers (OR = 2.16, 95 % CI 1.47-3.15, P value < 0.001), not attending training courses (OR = 1.30, 95 % CI 1.07-1.56, P value = 0.006), working in the surgery ward (OR = 1.83, 95 % CI 1.33-2.50, P value < 0.001), less work experience (OR = 1.43, 95 % CI 1.04-1.95, P value = 0.025) apposed a greater risk factors for NSI among healthcare workers. CONCLUSION Based on the results of this review, factors such as young age, less work experience, work shift, and female gender are considered as strong risk factors for NSI injury in Iran. Preventive measures including education programs can reduce the burden of NSI among healthcare personnel.
Health Personnel/statistics & numerical data* ; Humans ; Incidence ; Iran/epidemiology* ; Needlestick Injuries/epidemiology* ; Prevalence ; Risk Factors

BACKGROUND: The Japanese health and welfare industry has a shortage of professional caregivers, and work-related accidents and injuries among this group are therefore especially critical issues. This study aimed to examine the factors associated with turnover intentions and work-related injuries and accidents among professional caregivers in Japan. METHODS: Self-report questionnaires were distributed to care workers (N = 1396) at 26 geriatric-care facilities. The questionnaire addressed basic attributes, work and organizational characteristics, wage adequacy, and intrinsic motivations for work (e.g., "being suited to caring work"). Social-relational aspects of the work environment were assessed via three subscales of the Social Capital and Ethical Climate in the Workplace instrument (i.e., "Social Capital in the Workplace," "Exclusive Workplace Climate," and "Ethical Leadership"). Dependent variables were the experience of work-related accidents or injuries in the prior year and organizational and occupational turnover intentions. We used datasets of professional caregivers for analyses. RESULTS: The response rate was 68% (N = 949). Among the 667 professional caregivers, 63% were female. On multivariable logistic regression analysis for work-related accidents and injuries for each sex, those with higher scores for "being suited to caring work" were found to experience significantly fewer work-related accidents and injuries (odds ratio [OR] = 0.78, p < 0.01) among female caregivers. Male caregivers who perceived an exclusive workplace climate experienced more work-related accidents and injuries (OR = 1.61, p < 0.01). However, experience of work-related accidents and injuries did not show significant relationships with organizational and occupational turnover intentions. Additionally, "being suited to caring work" (OR = 0.73, p < 0.01) and ethical leadership (OR = 0.76, p < 0.05) were found to be negatively associated with organizational turnover intentions. "Being suited to caring work" (OR = 0.61, p < 0.01), inadequacy of wage (OR = 2.22, p < 0.05), and marital status (OR = 2.69, p < 0.01) were also associated with occupational turnover intentions of professional caregivers. CONCLUSIONS These findings highlight the need to foster intrinsic motivations for work as well as providing a supportive and ethical work environment to reduce high turnover rates and work-related injuries and accidents among professional caregivers.
Accidents, Occupational ; statistics & numerical data ; Adult ; Attitude of Health Personnel ; Caregivers ; psychology ; statistics & numerical data ; Female ; Humans ; Intention ; Japan ; Job Satisfaction ; Male ; Middle Aged ; Occupational Injuries ; statistics & numerical data ; Personnel Turnover ; statistics & numerical data ; Self Report

OBJECTIVETo investigate the knowledge level related to medical device adverse events (MDAEs) among medical personnels, some factors influencing the reporting behavior and supervision and administrative strategies.

METHODSStratified sampling, cluster sampling and random sampling were adopted together and a questionnaire survey was conducted among 1897 subjects from 33 hospitals.

RESULTSMedical personnels knew a very little about MDAEs and medical devices' post-market monitoring, but their attitudes towards its benefits were positive. Their intentions to report MDAEs were relatively strong, but there were still some barriers about it.

CONCLUSIONA monitoring system and a professional training model about MDAEs reporting should be established and improved in hospitals.

Equipment and Supplies ; adverse effects ; Health Knowledge, Attitudes, Practice ; Health Personnel ; education ; Humans ; Medical Errors ; statistics & numerical data