BACKGROUND: Medical Aid (MA) beneficiaries, belonging to low-income and vulnerable groups, tend to utilize more healthcare services than patients covered by general health insurance. This study aimed to investigate shifts in medical expenses among South Korean MA beneficiaries from 2010 to 2020 in response to changes in health coverage. METHODS: This study was a retrospective cohort study that involved analyzing data from 354,289 MA beneficiaries aged 20 years and older as of 2010 whose healthcare utilization data could be tracked up to 2020. The impact of changes in health coverage of MA beneficiaries on the increase in medical expenses was analyzed with multiple logistic regression analysis. RESULTS: The findings revealed that the group maintaining their MA eligibility had a higher rate of increase in medical expenses compared to those transitioning from MA to National Health Insurance (NHI). Even after adjusting for covariates, the likelihood of an increase in total annual medical expenses was more than 1.4 times higher for the MA maintenance group. However, the group that maintained MA also had higher initial healthcare expenses, indicating poorer health status, compared to the group that transitioned to NHI. CONCLUSION In the public healthcare domain, such as MA, it is crucial to enhance access to necessary healthcare services while preventing unnecessary medical treatments. There is a need for systemic improvements to ensure that low-income, medically vulnerable groups can appropriately use the healthcare services they require to achieve high-value health outcomes.
Republic of Korea ; Humans ; Retrospective Studies ; Middle Aged ; Adult ; Female ; Poverty/statistics & numerical data* ; Male ; Vulnerable Populations/statistics & numerical data* ; Aged ; Health Expenditures/statistics & numerical data* ; Young Adult ; Medical Assistance/statistics & numerical data* ; Insurance Coverage/statistics & numerical data*

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis (TB) in Guangdong province from 2016 to 2020 and provide evidence for the prevention and control of pulmonary TB. Methods: Descriptive epidemiological methods were used to analyze the incidence data of pulmonary TB reported in Guangdong from 2016 to 2020. Dynamic geometric series averaging and circular distribution methods were used to reveal the epidemic pattern. Results: A total of 356 748 pulmonary TB cases were reported in Guangdong from 2016 to 2020. The reported incidence of pulmonary TB decreased from 71.82/100 000 to 50.40/100 000 (trend χ²=6 905.57,P<0.001) , with an annual decline rate of 8.47%. Results from the circular distribution methods showed that the incidence peak would occur on May 4^th-5^th (Z=1 176.96,P<0.05), and the incidence was relatively higher in May compared with other months. The area distribution of the pulmonary TB epidemic was uneven, and the reported average annual incidence was in the order of the eastern area (72.15/100 000), the northern area (68.14/100 000), the western area (65.31/100 000) and the Pearl River Delta area (60.05/100 000). Results of dynamic geometric series averaging analysis showed a declining trend in the reported incidence of pulmonary TB in all areas, except Dongguan, with the average growth rate less than 0.00. The decline rate in the eastern area (-10.90%) and northern area (-10.63%) was higher than the provincial average (-8.47%). The male to female ratio of the cases was 2.63∶1 (258 562∶98 186). The reported average annual pulmonary TB incidence in men (88.37/100 000) was higher than that in women (36.86/100 000), the difference was significant (χ²=75.19, P<0.001). The reported incidence of pulmonary TB generally increased with age (trendχ²=123 849.44, P<0.001), and reached peak in age group ≥65 years (164.54/100 000). Dynamic geometric series averaging analysis showed an increasing trend of the reported pulmonary TB incidence in age groups 5-14 years and 15-24 years, with the average growth rate of 0.05% and 3.60%. Conclusions: The reported annual incidence of pulmonary TB showed a declining trend year by year in Guangdong from 2016 to 2020. However, an increasing incidence was reported in children and adolescents. Active case finding should be strengthened in the elderly and other key populations. With comprehensive TB prevention and control measures, it is still necessary to pay attention to the prevention and control of pulmonary TB in men, low-income groups and less developed areas in Guangdong and strengthen the comprehensive prevention and control in winter and spring.
Adolescent ; Child ; Aged ; Female ; Humans ; Male ; Child, Preschool ; Tuberculosis, Pulmonary/epidemiology* ; Epidemics ; Poverty ; Rivers ; China/epidemiology*

Purpose: This study aimed to determine the prevalence and status of refractive error among Chinese primary school children in a rural area in Pahang. Methods: This investigation entailed a cross-sectional retrospective study design involving case file analyses. The study site was a Chinese medium primary school in a rural locality within Bentong district. A total of 82 school children met the B40 classification and selection criteria; therefore, universal sampling was done. Analyses were done according to age group: Level 1 included ages 7 to 9 years, while Level 2 comprised 10- to 12-year-olds. Results: The mean age of the 82 Chinese school children was 9.72±1.5 years; the percentage of refractive errors found was 80.48%. A total of 53 (64.63%) children had myopia. Two-way ANOVA showed a significant difference (P=0.038) in the refractive error between age groups Level 1 and 2, but no significant difference (P=0.947) was observed in refractive error between genders. The chi-square test and Fisher’s exact test showed no significant association between the type of refractive error with gender (P>0.05) and age group (P=0.319). Conclusion Myopia was the most common type of refractive error among Chinese school children in a rural area in Pahang. Refractive error severity was influenced by age group but not by gender. Types of refractive error were not associated with age group and gender. Hence, it is recommended that Chinese school children in rural areas seek an annual vision screening or eye test.
Poverty Areas ; Refractive Errors ; Vision Screening

Blood Pressure Monitoring, Ambulatory ; COVID-19/therapy* ; Cardiac Rehabilitation ; Cardiovascular Diseases/therapy* ; Communicable Disease Control ; Contact Tracing ; Health Literacy ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Internet Access ; Poverty ; SARS-CoV-2 ; Singapore ; Social Class ; Social Conditions ; Socioeconomic Factors ; Telemedicine ; Telerehabilitation ; Transients and Migrants

Poverty alleviation by Chinese herbal medicine industry is an important way to implement the major strategic plan of the government and to effectively alleviate poverty and increase income of poor farmers in areas with high resource's endowment of Chinese medicinal materials. Based on the analysis of the existing achievements and problems in poverty alleviation by Chinese herbal medicine industry, this paper proposes that improving the comprehensive benefits of Chinese herbal medicine industry is an important direction for poverty alleviation in the poverty-stricken areas with the high endowment of traditional Chinese medicine resources in the future. Then, based on the concept of resource recycling of traditional Chinese medicinal materials, the feasibility and strategies of utilizing by-products in the production process of Chinese medicinal materials and expanding the ways of poverty alleviation were analyzed and discussed. The aim of all these works was to provide the support for enhancing the comprehensive competitiveness of the industry in poverty-stricken regions, enlarging the poverty alleviation effect of Chinese herbal medicine industry, and consolidating the achievements of poverty alleviation.
China ; Drug Industry/economics* ; Drugs, Chinese Herbal ; Herbal Medicine/economics* ; Medicine, Chinese Traditional ; Poverty

We investigated the associations of clinical and socioeconomic factors with delayed orchidopexy for cryptorchidism in China. A retrospective study was conducted on cryptorchid boys who underwent orchidopexy at Children's Hospital at Chongqing Medical University in China from January 2012 to December 2017. Of 2423 patients, 410 (16.9%) received timely repair by 18 months of age, beyond which surgery was considered delayed. Univariate analysis suggested that the laterality of cryptorchidism (P = 0.001), comorbidities including inguinal hernia/scrotal hydrocele (P < 0.001) or urinary tract disease (P = 0.016), and whether patients lived in a poverty county (P < 0.001) could influence whether orchidopexy was timely or delayed. Logistic regression analysis suggested that the following factors were associated with delayed repair: unilateral rather than bilateral cryptorchidism (odds ratio [OR] = 1.752, P < 0.001), absence of inguinal hernia or hydrocele (OR = 2.027, P = 0.019), absence of urinary tract disease (OR = 3.712, P < 0.001), and living in a poverty county (OR = 2.005, P < 0.001). The duration of postoperative hospital stay and hospital costs increased with the patient's age at the time of surgery.
Age Factors ; Child ; Child, Preschool ; China/epidemiology* ; Cryptorchidism/surgery* ; Hernia, Inguinal ; Humans ; Infant ; Male ; Orchiopexy/statistics & numerical data* ; Poverty ; Retrospective Studies ; Socioeconomic Factors ; Testicular Hydrocele ; Time-to-Treatment

The Dendrobium species are rare and endangered medicinal plants, and it is difficult to investigate their wild resources with conventional methods because of typical epiphytic herbaceous. We explored Dendrobium resources(include culture resource) of Qinba Mountains and the boundary Mountain area in Hubei, Chongqing using the methods of literatures and field investigation, and found that the cultural base of Dendrobium were profound in Qinba Mountains region. Furthermore, its germplasm resources of Dendrobium were established for the first time in Wanzhou Luotian town. In case the advantages of local rock resources and poverty alleviation demand, we have actively carried out the cultivating mode of Dendrobium which grow on rock, and the poverty alleviation model of local characteristic Dendrobium industry were established preliminarily. Our application case can provide reference for the mining and transformation of traditional Chinese medicine resources census results.
Agriculture ; economics ; China ; Dendrobium ; growth & development ; Medicine, Chinese Traditional ; Plants, Medicinal ; growth & development ; Poverty

BACKGROUND: More than half of the disease burden in Uganda can be prevented through improving water, sanitation, and hygiene (WASH). In slum communities, water supply is insufficient but also highly contaminated; therefore, ensuring that the safe water chain is maintained by households is paramount to preventing water-related diseases. This study aimed at assessing knowledge and practices of households on safe water chain maintenance in slum communities in Kampala City, Uganda. METHODS: This was a community-based cross-sectional study carried out among 395 households in slum communities in Kampala, Uganda. Data were collected using a semi-structured questionnaire. Prevalence ratios (PRs) and their 95% confidence intervals were used as a measure of association between safe water chain management and associated knowledge and practice factors. The PRs were obtained using a multivariable modified Poisson regression with logarithm as the link function, with robust standard errors. RESULTS: Majority (76.7%, 303/395) of the households collected their water from a piped water system and paid for the water (72.9%, 288/395). Almost all (97.2%, 384/395) of the participants said that they knew the dangers associated with drinking unsafe water, boiled their drinking water (95.4%, 377/395), and used storage containers that minimize contamination (97.0%, 383/395). However, only (32.4%, 128/395) of the households satisfactorily maintained the safe water chain. Female- (adjusted PR = 1.82, 95% CI (1.19-2.78)) and student-led households (adjusted PR = 1.58, 95% CI (1.03-2.41)) and those whose heads had attained post-primary education (adjusted PR = 1.48, 95% CI (1.02-2.17)) were more likely to satisfactorily maintain the safe water chain. This was similar among members who thought most contamination occurs during storage (adjusted PR = 1.47, 95% CI (1.10-1.97)). CONCLUSION Only a third of the households maintained the safe water chain satisfactory. Female-led, student-led, and post-primary educated-led household and household that thought most contamination occurs during storage were more likely to maintain the safe water chain. There is a need to improve the level of awareness about the importance of the safe water chain among slum dwellers.
Adult ; Cross-Sectional Studies ; Drinking Water ; analysis ; Family Characteristics ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hygiene ; Male ; Middle Aged ; Poverty Areas ; Sanitation ; statistics & numerical data ; Uganda ; Urban Population ; statistics & numerical data ; Water Supply ; statistics & numerical data ; Young Adult

BACKGROUND: Although lead neurotoxicity is a known phenomenon, it can often be missed at a primary or secondary care level especially if detailed environmental exposure history is missed. METHODS: This is an outbreak investigation where we observed 15 pediatric cases with neurologic signs and symptoms clustered in a slum area known for an unorganized artificial jewelry industry. Their clinical, biochemical, and epidemiological features were compared with 14 other children from the same region reporting with non-neurological symptoms who were considered as unmatched controls. RESULTS: Cases with neurological manifestations had a higher in-house lead smelting activity [OR 7.2 (95% CI 1.4-38.3)] as compared to controls. Toddlers below 3 years of age were more vulnerable to the effects of lead. CONCLUSION This study emphasizes that many focal sources of lead poisoning still remain especially in the unorganized sector. In cases presenting with unexplained neurotoxicity, specific occupational and environmental inquiry for chemical poisoning, with special consideration for lead, should be actively pursued.
Adolescent ; Air Pollution, Indoor ; adverse effects ; Case-Control Studies ; Child ; Child, Preschool ; Disease Outbreaks ; Female ; Humans ; India ; epidemiology ; Infant ; Inhalation Exposure ; adverse effects ; Jewelry ; poisoning ; Lead ; blood ; standards ; Lead Poisoning ; epidemiology ; pathology ; physiopathology ; Male ; Metallurgy ; Neurotoxicity Syndromes ; epidemiology ; pathology ; physiopathology ; Poverty Areas ; Risk Factors

OBJECTIVES: This study compared the dietary behaviors of single-person households when eating alone according to the employment pattern and age. METHODS: A total of 566 people aged 20~59 years old were collected from the status of workers and classified into three groups according to their employment pattern (regular, non-regular workers and business owner). The subjects were collected by purposive quota sampling on a Gallup panel from June to November in 2017. The dietary behavior and perception of eating alone of the subjects were surveyed via online and self-reported questionnaires. RESULTS: The frequency of eating alone was significantly higher in the regular group than the non-regular group and business group (p<0.01). The place of eating alone was significantly higher in the regular and non-regular group in the convenience store, and business group in the office (p<0.001). Ramen, the menu when eating alone, was significantly higher in the non-regular group than the other groups (p<0.01). The preference for eating alone was lower in the older age group (p<0.05). The young aged group (aged 20~30) ate more fast food and felt more convenience than the older aged group aged 40~50 years (p<0.05). CONCLUSIONS: Single-person households with a non-regular job have poorer dietary behavior in eating alone than those who had regular employment. In a situation of an increasing number of non-regular workers aged in their 20s and 30s, there is a high likelihood of social problems, such as health and poverty. This study highlights the need for a healthy food selection environment to improve the dietary life of single-person households with non-regular jobs for the diverse types of single-person households.
Commerce ; Eating ; Employment ; Family Characteristics ; Fast Foods ; Food Preferences ; Humans ; Poverty ; Social Problems