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Interdisciplinarity in Health and Health Care (Part II): Review, Management-Logistic-Risk and Prevention

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 40652

Special Issue Editors

Center for Health Care Management, Faculty of Management, University of Warsaw, 00-927 Warszawa, Poland
Interests: medical geography; medical innovation; telemedicine; health inequalities; socio-economic background of health and health care; quality management
Special Issues, Collections and Topics in MDPI journals
Southampton Business School, University of Southampton, Highfield SO17 1BJ, UK
Interests: health care modelling; HIV/AIDS; diabetes; cancer; sexually transmitted diseases; emergency care; healthcare information systems; operational research
Centre for Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-136 Lodz, Poland
Interests: management of healthcare system logistics; telematics in medicine; management of security in logistics; risk management; economics
Center for Health Care Management Faculty of Management, University of Warsaw, 00-927 Warszawa, Poland
Interests: practicing physician; internist; sexologist; health care management; pharmacology specialist

Special Issue Information

Dear Colleagues,

In view of the great interest in the subject of health and medical care from the perspective of many disciplines and subdisciplines, we are pleased to announce the launch of the second part of our Special Issue. In addition to our regular threads, such as Management–Education–Prevention, this time, we encourage authors to also submit texts emphasizing risk and logistics in healthcare organization. The importance of risk management in healthcare continues to grow, being particularly important during the COVID-19 pandemic. This area has with increasing frequency started to also include adverse events and chronic diseases. A new challenge is the growing population with post-COVID-19 (PC19) syndrome. The role of the area of risk management is becoming more and more important due to the limited and decreasing potential of provision of medical procedures in most countries around the world.

Due to technological progress, an increasing number of innovative applications can be found in the logistics of healthcare processes. An improvement of logistics management enables, among other things, higher operational efficiency of the organization, which is very important in the context of the pandemic.

In addition, we encourage authors to submit texts on health and medical care problems of different countries/regions, so that we can have a spectrum of points of view both due to the diversity of disciplines and also due to the geographic, cultural, and economic aspects of the external environment of patients and medical care. Let us be international in our interdisciplinarity.

Prof. Dr. Izabella Lecka
Prof. Dr. Sally Brailsford
Prof. Dr. Remigiusz Kozlowski
Prof. Dr. Józef Haczyński
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health
  • healthcare
  • logistic
  • risk management
  • prevention
  • education
  • interdisciplinarity
  • comparative studies
  • geography of health
  • COVID-19

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Published Papers (20 papers)

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12 pages, 2327 KiB  
Article
Protective Vaccination Used by Doctors for Prevention of Infections
Int. J. Environ. Res. Public Health 2023, 20(5), 4153; https://doi.org/10.3390/ijerph20054153 - 25 Feb 2023
Cited by 1 | Viewed by 1016
Abstract
Doctors, as with all healthcare workers, are a specific risk group due to a high probability of contact with contagious pathogens. An online survey was conducted among Polish doctors to establish their use of protective vaccination to decrease their personal risk of infection. [...] Read more.
Doctors, as with all healthcare workers, are a specific risk group due to a high probability of contact with contagious pathogens. An online survey was conducted among Polish doctors to establish their use of protective vaccination to decrease their personal risk of infection. The online survey was conducted using questions about medics’ vaccination decisions and approaches. The results revealed that immunization against VPDs for most participants was not adequate based on recommendations or developments in vaccinology. To increase vaccination as a prophylactic method among doctors, especially those not involved in the immunization of patients, an educational campaign is demanded. As non-immunized medics are at risk themselves and are also a threat to the safety of patients, legal changes and the monitoring of vaccine acceptance and perception among medics are required. Full article
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20 pages, 388 KiB  
Article
Assessment of In-Hospital Mortality and Its Risk Factors in Patients with Myocardial Infarction Considering the Logistical Aspects of the Treatment Process—A Single-Center, Retrospective, Observational Study
Int. J. Environ. Res. Public Health 2023, 20(4), 3603; https://doi.org/10.3390/ijerph20043603 - 17 Feb 2023
Cited by 1 | Viewed by 1588
Abstract
Technological progress, such as the launching of a new generation of drug-coated stents as well as new antiplatelet drugs, has resulted in the treatment of myocardial infarction (MI) becoming much more effective. The aim of this study was to assess in-hospital mortality and [...] Read more.
Technological progress, such as the launching of a new generation of drug-coated stents as well as new antiplatelet drugs, has resulted in the treatment of myocardial infarction (MI) becoming much more effective. The aim of this study was to assess in-hospital mortality and to conduct an assessment of risk factors relevant to the in-hospital death of patients with MI. This study was based on an observational hospital registry of patients with MI (ACS GRU registry). For the purpose of the statistical analysis of the risk factors of death, a univariate logistic regression model was applied. In-hospital general mortality amounted to 7.27%. A higher death risk was confirmed in the following cases: (1) serious adverse events (SAEs) that occurred during the procedure; (2) patients transferred from another department of a hospital (OR = 2.647, p = 0.0056); (3) primary percutaneous coronary angioplasty performed on weekdays between 10 p.m. and 8 a.m. (OR = 2.540, p = 0.0146). The influence of workload and operator experience on the risk of death in a patient with MI has not been confirmed. The results of this study indicate the increasing importance of new risk factors for in-hospital death in patients with MI, such as selected logistical aspects of the MI treatment process and individual SAEs. Full article
12 pages, 491 KiB  
Article
Identification and Preliminary Hierarchisation of Selected Risk Factors for Carbapenemase-Producing Enterobacteriaceae (CPE) Colonisation: A Prospective Study
Int. J. Environ. Res. Public Health 2023, 20(3), 1960; https://doi.org/10.3390/ijerph20031960 - 20 Jan 2023
Cited by 3 | Viewed by 1131
Abstract
Drug-resistant bacteria are one of the main reasons of deaths worldwide. One of the significant groups of these bacteria are carbapenemase-producing Enterobacteriaceae (CPE). The goal of this cross-sectional study was the identification and hierarchisation of selected risk factors of CPE colonisation. To achieve [...] Read more.
Drug-resistant bacteria are one of the main reasons of deaths worldwide. One of the significant groups of these bacteria are carbapenemase-producing Enterobacteriaceae (CPE). The goal of this cross-sectional study was the identification and hierarchisation of selected risk factors of CPE colonisation. To achieve that goal, we examined 236 patients for the presence of CPE using the standard method of anal swabs. The patients were divided into three groups: hospitalised patients; those chronically dialysed; those requiring home care. A very thorough medical interview was conducted for comorbidities. A statistical analysis relationship between comorbidities and locations of the patient’s stay with the positive result of the culture was investigated. A significant relationship was demonstrated between the positive result of the culture and confirmed dementia, heart failure, connective tissue diseases, and established irregularities in the level of leukocytes. No significant relationship was demonstrated with the remaining comorbidities considered in the study. Afterwards these factors were compared for importance for the assessment of risk of a positive swab result—the biggest importance was found in establishing connective tissue disease. Next were dementia, abnormal values of leukocytes, heart failure, and at the end, stay at the orthopaedics ward. Conclusions: The study identified asymptomatic carriers of CPE, which demonstrates the need for further studies in order to identify infection risk factors. The connective tissue diseases are the most important variable which enable the prediction of CPE colonisation—the next ones are dementia, abnormal values of leukocytes, heart failure, and stay at the orthopaedics ward. Full article
12 pages, 346 KiB  
Article
The Hospital Environment as a Potential Source for Clostridioides difficile Transmission Based on Spore Detection Surveys Conducted at Paediatric Oncology and Gastroenterology Units
Int. J. Environ. Res. Public Health 2023, 20(2), 1590; https://doi.org/10.3390/ijerph20021590 - 15 Jan 2023
Cited by 2 | Viewed by 1436
Abstract
Clostridioides difficile is an anaerobic, Gram-positive bacterium widely present in the hospital environment due to its ability to generate spores. The transfer of spores to patients through the hands of medical personnel is one of the most frequent paths of C. difficile transmission. [...] Read more.
Clostridioides difficile is an anaerobic, Gram-positive bacterium widely present in the hospital environment due to its ability to generate spores. The transfer of spores to patients through the hands of medical personnel is one of the most frequent paths of C. difficile transmission. In paediatric patients burdened with a serious primary illness requiring long-term hospitalisation and antibiotic therapy, C. difficile may be a significant risk factor for antibiotic-associated diarrhoea. The goal of the study was to assess the state of hospital environments as a potential source of C. difficile spores and to establish the share of hyperepidemic strains at the two paediatric units. The survey for C. difficile was conducted with a C. diff Banana BrothTM medium, used to detect spores and to recover vegetative forms of the bacteria. Environmental samples (n = 86) and swabs from the clothing of medical personnel (n = 14) were collected at two units of a paediatric hospital, where the cases of antibiotic-associated diarrhoea with a C. difficile aetiology constitute a significant clinical problem. In 17 samples, a change in the broth’s colour was observed, indicating the presence of spores. Out of seven samples, C. difficile strains were cultured. The pathogenic isolates of C. difficile were obtained from swabs collected from elements of beds, a toilet, a door handle and a doctor’s uniform. In our study, we indicated points of increased risk of pathogen transmission, which could constitute a source of infection. The clothing of medical personnel may be a dangerous carrier of pathogenic spores. Periodical surveys of hospital environments with the use of specialist microbiological mediums successfully indicate the direction of corrective actions to be undertaken by the medical facility in order to increase patient safety. Full article
23 pages, 3504 KiB  
Article
Implementation of Lean Management Tools Using an Example of Analysis of Prolonged Stays of Patients in a Multi-Specialist Hospital in Poland
Int. J. Environ. Res. Public Health 2023, 20(2), 1067; https://doi.org/10.3390/ijerph20021067 - 07 Jan 2023
Cited by 2 | Viewed by 1734
Abstract
Healthcare institutions in Poland constantly encounter challenges related both to the quality of provided services and to the pressures associated with treatment effectiveness and economic efficiency. The implemented solutions have a goal of improving the service quality of lowering the continuously increasing operational [...] Read more.
Healthcare institutions in Poland constantly encounter challenges related both to the quality of provided services and to the pressures associated with treatment effectiveness and economic efficiency. The implemented solutions have a goal of improving the service quality of lowering the continuously increasing operational costs. The aim of this paper is to present the application of Lean Management (LM) tools in a Polish hospital, which allowed for the identification of prolonged stays as one of the main issues affecting the service costs and the deteriorating financial results of the hospital. The study was conducted in the neurology department and involved an analysis of data for the whole of 2019 and the first half of 2022. In addition, surveys were conducted among the medical staff to help identify the main causes of prolonged stays. Methods of data analysis and feasible solutions were developed in order to improve the economic efficiency of the unit. The analysis shows that the application of LM tools may contribute to improvement in the functioning of hospitals and that further studies should focus on the development of the method to evaluate efficiency of the implemented solutions intended at shortening the hospital stays of the patients. Full article
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19 pages, 3535 KiB  
Article
Comparison between the American and the European Systems of Monitoring Adverse Effects of Dietary Supplements and Their Usefulness on the Polish Market
Int. J. Environ. Res. Public Health 2023, 20(2), 902; https://doi.org/10.3390/ijerph20020902 - 04 Jan 2023
Cited by 2 | Viewed by 1586
Abstract
Many Polish patients do not inform physicians about supplements they use in addition to prescribed medicines. This may be because they consider dietary supplements as being rather natural products that cannot cause health problems. Although dietary supplements may produce side effects, Poland’s food [...] Read more.
Many Polish patients do not inform physicians about supplements they use in addition to prescribed medicines. This may be because they consider dietary supplements as being rather natural products that cannot cause health problems. Although dietary supplements may produce side effects, Poland’s food safety system and medical statistics do not recognise the necessity of reporting such cases. However, a different approach is observed in France and the United States where adverse effects of food supplements as well as drugs are reported. The aim of this study was to determine the need for creating in Poland a general model of a register monitoring dietary supplements and their adverse effects. In order to achieve this goal, a detailed comparison between the American and European monitoring systems was made. It showed the relationship between negative symptoms caused by specific components in supplements and t profiles of patients who reported side effects. Additionally, it was found that there is a real risk associated with side effects caused by dietary supplements. Therefore, it necessary to establish in Poland a special system for recording such cases as it should be beneficial to patients, including polypragmatic patients. Full article
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15 pages, 1702 KiB  
Article
Can We Identify Patients in Danger of Delayed Treatment? Management of COVID-19 Pandemic Backlog in Urology Care in Poland
Int. J. Environ. Res. Public Health 2022, 19(24), 16547; https://doi.org/10.3390/ijerph192416547 - 09 Dec 2022
Cited by 1 | Viewed by 1654
Abstract
The COVID-19 pandemic had a tremendous impact on healthcare systems around the world. This study aims to research the course of surgical treatment in urology during the pandemic in 2020, evaluate the volume of deferred treatment in urology in Poland, and indicate groups [...] Read more.
The COVID-19 pandemic had a tremendous impact on healthcare systems around the world. This study aims to research the course of surgical treatment in urology during the pandemic in 2020, evaluate the volume of deferred treatment in urology in Poland, and indicate groups of patients that are especially vulnerable to a delay in the delivery of healthcare services. The National Health Found statistics (NHF) database was searched for information on procedures completed in urology departments from 2015 to 2020. Changes in hospital discharges of adults from 2019 to 2021 were investigated using monthly reports of NHF on patient billing groups. Statistics of PSA, testosterone, and creatinine testing were extracted from NHF reports. Annual changes in the number of surgeries were calculated. Then, the estimation of the expected quantity of procedures without the occurrence of the pandemic was performed using linear regression based on data from 2015 to 2020. The estimation was assumed reliable at R2 > 0.8. The difference between collected and estimated data was analysed. In 2020, the volume of radical prostatectomies, cystectomies, and kidney surgeries noted downturns following lockdowns in March and November. All analysed procedures, except radical cystectomy, noted a reduction in the entire year. The declines reached −34% in shockwave lithotripsy, −13% in ureterorenoscopic lithotripsy, −22% in cystolithotripsy, −28% in percutaneous lithotripsy, −12% in transurethral resection of a bladder tumour (TURBT), −31% in transurethral resection of the prostate, −15% in nephrectomy and kidney tumorectomy, and −10% in radical prostatectomy. Among the analysed procedures, only radical cystectomy rates increased 5%. Prostate-specific antigen and creatinine tests fell −17%, and testosterone testing was down −18%. In conclusion, the patients most vulnerable to delayed treatment due to the post-pandemic backlog are those requiring TURBT, kidney cancer operations, and radical prostatectomies. Solving backlogs in urology should prioritise cancer patients and thus requires improved access to cystoscopy, TURBT, diagnoses and surgery of prostate and kidney tumours. Addressing the needs of patients suffering from benign diseases demands appropriate measures to increase the surgical productivity of urology departments. Full article
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10 pages, 1625 KiB  
Article
Detection and Analysis of Clostridioides difficile Spores in a Hospital Environment
Int. J. Environ. Res. Public Health 2022, 19(23), 15670; https://doi.org/10.3390/ijerph192315670 - 25 Nov 2022
Cited by 2 | Viewed by 1378
Abstract
Clostridioides difficile, due to its long survival time in a hospital environment, is considered to be one of the most frequent factors in healthcare-associated infections. Patient care requires not only rapid and accurate diagnosis, but also knowledge of individual risk factors for [...] Read more.
Clostridioides difficile, due to its long survival time in a hospital environment, is considered to be one of the most frequent factors in healthcare-associated infections. Patient care requires not only rapid and accurate diagnosis, but also knowledge of individual risk factors for infections, e.g., with C. difficile, in various clinical conditions. The goal of this study was to analyse the degree of contamination of a hospital environment with C. difficile spores. Culturing was performed using C diff Banana BrothTM medium, which enables germination of the spores of these bacteria. Samples were collected from inanimate objects within a hospital environment in a specialist hospital in Poland. The results of the study demonstrated the presence of 18 positive samples of Clostridioides spp. (15.4%). Of these, C. difficile spores were detected in six samples, Clostridioides perfringens in eight samples, Clostridioides sporogenes in two samples and Clostridioides innocuum and Clostridioides baratii in one sample each. Among the six samples of C. difficile, a total of four strains which produce the B toxin were cultured. The binary toxin related to ribotype 027 was not detected in our study. Nosocomial infection risk management is a significant problem, mainly concerning the issues of hygiene maintenance, cleaning policy and quality control, and awareness of infection risk. Full article
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25 pages, 1823 KiB  
Article
Home Health Care Problem with Synchronization Visits and Considering Samples Transferring Time: A Case Study in Tehran, Iran
Int. J. Environ. Res. Public Health 2022, 19(22), 15036; https://doi.org/10.3390/ijerph192215036 - 15 Nov 2022
Cited by 4 | Viewed by 1676
Abstract
Health care facilities have not increased in response to the growing population. Therefore, government and health agencies are constantly seeking cost-effective alternatives so they can provide effective health care to their constituents. Around the world, health care organizations provide home health care (HHC) [...] Read more.
Health care facilities have not increased in response to the growing population. Therefore, government and health agencies are constantly seeking cost-effective alternatives so they can provide effective health care to their constituents. Around the world, health care organizations provide home health care (HHC) services to patients, especially the elderly, as an efficient alternative to hospital care. In addition, recent pandemics have demonstrated the importance of home health care as a means of preventing infection. This study is the first to simultaneously take into account nurses’ working preferences and skill levels. Since transferring samples from the patient’s home to the laboratory may affect the test results, this study takes into account the time it takes to transfer samples. In order to solve large instances, two metaheuristic algorithms are proposed: Genetic Algorithms and Particle Swarm Optimization. Nurses are assigned tasks according to their time windows and the tasks’ time windows in a three-stage scheduling procedure. Using a case study set in Tehran, Iran, the proposed model is demonstrated. Even in emergencies, models can generate effective strategies. There are significant implications for health service management and health policymakers in countries where home health care services are receiving more attention. Furthermore, they contribute to the growing body of knowledge regarding health system strategies by providing new theoretical and practical insights. Full article
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20 pages, 4283 KiB  
Article
The Usability of IT Systems in Document Management, Using the Example of the ADPIECare Dorothea Documentation and Nurse Support System
Int. J. Environ. Res. Public Health 2022, 19(14), 8805; https://doi.org/10.3390/ijerph19148805 - 20 Jul 2022
Cited by 3 | Viewed by 1879
Abstract
Background: In 2016, an IT system was developed at MUL for the documentation of nursing practice. Preparing nursing students for the implementation of eHealth solutions under simulated conditions is crucially important for achieving the digital competencies necessary for health care systems in the [...] Read more.
Background: In 2016, an IT system was developed at MUL for the documentation of nursing practice. Preparing nursing students for the implementation of eHealth solutions under simulated conditions is crucially important for achieving the digital competencies necessary for health care systems in the future. Scientific evidence demonstrates that the use of an IT system in clinical practice shortens the time required for the preparation of documentation, increases the safety of clinical decisions and provides data for analysis and for the creation of predictive models for the purposes of HB HTA. Methods: The system was created through the cooperation of an interprofessional team at the Medical University of Łódź. The ADPIECare system was implemented in 2016 at three universities in Poland, and in 2017 a study of its usability was conducted using a questionnaire made available by Healthcare Information and Management Systems Society, “Defining and Testing EMR Usability MASTER V2 Final” on 78 nurses—students of MA in Nursing at Medical University of Łódź. Findings: Over 50% of the surveyed nurses indicated the usability of the system for the “effectiveness of documentation” variable. The same group of respondents had a positive attitude towards patient care planning with the use of the assessed system. In the opinions of the examined parties, positive opinions predominated, such as, e.g., “the system is intuitive”, “the system facilitates work”, “all patient assessments are in one place”, and “the time needed for data entry would be shortened”. Full article
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13 pages, 1286 KiB  
Article
Factors Influencing Self-Confidence and Willingness to Perform Cardiopulmonary Resuscitation among Working Adults—A Quasi-Experimental Study in a Training Environment
Int. J. Environ. Res. Public Health 2022, 19(14), 8334; https://doi.org/10.3390/ijerph19148334 - 07 Jul 2022
Cited by 6 | Viewed by 1779
Abstract
Background: There is a potential relationship between the self-confidence and the willingness of bystanders to undertake resuscitation (CPR) and its training. The current guidelines increasingly focus on both the importance of the human factor and the fact that training programs should increase the [...] Read more.
Background: There is a potential relationship between the self-confidence and the willingness of bystanders to undertake resuscitation (CPR) and its training. The current guidelines increasingly focus on both the importance of the human factor and the fact that training programs should increase the willingness of bystanders to undertake resuscitation, which may have a direct impact on improving survival in out-of-hospital cardiac arrest (OHCA). Aim: The objective of the study was to analyze factors influencing the assessment of own skills crucial in basic life support (BLS) and the willingness to provide CPR to individual victims. Methods: A pre-test and post-test quasi-experimental design was used in this study. The data was collected from 4 December 2019 to 3 October 2020 in workplaces, during instructor-led BLS courses. Each intervention (training) consisted of a theoretical and a practical part. The program was focused both on the skills and the human factor. Results: Comparison of pre-test and post-test data concerning self-confidence scores of the ability to recognize OHCA among 967 participants demonstrated a significant difference (respectively, Me = 2.2, IQR [2–3] vs. Me = 3.4, IQR [3–4]; p = 0.000). Additionally, self-assessment scores for the ability to perform proper chest compressions between pre-test and post-test also differed significantly (respectively Me = 2.3, IQR [2–3] vs. Me = 3.3, IQR [3–4]; p = 0.000). A highly significant difference was found in the likelihood of changing the decision in favor of the willingness to undertake CPR for all types of victims, with the greatest difference found in relation to the willingness to conduct resuscitation on strangers (OR = 7.67, 95% CI 5.01–11.73; p < 0.01). Conclusions: Completing hands-on training has a highly significant, beneficial effect on the readiness to undertake resuscitation for all types of victims, strangers in particular. Training programs should place particular emphasis on developing readiness to undertake resuscitation for both those who have never been trained and those who had their last training more than one year ago. Full article
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19 pages, 1364 KiB  
Article
Dietary Supplements Questioned in the Polish Notification Procedure upon the Basis of Data from the National Register of Functional Foods and the European System of the RASFF
Int. J. Environ. Res. Public Health 2022, 19(13), 8161; https://doi.org/10.3390/ijerph19138161 - 03 Jul 2022
Cited by 3 | Viewed by 1540
Abstract
Dietary supplements (DS) in the countries of the European Union falls within the scope of the food law. DS may, however, contain substances that are simultaneously applied in medicinal products as defined in the pharmaceutical law. The presence of such ingredients may cause [...] Read more.
Dietary supplements (DS) in the countries of the European Union falls within the scope of the food law. DS may, however, contain substances that are simultaneously applied in medicinal products as defined in the pharmaceutical law. The presence of such ingredients may cause problems with the product qualification. The phenomenon of applying such borderline ingredients in dietary supplements may require additional regulations, and ensuring them may be problematic. We conducted an analysis aiming to identify dishonest market practices resorted to by the producers and distributors of non-conforming dietary supplements. We examined mostly questioned DS and compared them with data from the RASFF system and registers of medicinal substances and pharmaceutical entities. The results show that some operators tend to re-notify the same products in response to the initiation of official control procedures. Products in the form of capsules or powders were the most common re-notifications within the 50–100 days. Based on the data obtained, it can be concluded that some entities are obliged to document the safety of the product or its compliance with the regulations, use the imperfection of the notification procedure, and re-notify the questioned product in order to keep it on the market despite potential non-compliance. Full article
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20 pages, 9598 KiB  
Article
Financial Expenses and “Losses” of the Polish Healthcare System Resulting from the Occurrence of Adverse Events
Int. J. Environ. Res. Public Health 2022, 19(13), 7932; https://doi.org/10.3390/ijerph19137932 - 28 Jun 2022
Cited by 1 | Viewed by 1270
Abstract
Background: The globally increasing healthcare expenditures related to the need to treat the consequences of adverse events, as well as the number of claims filed by patients (or their families) and remuneration paid as their result mean that the interest in the subject [...] Read more.
Background: The globally increasing healthcare expenditures related to the need to treat the consequences of adverse events, as well as the number of claims filed by patients (or their families) and remuneration paid as their result mean that the interest in the subject of adverse event cost management is increasing. An increase in the number of cases concerning medical errors has also occurred in Poland in recent years. The newest statistics from the Ministry of Justice demonstrate that the courts are awarding increasingly higher amounts. The goal of this work was an attempt to approximate, based on our own experiences, the impact of adverse events on the expenditures of the healthcare system in Poland, including the costs of treatment of the consequences of such events, described by the authors as “secondary harm”. Methods: Based on the analysis of 100 cases for compensation for the occurrence of a medical event, an initial estimate of the costs of primary (initial) treatment, which resulted in the occurrence of the adverse event, and the costs of subsequent hospitalisations/stays, which were its consequences. The study was conducted in the period from October 2020 to November of 2021. Results: The statistical analysis of the examined cases enabled establishing that in 62% they concerned women. Only 38% were events which applied to men. The highest number of cases concerned events which occurred in the last years, that is 2018 (35%), 2019 (23%), and 2017 (17%). The most frequent events included those related to incorrect diagnosis (the lack of correct diagnosis), which resulted in appropriate activities not being undertaken and a lack of appropriate treatment, e.g., lack of diagnosis of cancer, myocardial infarction, appendicitis, or fracture (26%). The next one was incorrect surgical treatment (17%)—the consequence of which was most frequently a need for repeated surgery and an incorrect conservative treatment of injuries. The obtained results demonstrate that significantly higher funds are spent by medical entities for “restorative” actions (on average EUR 1433, which attempt to mitigate against the negative consequences of incorrect decisions or actions in the original treatment (average cost of EUR 814)). Conclusions: The consequences of adverse events include not only health-related harm for the patient, but also long-term social, familial, or professional results. The authors of the article are of an opinion that all the conducted analyses and conclusions drawn from them should serve the improvement of patient safety. They also form an initial point for establishing recommendations and advice for the improvement of safety and quality of medical services and the reduction of healthcare-related costs. The authors propose covering the parties injured by an adverse event (subjected to “secondary harm”) with a unique, innovative programme of post-accident health care, “Health Reconstruction”. Full article
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19 pages, 414 KiB  
Article
Assessing Urban Policies in a COVID-19 World
Int. J. Environ. Res. Public Health 2022, 19(9), 5322; https://doi.org/10.3390/ijerph19095322 - 27 Apr 2022
Cited by 4 | Viewed by 1787
Abstract
The aim of this study was to identify how the literature analyzes (identifies, evaluates, forecasts, etc.) the relationship between health issues and urban policy in relation to the COVID-19 pandemic. Four main levels were identified in these cases: (1) direct demands for changes [...] Read more.
The aim of this study was to identify how the literature analyzes (identifies, evaluates, forecasts, etc.) the relationship between health issues and urban policy in relation to the COVID-19 pandemic. Four main levels were identified in these cases: (1) direct demands for changes in health care, (2) social issues, (3) spatial organization and (4) redefining the tasks of public authority in the face of identified challenges. The basic working method used in the study assumed a critical analysis of the literature on the subject. The time scope of the search covered articles from January 2020 to the end of August 2021 (thus covering the period of three pandemic waves). Combinations of keywords in the titles were used to search for articles. The health perspective pointed to the need for urban policies to develop a balance between health and economic costs and for coordination between different professionals/areas. A prerequisite for such a balance in cities is the carrying out of social and spatial analyses. These should illustrate the diversity of the social situations in individual cities (and more broadly in urban areas, including, sometimes, large suburbs) and the diversity’s relationship (both in terms of causes and consequences) to the severity of pandemics and other health threats. Full article
15 pages, 1097 KiB  
Article
The Influence of Nurse Education Level on Hospital Readmissions—A Cost-Effectiveness Analysis
Int. J. Environ. Res. Public Health 2022, 19(7), 4177; https://doi.org/10.3390/ijerph19074177 - 31 Mar 2022
Cited by 4 | Viewed by 2542
Abstract
Background: Readmissions are adverse, costly, and potentially preventable. The study aimed to evaluate the cost-effectiveness of reducing readmissions resulting from missed care, depending on the level of education of nurses, from the perspective of the service provider. Methods: We calculated missed care resulting [...] Read more.
Background: Readmissions are adverse, costly, and potentially preventable. The study aimed to evaluate the cost-effectiveness of reducing readmissions resulting from missed care, depending on the level of education of nurses, from the perspective of the service provider. Methods: We calculated missed care resulting in additional readmissions based on the longitudinal study conducted between 2012 and 2014, as well as readmissions that could have been potentially prevented by adding a 10% increase in hours of nursing care provided by BSN/MSc nurses for 2014. The cost-effectiveness analysis (CEA) was performed to calculate the cost-effectiveness of preventing one hospitalization in non-surgical and surgical wards by increasing the number of nursing hours provided by BSN/MSc nurses. Cost–benefit analysis (CBA) was performed, and the CBR (cost–benefit ratio) and BCR (benefit–cost ratio) were calculated. Results: Increasing the number of hours of nursing care (RN) by 10% decreased the chance for an unplanned readmission by 11%; (OR = 0.89; 95% CI: 0.78−1.01; p = 0.08) in non-surgical wards and 43% (OR = 0.57; 95% CI: 0.49−0.67; p < 0.001) in surgical wards. In non-surgical wards, the number of readmissions that were preventable with extra hours provided by BSN/MSc nurses was 52, and the cost-effectiveness ratio (CER) was USD 226.1. The number of preventable readmissions in surgical wards was 172, and the CER was USD 54.96. In non-surgical wards, the CBR was USD 0.07, while the BCR was USD 1.4. In surgical wards, the CBR was USD 0.02, and the BCR was USD 4.4. Conclusions: The results of these studies broaden the understanding of the relationship among nursing education, patient readmission, and the economic outcomes of hospital care. According to the authors, the proposed intervention has an economic justification. Hence, the authors recommend it for approval by the service provider. Full article
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56 pages, 11409 KiB  
Article
Assessment of the Impact of Scientific Reports Published by EFSA and GIS on Functional Foods Newly Placed on the Market in Poland
Int. J. Environ. Res. Public Health 2022, 19(7), 4057; https://doi.org/10.3390/ijerph19074057 - 29 Mar 2022
Cited by 3 | Viewed by 1785
Abstract
Dietary supplements are health-promoting products. The legal categorization of dietary supplements as foods does not raise concerns, but a general understanding of how they work in the human body seems to deviate from the official definition. Thus, it is necessary to establish effective [...] Read more.
Dietary supplements are health-promoting products. The legal categorization of dietary supplements as foods does not raise concerns, but a general understanding of how they work in the human body seems to deviate from the official definition. Thus, it is necessary to establish effective methods of market control related to dietary supplements. This research aims at assessing the impact of recommendations by various food safety authorities on ingredients used in newly registered products. It probes how the proportions of utilized product ingredients were modified after the European Food Safety Authority (EFSA) and Chief Sanitary Inspector in Poland (GIS) published their recommendations. Research data on the composition of products comes from the Polish national register of dietary supplements and covers the period from 2012 to 28 November 2021. Note that 103,102 products were analysed for the presence of thirty-seven ingredients, and the joinpoint regression method was applied to assess changing trends related to the use of ingredients. As our research points out, most often, changes in the trend appeared in product ingredients for which the European Food Safety Authority and Chief Sanitary Inspector in Poland issued the recommendation of having the safest level of consumption. However, these changes seem to emerge randomly and should not be unquestionably considered as the result of the published recommendations. Full article
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13 pages, 1969 KiB  
Article
Nursing Care Plan for a Newborn with the Defect of Congenital Gastroschisis in the Postoperative Period Using ICNPTM and the Dedicated Software
Int. J. Environ. Res. Public Health 2022, 19(6), 3498; https://doi.org/10.3390/ijerph19063498 - 16 Mar 2022
Cited by 2 | Viewed by 5521
Abstract
Background: Congenital defect gastroschisis manifests as a defect in the sheath in the intestine of the newborn, which is not covered by the hernia sac. In this case, the priority task of the neonatal nurse is to diagnose patient care problems quickly and [...] Read more.
Background: Congenital defect gastroschisis manifests as a defect in the sheath in the intestine of the newborn, which is not covered by the hernia sac. In this case, the priority task of the neonatal nurse is to diagnose patient care problems quickly and accurately. Choosing the correct care plan elements has a significant impact on shortening the duration of hospitalization, reducing the number and severity of complications, and preventing their recurrence. The purpose of this study was to formulate a care plan for a newborn with diagnosed congenital defect gastroschisis in the postoperative period, using the International Classification for Nursing Practice (ICNPTM) within the nursing documentation and decision support system, the “ADPIECare Dorothea” software. Methods: After a review of the relevant literature and nursing documentation, a case study of a newborn with the congenital defect gastroschisis was described. A care plan was prepared using ICNP and the “ADPIECare” software. Results: It was possible to organize and standardize care plans to provide consistent and comprehensive professional nursing care. The system supporting nursing decisions suggested interventions personalized for the nursing diagnoses and to the patient needs. Conclusions: Our findings can help to optimize the nurse’s work organization to improve health care quality, outcomes, and effectiveness. Full article
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13 pages, 1983 KiB  
Article
Impact of the COVID-19 Pandemic on the Dental Preferences of Patients in the Private Sector
Int. J. Environ. Res. Public Health 2022, 19(4), 2183; https://doi.org/10.3390/ijerph19042183 - 15 Feb 2022
Cited by 5 | Viewed by 1920
Abstract
Proper oral health care has an impact on the health of the entire body. The COVID-19 pandemic has affected the functioning of the healthcare sector, including dental services. The aim of this study was to analyse the behaviour of patients with regard to [...] Read more.
Proper oral health care has an impact on the health of the entire body. The COVID-19 pandemic has affected the functioning of the healthcare sector, including dental services. The aim of this study was to analyse the behaviour of patients with regard to their use of dental services during the pandemic. The data were obtained from paper registration forms taken from five dental offices in the city of Cracow between March 2019 and February 2021. During the analysed periods, interest among first-time patients in dental services decreased to 37% (during the month when interest in dental services was at its lowest) compared to the year preceding the COVID-19 pandemic. The number of cancelled visits increased by between 15% and 50% compared to the pre-pandemic period. During the pandemic, appointments made by existing patients increased by up to 84% compared to 2019. The decision by patients to postpone dental treatment not only has adverse effects on their oral and body health, but in turn results in higher health care costs. Given the potential for another pandemic, further long-term research is required to develop and implement special protocols to make the public aware of the safety of health care. Full article
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19 pages, 2464 KiB  
Article
Developing a Risk Reduction Support System for Health System in Iran: A Case Study in Blood Supply Chain Management
Int. J. Environ. Res. Public Health 2022, 19(4), 2139; https://doi.org/10.3390/ijerph19042139 - 14 Feb 2022
Cited by 19 | Viewed by 3329
Abstract
Health systems are recognised as playing a potentially important role in many risk management strategies; however, there is strong evidence that health systems themselves have been the victims of unanticipated risks and have lost their functionality in providing reliable services. Existing risk identification [...] Read more.
Health systems are recognised as playing a potentially important role in many risk management strategies; however, there is strong evidence that health systems themselves have been the victims of unanticipated risks and have lost their functionality in providing reliable services. Existing risk identification and assessment tools in the health sector, particularly in the blood supply chain, address and evaluate risks without taking into account their interdependence and a holistic perspective. As a result, the aim of this paper is to develop a new systemic framework based on a semi-quantitative risk assessment approach to measure supply chain risks, which will be implemented through a case study on the Iranian BSC. This paper identifies and assesses supply chain risks (SCRs) by employing a novel systemic process known as SSM-SNA-ISM (SSI). First, the supply chain and its risks are identified using Soft Systems Methodology (SSM). Then, given the large number of risks, the second stage uses Social Network Analysis (SNA) to identify the relationships between the risks and select the most important ones. In the third stage, risk levelling is performed with a more in-depth analysis of the selected risks and the application of Interpretive Structural Modelling (ISM), and further analysis is performed using the Cross-Impact Matrix Multiplication Applied to Classification (MICMAC). The study found that by using the new proposed approach, taking into account risk relationships, and taking a holistic view, various supply chain risks could be assessed more effectively, especially when the number of risks is large. The findings also revealed that resolving the root risks of the blood supply chain frequently necessitates management skills. This paper contributes to the literature on supply chain risk management in two ways: First, a novel systemic approach to identifying and evaluating risks is proposed. This process offers a fresh perspective on supply chain risk modelling by utilising systems thinking tools. Second, by identifying Iranian BSC risks and identifying special risks. Full article
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Jump to: Research

16 pages, 1609 KiB  
Systematic Review
Telemedicine Technologies Selection for the Posthospital Patient Care Process after Total Hip Arthroplasty
Int. J. Environ. Res. Public Health 2022, 19(18), 11521; https://doi.org/10.3390/ijerph191811521 - 13 Sep 2022
Cited by 1 | Viewed by 1963
Abstract
For many years, the importance of using telematic technologies in medicine has been growing, especially in the period of the coronavirus pandemic, when direct contact and supervision of medical personnel over the patient is difficult. The existing possibilities of modern information and communication [...] Read more.
For many years, the importance of using telematic technologies in medicine has been growing, especially in the period of the coronavirus pandemic, when direct contact and supervision of medical personnel over the patient is difficult. The existing possibilities of modern information and communication technologies (ICTs) are not fully used. The aim of the study is to identify the telemedicine technologies that can be used in future implementation projects of the posthospital patient care process after total hip arthroplasty (THA). The literature search is reported according to PRISMA 2020. The search strategy included databases and gray literature. In total, 28 articles (EMBASE, PubMed, PEDro) and 24 records from gray literature (Google Search and Technology presentations) were included in the research. This multi-source study analyzes the possibilities of using different technologies useful in the patient care process. The conducted research resulted in defining visual and wearable types of telemedicine technologies for the original posthospital patient care process after THA. As the needs of stakeholders in the posthospital patient care process after THA differ, the awareness of appropriate technologies selection, information flow, and its management importance are prerequisites for effective posthospital patient care with the use of telemedicine technologies. Full article
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