Research

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9 pages, 603 KiB

Open AccessArticle

Cost of Surgical Treatment of Obesity and Its Impact on Healthcare Expense–Nationwide Data from a Polish Registry

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Int. J. Environ. Res. Public Health 2023, 20(2), 1118; https://doi.org/10.3390/ijerph20021118 - 08 Jan 2023

Cited by 1 | Viewed by 1160

Abstract

Weight loss surgery is linked to health benefits and may reduce the cost to the public healthcare systems. The aim of this study was to assess the cost and cost-structure in the one-year periods before and after a bariatric surgery in the Polish [...] Read more.

Weight loss surgery is linked to health benefits and may reduce the cost to the public healthcare systems. The aim of this study was to assess the cost and cost-structure in the one-year periods before and after a bariatric surgery in the Polish nationwide registry. The study included 2390 obese adults which underwent surgical treatment for obesity in 2017. The cost structure and the total costs per patient for one year before bariatric surgery, preoperatively, and for one year after surgery were analyzed. The total cost of the postoperative period was about PLN 3 million lower than during the preoperative period. After bariatric surgery, a reduction of approximately 59% in costs associated with hospital treatment was observed. The costs of outpatient specialist services, hospital treatment, psychiatric care, and addiction treatment also significantly decreased. There was a negative correlation between the changes in the cost of treatment of patients undergoing obesity surgery and their age. The health care cost during the period of one year after bariatric surgery is lower than in the year preceding the surgery (a greater cost difference is observed in younger people). This is mainly influenced by the reduction in costs associated with hospital treatment. Full article

(This article belongs to the Special Issue Health Data Analytics and Evaluation)

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18 pages, 843 KiB

Open AccessArticle

Assessing Digital Transformation of Cost Accounting Tools in Healthcare

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Anca Antoaneta Vărzaru

Int. J. Environ. Res. Public Health 2022, 19(23), 15572; https://doi.org/10.3390/ijerph192315572 - 23 Nov 2022

Cited by 3 | Viewed by 2032

Abstract

The expansion of digital technologies has significantly changed most economic activities and professions. Digital technologies penetrated managerial accounting and have a vast potential to transform this profession. Implementing emerging digital technologies, such as artificial intelligence, blockchain, the Internet of Things, big data, and [...] Read more.

The expansion of digital technologies has significantly changed most economic activities and professions. Digital technologies penetrated managerial accounting and have a vast potential to transform this profession. Implementing emerging digital technologies, such as artificial intelligence, blockchain, the Internet of Things, big data, and cloud computing, can trigger a crucial leap forward, leading to a paradigm-shifting in healthcare organizations’ accounting management. The paper’s main objective is to investigate the perception of Romanian accountants on implementing digital technologies in healthcare organizations’ accounting management. The paper implies a study based on a questionnaire among Romanian accountants who use various digital technologies implemented in traditional and innovative cost accounting tools. Based on structural equation modeling, the results emphasize the prevalence of innovative tools over traditional cost accounting tools improved through digital transformation, digital technologies assuming the most complex and time-consuming tasks. Moreover, the influence of cost accounting tools improved through digital transformation on healthcare organizations’ performance is much more robust in the case of innovative tools than in the case of traditional cost accounting tools. The proposed model provides managers in healthcare organizations with information on the most effective methods in the context of digital transformation. Full article

(This article belongs to the Special Issue Health Data Analytics and Evaluation)

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12 pages, 388 KiB

Open AccessArticle

Reliability, Validity and Responsiveness of the Polish Version of the Western Ontario Shoulder Instability Index (WOSI-PL) in Patients after Arthroscopic Repair for Shoulder Instability

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Int. J. Environ. Res. Public Health 2022, 19(21), 14015; https://doi.org/10.3390/ijerph192114015 - 27 Oct 2022

Cited by 1 | Viewed by 1057

Abstract

Apart from imaging and physical examination for shoulder instability (SI), medical history with patient feedback should be considered to assess the patient’s condition and recovery. The aim of this study was to evaluate psychometric properties of the Polish version of Western Ontario Shoulder [...] Read more.

Apart from imaging and physical examination for shoulder instability (SI), medical history with patient feedback should be considered to assess the patient’s condition and recovery. The aim of this study was to evaluate psychometric properties of the Polish version of Western Ontario Shoulder Instability Index (WOSI)—one of the most frequently used patient-reported outcome measures for SI. During examination 1, 74 patients after arthroscopic repair for SI (age

\bar{x}

= 30.01 ± 8.98) were tested. Examinations 2 and 3 involved 71 and 51 patients, respectively. They completed the Polish version of the WOSI, the shortened version of the Disabilities of Arm, Shoulder and Hand Questionnaire (QuickDASH), the Short Form-36 version 2.0 (SF-36 v. 2.0) and 7-point Global Rating Change scale (GRC). The WOSI-PL demonstrated high internal consistency (Cronbach’s alpha for total = 0.94), and test–retest reliability (Total ICC_2,1 = 0.99). High construct validity was found (89%) as the a priori hypotheses were confirmed. All domains and total scores of WOSI-PL showed a moderate to strong degree of responsiveness (ES = 0.37–0.44; SMR = 0.87–1.26). Minimal clinically important difference (MCID) for the Total WOSI-PL was 126.43 points/6% (95%CI 67.83–185.03) by the anchor-based method and 174.05 points/8% (95%CI 138.61–233.98) by the distribution-based method. The Polish version of the WOSI can be considered a reliable, valid and responsive PROM. It is recommended for assessing the quality of life in patients after arthroscopic repair for SI and can be applied in research and in the clinical setting for monitoring treatment and facilitating patient-centred therapeutic decisions. Full article

(This article belongs to the Special Issue Health Data Analytics and Evaluation)

13 pages, 1574 KiB

Open AccessArticle

Administrative Data in Cardiovascular Research—A Comparison of Polish National Health Fund and CRAFT Registry Data

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Maciej Janusz Krajsman

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Int. J. Environ. Res. Public Health 2022, 19(19), 11964; https://doi.org/10.3390/ijerph191911964 - 22 Sep 2022

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Abstract

(1) Background: Administrative data allows for time- and cost-efficient acquisition of large volumes of individual patient data invaluable for evaluation of the prevalence of diseases and clinical outcomes. The aim of the study was to evaluate the accuracy of data collected from the [...] Read more.

(1) Background: Administrative data allows for time- and cost-efficient acquisition of large volumes of individual patient data invaluable for evaluation of the prevalence of diseases and clinical outcomes. The aim of the study was to evaluate the accuracy of data collected from the Polish National Health Fund (NHF), from a researcher’s perspective, in regard to a cohort of atrial fibrillation patients. (2) Methods: NHF data regarding atrial fibrillation and common cardiovascular comorbidities was compared with the data collected manually from the individual patients’ health records (IHR) collected in the retrospective CRAFT registry (NCT02987062). (3) Results: Data from the NHF underestimated the proportion of patients with AF (NHF = 83% vs. IHR = 100%) while overestimating the proportion of patients with other cardiovascular comorbidities in the cohort. Significantly higher CHA2DS2VASc (Median, [Q1–Q3]) (NHF: 1, [0–2]; vs. IHR: 1, [0–1]; p < 0.001) and HAS-BLED (Median, [Q1–Q3]) (NHF: 4, [2–6] vs. IHR: 3, [2–5]; p < 0.001) scores were calculated according to NHF in comparison to IHR data, respectively. (4) Conclusions: Clinical researchers should be aware that significant differences between IHR and billing data in cardiovascular research can be observed which should be acknowledged while drawing conclusions from administrative data-based cohorts. Natural Language Processing of IHR could further increase administrative data quality in the future. Full article

(This article belongs to the Special Issue Health Data Analytics and Evaluation)

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13 pages, 1783 KiB

Open AccessArticle

Seasonally Dependent Change of the Number of Fractures after 50 Years of Age in Poland—Analysis of Combined Health Care and Climate Datasets

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Int. J. Environ. Res. Public Health 2022, 19(15), 9467; https://doi.org/10.3390/ijerph19159467 - 02 Aug 2022

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Abstract

Aim: The incidence of fractures correlates with many independent and interrelated factors. The aim of the study was to examine trends in fracture incidence and to find possible reasons for changes. Materials and methods: A complete dataset of Polish population aged above 50 [...] Read more.

Aim: The incidence of fractures correlates with many independent and interrelated factors. The aim of the study was to examine trends in fracture incidence and to find possible reasons for changes. Materials and methods: A complete dataset of Polish population aged above 50 from the National Heath Fund—which is a single, state-owned payer for the health service procedures in Poland—covering the years between 2010 and 2015 was analyzed along with climate dataset. Results: The analysis indicated that there was a substantial and statistically significant decrease in the incidence of forearm and hip fractures (p = 0.007 and 0.007, respectively). On the other side, there was a statistically significant increase in incidence of humerus and lumbar fractures (p = 0.002, p < 0.001, respectively). The observed changes (especially decrease in forearm and hip fracture incidence) happened mostly in the cold season and were correlated to mean-temperature changes during the assessed time period. Conclusion: In the analysis based on the dataset obtained from fracture-related database collected in Poland in the years 2010–2015 in the population of patients over 50 years of age, we observed that the changes of fracture incidence during the observation period are associated with and may be dependent on the season (warmer versus colder) and on mean temperature increase during the observation period. Full article

(This article belongs to the Special Issue Health Data Analytics and Evaluation)

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Review

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15 pages, 644 KiB

Open AccessReview

Bone Infarcts and Tumorigenesis—Is There a Connection? A Mini-Mapping Review

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Int. J. Environ. Res. Public Health 2022, 19(15), 9282; https://doi.org/10.3390/ijerph19159282 - 29 Jul 2022

Cited by 3 | Viewed by 1486

Abstract

(1) Background: Avascular necrosis (AVN) may affect every part of the bone. Epiphyseal infarcts are likely to be treated early because most are symptomatic. However, meta- and diaphyseal infarcts are silent and are diagnosed incidentally. Sarcomas developing in the necrotic bone are extremely [...] Read more.

(1) Background: Avascular necrosis (AVN) may affect every part of the bone. Epiphyseal infarcts are likely to be treated early because most are symptomatic. However, meta- and diaphyseal infarcts are silent and are diagnosed incidentally. Sarcomas developing in the necrotic bone are extremely rare, but they have been reported in the literature. (2) Methods: We conducted a mapping review of recent evidence regarding these malignancies. Methods: A mapping review using a systematic search strategy was conducted to answer research questions. We limited our research to the last ten years (2012–2022). (3) Results: A total of 11 papers were identified, including 9 case reports and 3 case series. The pathomechanism of carcinogenesis in AVN was not investigated to date. Histologically, most tumors were malignant fibrous histiocytoma. The prognosis is relatively poor, especially for patients with metastases, but adjuvant chemotherapy may increase short- and long-term survival. (4) Conclusions: Since AVN-related malignancies are sporadic, no prospective studies have been conducted. The majority of evidence comes from small case series. More research is needed to identify the risk factors that would justify follow-up of patients after bone infarcts at higher risk of developing a malignancy. Full article

(This article belongs to the Special Issue Health Data Analytics and Evaluation)

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14 pages, 1214 KiB

Open AccessReview

Avascular Necrosis of Femoral Head—Overview and Current State of the Art

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Int. J. Environ. Res. Public Health 2022, 19(12), 7348; https://doi.org/10.3390/ijerph19127348 - 15 Jun 2022

Cited by 27 | Viewed by 8268

Abstract

Avascular necrosis (AVN) of the femoral head is caused by disruption of the blood supply to the proximal femur. The alterations in the blood supply may occur following a traumatic event or result from a non-traumatic cause. Femoral neck fracture and hip dislocation [...] Read more.

Avascular necrosis (AVN) of the femoral head is caused by disruption of the blood supply to the proximal femur. The alterations in the blood supply may occur following a traumatic event or result from a non-traumatic cause. Femoral neck fracture and hip dislocation and associated surgical procedures, corticosteroid therapy, and alcohol abuse frequently lead to AVN development. Type of fracture (displaced or undisplaced) and time between injury and surgery are the most critical factors in assessing the risk of developing AVN. Diagnosis of AVN can be established based on patients’ complaints, medical history, and radiographic findings. There is no consensus on the treatment of patients with AVN to date. Non-surgical methods are dedicated to patients in the early pre-collapse stages of the disease and consist of pharmacotherapy and physiotherapy. Surgery is recommended for patients with advanced disease. Full article

(This article belongs to the Special Issue Health Data Analytics and Evaluation)

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Other

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16 pages, 1480 KiB

Open AccessSystematic Review

The Risk of Avascular Necrosis Following the Stabilization of Femoral Neck Fractures: A Systematic Review and Meta-Analysis

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Int. J. Environ. Res. Public Health 2022, 19(16), 10050; https://doi.org/10.3390/ijerph191610050 - 15 Aug 2022

Cited by 7 | Viewed by 3143

Abstract

Background: Avascular necrosis (AVN) of the femoral head often requires surgical treatment and is often associated with femoral neck fractures. We conducted a systematic review and meta-analysis of recent research on the risk of AVN following the stabilization of fractured femoral neck with [...] Read more.

Background: Avascular necrosis (AVN) of the femoral head often requires surgical treatment and is often associated with femoral neck fractures. We conducted a systematic review and meta-analysis of recent research on the risk of AVN following the stabilization of fractured femoral neck with implants in PubMed. We assessed the effect of age on AVN incidence among patients aged > 50 and younger, depending on fracture type, Garden stage, Pouwels degree, Delbet stage, and age category. We followed PRISMA guidelines. Relevant studies were defined as research articles describing real-world studies reporting on the risk of AVN following primary surgical fracture stabilization with implants, published between 1 January 2011 and 22 April 2021. Fifty-two papers met the inclusion criteria, with a total of N = 5930 with surgically managed fractures. The pooled mean AVN incidence was significantly higher among patients with displaced fractures (20.7%; 95% CI: 12.8–28.5%) vs. those with undisplaced fractures (4.7%; 95% CI: 3.4–6.0%). No significant correlation was observed between AVN incidence weighted by sample size and time interval from injury to surgery (p = 0.843, R² = 0.01). In conclusion, the risk of AVN following femoral neck fractures was generally high, especially in patients with displaced fractures. The time from injury to surgery did not correlate with AVN incidence. Full article

(This article belongs to the Special Issue Health Data Analytics and Evaluation)

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