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Journal of the American Geriatrics... Sep 2019Improving quality performance in home health is an increasingly high priority. The objective of this study was to examine trends in industry performance over time using...
BACKGROUND/OBJECTIVES
Improving quality performance in home health is an increasingly high priority. The objective of this study was to examine trends in industry performance over time using three quality measures: a composite quality metric (Q index), an infection prevention measure (vaccination verification), and an outcome measure (hospital avoidance).
DESIGN/SETTING/PARTICIPANTS/MEASURES
We linked Home Health Compare and Provider of Services data from 2012 to 2016, which included 39 211 observations during the 5-year study period and 7670 agencies in 2016. The Q index was developed to allow comparability over time, equally weighting the contributions of each element. After examining summary statistics, we developed three regression models stratified by ownership (for-profit/nonprofit agency) and included two constructs of nurse staffing, in addition to controlling for known confounders.
RESULTS
Most agencies (80.4%) were for-profit agencies. The Q index and vaccination verification improved substantially over time, but there was no change in hospital avoidance. Ownership status was associated with all three measures (P < .001). Registered nurse staffing (relative to licensed practical nurses and home health aides) was associated with higher Q index and vaccination verification (P < .001).
CONCLUSION
The Q index allows for assessment of trends over time in home healthcare. Ownership and nurse staffing are important factors in the quality of care. The overall home care market is driven by for-profit agencies, but their characteristics and outcomes differ from nonprofit agencies. J Am Geriatr Soc 67:1859-1865, 2019.
Topics: Home Care Services; Humans; Ownership; Personnel Staffing and Scheduling; Quality Indicators, Health Care; Reference Standards; Regression Analysis; United States
PubMed: 31063621
DOI: 10.1111/jgs.15963 -
Malaria Journal Aug 2010Insecticide-treated bed nets (ITNs) are an efficacious intervention for malaria prevention. During a national immunization campaign in Mozambique, vouchers, which were...
BACKGROUND
Insecticide-treated bed nets (ITNs) are an efficacious intervention for malaria prevention. During a national immunization campaign in Mozambique, vouchers, which were to be redeemed at a later date for free ITNs, were distributed in Manica and Sofala provinces. A survey to evaluate ITN ownership and usage post-campaign was conducted.
METHODS
Four districts in each province and four enumeration areas (EAs) in each district were selected using probability proportional to size. Within each EA, 32 households (HHs) were selected using a simple random sample. Interviews to assess ownership and usage were conducted in each of the selected HHs using personal digital assistants.
RESULTS
Valid interviews were completed for 947 (92.5%) (440 in Manica and 507 in Sofala) of the 1,024 selected HHs. Among participating HHs, 65.0% in Manica and 63.1% in Sofala reported that at least one child under five years of age slept in the house the previous night. HH ownership of at least one bed net of any kind was 20.6% (95% confidence interval [CI]: 7.9%-43.6%) and 35.6% (95% CI: 27.8%-44.3%) pre-campaign; and 55.1% (95% CI: 43.6%-66.1%) and 59.6 (95% CI: 42.4%-74.7%) post-campaign in Manica and Sofala, respectively. Post-campaign HH ownership of at least one ITN was 50.2% (95% CI: 41.8%-58.5%) for both provinces combined. In addition, 60.3% (95% CI: 50.6%-69.2%) of children under five years of age slept under an ITN the previous night.
CONCLUSIONS
This ITN distribution increased bed net ownership and usage rates. Integration of ITN distribution with immunization campaigns presents an opportunity for reaching malaria control targets and should continue to be considered.
Topics: Child, Preschool; Cross-Sectional Studies; Delivery of Health Care; Family Characteristics; Female; Government Programs; Health Care Surveys; Humans; Infant; Infant, Newborn; Insecticide-Treated Bednets; Insecticides; Malaria; Male; Mosquito Control; Mosquito Nets; Mozambique; Ownership; Pregnancy; Protective Devices; Social Marketing
PubMed: 20684764
DOI: 10.1186/1475-2875-9-222 -
PloS One 2022The popularity of online shopping is steadily increasing. At the same time, fake product reviews are published widely and have the potential to affect consumer...
The popularity of online shopping is steadily increasing. At the same time, fake product reviews are published widely and have the potential to affect consumer purchasing behavior. In response, previous work has developed automated methods utilizing natural language processing approaches to detect fake product reviews. However, studies vary considerably in how well they succeed in detecting deceptive reviews, and the reasons for such differences are unclear. A contributing factor may be the multitude of strategies used to collect data, introducing potential confounds which affect detection performance. Two possible confounds are data-origin (i.e., the dataset is composed of more than one source) and product ownership (i.e., reviews written by individuals who own or do not own the reviewed product). In the present study, we investigate the effect of both confounds for fake review detection. Using an experimental design, we manipulate data-origin, product ownership, review polarity, and veracity. Supervised learning analysis suggests that review veracity (60.26-69.87%) is somewhat detectable but reviews additionally confounded with product-ownership (66.19-74.17%), or with data-origin (84.44-86.94%) are easier to classify. Review veracity is most easily classified if confounded with product-ownership and data-origin combined (87.78-88.12%). These findings are moderated by review polarity. Overall, our findings suggest that detection accuracy may have been overestimated in previous studies, provide possible explanations as to why, and indicate how future studies might be designed to provide less biased estimates of detection accuracy.
Topics: Humans; Ownership; Research Design
PubMed: 36477257
DOI: 10.1371/journal.pone.0277869 -
BMC Veterinary Research Dec 2020The dog and cat population data is generally scarce in developing countries due to absence of surveys. The demography of owned dogs and cats, and the associated...
BACKGROUND
The dog and cat population data is generally scarce in developing countries due to absence of surveys. The demography of owned dogs and cats, and the associated ownership characteristics, are essential for the control of pet population and zoonosis. This study was conducted in three towns of West Shoa Zone of Ethiopia with the objectives of assessing demographic characteristics of owned dogs and cats and determinants of ownership.
RESULTS
About 65.1% (95% CI: 62.1-69.8%) of the householders own dogs, 39.2% (95% CI: 35.8-43.8%) own cats, and 30.6% (95% CI: 27.4-35.0%) own both. The majority of the dog-owning households own a single dog (74.8%) and cat (74.9%). There were significantly higher proportion of dog and cat-owning households in Bako than Ambo and Gojo towns. The human to owned-dog ratio was 6:1, and that of cat ratio was 10:1. There were more male dogs (72.1%) and more female cats (59.7%). The male to female sex ratio was estimated at 3:1 for the dog while nearly 1:1 for cats. About 37.5% of the owned dogs were indoor, and 62.5% have free access to outside. Dogs and cats were acquired as a gift from families, neighbors, and friends. The identified reason for not owning dogs/cats were fear of zoonosis, dislike, no time to devote, benefit not realized, and shortage of finance. Logistic regression analysis identified study town, community type, gender of head of household, ownership of other animals as determinants for dog/cat ownership. Besides, possessing dogs was significantly associated with cat ownership.
CONCLUSION
The current study provide insights into the determinants of dogs/cats ownership and their demographic characteristics in Ethiopia. Dogs are more commonly owned, but the household determinants for dog and cat ownership were comparable. Means of obtaining and reason of owning or abandoning dogs/cats is partly different from those reported in the developed countries. The results of this study could be used for the provision of veterinary services, quantifying health risks and benefits associated with dog/cat ownership, and control of pet population and related zoonosis.
Topics: Animals; Cats; Dogs; Ethiopia; Female; Humans; Male; Ownership; Pets
PubMed: 33302938
DOI: 10.1186/s12917-020-02699-4 -
British Journal of Clinical Pharmacology Jul 2017The success of the Regulation on Orphan Medicinal Products in the European Union is evidenced by the 127 orphan drugs that have had market authorization since 2000.... (Review)
Review
AIMS
The success of the Regulation on Orphan Medicinal Products in the European Union is evidenced by the 127 orphan drugs that have had market authorization since 2000. However, the incentives aimed at stimulating research and development have had the unintended consequence of increasing drug cost, resulting in many orphan drugs not being cost-effective. Orphan drugs command an increasing share of the pharmaceutical market and account for a disproportionate amount of healthcare expenditure. Orphan drug ownership by socially motivated, not-for-profit organizations may facilitate access to more affordable orphan drugs, for the benefit of patients and healthcare systems alike. This study aims to describe opportunities for such organizations to become orphan drug Market Authorization Holders.
METHODS
We reviewed data on the ownership of EMA designated and approved orphan drugs, identified funding opportunities and business models for not-for-profit organizations, and summarised relevant legal and policy documents concerning intellectual property rights and drug regulation.
RESULTS
Using repurposed drugs as a paradigm, this narrative review navigates the regulatory hurdles, describes the legal context and identifies funding opportunities, in a bid to facilitate and encourage not-for-profit organizations to lead on the development of affordable orphan drugs.
CONCLUSIONS
Although the regulatory steps required to obtain an MA for an orphan drug are numerous and challenging, they are not insurmountable and can be achieved by not-for-profit organizations that are socially motivated to reduce the costs of orphan drugs to the payers of healthcare. Opportunities for orphan drug development resulting in affordable products lie mainly with repurposed drugs.
Topics: Cost-Benefit Analysis; Drug Approval; Drug Costs; Drug Repositioning; European Union; Guidelines as Topic; Humans; Organizations, Nonprofit; Orphan Drug Production; Ownership
PubMed: 28109021
DOI: 10.1111/bcp.13240 -
Journal of Public Health Policy Feb 2012The 2011 attempted assassination of a US representative renewed the national gun control debate. Gun advocates claim mass-casualty events are mitigated and deterred with...
The 2011 attempted assassination of a US representative renewed the national gun control debate. Gun advocates claim mass-casualty events are mitigated and deterred with three policies: (a) permissive gun laws, (b) widespread gun ownership, (c) and encouragement of armed civilians who can intercept shooters. They cite Switzerland and Israel as exemplars. We evaluate these claims with analysis of International Crime Victimization Survey (ICVS) data and translation of laws and original source material. Swiss and Israeli laws limit firearm ownership and require permit renewal one to four times annually. ICVS analysis finds the United States has more firearms per capita and per household than either country. Switzerland and Israel curtail off-duty soldiers' firearm access to prevent firearm deaths. Suicide among soldiers decreased by 40 per cent after the Israeli army's 2006 reforms. Compared with the United States, Switzerland and Israel have lower gun ownership and stricter gun laws, and their policies discourage personal gun ownership.
Topics: Data Collection; Firearms; Homicide; Humans; Israel; Ownership; Suicide; Switzerland; Wounds, Gunshot
PubMed: 22089893
DOI: 10.1057/jphp.2011.56 -
Journal of Applied Clinical Medical... May 2018
Topics: Ownership; Publishing
PubMed: 29691966
DOI: 10.1002/acm2.12335 -
Health Affairs (Project Hope) Dec 2021Physician practices are increasingly being acquired by hospitals and health systems. Despite evidence that this type of vertical integration is profitable for hospitals,...
Physician practices are increasingly being acquired by hospitals and health systems. Despite evidence that this type of vertical integration is profitable for hospitals, the association between these acquisitions and the incomes of physicians in the acquired practices is unknown. We combined national survey data on physician practice ownership with data on physician income to examine whether hospital or health system ownership of physician practices was associated with differences in physician income during 2014-18. During the study period, hospital and health system ownership of physician practices increased by 89.2 percent, from 24.1 percent to 45.6 percent of all physicians in our sample. Among physician practices overall, vertical integration with hospitals or health systems was associated with, on average, 0.8 percent lower income compared with independent physicians after multivariable adjustment. In analyses by physician specialty, vertical integration of physician practices with hospitals or health systems was associated with lower income for nonsurgical specialists, no difference in income for primary care physicians, and slightly higher income for surgical specialists. Although vertical integration of physician practices is a rapidly growing trend, physicians might not directly benefit financially.
Topics: Hospitals; Humans; Income; Ownership; Physicians; Specialization; United States
PubMed: 34871086
DOI: 10.1377/hlthaff.2021.01007 -
Malaria Journal Aug 2013Over the past decade, significant gains have been made in the implementation of malaria prevention measures in pregnancy in sub-Saharan Africa, including the... (Review)
Review
Over the past decade, significant gains have been made in the implementation of malaria prevention measures in pregnancy in sub-Saharan Africa, including the distribution of insecticide-treated nets (ITNs). These have been shown to cause a reduction in the incidence of malaria and its consequences such as maternal anaemia, stillbirths and intrauterine growth restriction. Currently most nations in Africa have policies for distributing ITNs to pregnant women through various mechanisms, however coverage remains well below the targets. This review summarizes recent evidence regarding the correlation between ownership and use of ITNs and the determinants of both, in pregnancy in sub-Saharan Africa, and reviews interventions directed at improving coverage. A review of the literature using Pubmed, CINAHL and scanning of reference lists was conducted in October 2012 and 59 articles were selected for final review. The research obtained was a mixture of national and district level surveys, and a narrative synthesis of the data was undertaken. Ownership of ITNs varied from as low as 3% to greater than 80%, and the main determinants were found to be education level, knowledge of malaria, community involvement, socio-economic status and parity, although the significance of each varied between the different settings and studies reviewed. In more than half the settings where data were available, the combination of lack of availability and lack of use of an available net meant that less than half of all pregnancies received the recommended intervention. Supply and cost remain major barriers to achieving optimal coverage, but the additional important contributor to reduced efficiency of intervention was the clear discrepancy between ownership and use, with available ITN use below 60% in several settings. Cited reasons for not using an ITN, where one was available, included discomfort, problems with hanging up nets and lack of space, low awareness of need, and seasonal variations in use. These findings highlight the need for context-specific approaches and educational components to be incorporated into ITN distribution programmes to address some of the reasons why some pregnant women do not use the ITNs they own.
Topics: Africa South of the Sahara; Female; Humans; Insecticide-Treated Bednets; Malaria; Mosquito Control; Ownership; Pregnancy; Pregnancy Complications, Infectious
PubMed: 23914731
DOI: 10.1186/1475-2875-12-268 -
Journal of the American College of... Dec 2010
Topics: Biomedical Research; HeLa Cells; History, 20th Century; Humans; Informed Consent; Ownership; Socioeconomic Factors
PubMed: 21144976
DOI: 10.1016/j.jacc.2010.11.008