bluuebunny/crossref_metadata_2025_split huggingface dataset:
Which Patients gain more from short-term planned hospitalization?
Authors: Guarducci G , Panichella F , Gurnari J , Moirano F , Gentile A M , Nante N 
Published: October 2023

Abstract

Background
The measurement of health-related quality of life (HRQoL) has become one of the most important components in the evaluation of healthcare outcomes. The EQ-5D-5L is an econometric tool to transform HRQoL into Quality Adjusted Life Year (QALY). The study aims to measure the health gain, expressed in QALY, provided by an Italian clinic.

Methods
A retrospective study was conducted on 137 geriatric patients admitted, for short-term planned rehabilitation hospitalization, from March 2018 to March 2020. Patients completed the EQ-5D-5L questionnaire at both admission and discharge. We calculated QALY from the difference between EQ-5D-5L at discharge and admission, assuming that health gains (discounted at the rate of 3.5%) accumulate up to one year after discharge. A risk adjustment has been done through the Cumulative Illness Rating Scale (CIRS). We stratified our sample by gender, age, BMI and clinical severity. Descriptive (median and interquartile range) and statistical (Mann-Whitney and Dunn's Test) analysis was carried out using STATA.

Results
In our sample (62.8% female) the median age was 82[15] years old. The median length of stay was 16[17] days. Patients gained 0.14[0.19] QALY: this was greater (p &lt; 0.05) for female (0,15[0,14]) than males (0,12[0,14]). According to age groups, patients &gt;75 years old had a lower QALY (0.12[0.26]) than both patients ≤65 years (0.16[0.15]) and those between 65 and 75 years (0.15[0.12]), while patients younger than 65 years had a higher QALY gain than the other two groups (p &gt; 0.05). The obese class I (0.31[0.46]) gained more QALY than the other BMI classes (p &lt; 0,05), except that obese class II. Patients with a Severity Index of CIRS higher than the median of our sample had a greater health gain (0.18[0.20] vs. 0.12[0.20]) (p &gt; 0.05).

Conclusions
The EQ-5D-5L allowed us to quantify the ‘health gain’ obtained by patients through its transformation into QALY. The best results were obtained in female and obese class I patients.

Key messages
• The outcome assessment is essential when performing healthcare.
• The QALY allows us to assess quantitative and qualitative life expectancy's increases provided by healthcare.
A Comparative Study on the Efficiency of Health Care Systems in OECD Countries Against COVID-19
Authors: Baek S J , Jeong H S , Heo M H , Choi J A , Noh J W 
Published: October 2023

Abstract

Background
COVID-19 has resulted in more than 670 million confirmed cases and more than 6.8 million deaths worldwide as of March 2023. This pandemic situation has put a significant strain on health care systems in each country, and the crises experienced by the USA, Britain and Italy have shown that even developed countries’ systems can collapse. This this study aims to measure and evaluate the performance of OECD countries’ health care systems against COVID-19 in terms of relative efficiency.

Methods
This study uses DEA to measure and compare the relative efficiency of national health care systems in response to COVID-19. We calculate technical, pure technical, scale, and super efficiency ranks based on the CCR, BCC, and Super-SBM models. The input variables are COVID-19-related health expenses, ICUs, facilities and equipment, and the number of examiners, and the output variable is the excess mortality rate due to COVID-19 of 2020, one year.

Results
According to the CCR model, two of the 20 analyzed countries, including Denmark and Iceland, are 100% efficient, and the remaining 18 countries are relatively inefficient. The average of technological efficiency is 0.26. According to the BCC model, a total of 10 countries are 100% efficient. The average of pure technical efficiency is 0.71. As a result of measuring the efficiency of scale, Denmark and Iceland are 100% efficient, and the remaining 18 countries are relatively inefficient. The average scale efficiency is 0.28. The super-efficiency ranking was followed by Denmark, Iceland, Korea and, etc.

Conclusions
When the analysis results were classified by health security system again, efficiency was high in the order of NHS, NHI, and SHI. When classified by financing sources and service provider, it was confirmed that tax-type countries were more efficient than insurance-type countries, and public supply-oriented countries were more efficient than private supply-oriented countries.

Key messages
• The efficiency of health care system of OECD countries against COVID-19 was measured, and the causes of performance were explored in terms of the structure of the system.
• Through this, we intend to derive policy implications that can maintain the sustainability of the health care system in the face of health security crises such as the pandemic.
Effectiveness of the ‘Know what you eat’ nutrition education program for Dutch secondary schools
Authors: Hoefnagels F A , Battjes-Fries MCE 
Published: October 2023

Abstract

Background
School-based nutrition education programs have increasingly been used to teach children about healthy and sustainable nutrition, but there are less recognized programs available for secondary education. In this study we studied the effectiveness of the digital ‘Know what you eat’ program from the Netherlands Nutrition Centre among students (12-15y) on behavioral determinants and self-reported behaviors related to healthy, safe, and sustainable eating behavior.

Methods
Within a quasi-experimental research design, students in the first or second grade of 7 intervention schools and 11 control schools received a digital questionnaire during the pretest and posttest measurement. The questionnaire included questions on knowledge, self-efficacy, attitude, subjective norm, intention, and behavior related to healthy, safe, and sustainable eating behavior.

Results
The pre- and post-questionnaire was filled out by 364 students in the intervention and 247 in the control group. Linear multilevel regression analyses show a higher significant increase in self-efficacy, attitude, intention to drink water (all three p &lt; 0.01), and a significant decrease in sugary drinks, snacks and meat consumption (all p &lt; 0.05) in the intervention group than the control group. Additionally, students in both the intervention and control groups scored higher on knowledge during the post-test than the pre-test (both p &lt; 0.05), but the intervention group was not significantly higher than the control group (p = 0.14). No significant effects were found for subjective norm, intention, and fruit, vegetable, and whole grain bread consumption.

Conclusions
The results of this study showed effects of the ‘Know what you eat’ program on self-efficacy and attitude towards healthy, sustainable, and safe eating behavior, intention to drink more water, and several healthy eating behaviors of secondary school students. Further research is needed to determine the sustainability of these results in the long term.

Key messages
• The ‘Know what you eat’ program is effective on self-efficacy, attitude and certain eating behaviors related to healthy, sustainable, and safe eating behavior of students (12-15y).
• Nutrition education programs in secondary schools appears promising for promoting students food literacy.
Loneliness in emerging adulthood: A qualitative study using cultural probes and interviews
Authors: Nielsen B K , Nielsen L A , Lasgaard M 
Published: October 2023

Abstract

Background
Prolonged loneliness in emerging adults is a public health concern associated with poor mental health such as symptoms of depression and anxiety that may have negative implications for health and well-being in later life. This study aimed to explore how prolonged loneliness is experienced and coped with by emerging adults in their everyday life.

Methods
The study is a thematic analysis of qualitative data consisting of cultural probes and in-depth interviews. 21 emerging adults (mean age 21.3) completed cultural probes consisting of open and evocative activities for them to delve into in their own time thereby contributing to depicting their story about loneliness in everyday life. After completion of the probes, participants were interviewed using a semi-structured interview-guide.

Results
Through thematic analysis of the cultural probe material and interview data we identified three main themes: ‘the many faces of loneliness’ (subthemes: social exclusion and bullying, life interrupted, disconnected in a connected world), ‘internal struggles: the interplay between low self-esteem, intrusive thoughts, and mental health’ (subthemes: trapped in self-doubt, labelled and lonely), and ‘the duality of coping strategies’ (subthemes: reconnecting with others, distracting activities).

Conclusions
The study provides a deeper understanding of the lived experiences of prolonged loneliness among emerging adults and offers insights into the reasons underlying loneliness. Moreover, the findings can contribute to developing interventions aimed at reducing loneliness in emerging adults. The rich data from the cultural probes were subsequently used to create a traveling exhibition, which facilitates dialogue on loneliness.

Key messages
• Prolonged loneliness in emerging adults is a public health concern associated with poor mental health, which may have negative implications for health and well-being in later life.
• Insights on coping strategies and loneliness experiences of emerging adults in the study can help inform interventions aimed at reducing loneliness.
Experiences of catch-up vaccination among adult migrants in the UK: An in-depth interview study
Authors: Deal A , Crawshaw A F , Salloum M , Hayward S E , Carter J , Mounier-Jack S , Majeed A , Hargreaves S 
Published: October 2023

Abstract

WHO's Immunization Agenda 2030 emphasises equitable access to vaccination across the life course, including migrants who may have missed childhood vaccinations due to disrupted healthcare systems or differing vaccination schedules. Uptake of adult catch-up vaccination is thought to be poor in the UK, but limited evidence exists to explain this. In-depth semi-structured interviews were carried out across two studies with different adult migrant populations on views and experiences around vaccination. Study 1 recruited those resident &lt;10 years in the UK from a range of backgrounds (remote interviews, 09/2020-01/2022, REC2020.0058) and Study 2 (in-person, 01/2022-03/2022, REC2021.0128) engaged Congolese and Angolan migrants. Interviews were conducted in English, Lingala or French and were audio-recorded, transcribed, and analysed through qualitative content analysis in NVivo 12. 71 participants were interviewed (mean age 43.6 [SD:12.4], 69% female, mean 9.5 [SD:7] yrs in UK). Most reported having never been offered or asked about vaccination history in the UK. Participants more often reported being offered seasonal or selective vaccinations (flu [n = 20], travel-related [n = 8], pregnancy-related [pertussis, n = 7]) compared to catch-up vaccines (MMR (n = 3), DTP (n = 3)) in the UK. Generally, participants were not aware of catch-up vaccination but viewed it mostly positively. Concerns included side effects, barriers to attending primary care facilities, and vaccination fatigue. Trust was an important factor in vaccination decisions, and participants expressed varying levels of trust towards healthcare professionals’ recommendations and the NHS. There is a need to increase opportunities for catch-up vaccination in primary care by incentivisation of catch-up vaccination and education of healthcare professionals. Low trust and concerns around safety exist in some migrant groups, for which tailored information campaigns or community-led interventions could be developed.

Key messages
• There is a need to increase opportunities for catch-up vaccination in primary care.
• Low trust and concerns around safety exist in some migrant groups, for which tailored information campaigns or community-led interventions could be developed.
10.C. Round table: EU Global Health Strategy: Mapping European support for improving health and health systems globally
Authors:   Organised by: European Observatory on Health Systems and Policies,   Chair persons: Matthias Wismar (European Observatory)
Published: October 2023

Abstract

In November 2022, the European Commission unveiled its new Global Health Strategy. Featuring three cross-cutting priorities, the Strategy calls for the mobilisation of a “wide number of policies to work on a global health agenda” (1). The Strategy also highlights the importance of establishing a “permanent mapping of key measures and financing efforts of the EU and its Member States to better understand what actions are taking place and to allow for tying means to the strategy's priorities”(1).
The EU's ongoing actions are already delivering more for health systems globally than one would expect - and it has many policy tools and support instruments which affect Global Health. These instruments vary greatly in their intent and design, with some targeted at strengthening health systems and promoting health and wellbeing, while others contribute to these objectives more indirectly by generating spillover effects. The European Observatory's upcoming policy brief ‘European support for improving health and care systems globally’ aims to unpack the key EU instruments available in policy areas including:
• Trade in goods and services
• Public investment and fiscal instruments
• Official development assistance and humanitarian aid
• Solidarity, voice, and multilateralism
• Research and training partnerships
This roundtable will delve into the main priorities of the Strategy and reflect on upcoming plans for its realisation. Engaging with the audience, the panel will explore the need for transparency, alignment, and coordination of the existing instruments across the different policy areas. It will also discuss opportunities for collaboration between the European level and the EU Member States. This facilitated roundtable discussion will explore how resources such as the Policy Brief can serve as a steppingstone to map and make sense of the diverse range of EU actions relevant for Global Health, in order to maximise synergies, transparency and policy consistency for successful coordination and implementation of the Strategy.
(1) EU Global Health Strategy - Better Health for All in a Changing World. Commission Communication COM(2022) 675, https://health.ec.europa.eu/publications/eu-global-health-strategy-better-health-all-changing-world_en

Key messages
• The EU already has more policy instruments with an impact on Global Health than one would expect.
• Delivering on the priorities of the new EU Global Health Strategy will require taking stock of ongoing EU actions and forging meaningful synergies for cross-sectoral collaboration.

Speakers/Panelists
Scott Greer
University of Michigan, Ann Arbor, USA
Nicole Mauer
European Observatory on Health Systems and Policies, Brussels, Belgium
Elena Petelos
EUPHA-HTA, EUPHA-GH
Burden of T1DM and T2DM among adolescents in Western Europe, 1990-2019: results from the GBD 2019
Authors: Armocida B , Monasta L , Sawyer S , Bustreo F , Onder G , Castelpietra G , Pricci F , Giacomozzi C , Perel P , Beran D 
Published: October 2023

Abstract

Background
Type 1 (T1DM) and type 2 diabetes mellitus (T2DM) are major causes of global morbidity and mortality. As little is known about the burden of DM in adolescents in Western Europe (WE), we aimed to explore the epidemiology of T1DM and T2DM among 10-24-year-olds, including temporal trends.

Methods
Estimates were retrieved from the Global Burden of Diseases study 2019 (GBD 2019). We reported counts, rates per 100,000 population, and percentage changes from 1990 to 2019 for incidence, prevalence and years lived with disability (YLDs) of T1DM and T2DM, and the burden of T2DM in YLDs attributable to high body mass index (HBMI), for 24 WE countries.

Results
In 2019, prevalence and YLDs estimates were higher for T1DM than T2DM among 10-24 years old adolescents in WE. However, T2DM incidence rates per 100,000 population were 3.5 times higher than T1DM. T2DM showed a greater increase in prevalence and YLDs than T1DM in the 30-year observation period in all WE countries. The highest prevalence rate of T1DM was in Finland (542.7 [402.9-681.0]), while the United Kingdom had the highest prevalence for T2DM (751.0 [501.2-1063.3]). Prevalence increased with age, while only minor differences were observed between sexes. In 2019, HBMI accounted for 28.8 (12.6-54.9) of the attributable YLD rates for T2DM in age group 20-24 years in WE.

Conclusions
The findings show the substantial burden posed by DM among adolescents in WE. The study can help inform the development and implementation of appropriate infrastructure and healthcare frameworks for adolescent-centred diabetes care. It highlights the need for transition services, and adolescent-oriented education programs, as well as investments in data systems to improve the availability and quality of data for T1DM and T2DM in 10-24-year-olds. Finally, it can be used to guide policymakers towards prevention of obesity and broader policy actions on the social and commercial determinants of health across the life course.

Key messages
• Adolescent-oriented health system responses on transition services, data collection systems, education, and complications’ prevention are needed to achieve targets for NCDs within the 2030 UN SDGs.
• T2DM should not only be considered as an adult-onset disease, implying a paradigm shift for paediatric DM services and a strengthening of interventions on social and commercial determinants of health.
Disease burden in Norway in 2050: A forecasting analysis based on the Global Burden of Disease (GBD) Study
Authors: Knudsen A K , Sulo G , Klitkou S T , Vollset S E 
Published: October 2023

Abstract
Life expectancy in Norway has increased steadily in the past 50 years, in line with decreases in important causes and risk factors for premature mortality. However, due to the aging of the population, it is expected that a higher number will live with chronic diseases in the future. This will have implications for the planning of health services and public health work. The aim of this analysis was to forecast the disease burden in Norway up to 2050. The analyses were based on data on life expectancy and disease burden by 21 disease groups from the Global Burden of Disease Study 2019 (GBD 2019). The population was forecasted to get estimates on future size, age-composition and life expectancy up to 2050. Independent drivers of population health, in terms of sociodemographic factors and a selection of risk factors and preventive measures (e.g. vaccines) were included in the forecasting of general and cause-specific mortality. Non-fatal health loss was forecasted based on incidence/mortality ratios, or previous trends in disease development for causes not associated with mortality. Results are presented as rates, and compared with observed rates from the period 1990 to 2019. Both life expectancy and the proportion of elderly in Norway is forecasted to increase towards 2050. The decreasing trend in mortality and disease burden rates observed from 1990 to 2019 is, however, forecasted to turn, with a forecasted increase starting from 2020 and onward. Mortality due to cancers, neurological diseases and chronic respiratory diseases were forecasted to increase, while cardiovascular diseases were forecasted to contribute with decreased mortality in 2050. The non-fatal disease burden was forecasted to remain relatively stable. Aging of the population is the most important driver of future disease burden. Forecasting of disease burden by cause- and age-groups provides important background knowledge for planning of future health services and targeted health promotion.
10.G. Workshop: Investigating risk and protective factors for youth mental health using population-based datasets
Authors:   Organised by: Royal College of Surgeons in Ireland,   Chair persons: Mary Cannon (Ireland), David Cotter (Ireland)
Published: October 2023

Abstract

Mental health problems are increasing among young people both in Ireland and worldwide and the causes of this increase are not known. This workshop will focus on large population based datasets which provide recent and comprehensive information on the mental health of young people, including the Growing Up in Ireland study, the Planet Youth study and the ALSPAC cohort. We will present recent data on prevalence of mental health disorders among adolescents and we will present data on possible risk factors and protective factors for mental health problems in youth. We will focus on the possible role played by the COVID pandemic in this observed increase. We will also present data relating to substance use including cannabis use and diet . We will explore trajectories of psychopathology between childhood and adolescence and incidence and persistence of psychotic experiences in youth. This workshop will be a chance to bring together researchers and clinicians working in this important area to discuss the issue of youth mental health which will have importance not just for Ireland but for other countries worldwide.

Key messages
• An increase in mental health problems among young people has been observed over recent years but the causes for this increase are not known.
• There is an urgent need to identify risk and protective factors for mental health problems among youth and how these are changing over time.
The concept of personal responsibility in Bulgarian health and social legislation
Authors: Yankulovska S 
Published: October 2023

Abstract

Background
In the context of scarce health care resources, national policies and legislation increasingly advocate patients’ personal responsibility for their ill health. This report aims at studying the concept of personal responsibility as a basis for resources prioritisation in Bulgarian health and social legislation.

Methods
Official normative documents were subjected to content and comparative analysis.

Results
Indirect personal responsibility can be found in the Bulgarian Health Act, Art.94 stating the duty of the patient to take care of his own health. Further, in the liver transplant algorithm of the Recipient Selection Ordinance, it is possible to distinguish a hidden criterion of patient's responsibility. One possible interpretation of Article 12 of the Code of Professional Ethics of Physicians in Bulgaria is the right of a physician to refuse medical care on the grounds of lack of trust due to patient's non-compliance with prescriptions. The latter correlates with the idea of prospective responsibility. Direct personal retrospective responsibility is imputed in the Health Insurance Act, Art. 111, where persons who themselves have damaged their health or in a state of alcoholic intoxication or drug abuse have damaged the health of others, must reimburse the costs of the NHIF. We also find clearly defined personal responsibility in the Social Security Code, Art. 46, according to which monetary compensation for temporary incapacity is not paid to insured persons who intentionally damage their health. There is no official data on the applicability of these legal norms.

Conclusions
Although in a less categorical form and not in relation to access to specific planned treatments, the idea of the personal responsibility is embodied in the Bulgarian legislation. It is necessary to accumulate further data on the applicability of these norms, as well as to study the views of patients, users of social services, professionals and general public.

Key messages
• Personal responsibility is gradually entering Bulgarian legislation as an official criterion for the allocation of social and health resources.
• It is necessary to accumulate further data on the applicability of the prescribed legal norms, as well as to study the views of patients, users of social services, professionals and general public.