Healthcare Resource Utilization and Direct Medical Costs for Patients With Osteoporotic Fractures in China

Wu, Jing; Qu, Yi; Wang, Ke; Chen, Yu

doi:10.1016/j.vhri.2018.11.008

Cited by 17 publications

(9 citation statements)

References 27 publications

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“…AB is conducted directly by the feeling on performance of target behaviour [111]. e need for medical resource supply is literally urgent in China given the challenges of ageing, increasing prevalence of chronic diseases, and incompleteness of healthcare delivery [112]. Alternately, Wang and Zhang pointed out that CHM contains several opportunities for the private sector, where most individuals are willing to pay for PPP healthcare services at a reasonable level [15].…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Intention and Behaviour of Private Sector Participation in Healthcare Service Delivery via Public-Private Partnership: Evidence from China

Yang

Song

Yao

et al. 2020

Journal of Healthcare Engineering

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Private sector participation in the healthcare market via public-private partnership (PPP) could be considered an available approach to narrow down the medical resource gap and improve the operational efficiency of healthcare facilities. Accordingly, this study aims to examine the influence and relative importance among critical factors for the intention and behaviour of the private sector towards participation in Chinese healthcare market (CHM) via PPP. We defined five hypotheses from previous literature and built a theoretical model based on modified theory of planned behaviour. Then, covariance-based structural equation modelling was applied to analyse the questionnaires provided by 248 respondents from construction companies, real estate developers, pharmaceutical companies, private hospitals, asset management companies, and medical industry property investment companies in China. Results indicated that attitude towards behaviour (β = 0.466, P<0.001), subjective norm (β = 0.167, P<0.05), perceived behavioural control (β = 0.231, P<0.01), and facilitating conditions (β = 0.305, P<0.001) are positively significant to behavioural intention; behavioural intention also shows a strong linkage with behaviour (β = 0.931, P<0.001). Findings provide reference for governments and public authorities to exert additional efforts in implementing appropriate measures that will stimulate the private sector’s motivation to participate in CHM via PPP.

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Section: Discussionmentioning

confidence: 99%

Evaluating the Intention and Behaviour of Private Sector Participation in Healthcare Service Delivery via Public-Private Partnership: Evidence from China

Yang

Song

Yao

et al. 2020

Journal of Healthcare Engineering

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“…Osteoporosis is a prevalent and latent metabolic bone disease characterized by loss of bone mass and consequent susceptibility to fracture. With the progressively aging population, the number of patients in China with osteoporosis or osteoporotic fracture is projected to reach approximately 212 million and 5.99 million, respectively, by 2050 [1,2], which will cause substantial economic costs, morbidity, and mortality. Currently, osteoporosis remains substantially underdiagnosed.…”

Section: Introductionmentioning

confidence: 99%

Automatic opportunistic osteoporosis screening using low-dose chest computed tomography scans obtained for lung cancer screening

Pan

Shi²,

Wang

et al. 2020

Eur Radiol

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Objective Osteoporosis is a prevalent and treatable condition, but it remains underdiagnosed. In this study, a deep learning-based system was developed to automatically measure bone mineral density (BMD) for opportunistic osteoporosis screening using lowdose chest computed tomography (LDCT) scans obtained for lung cancer screening. Methods First, a deep learning model was trained and tested with 200 annotated LDCT scans to segment and label all vertebral bodies (VBs). Then, the mean CT numbers of the trabecular area of target VBs were obtained based on the segmentation mask through geometric operations. Finally, a linear function was built to map the trabecular CT numbers of target VBs to their BMDs collected from approved software used for osteoporosis diagnosis. The diagnostic performance of the developed system was evaluated using an independent dataset of 374 LDCT scans with standard BMDs and osteoporosis diagnosis. Results Our deep learning model achieved a mean Dice coefficient of 86.6% for VB segmentation and 97.5% accuracy for VB labeling. Line regression and Bland-Altman analyses showed good agreement between the predicted BMD and the ground truth, with correlation coefficients of 0.964-0.968 and mean errors of 2.2-4.0 mg/cm 3. The area under the curve (AUC) was 0.927 for detecting osteoporosis and 0.942 for distinguishing low BMD. Conclusion The proposed deep learning-based system demonstrated the potential to automatically perform opportunistic osteoporosis screening using LDCT scans obtained for lung cancer screening. Key Points • Osteoporosis is a prevalent but underdiagnosed condition that can increase the risk of fracture. • A deep learning-based system was developed to fully automate bone mineral density measurement in low-dose chest computed tomography scans. • The developed system achieved high accuracy for automatic opportunistic osteoporosis screening using low-dose chest computed tomography scans obtained for lung cancer screening. Keywords Bone mineral density. Deep learning. Osteoporosis. Screening Abbreviations AUC Area under the curve BMD Bone mineral density CNN Convolutional neural network CT Computed tomography DL Deep learning DXA Dual-energy X-ray absorptiometry LDCT Low-dose chest computed tomography QA Quality assurance QCT Quantitative computed tomography VB Vertebral body VOI Volume of interest Yaling Pan and Dejun Shi contributed equally to this work.

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“…1 Hip fracture not only causes dysfunction and poor quality of life, but also places economic burdens on families. 2,3 If hip fracture occurs in ESRD patients, preoperative delay can occur frequently due to preoperative electrolyte imbalance, low hemoglobin levels, and dialysis schedules. Complications such as wound hematoma, infection, implant failure, and nonunion are more likely to occur after surgery.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Renal Dialysis on All-Cause Mortality in Older Patients with Hip Fracture: a Korean Nationwide Cohort Study

Jang

Cha

et al. 2020

J Korean Med Sci

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Background: The purpose of this study was to analyze the all-cause mortality rate over time after elderly hip fracture in end-stage renal disease (ESRD) patients with dialysis, using a Korean nationwide claims database. Methods: This retrospective nationwide study identified subjects from the Korean National Health Insurance Service-Senior cohort (NHIS-Senior). The NHIS-Senior (total of 588,147 participants) was constructed by 10% random sampling and was designed to represent the elderly living in Korea. Subjects were patients aged 65-99 years who underwent surgical treatment for femoral neck fractures or intertrochanteric fractures. A generalized estimating equation model with Poisson distribution and logarithmic link function was used to estimate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) to measure associations between renal dialysis and cumulative mortality in various time frames. Results: The total number of patients included in this study was 16,818. These patients were divided into two groups: 116 (0.69%) in the dialysis group and 16,702 (99.31%) in the no-dialysis group. The mean length of hospital stay was 43.87 ± 48.45 days in the dialysis group and 36.29 ± 37.49 days in the no-dialysis group (P = 0.095). The effect of renal dialysis on all-cause mortality was 2.29-fold (aRR; 95% CI, 1.29-4.06; P = 0.005) within 30 days and 1.72-fold (aRR; 95% CI, 1.34-2.21; P < 0.001) within 1-year after hip fracture compared to the no-dialysis group. And, the effect of renal dialysis of in-hospital mortality was 2.72-fold (aRR; 95% CI, 1.71-4.33; P < 0.001) compared to the no-dialysis group. Conclusion: Elderly patients who underwent dialysis have very high mortality rates after hip fracture. Therefore, it is considered that postoperative care through multidisciplinary management and understanding of pathophysiology for the ESRD patients is necessary.

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Healthcare Resource Utilization and Direct Medical Costs for Patients With Osteoporotic Fractures in China

Cited by 17 publications

References 27 publications

Evaluating the Intention and Behaviour of Private Sector Participation in Healthcare Service Delivery via Public-Private Partnership: Evidence from China

Evaluating the Intention and Behaviour of Private Sector Participation in Healthcare Service Delivery via Public-Private Partnership: Evidence from China

Automatic opportunistic osteoporosis screening using low-dose chest computed tomography scans obtained for lung cancer screening

The Influence of Renal Dialysis on All-Cause Mortality in Older Patients with Hip Fracture: a Korean Nationwide Cohort Study

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