The Behavioral and Social Dimension of the Public Health System of European Countries: Descriptive, Canonical, and Factor Analysis

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Abstract

Background: The state and prospects of the healthcare industry of a country are among its top priorities because the quality of life and health of its citizens are indicators of its success and competitiveness. The aim of this study is to conduct a theoretical analysis and qualitative and quantitative assessments of indicators by developing an integral indicator in the context of behavioral, social, demographic, and economic factors that characterize the level of healthcare system development in European countries using multivariate statistical modeling methods. Methods: The study was implemented using Statistica 10 and Statistica Portable statistical packages. The statistical base of the study was formed using descriptive analysis; a group of 10 European countries was identified using a cluster analysis based on the application of an iterative divisive k-means method. The degree and significance of the interrelations between the components characterizing the studied groups of indicators were determined using canonical correlations by conducting a canonical analysis. Factor modeling is conducted by applying the analysis of the main components to determine the relevant indicators for assessing the level of healthcare system development to build integral indicators of the level of healthcare system development in European countries. Results: The need to improve the level of healthcare system development in European countries was confirmed. Shortcomings and possible reserves for potential improvement of the healthcare system were identified. Conclusions: The results can help public authorities, officials and employees of the healthcare sector organize and conduct effective, timely, high-quality regulation and adjustment of the regulatory and legislative framework to improve healthcare system development.

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Assessing hospital performance indicators. What dimensions? Evidence from an umbrella review

Elettra Carini, Irene Gabutti, Emanuela Maria Frisicale … (2020)

Background Patients’ increasing needs and expectations require an overall assessment of hospital performance. Several international agencies have defined performance indicators sets but there exists no unanimous classification. The Impact HTA Horizon2020 Project wants to address this aspect, developing a toolkit of key indicators to measure hospital performance. The aim of this review is to identify and classify the dimensions of hospital performance indicators in order to develop a common language and identify a shared evidence-based way to frame and address performance assessment. Methods Following the PRISMA statement, PubMed, Cochrane Library and Web of Science databases were queried to perform an umbrella review. Reviews focusing on hospital settings, published January 2000–June 2019 were considered. The quality of the studies selected was assessed using the AMSTAR2 tool. Results Six reviews ranging 2002–2014 were included. The following dimensions were described in at least half of the studies: 6 studies classified efficiency (55 indicators analyzed); 5 studies classified effectiveness (13 indicators), patient centeredness (10 indicators) and safety (8 indicators); 3 studies responsive governance (2 indicators), staff orientation (10 indicators) and timeliness (4 indicators). Three reviews did not specify the indicators related to the dimensions listed, and one article gave a complete definition of the meaning of each dimension and of the related indicators. Conclusions The research shows emphasis of the importance of patient centeredness, effectiveness, efficiency, and safety dimensions. Especially, greater attention is given to the dimensions of effectiveness and efficiency. Assessing the overall quality of clinical pathways is key in guaranteeing a truly effective and efficient system but, to date, there still exists a lack of awareness and proactivity in terms of measuring performance of nodes within networks. The effort of classifying and systematizing performance measurement techniques across hospitals is essential at the organizational, regional/national and possibly international levels to deliver top quality care to patients.

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Development of an integral assessment approach of health status in patients with obstructive airway diseases: the CORONA study

Edmée van den Akker, Alex J van ‘t Hul, Niels H Chavannes … (2015)

Background Traditional assessment of patients with obstructive lung diseases (asthma and chronic obstructive pulmonary disease; COPD) relies on physiological tests. The COPD and Asthma Rotterdam Integrated Care Approach (CORONA) study aims to develop a diagnostic pathway with a more comprehensive approach to the assessment of patients with asthma and COPD in secondary care. Methods An eight-step method was used to develop and implement the pathway for patients with asthma or COPD referred to an outpatient hospital setting. Results The diagnostic pathway consists of an evidence-based set of measurements prioritized by a Delphi procedure. The pathway incorporates three innovative diagnostics: the metronome-paced hyperventilation test to measure dynamic hyperinflation, an activity monitor to objectively evaluate physical activity in daily life, and the Nijmegen Clinical Screening Instrument as a comprehensive assessment tool to acquire detailed insight into symptoms, functional limitations, and quality of life. Conclusion An innovative diagnostic pathway was developed and implemented for patients with obstructive lung diseases referred to secondary care. As this pathway aims to provide a comprehensive analysis of health status, it focuses on biomedical aspects and also reviews behavioral aspects that further elucidate the patient’s health status. The added value of the diagnostic pathway needs to be determined from both an organizational perspective and from the individual patient’s viewpoint.

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USAGE INTENTIONS, ATTITUDES, AND BEHAVIORS TOWARDS ENERGY-EFFICIENT APPLICATIONS DURING THE COVID-19 PANDEMIC

Rebeka-Anna Pop, Dan-Cristian Dabija, Corina Pelău … (2022)

Energy waste is an emerging issue worldwide, with energy conservation goals, such as conscious energy consumption, playing a crucial role in helping the environment. The rapid growth of smart appliances has led to the development of mobile applications, with an increased interest among policymakers to design eco-saving plans for optimizing power and battery consumption. This study aims to explore the usage intention of energy-efficient applications, through young consumers’ energy conservation behavior, behavioral characteristics, and COVID-19 pandemic experience. Based on empirical investigation, a survey was applied in Romania among 590 mobile app users. The data were tested using partial least square structural equation modeling (SmartPLS, version 3). The results indicate the impact of behavioral characteristics, namely, energy conservation attitude, subjective norms, and environmental knowledge on young users’ energy conservation behavior. The influential effect of COVID-19 on energy-saving behavior was also proven. Energy conservation behavior, and functional and hedonic values positively influence Millennials’ and Gen Zers’ energy-efficient app usage intentions. The study also discusses some implications for policymakers, marketers, and software developers, as well as providing theoretical suggestions for future work.