Objectives This study aimed to estimate the prevalence of loss to follow-up (LTFU) among tuberculosis (TB) patients in Indonesia and to identify associated factors.
Methods This study analyzed data from the 2022 Tuberculosis Information System in Indonesia. A total of 71,665 drug-sensitive TB patients were included in the analysis. Age, sex, employment status, diagnosis type, human immunodeficiency virus (HIV) status, diabetes mellitus, TB type, mode of treatment, treatment standard, referral status, and type of residence. Categorical variables were analyzed using chi-square tests, followed by multivariable logistic regression to identify confounder-adjusted independent predictors of LTFU.
Results The prevalence of LTFU was 18.4%. A higher likelihood of LTFU was observed among older adults aged ≥65 years (adjusted-prevalence-odds-ratio [aPOR], 1.862), men (aPOR, 1.187), unemployed individuals (aPOR, 1.136), non-referred patients (aPOR, 1.547), patients with HIV (aPOR, 3.712), and those obtaining TB drugs out of pocket (aPOR, 4.998). The strongest predictor was receipt of non-standard treatment, which was associated with a markedly increased likelihood of LTFU (aPOR, 26.912). In contrast, rural residence demonstrated a protective association (aPOR, 0.610). All associations were statistically significant (p<0.001).
Conclusion This study highlights a substantial burden of LTFU among TB patients in Indonesia, with nearly one in five patients discontinuing treatment. Multiple sociodemographic and clinical factors—particularly non-standard treatment, non-referral status, and HIV co-infection—were strongly associated with LTFU, underscoring gaps in the TB care continuum. These findings emphasize the need for targeted, patient-centered interventions, strengthened referral pathways, improved communication, and enhanced care coordination to reduce LTFU in high-risk groups.
Objectives This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations. Methods: We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction. Results: Perceived support from healthcare providers emerged as the strongest predictor of satisfaction with medical services, demonstrating a significant positive association. While social support was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction. Conclusion: These findings underscore the importance of healthcare provider and social support in increasing satisfaction with medical services among medically underserved populations. Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.
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Objectives The objective of this study was to examine the hypothesis that periodontal disease is associated with chronic non-communicable diseases. Methods: In this cross-sectional study, we evaluated the periodontal health condition of the population, based on the community periodontal index, as well as the number of missing teeth and the presence of systemic health conditions. We quantified the association between oral health and the presence of chronic diseases using simple logistic regression, adjusting for confounding factors including age, smoking, and overweight. Results: The study population consisted of 334 volunteers, aged between 19 and 81 years. In patients over 45 years old, periodontal disease was found to be significantly associated with hypertension and diabetes. Furthermore, in female patients, periodontal disease was significantly associated with hypertension, diabetes, and cancer. Conclusion: Our findings indicate that periodontal disease is positively and significantly associated with both arterial hypertension and diabetes, independent of potential confounding factors.
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<sec>
<title>Objectives</title>
<p>Cardiovascular disease (CVD) has a substantial financial impact on healthcare systems in the US. This study aimed to examine the impact of CVD on health insurance coverage and health service use under economic stress as indicated by the Great Recession in the US (December 2007–June 2009).</p></sec>
<sec>
<title>Methods</title>
<p>Data of 26,483 adults aged ≥ 20 years from the 2003–2012 National Health and Nutrition Examination Survey were analyzed. There were 9,479 adults assigned to the group “before the Great Recession” (2003–2006), 5,674 adults assigned to “during the Great Recession” (2007–2008), and 11,330 adults assigned to “after the Great Recession” (2009–2012).</p></sec>
<sec>
<title>Results</title>
<p>Patients with CVD from low-income families were more likely to have health insurance during the recession (OR:1.57, 95% CI: 1.01,2.45). Those participants without CVD, who were from low-income families or < 65 years, were more likely to use the emergency room rather than primary care facilities to gain access to routine healthcare (<italic>p</italic> < 0.05). Patients with CVD from high-income families were also more likely to use the emergency room (<italic>p</italic> < 0.05). Patients with CVD but not those without CVD, who reported a high family income or were ≥ 65 years old, were less likely to use mental health services during the recession than before the recession.</p></sec>
<sec>
<title>Conclusion</title>
<p>Effective strategies need to be developed to promote primary care use among the general adult American population. In addition, use of mental health services among patients with CVD needs to be improved when financial stress occurs.</p></sec>
Objectives
This study aimed to examine the factors associated with health services utilization using Andersen's behavioral model. Methods
We collected Korea Health Panel data between the years 2010 and 2012 from the consortium of the National Health Insurance Service and the Korea Institute for Health and Social Affairs, and analyzed the data to determine the outpatients and inpatients of health services utilization. Results
Health services utilization was more significantly explained by predisposing and need factors than enabling factors. The outpatients were examined more specifically; sex, age, and marital status as predisposing factors, and chronic illness as a need factor were the variables that had significant effects on health-services-utilization experience. The inpatients were examined more specifically: sex, age, and marital status in predisposing factors; education level, economic activities, and insurance type in enabling factors; and chronic illness and disability status in need factors were the significant variables having greater effects on health-services-utilization experience. Conclusion
This study suggests the practical implications for providing health services for outpatients and inpatients. Moreover, verifying the general characteristics of outpatients and inpatients by focusing on their health services utilization provides the baseline data for establishing health service policies and programs with regard to the recently increasing interest in health services.
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The predictors of treatment pathways to mental health services among consumers in Ghana Anna Korley Nartey, Eric Badu, Peter Agyei‐Baffour, Naomi Gyamfi, Maxwell Preprah Opoku, Anthony Paul O'Brien, Rebecca Mitchell Perspectives in Psychiatric Care.2019; 55(2): 300. CrossRef
Catastrophic Health Expenditures and Its Inequality in Households with Cancer Patients: A Panel Study Munjae Lee, Kichan Yoon Processes.2019; 7(1): 39. CrossRef
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The Health and Retirement Study: Analysis of Associations Between Use of the Internet for Health Information and Use of Health Services at Multiple Time Points Hyunju Shim, Jennifer Ailshire, Elizabeth Zelinski, Eileen Crimmins Journal of Medical Internet Research.2018; 20(5): e200. CrossRef
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Dental hygienist attendance and its covariates in an ageing Swedish cohort Anne N. Åstrøm, Gunnar Ekbäck, Sven Ordell, Stein A. Lie, Ferda Gulcan European Journal of Oral Sciences.2017; 125(6): 487. CrossRef
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