Out of sight,out of mind? A qualitative study of patients’ perspectives on cross-border healthcare in a European border region

ObjectiveTo improve our understanding of patients’ needs in cross-border healthcare, with a specific focus on handover.MethodsIn this qualitative study, we conducted narrative interviews with 8 patients who had experienced cross-border healthcare, including handover. Based on an inductive analysis, we crafted stories representing participants’ perspectives. Crafted stories attend to the personal character of patients’ experiences.ResultsWe crafted 3 stories relating patients’ cross-border healthcare pathways. We identified 3 recurring issues in these stories: (1) Patient involvement in the decision-making process regarding their healthcare; (2) Communication with their healthcare providers; and (3) Information throughout the healthcare process.ConclusionThe said issues, albeit no novelty in healthcare, seem to be amplified by cross-border barriers, such as system, language, and cultural differences. To empower patients to be involved in their own healthcare process, these issues should become a topic of conversation between patients and healthcare professionals.Practice implicationsThe patient stories in this article could help raise awareness among professionals and patients about the issues patients face in cross-border healthcare. Awareness is a first step in overcoming these issues.     

Cross-border health and productivity effects of alcohol policies

This paper studies the cross-border health and productivity effects of alcohol taxes. We estimate the effect of a large cut in the Finnish alcohol tax on mortality, alcohol-related illnesses and work absenteeism in Sweden. This tax cut led to large differences in the prices of alcoholic beverages between these two countries and to a considerable increase in cross-border shopping. The effect is identified using differences-in-differences strategy where changes in these outcomes in regions near the Finnish border are compared to changes in other parts of northern Sweden. We use register data where micro level data on deaths, hospitalisations and absenteeism is merged to population-wide micro data on demographics and labour market outcomes. Our results show that the Finnish tax cut did not have any clear effect on mortality or alcohol-related hospitalisations in Sweden. However, we find that workplace absenteeism increased by 9% for males and by 15% for females near the Finnish border as a result of the tax cut.     

不同类别高危场所暗娼STD/AIDS防治需求分析

目的 了解攀枝花市不同类别高危场所暗娼的性传播疾病/艾滋病(STD／AIDS)防治需求。方法 采用分层随机抽样法抽取不同类别高危场所，填写统一的暗娼健康及其影响因素调查表。结果 178名暗娼的年龄、文化程度、上月经济收入均有不同程度的差异，与其他性伙伴最近1次发生性行为时安全套使用率不同类别场所暗娼间有差异。暗娼中有一部分吸毒者，即具有双重身份。结论 不同类别场所暗娼安全套使用现状不一，提示在安全套干预工作中应根据其特点制定不同的策略；不同类别场所暗娼均需要STD门诊的外展服务和咨询。促进正确的求医行为；在暗娼健康教育中应加入毒品危害的内容。     

龙陵县缅籍媳妇艾滋病相关知识知晓率与影响因素调查

目的了解中国边境保山市龙陵县渉缅事实婚姻家庭缅籍媳妇艾滋病相关知识的知晓状况及其影响因素。方法采用普查法,于2010~2011年度对全县渉缅事实婚姻家庭中的缅籍媳妇进行艾滋病相关知识的问卷调查。结果调查对象共845人,应答率为100%,平均年龄28.5岁。艾滋病相关知识知晓率为66.0%,8个条目艾滋病相关知识完全知晓率为41.5%,完全不知晓率为17.9%。龙陵县渉缅事实婚姻家庭艾滋病知识知晓率的主要影响因素为不同年龄段、文化程度、在缅甸的婚姻状况、进入中国的时间分段、在缅甸时的职业分布、在缅甸时HIV检测情况(P0.05)。结论龙陵县渉缅婚姻家庭人员艾滋病相关知识普遍不足,且知识掌握程度在不同特征人群分布不均,需要通过多种形式健康教育在该人群中加强艾滋病防治知识的宣传。     

以规范化性病门诊为依托的暗娼艾滋病综合干预效果评价

目的利用连续开展的行为学和血清学监测数据,对以规范化性病门诊为依托的暗娼艾滋病综合干预效果进行评价。方法在铜陵市城区,针对娱乐场所暗娼,开展以规范化性病门诊为依托的艾滋病综合干预工作,每年开展行为学与血清学监测,利用连续开展的综合监测数据对干预效果进行评价。结果 2006-2009年分别有效监测暗娼384人、444人、402人和412人。8个艾滋病知识题答对6题为知晓,暗娼的知晓率逐年增加,从2006年的73.44%上升到2009年的88.35%。最近一次与客人发生性关系时安全套使用率,由2006年的41.93%增加到2009年的66.26%,趋势性检验(χ2=44.641,P<0.001)表明,使用率呈逐年增长的趋势。最近一个月每次都用安全套的比例从2006年的14.32%提高到2008年的30.85%、2009年的25.49%。多因素Logistic回归分析提示,未婚、户籍为外省的暗娼艾滋病知识达到知晓程度者在最近一次性服务中更倾向于使用安全套。监测4年间均未发现HIV抗体阳性者,梅毒阳性检出率2006-2009年分别为3.13%、0.68%、1.49%、0.73%。结论以规范化性病门诊为依托的暗娼艾滋病综合干预取得了较好的效果,应充分利用连续开展的行为学监测和血清学监测数据对艾滋病干预活动进行效果评估。     

Factors that infertile couples from mainland China may take into consideration for cross-border reproductive care – A cross-sectional questionnaire study

ObjectiveCross-border reproductive care (CBRC) has become popular in the world, including mainland China. We designed a questionnaire and aimed to determine the main factors that infertile couples from mainland China may consider for CBRC.Materials and methodsIn this cross-sectional questionnaire-based study, we retrospectively analyzed the data from questionnaires collected at the Reproductive Center of Beijing BaoDao Obstetrics and Gynecology Hospital from January 2018 to June 2018. The questionnaire contained 38 items that belonged to six different categories (environment and equipment, service quality, patient safety, medical quality, information acquisition channel and overseas medical services). The item scores for each factor were calculated and then weighted using principal component analysis.ResultsA total of 297 infertile couples were identified. Most of the infertile women were aged 31–35 years, were married 1–3 years, and had a bachelor's degree. In the weighted factor analysis, “clean outpatient clinic and medical equipment” had the highest weight in the dimension of environment and equipment. The item with the highest weight in the dimension of service quality was “wait time for examination”. In the dimension of patient safety, “health education on medication and surgery by counselors” had the highest weight. The item with the highest weight in the dimension of medical quality was “fee charged for ART treatment”. The items with the three highest weights in the dimension of information acquisition channel were “other (seminar, exhibition, dissertation …)”, “introduction from friends and relatives”, and “telephone inquiry”. In the dimension of overseas medical services, the two items with the highest weights were “cultural similarities” and “language similarities”.ConclusionFor CBRC, infertile couples from mainland China may take following significant factors into consideration: a high success rate and inexpensive treatment, cultural and linguistic familiarity, high-quality service and short wait time.     

社会网络分析法在暗娼艾滋病高危行为干预中的应用研究

目的通过分析自贡市富顺县暗娼的社会网络特征,探讨将社会网络分析法应用于暗娼艾滋病高危行为干预工作的可行性和价值。方法采用SPSS 18.0、MLwiN多水平模型统计软件以及UCINET 6,对123名暗娼以个人为中心的社会网络进行分析。结果 123人提及的个人社会网络成员实际人数352人,多为初中文化的在富顺县城工作的青年女性,28.2%为暗娼,67.3%有固定性伴。调查对象以在社会上认识的朋友居多(占28.9%),认识时间多为≤5.0y(占52.4%),联系方式以见面为主(占60.5%);咨询网络存在。结论社会网络分析法可用以帮助选择干预者和同伴教育者,扩大干预覆盖面,在暗娼艾滋病行为干预中是可行的。     

肇庆市暗娼人群STD／AIDS相关知识及求医行为调查

目的了解肇庆市暗娼对STD／AIDS相关知识的掌握程度及求医行为,为在暗娼人群中开展有针对性的STD／AIDS防治策略提供科学依据。方法采用面对面问卷调查的方式,对肇庆市娱乐场所346名暗娼人员STI）／AIDS相关知识及求医行为进行调查。结果肇庆市暗娼人群对STD／AIDS基本知识及安全套使用知识总体知晓率分剐为74．3％、75t0％,全部答对率分别为36．1％、26．3％;正确就医比例为87．3％;获取STD／AIDS知识来源主要通过书报杂志（55．O％）、电视或广播（54．3％）等大众传播媒介。结论暗娼人群STD／AIDS相关知识有待提高,暗娼人员的STD,址DS防治知识宣传教育工作仍需要进一步加强。