Impact of alternative healthcare plans on out-of-hours help-seeking intentions in Switzerland

Awareness regarding Teledentistry among Dental Professionals in Malaysia

Objective. Teledentistry is considered to be a technological advancement in providing dental care to patients while effectively addressing the time management. Furthermore, the pandemic of COVID-19 has been here for quite long now, forcing the dental practitioners to ponder upon other methods of healthcare delivery apart from the traditional in-office direct clinical examination. The aim of this study was to explore the perceptions of dental professionals of Malaysia regarding teledentistry, which can act as a future pedestal for improvements in virtual dental practice and patient care. Materials and Methods. It was a descriptive, cross-sectional study involving an electronic survey of a sample of dental professionals of Malaysia. A prevalidated, 26-item, 5-point Likert-scale questionnaire was used in assessing the perceptions of dental professionals regarding teledentistry in four domains: existing concerns about teledentistry use, the potential of teledentistry in improving practice, usefulness of teledentistry for dental practice, and its usefulness for patients. Statistical analyses involved descriptive statistics which included frequency distributions. Results. An overall response rate of 31.0% was observed with 310 dental practitioners participating in the survey. More than 60% of respondents agreed that teledentistry would benefit the dental practice through enhancement of communication with peers, guidance, and new patients’ referral. However, a substantial proportion of practitioners (70-80%) expressed uncertainty with accuracy of diagnosis, technical reliability, and privacy. Conclusion. Generally, the results of this study point towards the readiness of dental professionals of Malaysia to engage in teledentistry practice. However, further work needs to be done to assess the commercial feasibility of teledentistry, not only in Malaysia but also in other parts of the world. To start with, directed campaigns in reference to teledentistry are necessary to educate dentists and the public about the technology and its potential.

On the Relative Importance of Different Factors Explaining Health Plan Choices: Evidence From Mandatory Health Insurance in Switzerland

Many factors influence health plan choices. Classical individual-level determinants include socioeconomic and health-related characteristics, and risk attitudes. However, little is known to what extent personality traits can determine insurance choices. Using representative survey data from Switzerland, we investigate the associations between choices of health plans and traditional individual factors as well as personality traits. We employ dominance analysis to explore the relative importance of the different predictors. We find that personality traits play an at least equally important role in predicting health plan choices as common factors like age, health status, and income. Our results have implications regarding recent efforts to empower people in making better health plan choices and support theoretical models that integrate insights from behavioral sciences.

Use of acute care services by adults with a migrant background: a secondary analysis of a EurOOHnet survey

BACKGROUND

High demands create pressure on acute care services, such as emergency medical services (EMS), emergency departments (ED) and out-of-hours primary care (OOH-PC) services. A variety of patient- and organisational factors have been discussed as reasons why especially non-western migrants more frequently contact an ED or OOH-PC service than native born. We aim to investigate whether persons with a non-western and western migrant background more often contact an acute care service than native born and how this relates to the number of contacts with their general practitioners (GPs). In addition, we aim to explore how possible differences in acute care use by migrants can be explained.

METHODS

We performed secondary analysis of data collected for the EurOOHnet survey on OOH help-seeking behaviour in Denmark, the Netherlands and Switzerland. Differences in self-reported acute care use (sum of number of contacts with OOH-PC, the ED and 1-1-2/1-4-4) between non-western and western migrants and native born were tested with a quasi Poisson regression analysis. Mediation analyses were performed to examine the impact of factors related to help-seeking on the relation between self-reported acute care use and migrant background.

RESULTS

Non-western migrants had more acute care contacts than native born (adjusted IRR 1.74, 95% CI 1.33-2.25), whereas no differences were found between western migrants and native born. Migrants who regularly contacted OOH-PC or the ED also regularly contacted their GP. Mediation analyses showed that the factors employment, anxiety, attitude towards use of OOH-PC and problems in accessing the own GP could partly explain the higher acute care use of non-western migrants.

CONCLUSION

The higher use of acute care services by non-western migrants compared with native born could partly be explained by feeling fewer barriers to contact these services, feeling more anxiety, more unemployment and problems making an appointment with the GP. Increasing awareness and improving GP access could help migrants in navigating the healthcare system.

Teledentistry awareness among dental professionals in Saudi Arabia

Background

Teledentistry is believed to improve dentalcare provided to patients and time management efficiency. In addition, teledentistry can be a useful tool for peer education, consultations and ensures proper channeling for referrals.

Objective

This study aimed to explore Saudi Arabian dental professionals' perceptions of teledentistry's benefits in improving dental practice and patient care.

Methods

A descriptive cross-sectional study involving an electronic survey of a sample of Saudi Arabian dental professionals. A validated 26-item, 5-point Likert-scale questionnaire was used to assess perceptions of dental professionals in four domains: usefulness of teledentistry for patients, the usefulness of teledentistry for dental practice; the potential of teledentistry to improve practice; and existing concerns about the use of teledentistry. Statistical analyses involved descriptive statistics, bivariate analysis using SPSS software. Significant differences were considered at a p-value of 0.05.

Results

With an overall response rate of 28.6%, 286 dental professionals participated in the study. More than 70% of respondents agreed or strongly agreed that teledentistry would improve dental practice through enhancing communication with peers, guidance and referral of new patients. A substantial proportion of respondents (60–70%) expressed uncertainty with technical reliability, privacy and diagnostic accuracy. The participants' qualification was statistically significant with usefulness of teledentistry for patients (p = 0.027), while work experience in years was statistically significant with both usefulness of teledentistry for dental practice and patients (p = 0.046 and <0.0001 respectively).

Conclusion

Generally, the feedback gained by this study showed readiness of the dental professionals to be engaged in the teledentistry approach. Further investigation of the business model of teledentistry is needed to understand the readiness and challenges. Directed campaign to educate dentists and the public of the technology and it is potential is necessary.

Patterns of benzodiazepine prescription among older adults in Switzerland: a cross-sectional analysis of claims data

OBJECTIVE

This study aimed to examine the prevalence and determinants of benzodiazepine prescription among older adults in Switzerland, and analyse association with hospitalisation and costs.

DESIGN

Retrospective analysis of claims data.

SETTING

The study was conducted in nine cantons in Switzerland.

PARTICIPANTS

Older adults aged 65 years and older enrolled with a large Swiss health insurance company participated in the study.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was prevalence of benzodiazepine prescription. The secondary outcomes were (1) determinants of any benzodiazepine prescription; (2) the association between any prescription and the probability of hospitalisation for trauma and (3) the association between any prescription and total healthcare expenditures.

RESULTS

Overall, 69 005 individuals were included in the study. Approximately 20% of participants had at least one benzodiazepine prescription in 2017. Prescription prevalence increased with age (65-69: 15.9%; 70-74: 18.4%; 75-80: 22.5%; >80: 25.8%) and was higher in women (25.1%) compared with men (14.6%). Enrollees with the highest deductible of Swiss Francs (CHF) 2500 were 70% less likely to receive a prescription than enrollees with the lowest deductible of CHF 300 (adjusted OR=0.29, 95% CI 0.24 to 0.35).Individuals with at least one prescription had a higher probability of hospitalisation for trauma (OR=1.31, 95% CI 1. 20 to 1.1.44), and 70% higher health care expenditures (β=0.72, 95% CI 0. 67 to 0.77). Enrollees in canton Valais were three times more likely to receive a prescription compared to enrollees from canton Aargau (OR=2.84, 95% 2.51 to 3.21).

CONCLUSIONS

The proportion of older adults with at least one benzodiazepine prescription is high, as found in the data of one large Swiss health insurance company. These enrollees are more likely to be hospitalised for trauma and have higher healthcare expenditures. Important differences in prescription prevalence across cantons were observed, suggesting potential overuse. Further research is needed to understand the drivers of variation, prescription patterns across providers, and trends over time.

Factors related to out-of-hours help-seeking for acute health problems: a survey study using case scenarios

Background

The acute out-of-hours healthcare services are challenged by increasing demand in many countries. We aimed to examine factors influencing the intended help-seeking in out-of-hours care for acute health problems during evenings, nights, and weekends.

Methods

We conducted a survey study based on data from parents of children (aged 0–4 years) and adults (aged 30–39 and 50–59 years) in Denmark, the Netherlands and Switzerland. Intended help-seeking behaviour was measured by six hypothetical case scenarios. We used Andersen’s Behavioural Model to categorise potentially influential factors and applied multiple binomial regression to assess the influence of selected factors.

Results

A total of 1015 parents and 2942 adults participated. We identified several significant influential factors. Parents holding a low education (OR 1.56), having migrant background (western: OR 1.23; non-western: OR 1.93), having one child (OR 1.24), perceiving few barriers to using out-of-hours primary care (OR 1.59), perceiving difficulties with organising childcare (OR 1.13), and having a history of frequent contacts with out-of-hours care (OR 1.55) were more inclined to contact out-of-hours care, whereas female (OR 0.85) and non-anxious parents (OR 0.77) were less inclined. Adults who were older (OR 1.01), holding a medical education (OR 1.13), having non-western background (OR 1.28), being unemployed (OR 1.17), perceiving few barriers to using out-of-hours primary care (OR 1.37), and having a history of frequent contacts with a GP (few: OR 1.15; more: OR 1.22) and/or with out-of-hours care (one: OR 1.20; more: OR 1.49) were more inclined to contact out-of-hours care, whereas adults with no or little social support (OR 0.84) and adults with high health literacy level on health information (OR 0.91) were less inclined. Dutch parents were less inclined than Danish parents to contact out-of-hours care (OR 0.62), whereas Swiss adults were more inclined than Danish adults to contact out-of-hours care (OR 1.16).

Conclusion

We identified several factors related to intended help-seeking in out-of-hours care. These results could be used to develop targeted interventions, but more research is needed to examine the underlying explanations for the identified differences.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6332-6) contains supplementary material, which is available to authorized users.