Measuring Our Way to Mediocrity

Low quality of care has emerged as key policy concern in low and middle-income countries. This study explores the changes and heterogeneity in prevent…

Balancing hope, fear, and evidence in colorectal cancer prevention

How BMI screening & follow-up plan burdens PCPs without decreasing obesity

YouTube video by Salud Mesoamérica / IREM

Background: Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are responsible for a significant amount of the economic and chronic disease burden that impacts the Ontario health system. Telehomecare, a home self-management program launched by the Ontario Telemedicine Network (OTN), was created to improve access to quality care and limit health care use. However, few data are available on patient-, caregiver-, and provider-reported outcomes of telehomecare. Objective: This study aims to evaluate the impact of the OTN telehomecare program on the health-related quality of life (HRQoL), disease-management skills, and satisfaction of patients with HF and those with COPD; informal caregiver strain index; and nurse satisfaction with telehomecare. Methods: We used a prospective longitudinal cohort design, including patients with HF and those with COPD enrolled in Ontario’s telehomecare program, informal caregivers of patients in the program, and nurses providing services in telehomecare. Patients and informal caregivers were administered telephone surveys at baseline, month 3, month 6, and month 12 follow-up from July 2016 to December 2019. The outcomes for the longitudinal surveys were patient-perceived HRQoL, disease self-management skills, perception of telehomecare (ease of use and usefulness), satisfaction with telehomecare, and informal caregiver-perceived strain. Cross-sectional surveys were conducted with nurses to assess nurse perception and satisfaction with telehomecare. Participant data were analyzed using general linear mixed models in SAS Statistical Software (version 9.4; SAS Institute Inc). Results: Overall, a total of 194 patients (HF, n=117; COPD, n=77), 62 caregivers, and 24 nurses participated, with an overall response rate of 51% (280/551). The average age of patients with HF and those with COPD was 71 (SD 11.3) years and 70 (SD 11.1) years, respectively, and 52% (100/194) were men. A significant improvement in overall HRQoL was observed among patients with HF at month 12 (−18.37, P

Background: The digital divide has loomed as a global public issue in recent years. However, evidence is limited regarding whether the digital divide is associated with health-related quality of life (HRQOL) and whether digital back-feeding would buffer this association. Objective: This study aims to explore the role of digital back-feeding in the relationship between the digital divide and HRQOL among older men and women living in rural China. Methods: We used data from wave 3 of the Shandong Rural Elderly Health Cohort, conducted in 2022. A total of 3242 (n=1946, 60.02% women) rural older adults were included in the analysis. Moderating effect analysis was performed using Tobit regression models and margins plots. Results: A total of 71.01% (2302/3242) of the participants reported experiencing digital divide. Participants experiencing digital divide were significantly associated with lower HRQOL as measured by EQ-5D-5L scores (β=–0.020; P

Established in 1843, the County of Simcoe is a municipality comprised of sixteen towns and townships, serving a growing population of over 530,000 residents. As the largest county in Ontario, Simcoe p...

Rhetoric vs Reality in "Controlling Blood Pressure" Quality Measure