RESUMEN
Mongolia is located at 45° north latitude in the center of the Asian continent, and about 80% of the territory is at 1000 m above sea level. Epidemiologically, multiple sclerosis (MS) has not been investigated in Mongolia, although there have been a few MS case reports. We investigated the characteristics of MS in Mongolia for the first time, focusing on the association between MS-related parameters and depression levels. We initiated cross-sectional analyses, using data from 27 MS patients aged 20 to 60 years in Ulaanbaatar, Mongolia. The patients completed a questionnaire on their lifestyles and clinical information. We classified the MS patients on the basis of disability levels using the expanded disability status scale (EDSS) scores: 11.1% mild disability and 88.9% moderate to severe disability (median EDSS score, 5.5). We also classified the patients on the basis of depression levels using the 9-item patient health questionnaire (PHQ-9) scores: 44.4% mild depression, 40.7% moderate depression, and 14.8% severe depression (mean PHQ-9's score, 9.96 ± 5.05). We used multivariate logistical regression analyses to identify predictors of EDSS or PHQ-9 scores. Disability levels were associated with vision and balance problems. Depression levels were associated with corticosteroid treatment; no patients were treated with disease-modifying drugs (DMDs). The odds ratios for disease onset age and treatment duration were associated with EDSS scores. In conclusion, MS onset age and treatment duration were independent predicting factors influencing the level of disability. Appropriate DMD treatment would lower the disability and depression levels.
RESUMEN
BACKGROUND: The adoption of health information technology (HIT) is an important measure for improving healthcare quality and safety, which is affected by many hospital factors, but it has not yet been estimated in the Mongolian hospital sectors. This study examines how hospitals' organisational and geographical characteristics influence the adoption of HIT in Mongolian tertiary and secondary care hospitals. METHODS: Ð cross-sectional study involving the executive directors and medical equipment engineers was conducted in 39 hospitals. Data acquired from questionnaires are (1) hospitals' organisational and geographical characteristics, including bed-size capacity, ownership type, status, and location of the hospitals, and (2) the adoption rate of HIT, and its categories are based on the Health Information and Management Systems Society's classification (2002). The dependent variable was measured as numbers and the rate of HIT programs adopted clinical, administrative, and strategic information technologies (IT). A regression analysis was used to estimate the factors of impact on the adoption of clinical, administrative, and strategic IT. RESULTS: We found a concerning relationship between the characteristics and adoption of HITs. On average, the number of HIT programs adopted was 18, covering nine clinical IT programs, six administrative IT programs, and three strategic IT programs. The adoption rate of overall HIT was 33.29% in the hospitals. In regression analysis, the organisational and geographical characteristics' impact and HIT adoption of hospitals was positively associated with large bed-size (clinical IT: ß = 0.256, P < 0.001; administrative IT: ß = 0.3654, P < 0.001; strategic IT: ß = 0.0006, P < 0.001), for-profit (strategic IT: ß = 0.1995, P < 0.01), teaching (clinical IT: ß = 0.2560, P < 0.05; administrative IT: ß = 0.1985, P < 0.05; strategic IT: ß = 0.2236, P < 0.01), and urban location (clinical IT: ß = 0.2840, P < 0.001, administrative IT: ß = 0.2256, P < 0.01; strategic IT: ß = 0.2256, P < 0.001). CONCLUSION: Our study found that the HIT adoption rate in Mongolia is poor, and its adoption is mainly positively associated with bed-size capacity, status, and location of the hospitals. Also, we found that the ownership type is partially affected HIT adoption.
