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Temporal trends of infant and birth outcomes in Minamata after severe methylmercury exposure
2017
Yorifuji, Takashi | Kashima, Saori | Suryadhi, Made Ayu Hitapretiwi | Abudureyimu, Kawuli
Severe methylmercury poisoning occurred in Minamata and neighboring communities in Japan during the 1950s and 1960s, causing what is known as Minamata disease. Although an increase in stillbirths and a reduced male proportion at birth (i.e., reduced sex ratio) have been reported, no studies have evaluated the impact of exposure on an entire set of infant and birth outcomes. We therefore evaluated the temporal trends of these outcomes in the Minamata area from 1950 to 1974. We focused on the spontaneous/artificial stillbirth rate, crude fertility rate, male proportion at birth, male proportion among stillbirths, and infant mortality. We obtained the number of stillbirths, live births, and infant deaths in Minamata City and Kumamoto Prefecture (as a reference) from 1950 to 1974. After plotting annual figures for each outcome, we divided the study period into five intervals and compared them between Minamata City and Kumamoto Prefecture using the chi-squared test. We observed a slightly increased spontaneous stillbirth rate and decreased artificial stillbirth rate in Minamata City, followed by a reduced crude fertility rate. The crude fertility rates in Minamata City during the period 1955–1965 were significantly lower compared with those in Kumamoto Prefecture (p < 0.001). An increase in the male proportion among stillbirths was observed, corresponding to a reduction in the proportion of males at birth in the late 1950s. The impact on infant mortality was equivocal. These descriptive analyses demonstrate a severe regional impact of methylmercury exposure on a series of birth outcomes in the Minamata area.
Show more [+] Less [-]Assessing the financial efficiency of healthcare services and its influencing factors of financial development: fresh evidences from three-stage DEA model based on Chinese provincial level data
2022
Liu, Hongda | Wu, Wangqiang | Yao, Pinbo
Pediatrics is an integral part of public health services. With the impact of the epidemic and the high-quality transformation of China’s development, the contradiction in the supply of pediatric public services has become more prominent. Scientific evaluation of the efficiency and quality of pediatric services, clarifying the redundancy of pediatric input resources and adjusting the construction of pediatric services with the help of influencing factors have become important research topics. This paper uses the three-stage SBM-DEA model to summarize the efficiency of China’s pediatric services using panel data from 31 provinces and cities in 2008–2019, taking into account undesired outputs such as doctor-patient disputes. Among them, the evaluation system focuses on the role of financial, capital, and other factors, and the Tobit regression model is used to clarify the degree of influence of various factors. The study found that (1) China’s pediatric service supply has the characteristics of geographic heterogeneity. (2) The redundancy of various resource inputs is apparent, and the supporting capacity of financial capital is not significant. (3) The economic, technological, and professional environment helps to digest the redundancy of inputs. (4) Capital, urbanization, education development, and birth rate increase under financial operation will promote the increase of the efficiency of pediatric public services.
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