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However, the bargaining power of health plans remains limited due to a limited use of selective hospital contracting by health plans.
However, assessments of the reliability of the ESS among these individuals are typically conducted on cohorts of clinical groups from selective hospital outpatient departments [ 53], and therefore the same issues may not be present in all adults.
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The possibility of bias through selective referral to hospital must also be considered.
Some small rural studies have made estimates for proportions of sex selective abortions from hospital based and community birth records.
At the haematology ward of our hospital, selective decontamination of the digestive tract (SDD) is performed in patients with an (expected) reversible neutropenia or increased risk of infection.
Furthermore, there was a significantly higher prevalence (p<0.05) of HPIs in the non-EHOS isolates that were isolated during the EHOS outbreak period in the UMCU in comparison with those not linked to the UMCU EHOS outbreak, which could indicate transfer, although it cannot be excluded that these isolates were selected under the selective pressure in the hospital.
We cannot rule out the possibility that unmeasured, complex motivational factors may have contributed to the selective response by hospitals to participate in the surveys.
We observed a high prevalence (70%) of the integron, which also raises the question of whether antibiotic selective pressure in hospitals in Taiwan may have led to the dissemination of this integron, which contains an ESBL-carrying cassette.
The fact that 126 of 128 isolates of complex-17 were resistant to ampicillin and only 77 of 139 isolates of complex-17 contain PAI (Table 1) suggests that E. faecium acquired ampicillin resistance first, which resulted in a selective advantage in hospitals, followed by the acquisition of PAI, which further facilitated transmission.
The population based design in a country with universal healthcare reduced selection biases stemming from selective inclusion of specific hospitals, health insurance systems, or age groups.
Our population-based design in the setting of a universal healthcare system largely eliminated selection biases stemming from selective inclusion of specific hospitals, health insurance systems, patients, or age groups.
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