scholarly journals Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons With Severe Alcohol Problems

JAMA ◽  
2009 ◽  
Vol 301 (13) ◽  
pp. 1349 ◽  
Author(s):  
Mary E. Larimer
Keyword(s):  
Health Care ◽  
Public Service ◽  
Service Use ◽  
Homeless Persons ◽  
Alcohol Problems ◽  
Before And After

scholarly journals Comparison of data sources on alcohol problems: An exploratory exercise using surveys vs. national healthcare registers

2020 ◽  
pp. 145507252096802
Author(s):  
Pia Mäkelä ◽  
Kristiina Kuussaari ◽  
Airi Partanen ◽  
Elina Rautiainen
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Healthcare Service ◽  
Service Use ◽  
Basic Education ◽  
Alcohol Problems ◽  
Register Data ◽  
Data Sources ◽  
National Healthcare ◽  
Healthcare Service Use

Aims: Both survey and healthcare register data struggle as data sources to capture the phenomenon of alcohol problems. We study a large group of people for whom survey data and two types of register data are available, and examine the overlaps of similar or related measures in the different data sources to learn about potential weaknesses in each. We also examine how register-based data on the prevalence of alcohol problems change depending on which register data are used. Design: We use data from the Regional Health and Wellbeing Study (ATH) of the adult Finnish population collected in 2013 and 2014 ( n = 69,441), individually linked with data on two national healthcare registers (Care Register for Health Care; Register of Primary Health Care visits) for the survey year and previous year. Results: The prevalence of substance-abuse-related healthcare was almost two-fold if data on outpatient primary care visits were included in addition to hospitalisations. Forty-six per cent of the survey respondents self-reporting substance-abuse-related healthcare service use were identified in the registers, and 22% of all respondents with such service use according to registers reported this in the survey. Records of substance-abuse-related healthcare service use, controlled for self-reported alcohol use and self-reported substance-abuse-related service use, were found more often for men, the middle-aged, people with basic education only, and the non-employed. Conclusions: The results are suggestive of underreporting in both data sources. There is an evident need to develop recording practices in the healthcare registers regarding substance use disorders.

Sleep Problems During the Preschool Years and Beyond as a Marker of Risk and Resilience in Substance Use

2018 ◽  
Author(s):  
Maria M. Wong
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Sleep Problems ◽  
Problem Drinking ◽  
Alcohol Problems ◽  
Risk And Resilience ◽  
Regulatory Processes ◽  
Sleep Physiology ◽  
Before And After

Individuals with alcohol problems have well-described disturbances of sleep, but the development of these disturbances both before and after the onset of problem drinking is poorly understood. This chapter first discusses sleep physiology and its measurement in humans. It then examines the functions of sleep and its role in development. Next, it reviews recent research on the relationship between sleep and alcohol use and related problems. Whereas sleep problems (e.g., difficulties falling or staying asleep) increase the risk of early onset of alcohol use and related problems, sleep rhythmicity promotes resilience to the development of alcohol use disorder and problem substance use. Based on existing research, this chapter proposes a theoretical model of sleep and alcohol use, highlighting the role of self-regulatory processes as mediators of this relationship.

scholarly journals Evaluation of Emergency Health-Care Initiatives to Reduce Overcrowding in a Referral Medical Complex, Jeddah, Saudi Arabia

2021 ◽  
pp. 1-6
Author(s):  
Khalid Alabbasi ◽  
Estie Kruger ◽  
Marc Tennant
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Public Hospital ◽  
Waiting Times ◽  
Care Centre ◽  
Health Care Centre ◽  
Transfer Policy ◽  
Primary Health ◽  
Before And After ◽  
Ed Visits

<b><i>Purpose:</i></b> Excessive delays and emergency department (ED) overcrowding have become an increasingly major problem for public health worldwide. This study was to assess the key strategies adopted by an ED, at a public hospital in Jeddah, to reduce delays and streamline patient flow. <b><i>Materials and Methods:</i></b> This study was a service evaluation for a Saudi patient population of all age-groups who attended the ED of a public hospital for the period between June 2016 and July 2019. The Saudi initiative to reduce the ED visits at the King Abdullah Medical Complex hospital has started on August 7, 2018. The initiative was to apply an urgency transfer policy which outlines the procedures to follow when patients arrive to the ED where they are reviewed based on the Canadian Triage and Acuity Scale (CTAS). Patients with less-urgent conditions (category 4 and 5) are referred to a primary health-care practice (where a family medicine consultant is available). Patients with urgent conditions (category 1–3) are referred to a specialized health-care centre if the service is not currently provided. To test the effectiveness of ED initiative on reducing the overcrowd, data were categorized into before and after the initiative. The bivariate analysis χ<sup>2</sup> tests and 2 sample <i>t</i>-tests were run to explore the relationship of gender and age with dependent variable emergency. <b><i>Results:</i></b> A total of 233,998 patients were included in this study, 61.8% of them were males and the average age of ED patients were 35.5 ± 18.6 years. The majority of cases were those classified as “less urgent” (CTAS 4), which accounted for 65.4%. Number of ED visits before and after the initiative was 67 and 33%, respectively. ED waiting times after the initiative have statistically significantly decreased across all acuity levels compared to ED waiting times before the initiative. <b><i>Conclusion and Implication:</i></b> The findings suggest that the majority of patients arrive to the ED with less-urgent conditions and arrived by walking-in. The number of cases attending the ED significantly decreased following the introduction of the urgency transfer policy. Referral for less-urgent patients to primary health-care centre may be an important front-end operational strategy to relieve congestion.

Health-Care Workers’ Perception of Reimbursement for Complex Surgical Oncology Procedures

2020 ◽  
Vol 86 (2) ◽  
pp. 140-145
Author(s):  
Shoshana Levi ◽  
Emily Alberto ◽  
Dakota Urban ◽  
Nicholas Petrelli ◽  
Gregory Tiesi
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Online Survey ◽  
Surgical Oncology ◽  
Patient Perceptions ◽  
Cancer Center ◽  
Physician Reimbursement ◽  
Care Workers ◽  
Before And After ◽  
Fee Schedule

Perception of physician reimbursement for surgical procedures is not well studied. The few existing studies illustrate that patients believe compensation to be higher than in reality. These studies focus on patient perceptions and have not assessed health-care workers’ views. Our study examined health-care workers’ perception of reimbursement for complex surgical oncology procedures. An anonymous online survey was distributed to employees at our cancer center with descriptions and illustrations of three oncology procedures—hepatectomy, gastrectomy, and pancreaticoduodenectomy. Participants estimated the Medicare fee and gave their perceived value of each procedure. Participants recorded their perception of surgeon compensation overall, both before and after revealing the Medicare fee schedule. Most of the 113 participants were physicians (33.6%) and nurses (28.3%). When blinded to the Medicare fee schedules, most felt that reimbursements were too low for all procedures (60–64%) and that surgeons were overall undercompensated (57%). Value predictions for each procedure were discordant from actual Medicare fee schedules, with overestimates up to 374 per cent. After revealing the Medicare fee schedules, 55 per cent of respondents felt that surgeons were undercompensated. Even among health-care workers, a large discrepancy exists between perceived and actual reimbursement. Revealing actual reimbursements did not alter perception on overall surgeon compensation.

Accessibility, Mobility and Spatial Patterns of Primary Health Care use in Ajedabiya: a Household Interview Survey

2010 ◽  
Vol 41 ◽  
pp. 47-62
Author(s):  
Salem F. Salem
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Service Use ◽  
Primary Objective ◽  
Health Care Use ◽  
International Standards ◽  
Consultation Rate ◽  
General Evaluation ◽  
Primary Health ◽  
Time Required

AbstractThe primary objective of this study is to examine the type of Primary Health Care (PHC) facility used by a sample of households in Ajedabiya, taking into account the respondents' living standards and their perception of the quality of the care provided, as well as the mode of travel and travel time required to reach the health care centres. The overall level of service use has been increasing over time, reaching an annual consultation rate of up to four visits per person per year, a high level by international standards. Three major groupings of disease were identified for which the four selected PHC facilities were preferred. Satisfaction with care was analysed by looking at key variables, including staff behaviour, availability of doctors, vector distance to the PHC facility, general evaluation of health services and qualified doctors. Household incomes did not appear to be an important factor except for attending private clinics. Unlike income, distance had a strong effect on utilisation, leading to the conclusion that PHC should continue to be provided within the community, and developed further to achieve equity, effectiveness and affordability.

Health care contacts before and after attempted suicide

2002 ◽  
Vol 37 (2) ◽  
pp. 89-94 ◽  
Author(s):  
Kirsi H. Suominen ◽  
Erkki T. Isometsä ◽  
Aini I. Ostamo ◽  
Jouko K. Lönnqvist
Keyword(s):  
Health Care ◽  
Attempted Suicide ◽  
Before And After
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