scholarly journals The Impact of Driving Time to Family Planning Facilities on Preventive Service Use in Ohio

2021 ◽  
Author(s):  
Jacqueline Ellison ◽  
Kevin Griffith ◽  
Madalyn Thursby ◽  
David J.G. Slusky ◽  
Jacob Bor
Keyword(s):  
Family Planning ◽  
Service Use ◽  
Preventive Service ◽  
Driving Time ◽  
The Impact

scholarly journals 1535. Impact of Defunding Family Planning Health Centers on Gonorrhea and Chlamydia Cases in Iowa: A Spatiotemporal Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S768-S768
Author(s):  
Megan L Srinivas ◽  
Eileen Yang ◽  
Weiming Tang ◽  
Joseph Tucker
Keyword(s):  
Family Planning ◽  
Low Income ◽  
Rural Areas ◽  
Spatiotemporal Analysis ◽  
Incidence Rates ◽  
Health Centers ◽  
Transmitted Infection ◽  
Missed Opportunities ◽  
Linear Regression Modeling ◽  
The Impact

Abstract Background Fifteen states have defunded family planning health centers (FPHCs), causing thousands to be left without health services. This has accelerated in the COVID-19 era. FPHCs provide low-income individuals in rural areas with essential primary care services, including sexually transmitted infection prevention, testing, and treatment. The purpose of this analysis is to use spatiotemporal methods to examine the impact of FPHC closures in Iowa on the reported number of gonorrhea and chlamydia cases at the county level. Methods This analysis investigates the association between FPHC closures and changes in the number of gonorrhea and chlamydia cases between 2016 and 2018. Iowa implemented defunding policies for family planning clinics, resulting in four FPHC closures in June 2017. 2016 pre-closure STI incidence rates were compared to 2018 post-closure rates. Gonorrhea and chlamydia rates in the four Iowa counties with clinic closures were compared to the 95 Iowa counties without closures. T tests were used to compare changes in reported gonorrhea and chlamydia rates in the two settings. Linear regression modeling was used to determine the relationship between clinic closures and changes in gonorrhea and chlamydia cases. Results The gonorrhea burden in Iowa increased from 83 cases per 100,000 people in 2016 to 153.8 cases per 100,000 people in 2018. The four counties with clinic closures experienced a significantly larger increase (absolute 217 cases per 100,000 population) in their gonorrhea rate compared to counties without FPHC closures (absolute 121 cases per 100,000 population). There was also a significant relationship between clinic closures and increasing gonorrhea rates (p = 0.0015). Over the three-year period, there was no change in chlamydia rates (p = 0.1182). However, there was a trend towards counties with more FPHC closures having a higher number of chlamydia cases (p = 0.057). Conclusion Despite the fact that many STI diagnoses are made and reported by FPHCs, our data suggest that clinic closures may have contributed to an increase in gonorrhea and chlamydia cases. This is consistent with delayed diagnoses and missed opportunities for providing essential STI services to vulnerable and under-served rural residents. Legislative action is urgently needed to curtail this trend. Disclosures All Authors: No reported disclosures

scholarly journals Measuring the impact of an acute visiting scheme on emergency department attendances – a pre-post cohort design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Axel Kaehne ◽  
Paula Keating
Keyword(s):  
Emergency Department ◽  
Service Use ◽  
Emergency Department Visits ◽  
Service Utilisation ◽  
Specific Patient ◽  
Access Points ◽  
Latent Demand ◽  
Frequent Attenders ◽  
Cohort Design ◽  
The Impact

Abstract Background Emergency department (ED) attendances are contributing to rising costs of the National Health Service (NHS) in England. Critically assessing the impact of new services to reduce emergency department use can be difficult as new services may create additional access points, unlocking latent demand. The study evaluated an Acute Visiting Scheme (AVS) in a primary care context. We asked if AVS reduces overall ED demand and whether or not it changed utilisation patterns for frequent attenders. Method The study used a pre post single cohort design. The impact of AVS on all-cause ED attendances was hypothesised as a substitution effect, where AVS duty doctor visits would replace emergency department visits. Primary outcome was frequency of ED attendances. End points were reduction of frequency of service use and increase of intervals between attendances by frequent attenders. Results ED attendances for AVS users rose by 47.6%. If AVS use was included, there was a more than fourfold increase of total service utilisation, amounting to 438.3%. It shows that AVS unlocked significant latent demand. However, there was some reduction in the frequency of ED attendances for some patients and an increase in time intervals between ED attendances for others. Conclusion The study demonstrates that careful analysis of patient utilisation can detect a differential impact of AVS on the use of ED. As the new service created additional access points for patients and hence introduces an element of choice, the new service is likely to unlock latent demand. This study illustrates that AVS may be most useful if targeted at specific patient groups who are most likely to benefit from the new service.

Family planning and fertility decline in rural Iran: the impact of rural health clinics

2010 ◽  
Vol 19 (S1) ◽  
pp. 159-180 ◽  
Author(s):  
Djavad Salehi-Isfahani ◽  
M. Jalal Abbasi-Shavazi ◽  
Meimanat Hosseini-Chavoshi
Keyword(s):  
Family Planning ◽  
Rural Health ◽  
Fertility Decline ◽  
Health Clinics ◽  
Rural Health Clinics ◽  
The Impact

Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

2012 ◽  
Vol 27 (4) ◽  
pp. 325-329 ◽  
Author(s):  
David Howard ◽  
Rebecca Zhang ◽  
Yijian Huang ◽  
Nancy Kutner
Keyword(s):  
Hurricane Katrina ◽  
Large Scale ◽  
Service Use ◽  
Hospital Admissions ◽  
Gulf Coast ◽  
The United States ◽  
Time Varying ◽  
Dialysis Patients ◽  
Hospitalization Rates ◽  
The Impact

AbstractIntroductionDialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.ProblemThe impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.MethodsData from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.ResultsThe rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.ConclusionsHospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

scholarly journals Using Patient Portals to Improve Patient Outcomes: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Hae-Ra Han ◽  
Kelly T Gleason ◽  
Chun-An Sun ◽  
Hailey N Miller ◽  
Soo Jin Kang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Clinical Outcomes ◽  
Patient Outcomes ◽  
Service Use ◽  
The United States ◽  
Preventive Service ◽  
Patient Portal ◽  
Patient Portals ◽  
Wide Range

BACKGROUND With the advent of electronic health record (EHR) systems, there is increasing attention on the EHR system with regard to its use in facilitating patients to play active roles in their care via secure patient portals. However, there is no systematic review to comprehensively address patient portal interventions and patient outcomes. OBJECTIVE This study aimed to synthesize evidence with regard to the characteristics and psychobehavioral and clinical outcomes of patient portal interventions. METHODS In November 2018, we conducted searches in 3 electronic databases, including PubMed, EMBASE, and Cumulative Index to Nursing and Allied Health Literature, and a total of 24 articles met the eligibility criteria. RESULTS All but 3 studies were conducted in the United States. The types of study designs varied, and samples predominantly involved non-Hispanic white and highly educated patients with sizes ranging from 50 to 22,703. Most of the portal interventions used tailored alerts or educational resources tailored to the patient’s condition. Patient portal interventions lead to improvements in a wide range of psychobehavioral outcomes, such as health knowledge, self-efficacy, decision making, medication adherence, and preventive service use. Effects of patient portal interventions on clinical outcomes including blood pressure, glucose, cholesterol, and weight loss were mixed. CONCLUSIONS Patient portal interventions were overall effective in improving a few psychological outcomes, medication adherence, and preventive service use. There was insufficient evidence to support the use of patient portals to improve clinical outcomes. Understanding the role of patient portals as an effective intervention strategy is an essential step to encourage patients to be actively engaged in their health care.

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