Health service utilization, use of psychotropic agents and anticholinergic burden of older people with dementia in Taiwan: A nationwide 10-year cohort study

2013 ◽  
Vol 4 ◽  
pp. S84
Author(s):  
L.N. Peng ◽  
F.Y. Hsiao ◽  
Y.W. Tsai ◽  
L.K. Chen
Keyword(s):  
Cohort Study ◽  
Health Service ◽  
Older People ◽  
Service Utilization ◽  
Health Service Utilization ◽  
People With Dementia ◽  
Psychotropic Agents ◽  
Anticholinergic Burden

scholarly journals Pattern of Outpatient Health Service Utilization by Older People in Iran

Salmand ◽  
2021 ◽  
Vol 15 (4) ◽  
pp. 410-427
Author(s):  
Maryam Tajvar ◽  
◽  
Mehdi Yaseri ◽  
Badriye Karami ◽  
Mariya Mohammadi ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Older People ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Planning ◽  
The Elderly ◽  
National Study ◽  
Outpatient Services ◽  
To Receive

Objectives: Considering the rapid growth of Iran’s elderly population with consequent increase in the costs of health services, it is necessary to be aware of the pattern of outpatient health service utilization, in the elderly for resource allocation and health planning. This study aims to determine the pattern of outpatient service utilization for the elderly in Iran and explore determinant factors. Methods & Materials: This is a cross-sectional study using secondary analysis method and the data from 2015 National Study of Health Service Utilization. Study population consists of older people aged ≥60 years. Of these, 8205 were selected as study samples. The data were collected using personal and household questionnaires collecting information on subjects’ need for, referral to, utilization from, and satisfaction with outpatient services. Logistic regression analysis was used to identify factors related to the need, referral, benefit, and satisfaction with the received outpatient services. Results: Out of 8205 participants, 3172 (39%) reported the need for outpatient services, of which 66% referred for services; of these, 98% (N=2060) benefited outpatient services. Females, older subjects, villagers, unmarried and illiterate subjects were more in need of outpatient services, but their referrals to receive the services were not more than those of other groups. Lack of basic insurance, supplementary insurance, and a personal care had a significant impact on reducing the number of subjects referred to receive outpatient services. Inability to pay treatment costs (30%), self-treatment (28%) and lack of proper insurance coverage (13%) were the most important reasons for not referring to receive outpatient services. The highest satisfaction was related to the behavior of physicians and medical staff and the lowest satisfaction was related to the cost of outpatient services. Conclusion: Although the use of outpatient health services should be based on the need for these services, the present study showed that the older people with higher socio-economic status had higher utilization from the services in Iran. Therefore, there is an inequality in access to outpatient services in the elderly. The reasons for not using outpatient services and dissatisfaction with these services should be seriously considered by health policy makers.

Health service utilization of heroin abusers: A retrospective cohort study

2015 ◽  
Vol 45 ◽  
pp. 281-286 ◽  
Author(s):  
I-Ming Chen ◽  
Charles Lung-Cheng Huang ◽  
Bao-Juan Yeh ◽  
Yi-Ling Chien
Keyword(s):  
Cohort Study ◽  
Health Service ◽  
Service Utilization ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Health Service Utilization ◽  
Heroin Abusers

scholarly journals How and to What Extent Can Pensions Facilitate Increased Use of Health Services by Older People: Evidence From Social Pension Expansion in Rural China

2020 ◽  
Author(s):  
shanquan chen ◽  
Xi Chen ◽  
Stephen Law ◽  
Henry Lucas ◽  
Shenlan Tang ◽  
...  
Keyword(s):  
Health Service ◽  
Older People ◽  
Service Utilization ◽  
Low Income ◽  
Health Service Utilization ◽  
Service Use ◽  
Fuzzy Regression ◽  
Sample Survey ◽  
Inpatient Service ◽  
The Impact

Abstract Background: The proportion of people aged 60 years or over is growing faster than other age groups. Traditionally, retirement has been considered as both a loss to the labour market and an additional economic burden on the nation. More recently, it is widely accepted that retired people can still contribute to society in many ways, though the extent of their contributions will depend heavily on their state of health. In this background, a significant practice issue is how to promote older people utilizing health service they need in via of pension. This study aims to evaluate the effects of pensions on older adults’ health service utilization, and estimate the level of pension required to influence such utilization.Methods: Using a nationally representative sample survey, China Health and Retirement Longitudinal Study, we conducted fuzzy regression discontinuity and segmented regression.Results: It was found that a pension did facilitate low-income people in utilizing outpatient income (OR = 1.219, 95% 1.018-1.460) and inpatient services income (OR = 1.269, 95% 1.020-1.579); but also encouraged both low- and high-income people to choose self-treatment, specifically over-the-counter (OR = 1.208, 95% 1.037-1.407; OR = 1.206, 95% 1.024-1.419; respectively) and traditional Chinese medicines (OR = 1.452, 95% 1.094-1.932; OR = 1.456, 95% 1.079-1.955; respectively). However, receiving a pension had no effect on the frequency of outpatient and inpatient service use. Breakpoints for a pension to promote recipients’ health service utilization were mainly located in the range 55-95 CNY.Conclusions: The pension has mixed effects on recipients' health service utilization from different income groups. Our study enriches related evidence on the impact of pension on healthcare-seeking behaviour and can be helpful in policy design. The information our study presents can also allow economists to formulate models relating to pensions and healthcare utilisation with greater precision.

scholarly journals Prevalence of multimorbidity in adults with cancer, and associated health service utilization in Ontario, Canada: a population-based retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Péfoyo Koné ◽  
Deborah Scharf
Keyword(s):  
Cohort Study ◽  
Health Service ◽  
Service Utilization ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Health Service Utilization ◽  
Premature Death ◽  
Population Based ◽  
Chronic Medical Condition ◽  
Cancer Type

Abstract Background The majority of people with cancer have at least one other chronic health condition. With each additional chronic disease, the complexity of their care increases, as does the potential for negative outcomes including premature death. In this paper, we describe cancer patients’ clinical complexity (i.e., multimorbidity; MMB) in order to inform strategic efforts to improve care and outcomes for people with cancer of all types and commonly occurring chronic diseases. Methods We conducted a population-based, retrospective cohort study of adults diagnosed with cancer between 2003 and 2013 (N = 601,331) identified in Ontario, Canada healthcare administrative data. During a five to 15-year follow-up period (through March 2018), we identified up to 16 co-occurring conditions and patient outcomes for the cohort, including health service utilization and death. Results MMB was extremely common, affecting more than 91% of people with cancer. Nearly one quarter (23%) of the population had five or more co-occurring conditions. While we saw no differences in MMB between sexes, MMB prevalence and level increased with age. MMB prevalence and type of co-occurring conditions also varied by cancer type. Overall, MMB was associated with higher rates of health service utilization and mortality, regardless of other patient characteristics, and specific conditions differentially impacted these rates. Conclusions People with cancer are likely to have at least one other chronic medical condition and the presence of MMB negatively affects health service utilization and risk of premature death. These findings can help motivate and inform health system advances to improve care quality and outcomes for people with cancer and MMB.

scholarly journals How and to what extent can pensions facilitate increased use of health services by older people: evidence from social pension expansion in rural China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shanquan Chen ◽  
Xi Chen ◽  
Stephen Law ◽  
Henry Lucas ◽  
Shenlan Tang ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Older People ◽  
Service Utilization ◽  
Low Income ◽  
Health Service Utilization ◽  
Sample Survey ◽  
Inpatient Service ◽  
Fuzzy Regression Discontinuity Design ◽  
The Impact

Abstract Background The proportion of people aged 60 years or over is growing faster than other age groups. Traditionally, retirement has been considered as both a loss to the labour market and an additional economic burden on the nation. More recently, it is widely accepted that retired people can still contribute to society in many ways, though the extent of their contributions will depend heavily on their state of health. In this context, a significant practical issue is how to encourage older people to use the health services they need. This study aims to evaluate the effects of pensions on older adults’ health service utilization, and estimate the level of pension required to influence such utilization. Methods Using data from a nationally representative sample survey, the China Health and Retirement Longitudinal Study, we adopted a fuzzy regression discontinuity design and undertook segmented regression analysis. Results It was found that a pension did encourage low-income people to use both outpatient (OR = 1.219, 95% 1.018–1.460) and inpatient services (OR = 1.269, 95% 1.020–1.579); but also encouraged both low- and high-income people to choose self-treatment, specifically over-the-counter (OR = 1.208, 95% 1.037–1.407; OR = 1.206, 95% 1.024–1.419; respectively) and traditional Chinese medicines (OR = 1.452, 95% 1.094–1.932; OR = 1.456, 95% 1.079–1.955; respectively). However, receiving a pension had no effect on the frequency of outpatient and inpatient service use. Breakpoints for a pension to promote health service utilization were mainly located in the range 55–95 CNY (7.1–12.3 EUR or 8.0–13.8 USD). Conclusions A pension was found to have mixed effects on health service utilization for different income groups. Our study enriches existing evidence on the impact of pensions on healthcare-seeking behaviour and can be helpful in policy design and the formulation of improved models relating to pensions and healthcare utilisation.

scholarly journals Prevalence of Multimorbidity in Adults with Cancer, and Associated Health Service Utilization in Ontario, Canada: A Population-based Retrospective Cohort Study

2021 ◽  
Author(s):  
Anna Kone ◽  
Deborah Scharf
Keyword(s):  
Cohort Study ◽  
Health Service ◽  
Service Utilization ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Health Service Utilization ◽  
Premature Death ◽  
Population Based ◽  
Chronic Medical Condition ◽  
Cancer Type

Abstract Background: The majority of people with cancer have at least one other chronic health condition. With each additional chronic disease, the complexity of their care increases, as does the potential for negative outcomes including premature death. In this paper, we describe cancer patients’ clinical complexity (i.e., multimorbidity; MMB) in order to inform strategic efforts to improve care and outcomes for people with cancer of all types and commonly occurring chronic diseases. Methods: We conducted a population-based, retrospective cohort study of adults diagnosed with cancer between 2003 and 2013 (N=601,331) identified in Ontario, Canada healthcare administrative data. During a five to 15-year follow-up period (through March 2018), we identified up to 16 co-occurring conditions and patient outcomes including health service utilization and death. Results: MMB was extremely common, affecting more than 91% of people with cancer. Nearly one quarter (23%) of the population had five or more co-occurring conditions. While we saw no differences in MMB between sexes, MMB prevalence and level increased with age. MMB prevalence and type of co-occurring conditions also varied by cancer type. Overall, MMB was associated with higher rates of health service utilization and mortality, regardless of other patient characteristics, and specific conditions differentially impacted these rates.Conclusions: People with cancer are likely to have at least one other chronic medical condition and the presence of MMB negatively affects health service utilization and risk of premature death. These finds can help motivate and inform health system advances to improve care quality and outcomes for people with cancer and MMB due to commonly occurring chronic conditions.

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