Physical symptoms and health-care utilization in victims of the 2013 flood disaster in Germany – A longitudinal study of health-related flood consequences and evaluation of psycho-social support

2020 ◽  
pp. 101949
Author(s):  
Daniel Apel ◽  
Michaela Coenen
Keyword(s):  
Social Support ◽  
Health Care ◽  
Longitudinal Study ◽  
Health Care Utilization ◽  
Physical Symptoms ◽  
Flood Disaster ◽  
Care Utilization ◽  
Health Related

scholarly journals Screening, Counseling, and Health Care Utilization Among a National Sample of Adolescent Smokers

2020 ◽  
Vol 59 (4-5) ◽  
pp. 467-475
Author(s):  
Ashley L. Merianos ◽  
E. Melinda Mahabee-Gittens
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Tobacco Use ◽  
Secondary Analysis ◽  
National Sample ◽  
Care Utilization ◽  
Adolescent Smokers ◽  
Health Related ◽  
Fair Poor ◽  
Smoking And Health

Our objective was to assess the association between cigarette smoking and tobacco use screening and advising to quit use by a clinician among adolescents nationwide. We also examined the relationships between smoking and health-related indicators and health care utilization. A secondary analysis of the 2017 National Survey on Drug Use and Health was conducted (N = 11 884). Ever smokers were less likely to be screened for tobacco use. Current smokers and those who were nicotine dependent were more likely to have been advised to quit use. Ever and current smokers were significantly more likely to report good/fair/poor health status, illness-related school absenteeism in the past 30 days, and were more likely to have had an emergency department visit or an overnight hospital stay. Standardized tobacco control efforts are needed in health care settings to support clinicians to screen all adolescents for tobacco use and advise every smoker irrespective of smoking frequency to quit use.

Longitudinal Medication Adherence in Older Adults With Multimorbidity and Association With Health Care Utilization: Results From the Irish Longitudinal Study on Ageing

2020 ◽  
Vol 55 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Caroline A. Walsh ◽  
Caitriona Cahir ◽  
Kathleen E. Bennett
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Longitudinal Study ◽  
Medication Adherence ◽  
Health Care Utilization ◽  
Negative Binomial ◽  
Care Utilization ◽  
Multiple Chronic Conditions ◽  
Visit Rate ◽  
Management Interventions

Background: The association between objectively measured nonadherence and health care utilization in multimorbid older people is unclear. Objective: To measure medication adherence across multiple chronic conditions, identify adherence patterns, and estimate the association between adherence and self-reported health care utilization. Methods: This is a retrospective cohort study of multimorbid participants aged ≥70 years in the Irish LongituDinal Study on Ageing (TILDA). Eligible participants had linked pharmacy claims data and completed TILDA wave 2 (2 years after wave 1). The RxRisk-V tool was used to identify multimorbidity. Average adherence (AA) across RxRisk-V conditions was estimated using the CMA7 function (AdhereR). Group-based trajectory models (GBTMs) identified adherence patterns in the 12 months following wave 1. Negative binomial regression was used to estimate the association between adherence and the rate of subsequent self-reported general practitioner [GP] visits, emergency department (ED) visits, outpatient visits, and hospitalizations in the 12 months following adherence measurement (reported at wave 2). Adjusted Incident Rate Ratios (aIRR) and 95% CIs are presented. Results: Higher AA (CMA7) was associated with a small significant decrease in GP visit rate (aIRR = 0.70; CI = 0.53-0.94) and outpatient visit rate (aIRR = 0.44; CI = 0.23-0.81). GBTM identified 6 adherence groups (n = 1050). Compared with high adherers, group 1 (rapid decline, modest increase) membership (aIRR = 1.72; CI = 1.09-2.73) and group 4 (high adherence, delayed decline) membership (aIRR = 1.92; CI = 1.19-3.05) significantly increased ED visit rate. Conclusion and Relevance: Suboptimal medication adherence in multimorbid older adults is associated with increased health care utilization. Identification of suboptimal adherence groups for medication management interventions may help decrease the health system burden and health care costs.

Depression in Primary Care—More like Asthma Than Appendicitis: The Michigan Depression Project

1997 ◽  
Vol 42 (9) ◽  
pp. 966-973 ◽  
Author(s):  
Michael S Klinkman ◽  
Thomas L Schwenk ◽  
James C Coyne
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Health Care ◽  
Health Care Utilization ◽  
Family Practice ◽  
Care Setting ◽  
Primary Care Setting ◽  
Past History ◽  
Care Utilization ◽  
Primary Care Patients

Objective: To explore the relationships between detection, treatment, and outcome of depression in the primary care setting, based upon results from the Michigan Depression Project (MDP). Methods: A weighted sample of 425 adult family practice patients completed a comprehensive battery of questionnaires exploring stress, social support, overall health, health care utilization, treatment attitudes, self-rated levels of stress and depression, along with the Center for Epidemiologic Studies Depression Scale (CES-D), the Hamilton Rating Scale for Depression (HAM-D), and the Structured Clinical Interview for DSM-III (SCID), which served as the criterion standard for diagnosis. A comparison sample of 123 depressed psychiatric outpatients received the same assessment battery. Family practice patients received repeated assessment of depressive symptoms, stress, social support, and health care utilization over a period of up to 60 months of longitudinal follow-up. Results: The central MDP findings confirm that significant differences in past history, severity, and impairment exist between depressed psychiatric and family practice patients, that detection rates are significantly higher for severely depressed primary care patients, and that clinicians use clinical cues such as past history, distress, and severity of symptoms to “detect” depression in patients at intermediate and mild levels of severity. As well, there is a lack of association between detection and improved outcome in primary care patients. Conclusion: These results call into question the assumption that “depression is depression” irrespective of the setting and physician, and they are consistent with a model of depressive disorder as a subacute or chronic condition characterized by clinical parameters of severity, staging, and comorbidity, similar to asthma. This new model can guide further investigation into the epidemiology and management of mood disorders in the primary care setting.

scholarly journals The Effect of Back Pain on Health Care Utilization and Costs

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Jessica J Wong ◽  
Pierre Côté ◽  
Andrea C Tricco ◽  
Tristan Watson ◽  
Laura C Rosella
Keyword(s):  
Health Care ◽  
Back Pain ◽  
Propensity Score ◽  
Health Care Utilization ◽  
Canadian Community Health Survey ◽  
Population Based ◽  
Care Utilization ◽  
Physician Visits ◽  
Health Related ◽  
Behavioural Factors

Introduction: We assessed the effect of self-reported back pain on health care utilization and costs in a population-based sample of Ontario adults. Methods: We conducted a population-based matched cohort study of Ontarian respondents aged ≥18 years of Canadian Community Health Survey (CCHS) from 2003-2012. CCHS data were individually linked to health administrative data to measure health care utilization and costs up to 2018. We propensity-score matched (hard-matched on sex) adults with self-reported back pain to those without back pain, accounting for sociodemographic, health-related, and behavioural factors. We evaluated back pain-specific and all-cause health care utilization and costs from healthcare payer perspective adjusted to 2018 Canadian dollars. Poisson and linear (log-transformed) models were used to assess healthcare utilization rates and costs.  Results: After propensity-score matching, we identified 36,806 pairs (21,054 for women, 15,752 for men) of CCHS respondents with and without back pain (mean age 51 years; SD=18). Compared to propensity-score matched adults without back pain, adults with back pain had two times the rate of back pain-specific visits (women: rate ratio [RR] 2.06, 95% CI 1.88-2.25; men: RR 2.32, 95% CI 2.04-2.64), 1.1 times the rate of all-cause physician visits (women: RR 1.12, 95% CI 1.09-1.16; men: RR 1.10, 95% CI 1.05-1.14), and 1.2 times the costs (women: 1.21, 95% CI 1.16-1.27; men: 1.16, 95% CI 1.09-1.23). Incremental annual per-person costs were higher in adults with back pain versus those without (women: $395, 95% CI $281-$509; men: $196, 95% CI $94-$300), corresponding to $532 million for women and $227 million CAD for men annually in Ontario. Conclusions: Adults with back pain had considerably higher health care utilization and costs compared to adults without back pain. These findings provide the most recent, comprehensive, and high-quality estimates of the health system burden of back pain to inform healthcare policy and decision-making. New strategies to reduce the substantial burden of back pain are warranted.

Functional versus Structural Social Support and Health Care Utilization in a Family Medicine Outpatient Practice

Medical Care ◽  
1989 ◽  
Vol 27 (3) ◽  
pp. 221-233 ◽  
Author(s):  
W E Broadhead ◽  
Stephen H. Gehlbach ◽  
Frank V. deGruy ◽  
Berton H. Kaplan
Keyword(s):  
Social Support ◽  
Health Care ◽  
Family Medicine ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Functional Versus ◽  
Outpatient Practice

Occupational History For Adults With Sickle Cell Disease Compared With Healthy Siblings

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2244-2244 ◽  
Author(s):  
Modupe Idowu ◽  
Omotayo Fawibe ◽  
Paul Rowan ◽  
Harinder S. Juneja ◽  
Deborah Brown
Keyword(s):  
Health Care ◽  
Sickle Cell Disease ◽  
Health Care Utilization ◽  
Sickle Cell ◽  
Negative Impact ◽  
Care Utilization ◽  
Job Retention ◽  
Cell Disease ◽  
Healthy Siblings ◽  
Health Related

Abstract Introduction Sickle cell disease (SCD) has a negative impact on academic and job functioning. Recurrent acute vaso-occlusive crises and organ dysfunction related to SCD can limit employment options and interfere with job retention. Potential associates of unemployment and poor job performance in adults with SCD include health-related (pain frequency and intensity, health-care utilization) and psychosocial (support system, coping mechanism). Moreover, poor academic achievement may increase the rates of unemployment in this patient group. The goal of this study is to compare patients’ rates of unemployment and disability with those of their unaffected siblings. Patients and Methods Twenty adult SCD patients (16 hemoglobin SS and 4 hemoglobin SC ; age: median = 29, range 20-56 years; sex: 8 males, 12 females) completed questionnaires relating to occupational experiences. Questionnaires were administered during routine clinic visits. Questions on the questionnaires relate to demographics, chronic pain scale, health-care utilization, use of hydroxyurea, employment status, length of employment, annual income, job satisfaction and use of tobacco, alcohol, or illicit drugs. These questionnaires also included questions relating to patients unaffected siblings who are within 5 years of age difference. We also performed paper and electronic chart review to obtain each patient’s health related data including number of days in the hospital for acute illnesses and for routine clinic appointments in the previous year, number of pain medications, other chronic medical conditions and SCD-related laboratory and tests results. Fourteen out of twenty patients (70%) were on hydroxyurea therapy and 14/20 (70%) had 3 or more hospitalizations in the previous one year. Patients on chronic transfusion therapy and those with other disabling conditions unrelated to SCD were excluded. Results Four out of twenty SCD patients (20%) are currently employed as compared to 15/20 (75%) of their healthy siblings (p < .001, all tests reported are Fisher’s Exact Test). Two of the SCD patients have been employed for more than 2 years as compared to 11 of their siblings (p = .006). Fourteen of SCD patients are on disability, while this is true for only one of the siblings (p < .001). Four of the twenty SCD patients are college graduates compared with 6 of the 20 unaffected siblings (p = .36). It is interesting to note that 12 out of 14 (86%) SCD patients who are currently on disability have previously had a job. Five of the fourteen (36%) SCD patients on disability reported that they missed more than 3 days per week of work due to their SCD. Of the unemployed patients, fourteen out of 16 (88%) wished they had a job. Conclusions This study highlights the negative impact of sickle cell disease on adult patients’ employment rates and job retention. Even though 16/20 (80%) of the SCD patients have previously had a job, only 20% are currently employed. Extension of this study will focus on development of specific interventions that may improve accommodation of SCD patients by encouraging collaboration between patients, families, medical providers, and employers. We believe that this is necessary in order to provide the most favorable environment for these patients to have better job functioning and it will also result in less economic burden on the society. Disclosures: No relevant conflicts of interest to declare.

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