scholarly journals B.4 Use of Health Care Resources by Pediatric Headache Patients: A population-based cohort study In the Province of Alberta

Author(s):  
T Rajapakse ◽  
J Bakal ◽  
J Mailo ◽  
M Nabipoor ◽  
J Kassiri ◽  
...  

Background: Headache is a prevalent and disabling condition in children. It is a frequent cause of medication and health resource use in children. We examined the incidence and nature of health service use of the pediatric patient population in Alberta using provincial linked administrative databases. Methods: We used linked administrative data to identify patients under the age of 18 years from 2010-2017 and ICD-10 headache type at diagnosis and health service utilization including cost, medication use, outpatient/ED visits and hospitalizations. Patient geographic location was mapped. We explored health system use in the 3 years before and after diagnosis by identifying visits to community physicians, outpatient clinics emergency departments an inpatient admissions. Results: Over the 7 year study period 45,454 patients were identified under 18 years, 60% of patients first diagnosed with migraine, 11.7% (5308) with tension headache and 28.2 (12,833) with unspecified headache. Higher health system utilization seen immediately before and after headache diagnosis, returning to pre-diagnosis values within the 3 years following. Conclusions: This is the first population based reporting of pediatric headache prevalence and health resource utilization in Alberta. This contemporary prevalence and health resource data use should help inform future policy and headache care in the province of Alberta.

2020 ◽  
Vol 12 ◽  
pp. 1759720X2092171
Author(s):  
Bindee Kuriya ◽  
Vivian Tia ◽  
Jin Luo ◽  
Jessica Widdifield ◽  
Simone Vigod ◽  
...  

Background: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with mental illness. Whether acute mental health (MH) service utilization (i.e. emergency visits or hospitalizations) is increased in RA or AS is not known. Methods: Two population-based cohorts were created where individuals with RA ( n = 53,240) or AS ( n = 13,964) were each matched by age, sex, and year to unaffected comparators (2002–2016). Incidence rates per 1000 person-years (PY) were calculated for a first MH emergency department (ED) presentation or MH hospitalization. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated, adjusting for demographic, clinical, and health service use variables. Results: Individuals with RA had higher rates of ED visits [6.59/1000 person-years (PY) versus 4.39/1000 PY in comparators] and hospitalizations for MH (3.11/1000 PY versus 1.80/1000 PY in comparators). Higher rates of ED visits (7.92/1000 PY versus 5.62/1000 PY in comparators) and hospitalizations (3.03/1000 PY versus 1.94/1000 PY in comparators) were also observed in AS. Overall, RA was associated with a 34% increased risk for MH hospitalization (HR 1.34, 95% CI 1.22–1.47) and AS was associated with a 36% increased risk of hospitalization (HR 1.36, 95% CI 1.12–1.63). The risk of ED presentation was attenuated, but remained significant, after adjustment in both RA (HR 1.08, 95% CI 1.01–1.15) and AS (HR 1.14, 95% CI 1.02–1.28). Conclusions: RA and AS are both independently associated with a higher rate and risk of acute ED presentations and hospitalizations for mental health conditions. These findings underscore the need for routine evaluation of MH as part of the management of chronic inflammatory arthritis. Additional research is needed to identify the underlying individual characteristics, as well as system-level variation, which may explain these differences, and to help plan interventions to make MH service use more responsive to the needs of individuals living with RA and AS.


2016 ◽  
Vol 61 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Sima Gandhi ◽  
Maria Chiu ◽  
Kelvin Lam ◽  
John C. Cairney ◽  
Astrid Guttmann ◽  
...  

Author(s):  
Guilherme Oliveira de Arruda ◽  
Sonia Silva Marcon

Objective estimate the prevalence and identify factors associated with the use of health services by men between 20 and 59 years of age. Method population-based, cross-sectional domestic survey undertaken with 421 adult men, selected through systematic random sampling. The data were collected through a structured instrument and analyzed using descriptive and inferential statistics with multiple logistic regression. Results the prevalence rate of health service use during the three months before the interviews was 42.8%, being higher among unemployed men with a religious creed who used private hospitals more frequently, had been hospitalized in the previous 12 months and referred some disease. Conclusion the prevalence of health service use by adult men does not differ from other studies and was considered high. It shows to be related with the need for curative care, based on the associated factors found.


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