Long-term Effects of Disasters on Health Care Utilization: Hurricane Katrina and Older Individuals with Diabetes

2019 ◽  
Vol 13 (4) ◽  
pp. 724-731 ◽  
Author(s):  
Troy Quast ◽  
Lijuan Feng
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Hurricane Katrina ◽  
Fixed Effects ◽  
Care Utilization ◽  
Older Individuals ◽  
Control Groups ◽  
Short Term ◽  
Age Cohorts

ABSTRACTObjectiveWhile the short-term effects of disasters on health care utilization are well documented, less is known regarding potential longer-term effects. This study investigates the effects of Hurricane Katrina on the health care utilization of older individuals with diabetes.MethodsWe examined Medicare claims and enrollment data for the 2002-2004 and 2006-2008 time periods for older individuals with diabetes. Our quasi-experimental design analyzed utilization across 2 treated and 3 control groups. We compared the proportion of individuals who received a screen related to diabetes before and after Katrina in the treated groups to the proportions in the control groups. Our regression analysis employs individual and year fixed effects to control for factors specific to a given individual or to a given year.ResultsWe found that utilization rates in the 2002-2004 period exhibited roughly parallel trends for the treated and control groups, which provides support for our research design. The 2006-2008 utilization rates were generally lower for the treated groups than they were for the control groups. The differences were especially pronounced for older age cohorts.ConclusionsOur study suggests that the effects of disasters on health care utilization may persist for years after the event. Recovery efforts may be improved by addressing both short-term and long-term health care interruptions. (Disaster Med Public Health Preparedness. 2019;13:724–731)

scholarly journals The employment and mental health impact of integrated improving access to psychological therapies services: Evidence on secondary health care utilization from a pragmatic trial in three English counties

2021 ◽  
pp. 135581962199749
Author(s):  
Veronica Toffolutti ◽  
David Stuckler ◽  
Martin McKee ◽  
Ineke Wolsey ◽  
Judith Chapman ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Utilization ◽  
Physical Health ◽  
Health Problems ◽  
Care Utilization ◽  
Psychological Therapies ◽  
Physical Health Problems ◽  
Secondary Health Care

Objective Patients with a combination of long-term physical health problems can face barriers in obtaining appropriate treatment for co-existing mental health problems. This paper evaluates the impact of integrating the improving access to psychological therapies services (IAPT) model with services addressing physical health problems. We ask whether such services can reduce secondary health care utilization costs and improve the employment prospects of those so affected. Methods We used a stepped-wedge design of two cohorts of a total of 1,096 patients with depression and/or anxiety and comorbid long-term physical health conditions from three counties within the Thames Valley from March to August 2017. Panels were balanced. Difference-in-difference models were employed in an intention-to-treat analysis. Results The new Integrated-IAPT was associated with a decrease of 6.15 (95% CI: −6.84 to −5.45) [4.83 (95% CI: −5.47 to −4.19]) points in the Patient Health Questionnaire-9 [generalized anxiety disorder-7] and £360 (95% CI: –£559 to –£162) in terms of secondary health care utilization costs per person in the first three months of treatment. The Integrated-IAPT was also associated with an 8.44% (95% CI: 1.93% to 14.9%) increased probability that those who were unemployed transitioned to employment. Conclusions Mental health treatment in care model with Integrated-IAPT seems to have significantly reduced secondary health care utilization costs among persons with long-term physical health conditions and increased their probability of employment.

The Impacts of Long-Term Care Insurance on Health Care Utilization and Expenditure: Evidence From China

2022 ◽  
Author(s):  
He Chen ◽  
Jing Ning
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Treatment Effect ◽  
Health Expenditure ◽  
Long Term Care ◽  
Care Utilization ◽  
Ageing Population ◽  
Term Care ◽  
Long Term Care Insurance

Abstract Long-term care insurance (LTCI) is one of the important institutional responses to the growing care needs of the ageing population. Although previous studies have evaluated the impacts of LTCI on health care utilization and expenditure in developed countries, whether such impacts exist in developing countries is unknown. The Chinese government has initiated policy experimentation on LTCI to cope with the growing and unmet need for aged care. Employing a quasi-experiment design, this study aims to examine the policy treatment effect of LTCI on health care utilization and out-of-pocket health expenditure in China. The Propensity Score Matching with Difference-in-difference approach was used to analyse the data obtained from four waves of China Health and Retirement Longitudinal Study (CHARLS). Our findings indicated that, in the aspect of health care utilization, the introduction of LTCI significantly reduced the number of outpatient visits by 0.322 times (p<0.05), the number of hospitalizations by 0.158 times (p<0.01), and the length of inpatient stay during last year by 1.441 days (p<0.01). In the aspect of out-of-pocket health expenditure, we found that LTCI significantly reduced the inpatient out-of-pocket health expenditure during last year by 533.47 yuan (p<0.01), but it did not exhibit an impact on the outpatient out-of-pocket health expenditure during last year. LTCI also had a significantly negative impact on the total out-of-pocket health expenditure by 512.56 yuan. These results are stable in the robustness tests. Considering the evident policy treatment effect of LTCI on health care utilization and out-of-pocket health expenditure, the expansion of LTCI could help reduce the needs for health care services and contain the increases in out-of-pocket health care expenditure in China.

scholarly journals Where to Start? A Two Stage Residual Inclusion Approach to Estimating Influence of the Initial Provider on Health Care Utilization and Costs for Low Back Pain in the US

2021 ◽  
Author(s):  
Kenneth Harwood ◽  
Jesse Pines ◽  
C. Holly A. Andrilla ◽  
Bianca K. Frogner
Keyword(s):  
Health Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Health Care Utilization ◽  
Index Date ◽  
Care Utilization ◽  
Low Back ◽  
Opioid Prescription ◽  
Serious Illness

Abstract Background: Diagnostic testing and treatment recommendations can vary when medical care is sought by individuals for low back pain (LBP), leading to variation in quality and costs of care. We examine how first provider seen by an individual at initial diagnosis of LBP influences downstream utilization and costs. Methods: Using national private health insurance claims data, individuals age 18 or older were retrospectively assigned to cohorts based on the first provider seen at the index date of LBP diagnosis. Exclusion criteria included individuals with a diagnosis of LBP or any serious medical conditions, or an opioid prescription recorded in the six months prior to the index date. Outcome measures included use of imaging, back surgery rates, hospitalization rates, emergency department visits, early- and long-term opioid use, and costs (out-of-pocket and total costs of care) twelve months post-index date. We used a common econometric technique, two-stage residual inclusion (2SRI) estimation to reduce selection bias in the choice of first provider, controlling for demographics.Results: Among 3,799,593 individuals, cost and utilization varied considerably based on first provider seen by the patient. The frequency of early opioid prescription was significantly lower when care began with an acupuncturist or chiropractor, and highest for those who began with an emergency medicine physician or advanced practice registered nurse (APRN). Long-term opioid prescriptions were low across most providers except physical medicine and rehabilitation physicians and APRNs. The frequency and time to serious illness varied little across providers. Total cost of care was lowest when starting with a chiropractor ($5,093) or primary care physician ($5,660), and highest when starting with an orthopedist ($9,434) or acupuncturist ($9,205). Conclusion: The first provider seen by individuals with LBP was associated with large differences in health care utilization, opioid prescriptions, and cost while there were no differences in delays in diagnosis of serious illness.

A regional evaluation of the health care utilization and outcomes of children and young people with long‐term ventilation needs

2020 ◽  
Vol 47 (1) ◽  
pp. 70-76
Author(s):  
Emma Popejoy ◽  
Takawira C. Marufu ◽  
David A. Thomas ◽  
Rachel Gregory ◽  
Adele Frost ◽  
...  
Keyword(s):  
Health Care ◽  
Young People ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Children And Young People ◽  
Long Term Ventilation

scholarly journals Increased health care utilization among long-term cancer survivors compared to the average Dutch population: A population-based study

2007 ◽  
Vol 121 (4) ◽  
pp. 871-877 ◽  
Author(s):  
Floortje Mols ◽  
Kazimier A. Helfenrath ◽  
Ad J.J.M. Vingerhoets ◽  
Jan Willem W. Coebergh ◽  
Lonneke V. van de Poll-Franse
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Cancer Survivors ◽  
Population Based ◽  
Care Utilization ◽  
Dutch Population ◽  
Population Based Study

Childhood, adolescent, and young adult cancer survivors (CAYACS) research program of British Columbia: Data linkage: Results to date

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9555-9555
Author(s):  
P. C. Rogers ◽  
M. Lorenzi ◽  
A. Broemeling ◽  
V. Glickman ◽  
K. Goddard ◽  
...  
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Health Care Utilization ◽  
Educational Outcomes ◽  
Data Linkage ◽  
Population Based ◽  
Care Utilization ◽  
Late Mortality ◽  
Late Morbidity

9555 Background: Long-term survivors of childhood and adolescent cancers are at risk for late mortality and morbidity. Using database linkages we assessed the extent of these issues and health care utilization in a population based cohort in British Columbia. Methods: Retrospective cohorts of 3,483 survivors (>5 years from diagnosis), and representative comparison groups, have been identified from population-based registries. Linkages were made with administrative databases of risk factors and outcomes. Late mortality, second cancers, late morbidity, health services utilization, continuity of care, and educational outcomes, among those diagnosed before age 20 between 1970 to 1995, and followed to 2000, have been examined. Results: Survivors experienced a 9-fold increase in mortality (SMR 9.1, 95% CI 7.8–10.5). Risk of developing a second cancer was 5 times higher than in the general population (SIR 5.0, 95% CI 3.8–6.5). Survivors had three times the odds of being hospitalized (OR 2.97, 95% CI 2.56–3.45) in a three-year period (1998–2000). Survivors were significantly more likely than the population group to consult any physician (excluding oncologists) (adj. RR 1.61, 95% CI 1.51–1.70). Survivors were found to experience a drop in continuity of primary health care as they aged and transitioned into adult care. Survivors were significantly more likely than their peers to receive special education (32.5% vs. 14.1%), most significantly among CNS survivors who received cranial irradiation. Conclusions: Survivors of childhood and adolescent cancers have severe long term health issues and increased health care utilization. Survivors of CNS tumors were at highest risk of poor health and educational outcomes measured. Data linkage provides useful insights for survivorship research. No significant financial relationships to disclose.

Short-Term Absenteeism and Health Care Utilization Due to Lower Extremity Injuries Among Novice Runners

2016 ◽  
Vol 26 (6) ◽  
pp. 502-509 ◽  
Author(s):  
Dirk-Wouter Smits ◽  
Bionka Huisstede ◽  
Evert Verhagen ◽  
Henk van der Worp ◽  
Bas Kluitenberg ◽  
...  
Keyword(s):  
Health Care ◽  
Lower Extremity ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Short Term ◽  
Lower Extremity Injuries ◽  
Extremity Injuries
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