Healthy, working-age, privately insured consumers currently may be over-insuring for medical care

2001 ◽  
BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043276
Author(s):  
Juhani Juhola ◽  
J P A Arokoski ◽  
Jenni Ervasti ◽  
Mika Kivimäki ◽  
Jussi Vahtera ◽  
...  

ObjectivesTo assess the internal consistency and construct validity of the Finnish translation of the Jenkins Sleep Scale (JSS) in a large healthy working-age population with diverse work characteristics.DesignSurvey-based cross-sectional cohort study.SettingSurvey conducted by an institute of occupational health.ParticipantsEmployees of 10 towns and 6 hospital districts.Primary and secondary outcome measuresThe internal consistency defined by a Cronbach’s alpha. Exploratory and confirmatory factor analyses to evaluate the construct structure of the JSS.ResultsOf 81 136 respondents, 14 890 (18%) were men and 66 246 (82%) were women. Their average age was 52.1 (13.2) years. Of the respondents, 41 823 (52%) were sleeping 7 or less hours per night. The mean JSS total score was 6.4 (4.8) points. The JSS demonstrated high internal consistency with an alpha of 0.80 (lower 95% confidence limit 0.80). Exploratory factor analysis supported a one-factor solution with eigenvalue of 1.94. Confirmatory factor analysis showed that all four items were positively correlated with a single common factor explaining 44%–61% of common factor’s variance.ConclusionsThe Finnish translation of JSS was found to be a unidimensional scale with good internal consistency. As such, the scale may be recommended as a practicable questionnaire when studying sleep difficulties in a healthy working-age population.


2017 ◽  
Vol 40 (7) ◽  
pp. 1049-1068 ◽  
Author(s):  
Vicki Simpson ◽  
Lindsey Pedigo

Identification of risk factors unique to the aging experience is vital to support health promotion efforts and prevent loss of independence for the increasing aging population. Health risk appraisals are tools capable of identifying a broad range of factors that affect health; however, these tools were designed for use with predominantly healthy working-age adults. The purpose of this integrative review was to describe uses and adaptations of health risk appraisals with aging adults. A total of 43 articles met inclusion criteria, identifying multiple adaptations necessary to effectively identify the risks faced by aging adults, including those related to activities of daily living, pain, depression, social support/network, vision, hearing, and cognitive status. Uses included support for health promotion efforts and to determine risk for depression, falls, and loss of independence. Further research needs to be done to evaluate impact when used as a health promotion and prevention tool for aging adults.


2009 ◽  
Vol 39 (6) ◽  
pp. 478-483 ◽  
Author(s):  
Petri K. Salo ◽  
Arja H. HÄkkinen ◽  
Hannu Kautiainen ◽  
Jari J. Ylinen

2022 ◽  
Vol 20 (8) ◽  
pp. 3111
Author(s):  
K. V. Omelyanenko ◽  
A. Yu. Gorshkov ◽  
A. A. Fedorovich ◽  
A. I. Korolev ◽  
V. A. Dadaeva ◽  
...  

Aim. To study sex characteristics of cutaneous microvascular structure and function in a cohort of healthy working-age people without cardiovascular diseases.Material and methods. The study included 35 healthy men (42±4 years) and 34 women (41 ±5 years). The cardiovascular system was assessed in all patients. The microcirculatory bed of the skin was investigated by the following non-invasive methods: 1) computerized video capillaroscopy; 2) laser Doppler flowmetry; 3) photoplethysmography.Results. According to computerized video capillaroscopy in men, compared with women, there was a smaller number of both functioning capillaries (78 vs 86 capillaries/mm2, respectively (p<0,05)) and their total number (100 vs 120 capillaries/mm2, respectively (p<0,001)). Against the background of a decrease in capillary density in men, there was a higher skin interstitial hydration — 113 vs 96 gm (p<0,005) in men than in women. At the level of precapillary arterioles, where humoral tone regulation prevails. Laser Doppler flowmetry revealed lower pulse amplitude in men than in women — 0,87 vs 1,02 pf, respectively (p<0,05), which indicates a lower arterial blood inflow to exchange microvessels. Against this background, the constrictor response of precapillary arterioles to a sympathetic nervous system stimulation in men is higher than in women — 45% vs 40%, respectively (p<0,05). At the level of large arterioles, where neural tone regulation prevails, photoplethysmography revealed lower augmentation index standardized at a heart rate in men (-4,6 vs 1,7%, respectively, p<0,05), which indicates lower rigidity of muscular vessels in men.Conclusion. In working-age healthy people, sex differences are noted at all cutaneous microvascular levels, which must be taken into account when planning studies.


2021 ◽  
Vol 29 (5) ◽  
pp. 49-57
Author(s):  
Anastasiya Yurevna Simonova ◽  
Pavel Gennadevich Rozhkov ◽  
Mariya Vladimirovna Belova ◽  
Kapitolina Konstsntinovna Ilyashenko ◽  
Mikhail Mikhaylovich Potskhveriya ◽  
...  

Introduction. On March 11, 2020, WHO announced the global COVID-19 pandemic. According to literature data, the spread of coronavirus infection COVID-19 affected the structure of acute chemical poisoning. The aim. Assessment of the impact of the COVID-19 pandemic and restrictive measures on the peculiarities of seeking advice and the structure of acute chemical poisoning in Moscow. Material and methods. The data of the registration forms “Card of recording of a consultation of a patient with acute poisoning of chemical etiology” in the period from March 30 to June 30, 2020 and 2019 were studied. The analysis indicators of a hospitalization of patients in the department of acute poisoning and somatopsychiatric disorders of N.V. Sklifosovsky, the Research Institute of Emergency Medicine. Results. It was found that in the analyzed period of 2020 compared to 2019, the proportion of injured people of working age decreased by 11.2%, while it increased at the age of 0-17 years by 3.2 times. An increase in the number of consultations for individuals by 2.1 times was noted. There was an increase in the number of complaints about poisoning with antibiotics, drugs from the T45 group (anticoagulants, vitamins, etc.), T37 (antiviral, anti-microbial, etc.) by 1.7-2 times. In March-June 2020, there was an increase in the number of complaints about the toxic effects of alcohol (T51), an increase in hospitalized patients with acute alcohol poisoning by 4 times, and with combined alcohol poisoning - by 2.7 times. The number of complaints about poisoning with detergents and disinfectants in the first three months of the pandemic increased by 2.7 times. Conclusion. The pandemic and the introduction of restrictive measures for COVID-19 have affected the toxicological situation in Moscow, which must be taken into account when determining the guidelines for organizational measures for the provision of medical care for acute chemical poisoning during the COVID-19 pandemic.


2016 ◽  
Vol 50 (2) ◽  
pp. 270-277 ◽  
Author(s):  
Benjamin T. Allaire ◽  
Donatus U. Ekwueme ◽  
Gery P. Guy ◽  
Chunyu Li ◽  
Florence K. Tangka ◽  
...  

Bone ◽  
2006 ◽  
Vol 38 (5) ◽  
pp. 731-737 ◽  
Author(s):  
Becky A. Briesacher ◽  
Denise Orwig ◽  
Margaret Seton ◽  
Mohamed Omar ◽  
Kristijan H. Kahler

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Lauren Lindsey ◽  
Jessica Baedke ◽  
Aimee James ◽  
I-Chan Huang ◽  
Kirsten Ness ◽  
...  

Abstract Background Among adult childhood cancer survivors, the relationship between race/ethnicity and health insurance status, as a contributor to disparities in healthcare utilization, is poorly understood. Methods We examined racial/ethnic-related disparities by insurance status in “forgoing needed medical care in the last year due to finances” using 3,964 adult childhood cancer survivors (3310 non-Hispanic/Latinx White, 562 non-Hispanic/Latinx Black, and 92 Hispanic/Latinx) participating in the St. Jude Lifetime Cohort Study (SJLIFE). Multivariable logistic regression analyses, guided by Andersen’s Healthcare Utilization Model, were adjusted for “predisposing” (age, sex, childhood cancer diagnosis, cancer treatment, surgery, and treatment era) and “need” (perceived health status) factors. Additional adjustment for income/education and chronic health conditions was considered. Results The risk of forgoing care was highest among non-Hispanic/Latinx Blacks and lowest among Hispanics/Latinxs for each insurance status. Among privately-insured survivors, relative to non-Hispanic/Latinx Whites, non-Hispanic/Latinx Blacks were more likely to forgo care (adjusted OR: 1.82, 95% CI: 1.30–2.54): this disparity remained despite additional adjustment for income/education (adjusted OR: 1.43, 95% CI: 1.01–2.01). In contrast, publicly-insured survivors, regardless of race/ethnicity, had similar risk of forgoing care as privately-insured non-Hispanic/Latinx Whites. All uninsured survivors had high risk of forgoing care. Additional adjustment for chronic health conditions did not alter these results. Conclusions The findings of this study show that provision of public insurance to all childhood cancer survivors may diminish racial/ethnic disparities in forgoing care that exist among the privately-insured and reduce the risk of forgoing care among uninsured survivors to that of privately-insured non-Hispanic/Latinx Whites. Key messages Providing publicly funded health insurance coverage to childhood cancer survivors can reduce disparities in forgoing medical care.


10.12737/5762 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Токарев ◽  
A. Tokarev ◽  
Киреев ◽  
Semen Kireev ◽  
Малыченко ◽  
...  

Definition risk factors, the proof of their role in human health, as well as a quantitative characteristic of dependences of harmful effects on the levels of exposure to specific factors are one of the fundamental problems of modern clinical medicine, epidemiology, toxicology, occupational health, environmental and other sections of biology and medicine. The object of this study is the population of the city of Tula (22282 patients) and Astrakhan (27776 patients) who applied for emergency medical care apropos of diseases characterized by high blood pressure (ICD I10-I15) in 2013. Women at the age older than working age are the most weather-sensitive group. In the winter time there is a tendency to increase the number of calls to the AG at low amplitude changes daily temperature at high air humidity, wind speed. In spring there is increasing dependence on the number of calls AG at low mean temperature, maximum temperature, speed of wind. In summer there is a significant dependence of increasing the number of calls on AG low average daily temperature, maximum temperature, at low amplitude changes daily temperature; there is a tendency of increasing the number of calls to hypertension in increasing atmospheric pressure difference, while increasing humidity. There are more pronounced changes during sudden changes of weather conditions and a short period of adaptation to temperature changes and humidity.


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