Multimorbidity is associated with higher out-of-pocket spending: a study of older Australians with multiple chronic conditions

2013 ◽  
Vol 19 (2) ◽  
pp. 144 ◽  
Author(s):  
Ian McRae ◽  
Laurann Yen ◽  
Yun-Hee Jeon ◽  
Pushpani M. Herath ◽  
Beverley Essue
Keyword(s):  
Chronic Disease ◽  
Chronic Conditions ◽  
Financial Burden ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Economic Consequences ◽  
Multiple Chronic Conditions ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Health Related

Most older Australians have at least one chronic health condition. The management of chronic disease is associated with potentially severe economic consequences for patients and their households, partially due to the financial burden associated with out-of-pocket costs for medical and health-related care. A questionnaire was mailed to a cross-sectional sample of older Australians in mid-2009, with 4574 responding. Multivariate logistic regression models were developed to investigate the relationships between multimorbidity and out-of-pocket spending on medical and health-related expenses, including the factors associated with severe financial stress among older Australians. We found a positive relationship between number of chronic conditions and out-of-pocket spending on health and that people with multiple chronic conditions tend to be on lower incomes. People with five or more chronic conditions spent on average five times as much on their health as those with no diagnosed chronic conditions and each additional chronic disease added 46% to the likelihood of a person facing a severe financial burden due to health costs. While health policy may minimise out-of-pocket spending for individual conditions, costs compound rapidly for patients with multiple conditions and this burden falls most heavily on those with the lowest incomes.

scholarly journals Risk of Poor Outcomes with COVID-19 Among U.S. Detained Immigrants: A Cross-Sectional Study

2021 ◽  
Author(s):  
Caitlin Patler ◽  
Altaf Saadi
Keyword(s):  
Chronic Conditions ◽  
Chronic Health Condition ◽  
Cross Sectional Study ◽  
Health Condition ◽  
Health Conditions ◽  
Multiple Chronic Conditions ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Poor Outcomes ◽  
Immigrant Detention

AbstractConditions in immigrant detention centers facilitate the spread of infectious diseases like COVID-19. However, there is no publicly-available data on detainees’ health characteristics, making it difficult to estimate the prevalence of risk among detained people. We use cross-sectional survey data from the only survey of detained immigrants, conducted in California in 2013–2014, to assess the prevalence and health-related correlates of health conditions among detained immigrants. We calculated the proportion of detained immigrants with chronic conditions, their interruptions in care, and stratified by sociodemographic characteristics, evaluating differences using two-tailed tests. Among 529 detained immigrants, 42.5% had at least one chronic health condition; 15.5% had multiple chronic conditions. 20.9% experienced disruption in care upon entering detention. 95.6% had access to stable housing in the U.S. Many detained people face health conditions that confer greater risk for poor outcomes with COVID-19. Stable residence can facilitate release of detainees via Alternatives to Detention programs.

scholarly journals Artificial intelligence decision-making in mobile health

2019 ◽  
Vol 41 (5) ◽  
pp. 20-24 ◽  
Author(s):  
Marianne Menictas ◽  
Mashfiqui Rabbi ◽  
Predrag Klasnja ◽  
Susan Murphy
Keyword(s):  
Chronic Disease ◽  
Healthy Eating ◽  
Chronic Conditions ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Physically Active ◽  
Prevention And Health Promotion ◽  
The Usa ◽  
The Many ◽  
Sleeping Habits

It is likely that you or someone you know is affected by a chronic health condition. For example, a staggering six in 10 adults in the USA are currently suffering from a chronic disease (National Center for Chronic Disease Prevention and Health Promotion, 2019). Unfortunately, chronic conditions are not treatable overnight, but they can often be improved by regular incorporation of preventative behaviours (e.g., taking medication, healthy sleeping habits, being physically active, healthy eating, etc.). However, due to the many contingencies that arise in our lives, regular incorporation of healthy behaviours is difficult, and often when we need help in enacting these behaviours, support from clinical professionals is not available.

scholarly journals A Postcard From Italy: Challenges and Psychosocial Resources of Partners Living With and Without a Chronic Disease During COVID-19 Epidemic

2020 ◽  
Vol 11 ◽  
Author(s):  
Giada Rapelli ◽  
Giulia Lopez ◽  
Silvia Donato ◽  
Ariela Francesca Pagani ◽  
Miriam Parise ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronically Ill ◽  
Well Being ◽  
Chronic Health Condition ◽  
Protective Role ◽  
Health Condition ◽  
World Health ◽  
Italian Population ◽  
Cross Sectional ◽  
Psychological Well Being

The new Coronavirus (COVID-19) has been declared a global pandemic by the World Health Organization (WHO). The sudden outbreak of this new virus and the measure of lockdown adopted to contain the epidemic have profoundly changed the lifestyles of the Italian population, with an impact on people’s quality of life and on their social relationships. In particular, due to forced and prolonged cohabitation, couples may be subject to specific stressors during the epidemic. In addition, living with a chronic health condition may add specific challenges to the ones posed by the epidemic itself. The present cross-sectional study aimed to provide a picture of the challenges as well as the resources for both individual and relational well-being of Italian individuals in a couple relationship (N = 1921), with a specific attention to the comparison between individuals living with and without a chronic disease. Results showed that people with a chronic disease had lower psychological well-being and more fears and worries about the COVID-19. People with a chronic disease perceived fewer resources than healthy people. Moreover, the challenges are shown to be associated with less psychological well-being and high pessimism about the future. Instead individual, relational, and social resources play a protective role during the pandemic for both healthy and chronically ill people.

scholarly journals Clustering and Healthcare Costs With Multiple Chronic Conditions in a US Cross-Sectional Study

2020 ◽  
Author(s):  
cother hajat ◽  
yakir siegal ◽  
amalia adler-waxman
Keyword(s):  
Mental Health ◽  
Chronic Conditions ◽  
Healthcare Costs ◽  
Multiple Chronic Conditions ◽  
Cross Sectional ◽  
The Us ◽  
Health Related ◽  
Insured Patients ◽  
The Impact ◽  
Hiv Aids

Objective To investigate healthcare costs and contributors to costs for multiple chronic conditions (MCCs), common clusters of conditions and their impact on cost and utilisation. Methods This was a cross-sectional analysis of US financial claims data representative of the US population, including Medicare, Medicaid and Commercial insurance claims in 2015. Outcome measures included healthcare costs and contributors; ranking of clusters of conditions according to frequency, strength of association and unsupervised (k-means) analysis; the impact of clustering on costs and contributors to costs. Results Of 1,878,951 patients, 931,045(49.6%) had MCCs, 56.5% weighted to the US population. Mean age was 53.0 years(SD16.7); 393,121(42.20%) were male. Mean annual healthcare spending was $12,601, ranging from $4,385 (2 conditions) to $33,874 (11 conditions), with spending increasing by 22-fold for inpatient services, 6-fold for outpatient services, 4.5-fold for generic drugs and 4.2-fold for branded drugs. Cluster ranking using the 3 methodologies yielded similar results: highest ranked clusters included metabolic syndrome(12.2% of US insured patients), age related diseases(7.7%), renal failure(5.6%), respiratory disorders(4.5%), cardiovascular disease(CVD)(4.3%), cancers(4.1-4.3%), mental health-related clusters(1.0-1.5%) and HIV/AIDS(0.2%). Highest spending was in HIV/AIDS clusters ($48,293), mental health-related clusters ($38,952-$40,637), renal disease ($38,551) and CVD ($37,155); with 89.9% of spending on outpatient and inpatient care combined, and 10.1% on medication. Conclusion and Relevance Over 57% of insured patients in the US may have MCCs. MCC Clustering is frequent and is associated with healthcare utilisation. The findings favour health system redesign towards a multiple condition approach for clusters of chronic conditions, alongside other cost-containment measures for MCCs.

GPS' PERCEPTION OF THE PATIENT ORIENTED INTERVENTIONS AS KEY ELEMENTS OF PATIENT CENTRED CARE FOR PEOPLE WITH MULTIMORBIDITY.pdf

2018 ◽  
Vol 28 (2) ◽  
pp. 561-565
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
Chronic Conditions ◽  
Patient Centered Care ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Positive Health ◽  
Patient Centered ◽  
Effective Response ◽  
Patient Centred Care ◽  
Centered Care ◽  
Health Related

Background: Patients with multimorbidity represent a significant portion of the primary healthcare population. For healthcare providers, managing patients with multiple chronic conditions represents a challenge given the complexity and the intensity of interventions. Integrated and patient-centered care is considered an effective response to the needs of people who suffer from multiple chronic conditions. According to the literature providing patient-centered care is one of the most important interventions in terms of positive health-related outcomes for patients with multimorbidity.Aim: The aim of the study is to evaluate the GPs’ perception of patient oriented interventions as key elements of patient centred care for patients with multimorbidity.Material and methods: A cross-sectional pilot study was conducted among randomly selected 73 GPs. A direct individual anonymous survey was performed to explore the opinion of respondents about the importance of two patient-oriented interventions, each one including specific elements of patient-centered care for patients with multimorbidity. The tool was developed as a result of the scoping review performed by Smith et al. (2012;2016). A 5-point Likert scale (0-not at all, 1-little, 2-rather, 3-much, 4-very strong) was used. The data were analysed using descriptive statistics. In processing the data, the software product for statistical analyses - SPSS version 17 was performed for Windows XP.Results: Our results show that both categories - providing patient-oriented approach and self-management support interventions were highly accessed by the respondents. The most frequent categories of interventions identified in our study were Creating individualized and adapted interventions, Performing regular contacts and Reinforcing adherence. Less frequently reported elements such as Considering relatives’ needs and Developing self-management plan are still underestimated by the Bulgarian GPs.Conclusions: The acceptance and understanding of innovative patient-centered interventions adapted to patients with multimorbidity could be accepted as a good indicator for improving health-related outcomes and care for patients with multiple chronic conditions.

scholarly journals Using Electronic Medical Records and Health Claim Data to Develop a Patient Engagement Score for Patients With Multiple Chronic Conditions: An Exploratory Study

2021 ◽  
Vol 8 ◽  
pp. 237437352098148
Author(s):  
Surachat Ngorsuraches ◽  
Semhar Michael ◽  
Nabin Poudel ◽  
Gemechis Djira ◽  
Emily Griese ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Patient Engagement ◽  
Medical Records ◽  
Chronic Conditions ◽  
Claim Data ◽  
Hospital Charges ◽  
Multiple Chronic Conditions ◽  
Health Claim ◽  
Study Objective ◽  
Health Related

The study objective was to (1) develop a statistical model that creates a novel patient engagement score (PES) from electronic medical records (EMR) and health claim data, and (2) validate this developed score using health-related outcomes and charges of patients with multiple chronic conditions (MCCs). This study used 2014-16 EMR and health claim data of patients with MCCs from Sanford Health. Patient engagement score was created based on selected patients’ engagement behaviors using Gaussian finite mixture model. The PES was validated using multiple logistic and linear regression analyses to examine the associations between the PES and health-related outcomes, and hospital charges, respectively. Patient engagement score was generated from 5095 patient records and included low, medium, and high levels of patient engagement. The PES was a significant predictor for low-density lipoprotein, emergency department visit, hemoglobin A1c, estimated glomerular filtration rate, hospitalization, and hospital charge. The PES derived from patient behaviors recorded in EMR and health claim data can potentially serve as a patient engagement measure. Further study is needed to refine and validate the newly developed score.

FRAILTY IS NOT ASSOCIATED WITH MISTREATMENT

2017 ◽  
pp. 1-4
Author(s):  
S.D. Piña-Escudero ◽  
J.M.A. García-Lara ◽  
J.A. Avila-Funes
Keyword(s):  
Cross Sectional Study ◽  
Social Consequences ◽  
Community Dwelling ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Health Related ◽  
The Mean ◽  
Unadjusted Analysis ◽  
Frailty Score

Muscle Frailty has been previously associated with increased vulnerability for adverse health-related outcomes that could lead to social consequences such as mistreatment. The aim of this cross-sectional study is to determine the association between frailty and mistreatment in 852 community-dwelling persons aged 70 or older. Mistreatment was defined as one positive answer in the Geriatric Mistreatment Scale and frailty was used as a continuum where the greater number of positive criteria according to Fried et al. indicates a higher frailty score. Multivariate logistic regression models were run to establish this association. The mean age of participants was 77.7 years (SD=6.1). Prevalence of frailty phenotype and mistreatment were 13.9% and 20% respectively. Unadjusted analysis showed frailty score was associated with mistreatment (OR = 1.16; 95% CI 1.02 to 1.3, p=0.022). However, after adjustment, the association was no longer present. The results showed that in the presence of other geriatric syndromes such as disability or depression, frailty did not show association with mistreatment in this population.

scholarly journals Examining core self-management skills among adolescents with celiac disease

2020 ◽  
pp. 135910532092230
Author(s):  
Sonya Meyer ◽  
Sara Rosenblum
Keyword(s):  
Celiac Disease ◽  
Executive Function ◽  
Cognitive Skills ◽  
Chronic Health Condition ◽  
Cross Sectional Study ◽  
Health Condition ◽  
Management Skills ◽  
Cross Sectional ◽  
Daily Food ◽  
Core Self

A strict gluten-free diet is the only treatment for celiac disease, and it is especially challenging among adolescents. Participation in food-related activities and self-managing the chronic health condition involve use of cognitive skills. This cross-sectional study examined how executive functions might be associated with participation in food-related activities. Adolescents aged 12–18 years ( N = 65; Mage = 14.67) with celiac were interviewed about participation, and their parents completed an executive function questionnaire. Poorer participation significantly correlated with poorer executive abilities. Identifying executive function profiles may contribute to understanding and advancing resourceful daily functioning and participation in daily food-related activities.

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