A systematic review of engagement in care and health care utilization among older adults living with HIV and non-communicable diseases

Abstract Background and Objectives This review synthesizes the current literature surrounding chronic disease outcomes after weather- and climate-related disasters among older adults. The associations between exposure of older adults to weather- and climate-related disasters and the primary outcomes of diabetes, end-stage renal disease (ESRD), congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD) were examined. Research Design and Methods A systematic review of studies reporting on clinical outcomes of four chronic diseases after disaster exposure was performed. Under the direction of an informationist, the databases PubMed, Scopus, EMBASE, and Web of Science (Science and Social Science Citation Index) were searched from inception to July 2019. Results Of 5,229 citations identified, 17 articles met the study criteria. Included articles were retrospective observational in nature and focused on earthquakes (24%, n = 4), hurricane (41%, n = 7), and wildfire (35%, n = 6) disasters. Outcome data by disease process included COPD (35%, n = 6), ESRD (41%, n = 7), CHF (24%, n = 4), and diabetes (29%, n = 5). Three main categories were identified: access to health care, postdisaster health care utilization, and study rigor. The age-stratified analyses reported in this review found multiple instances where disasters have limited or insignificant effects on older adults relative to younger populations. Discussion and Implications Disaster research faces unique methodological challenges, and there remains a need for data-driven conclusions on how best to care for older adults before, during, and after disasters. To encourage consistent dialogue among studies, we advocate for the use of rigorous and standardized scientific methodology to examine the health impacts of disasters on adults with chronic disease.

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Leisure-Time Physical Activity and Health-Care Utilization in Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.14.4.392 ◽

2006 ◽

Vol 14 (4) ◽

pp. 392-410 ◽

Cited By ~ 28

Author(s):

Michelle Y. Martin ◽

M. Paige Powell ◽

Claire Peel ◽

Sha Zhu ◽

Richard Allman

Keyword(s):

Physical Activity ◽

Older Adults ◽

Health Care ◽

Health Care Utilization ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Community Dwelling ◽

Care Utilization ◽

Physically Active ◽

Physician Visits

This study examined whether leisure-time physical activity (LTPA) was associated with health-care utilization in a racially diverse sample of rural and urban older adults. Community-dwelling adults (N= 1,000, 75.32 ± 6.72 years old) self-reported participating in LTPA and their use of the health-care system (physician visits, number and length of hospitalizations, and emergency-room visits). After controlling for variables associated with health and health-care utilization, older adults who reported lower levels of LTPA also reported a greater number of nights in the hospital in the preceding year. There was no support, however, for a relationship between LTPA and the other indicators of health-care utilization. Our findings suggest that being physically active might translate to a quicker recovery for older adults who are hospitalized. Being physically active might not only have health benefits for older persons but also lead to lower health-care costs.

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Depression and Health Care Utilization at End of Life Among Older Adults With Advanced Non–Small-Cell Lung Cancer

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2018.08.004 ◽

2018 ◽

Vol 56 (5) ◽

pp. 699-708.e1 ◽

Cited By ~ 7

Author(s):

Cara L. McDermott ◽

Aasthaa Bansal ◽

Scott D. Ramsey ◽

Gary H. Lyman ◽

Sean D. Sullivan

Keyword(s):

Lung Cancer ◽

Older Adults ◽

Health Care ◽

Health Care Utilization ◽

Small Cell Lung Cancer ◽

End Of Life ◽

Cell Lung Cancer ◽

Small Cell ◽

Care Utilization ◽

Small Cell Lung

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Economic burden of vertigo: a systematic review

Health Economics Review ◽

10.1186/s13561-019-0258-2 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 6

Author(s):

Eva Kovacs ◽

Xiaoting Wang ◽

Eva Grill

Keyword(s):

Systematic Review ◽

Health Care ◽

Economic Evaluation ◽

Health Care Utilization ◽

Economic Burden ◽

Population Based ◽

Care Utilization ◽

Vestibular Disease ◽

Societal Burden ◽

Vestibular Vertigo

Abstract Background Vertigo, a highly prevalent disease, imposes a rising burden on the health care system, exacerbated by the ageing of the population; and further, contributes to a wide span of indirect burden due to reduced capacity to work or need of assistance in activities of daily living. The aim of this review was to summarise the evidence on the economic burden of vertigo. Methods All original studies published between 2008 and 2018 about the economic evaluation of peripheral or central vestibular vertigo in developed countries were considered eligible, unrestricted to setting, health care provider, or study type. Results The electronic search in three databases identified 154 studies from which 16 qualified for inclusion. All studies presented partial economic evaluation referring to a variety of vestibular vertigo including unspecified vertigo. Nine studies presented monetised cost results and seven studies reported health care utilization. Direct costs derived mainly from repeated and not well-targeted consultations at all levels of health care, excessive use of diagnostic imaging, and/or of emergency care. Considerable societal burden was caused by decreased productivity, mainly due to work absenteeism. Conclusion To the best of our knowledge, this is the first systematic review of the existing evidence of the economic burden of vertigo. The lack of conclusive evidence revealed apparent targets of future research. First, studies of diagnostics and therapies for vestibular disease should include cost-effectiveness considerations. Population-based studies of health services utilization should include simple vestibular assessments to get more reliable estimates of the burden of disease and associated costs on the level of the general population. Further, clinical and population-based registries that include patients with vestibular disease, should consider collecting long-term data of societal burden. Primary data collection should increasingly include assessment of health care utilization e.g. by linking their diagnoses and outcomes to routine data from health insurances.

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PEER TO PEER SUPPORT AND HEALTH CARE UTILIZATION AMONG COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.3151 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S857-S857

Author(s):

Elizabeth A Jacobs ◽

Rebecca Schwei ◽

Scott Hetzel ◽

Jane Mahoney ◽

KyungMann Kim

Keyword(s):

Older Adults ◽

Health Care ◽

Emergency Department ◽

Health Care Utilization ◽

Peer Support ◽

Peer Group ◽

Peer To Peer ◽

Emergency Department Visits ◽

Urgent Care ◽

Care Utilization

Abstract The majority of older adults want to live and age in their communities. Some community-based organizations (CBOs) have initiated peer-to-peer support services to promote aging in place but the effectiveness of these programs is not clear. Our objective was to compare the effectiveness of a community-designed and implemented peer-to-peer support program vs. access to standard community services, in promoting health and wellness in vulnerable older adult populations. We partnered with three CBOs, one each in California, Florida, and New York, to enroll adults 65 > years of age who received peer support and matched control participants (on age, gender, and race/ethnicity) in an observational study. We followed participants over 12 months, collecting data on self-reported urgent care and emergency department visits and hospitalizations. In order to account for the lack of randomization, we used a propensity score method to compare outcomes between the two groups. We enrolled 222 older adults in the peer-to-peer group and 234 in the control group. After adjustment, we found no differences between the groups in the incidence of hospitalization, urgent and emergency department visits, and composite outcome of any health care utilization. The incidence of urgent care visits was statistically significantly greater in the standard community service group than in the peer-to-peer group. Given that the majority of older adults and their families want them to age in place, the question of how to do this is highly relevant. Peer-to-peer services may provide some benefit to older adults in regard to their health care utilization.

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