scholarly journals The Andersen–Newman Behavioral Model of Health Service Use as a conceptual basis for understanding patient behavior within the patient–physician dyad: The influence of trust on adherence to statins in older people living with HIV and cardiovascular disease

2015 ◽  
Vol 2 (1) ◽  
pp. 1038894 ◽  
Author(s):  
Kimberly Petrovic ◽  
Thomas O. Blank
Keyword(s):  
Cardiovascular Disease ◽  
Health Service ◽  
Older People ◽  
Service Use ◽  
Behavioral Model ◽  
Health Service Use ◽  
People Living With Hiv ◽  
Conceptual Basis ◽  
Patient Behavior ◽  
Living With Hiv

scholarly journals A Qualitative Exploration of Facilitators for Health Service Use among Aging Gay Men Living with HIV

2019 ◽  
Vol 18 ◽  
pp. 232595821988056
Author(s):  
Daniel Colton Green ◽  
Elizabeth Mirizio Wheeler
Keyword(s):  
Health Service ◽  
Gay Men ◽  
Service Use ◽  
Behavioral Model ◽  
Predisposing Factors ◽  
Health Service Use ◽  
Enabling Factors ◽  
Hiv Management ◽  
The Face ◽  
Living With Hiv

Using Anderson’s Health Behavioral Model of Health Service Use, this study explores factors facilitating health service use among aging gay men living with HIV. Qualitative data from 10 participants recruited from a federally qualified health center were analyzed using theoretical thematic analysis. Results shown to facilitate health service use include an existing need for services in the form of HIV management; predisposing factors of age and the development of resilience in the face of stigmatizing experiences related to their sexual identity and health status; and enabling influences including comfort with medical providers, providers knowledgeable in lesbian, gay, bisexual, transgender, and queer issues, and sexual concordant providers. Need for services, predisposing factors, and enabling factors are discussed in relation, as well as each factor’s unique implications for this population. Results from this study may be used to improve service use and provides tangible clinical recommendations.

Vulnerable Older People in the Community: Relationship Between the Vulnerable Elders Survey and Health Service Use

2008 ◽  
Vol 56 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Hannah M. McGee ◽  
Ann O'Hanlon ◽  
Maja Barker ◽  
Anne Hickey ◽  
Anthony Montgomery ◽  
...  
Keyword(s):  
Health Service ◽  
Older People ◽  
Service Use ◽  
Health Service Use ◽  
Community Relationship

scholarly journals Retrospective cohort study of health service use for cardiovascular disease among adults with and without a record of injury hospital admission

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039104
Author(s):  
Sean M Randall ◽  
Fiona M Wood ◽  
Mark W Fear ◽  
James Boyd ◽  
Suzanne Rea ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Health Service ◽  
Beta Blocker ◽  
Retrospective Cohort ◽  
Service Use ◽  
Beta Blockers ◽  
Health Service Use ◽  
Post Injury ◽  
Prescription Rates

ObjectiveTo quantify postinjury cardiovascular-related health service use experienced by mid to older aged adults hospitalised for injury, compared with uninjured adults. Additionally, to explore the effect of beta-blocker medications on postinjury cardiovascular hospitalisations among injury patients, given the potential cardioprotective effects of beta blockers.DesignA retrospective cohort study using linked administrative and survey data.ParticipantsRecords of 35 026 injured and 60 823 uninjured matched adults aged over 45 from New South Wales, Australia, who completed the 45 and up survey.Primary and secondary outcome measuresAdmission rates and cumulative lengths of stay for cardiovascular hospitalisations, and prescription rates for cardiovascular medications. Negative binomial and Cox proportional hazards regression modelling were used to generate incident rate ratios (IRRs) and HR.ResultsCompared with the uninjured, those with injury had a 19% higher adjusted rate of postinjury cardiovascular admissions (IRR 1.19, 95% CI 1.14 to 1.25), spent 40% longer in hospital for ardiovascular disease (IRR 1.40, 95% CI 1.26 to 1.57) and had slightly higher cardiovascular prescription rates (IRR 1.04, 95% CI 1.02 to 1.06), during study follow-up. Those in the injury cohort that used beta blockers both prior to and after injury (continuous) appeared to have reduced need for post-injury cardiovascular hospitalisation (IRR 1.09, 95% CI 1.17 to 1.42) compared with those commencing on beta blockers after injury (after 30 days: IRR 1.69, 95% CI 1.37 to 2.08).ConclusionsApparent increased postinjury hospitalisation rates and prolonged length of stay related to cardiovascular disease suggest that injury patients may require clinical support for an extended period after injury. Additionally, injury patients who were on continuous beta blocker treatment appeared to have lower need for post-injury cardiovascular hospitalisations. However, the data do not allow us to draw clear conclusions and further clinical research is required.

scholarly journals Evidence assessment and narrative synthesis of the key characteristics of older people living in service-integrated housing facilities, and their ‘accommodation journey’

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Juliana Thompson ◽  
Michael Hill ◽  
Lesley Bainbridge ◽  
Daniel Cowie ◽  
Emma Flewers
Keyword(s):  
Health Service ◽  
Older People ◽  
Workforce Development ◽  
Service Use ◽  
Well Being ◽  
Health Service Use ◽  
Narrative Synthesis ◽  
Care Needs ◽  
Content Type ◽  
Key Characteristics

Purpose This paper aims to provide an evidence assessment and narrative synthesis of literature regarding the key characteristics of older people living in service-integrated housing (SIH) facilities and their “accommodation journey”. Design/methodology/approach A rapid evidence assessment was conducted: 22 research publications met the inclusion criteria and were analysed using narrative synthesis. Findings The quality of studies in this area is low, but consistency across components of the results of studies included in the review is apparent. Results suggest key characteristics of older people that drive moves into SIH are a decline in health, increased dependency, increased health service use and carer burden. Suggested key characteristics of SIH residents are high levels of health problems, dependency and health service use, but high self-reported health and well-being. Results indicate that the key driver for older people leaving SIH is a lack of workforce competency to manage further declines in health and dependency status. Research limitations/implications Current policy may not realise or account for the complex health and care needs of SIH residents. Investment into integrated care, robust community health services and workforce development to facilitate a comprehensive assessment approach may be required to support residents to remain in SIH and live well. Further longitudinal studies are required to map the progression of SIH residents’ health status in detail over time to provide an understanding of preventative and enablement support, development of care pathways and workforce planning and development requirements. Originality/value This evidence assessment is the first to consider the accommodation journey of older people residing in SIH.

scholarly journals Common elements of service delivery models that optimise quality of life and health service use among older people with advanced progressive conditions: a tertiary systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e048417
Author(s):  
Joanne Bayly ◽  
Anna E Bone ◽  
Clare Ellis-Smith ◽  
India Tunnard ◽  
Shuja Yaqub ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Health Service ◽  
Older People ◽  
Low Income ◽  
Service Use ◽  
Functional Decline ◽  
Low Income Countries ◽  
Health Service Use

IntroductionHealth and social care services worldwide need to support ageing populations to live well with advanced progressive conditions while adapting to functional decline and finitude. We aimed to identify and map common elements of effective geriatric and palliative care services and consider their scalability and generalisability to high, middle and low-income countries.MethodsTertiary systematic review (Cochrane Database of Systematic Reviews, CINAHL, Embase, January 2000–October 2019) of studies in geriatric or palliative care that demonstrated improved quality of life and/or health service use outcomes among older people with advanced progressive conditions. Using frameworks for health system analysis, service elements were identified. We used a staged, iterative process to develop a ‘common components’ logic model and consulted experts in geriatric or palliative care from high, middle and low-income countries on its scalability.Results78 studies (59 geriatric and 19 palliative) spanning all WHO regions were included. Data were available from 17 739 participants. Nearly half the studies recruited patients with heart failure (n=36) and one-third recruited patients with mixed diagnoses (n=26). Common service elements (≥80% of studies) included collaborative working, ongoing assessment, active patient participation, patient/family education and patient self-management. Effective services incorporated patient engagement, patient goal-driven care and the centrality of patient needs. Stakeholders (n=20) emphasised that wider implementation of such services would require access to skilled, multidisciplinary teams with sufficient resource to meet patients’ needs. Identified barriers to scalability included the political and societal will to invest in and prioritise palliative and geriatric care for older people, alongside geographical and socioeconomic factors.ConclusionOur logic model combines elements of effective services to achieve optimal quality of life and health service use among older people with advanced progressive conditions. The model transcends current best practice in geriatric and palliative care and applies across the care continuum, from prevention of functional decline to end-of-life care.PROSPERO registration numberCRD42020150252.

scholarly journals Cohort profile: the Comparative Outcomes And Service Utilization Trends (COAST) Study among people living with and without HIV in British Columbia, Canada

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019115 ◽  
Author(s):  
Oghenowede Eyawo ◽  
Mark W Hull ◽  
Kate Salters ◽  
Hasina Samji ◽  
Angela Cescon ◽  
...  
Keyword(s):  
Health Care ◽  
British Columbia ◽  
General Population ◽  
Health Service ◽  
Service Utilization ◽  
Service Use ◽  
Data Linkage ◽  
Health Care Use ◽  
Health Service Use ◽  
People Living With Hiv

PurposeThe Comparative Outcomes And Service Utilization Trends (COAST) Study in British Columbia (BC), Canada, was designed to evaluate the determinants of health outcomes and health care services use among people living with HIV (PLHIV) as they age in the period following the introduction of combination antiretroviral therapy (cART). The study also assesses how age-associated comorbidities and health care use among PLHIV may differ from those observed in the general population.ParticipantsCOAST was established through a data linkage between two provincial data sources: The BC Centre for Excellence in HIV/AIDS Drug Treatment Program, which centrally manages cART dispensation across BC and contains prospectively collected data on demographic, immunological, virological, cART use and other clinical information for all known PLHIV in BC; and Population Data BC, a provincial data repository that holds individual event-level, longitudinal data for all 4.6 million BC residents. COAST participants include 13 907 HIV-positive adults (≥19 years of age) and a 10% random sample inclusive of 516 340 adults from the general population followed from 1996 to 2013.Findings to dateFor all participants, linked individual-level data include information on demographics, health service use (eg, inpatient care, outpatient care and prescription medication dispensations), mortality, and HIV diagnostic and clinical data. Publications from COAST have demonstrated the significant mortality reductions and dramatic changes in the causes of death among PLHIV from 1996 to 2012, differences in the amount of time spent in a healthy state by HIV status, and high levels of injury and mood disorder diagnosis among PLHIV compared with the general population.Future plansTo capture the dynamic nature of population health parameters, regular data updates and a refresh of the data linkage are planned to occur every 2 years, providing the basis for planned analysis to examine age-associated comorbidities and patterns of health service use over time.

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