scholarly journals The association between psychological distress in mid-life and hospital-based multimorbidity

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Johnston ◽  
C Black ◽  
S W Mercer
Keyword(s):  
Psychological Distress ◽  
Reference Group ◽  
General Health Questionnaire ◽  
Healthcare Services ◽  
Poor Mental Health ◽  
Older Age ◽  
Adult Body Mass ◽  
Course Variables ◽  
Screening For Psychological Distress ◽  
The Cost

Abstract Background Mental ill-health is common with significant impact on individuals and services. Using healthcare records to identify poor mental health missed individuals who do not seek healthcare treatment. A screening questionnaire (General Health Questionnaire (GHQ)) can detect psychological distress. However, before considering implementing such a screening tool, we need to understand if it detects those at high risk of experiencing poorer outcomes. Hospital-based multimorbidity is a rising healthcare challenge. The aim was to assess the prevalence of psychological distress in mid-life and its influence on hospital-based multimorbidity by older age in the Aberdeen Children of the 1950s (ACONF) cohort. Methods Prospective cohort study using ACONF. GHQ-4 was measured in mid-life from questionnaire. Multimorbidity (2 or more co-existing conditions) was measured using linked hospital records in older age (15 years after the questionnaire). The relationship between psychological distress (GHQ-4 score of 1 or more) and multimorbidity was assessed using logistic regression with adjustment for key life-course variables. Results Of 5,839 individuals (48% male, mean age 48), psychological distress prevalence was 20% and was associated with being female, lower childhood cognition, lower educational attainment, lower adult social class, unemployment, higher adult body mass index, smoking and alcohol misuse. In comparison to the asymptomatic reference group, the odds ratio for multimorbidity in older age in those with psychological distress was 2.2 (95% CI 1.8-2.7) in the unadjusted model. In the adjusted model this was 1.4 (95% CI 1.1-1.8). Conclusions 1 in 5 individuals in the general population in mid-life had psychological distress. This was associated with hospital-based multimorbidity by older age. Intervening early could reduce costs to both individuals and healthcare services. The next step is research of the cost-effectiveness of population screening for psychological distress. Key messages Psychological distress in mid-life is associated with hospital-based multimorbidity by older age. Screening for psychological distress early in life should be explored as an intervention to reduce costs to individuals and healthcare services.

Marginal assessment of the cost and benefits of aphasia treatment: Evidence from community-based telerehabilitation treatment for aphasia

2021 ◽  
pp. 1357633X2098277
Author(s):  
Molly Jacobs ◽  
Patrick M Briley ◽  
Heather Harris Wright ◽  
Charles Ellis
Keyword(s):  
Cost Effectiveness ◽  
Economies Of Scale ◽  
Reference Group ◽  
Unit Cost ◽  
Community Based ◽  
Face To Face ◽  
Conduction Aphasia ◽  
Aphasia Treatment ◽  
The Cost ◽  
The Relationship

Introduction Few studies have reported information related to the cost-effectiveness of traditional face-to-face treatments for aphasia. The emergence and demand for telepractice approaches to aphasia treatment has resulted in an urgent need to understand the costs and cost-benefits of this approach. Methods Eighteen stroke survivors with aphasia completed community-based aphasia telerehabilitation treatment, utilizing the Language-Oriented Treatment (LOT) delivered via Webex videoconferencing program. Marginal benefits to treatment were calculated as the change in Western Aphasia Battery-Revised (WAB-R) score pre- and post-treatment and marginal cost of treatment was calculated as the relationship between change in WAB-R aphasia quotient (AQ) and the average cost per treatment. Controlling for demographic variables, Bayesian estimation evaluated the primary contributors to WAB-R change and assessed cost-effectiveness of treatment by aphasia type. Results Thirteen out of 18 participants experienced significant improvement in WAB-R AQ following telerehabilitation delivered therapy. Compared to anomic aphasia (reference group), those with conduction aphasia had relatively similar levels of improvement whereas those with Broca’s aphasia had smaller improvement. Those with global aphasia had the largest improvement. Each one-point of improvement cost between US$89 and US$864 for those who improved (mean = US$200) depending on aphasia type/severity. Discussion Individuals with severe aphasia may have the greatest gains per unit cost from treatment. Both improvement magnitude and the cost per unit of improvement were driven by aphasia type, severity and race. Economies of scale to aphasia treatment–cost may be minimized by treating a variety of types of aphasia at various levels of severity.

scholarly journals Analysis of Annual Costs of Mobile Clinics in the Southern United States

2020 ◽  
Vol 11 ◽  
pp. 215013272098062
Author(s):  
Sharon Attipoe-Dorcoo ◽  
Rigoberto Delgado ◽  
Dejian Lai ◽  
Aditi Gupta ◽  
Stephen Linder
Keyword(s):  
Primary Care ◽  
Healthcare Services ◽  
Medicare Beneficiaries ◽  
Mobile Clinic ◽  
Efficient Manner ◽  
Healthcare Facilities ◽  
Capital Costs ◽  
At Risk Populations ◽  
Mobile Clinics ◽  
The Cost

Introduction Mobile clinics provide an efficient manner for delivering healthcare services to at-risk populations, and there is a need to understand their economics. This study analyzes the costs of operating selected mobile clinic programs representing service categories in dental, dental/preventive, preventive care, primary care/preventive, and mammography/primary care/preventive. Methods The methodology included a self-reported survey of 96 mobile clinic programs operating in Texas, North Carolina, Georgia, and Florida; these states did not expand Medicaid and have a large proportion of uninsured individuals. Data were collected over an 8-month period from November 2016 to July 2017. The cost analyses were conducted in 2018, and were analyzed from the provider perspective. The average annual estimated costs; as well the costs per patient in each mobile clinic program within different service delivery types were assessed. Costs reported in the study survey were classified into recurrent direct costs and capital costs. Results Results indicate that mean operating costs range from about $300 000 to $2.5 million with costs increasing from mammography/primary care/preventive delivery to dental/preventive. The majority of mobile clinics provided dental care followed by dental/preventive. The cost per patient visit for all mobile clinic service types ranged from $65 to $529, and appears to be considerably less than those reported in the literature for fixed clinic services. Conclusion The overall costs of all delivery types in mobile clinics were lower than the costs of providing care to Medicare beneficiaries in federally funded health centers, making mobile clinics a sound economic complement to stationary healthcare facilities.

scholarly journals Design and Adoption of Low-Cost Point-of-Care Diagnostic Devices: Syrian Case

Micromachines ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 882
Author(s):  
M. Munzer Alseed ◽  
Hamzah Syed ◽  
Mehmet Cengiz Onbasli ◽  
Ali K. Yetisen ◽  
Savas Tasoglu
Keyword(s):  
Civil Wars ◽  
Healthcare Workers ◽  
New Technologies ◽  
Point Of Care ◽  
Low Cost ◽  
Healthcare Services ◽  
Efficient Solutions ◽  
Humanitarian Crises ◽  
Technology Experience ◽  
The Cost

Civil wars produce immense humanitarian crises, causing millions of individuals to seek refuge in other countries. The rate of disease prevalence has inclined among the refugees, increasing the cost of healthcare. Complex medical conditions and high numbers of patients at healthcare centers overwhelm the healthcare system and delay diagnosis and treatment. Point-of-care (PoC) testing can provide efficient solutions to high equipment cost, late diagnosis, and low accessibility of healthcare services. However, the development of PoC devices in developing countries is challenged by several barriers. Such PoC devices may not be adopted due to prejudices about new technologies and the need for special training to use some of these devices. Here, we investigated the concerns of end users regarding PoC devices by surveying healthcare workers and doctors. The tendency to adopt PoC device changes is based on demographic factors such as work sector, education, and technology experience. The most apparent concern about PoC devices was issues regarding low accuracy, according to the surveyed clinicians.

Using the 12-item General Health Questionnaire to screen psychological distress from survivorship to end-of-life care: dimensionality and item quality

2011 ◽  
Vol 21 (9) ◽  
pp. 954-961 ◽  
Author(s):  
Wei Gao ◽  
Daniel Stark ◽  
Michael I. Bennett ◽  
Richard J. Siegert ◽  
Scott Murray ◽  
...  
Keyword(s):  
Psychological Distress ◽  
End Of Life ◽  
End Of Life Care ◽  
General Health ◽  
General Health Questionnaire ◽  
Life Care ◽  
Health Questionnaire ◽  
Item Quality

Mental Health Status of a Latin American Community in New South Wales

1996 ◽  
Vol 30 (4) ◽  
pp. 457-462 ◽  
Author(s):  
Robert McDonald ◽  
Carmen Vechi ◽  
Jenny Bowman ◽  
Robert Sanson-Fisher
Keyword(s):  
Psychological Distress ◽  
Latin American ◽  
Employment Status ◽  
New South ◽  
General Health Questionnaire ◽  
New South Wales ◽  
Independent Variables ◽  
South Wales ◽  
Threshold Score ◽  
Hunter Region

Objective: To determine the levels and predictors of psychological distress within a Latin American community in the Hunter region of New South Wales, Australia. Method: Participants (n=184) were interviewed in their homes by a bilingual interviewer using a specially prepared questionnaire and the General Health Questionnaire (GHQ-12). Results: Of the 13 independent variables examined, two demographic and two immigrant-related variables were significantly associated with an above-threshold score: marital status, employment status, perceived discrimination, and dissatisfaction with life in Australia. Conclusions: Compared to results from other community surveys, the levels of psychological distress within this Latin American community appear to be relatively high.

scholarly journals THU0548 THE ECONOMIC BURDEN OF ANKYLOSING SPONDYLITIS IN SPAIN. RESULTS OF THE SPANISH ATLAS 2017

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 514.2-514
Author(s):  
M. Merino ◽  
O. Braçe ◽  
A. González ◽  
Á. Hidalgo-Vega ◽  
M. Garrido-Cumbrera ◽  
...  
Keyword(s):  
Health Care ◽  
Ankylosing Spondylitis ◽  
Health Care Costs ◽  
Health Care Cost ◽  
Labour Productivity ◽  
General Health Questionnaire ◽  
Indirect Costs ◽  
Productivity Losses ◽  
The Cost ◽  
Care Costs

Background:Ankylosing Spondylitis (AS) is a disease associated with a high number of comorbidities, chronic pain, functional disability, and resource consumption.Objectives:This study aimed to estimate the burden of disease for patients diagnosed with AS in Spain.Methods:Data from 578 unselected patients with AS were collected in 2016 for the Spanish Atlas of Axial Spondyloarthritis via an online survey. The estimated costs were: Direct Health Care Costs (borne by the National Health System, NHS) and Direct Non-Health Care Costs (borne by patients) were estimated with the bottom-up method, multiplying the resource consumption by the unit price of each resource. Indirect Costs (labour productivity losses) were estimated using the human capital method. Costs were compared between levels of disease activity using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score (<4 or low inflammation versus ≥4 or high inflammation) and risk of mental distress using the 12-item General Health Questionnaire (GHQ-12) score (<3 or low risk versus ≥3 or high risk).Results:The average annual cost per patient with AS in 2015 amounted to €11,462.3 (± 13,745.5) per patient. Direct Health Care Cost meant an annual average of €6,999.8 (± 9,216.8) per patient, to which an annual average of €611.3 (± 1,276.5) per patient associated with Direct Non-Health Care Cost borne by patients must be added. Pharmacological treatment accounted for the largest percentage of the costs borne by the NHS (64.6%), while for patients most of the cost was attributed to rehabilitative therapies and/or physical activity (91%). The average annual Indirect Costs derived from labour productivity losses were €3,851.2 (± 8,484.0) per patient, mainly associated to absenteeism. All categories showed statistically significant differences (p<0.05) between BASDAI groups (<4 vs ≥4) except for the Direct Non-Healthcare Cost, showing a progressive rise in cost from low to high inflammation. Regarding the 12-item General Health Questionnaire (GHQ-12), all categories showed statistically significant differences between GHQ-12 (<3 vs ≥3), with higher costs associated with higher risk of poor mental health (Table 1).Table 1.Average annual costs per patient according to BASDAI and GHQ-12 groups (in Euros, 2015)NDirect Health CostsDirect Non-Health CostsIndirect CostsTotal CostBASDAI<4917,592.0*557.32,426.5*10,575.8*≥43769,706.9*768.05,104.8*15,579.7*Psychological distress (GHQ-12)<31468,146.8*493.6*3,927.2*12,567.6*≥32609,772.9*807.2*4,512.3*15,092.5*Total5786,999.8611.33,851.211,462.3* p <0.05Conclusion:Direct Health Care Costs, and those attributed to pharmacological treatment in particular, accounted for the largest component of the cost associated with AS. However, a significant proportion of the overall costs can be further attributed to labour productivity losses.Acknowledgments:Funded by Novartis Farmacéutica S.A.Disclosure of Interests:María Merino: None declared, Olta Braçe: None declared, Almudena González: None declared, Álvaro Hidalgo-Vega: None declared, Marco Garrido-Cumbrera: None declared, Jordi Gratacos-Masmitja Grant/research support from: a grant from Pfizzer to study implementation of multidisciplinary units to manage PSA in SPAIN, Consultant of: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly

scholarly journals Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 888
Author(s):  
Leopoldo Sdino ◽  
Andrea Brambilla ◽  
Marta Dell’Ovo ◽  
Benedetta Sdino ◽  
Stefano Capolongo
Keyword(s):  
Healthcare Services ◽  
Construction Cost ◽  
Design Stage ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Early Design Stage ◽  
Hospital Facility ◽  
Italian Context ◽  
The Cost ◽  
Cost Components

The need for 24/7 operation, and the increasing requests of high-quality healthcare services contribute to framing healthcare facilities as a complex topic, also due to the changing and challenging environment and huge impact on the community. Due to its complexity, it is difficult to properly estimate the construction cost in a preliminary phase where easy-to-use parameters are often necessary. Therefore, this paper aims to provide an overview of the issue with reference to the Italian context and proposes an estimation framework for analyzing hospital facilities’ construction cost. First, contributions from literature reviews and 14 case studies were analyzed to identify specific cost components. Then, a questionnaire was administered to construction companies and experts in the field to obtain data coming from practical and real cases. The results obtained from all of the contributions are an overview of the construction cost components. Starting from the data collected and analyzed, a preliminary estimation tool is proposed to identify the minimum and maximum variation in the cost when programming the construction of a hospital, starting from the feasibility phase or the early design stage. The framework involves different factors, such as the number of beds, complexity, typology, localization, technology degree and the type of maintenance and management techniques. This study explores the several elements that compose the cost of a hospital facility and highlights future developments including maintenance and management costs during hospital facilities’ lifecycle.

Psychological Well-being and Active Ageing: Maintaining Quality of Life in Older Age

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
T. McFarquhar ◽  
A. Bowling
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
General Health Questionnaire ◽  
Well Being ◽  
Poor Mental Health ◽  
Postal Survey ◽  
Active Ageing ◽  
Psychological Well Being ◽  
British Sample

Aims:To investigate the relationship between psychological well-being and measures of active ageing in a British sample of older people. Active ageing is the process of optimising opportunities for health, participation and security to embrace quality of life as people age.Methods:A national survey of quality of life and psychological well-being including 999 people aged ≥65 years living in private households in Britain commenced in 1999. in the most recent follow up of 2007, 323 survivors aged ≥72 years completed a postal survey regarding their quality of life and specifically the process of active ageing. A subset of 42 participants was also interviewed qualitatively in 2008 about their perceptions of active ageing. Psychological well-being at baseline was measured using the 12 item General Health Questionnaire (GHQ12) and correlated with measures of active ageing at baseline and in subsequent follow ups. Measures of active ageing included number and frequency of leisure and social activities, physical ability and access to support networks.Results:A significant positive relationship between psychological well being and measures of active ageing was found at baseline (p< 0.05). Measure of active ageing in 2007 were also correlated with psychological well-being at baseline (p< 0.05). Qualitative interviews in 2008 provided additional insights into this relationship.Conclusions:Results suggesting a strong relationship between psychological health and ageing actively. Good psychological health may allow the elderly to maintain an active and fulfilling lifestyle and reduce isolation and dependence, which in turn may protect against some aspects of poor mental health.

Importance of Behavioral and Psychological Symptoms of Dementia in Primary Care

2000 ◽  
Vol 12 (S1) ◽  
pp. 67-72 ◽  
Author(s):  
William H. Coleman
Keyword(s):  
United States ◽  
Primary Care ◽  
Psychological Distress ◽  
Direct Relationship ◽  
Psychological Symptoms ◽  
The United States ◽  
Comprehensive Treatment ◽  
The Cost ◽  
Number Of Individuals ◽  
Behavioral And Psychological Symptoms

There is a direct relationship between years lived beyond age 65 and the number of individuals diagnosed with dementia, primarily Alzheimer's disease (AD). The occurrence of AD has no socioeconomic, geographical, or ethnic limitations. The problem is worldwide. Its magnitude is demonstrated by the following facts: (a) approximately 6% to 8% of persons 65 years or older have AD, and the prevalence of the disease doubles each 5 years after 60 years of age; (b) 30% of 85-year-old individuals can be expected to have the disease; (c) AD affects an estimated 4 million people in the United States, and is expected to affect approximately 14 million Americans within the next few decades; (d) AD patients average 6 to 10 years of comprehensive treatment from symptom onset to death; (e) AD is the fourth leading cause of mortality among elderly Americans, more than 100,000 each year; (f) caregiver attempts at management of the behavioral and psychological symptoms of AD result in up to 50% developing significant psychological distress themselves; and (g) the cost for the management of AD patients is estimated to be between US $80 billion and US $120 billion annually. Primary care is essential for the appropriate diagnosis and treatment of the complex set of behavioral and psychological symptoms of dementia (BPSD) associated with AD.

First-Time Fathers’ Study: Psychological Distress in Expectant Fathers During Pregnancy

2007 ◽  
Vol 41 (9) ◽  
pp. 718-725 ◽  
Author(s):  
Philip Boyce ◽  
John Condon ◽  
Jodi Barton ◽  
Carolyn Corkindale
Keyword(s):  
Social Support ◽  
Psychological Distress ◽  
Psychological Functioning ◽  
General Health Questionnaire ◽  
First Trimester ◽  
Psychological Variables ◽  
Pregnancy And Childbirth ◽  
Expectant Fathers ◽  
Excess Number

Objective: High levels of distress have previously been reported among expectant fathers, with the level of distress for new fathers falling after the birth and during the first year of their infants’ lives. The aim of the present study was to report on the associations with the fathers’ initial high levels of distress. Method: The men completed a series of questionnaires on various aspects of their psychological functioning at a baseline assessment when their partners were in the late first trimester of their pregnancy. The General Health Questionnaire-28 (GHQ-28) was the key measure of psychological distress for the present study. Men scoring >5 on the GHQ were considered to be cases of distress. The cases and non-cases were contrasted on the baseline psychosocial measures. Results: A total of 312 men completed the questionnaires, of whom 18.6% were designated as cases. GHQ caseness was associated with high levels of symptoms on other measures of psychological distress, higher levels of alcohol consumption, poorer quality of their current intimate relationship, poorer social support, a lower quality of life, high levels of neuroticism and the use of immature ego defences. Multiple regression analysis identified the key variables associated with psychological distress to be high levels of neuroticism, dissatisfaction with social support and an excess number of additional life events. Conclusions: Psychological distress among expectant fathers is associated with a range of psychological variables, particularly poor marital relationship and poor social networks. This is consistent with a general vulnerability model for psychological distress. Fathers who had insufficient information about pregnancy and childbirth were also at risk of being distressed, suggesting that more attention needs to be paid to providing information to men about their partner's pregnancy, childbirth and issues relating to caring for a newborn infant.

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