scholarly journals Health needs assessment for elderly in primary health care in Zagreb

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Polic-Vizintin ◽  
M Marić Bajs ◽  
I Portolan Pajić ◽  
J Tucak ◽  
Z Šostar
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Population ◽  
Intervertebral Disk ◽  
Health Needs ◽  
Health Care Needs ◽  
Care Needs ◽  
Primary Health ◽  
Hypertensive Diseases ◽  
Circulatory Diseases

Abstract Background The purpose of any health system is to guarantee access to care for the entire population served. Zagreb population is 'very old', with 17.3% older than 65. The aim is to assess health care needs for elderly in primary health care (PHC). Methods Data on morbidity and visits are recorded in PHC facilities Variation in the mortality rate in 1971-2014 period is analyzing, using descriptive method. Results The highest index of PHC utilization (88.1%) is recorded for the +65 age, with 14.3 visits per capita (vs 7.7 for general population). Acute respiratory infections ranked first in all age groups; the rate per 100 was considerably lower in the ≥65 group than in the 0-19 group (27.82/100 vs 111.20/100). Hypertensive diseases ranked second most common (23.09 per 100) in the age group ≥65, followed by intervertebral disk diseases and other dorsopathies (15.10/100), and neuroses and affective disorders (6.63/100). The prevalence of hypertensive diseases and of intervertebral disk diseases and other dorsopathies was significantly higher in the ≥65 group (χ2=27.3 and χ2=13.43, respectively; p < 0.05 both). Among mortality causes circulatory diseases and neoplasms showes a constant rise during the period 1971-2014 (circulatory diseases 26.4%; neoplasms 83.9%). The highest rise is recorded in group of endocrine and metabolic disease owing diabetes mellitus(159%). Conclusions Many of older people although independent, have multiple chronic conditions and meet criteria for fraility. The number of PHC visits is high, twice in comparison with general population. Health needs are very related to coping with appropriate organization and management of public health services, esspecially of senior- friendly primary care concept. Key messages The aging of the general population influences the type of morbidity and health care needs. The concept of senior-friendly primary care has to be promoted.

scholarly journals Developing population segments with different levels of complexity and primary health care needs: An analysis using health administrative data in British Columbia, Canada

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Julia Langton ◽  
Sabrina Wong ◽  
Sandra Peterson ◽  
Kim McGrail
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Administrative Data ◽  
Health Care Needs ◽  
Care Needs ◽  
Health Administrative Data ◽  
Population Segmentation ◽  
Primary Health

ABSTRACTObjectivesPopulation subgroups can be been used organize health services and understand the quality of health care. Most commonly, populations are have been by specific diseases (e.g., health care received by diabetes patients), patient age (e.g., elderly populations), or life-stage (e.g., end-of-life care). However, these subgroups may not adequately capture the complexity and/or health care needs of different patient groups (e.g., multi-morbidity, frail elderly). Our objective is to use health administrative data to develop population segments based on patients’ primary health care needs.  ApproachOur development process occurred in three stages. First, we examined examples of population segmentation in the peer reviewed and grey literature to develop principles for our population segments. Second, we held a workshop with primary care patients, decision-makers, clinicians and researchers to seek their input on important considerations for the population segments. Third, we used health administrative data (physician claims, hospitalisations) to develop population segments for the British Columbia (BC, Canada) population. Segments were based on diagnosis codes over a two year period; for each segment we examined health care use and costs, overall and by service type, in 2014-15. ResultsWe designed our segments to be mutually exclusive, capture the vast majority of people who use primary care services, and range from healthy patients (fewer primary care needs) to more complex patients (more extensive needs). Stakeholders were supportive of population segmentation approach and suggested incorporating patient vulnerability and primary care involvement such that segments would range from patients whose needs could be fully met in primary care to those who require additional services such as specialists/acute care. Our first iteration includes three segments: stable (≤1 chronic condition, needs met by primary care); multi-morbid (≥2 chronic conditions, needs mostly met by primary care); and complex (≤1 chronic condition and presence of a health care event associated with the management of this condition suggesting the patients’ needs not fully met by primary care). ConclusionWe developed population segments designed to account for patient complexity and primary health care needs; as such, segments provide more information than traditional indices of morbidity burden based on counts of chronic conditions. These segments will be used to report information on the quality of primary care. We plan to include conduct validation studies using additional variables (e.g, socio-economic factors, level of vulnerability from patient surveys) so that segments more accurately represent the level of complexity and patients’ primary health care needs.

scholarly journals Therapeutic budget modelling: a possible road to budgetary allocations in the public health care setting

2007 ◽  
Vol 12 (2) ◽  
Author(s):  
George K John ◽  
Martie S Lubbe ◽  
Jan HP Serfontein
Keyword(s):  
Public Health ◽  
Health Care ◽  
Care Setting ◽  
Public Health Care ◽  
Health Care Needs ◽  
Care Needs ◽  
The Public ◽  
Primary Health ◽  
Health Care Structure ◽  
Care Structure

In South Africa, 70% of the country’s population is dependent on the public health care sector (especially the primary health care structure) for their basic health care needs. Opsomming In Suid-Afrika is 70% van die land se bevolking van die openbare gesondheidsorgsektor (veral die primêre gesondheidsorgstruktuur) afhanklik vir hulle basiese behoeftes aan gesondheidsorg. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

scholarly journals Improving Health Care Management in Primary Care for Homeless People: A Literature Review

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Jego ◽  
J Abcaya ◽  
C Calvet-montredon ◽  
S Gentile
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
General Population ◽  
Literature Review ◽  
Care Management ◽  
Multidisciplinary Approach ◽  
Homeless People ◽  
Primary Health

Abstract Background Homeless people have poorer health status than the general population. They need complex care management, because of associated medical troubles (somatic and psychiatric) and social difficulties. However, they face multiple difficulties in accessing primary health care and receive less preventive health care than the general population. Methods We performed a literature review that included articles which described and evaluated primary care programs for homeless people. We searched into the MEDLINE, PsycINFO, COCHRANE library, and Cairn.info databases primary articles published between 1 January 2012 and 15 December 2016. We also performed a grey literature search, and we added relative articles as we read the references of the selected articles. We described the main characteristics of the primary care programs presented in the selected articles. Then we classified these characteristics in main categories, as a descriptive thematic analysis. Secondarily, we synthetized the main results about the evaluation of each intervention or organization. Results Most of the programs presented a team-based approach, multidisciplinary and/or integrated care. They often proposed co-located services between somatic health services, mental health services and social support services. They also tried to answer to the specific needs of homeless people. Some characteristics of these programs were associated with significant positive outcomes: tailored primary care organizations, clinic orientation, multidisciplinary team-based models which included primary care physicians and clinic nurses, integration of social support, and engagement in the community’s health. Conclusions Primary health care programs that aimed at taking care of the homeless people should emphasize a multidisciplinary approach and should consider an integrated (mental, somatic and social) care model. Key messages To improve the health care management of homeless people it seems necessary to priorize multidisciplinary approach, integrated care, involve community health and answer their specific needs. It is necessary to evaluate more non-tailored primary care programs that collaborate with tailored structures.

scholarly journals UNDERSTANDING DEMENTIA PREVALENCE AND HEALTH CARE USE PATTERNS IN RURAL NORTH CAROLINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S904-S905
Author(s):  
Amanda N Grant ◽  
Tsai-Ling Liu ◽  
Nigel L Rozario ◽  
Deanna A Mangieri ◽  
Jennifer M Woodward ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
North Carolina ◽  
Health Care Use ◽  
Health Care Needs ◽  
Care Needs ◽  
Dementia Prevalence ◽  
Care Services ◽  
Dementia Patients ◽  
Acute Care Services

Abstract Rural and remote communities have limited access to high quality dementia care, prompting a need for innovative solutions to meet the health care needs of affected older adults. As part of a study aimed at implementing a telehealth intervention for primary care patients with dementia in two rural North Carolina counties, we examined baseline dementia prevalence and compared health care use between patients with and without dementia. Electronic health records from January 2018 to December 2018 were examined for 2,288 patients aged 65 or older. A zero-inflated Poisson regression model was used to compare healthcare use between patients with and without dementia adjusting for patients’ demographic and clinical characteristics. Dementia prevalence was 8.7% based on diagnosis codes. Most patients with dementia were women (70%), not married (55%), Medicare-insured (78%), and had more comorbidities (mean: 2±2) than non-dementia patients. Dementia patients had a significantly higher number of primary care visits, emergency department visits, inpatient visits, and preventable hospitalizations than patients without dementia (risk ratio = 1.1, 1.8, 2.18, and 1.3, respectively; all P< 0.05). Dementia burden was higher among women and use of acute care services by patients with dementia in this rural setting was higher than patients without the disease, similar to urban settings. These findings suggest opportunities to improve care coordination and access to resources to help reduce the need for acute care services among patients with dementia and can help tailor interventions to address the health care needs of this group.

scholarly journals Unmet mental health needs in the general population: perspectives of Belgian health and social care professionals

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Eva Rens ◽  
Geert Dom ◽  
Roy Remmen ◽  
Joris Michielsen ◽  
Kris Van den Broeck
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
General Population ◽  
Mental Health Care ◽  
Unmet Needs ◽  
Health Needs ◽  
Mental Health Needs ◽  
Epidemiological Research ◽  
Unmet Mental Health

Abstract Background An unmet mental health need exists when someone has a mental health problem but doesn’t receive formal care, or when the care received is insufficient or inadequate. Epidemiological research has identified both structural and attitudinal barriers to care which lead to unmet mental health needs, but reviewed literature has shown gaps in qualitative research on unmet mental health needs. This study aimed to explore unmet mental health needs in the general population from the perspective of professionals working with vulnerable groups. Methods Four focus group discussions and two interviews with 34 participants were conducted from October 2019 to January 2020. Participants’ professional backgrounds encompassed social work, mental health care and primary care in one rural and one urban primary care zone in Antwerp, Belgium. A topic guide was used to prompt discussions about which groups have high unmet mental health needs and why. Transcripts were coded using thematic analysis. Results Five themes emerged, which are subdivided in several subthemes: (1) socio-demographic determinants and disorder characteristics associated with unmet mental health needs; (2) demand-side barriers; (3) supply-side barriers; (4) consequences of unmet mental health needs; and (5) suggested improvements for meeting unmet mental health needs. Conclusions Findings of epidemiological research were largely corroborated. Some additional groups with high unmet needs were identified. Professionals argued that they are often confronted with cases which are too complex for regular psychiatric care and highlighted the problem of care avoidance. Important system-level factors include waiting times of subsidized services and cost of non-subsidized services. Feelings of burden and powerlessness are common among professionals who are often confronted with unmet needs. Professionals discussed future directions for an equitable mental health care provision, which should be accessible and targeted at those in the greatest need. Further research is needed to include the patients’ perspective of unmet mental health needs.

Barriers to Care for Children and Youth With Special Health Care Needs

2011 ◽  
Vol 51 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Rishi Agrawal ◽  
Parag Shah ◽  
Kathy Zebracki ◽  
Kathy Sanabria ◽  
Claire Kohrman ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Special Health Care Needs ◽  
Children And Youth ◽  
Blood Glucose Monitoring ◽  
Health Care Needs ◽  
Care Needs ◽  
Special Health Care ◽  
Billing And Coding ◽  
Special Health

Objective. To assess primary care pediatricians’ (PCPs’) perceptions of caring for children and youth with special health care needs (CYSHCN). Methods. Cross-sectional survey of Illinois pediatricians. Results. Thirty-five percent of surveys were returned and 26% were analyzed. The top 3 perceived barriers were insufficient time (72%), insufficient reimbursement (68%), and lack of support services (59%). Insufficient interest was the least cited barrier (19%). Preparedness to perform tasks related to care of CYSHCN ranged from 89% for accessing early intervention services to 24% for billing and coding. The percentage of PCPs somewhat or very comfortable providing primary care to patients with technology dependence ranged from 75% for blood glucose monitoring to 12% for dialysis. Conclusions. The issues of time, reimbursement, billing, and coding are perceived as significant barriers to the care CYSHCN. There is substantial variation in PCPs’ comfort in the care of CYSHCN who require the assistance of medical technologies.

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