scholarly journals Changes in Health Care Use by Mexican American Medicare Beneficiaries Before and After a Diagnosis of Dementia

2020 ◽  
Author(s):  
Brian Downer ◽  
Soham Al Snih ◽  
Lin-Na Chou ◽  
Yong-Fang Kuo ◽  
Mukaila Raji ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Mexican Americans ◽  
Mexican American ◽  
Health Care Use ◽  
Care Utilization ◽  
Medicare Beneficiaries ◽  
Physician Visits ◽  
Piecewise Regression ◽  
Before And After

Abstract Background Evidence from predominantly non-Hispanic White cohorts indicates health care utilization increases before Alzheimer’s disease and related dementias (ADRD) is diagnosed. We investigated trends in health care utilization by Mexican American Medicare beneficiaries before and after an incident diagnosis of ADRD. Methods Data came from the Hispanic Established Populations for the Epidemiological Study of the Elderly that has been linked with Medicare claims files from 1999 to 2016 (n = 558 matched cases and controls). Piecewise regression and generalized linear mixed models were used to compare the quarterly trends in any (ie, one or more) hospitalizations, emergency room (ER) admissions, and physician visits for 1 year before and 1 year after ADRD diagnosis. Results The piecewise regression models showed that the per-quarter odds for any hospitalizations (odds ratio [OR] = 1.62, 95% CI = 1.43–1.84) and any ER admissions (OR = 1.40, 95% CI = 1.27–1.54) increased before ADRD was diagnosed. Compared to participants without ADRD, the percentage of participants with ADRD who experienced any hospitalizations (27.2% vs 14.0%) and any ER admissions (19.0% vs 11.7%) was significantly higher at 1 quarter and 3 quarters before ADRD diagnosis, respectively. The per-quarter odds for any hospitalizations (OR = 0.88, 95% CI = 0.80–0.97) and any ER admissions (OR = 0.89, 95% CI = 0.82–0.97) decreased after ADRD was diagnosed. Trends for any physician visits before or after ADRD diagnosis were not statistically significant. Conclusions Older Mexican Americans show an increase in hospitalizations and ER admissions before ADRD is diagnosed, which is followed by a decrease after ADRD diagnosis. These findings support the importance of a timely diagnosis of ADRD for older Mexican Americans.

scholarly journals Understanding Patients’ Decisions to Obtain Unplanned, High-Resource Health Care After Colorectal Surgery

2021 ◽  
pp. 104973232110024
Author(s):  
Stephanie T. Lumpkin ◽  
Eileen Harvey ◽  
Paul Mihas ◽  
Timothy Carey ◽  
Alessandro Fichera ◽  
...  
Keyword(s):  
Health Care ◽  
Colorectal Surgery ◽  
Health Care Utilization ◽  
Care Coordination ◽  
Health Care Use ◽  
Care Utilization ◽  
Discharge Instructions ◽  
Care Needs ◽  
High Resource ◽  
Optimal Health

Readmissions and emergency department (ED) visits after colorectal surgery (CRS) are common, burdensome, and costly. Effective strategies to reduce these unplanned postdischarge health care visits require a nuanced understanding of how and why patients make the decision to seek care. We used a purposefully stratified sample of 18 interview participants from a prospective cohort of adult CRS patients. Thirteen (72%) participants had an unplanned postdischarge health care visit. Participant decision-making was classified by methodology (algorithmic, guided, or impulsive), preexisting rationale, and emotional response to perceived health care needs. Participants voiced clear mental algorithms about when to visit an ED. In addition, participants identified facilitators and barriers to optimal health care use. They also identified tangible targets for health care utilization reduction efforts, such as improved care coordination with streamlined discharge instructions and improved communication with the surgical team. Efforts should be directed at improving postdischarge communication and care coordination to reduce CRS patients’ high-resource health care utilization.

scholarly journals Health Care Utilization and Cost Outcomes of a Comprehensive Dementia Care Program for Medicare Beneficiaries

2019 ◽  
Vol 179 (2) ◽  
pp. 161 ◽  
Author(s):  
Lee A. Jennings ◽  
Alison M. Laffan ◽  
Anna C. Schlissel ◽  
Erin Colligan ◽  
Zaldy Tan ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Care Program ◽  
Dementia Care ◽  
Care Utilization ◽  
Medicare Beneficiaries ◽  
Cost Outcomes

scholarly journals Health Care Utilization Among Texas Veterans Health Administration Enrollees Before and After Hurricane Harvey, 2016-2018

2021 ◽  
Vol 4 (12) ◽  
pp. e2138535
Author(s):  
Margaret Carrel ◽  
Gosia S. Clore ◽  
Seungwon Kim ◽  
Mary Vaughan Sarrazin ◽  
Eric Tate ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Veterans Health Administration ◽  
Care Utilization ◽  
Veterans Health ◽  
Health Administration ◽  
Before And After

Half-Managed Care

2015 ◽  
Vol 47 (3) ◽  
pp. 519-531
Author(s):  
Shou-Hsia Cheng ◽  
Chih-Ming Chang ◽  
Chi-Chen Chen ◽  
Chih-Yuan Shih ◽  
Shu-Ling Tsai
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Estimating Equation ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
The Novel ◽  
Minimal Impact ◽  
Physician Visits ◽  
Comparison Groups ◽  
Patient Model

In 2011, a novel capitation program was launched in Taiwan under its universal health insurance plan. This study aimed to assess the short-term impact of the program. Two hospitals in the greater Taipei area, one participating in the “loyal patient” model (13,319 enrollees) and one in the “regional resident” model (13,768 enrollees), were analyzed. Two comparison groups were selected by propensity score matching. Generalized estimating equation models with differences-in-differences analysis were used to examine the net effects of the capitation program on health care utilization, expenses, and outcomes. Enrollees in the loyal patient model had fewer physician visits in the host hospital, but more physician visits outside that hospital during the program year than they had the year before. Compared with non-enrollees, the loyal patient model enrollees incurred fewer physician visits (β = −0.042, p < .001), fewer emergency department visits, (β = −0.140, p < .001), and similar total expenses and outcome. For the regional resident model, no differences were found in the number of physician visits, expenses, or outcomes between enrollees and non-enrollees. The novel capitation models in Taiwan had minimal impact on health care utilization after 1 year of implementation and the health care outcome was not compromised.

scholarly journals PMH43 HEALTH CARE UTILIZATION OF PATIENTS WITH DEPRESSION BEFORE AND AFTER INTIATING DULOXETINE

2010 ◽  
Vol 13 (7) ◽  
pp. A453
Author(s):  
N Shi ◽  
E Durden ◽  
Z Cao ◽  
A Torres ◽  
M Happich
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Before And After

scholarly journals ME4 THE IMPACT OF MEDICARE PART D ON HEALTH CARE UTILIZATION AND HEALTH OF THE MEDICARE BENEFICIARIES

2010 ◽  
Vol 13 (3) ◽  
pp. A7
Author(s):  
FX Liu ◽  
GC Alexander ◽  
SY Crawford ◽  
AS Pickard ◽  
DR Hedeker ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Medicare Part D ◽  
Medicare Part ◽  
Care Utilization ◽  
Medicare Beneficiaries ◽  
Part D ◽  
The Impact

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

2006 ◽  
Vol 14 (4) ◽  
pp. 392-410 ◽  
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.

scholarly journals The impact of marital status on health care utilization among Medicare beneficiaries

Medicine ◽  
2019 ◽  
Vol 98 (12) ◽  
pp. e14871 ◽  
Author(s):  
Kiran Raj Pandey ◽  
Fan Yang ◽  
Kathleen A. Cagney ◽  
Fabrice Smieliauskas ◽  
David O. Meltzer ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Marital Status ◽  
Care Utilization ◽  
Medicare Beneficiaries ◽  
The Impact
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