scholarly journals Telemedicine Use Among Older Adults During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 469-469
Author(s):  
Anita Szerszen ◽  
Yulia Kogan ◽  
Edith Burns
Keyword(s):  
Older Adults ◽  
Health Care ◽  
New York ◽  
Access To Health Care ◽  
Health Care Disparities ◽  
Age Groups ◽  
Older Individuals ◽  
Older Americans ◽  
York Metropolitan Area ◽  
Insurance Payer

Abstract Objective Although technology adoption among older adults is improving, ethnic minorities and those with socioeconomic disadvantages may have lower utilization of telemedicine. Here, we evaluate telemedicine uptake amongst community-based older adults. Materials and Methods Using a retrospective cohort design, we examined electronic medical records (EMR) for documentation of telemedicine use among patients > 65 years old at Geriatric practices in the New York metropolitan area from January-November 2020. Demographic details and insurance payer were captured for telemedicine visits and compared to in-person encounters. Multivariable regression was used to evaluate the association of demographic, socioeconomic factors and visit type. Results A total of 712 patients (32.3%) engaged in 1,085 telemedicine visits. Telemedicine represented 80% and 66% of all encounters during April and May, respectively and averaged 11.8% between June and November. Use was similar across age groups, gender, race and insurance payer status between telemedicine versus in-person encounters. Patients with greater number of comorbidities were more likely to use telemedicine-. Medicaid recipients had preference for video visits. 47.5% of patients who engaged in video visits had another person/family member present during an encounter. Conclusions Telemedicine augmented access to health care for older individuals during the peak of the COVID pandemic and continues to be utilized to improve access to care for older Americans. Given the distinct preference for video visits among patients with multiple medical conditions and those who have Medicaid, telemedicine has potential to serve as a tool to reduce enduring health care disparities beyond the pandemic.

scholarly journals An Overview of Cancer Health Disparities: New Approaches and Insights and Why They Matter

2020 ◽  
Author(s):  
Tsion Zewdu Minas ◽  
Maeve Kiely ◽  
Anuoluwapo Ajao ◽  
Stefan Ambs
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Social Stress ◽  
Access To Health Care ◽  
Health Care Disparities ◽  
Underserved Populations ◽  
Tumor Biology ◽  
Cultural Barriers ◽  
Cancer Therapies ◽  
Cancer Health Disparities

Abstract Cancer health disparities remain stubbornly entrenched in the US health care system. The Affordable Care Act was legislation to target these disparities in health outcomes. Expanded access to health care, reduction in tobacco use, uptake of other preventive measures and cancer screening, and improved cancer therapies greatly reduced cancer mortality among women and men and underserved communities in this country. Yet, disparities in cancer outcomes remain. Underserved populations continue to experience an excessive cancer burden. This burden is largely explained by health care disparities, lifestyle factors, cultural barriers, and disparate exposures to carcinogens and pathogens, as exemplified by the COVID-19 epidemic. However, research also shows that comorbidities, social stress, ancestral and immunobiological factors, and the microbiome, may contribute to health disparities in cancer risk and survival. Recent studies revealed that comorbid conditions can induce an adverse tumor biology, leading to a more aggressive disease and decreased patient survival. In this review, we will discuss unanswered questions and new opportunities in cancer health disparity research related to comorbid chronic diseases, stress signaling, the immune response, and the microbiome, and what contribution these factors may have as causes of cancer health disparities.

scholarly journals Effect of Demographic and Health Dynamics on Cognitive Status in Mexico between 2001 and 2015: Evidence from the Mexican Health and Aging Study

Geriatrics ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 63
Author(s):  
Silvia Mejia-Arango ◽  
Jaqueline Avila ◽  
Brian Downer ◽  
Marc A. Garcia ◽  
Alejandra Michaels-Obregon ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cognitive Impairment ◽  
Cardiovascular Diseases ◽  
Educational Attainment ◽  
Access To Health Care ◽  
Sociodemographic Factors ◽  
Cognitive Status ◽  
Access To Health ◽  
Mexican Adults

Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how sociodemographic factors, cardiovascular diseases, and their treatment relate to changes in cognitive function of Mexican adults aged 60 and older between 2001 and 2015. Self and proxy respondents were classified as dementia, cognitive impairment no dementia (CIND), and normal cognition. We use logistic regression models to examine the trends in dementia and CIND for men and women aged 60 years or older using pooled national samples of 6822 individuals in 2001 and 10,219 in 2015, and sociodemographic and health variables as covariates. We found higher likelihood of dementia and a lower risk of CIND in 2015 compared to 2001. These results remain after adjusting for sociodemographic factors, cardiovascular diseases, and their treatment. The improvements in educational attainment, treatment of diabetes and hypertension, and better access to health care in 2015 compared to 2001 may not have been enough to counteract the combined effects of aging, rural residence disadvantage, and higher risks of cardiovascular disease among older Mexican adults.

ActionHealthNYC: Effectiveness of a Health Care Access Program for the Uninsured, 2016‒2017

2021 ◽  
pp. e1-e10
Author(s):  
Rishi K. Sood ◽  
Jin Yung Bae ◽  
Adrienne Sabety ◽  
Pui Ying Chan ◽  
Caroline Heindrichs
Keyword(s):  
Public Health ◽  
Health Care ◽  
New York ◽  
Health Care Access ◽  
Access To Health Care ◽  
Controlled Trial ◽  
The Past ◽  
Care Access ◽  
State And Local ◽  
Access Program

Objectives. To evaluate the effectiveness of a novel health care access program (ActionHealthNYC) for uninsured immigrants. Methods. The evaluation was conducted as a randomized controlled trial in New York City from May 2016 through June 2017. Using baseline and follow-up survey data, we assessed health care access, patient experience, and health status. Results.At baseline, 25% of participants had a regular source of care; two thirds had visited a doctor in the past year and reported 2.5 visits in the past 12 months, on average. Nine to 12 months later, intervention participants were 1.2 times more likely to report having a primary care provider (58% vs 46%), were 1.2 times more likely to have seen a doctor in the past 9 months (91% vs 77%), and had 1.5 times more health care visits (4.1 vs 2.9) compared with control participants. Conclusions. ActionHealthNYC increased health care access among program participants. Public Health Implications. State and local policymakers should build on the progress that has been made over the last decade to expand and improve access to health care for uninsured immigrants. (Am J Public Health. Published online ahead of print June 10, 2021: e1–e10. https://doi.org/10.2105/AJPH.2021.306271 )

scholarly journals Older adults with disability in extreme poverty in Peru: How is their access to health care?

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0208441
Author(s):  
Oscar Flores-Flores ◽  
Ruth Bell ◽  
Rodney Reynolds ◽  
Antonio Bernabé-Ortiz
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Access To Health Care ◽  
Extreme Poverty ◽  
Access To Health

scholarly journals Health Outcomes After Disaster for Older Adults With Chronic Disease: A Systematic Review

2019 ◽  
Vol 60 (7) ◽  
pp. e535-e547 ◽  
Author(s):  
Sue Anne Bell ◽  
Jennifer Horowitz ◽  
Theodore J Iwashyna
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Health Care ◽  
Chronic Disease ◽  
Access To Health Care ◽  
Disease Process ◽  
Outcome Data ◽  
Care Utilization ◽  
Chronic Obstructive ◽  
Weather And Climate

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.

scholarly journals Automated Speech Recognition Systems and Older Adults: A Literature Review and Synthesis

2019 ◽  
Vol 63 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Lauren Werner ◽  
Gaojian Huang ◽  
Brandon J. Pitts
Keyword(s):  
Older Adults ◽  
Speech Recognition ◽  
Current Knowledge ◽  
Age Groups ◽  
Older Individuals ◽  
Age Related ◽  
Wide Range ◽  
Automated Speech Recognition ◽  
Technological Developments ◽  
Physical Changes

The number of older adults is growing significantly worldwide. At the same time, technological developments are rapidly evolving, and older populations are expected to interact more frequently with such sophisticated systems. Automated speech recognition (ASR) systems is an example of one technology that is increasingly present in daily life. However, age-related physical changes may alter speech production and limit the effectiveness of ASR systems for older individuals. The goal of this paper was to summarize the current knowledge on ASR systems and older adults. The PRISMA method was employed and 17 studies were compared on the basis of word error rate (WER). Overall, WER was found to be influenced by age, gender, and the number of speech samples used to train ASR systems. This work has implications for the development of future human-machine technologies that will be used by a wide range of age groups.

scholarly journals Timely Postpartum Visits for Low-Income Women: A Health System and Medicaid Payer Partnership

2020 ◽  
Vol 110 (S2) ◽  
pp. S215-S218 ◽  
Author(s):  
Elizabeth A. Howell ◽  
Amy Balbierz ◽  
Susan Beane ◽  
Rashi Kumar ◽  
Tom Wang ◽  
...  
Keyword(s):  
Health Care ◽  
New York ◽  
High Risk ◽  
Health Care System ◽  
Low Income ◽  
Access To Health Care ◽  
Health Care Services ◽  
Control Group ◽  
Postpartum Visit ◽  
Care System

A health care system and a Medicaid payer partnered to develop an educational intervention and payment redesign program to improve timely postpartum visits for low-income, high-risk mothers in New York City between April 2015 and October 2016. The timely postpartum visit rate was higher for 363 mothers continuously enrolled in the program than for a control group matched by propensity score (67% [243/363] and 56% [407/726], respectively; P < .001). An innovative partnership between a health care system and Medicaid payer improved access to health care services and community resources for high-risk mothers.

Traumatic Stress in Older Adults

2012 ◽  
pp. 118-127
Author(s):  
Joan M. Cook ◽  
Tatyana Biyanova ◽  
Diane L. Elmore
Keyword(s):  
Older Adults ◽  
World War Ii ◽  
Functional Impairment ◽  
Stress Disorder ◽  
Acute Stress ◽  
Age Groups ◽  
Care Utilization ◽  
Older Individuals ◽  
Delayed Recognition ◽  
The Impact

This chapter focuses on older adult trauma survivors. Information is presented on prevalence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD); course, functional impairment, suicide risk, and health care utilization in older adults with PTSD; and the impact of demographic factors such as gender, ethnicity, and race on PTSD in older individuals. In general, rates of ASD and PTSD are lower in older adults compared to other age groups. PTSD in older adults has been linked to suicidal ideation and attempts, functional impairment, physical health, and increased healthcare utilization. Although delayed onset of PTSD has been empirically verified in some military samples with World War II veterans and younger adult civilians, it is rare in the absence of any prior symptoms and might more accurately be labeled “delayed recognition.” More information on trauma and PTSD in diverse populations of older adults is needed, such as racial and ethnic minorities, those with severe physical or mental impairment, noncommunity-residing groups, and those from nonindustrialized countries.

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