scholarly journals Comparison of Association Between Divorce and Access to Healthcare Services Among Married Immigrants

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 514-514
Author(s):  
Suyeong Bae ◽  
James Graham ◽  
Sanghun Nam ◽  
Ickpyo Hong
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Minority Population ◽  
Service Access ◽  
Family Dissolution ◽  
History Of ◽  
Multicultural Family

Abstract The number of married immigrants is increasing in Korea, and family dissolution is also growing in this population. Although divorce could impact immigrants' health status, it is unclear whether they have difficulties accessing healthcare and medical services. Thus, we examined whether divorce in married immigrants is independently associated with access to healthcare services. A retrospective analysis of 11,778 adults who participated in the 2018 National Multicultural Family Survey. We used three different covariate adjustment methods (multivariate logistic regression, inverse probability of treatment weighting, 1:1 greedy propensity score matching) to examine the association between divorce and access to healthcare services after accounting for various demographic and clinical characteristics. Overall, 5.8% (n = 691) of married immigrants reported a history of divorce. The divorce group included 107 (15.5%) males and 584 (84.5%) females, with an average age of 45.17 years (SD = 10.9). The non-divorced group included 1992 males (18.0%) and 9095 (82.0%) females, with an average age of 39.1 years (SD = 10.5). After propensity score matching, all variables were balanced (all p>0.05). Individuals who experienced divorce were more likely to have difficulties in healthcare service access than those who did not experience divorce (adjusted odds ratio 1.423, 95% CI [1.075, 1.882]). Our findings revealed that divorce increased the risk of limited healthcare services among immigrants in Korea. Healthcare policymakers should be aware of the healthcare access issues in this minority population. In addition, to improve the lifestyles of minority populations, it is necessary to study their overall lives.

scholarly journals Association Between Divorce and Access to Healthcare Services Among Married Immigrants: Propensity Score Approaches

2021 ◽  
Author(s):  
Suyeong Bae ◽  
James E. Graham ◽  
Sangun nam ◽  
Ickpyo Hong
Keyword(s):  
Propensity Score ◽  
Minority Groups ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Social Determinant ◽  
Access To Healthcare ◽  
Multivariable Logistic Regression Analysis ◽  
Minority Population ◽  
Health Providers ◽  
Data Set

Abstract Background: Research is needed to improve access to healthcare services by minority groups. The population of married immigrants is increasing rapidly in Korea. While divorce is a social determinant of health among married immigrans, it is not clear about its association with access to healthcare services. Therefore, we examined healthcare services utilization in married immigrants.Methods: We retrieved data from 11,778 adults in the 2018 Korea National Multicultural Family Survey. We used propensity score matching methods. We analyzed whether the sex of divorced immigrants is associated with healthcare access using multivariable logistic regression analysis. Further, we analyzed the association between divorce and access to healthcare services among married immigrants. Results: There were 691 (5.8%) divorced immigrants in the data set. The married male immigrants had no association between divorce status and healthcare access (adjusted odds ratio = 1.059, 95% confidence interval [CI]=0.552–2.033, p = 0.8620). Divorced immigrants were less likely to receive healthcare services than married immigrants (adjusted OR=1.42, 95% CI=1.06–1.88). Conclusion: Our findings revealed that divorce increased the risk of limited healthcare services among immigrants. Policymakers and health providers should be aware of these potential disparities in this vulnerable minority population.

scholarly journals Impact of household shocks on access to healthcare services in Kenya: a propensity score matching analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048189
Author(s):  
Purity Njagi ◽  
Wim Groot ◽  
Jelena Arsenijevic
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Social Protection ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Income Shocks ◽  
Health Seeking ◽  
Cross Sectional Survey ◽  
Causal Pathway ◽  
Household Shocks

ObjectiveThis study examines the effects of household shocks on access to healthcare services in Kenya. Shocks are adverse events that lead to loss of household income and/or assets.Design and settingThe study used data from the Kenya Integrated Household Budget Survey 2015/2016, a nationally representative cross-sectional survey. A propensity score matching approach was applied for the analysis.ParticipantsThe study sample included 16 297 individuals from households that had experienced shocks (intervention) and those that had not experienced shocks (control) within the last 12 months preceding the survey.Outcome measuresThe outcome of interest was access to healthcare services based on an individual’s perceived need for health intervention.ResultsThe results indicate that shocks reduce access to healthcare services when household members are confronted with an illness. We observed that multiple shocks in a household exacerbate the risk of not accessing healthcare services. Asset shocks had a significant negative effect on access to healthcare services, whereas the effect of income shocks was not statistically significant. This is presumably due to the smoothing out of income shocks through the sale of assets or borrowing. However, considering the time when the shock occurred, we observed mixed results that varied according to the type of shock.ConclusionsThe findings suggest that shocks can limit the capacity of households to invest in healthcare services, emphasising their vulnerability to risks and inability to cope with the consequences. These results provoke a debate on the causal pathway of household economic shocks and health-seeking behaviour. The results suggest a need for social protection programmes to integrate mechanisms that enable households to build resilience to shocks. A more viable approach would be to expedite universal health insurance to cushion households from forgoing needed healthcare when confronted with unanticipated risks.

scholarly journals TOTAL AND POST-DISCHARGE 30-DAY EPISODE PAYMENTS FOR BENEFICIARIES WITH ALZHEIMER’S AND DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S454-S454
Author(s):  
Neil Kamdar ◽  
Elham Mahmoudi
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Healthcare Services ◽  
Administrative Claims ◽  
Medical Procedures ◽  
Diagnosis Code ◽  
Post Discharge ◽  
Surgical Services ◽  
Icd 10 ◽  
Utilization Of Healthcare

Abstract There exists lack of evidence regarding incremental post-discharge cost and utilization of healthcare services for older adults with Alzheimer’s and dementia (AD). We quantified episode payments associated with AD vs. non-AD 30 days after medical or surgical procedures. We utilized administrative claims between January 2012 and June 2017 from the Michigan Value Collaborative (MVC) across 31 different medical and surgical services. We identified all patients with any AD diagnosis code throughout their enrollment using ICD-9-CM, ICD-10-CM codes. We price standardized 30-day episode payments and split them based on patient setting. Payments were risk adjusted and winsorized at the 99th /1st percentile. Propensity score matching using calipers without replacement adjusted for clinically relevant surgical and medical procedures, HCCs, insurance type, and age to control for selection bias. We identified 66,676 AD episodes and 656,235 non-AD episodes. After propensity score matching, there were 58,485 AD and non-AD episodes with significant differences in total episode payments of ($22,378 vs. $19,595, 95% CI Diff: ($2,658, $2,910)). Post-acute care and readmission payments were significant ($4,561 vs. $3,272, 95% CI Diff: ($1,235, $1,342)) and ($1,807 vs. $1,165, 95% CI Diff: ($595, $691)), respectively. AD episodes had a higher readmission rate (21.6% vs. 14.8%, p<0.0001). County variation in payments for AD episodes was substantial (Median: $4,370, Range: $3,881). AD patients are at higher risk of readmission and more resource intensive to hospitals and health systems. Examining drivers of post-discharge cost variation can influence practice pattern changes in management of AD patients.

scholarly journals The impact of the obstetrical risk insurance scheme in Mauritania on maternal healthcare utilization: a propensity score matching analysis

2020 ◽  
Vol 35 (4) ◽  
pp. 388-398 ◽  
Author(s):  
Marion Ravit ◽  
Andrainolo Ravalihasy ◽  
Martine Audibert ◽  
Valéry Ridde ◽  
Emmanuel Bonnet ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Neonatal Mortality ◽  
Estimation Method ◽  
Healthcare Services ◽  
Child Health Services ◽  
Public Healthcare ◽  
Payment Scheme ◽  
Risk Insurance ◽  
The Impact

Abstract In Mauritania, obstetrical risk insurance (ORI) has been progressively implemented at the health district level since 2002 and was available in 25% of public healthcare facilities in 2015. The ORI scheme is based on pre-payment scheme principles and focuses on increasing the quality of and access to both maternal and perinatal healthcare. Compared with many community-based health insurance schemes, the ORI scheme is original because it is not based on risk pooling. For a pre-payment of 16–18 USD, women are covered during their pregnancy for antenatal care, skilled delivery, emergency obstetrical care [including caesarean section (C-section) and transfer] and a postnatal visit. The objective of this study is to evaluate the impact of ORI enrolment on maternal and child health services using data from the Multiple Indicator Cluster Survey (MICS) conducted in 2015. A total of 4172 women who delivered within the last 2 years before the interview were analysed. The effect of ORI enrolment on the outcomes was estimated using a propensity score matching estimation method. Fifty-eight per cent of the studied women were aware of ORI, and among these women, more than two-thirds were enrolled. ORI had a beneficial effect among the enrolled women by increasing the probability of having at least one prenatal visit by 13%, the probability of having four or more visits by 11% and the probability of giving birth at a healthcare facility by 15%. However, we found no effect on postnatal care (PNC), C-section rates or neonatal mortality. This study provides evidence that a voluntary pre-payment scheme focusing on pregnant women improves healthcare services utilization during pregnancy and delivery. However, no effect was found on PNC or neonatal mortality. Some efforts should be exerted to improve communication and accessibility to ORI.

scholarly journals The effect of prophylactic hemoclip placement and risk factors of delayed post-polypectomy bleeding in polyps sized 6 to 20 millimeters: a propensity score matching analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chun-Wei Chen ◽  
Chia-Jung Kuo ◽  
Cheng-Tang Chiu ◽  
Ming-Yao Su ◽  
Chun-Jung Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Major Complication ◽  
Potential Bias ◽  
Polyp Size ◽  
Propensity Score Matching Analysis ◽  
History Of ◽  
Snare Polypectomy

Abstract Background Delayed post-polypectomy bleeding (PPB) is a major complication of polypectomy. The effect of prophylactic hemoclipping on delayed PPB is uncertain. The aim of this study was to evaluate the effectiveness of prophylactic hemoclipping and identify the risk factors of delayed PPB. Methods Patients with polyps sized 6 to 20 mm underwent snare polypectomy from 2015 to 2017 were retrospectively reviewed. The patients with prophylactic hemoclipping for delayed PPB prevention were included in the clipping group, and those without prophylactic hemoclipping were included in the non-clipping group. The incidence of delayed PPB and time to bleeding were compared between the groups. Multivariate analysis was used to identify the risk factors of delayed PPB. Propensity score matching was used to minimize potential bias. Results After propensity score matching, 612 patients with 806 polyps were in the clipping group, and 576 patients with 806 polyps were in the non-clipping group. There were no significant differences in the incidence of delayed PPB and days to bleeding between two groups (0.8% vs 1.3%, p = 0.4; 3.4 ± 1.94 days vs 4.13 ± 3.39 days, p = 0.94). In the multivariate analysis, the polyp size [Odds ratio (OR):1.16, 95% confidence interval (CI):1.01–1.16, p = 0.03), multiple polypectomies (OR: 4.64, 95% CI:1.24–17.44, p = 0.02) and a history of anticoagulant use (OR:37.52, 95% CI:6.49–216.8, p < 0.001) were associated with delayed PPB. Conclusions In polyps sized 6 to 20 mm, prophylactic hemoclip placement did not decrease the risk of delayed PPB. Patients without risk factors including multiple polypectomies and anticoagulant use are no need to performing prophylactic hemoclipping.

scholarly journals The impact of the COVID-19 pandemic on healthcare service access for the victims of sexual assault

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Ramprakash Kaswa
Keyword(s):  
South Africa ◽  
Sexual Assault ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Control Group ◽  
Service Access ◽  
Sexual Assault Survivors ◽  
The Impact ◽  
Degrees Of Severity ◽  
Assault Survivors

Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted the provision or exacerbated the existing gap of access to essential healthcare services. An unanticipated effect on access to healthcare services emerged with the introduction of COVID-19 lockdown regulations. Violence against women is prevalent with varying degrees of severity in all spheres of society.Methods: This study aims to evaluate the impact of the COVID-19 pandemic on the access to healthcare services for the victims of sexual assault in the Mthatha region of South Africa. This is a records review of victims of sexual assault survivors who visited and were treated at the Sinawe TCC at Mthatha Regional Hospital. The data on sexual assault cases at Sinawe TCC were compared with a time-matched control group from 2014 to 2020.Results: There were 5747 sexual assault cases reported at Sinawe TCC between 01 January 2014 and 31 December 2020. There was a major drop in reported cases at Sinawe TCC during the 2020 year, with only about half (451) of the annual average cases being reported.Conclusion: The COVID-19 pandemic has an impact on access to healthcare services for the victims of sexual assault survivors in the Mthatha region of South Africa.

scholarly journals Visual Impairment Prevalence, Causes, and Role of Healthcare Access: A Systematic Review and Meta-Analysis in Iran

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Mehrdad Afarid ◽  
Hossein Molavi Vardanjani ◽  
Hamideh Mahdaviazad ◽  
Marzieh Alamolhoda ◽  
Saman Farahangiz
Keyword(s):  
Systematic Review ◽  
Visual Impairment ◽  
Low Vision ◽  
Meta Analysis ◽  
Healthcare Access ◽  
Random Effect ◽  
Public Health Problem ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Pooled Prevalence

Purpose. Healthcare access is one of the determinants of visual impairment (VI), as a public health problem. The objective of this study was to estimate VI prevalence, related causes, and its correlation with access to physicians in Iran. Methods: This systematic review and meta-analysis include observational studies published in Iran. PubMed, Web of Science, Scopus, Google Scholar, and local databases were systematically searched by using the MeSH headings. Data on the provincial distribution of physicians, as an index of access to healthcare, was retrieved. A random-effect meta-analysis was performed to assess. Results. Eight articles were included. The pooled prevalence of blindness, low vision, and VI was 0.80% (95% CI: 0.61–0.99%), 2.92% (95% CI: 2.40–3.44%), and 5.57% (95% CI: 4.71–6.43%). Refractive errors were the most common causes of VI based on PVA with the pooled prevalence of 54.6% (95% CI: 43.4–65.8%). Based on BCVA, we found that the pooled prevalence of cataracts was 37.4% (95% CI: 29.5–45.3%) as the most common cause of VI. The results of metaregression showed that the greater number of general practitioners (GPs) ( P   value = 0.01 ) and pharmacists ( P   value = 0.024 ) per population were associated with a lower prevalence of blindness. Conclusion. Some of the main causes of visual impairment in Iran are preventable. Access to healthcare services may lead to early diagnosis of preventable causes of VI. Further well-designed studies and national surveys should be conducted to provide accurate data from different regions of Iran.

scholarly journals The Risk of Infective Endocarditis among COVID-19 Patients with Non-Medical Opioid Use

2021 ◽  
pp. 1-6
Author(s):  
Ruchi Bhandari ◽  
R. Constance Wiener ◽  
Christopher Waters ◽  
Cassandra Bambrick ◽  
Ruchi Bhandari
Keyword(s):  
Infective Endocarditis ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Significant Risk ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Web Based ◽  
Objective Evidence ◽  
History Of ◽  
The Difference

Patients with opioid use disorder are more likely to get coronavirus disease 2019 (COVID-19). Cardiovascular diseases frequently present in COVID-19 patients and can increase their susceptibility to invasive infectious diseases, such as infective endocarditis (IE). This study examines the difference in IE incidence following COVID-19 diagnosis between individuals with and without non-medical opioid use. De-identified electronic medical records data were retrieved from TriNetX, a web-based database. Patients in the U.S., aged 18-60 years, with a diagnosis of COVID-19 during January 2020 - January 2021 were included in this study. Development of IE was determined within three months after COVID-19 diagnosis. Logistic regression was conducted to estimate the risk of developing IE between COVID-19 patients with and without opioid use after propensity score matching. COVID-19 patients with non-medical opioid use had 6.8 times the risk of developing IE compared with COVID-19 patients without opioid use (95% CI: 5.44, 8.56; p<0.0001) after propensity score matching. Findings suggest a significant risk of IE among COVID-19 patients with a history of non-medical opioid use. It provides objective evidence to account for baseline opioid use in the risk assessment of IE among COVID-19 patients.

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