scholarly journals A Typology of Health Services Regulated in U.S. Assisted Living Communities

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 528-528
Author(s):  
Lindsey Smith ◽  
Wenhan Zhang ◽  
Sheryl Zimmerman ◽  
Philip Sloane ◽  
Kali Thomas ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Assisted Living ◽  
Service Use ◽  
Health Service Use ◽  
Case Mix ◽  
State Agencies ◽  
Black Residents ◽  
Health Related ◽  
Dual Eligible

Abstract State agencies regulate assisted living (AL) with varying approaches across and within states. The implications of this variation for resident case mix, health service use, and policy, are not well described. We collected health services-relevant AL regulatory requirements for all 50 states and DC and used a mixed-methods approach (thematic analysis; k-means cluster analysis) to identify six types: Housing, Affordable, Hybrid, Hospitality, Healthcare, and Hybrid-Healthcare. We stratified Medicare claims data by regulatory type, identifying variation in resident case mix and health service use. Housing and Affordable clusters have larger proportions of dual-eligible beneficiaries, Black residents, and residents of Affordable had more long-term nursing home use compared to other clusters. Dual-eligible beneficiaries account for 26.6% of Housing cluster residents compared to 8.1% of Hybrid Healthcare cluster residents. We provide other examples and explain the implications in terms of sampling AL for single and multi-state studies, racial disparities, and health-related policies.

scholarly journals Higher Rates of Untreated Distress in Older Versus Younger Adults With Indolent Lymphoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 466-466
Author(s):  
Kelly Trevino ◽  
Peter Martin ◽  
John Leonard
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Younger Adults

Abstract Indolent lymphomas are incurable but slow-growing cancers, resulting in a large number of older adults living with these diseases. Patients typically live with their illness for years with the knowledge that disease progression is likely. Yet, little is known about psychological distress in this population. This study examined rates of and the relationship between distress and mental health service use in older and younger adults with indolent lymphomas. Adult patients diagnosed with an indolent lymphoma (e.g., follicular lymphoma, marginal zone lymphoma) within the past six months completed self-report surveys of distress (Hospital Anxiety and Depression Scale; HADS) and mental health service use since the cancer diagnosis (yes/no). Descriptive statistics, t-tests, and chi-square analyses were used to examine study questions. The sample (n=84) included 35 patients 65 years or older. Across the entire sample, 21.4% screened positive for distress on the HADS; 58.8% of these patients did not receive mental health services. Older adults reported lower distress levels than younger adults (17.1% v. 24.5%; p=.038). Among younger adults, 50% of distressed patients received mental health services; only 20% of distressed older adults received mental health services. Distress was associated with mental health service use in younger adults (p=.004) but not in older adults (p=.17). Older adults with indolent lymphomas have higher levels of untreated distress than younger adults. Research on the mechanisms underlying these age differences (e.g., stigma toward mental health services, ageism) would inform interventions to increase rates of mental health service use and reduce care disparities due to age.

scholarly journals Mental Health Services in Childhood: The Role of Family Adversity

2019 ◽  
Vol 134 (2) ◽  
pp. 180-188
Author(s):  
Héctor E. Alcalá ◽  
Rajesh Balkrishnan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Childhood Adversity ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Continuous Measure

Objective: Much of the research on the effects of childhood adversity on mental health has focused on adults. The objective of our study was to examine the individual and cumulative effect of childhood adversity on mental health service use among children. Methods: We used data from the 2011-2012 National Survey of Children’s Health (n = 79 834) to determine the use of mental health services in the past 12 months among children aged 2-17. The independent variables of interest were experiencing any 1 of 9 adverse family experiences (AFEs). We used logistic regression models to determine if each AFE was associated with mental health service use. We also examined AFEs as a continuous measure, representing the number of AFEs (ranging from 0 to 9) that summed them individually, and we examined age-by-AFE and age-by-need interaction terms. We adjusted all models for confounders. Results: Compared with not experiencing an AFE, experiencing all AFEs was associated with higher odds of mental health service use. Neighborhood violence was associated with the greatest increase in odds of mental health service use (adjusted odds ratio [aOR] = 2.35; 95% confidence interval [CI], 2.00-2.77). When measured as a continuous scale, each additional AFE was associated with higher odds of mental health service use (aOR = 1.33; 95% CI, 1.28-1.37). The effect of AFEs on mental health service use decreased with age. Conclusions: The observed association between AFEs and use of mental health services may be attributable to more severe or poorly managed mental illness among these children. Efforts are needed to increase access to and quality of mental health care among children affected by AFEs.

scholarly journals Timing of Health Service Use Among Truck Drivers After a Work-Related Injury or Illness

2021 ◽  
Author(s):  
Ting Xia ◽  
Alex Collie ◽  
Sharon Newnam ◽  
Dan I. Lubman ◽  
Ross Iles
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Truck Drivers ◽  
Health Service Use ◽  
Work Related ◽  
Work Related Injury ◽  
Service Type ◽  
Compensation Claims

AbstractPurposes Timely delivery of treatment and rehabilitation is generally acknowledged to support injury recovery. This study aimed to describe the timing of health service use by injured truck drivers with work-related injury and to explore the association between demographic and injury factors and the duration of health service use. Methods Retrospective cohort study of injured truck drivers with accepted workers’ compensation claims in the state of Victoria, Australia. Descriptive analyses examined the percentage of injured truck drivers using health services by service type. Logistic regression model examined predictors of any service use versus no service use, and predictors of extended service use (≥ 52 weeks) versus short-term use. Results The timing of health service use by injured truck drivers with accepted workers’ compensation claims varies substantially by service type. General practitioner, specialist physician, and physical therapy service use peaks within the 14 weeks after compensation claim lodgement, whilst the majority of mental health services were accessed in the persistent phase beyond 14 weeks after claim lodgement. Older age, being employed by small companies, and claiming compensation for mental health conditions were associated with greater duration of health service use. Conclusions Injured truck drivers access a wide range of health services during the recovery and return to work process. Delivery of mental health services is delayed, including for those making mental health compensation claims. Health service planning should take into account worker and employer characteristics in addition to injury type.

scholarly journals Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population

2021 ◽  
Vol 18 (21) ◽  
pp. 11197
Author(s):  
Neeru Gupta ◽  
Dan Lawson Crouse ◽  
Ismael Foroughi ◽  
Thalia Nikolaidou
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Cross Sectional ◽  
Neighbourhood Characteristics

Background: Little is known about the extent to which socioenvironmental characteristics may influence mental health outcomes in smaller population centres or differently among women and men. This study used a gender-based analysis approach to explore individual- and neighbourhood-level sex differences in mental health service use in a context of uniquely smaller urban and rural settlements. Methods: This cross-sectional analysis leveraged multiple person-based administrative health datasets linked with geospatial datasets among the population aged 1 and over in the province of New Brunswick, Canada. We used multinomial logistic regression to examine associations between neighbourhood characteristics with risk of service contacts for mood and anxiety disorders in 2015/2016, characterizing the areal measures among all residents (gender neutral) and by males and females separately (gender specific), and controlling for age group. Results: Among the province’s 707,575 eligible residents, 10.7% (females: 14.0%; males: 7.3%) used mental health services in the year of observation. In models adjusted for gender-neutral neighbourhood characteristics, service contacts were significantly more likely among persons residing in the most materially deprived areas compared with the least (OR = 1.09 [95% CI: 1.05–1.12]); when stratified by individuals’ sex, the risk pattern held for females (OR = 1.13 [95% CI: 1.09–1.17]) but not males (OR = 1.00 [95% CI: 0.96–1.05]). Residence in the most female-specific materially deprived neighbourhoods was independently associated with higher risk of mental health service use among individual females (OR = 1.08 [95% CI: 1.02–1.14]) but not among males (OR = 1.02 [95% CI: 0.95–1.10]). Conclusion: These findings emphasize that research needs to better integrate sex and gender in contextual measures aiming to inform community interventions and neighbourhood designs, notably in small urban and rural settings, to reduce socioeconomic inequalities in the burden of mental disorders.

scholarly journals Cry for health: a quantitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse

2019 ◽  
Author(s):  
Gemma Halliwell ◽  
Sandi Dheensa ◽  
Elisabetta Fenu ◽  
Sue K Jones ◽  
Jessica Asato ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Cost Savings ◽  
Health Service Use ◽  
Potential Cost ◽  
Safety Outcomes ◽  
The Cost ◽  
Domestic Violence And Abuse

Abstract Background Domestic violence and abuse damages the health of survivors and increases use of healthcare services. We report findings from a multi-site evaluation of hospital-based advocacy services, designed to support survivors attending emergency departments and maternity services. Methods Independent Domestic Violence Advisors (IDVA) were co-located in five UK hospitals. Case-level data were collected at T1 (initial referral) and T2 (case closure) from survivors accessing hospital (T1 N = 692; T2 N = 476) and community IDVA services (T1 N = 3,544; T2 N = 2,780), used as a comparator. Measures included indicators of sociodemographic characteristics, experience of abuse, health service use, health and safety outcomes. Multivariate analyses tested for differences in changes in abuse, health and factors influencing safety outcomes. Health service use data in the six months pre-and post- intervention were compared to generate potential cost savings by hospital IDVA services. Results Hospital IDVAs worked with survivors less visible to community IDVA services and facilitated intervention at an earlier point. Hospital IDVAs received higher referrals from health services and enabled access to a greater number of health resources. Hospital survivors were more likely to report greater reductions in and cessation of abuse. No differences were observed in health outcomes for hospital survivors. The odds of safety increased two-fold if hospital survivors received over five contacts with an IDVA or accessed six or more resources / programmes over a longer period of time. Six months preceding IDVA intervention, hospital survivors cost on average £2,463 each in use of health services; community survivors cost £533 each. The cost savings observed among hospital survivors amounted to a total of £2,050 per patient per year. This offset the average cost of providing hospital IDVA services. Conclusions Hospital IDVAs can identify survivors not visible to other services and promote safety through intensive support and access to resources. The co-location of IDVAs within the hospital encouraged referrals to other health services and wider community agencies. Further research is required to establish the cost-effectiveness of hospital IDVA services, however our findings suggest these services could be an efficient use of health service resources.

Influence of living arrangements on health services utilisation in Australia

2012 ◽  
Vol 36 (1) ◽  
pp. 34 ◽  
Author(s):  
M. Afzal Mahmood ◽  
Anna E. Bauze ◽  
Justin T. Lokhorst ◽  
Peng Bi ◽  
Arthur Saniotis
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Health Service ◽  
Health Services ◽  
Informal Care ◽  
Living Arrangements ◽  
Service Use ◽  
Household Composition ◽  
Health Service Use ◽  
Use Of Health Services

Background. The number of people living alone is increasing markedly. Others live as couples only, couples with child(ren) and single adult with child(ren). Health service utilisation could differ for people in different living arrangements as a result of varying levels of risk factors, health status, access to informal care and decision-making for accessing care. Objective. To identify the association between living arrangements and health service use. Methods. The Australian Bureau of Statistics’ National Health Survey 2001 data for people 18–65 years old were analysed for household composition and service use. Results. People in various household types differ in terms of their overall use of health services and their use of services by general practitioners. Sex, rurality, socioeconomic status and status of heart condition significantly influenced the use of health services. Conclusion. There are implications for health services provision and planning within the context of rapid changes in living arrangements. Additional research is required to explore the reasons to such differences, level of access to informal care, healthcare decision-making processes and consequences of under- or over-utilisation of services. What is known about the topic? Health service use is influenced by the disease burden and pattern, demography, economic factors, access to social support, quality of care and satisfaction with standards of care. These factors may influence access to and use of care. What does this paper add? This research points to the potential role of living arrangements on health services use. Many people now live alone and may not have access to informal care, and access to health information and education. People in different living arrangements appear to have different health service use. What are the implications for practitioners? Practitioners, in both primary care and acute care sectors, need to consider that patients, including younger people, may not have access to informal care, may present with delays and may not have the needed adequate support during convalescence. Health education needs to consider that people in different living arrangements may be exposed to different levels of risk factors in terms of their healthcare use.

scholarly journals Remote mood monitoring for adults with bipolar disorder: An explorative study of compliance and impact on mental health service use and costs

2017 ◽  
Vol 45 ◽  
pp. 14-19 ◽  
Author(s):  
J. Simon ◽  
K. Budge ◽  
J. Price ◽  
G.M. Goodwin ◽  
J.R. Geddes
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Mental Health Service ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Psychiatric Medication ◽  
Medication Costs

AbstractBackground:Remote monitoring of mood disorders may be an effective and low resource option for patient follow-up, but relevant evidence remains very limited. This study explores real-life compliance and health services impacts of mood monitoring among patients with bipolar disorder in the UK.Methods:Patients with a diagnosis of bipolar disorder who were registered users of the True Colours monitoring system for at least 12 months at study assessment were included in this retrospective cohort study (n = 79). Compliance was measured as the proportion of valid depression and mania scale messages received in comparison to their expected numbers over the first 12 months of monitoring. Mental health service use data were extracted from case notes, costed using national unit costs, and compared 12 months before (pre-TC period) and 12 months after (TC period) patients’ engagement with monitoring. Associations with relevant patient factors were investigated in a multiple regression model.Results:Average compliance with monitoring was 82%. Significant increases in the annual use and costs of psychiatrist contacts and total mental health services were shown for patients newly referred to the clinic during the pre-TC period but not for long-term patients of the clinic. Psychiatric medication costs increased significantly between the pre-TC and TC periods (£ 235, P = 0.005) unrelated to patients’ referral status.Conclusions:Remote mood monitoring has good compliance among consenting patients with bipolar disorder. We found no associations between observed changes in mental health service costs and the introduction of monitoring except for the increase in psychiatric medication costs.

Predictors of mental health service costs for representative cases of psychosis in south London

1998 ◽  
Vol 28 (1) ◽  
pp. 159-164 ◽  
Author(s):  
P. McCRONE ◽  
G. THORNICROFT ◽  
S. PARKMAN ◽  
D. NATHANIEL-JAMES ◽  
W. OJURONGBE
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Patient Characteristics ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Disability Identification

Background. Increasingly, evaluations of mental health services include an economic component, although often only summary statistics such as the mean or median are reported. Measures of variation are often limited to the standard error or standard deviation, though costs are rarely normally distributed and vary substantially between patients. The aim of this study is to identify factors that can explain variations in the cost of mental health services for epidemiologically representative cases of psychosis.Methods. Cases with ICD-10 diagnoses of functional psychosis were drawn from a sample that included all identified cases of psychosis in two geographically defined sectors in Camberwell, south London. Mental health service use was measured and costed. A predictive model was developed using multiple regression analyses, in which patient characteristics and previous service use indicators were used as predictor variables. Services were measured using the Client Service Receipt Interview.Results. Among the 147 cases included, the amount of cost variation explained by the model was 31·5%. The most significant predictive factor was social functioning, which was highly negatively associated with cost.Conclusions. Current mental health service use can be predicted to a reasonable extent by previous service use and patient characteristics, especially the degree of social disability. Identification of such factors can aid the effective allocation of scarce resources. In particular, subgroups of patients who use most resources can be identified and targeted by mental health services.

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