scholarly journals The Myth of Care Coordination: Whether Professional Care Coordination Improved Older Adults’ Health Outcomes?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1058-1058
Author(s):  
Kedong Ding
Keyword(s):  
Older Adults ◽  
Health Service ◽  
Health Outcomes ◽  
Physical Health ◽  
Service Utilization ◽  
Care Coordination ◽  
Health Service Utilization ◽  
Care Coordinators ◽  
Professional Care ◽  
Multidimensional Health

Abstract Background Current evidence on the effects of Care Coordination (CC) on older adults’ well-being and health service utilization is inconsistent. Previous studies are mostly limited to regional data and focus mostly on nurse-led CC instead of layperson Care Coordinators like family caregivers. This study explores the effects of having CC in a national sample of U.S. older adults and whether the coordinators’ professionalism impacts the effect of having CC on multidimensional health outcomes (Health outcomes were conceptualized as physical health, healthcare utilization, and care encounters). Methods Data were from the 2016 and 2018 waves of the Health and Retirement Study (HRS) (n=1,372). Multivariate regression models were used to examine the effects of CC on multidimensional health outcomes in 2016 and the longitudinal effects of having CC. We also tested the effect of Care Coordinators’ professionalism on the multidimensional health outcomes. All models controlled for sociodemographic characteristics and health status. Results Findings suggest that having CC doesn’t have a positive effect on older adults’ health outcomes. Having CC was associated with an increased number of acute diseases (β = 0.16, p < .001) and nonacute diseases (β = 0.21, p < .01) in longterm. The results regarding cross-sectional effects show that receiving care from a Coordinator was related to increased health service utilization. Participants with professional Care Coordinators were more likely to report receiving person-centered care (OR=1.60, p<.05). Conclusion This study demonstrates the limited effects of CCs on older adults’ physical health outcomes, and emphasized the importance of care coordinators’ qualifications.

scholarly journals Health literacy and health outcomes in China’s floating population: mediating effects of health service

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hai-YanYu ◽  
Wei-Ling Wu ◽  
Lin-Wei Yu ◽  
Lei Wu
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Health Outcomes ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Mediating Effect ◽  
Floating Population ◽  
Equation Modeling ◽  
Mediating Effects

Abstract Background The floating population in China consists primarily of internal immigrants and represents a typical health vulnerable group. Poor health literacy has recently become an obstacle in the accessibility and utilization of health services for the vulnerable population, leading to adverse health outcomes. This study aimed to examine whether health literacy affected health outcomes in China’s floating population and whether health service utilization had a mediating effect between health literacy and health outcomes. Method The current study utilized a cross-sectional stratified, multistage, proportional to scale (PPS) study in Zhejiang Province, China, in November and December 2019. In total, 657 valid self-reported questionnaires were recovered and used for data collection. Questionnaires included questions regarding sociodemographic characteristics, health literacy, health outcomes, and health service utilization. Confirmatory factor analysis was used to test questionnaire validity; descriptive statistics were used to understand the demographic characteristics of the floating population; and structural equation modeling was used to determine whether health service utilization mediated health literacy and health outcomes. Results We report positive correlations between health literacy, health service utilization, and health outcomes. Mediation analysis demonstrated that health service utilization had partial mediating effects between health literacy and health outcomes. In the relationship between health literacy and health outcomes, the indirect effects of health service utilization accounted for 6.6–8.7% of the total effects. Conclusion Complete health literacy, through health care literacy and health promotion literacy, affects the mobile population’s initiative to use health services, which, in turn, affects health outcomes. Thus, improving the health literacy of the floating population will help to improve health outcomes. Furthermore, health service providers should enhance the diversity of health service supply to ensure that the floating population has the external resources to improve personal health literacy.

scholarly journals Assessing inequities in community health worker’s interaction and its impact in Uttar Pradesh, India

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Gupta ◽  
S Tomar ◽  
A Dey ◽  
D Chandurkar
Keyword(s):  
Health Service ◽  
Health Outcomes ◽  
Community Health ◽  
Community Health Workers ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Workers ◽  
Uttar Pradesh ◽  
Economic Determinants

Abstract Given the high Neo-natal mortality in the state of Uttar Pradesh, India, an emphasis has been given to community health workers (CHW). CHW provides behavior push to pregnant women for utilizing health services, through the strategies of household contact and messaging. However, the disparity in health outcomes and interaction of CHW is profoundly affected by socio-economic determinants; still, the evidence is limited. This study aims to explore socio-economic inequities in quantity and quality of contacts by the CHW and its differential effect on health service utilization. Multistage sampling design identified live births in the last 12 months across the 25 highest-risk districts of Uttar Pradesh(n = 3703). Regression models described the relation between household demographics and CHW contact & specific messaging and interactions of demographics and CHW contact & messaging in predicting health service utilization ( > = 4 antenatal care (ANC) visits, Institutional delivery and 100 iron folic acid (IFA) consumption). No differential likelihood in contact of CHW and specific messaging is found. Further, association of CHW contacts and specific messaging with health outcomes were significantly affected by socio-economic determinants.2 or more contacts along with specific messaging increased the odds of 4+ ANC to a higher degree among illiterate women compared to literate women(AOR:3.39, 95% CI:2.28-5.04 vs AOR:1.44, 95% CI:1.09-1.92). Similarly, the odds of facility delivery increased to a higher degree among lower wealth women compared to higher wealth women (AOR:3.41, 95% CI:2.47-4.71 vs. AOR:1.53, 95% CI: 1.09-2.15). Specific messaging, along with CHW contacts, have a higher magnitude of effects on the marginalized population. This study provides evidence for adjusting implementation strategies based on socio-economic determinants to achieve equitable health service utilization. However, further research on training of CHW on heterogeneous interaction is recommended Key messages There exists differential effects of quantity and quality of contact by community health workers on health service utilization across the different socio-economic strata. Implementation agencies in the LMIC can reduce health inequity by shifting from coverage-oriented target approach towards more prioritized and focused interaction across socio-economic groups.

scholarly journals Health service utilization and direct healthcare costs associated with obesity in older adult population in Ghana

2019 ◽  
Vol 35 (2) ◽  
pp. 199-209 ◽  
Author(s):  
Stella T Lartey ◽  
Barbara de Graaff ◽  
Costan G Magnussen ◽  
Godfred O Boateng ◽  
Moses Aikins ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Health Service ◽  
Older Adult ◽  
Service Utilization ◽  
Healthcare Costs ◽  
Health Service Utilization ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Direct Healthcare Costs

Abstract Obesity is a major risk factor for many chronic diseases and disabilities, with severe implications on morbidity and mortality among older adults. With an increasing prevalence of obesity among older adults in Ghana, it has become necessary to develop cost-effective strategies for its management and prevention. However, developing such strategies is challenging as body mass index (BMI)-specific utilization and costs required for cost-effectiveness analysis are not available in this population. Therefore, this study examines the associations between health services utilization as well as direct healthcare costs and overweight (BMI ≥25.00 and <30.00 kg/m2) and obesity (BMI ≥30.00 kg/m2) among older adults in Ghana. Data were used from a nationally representative, multistage sample of 3350 people aged 50+ years from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE; 2014/15). Health service utilization was measured by the number of health facility visits over a 12-month period. Direct costs (2017 US dollars) included out-of-pocket payments and the National Health Insurance Scheme (NHIS) claims. Associations between utilization and BMI were examined using multivariable zero-inflated negative binomial regressions; and between costs and BMI using multivariable two-part regressions. Twenty-three percent were overweight and 13% were obese. Compared with normal-weight participants, overweight and obesity were associated with 75% and 159% more inpatient admissions, respectively. Obesity was also associated with 53% additional outpatient visits. One in five of the overweight and obese population had at least one chronic disease, and having chronic disease was associated with increased outpatient utilization. The average per person total costs for overweight was $78 and obesity was $132 compared with $35 for normal weight. The NHIS bore approximately 60% of the average total costs per person expended in 2014/15. Overweight and obese groups had significantly higher total direct healthcare costs burden of $121 million compared with $64 million for normal weight in the entire older adult Ghanaian population. Compared with normal weight, the total costs per person associated with overweight increased by 73% and more than doubled for obesity. Even though the total prevalence of overweight and obesity was about half of that of normal weight, the sum of their cost burden was almost doubled. Implementing weight reduction measures could reduce health service utilization and costs in this population.

Predictors of mental and physical health service utilization among Vietnam veterans.

2007 ◽  
Vol 4 (3) ◽  
pp. 168-180 ◽  
Author(s):  
Shira Maguen ◽  
Jeremiah A. Schumm ◽  
Rebecca L. Norris ◽  
Casey Taft ◽  
Lynda A. King ◽  
...  
Keyword(s):  
Health Service ◽  
Physical Health ◽  
Service Utilization ◽  
Vietnam Veterans ◽  
Health Service Utilization ◽  
Mental And Physical Health

scholarly journals Depressive symptoms and health service utilization among Chinese middle aged and older adults: A national population-based longitudinal survey

2020 ◽  
Author(s):  
Jing Guo ◽  
Dexia Kong ◽  
Anao Zhang ◽  
Liming Fang ◽  
Yingxue Zhu
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Services Utilization ◽  
Middle Aged ◽  
Cross Sectional ◽  
Services Utilization

Abstract Background: The prevalence of depressive symptoms has been steadily increasing in recent years, however middle aged and older adults was less likely to use mental health services. The aims of this study were to 1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and 2) evaluate whether there exists a rural-urban difference in such relationships. Methods: Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Multivariate logistic regression analyses were conducted to assess the cross-sectional and longitudinal relationship between depressive symptoms and health services utilization in the whole sample, and urban and rural subsamples respectively. Results: Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. In addition, the relationships between depressive symptoms and health service use were consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions: Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.

Sign in / Sign up

Export Citation Format

Share Document