scholarly journals REDUCING HEALTH DISPARITIES IN THE ERA OF VALUE-BASED CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S562-S563
Author(s):  
Amit Kumar ◽  
Elham Mahmoudi ◽  
Maricruz Rivera-Hernandez
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Puerto Rico ◽  
Mortality Rates ◽  
Minority Populations ◽  
Social Risk ◽  
Social Risk Factors ◽  
Physician Visits ◽  
The Us ◽  
The Impact

Abstract The US health care system is at a critical moment of transformation. The implementation of value-based models has made significant progress towards improving care quality and coordination, continuity of care and reducing cost. However, concerns have been raised regarding “cherry-picking” healthier people that may negatively impact patients with more complex needs and minority populations. Given that the US is becoming more diverse, there is a need for understanding the impact of social risk factors including ethnicity, immigration status, income and geography on health outcomes and issues of health care disparities. This panel brings together four studies that examine these phenomena in minority populations. These studies will provide novel insight regarding 1) healthcare utilization in Mexican-American Medicare beneficiaries and showing that social determinants of health are associated with a higher risk of hospitalization, emergency room admissions, and outpatient visits. 2) Mortality rates and predialysis care among Hispanics in the US, Hispanics in Puerto Rico, and Whites in the US demonstrating substantial disparities in access to recommended nephrology care for Hispanics in Puerto Rico; 3) Trends in age-adjusted mortality rates and supply of physicians in states with different nurse-practitioners regulation. 4) The impact of social risk factors on disenrollment from Fee-For-Service and enrollment in a Medicare Advantage plan in older Mexican-Americans. 5) Racial disparities in access to physician visits, prescription drugs, and healthcare spending among older adults with cognitive limitation. Studies in this panel will also discuss the effects of changes in care delivery and payment innovations in improving health equity.

scholarly journals The phenomenon of social risk families and its dynamics in Lithuania

2018 ◽  
Vol 51 ◽  
pp. 03001
Author(s):  
Vide Gudzinskiene ◽  
Rimvydas Augutavicius
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Physical Environment ◽  
Social Risk ◽  
Public Concern ◽  
Social Risk Factors ◽  
Scientific Problem ◽  
Number Of Children ◽  
Social And Physical Environment ◽  
The Impact

Families at risk are definitely the urgent public concern that requires immediate solutions in Lithuania. It is important to mention that the children growing within the families at risk are in the centre of concern as their social and physical environment is not stimulating enough, leading to a number of different problems the families and children themselves are facing. In general, the number of such children makes about 4 percent of the total number of children in the country and this rate has remained stable for many years. Scientific problem – the problems experienced by children growing within social risk families and the impact of social risk factors on children's socialization and integration. Object – phenomenon of families at risk in Lithuania. Task of the article – to analyze the phenomenon of social risk families and its trends in Lithuania.

scholarly journals Presentation and healthcare delays among people with tuberculosis in London, and the impact on treatment outcome

2019 ◽  
Vol 6 (1) ◽  
pp. e000468
Author(s):  
Poppy Evenden ◽  
Anita Roche ◽  
Basel Karo ◽  
Sooria Balasegaram ◽  
Charlotte S Anderson
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
P Value ◽  
Social Risk ◽  
Social Risk Factors ◽  
Asian Ethnicity ◽  
The Third ◽  
Female Sex ◽  
The Impact ◽  
Healthcare Visit

BackgroundA quarter of London’s pulmonary tuberculosis (TB) patients have over 4 months of delay. Late diagnosis increases disease severity and the risk of transmission. We aim to classify delays, identify associated risk factors and assess treatment outcome.MethodsWe conducted a retrospective cohort study using London surveillance data, 2012–2018 on adults aged ≥18 years with pulmonary TB. We defined presentation delay (days from symptom onset to first healthcare visit) and healthcare delay (first healthcare visit to treatment commencement) as dichotomous variables; positive delay being days equal or greater than the third quartile. We applied logistic regression models to identify risk factors associated with delays and treatment outcome at 12 months.ResultsOf 7216 people, 4539 reported presentation and 5193 healthcare delays. The third quartiles for presentation and healthcare delay were 84 and 61 days, respectively. Presentation delay was associated with female sex (adjusted OR (aOR)=1.21; 95% CI 1.04 to 1.39), increasing age (aOR=1.004; 95% CI 1.001 to 1.008), white compared to Asian ethnicity (aOR=1.35; 95% CI 1.12 to 1.62), previous imprisonment (aOR=1.66; 95% CI 1.22 to 2.26) and alcohol misuse (aOR=1.44; 95% CI 1.04 to 1.89). Healthcare delay was associated with female sex (aOR=1.39; 95% CI 1.21 to 1.59), increasing age (aOR=1.014; 95% CI 1.009 to 1.018) and white ethnicity (aOR=1.41; 95% CI 1.19 to 1.68). 16% of 5678 people with known outcome did not complete treatment. Neither delay was associated with non-completion (p value <0.05).ConclusionsFemale, white and older people with TB were more likely to experience both presentation and healthcare delays. Social risk factors were also associated with delay in presentation. Early diagnosis and treatment remain critical to reduce transmission, regardless of whether delay affected completion.

scholarly journals Sickness Presence among Health Care Professionals: A Cross Sectional Study of Health Care Professionals in Slovenia

2020 ◽  
Vol 17 (1) ◽  
pp. 367 ◽  
Author(s):  
Alenka Skerjanc ◽  
Metoda Dodic Fikfak
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Sick Leave ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Social Risk ◽  
Sectional Study ◽  
Social Risk Factors ◽  
Cross Sectional ◽  
Sickness Presence

Background and objectives: Presenteeism is a relatively new phenomenon that people, despite complaints and ill health that should prompt them to rest and take sick leave, go to work in any case. The highest sickness presence is largely to be found in the care and welfare and educational sectors. The aim of the study is to investigate the relations between different factors and sickness presence among health care professionals. Materials and Methods: A cross-sectional study was conducted at the largest hospital in Slovenia involving 5865 health care professionals employed at the University Medical Centre Ljubljana in the period between 1 January 2010 and 31 December 2010. Logistic regression methods were used to assess the associations between risk factors and their interactions and sickness presence. Results: Besides high odds for sickness presence in multivariate modelling for acute (OR = 359.7; 95%CI = 89.1–1452.8) and chronic disease (OR = 722.5; 95%CI = 178.5–2924.5) the highest odds were calculated for poor self-related health (OR = 3.0; 95%CI = 1.9–4.8), no possibility of replacement (OR = 1.9; 95%CI = 1.5–2.3), sickness absence > two times a year (OR = 1.6; 95%CI = 1.2–2.1), disabled workers (OR = 1.6; 95%CI = 1.0–2.5), and lower salary when on sick leave (OR = 1.5; 95%CI = 120–1.9). Risk factors interactions were not found to be associated with sickness presence among health care workers. Conclusions: The pre-requisite for higher sickness presence is workers’ bad health. The results indicate that sickness presence was associated with psycho social risk factors at work and their economic consequences. Continued sickness presence might have negative rather than positive consequences on work and health care professionals’ health in the future. Sickness presence needs to be taken into account for health care organizers.

scholarly journals Assessment of Social Risk Factors and Interest in Receiving Health Care–Based Social Assistance Among Adult Patients and Adult Caregivers of Pediatric Patients

2020 ◽  
Vol 3 (10) ◽  
pp. e2021201
Author(s):  
Emilia H. De Marchis ◽  
Danielle Hessler ◽  
Caroline Fichtenberg ◽  
Eric W. Fleegler ◽  
Amy G. Huebschmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Pediatric Patients ◽  
Social Assistance ◽  
Adult Patients ◽  
Social Risk ◽  
Social Risk Factors ◽  
Adult Caregivers

scholarly journals Complex Assessment of Medical and Social Risk Factors and Their Effect on the Health Condition of Children Working at Industrial Waste Landfills

2019 ◽  
Vol 5 (4) ◽  
pp. 137-143
Author(s):  
N. Kudaibergenov
Keyword(s):  
Risk Factors ◽  
Industrial Waste ◽  
Health Condition ◽  
Working Environment ◽  
Control Group ◽  
External Respiration ◽  
Social Risk ◽  
Social Risk Factors ◽  
Statistical Research ◽  
The Impact

The comprehensive assessment of medical and social risk factors and their impact on the health of children working at industrial waste landfills of the Kyrgyz Chemical Metallurgical Plant has presented. Various industrial and environmental factors were covered. To identify signs of environmental pollution by radioactive substances of natural and artificial origin the average values of gamma-radiation power levels have been examined. The hygienic, sociological, medical and statistical research methods are used. During the study, the social-hygienic and living conditions of life and work of children were studied. The selection of respondents conducted by random sampling. The health condition of children living in the region but not working at industrial waste landfills has studied to compare the data of a control group. An assessment of the physical and biological development of children in the experimental and control groups was carried out by measuring somatometric indicators (length and body weight, head circumference), as well as indicators of dynamometry and their external respiration function. The intensive morbidity rates of children have been studied. The article analyzes the impact of medical and social risk factors that adversely affect the health conditions of working children. It describes the various factors of the working environment and the labor process, which form the occupational risk of morbidity. An important part of the study was to assess the situation and identify possible causes that force families to involve children to work at industrial waste landfills.

scholarly journals Examining the association of social risk with heart failure readmission in the Veterans Health Administration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charlie M. Wray ◽  
Marzieh Vali ◽  
Louise C. Walter ◽  
Lee Christensen ◽  
Wendy Chapman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Social Support ◽  
Substance Abuse ◽  
Low Income ◽  
Model Performance ◽  
Social Risk ◽  
Veterans Health ◽  
Social Risk Factors ◽  
Increased Risk ◽  
The Impact

Abstract Background Previous research has found that social risk factors are associated with an increased risk of 30-day readmission. We aimed to assess the association of 5 social risk factors (living alone, lack of social support, marginal housing, substance abuse, and low income) with 30-day Heart Failure (HF) hospital readmissions within the Veterans Health Affairs (VA) and the impact of their inclusion on hospital readmission model performance. Methods We performed a retrospective cohort study using chart review and VA and Centers for Medicare and Medicaid Services (CMS) administrative data from a random sample of 1,500 elderly (≥ 65 years) Veterans hospitalized for HF in 2012. Using logistic regression, we examined whether any of the social risk factors were associated with 30-day readmission after adjusting for age alone and clinical variables used by CMS in its 30-day risk stratified readmission model. The impact of these five social risk factors on readmission model performance was assessed by comparing c-statistics, likelihood ratio tests, and the Hosmer-Lemeshow goodness-of-fit statistic. Results The prevalence varied among the 5 risk factors; low income (47 % vs. 47 %), lives alone (18 % vs. 19 %), substance abuse (14 % vs. 16 %), lacks social support (2 % vs. <1 %), and marginal housing (< 1 % vs. 3 %) among readmitted and non-readmitted patients, respectively. Controlling for clinical factors contained in CMS readmission models, a lack of social support was found to be associated with an increased risk of 30-day readmission (OR 4.8, 95 %CI 1.35–17.88), while marginal housing was noted to decrease readmission risk (OR 0.21, 95 %CI 0.03–0.87). Living alone (OR: 0.9, 95 %CI 0.64–1.26), substance abuse (OR 0.91, 95 %CI 0.67–1.22), and having low income (OR 1.01, 95 %CI 0.77–1.31) had no association with HF readmissions. Adding the five social risk factors to a CMS-based model (age and comorbid conditions; c-statistic 0.62) did not improve model performance (c-statistic: 0.62). Conclusions While a lack of social support was associated with 30-day readmission in the VA, its prevalence was low. Moreover, the inclusion of some social risk factors did not improve readmission model performance. In an integrated healthcare system like the VA, social risk factors may have a limited effect on 30-day readmission outcomes.

US public views toward biosocial risk factors for criminality: a brief report

2017 ◽  
Vol 3 (4) ◽  
pp. 294-299 ◽  
Author(s):  
Colleen M. Berryessa
Keyword(s):  
Risk Factors ◽  
Survey Data ◽  
Social Risk ◽  
Social Risk Factors ◽  
Content Type ◽  
The Public ◽  
The Us ◽  
Public Views ◽  
Lay Public ◽  
Practical Implications

Purpose The purpose of this paper is to present preliminary survey data measuring attitudes of members of the US public on the importance, existence, and potential legal use of biological risk factors for criminality. Design/methodology/approach Survey data were collected from an online sample of US public in conjunction with an experiment not included in this report. Findings Data suggest that the public generally agrees that there are certain biological characteristics that make one more likely to exhibit criminality. The public does not appear to agree on whether or not this type of evidence should be allowed in court, but the large majority of respondents were worried about its potential misuse. Practical implications Social risk factors were generally viewed by respondents as more important to explaining criminality, suggesting that sociological views of crime may be still more prevalent in the lay public. Worries about biosocial risk factor evidence being misused in court have been previously discussed in academic literature, but the public also appears to share these concerns. The public especially worries that this kind of evidence could be used to incorrectly excuse an offender’s behavior, showing that they may be weary of this evidence in court as potential jurors. Attitudes of many members of the public on these issues may be affected by academic disagreement in the criminology community on the importance of these issues. Originality/value Scholars have emphasized the need for discussion on how the US public views biosocial risk factors for criminality. As there are no known data of this type, these data are the first of their kind.

Adjusting Quality Measures For Social Risk Factors Can Promote Equity In Health Care

2021 ◽  
Vol 40 (4) ◽  
pp. 637-644
Author(s):  
David R. Nerenz ◽  
J. Matthew Austin ◽  
Daniel Deutscher ◽  
Karen E. Joynt Maddox ◽  
Eugene J. Nuccio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Quality Measures ◽  
Social Risk ◽  
Social Risk Factors ◽  
Equity In Health ◽  
Equity In Health Care

Hygienic assessment of risk factors and health of forensic scientists

2021 ◽  
Author(s):  
MI Timerzyanov ◽  
OA Ilina ◽  
EA Dubrvina ◽  
OYu Milushkina ◽  
DE Vasilev
Keyword(s):  
Risk Factors ◽  
Working Environment ◽  
Control Group ◽  
Social Risk ◽  
Social Risk Factors ◽  
Hygienic Measures ◽  
Rising Incidence ◽  
Forensic Scientists ◽  
The Impact ◽  
Labor Potential

The objective of the study was to develop and implement the system of hygienic measures eliminating (mitigating) the impact of risk factors in the work of forensic scientists and to estimate effectiveness of these measures and the program aimed at improvement of employment terms for forensic scientists [1, 2]. Forensic scientists were compared to a control group of other doctors. The following researches were carried out: survey of 303 forensic scientists, analysis of their employment terms based on employment terms special evaluation (2,736 materials of employment terms special evaluation), examination of forensic scientists’ health compared to other doctors by analyzing medical examination results (309 health records). Protection and promotion of working population’s health is the state priority. Its purpose is to preserve labor potential and create conditions for economic development of the country. Medical workers are exposed to a combined, complex, and associated effect of working environment conditions and parameters [3, 4]. Industrial and social factors can result in a rising incidence, reduction in life expectancy, ill health and medical staff performance increment, and require preventive measures. Those working for forensic expert organizations constitute a special population due to a large number of professional, medical and organizational, and social risk factors [5].

scholarly journals ASSESSMENT OF RISK FACTORS INFLUENCING DENTAL HEALTH IN HIGHER EDUCATION STUDENTS

InterConf ◽  
2021 ◽  
pp. 721-732
Author(s):  
Farrukh Ismatov ◽  
Davron Ibragimov ◽  
Usmon Gaffarov ◽  
Zukhra Iskhakova ◽  
Farangiza Valieva ◽  
...  
Keyword(s):  
Higher Education ◽  
Risk Factors ◽  
Dental Health ◽  
Medical Institute ◽  
Social Risk ◽  
State University ◽  
Social Risk Factors ◽  
Education Students ◽  
Carious Process ◽  
The Impact

The aim of the study was to study the dental health of university students in Samarkand and assess the impact of organizational, medical and social risk factors on it. A comprehensive examination of the dental health of students in the city of Samarkand was carried out. The research took place between Institutions of Higher Education. The total number of students is 574. The following universities participated: Samarkand Medical Institute and Samarkand State University among which there were 193 students of the 1st year, 175 students of the 2nd year, 206 students of the 3rd year, respectively. The prevalence of dental caries was revealed, which was 91.87 ± 1.30%. ... The intensity of the carious process was 5.31 ± 0.14 teeth at 8.34 ± 0.26 of the surface, signs of periodontal tissue diseases were revealed with an intensity of 3.88 ± 0.06 segment. 53.05 ± 2.37% of students had dentoalveolar anomalies and deformities,

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