scholarly journals SUCCESSFUL AGING AND HEALTHCARE SERVICE UTILIZATION IN EAST ASIA: NATIONAL COMPARISONS OF CHINA, KOREA, AND JAPAN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S722-S722
Author(s):  
Jinmyoung Cho ◽  
Takeshi Nakagawa ◽  
Dannii Yeung
Keyword(s):  
Longitudinal Study ◽  
Hospital Stay ◽  
East Asia ◽  
Service Utilization ◽  
Successful Aging ◽  
Healthcare Service ◽  
Medical Center ◽  
High Cognitive Function ◽  
Visit Number ◽  
Cross National

Abstract As the older population increases and lives longer, the demand for healthcare has been increased dramatically. To date, it is unknown whether older people’s healthcare utilization varies between countries and how it relates to successful aging. Using Rowe and Kahn’s model, we examine cross-national differences in the relationship between successful aging and healthcare service utilization in East Asia. Harmonized datasets at baseline from China Health and Retirement Longitudinal Study (CHARLS), Korean Longitudinal Study (KLoSA), and Japanese Study on Aging and Retirement (JSTAR) were used. Including 7,651 participants (aged 65-75 years), successful agers were identified using Rowe and Kahn’s criteria (i.e., no disease, no disability, high cognitive function, and active engagement). Healthcare service utilization includes hospital visit, number of hospital stay, number of nights per hospital stay, regular medical center visit, number of medical center visits, and possession of private insurance in previous year. Generalized linear models showed that successful agers’ healthcare service utilization is significantly different from non-successful agers (e.g., OR=2.19, p<.001 for regular medical center visits), and Korean and Chinese healthcare service utilization is different from Japanese (e.g., OR=0.44 and OR=10.18 for Chinese and Korean number of medical center regular visits, respectively, p<.001). Furthermore, the number of nights in hospital among Chinese and Korean successful agers tend to be greater than that of Japanese successful agers (OR=2.93 and OR=1.99 for Chinese and Korean successful agers, respectively, p<.001). This study indicates cross-national variations in pattern of healthcare service utilization between successful and non-successful agers in East Asia.

scholarly journals Socio-economic and rural-urban differences in healthcare and catastrophic health expenditures among cancer patients in China: analysis of the China Health and Retirement Longitudinal Study

2021 ◽  
Author(s):  
Yang Zhao ◽  
Shenglan Tang ◽  
Wenhui Mao ◽  
Tomi F Akinyemiju
Keyword(s):  
Longitudinal Study ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Service Utilization ◽  
Rural Areas ◽  
Urban Areas ◽  
Healthcare Service ◽  
Service Use ◽  
Increased Risk ◽  
Chinese Cancer Patients

Abstract Background In China, cancer deaths account for one-fifth of all deaths and exert a heavy toll on patients, families, healthcare systems, and society as a whole. This study aims to examine socio-economic and rural-urban differences in treatment, healthcare service utilization and catastrophic health expenditure (CHE) among Chinese cancer patients, and to investigate the relationship between different treatment types and healthcare service use as well as incidence of CHE. Methods We analyzed a nationally representative sample from the China Health and Retirement Longitudinal Study including 17,224 participants in 2011 and 19,569 participants in 2015. Multivariable regression models were performed to investigate the association of cancer treatments with healthcare service utilization and CHE. Results The age-adjusted prevalence of cancer is 1.37% for 2011 and 1.84% for 2015. Approximately half of the cancer patients utilized treatment for their disease, with a higher proportion of urban residents (54%) than rural residents (46%) receiving cancer treatment in 2015. CHE declined by 22% in urban areas (25% in 2011 and 19% in 2015) but increased by 31% in rural areas (25% in 2011 to 33% in 2015). There was a positive relationship between cancer treatment and outpatient visit (OR = 2.098, 95% CI = 1.453, 3.029), admission to hospital (OR = 1.961, 95% CI = 1.346, 2.857) and CHE (OR = 1.796, 95% CI = 1.231, 2.620). Chemotherapy and surgery were each associated with a 2-fold increased risk of CHE. Conclusions Meaningful changes to improve health insurance benefit packages are needed to ensure universal, affordable and patient-centered health coverage for the Chinese cancer patients.

scholarly journals Education as A Moderator in the Effect of Successful Aging on Mortality Risk in Different Genders of Elderly Chinese: a National Longitudinal Study (2011-2016)

2020 ◽  
Author(s):  
Peiya Cao ◽  
Huiqiang Luo ◽  
Jijie Li ◽  
Xiaohui Ren
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Mortality Risk ◽  
Social Engagement ◽  
Successful Aging ◽  
Cox Proportional Hazards ◽  
Cross Sectional ◽  
High Cognitive Function ◽  
Lower Education ◽  
The Relationship

Abstract Background Plenty of evidence has found that successful aging and its components were significantly associated with older adults’ health, their achievement has a positive effect on reducing mortality rates. However, it is unclear whether education could modify the effect of successful aging on morality risk. Numerous literatures from worldwide were cross-sectional and previous studies on the association between successful aging and mortality in China were quite few. Methods Using four waves (2011-2012, 2013-2014, 2014-2015, 2015-2016) of a large nationally representative survey in China derived from CHARLS (China Health and Retirement Longitudinal Study) with 4,824 older adults aged 60 and older, this study aimed to evaluate the effect of successful aging and each of its components on mortality risk of different gender of older adults in China, we further discussed whether education was a moderator in this effect and investigated differences in results among males and females. Successful aging was measured by absence of major diseases, freedom from disability, high cognitive function, no depressive symptoms, and active social engagement in life. Cox proportional hazards models were applied to estimate the education's moderate effect on the relationship between successful aging and mortality after controlling a rich set of covariates that included demographics, socioeconomic status, and health behaviors.Results We found that 15.18% (n=367) for males and 15.74% (n=379) for females were defined as successful aging and the mortality were 2.61% (n=63) for males and 3.45% (n=83) for females during the survey. The overall prevalence of successful aging in both genders were12.5% (n=603) and the overall mortality rate was 3.03% (n=146).It is the first longitudinal study using national cohort data to research the educational effects on the association between mortality and successful aging, our study showed that the effect only existed in females aged 65-74 years old group with lower education.Conclusions Education has the significant effect on the relationship between successful aging and mortality. Physical health is significantly associated with the achieving of successful aging among young older. More measures should be paid on improving mental health among the young female older with lower education to achieve successful aging and to against mortality and live longevity.

scholarly journals Socio-Economic and Rural-Urban Differences in Healthcare and Catastrophic Health Expenditure Among Cancer Patients in China: Analysis of the China Health and Retirement Longitudinal Study

2022 ◽  
Vol 9 ◽  
Author(s):  
Yang Zhao ◽  
Shenglan Tang ◽  
Wenhui Mao ◽  
Tomi Akinyemiju
Keyword(s):  
Longitudinal Study ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Service Utilization ◽  
Health Expenditure ◽  
Healthcare Service ◽  
Catastrophic Health Expenditure ◽  
Cancer Treatments ◽  
Increased Risk ◽  
Different Types

Objective: In China, cancer accounts for one-fifth of all deaths, and exerts a heavy toll on patients, families, healthcare systems, and society as a whole. This study aims to examine the temporal trends in socio-economic and rural-urban differences in treatment, healthcare service utilization and catastrophic health expenditure (CHE) among adult cancer patients in China. We also investigate the relationship between different types of treatment and healthcare service utilization, as well as the incidence of CHE.Materials and Methods: We analyzed data from the 2011 and 2015 China Health and Retirement Longitudinal Study, a nationally representative survey including 17,224 participants (234 individuals with cancer) in 2011 and 19,569 participants (368 individuals with cancer) in 2015. The study includes six different types of cancer treatments: Chinese traditional medication (TCM); western modern medication (excluding TCM and chemotherapy medications); a combination of TCM & western medication; surgery; chemotherapy; and radiation therapy. Multivariable regression models were performed to investigate the association between cancer treatments and healthcare service utilization and CHE.Results: The age-adjusted prevalence of cancer increased from 1.37% to 1.84% between 2011 and 2015. More urban patients (54%) received cancer treatment than rural patients (46%) in 2015. Patients with high socio-economic status (SES) received a higher proportion of surgical and chemotherapy treatments compared to patients with low SES in 2015. Incidence of CHE declined by 22% in urban areas but increased by 31% in rural areas. We found a positive relationship between cancer treatment and outpatient visits (OR = 2.098, 95% CI = 1.453, 3.029), hospital admission (OR = 1.961, 95% CI = 1.346, 2.857) and CHE (OR = 1.796, 95% CI = 1.231, 2.620). Chemotherapy and surgery were each associated with a 2-fold increased risk of CHE.Conclusions: Significant improvements in health insurance benefit packages are necessary to ensure universal, affordable and patient-centered health coverage for cancer patients in China.

scholarly journals Perceptions of Care Among Older Adults Identified as Fall Risk During a Hospital Stay

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 139-139
Author(s):  
Barbara King
Keyword(s):  
Older Adults ◽  
Hospital Stay ◽  
Older Adult ◽  
Fall Prevention ◽  
Fall Risk ◽  
Medical Center ◽  
Academic Medical Center ◽  
Common Strategy ◽  
Open Coding ◽  
Perceptions Of Care

Abstract In-hospital falls are a significant clinical, legal and regulatory problem. The Centers for Medicare and Medicaid no longer reimburse hospitals for falls that result in injury, adding increase pressure on acute care settings to prevent falls. Additionally, evidence-based practice recommendations for fall prevention in hospitals do not exist, thus leaving administrators to create their own programs. One common strategy used by hospital providers to prevent falls is to restrict patient mobility. Little information on how older adult patients experience fall prevention during a hospital stay has been published. The purpose of this study was to understand perceptions of care among older adults identified as fall risk during a hospital stay. This qualitative study utilized inductive content analysis. Older adults (N=20) from a large academic medical center in the Midwest were recruited to participate in one-to one in-depth interviews. Open coding, categorization and abstraction was used to analyze the data. Three main categories were identified that summarized the older adult patient perception of hospitalization: Act of Caring, something they received from staff, provide to staff or provided to self; Being Restricted in movement resulting in either accepting or rejecting the restriction and Being Freed at discharge, often being told “just be careful”. Older adult identified as fall risk described being restricted in movement during a hospital stay. Many passively accepted this restriction even though they felt a lack of movement would be harmful to them. Additional research on the patient experience with fall prevention is needed.

scholarly journals Hardiness and attitudes toward professional healthcare services: Implications for healthcare service utilization among Black American adults

2021 ◽  
Vol 8 (2) ◽  
pp. 205510292110291
Author(s):  
Drexler James
Keyword(s):  
Locus Of Control ◽  
Healthcare Provider ◽  
Service Utilization ◽  
Indirect Effect ◽  
Indirect Effects ◽  
Healthcare Service ◽  
Healthcare Services ◽  
Black American ◽  
Health Value ◽  
Health Domains

This study ( N = 780) examines the indirect effects of hardiness—health locus of control (HLOC), health competence (HC), health value (HV)—on past-year healthcare provider visit via attitudes toward seeking and receiving professional healthcare services (ATSRPHS). Across four health domains (dental, general health, mental, vision), ATSRPHS mediated the indirect effect of (1) HV and (2) internal HLoC on past-year healthcare provider visit. ATSRPHS also mediated the indirect effect of external HLoC on past-year visit to healthcare provider visit for general medical, mental, and vision health. ATSRPHS did not mediate any indirect effect of HC on past-year healthcare provider visit. This research contributes to understanding determinants of healthcare service utilization among Black American adults.

Nosocomial Methicillin-Resistant and Methicillin-SusceptibleStaphylococcus AureusPrimary Bacteremia: At What Costs?

1999 ◽  
Vol 20 (6) ◽  
pp. 408-411 ◽  
Author(s):  
Murray A. Abramson ◽  
Daniel J. Sexton
Keyword(s):  
Hospital Stay ◽  
Medical Center ◽  
A Priori ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Bloodstream Infections ◽  
Methicillin Resistant ◽  
Tertiary Care Medical Center ◽  
Matching Criteria ◽  
Nested Case Control

Objective:To determine the attributable hospital stay and costs for nosocomial methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistantS aureus(MRSA) primary bloodstream infections (BSIs).Design:Pairwise-matched (1:1) nested case-control study.Setting:University-based tertiary-care medical center.Patients:Patients admitted between December 1993 and March 1995 were eligible. Cases were defined as patients with a primary nosocomialS aureusBSI; controls were selected according to a priori matching criteria.Measurements:Length of hospital stay and total and variable direct costs of hospitalization.Results:The median hospital stay attributable to primary nosocomial MSSA BSI was 4 days, compared with 12 days for MRSA (P=.023). Attributable median total cost for MSSA primary nosocomial BSIs was $9,661 versus $27,083 for MRSA nosocomial infections (P=.043).Conclusion:Nosocomial primary BSI due toS aureussignificantly prolongs the hospital stay. Primary nosocomial BSIs due to MRSA result in an approximate threefold increase in direct cost, compared with those due to MSSA.

scholarly journals Lockdown Lives: A longitudinal study of inter-relationships amongst feelings of loneliness, social contacts and solidarity during the COVID-19 lockdown in early 2020.

2020 ◽  
Author(s):  
Jolien van Breen ◽  
Maja Kutlaca ◽  
Yasin Koc ◽  
Bertus F. Jeronimus ◽  
Anne Margit Reitsema ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Public Debate ◽  
Public Understanding ◽  
National Data ◽  
Social Contacts ◽  
Face To Face ◽  
The Public ◽  
Time Points ◽  
The Impact ◽  
Cross National

In this work, we study how social contacts and feelings of solidarity shape experiences of loneliness during the COVID-19 lockdown in early 2020. We draw on cross-national data, collected across four time points between mid-March until early May 2020. We situate our work within the public debate on these issues and discuss to what extent the public understanding of the impact of lockdown is borne out in the data. Results show, first, that although online contacts are beneficial in combating feelings of loneliness, people who feel more lonely are less likely to make use of this strategy. Second, online contacts do not function as a substitute to face-to-face contacts - in fact, more frequent online contacts in earlier weeks predicted an increase in face-to-face contacts in later weeks. Finally, solidarity played only a small role in shaping people’s feelings of loneliness during lockdown. In sum, our findings suggest that we must look beyond the current focus on online contact and solidarity, if we want to help people address their feelings of loneliness. We hope that this work will be instrumental not only in understanding the impact of the lockdown in early 2020, but also in preparing for possible future lockdown periods.

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