scholarly journals Healthcare presentations with self-harm and the association with COVID-19: an e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016 - March 2021

2021 ◽  
Author(s):  
Marcos del Pozo Banos ◽  
Sze Chim Lee ◽  
Yasmin Friedmann ◽  
Ashley Akbari ◽  
Fatemeh Tobari ◽  
...  
Keyword(s):  
Healthcare Service ◽  
Hospital Admissions ◽  
Healthcare Services ◽  
Population Based ◽  
Population Based Study ◽  
Individual Level ◽  
Healthcare Data ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Self Harm

Background Multi-setting population-based studies on healthcare service presentations with self-harm covering the first 12 months of the COVID-19 pandemic are yet to be published. Aims Ascertain changes across settings in healthcare service presentations with self-harm during Waves 1 and 2 of the COVID-19 pandemic. Method E-cohort study using individual-level linked routine healthcare data from Wales, UK, 2016-March 2021. We measured weekly proportion of self-harm contacts and people who self-harmed in contact with general practice (GP), emergency department (ED) and hospital admissions. We modelled weekly trends using linear regression and generalised estimated equations, quantifying time differences using difference-in-difference (DiD). Results We included 3,552,210 Welsh residents aged ≥10 years. Counts of self-harm presentations across settings was at a minimum at the start of stay-at-home restrictions during both waves and recovered compared to previous years in 3-5 months. Those who self-harmed in April 2020 were more likely to be seen in GP compared to other settings and previous years - mean rate of OR=1.2, although actual numbers fell. The proportion of self-harm ED contacts admitted to hospital dropped from June 2020 (1.9 [1.5-2.3] pp/month). Self-harm and COVID-19 infection had a bidirectional effect - self-harm history had OR=1.4 [1.2-1.6] and incidence had DiD=1.1 [0.8-1.4]. Conclusions Those that self-harmed and sought help during the COVID-19 pandemic potentially encountered stringent criteria for hospitalisation, particularly in Wave 2, while in Wave 1 they preferentially presented to GP. Reductions in contacts likely resulted in unmet healthcare needs which may later emerge placing further burden on individuals and healthcare services.

scholarly journals Self-harm presentation across healthcare settings by sex in young people

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Amanda Marchant ◽  
Samantha Turner ◽  
Lloyd Balbuena ◽  
Evyn Peters ◽  
Dave Williams ◽  
...  
Keyword(s):  
Primary Care ◽  
Linked Data ◽  
Hospital Admissions ◽  
Population Level ◽  
Population Based ◽  
Service Planning ◽  
Individual Level ◽  
Healthcare Data ◽  
Healthcare Settings ◽  
Self Harm

BackgroundAccurate data on self-harm is crucial to suicide prevention efforts. It has been previously found that around twice as many people who self-harm seek help in primary care than in secondary care. Little is known about how contacts for self-harm differ across settings at a population level. This study utilised individual-level linked data across GP, Emergency Departments (ED), outpatients and hospital admissions examining contacts across settings and time by sex for self-harm in 10-24 year olds. MethodsA whole-population based e-cohort study of routinely collected healthcare data was conducted. Rates of self-harm across settings over time by sex were examined. Individuals were categorised based on the service(s) to which they presented. ResultsA total of 937,697 individuals aged 10-24 years contributed 5,369,794 person years of data from the 01.01.2003-30.09.2015. There were differences in self-harm contacts by demographic variables particularly with regards to sex and admissions to hospital following ED attendance. ConclusionThis is the first study to compare self-harm in people aged 10-24 years across primary care, EDs, and hospital settings in the UK. The high rates of self-harm in primary care and for young men in EDs highlight these as important settings for intervention. Understanding patterns of presentation will inform service planning and configuration for follow-up care and could inform tailored support, for example for males in ED. Linked data provides important evidence to support the development of interventions across healthcare settings.

scholarly journals Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK

2019 ◽  
Vol 105 (4) ◽  
pp. 347-354 ◽  
Author(s):  
Amanda Marchant ◽  
Samantha Turner ◽  
Lloyd Balbuena ◽  
Evyn Peters ◽  
Dave Williams ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Hospital Admissions ◽  
Population Based ◽  
Age Group ◽  
Individual Level ◽  
Healthcare Data ◽  
Self Harm ◽  
The Uk ◽  
Over Time

BackgroundThis study used individual-level linked data across general practice, emergency departments (EDs), outpatients and hospital admissions to examine contacts across settings and time by sex for self-harm in individuals aged 10–24 years old in Wales, UK.MethodsA whole population-based e-cohort study of routinely collected healthcare data was conducted. Rates of self-harm across settings over time by sex were examined. Individuals were categorised based on the service(s) to which they presented.ResultsA total of 937 697 individuals aged 10–24 years contributed 5 369 794 person years of data from 1 January 2003 to 30 September 2015. Self-harm incidence was highest in primary care but remained stable over time (incident rate ratio (IRR)=1.0; 95% CI 0.9 to 1.1). Incidence of ED attendance increased over time (IRR=1.3; 95% CI 1.2 to 1.5) as did hospital admissions (IRR=1.4; 95% CI 1.1 to 1.6). Incidence in the 15–19 years age group was the highest across all settings. The largest increases were seen in the youngest age group. There were increases in ED attendances for both sexes; however, females are more likely than males to be admitted following this. This was most evident in individuals 10–15 years old, where 76% of females were admitted compared with just 49% of males. The majority of associated outpatient appointments were under a mental health specialty.ConclusionsThis is the first study to compare self-harm in people aged 10–24 years across primary care, EDs and hospital settings in the UK. The high rates of self-harm in primary care and for young men in EDs highlight these as important settings for intervention.

Nonelective hospital admissions, discharge disposition, and health services utilization in epilepsy patients: A population‐based study

Epilepsia ◽  
2020 ◽  
Vol 61 (9) ◽  
pp. 1969-1978
Author(s):  
Churl‐Su Kwon ◽  
Bonnie Wong ◽  
Parul Agarwal ◽  
Jung‐Yi Lin ◽  
Madhu Mazumdar ◽  
...  
Keyword(s):  
Health Services ◽  
Hospital Admissions ◽  
Health Services Utilization ◽  
Population Based ◽  
Population Based Study ◽  
Services Utilization ◽  
Discharge Disposition

Huntington’s Disease in Israel: A Population-based Study Using 20 Years of Routinely-Collected Healthcare Data

2021 ◽  
pp. 1-9
Author(s):  
Natalie Gavrielov-Yusim ◽  
Yael Barer ◽  
Michael Martinec ◽  
Athanasios Siadimas ◽  
Spyros Roumpanis ◽  
...  
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Healthcare Utilization ◽  
Behavioral Problems ◽  
Clinical Manifestations ◽  
Population Based ◽  
Emergency Department Visits ◽  
Study Cohort ◽  
Population Based Study ◽  
Healthcare Data

Background: Huntington’s disease (HD) is a rare, genetic, neurodegenerative disease. Obtaining population-level data on epidemiology and disease management is challenging. Objective: To investigate the epidemiology, clinical manifestations, treatment, and healthcare utilization of patients with HD in Israel. Methods: Retrospective population-based cohort study, including 20 years of routinely collected data from Maccabi Healthcare Services, an insurer and healthcare provider for one-quarter of the Israeli population. Results: The study cohort included 109 adult patients (aged ≥18 years) diagnosed with HD, with mean age of 49.9 years and 56%females. The most common HD-related conditions were anxiety (40%), behavioral problems (34%), sleep disorders (21%), and falls (13%). Annual incidence rates for HD ranged from 0.17 to 1.34 per 100,000 from 2000 to 2018; the 2018 crude prevalence in adults was 4.36 per 100,000. Median survival from diagnosis was approximately 12 years (95%CI: 10.4–15.3). The most frequent symptomatic treatments were antidepressants (69%), antipsychotics (63%), and tetrabenazine (63%), the only drug approved for the treatment of HD chorea in Israel during the examined period. Patterns of healthcare utilization changed as disease duration increased, reflected by increased frequency of emergency department visits and home visits. Conclusion: This retrospective population-based study provides insights into the prevalence, incidence, clinical profile, survival, and resource utilization of patients with HD in ethnically diverse Israel. The findings in this study are generally consistent with the international literature and demonstrate the value of routinely collected healthcare data as a complementary resource in HD research.

scholarly journals Driving Factors for the Utilisation of Healthcare Services by People with Osteoarthritis: Results from A Nationwide Population-Based study

2021 ◽  
Author(s):  
Daniela Costa ◽  
Ana M Rodrigues ◽  
Eduardo B Cruz ◽  
Helena Canhão ◽  
Jaime da Cunha Branco ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Multinomial Logistic Regression ◽  
Healthcare Utilisation ◽  
Healthcare Services ◽  
Structured Interview ◽  
Population Based ◽  
Enabling Factors ◽  
Population Based Study ◽  
The Impact

Abstract Background: Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the profiles of healthcare services utilisation by people with knee osteoarthritis, and to analyse their determinants, according to Andersen’s behavioural model. Methods: We analysed a sample of 978 participants diagnosed with knee osteoarthritis from the population-based study EpiReumaPt . Data was collected with a structured interview, and the diagnosis of knee osteoarthritis was validated by a rheumatologist team. With the Two-step Cluster procedure, we primarily identified different profiles of healthcare utilisation according to the services most used by patients with knee osteoarthritis. Secondly, we analysed the determinants of each profile, using multinomial logistic regression, according to the predisposing characteristics, enabling factors and need variables.Results: In our sample, a high proportion of participants are overweight or obese (82,6%, n=748) and physically inactive (20,6%, n=201) and a small proportion had physiotherapy management (14,4%, n=141). We identified three profiles of healthcare utilisation: “HighUsers”; “GPUsers”; “LowUsers”. “HighUsers” represents more than 35% of the sample, and are also the participants with higher utilisation of medical appointments. "GPUsers" represent the participants with higher utilisation of general practitioner appointments. Within these profiles, age and geographic location – indicated as predisposing characteristics; employment status and healthcare insurance - as enabling factors; number of comorbidities, physical function, health-related quality of life, anxiety and physical exercise - as need variables, showed associations ( p <0,05) with the higher utilisation of healthcare services profiles. Conclusions: Healthcare utilisation by people with knee osteoarthritis is not driven only by clinical needs. The predisposing characteristics and enabling factors associated with healthcare utilisation reveal inequities in the access to healthcare and variability in the management of people with knee osteoarthritis. Research and implementation of whole-system strategies to improve equity in the access and quality of care are paramount in order to diminish the impact of osteoarthritis at individual-, societal- and economic-level.

The pattern of self-harm in Fars Province in South Iran: A population-based study

2017 ◽  
Vol 51 ◽  
pp. 34-38
Author(s):  
Saeid Gholamzadeh ◽  
Mozhghan Zahmatkeshan ◽  
Mohammad Zarenezhad ◽  
Elaheh Ghaffari ◽  
Sanaz Hoseni
Keyword(s):  
Population Based ◽  
Fars Province ◽  
Population Based Study ◽  
Self Harm

scholarly journals Cognitive impairment and healthcare needs: findings from a population based study in Turkey

2017 ◽  
Vol 27 (suppl_3) ◽  
Author(s):  
O Karadag Caman ◽  
S Kiran ◽  
S Karahan ◽  
N Bilir ◽  
Y Ayhan
Keyword(s):  
Cognitive Impairment ◽  
Population Based ◽  
Population Based Study ◽  
Healthcare Needs

scholarly journals Unmet Healthcare Needs and Associated Factors in Rural and Suburban Vietnam: A Cross-Sectional Study

2020 ◽  
Vol 17 (17) ◽  
pp. 6320
Author(s):  
Ju Young Kim ◽  
Dae In Kim ◽  
Hwa Yeon Park ◽  
Yuliya Pak ◽  
Phap Ngoc Hoang Tran ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Associated Factors ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs

The purpose of this study was to examine the current utilization of healthcare services, exploring unmet healthcare needs and the associated factors among people living in rural Vietnam. This cross-sectional study was conducted with 233 participants in a rural area. The methods included face-to-face interviews using a structured questionnaire, and anthropometric and blood pressure measurements. We considered participants to have unmet health needs if they had any kind of health problem during the past 12 months for which they were unable to see a healthcare provider. Multivariate logistic regression analysis was performed to determine the factors associated with unmet healthcare needs. Of the participants, 18% (n = 43) had unmet healthcare needs, for reasons like transportation (30%), a lack of available doctors or medicine (47%), and communication issues with healthcare providers (16%). The multivariate logistic regression showed that living in a rural area, having stage 2 hypertension, and having insurance were associated with unmet healthcare needs. To better meet the healthcare needs in rural or suburban areas of Vietnam, allocation of adequate healthcare resources should be distributed in rural areas and insurance coverage for personalized healthcare needs might be required. Efforts should focus on availability of medicine, improvement of transportation systems, and communication skills of healthcare providers to improve access to healthcare services.

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