scholarly journals SARS-CoV-2 testing and COVID-19 related primary care use among people with citizenship, permanent residency, and temporary immigration status in British Columbia: Cross-sectional analysis of population-based administrative data

2021 ◽  
Author(s):  
Mei-ling Wiedmeyer ◽  
Shira Goldenberg ◽  
Sandra Peterson ◽  
Susitha Wanigaratne ◽  
Stefanie Machado ◽  
...  
Keyword(s):  
Primary Care ◽  
British Columbia ◽  
Administrative Data ◽  
Access To Health Care ◽  
Service Use ◽  
Care Service ◽  
Income Quintile ◽  
Immigration Status ◽  
Permanent Resident ◽  
Permanent Residency

Background: Having temporary immigration status affords limited rights, workplace protections, and access to services. There is not yet research data on impacts of the COVID-19 pandemic for people with temporary immigration status in Canada. Methods: We use linked administrative data to describe SARS-CoV-2 testing, positive tests, and COVID-19 primary care service use in British Columbia from January 1, 2020, to July 31, 2021, stratified by immigration status (Citizen, Permanent Resident, Temporary Resident). We plot the rate of people tested and the rate of people confirmed positive for COVID-19 by week from April 19, 2020, to July 31, 2021, across immigration groups. Results: 4.9% of people with temporary immigration status had a positive test for SARS-CoV-2 over this period, compared to 4.0% among people with permanent residency and 2.1% among people who hold Canadian citizenship. This pattern is persistent by sex/gender, age group, neighborhood income quintile, health authority, and in both metropolitan and small urban settings. At the same time we observe lower access to testing and COVID-19 related primary care among people with temporary status. Interpretation: People with temporary immigration status in BC experience higher SARS-CoV-2 test positivity; alarmingly, this was coupled with lower access to testing and primary care. Interwoven immigration, health and occupational policies place people with temporary status in circumstances of precarity and higher health risk. Extending permanent residency status to all immigrants residing in Canada and decoupling access to health care from immigration status could reduce precarity due to temporary immigration status.

scholarly journals Patterns of primary care service use by families with young children

2013 ◽  
Vol 30 (6) ◽  
pp. 679-694 ◽  
Author(s):  
C. Wilson ◽  
R. Hogg ◽  
M. Henderson ◽  
P. Wilson
Keyword(s):  
Primary Care ◽  
Young Children ◽  
Service Use ◽  
Care Service ◽  
Primary Care Service

scholarly journals Effect of socio-demographic factors on the association between multimorbidity and acute care service use: a population-based retrospective cohort study

2020 ◽  
Author(s):  
Kathryn Ann Fisher ◽  
Lauren Griffith ◽  
Andrea Gruneir ◽  
Richard Perez ◽  
Lindsay Favotto ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Administrative Data ◽  
Service Use ◽  
Care Service ◽  
Demographic Factors ◽  
Emergency Department Visits ◽  
Socio Demographic Factors ◽  
The Relationship ◽  
Acute Care Service

Abstract Background: This study explores how a broad-range of socio-demographic factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) among older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Community Health Survey (CCHS) to health administrative data to create a cohort of adults aged 65 and older in Ontario. Twelve chronic conditions identified from the administrative data were used to estimate multimorbidity (number of chronic conditions). We identified acute care service use over one year from the administrative data. We examined the relationship between multimorbidity and service use stratified by a comprehensive range of socio-demographic variables available from the CCHS. Logistic and Poisson multivariable regressions were used to explore the association between multimorbidity and service use and the role of socio-demographic factors in shaping this relationship. Results: Of the 28,361 members of the study sample, 60% were between the ages of 65 and 74 years, 57% were female, 72% were non-immigrant, and over 75% lived in an urban area. Emergency department visits and hospitalizations consistently increased with the level of multimorbidity. Stratified analyses revealed further patterns, with many being similar for both services – e.g., the odds ratios for both services were higher at all levels of multimorbidity for men, older age groups, and those with lower annual household income. Rurality and immigrant status appeared to impact emergency department use (higher in rural residents and non-immigrants) but not hospitalizations. Multimorbidity and most socio-demographic variables remained significant predictors of acute care service use in the multivariable regressions. Conclusions: Strong evidence links multimorbidity with increased acute care service use. This study showed that socio-demographic factors did not modify the relationship between multimorbidity and acute care service use, they were independently associated with acute care service use. Acute care service use was associated with perceived physical and mental health status as well as psychosocial factors, suggesting that optimizing service use requires attention to self-reported health status and social determinants, with programs that are multifaceted and integrated across the health and social service sectors.

scholarly journals Effect of socio-demographic and health factors on the association between multimorbidity and acute care service use: population-based survey linked to health administrative data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathryn A. Fisher ◽  
Lauren E. Griffith ◽  
Andrea Gruneir ◽  
Ross Upshur ◽  
Richard Perez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Administrative Data ◽  
Service Use ◽  
Care Service ◽  
Emergency Department Visits ◽  
Socio Demographic Factors ◽  
One Year ◽  
The Relationship ◽  
Acute Care Service

Abstract Background This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada. Methods We linked multiple cycles (2005–2006, 2007–2008, 2009–2010, 2011–2012) of the Canadian Community Health Survey (CCHS) to health administrative data to create a cohort of adults aged 65 and older. Administrative data were used to estimate one-year service use and to identify 12 chronic conditions used to measure multimorbidity. We examined the relationship between multimorbidity and service use stratified by a range of socio-demographic and health variables available from the CCHS. Logistic and Poisson regressions were used to explore the association between multimorbidity and service use and the role of socio-demographic factors in this relationship. Results Of the 28,361 members of the study sample, 60% were between the ages of 65 and 74 years, 57% were female, 72% were non-immigrant, and over 75% lived in an urban area. Emergency department visits and hospitalizations consistently increased with the level of multimorbidity. This study did not find strong evidence of moderator or interaction effects across a range of socio-demographic factors. Stratified analyses revealed further patterns, with many being similar for both services – e.g., the odds ratios were higher at all levels of multimorbidity for men, older age groups, and those with lower household income. Rurality and immigrant status influenced emergency department use (higher in rural residents and non-immigrants) but not hospitalizations. Multimorbidity and the range of socio-demographic variables remained significant predictors of service use in the regressions. Conclusions Strong evidence links multimorbidity with increased acute care service use. This study showed that a range of factors did not modify this relationship. Nevertheless, the factors were independently associated with acute care service use, pointing to modifiable risk factors that can be the focus of resource allocation and intervention design to reduce service use in those with multimorbidity. The study’s results suggest that optimizing acute care service use in older adults requires attention to both multimorbidity and social determinants, with programs that are multifactorial and integrated across the health and social service sectors.

scholarly journals Routine health monitoring and preventative care for people with dementia in UK primary care

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X703097
Author(s):  
Cini Bhanu ◽  
Mary Elizabeth Jones ◽  
Kate Walters ◽  
Irene Petersen ◽  
Claudia Cooper
Keyword(s):  
Primary Care ◽  
Service Use ◽  
Minority Groups ◽  
Care Service ◽  
Care Plan ◽  
Health Improvement ◽  
Preventative Care ◽  
Dementia Diagnosis ◽  
People With Dementia ◽  
Significant Difference

BackgroundUK National Dementia Strategies prioritise fair access to dementia treatment for all. It has been shown that people from black and minority ethnic (BME) groups are diagnosed later and those are less likely to receive anti-dementia medication.AimIt is hypothesised that access to primary care services post diagnosis is also reduced in ethnic minority groups.MethodThe Health Improvement Network (THIN) database of UK primary care records was analysed between 2015 and 2016, all patients with dementia were identified, and health service use was compared. Annual GP consultations, blood pressure (BP), weight/body mass index (BMI), Quality and Outcomes Framework (QOF) dementia review, and flu vaccination recordings were compared between ethnic groups.ResultsOver 20 000 individuals with a dementia diagnosis aged 50–105 years were included. There was no significant difference between white, black, and Asian groups across all outcomes. Overall 80% received an annual BP check, 86% received at least one annual GP consultation, 68% received an annual dementia review, and 48% had a weight/BMI recorded. People with dementia who did not have cardiovascular risk factors were less likely to have their BP checked (59%) and be seen by a GP.ConclusionThere do not appear to be ethnic inequalities in primary care service use post-dementia diagnosis. The overall proportion receiving an annual dementia review and weight check was low, despite recommendations that a care plan should be reviewed annually (including nutrition as a key priority). Post-diagnosis support and preventative care should be prioritised in general practice for all people living with dementia.

scholarly journals Evaluating a specialist primary care service for patients experiencing homelessness: a qualitative study

BJGP Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. bjgpopen20X101049
Author(s):  
Emily Clark ◽  
Emily Player ◽  
Tara Gillam ◽  
Sarah Hanson ◽  
Nicholas Steel
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Continuity Of Care ◽  
Service Use ◽  
Care Service ◽  
Service Planning ◽  
Primary Care Service ◽  
Care Staff ◽  
City Centre ◽  
Free Text

BackgroundPeople experiencing homelessness (PEH) often experience poor health, multimorbidity, and early mortality and experience barriers to accessing high quality health care. Little is known about how best to provide specialist primary care for these patients.AimTo evaluate the health care provided to patients experiencing homelessness who were seen in a specialist primary care service.Design & settingA qualitative evaluation of a city centre primary healthcare service for excluded and vulnerable people, such as rough sleepers, who find it difficult to visit mainstream GP services.MethodData on patient characteristics and service use were extracted from primary care records using electronic and free-text searches to provide context to the evaluation. Semi-structured interviews with 11 patients and four staff were used to explore attitudes and experiences.ResultsPatients had high needs compared with the general population. Patients valued continuity of care, ease of access, multidisciplinary care, and person-centred care. Staff were concerned that they lacked opportunities for reflection and learning, and that low clinical capacity affected service safety and quality. Staff also wanted more patient involvement in service planning.ConclusionPEH’s complex health and social problems benefited from a specialist primary care service, which is thought to reduce barriers to access, treat potentially challenging patients in a non-judgmental way, and provide personal continuity of care in order to develop trust.

scholarly journals Effect of socio-demographic and health factors on the association between multimorbidity and acute care service use: population-based survey linked to health administrative data

2020 ◽  
Author(s):  
Kathryn Ann Fisher ◽  
Lauren Griffith ◽  
Andrea Gruneir ◽  
Ross Upshur ◽  
Richard Perez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Administrative Data ◽  
Service Use ◽  
Care Service ◽  
Emergency Department Visits ◽  
Socio Demographic Factors ◽  
One Year ◽  
The Relationship ◽  
Acute Care Service

Abstract Background: This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada.Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Community Health Survey (CCHS) to health administrative data to create a cohort of adults aged 65 and older. Administrative data were used to estimate one-year service use and to identify 12 chronic conditions used to measure multimorbidity. We examined the relationship between multimorbidity and service use stratified by a range of socio-demographic and health variables available from the CCHS. Logistic and Poisson regressions were used to explore the association between multimorbidity and service use and the role of socio-demographic factors in this relationship.Results: Of the 28,361 members of the study sample, 60% were between the ages of 65 and 74 years, 57% were female, 72% were non-immigrant, and over 75% lived in an urban area. Emergency department visits and hospitalizations consistently increased with the level of multimorbidity. This study did not find strong evidence of moderator or interaction effects across a range of socio-demographic factors. Stratified analyses revealed further patterns, with many being similar for both services – e.g., the odds ratios were higher at all levels of multimorbidity for men, older age groups, and those with lower household income. Rurality and immigrant status influenced emergency department use (higher in rural residents and non-immigrants) but not hospitalizations. Multimorbidity and the range of socio-demographic variables remained significant predictors of service use in the regressions.Conclusions: Strong evidence links multimorbidity with increased acute care service use. This study showed that a range of factors did not modify this relationship. Nevertheless, the factors were independently associated with acute care service use, pointing to modifiable risk factors that can be the focus of resource allocation and intervention design to reduce service in those with multimorbidity. The study’s results suggest that optimizing acute care service use in older adults requires attention to both multimorbidity and social determinants, with programs that are multifactorial and integrated across the health and social service sectors.

scholarly journals Effect of socio-demographic and health factors on the association between multimorbidity and acute care service use: population-based survey linked to administrative data

2021 ◽  
Author(s):  
Kathryn Ann Fisher ◽  
Lauren Griffith ◽  
Andrea Gruneir ◽  
Ross Upshur ◽  
Richard Perez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Administrative Data ◽  
Service Use ◽  
Care Service ◽  
Emergency Department Visits ◽  
Socio Demographic Factors ◽  
One Year ◽  
The Relationship ◽  
Acute Care Service

Abstract Background: This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Community Health Survey (CCHS) to health administrative data to create a cohort of adults aged 65 and older. Administrative data were used to estimate one-year service use and to identify 12 chronic conditions used to measure multimorbidity. We examined the relationship between multimorbidity and service use stratified by a range of socio-demographic and health variables available from the CCHS. Logistic and Poisson regressions were used to explore the association between multimorbidity and service use and the role of socio-demographic factors in this relationship.Results: Of the 28,361 members of the study sample, 60% were between the ages of 65 and 74 years, 57% were female, 72% were non-immigrant, and over 75% lived in an urban area. Emergency department visits and hospitalizations consistently increased with the level of multimorbidity. This study did not find strong evidence of moderator or interaction effects across a range of socio-demographic factors. Stratified analyses revealed further patterns, with many being similar for both services – e.g., the odds ratios were higher at all levels of multimorbidity for men, older age groups, and those with lower household income. Rurality and immigrant status influenced emergency department use (higher in rural residents and non-immigrants) but not hospitalizations. Multimorbidity and the range of socio-demographic variables remained significant predictors of service use in the regressions. Conclusions: Strong evidence links multimorbidity with increased acute care service use. This study showed that a range of factors did not modify this relationship. Nevertheless, the factors were independently associated with acute care service use, pointing to modifiable risk factors that can be the focus of resource allocation and intervention design to reduce service in those with multimorbidity. The study’s results suggest that optimizing acute care service use in older adults requires attention to both multimorbidity and social determinants, with programs that are multifactorial and integrated across the health and social service sectors.

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