scholarly journals Evidence assessment and narrative synthesis of the key characteristics of older people living in service-integrated housing facilities, and their ‘accommodation journey’

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Juliana Thompson ◽  
Michael Hill ◽  
Lesley Bainbridge ◽  
Daniel Cowie ◽  
Emma Flewers
Keyword(s):  
Health Service ◽  
Older People ◽  
Workforce Development ◽  
Service Use ◽  
Well Being ◽  
Health Service Use ◽  
Narrative Synthesis ◽  
Care Needs ◽  
Content Type ◽  
Key Characteristics

Purpose This paper aims to provide an evidence assessment and narrative synthesis of literature regarding the key characteristics of older people living in service-integrated housing (SIH) facilities and their “accommodation journey”. Design/methodology/approach A rapid evidence assessment was conducted: 22 research publications met the inclusion criteria and were analysed using narrative synthesis. Findings The quality of studies in this area is low, but consistency across components of the results of studies included in the review is apparent. Results suggest key characteristics of older people that drive moves into SIH are a decline in health, increased dependency, increased health service use and carer burden. Suggested key characteristics of SIH residents are high levels of health problems, dependency and health service use, but high self-reported health and well-being. Results indicate that the key driver for older people leaving SIH is a lack of workforce competency to manage further declines in health and dependency status. Research limitations/implications Current policy may not realise or account for the complex health and care needs of SIH residents. Investment into integrated care, robust community health services and workforce development to facilitate a comprehensive assessment approach may be required to support residents to remain in SIH and live well. Further longitudinal studies are required to map the progression of SIH residents’ health status in detail over time to provide an understanding of preventative and enablement support, development of care pathways and workforce planning and development requirements. Originality/value This evidence assessment is the first to consider the accommodation journey of older people residing in SIH.

scholarly journals Migrant mental health and representation in routine administrative registers

2018 ◽  
Vol 14 (1) ◽  
pp. 82-95
Author(s):  
Ciara Mary Close ◽  
Tania Bosqui ◽  
Dermot O’Reilly ◽  
Michael Donnelly ◽  
Anne Kouvonen
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Cultural Awareness ◽  
Service Use ◽  
Well Being ◽  
Health Staff ◽  
Local Health ◽  
Migrant Population ◽  
Content Type ◽  
Migrant Mental Health

Purpose There has been an increase in the use of registers and record linkages to study migrant mental health. However, the accuracy of these registers and the degree to which they are representative of the migrant population in Northern Ireland (NI) are unclear. The purpose of this paper is to explore: the coverage of the NI migrant population in general practitioner (GP) data and Census records; the issues faced by migrants in terms of registering and accessing the local health system; and the reporting of racial hate crimes against migrants to police. Design/methodology/approach Two focus groups of professionals (n=17) who worked with migrants were conducted. Group discussions were guided by a research-informed topic guide, and the data were analysed using thematic analysis. Findings Three main themes emerged: issues with the use of GP registration, Census and hate crime data for researching migrant mental health; barriers to health service use (e.g. low cultural awareness among health staff and access to interpreters); and risk factor exposure and mental health status in migrant communities (e.g. poverty, isolation and poor working conditions). Originality/value Record linkage and registry studies of migrant health and well-being using Census and health service sources need to be mindful of the likelihood that some migrants may be missed. The possible underrepresentation of migrants in health registers may be explained by reduced use of such services which may be caused my encountering staff with limited cultural competency and the inability to access an interpreter promptly.

Bridging community and prison for older adults: invoking human rights and elder and intergenerational family justice

2014 ◽  
Vol 10 (1) ◽  
pp. 55-73 ◽  
Author(s):  
Tina Maschi ◽  
Deborah Viola ◽  
Mary T. Harrison ◽  
William Harrison ◽  
Lindsay Koskinen ◽  
...  
Keyword(s):  
Older Adults ◽  
Human Rights ◽  
Service Use ◽  
Family System ◽  
Prison Population ◽  
Interdisciplinary Approach ◽  
Well Being ◽  
Care Needs ◽  
Cross Sectional ◽  
Content Type

Purpose – Older adults in prison present a significant health and human rights challenge for the criminal justice system. To date, there is no known study that provides a comprehensive examination or portrait of older persons in prison. The purpose of this paper is to understand individual, family, system, and community vulnerabilities that can complicate successful community reintegration for these individuals. Design/methodology/approach – This study provides a cross-sectional, descriptive analysis of biopsychosocial, spiritual, and prison use characteristics associated with a sample of 677 older prisoners, aged 50+, in a state-wide prison system. Findings – Results indicate the extent of diversity within this population based on demographic, clinical, social, legal profiles, prison service use patterns, and professional and personal contacts. Research limitations/implications – Due to the diversity within this population, an interdisciplinary approach is needed to address the complex social and health care needs of an aging prison population and to plan for their reentry. Practical implications – These findings suggest the need for holistic prevention, assessment, and interventions to interrupt the social-structural disparities that foster and support pathways to incarceration and recidivism. Originality/value – The human rights implications for the current treatment of older adults in prison include providing in-prison treatment that promotes safety, well-being, reconciliation, and seamless bridges between prison and community for older adults and their families. The True Grit Program is presented as an example of a humanistic and holistic approach of such an approach.

scholarly journals Gender Differences in Self-Rated Health among University Students in England, Wales and Northern Ireland: Do Confounding Variables Matter?

2016 ◽  
Vol 8 (11) ◽  
pp. 168 ◽  
Author(s):  
Walid EL-Ansari ◽  
Christiane Stock
Keyword(s):  
Quality Of Life ◽  
Health Service ◽  
Physical Health ◽  
Service Use ◽  
Health Behaviours ◽  
Well Being ◽  
Health Service Use ◽  
Health Complaints ◽  
Self Rated Health

<p><strong>INTRODUCTION:</strong> We assessed gender differences in self-rated health (SRH) while considering physical health, health complaints, health service use, wider wellbeing, and health behaviours.</p><p><strong>METHODS:</strong> 3706 undergraduates at 7 Universities in the United Kingdom completed a self-administered questionnaire (2009–2008). Logistic regressions with excellent/very good SRH as dependent variable assessed the variables that explained the SRH sex difference. </p><p><strong>RESULTS:</strong> Females had more health complaints, illness periods, lower quality of life, more burdens, and took medication/s more often. The crude (unadjusted) odds ratio (OR) proposed that females were less likely to report excellent/very good SRH than males [OR 0.79, 95% CI 0.68-0.94]. Adjusting only for physical health and health service use, females’ OR increased considerably, and the association between female sex and SRH was no longer significant. Also, when adjusting only for wider well-being or when adjusting only for health behaviour, the negative association between females and SRH was no longer significant. Adjusting for all the variables simultaneously (physical health, health service use, wider well-being, health behaviours) resulted in considerable increase of females’ OR indicating now a positive association between female sex and SRH [OR 1.33, 95% CI 1.04-1.74].  </p><p><strong>CONCLUSION:</strong> Females’ lower SRH found in the crude analyses was confounded by their higher stress level, lower quality of life, lower physical activity and by more illnesses or health complaints when compared with males. Gender-related SRH research should control for many potential confounders to prevent overestimation of the gender effect. Health promotion programs should consider these factors when tackling gender health disparities.</p>

Vulnerable Older People in the Community: Relationship Between the Vulnerable Elders Survey and Health Service Use

2008 ◽  
Vol 56 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Hannah M. McGee ◽  
Ann O'Hanlon ◽  
Maja Barker ◽  
Anne Hickey ◽  
Anthony Montgomery ◽  
...  
Keyword(s):  
Health Service ◽  
Older People ◽  
Service Use ◽  
Health Service Use ◽  
Community Relationship

scholarly journals Common elements of service delivery models that optimise quality of life and health service use among older people with advanced progressive conditions: a tertiary systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e048417
Author(s):  
Joanne Bayly ◽  
Anna E Bone ◽  
Clare Ellis-Smith ◽  
India Tunnard ◽  
Shuja Yaqub ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Health Service ◽  
Older People ◽  
Low Income ◽  
Service Use ◽  
Functional Decline ◽  
Low Income Countries ◽  
Health Service Use

IntroductionHealth and social care services worldwide need to support ageing populations to live well with advanced progressive conditions while adapting to functional decline and finitude. We aimed to identify and map common elements of effective geriatric and palliative care services and consider their scalability and generalisability to high, middle and low-income countries.MethodsTertiary systematic review (Cochrane Database of Systematic Reviews, CINAHL, Embase, January 2000–October 2019) of studies in geriatric or palliative care that demonstrated improved quality of life and/or health service use outcomes among older people with advanced progressive conditions. Using frameworks for health system analysis, service elements were identified. We used a staged, iterative process to develop a ‘common components’ logic model and consulted experts in geriatric or palliative care from high, middle and low-income countries on its scalability.Results78 studies (59 geriatric and 19 palliative) spanning all WHO regions were included. Data were available from 17 739 participants. Nearly half the studies recruited patients with heart failure (n=36) and one-third recruited patients with mixed diagnoses (n=26). Common service elements (≥80% of studies) included collaborative working, ongoing assessment, active patient participation, patient/family education and patient self-management. Effective services incorporated patient engagement, patient goal-driven care and the centrality of patient needs. Stakeholders (n=20) emphasised that wider implementation of such services would require access to skilled, multidisciplinary teams with sufficient resource to meet patients’ needs. Identified barriers to scalability included the political and societal will to invest in and prioritise palliative and geriatric care for older people, alongside geographical and socioeconomic factors.ConclusionOur logic model combines elements of effective services to achieve optimal quality of life and health service use among older people with advanced progressive conditions. The model transcends current best practice in geriatric and palliative care and applies across the care continuum, from prevention of functional decline to end-of-life care.PROSPERO registration numberCRD42020150252.

scholarly journals Understanding the use and impact of allied health services for people with chronic health conditions in Central and Eastern Sydney, Australia: a five-year longitudinal analysis

2019 ◽  
Vol 20 ◽  
Author(s):  
Margo Linn Barr ◽  
Heidi Welberry ◽  
Elizabeth J. Comino ◽  
Ben F. Harris-Roxas ◽  
Elizabeth Harris ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Allied Health ◽  
Service Use ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Health Service Use ◽  
Complex Care ◽  
Care Needs ◽  
Complex Care Needs

AbstractAim:To describe the characteristics of people in Central and Eastern Sydney (CES), NSW, who had a General Practice Management Plan (GPMP) and claimed for at least one private allied health service item; and to examine if allied health service use results in less hospitalisations over a five-year period.Background:The number of people living with chronic health conditions is increasing in Australia. The Chronic Disease Management programme was introduced to the Medicare Benefits Schedule (MBS) to provide a more structured approach to managing patients with chronic conditions and complex care needs. The programme supports general practitioners claiming up to one GPMP and one Team Care Arrangement every year, and the patient additionally claiming for up to five private allied health services visits.Methods:A prospective longitudinal study was conducted. The sample consisted of 5771 participants in CES who had a GPMP within a two-year health service utilisation baseline period (2007–2009). The analysis used the 45 and Up Study questionnaire data linked to the MBS, hospitalisation, death and emergency department data for the period 2006–2014.Findings:Of the eligible participants, 43% (2460) had at least one allied health service item claim in the subsequent 12 months. Allied health services were reported as physiotherapy, podiatry and other allied health services. The highest rates of allied health service use were among participants aged 85 years and over (49%). After controlling for confounding factors, a significant difference was found between having claimed for five or more physiotherapy services and emergency admissions (HR: 0.83; 95% CI: 0.72–0.95) and potentially preventable hospitalisations (HR: 0.79; 95% CI: 0.64–0.96) in the subsequent five years. Use of allied health service items was well targeted towards those with chronic and complex care needs, and use of physiotherapy services was associated with less avoidable hospitalisations.

scholarly journals Service Use for Mental Health Reasons: Cross-Provincial Differences in Rates, Determinants, and Equity of Access

2005 ◽  
Vol 50 (10) ◽  
pp. 614-619 ◽  
Author(s):  
Helen-Maria Vasiliadis ◽  
Alain Lesage ◽  
Carol Adair ◽  
Richard Boyer
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Service ◽  
Mental Disorder ◽  
Resource Use ◽  
Service Use ◽  
Well Being ◽  
Medical System ◽  
Health Service Use ◽  
Health And Well Being

Objectives: In 2002, Canada undertook its first national survey on mental health and well-being, including detailed questioning on service use. Mental disorders may affect more than 1 person in 5, according to past regional and less comprehensive mental health surveys in Canada, and most do not seek help. Individual determinants play a role in health resource use for mental health (MH) reasons. This study aimed to provide prevalence rates of health care service use for MH reasons by province and according to service type and to examine determinants of MH service use in Canada and across provinces. Methods: We assessed the prevalence rate (95% confidence interval [CI]) of past-year health service use for MH reasons, and we assessed potential determinants cross-sectionally, using data collected from the Statistics Canada Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). We estimated models of resource use with logistic regression (using odds ratios and 95%CIs). Results: The prevalence of health service use for MH reasons in Canada was 9.5% (95%CI, 9.1% to 10.0%). The highest rates, on average, were observed in Nova Scotia (11.3%; 95%CI, 9.6% to 13.0%) and British Columbia (11.3%; 95%CI, 10.1% to 12.6%). The lowest rates were observed in Newfoundland and Labrador (6.7%; 95%CI, 5.3% to 8.0%) and Prince Edward Island (7.5%; 95%CI, 5.8% to 9.3%). In Canada, the general medical system was the most used for MH reasons (5.4%; 95%CI, 5.1% to 5.8%) and the voluntary network sector was the least used (1.9%; 95%CI, 1.7% to 2.1%). No difference was observed in the rate of service use between specialty MH (3.5%; 95%CI, 3.2% to 3.8%) and other professional providers (4.0%; 95%CI, 3.7% to 4.3%). In multivariate analyses, after adjusting for age and sex, the presence of a mental disorder was a consistent predictor of health service use for MH across the provinces. Conclusions: There is up to a twofold difference in the type of service used for MH reasons across provinces. The primary care general medical system is the most widely used service for MH. Need remains the strongest predictor of use, especially when a mental disorder is present. Barriers to access, such as income, were not identified in all provinces. Different sociodemographic variables played a role in service seeking within each province. This suggests different attitudes toward common mental disorders and toward care seeking among the provinces.

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