Factors associated with patient and health care system delay in diagnosis and treatment for TB in sub-Saharan African countries with high burdens of TB and HIV

BACKGROUND: Even though maternal mortality, which is a pregnancy-related death is preventable, it has continued to increase in many nations of the world, especially in the African countries of the sub-Saharan regions caused by factors which include a low level of socioeconomic development. AIM: This paper focuses on cogent issues affecting maternal mortality by unpacking its precipitating factors and examining the maternal health care system in Nigeria. METHODS: Contemporary works of literature were reviewed, and the functionalist perspective served as a theoretical guide to examine the interrelated functions of several sectors of the society to the outcome of maternal mortality. RESULTS: It was noted that apart from the medical related causes (direct and indirect) of maternal mortality, certain socio-cultural and socioeconomic factors influence the outcome of pregnancy. Also, a poor health care system, which is a consequent of weak social structure, is a contributing factor. CONCLUSION: As a result, maternal mortality has debilitating effects on the socioeconomic development of any nation. It is therefore pertinent for the government to improve maternal health and eradicate poverty to ensure sustainable development.

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Factors associated with patient and health care system delay in the diagnosis of tuberculosis in France

The International Journal of Tuberculosis and Lung Disease ◽

10.5588/ijtld.11.0420 ◽

2012 ◽

Vol 16 (4) ◽

pp. 510-515 ◽

Cited By ~ 27

Author(s):

P. Tattevin ◽

D. Che ◽

P. Fraisse ◽

C. Gatey ◽

C. Guichard ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

System Delay ◽

Factors Associated ◽

Care System

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Diagnostic and treatment challenges of adolescent and young adult oncology patients.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.9557 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 9557-9557

Author(s):

Yanqing Xu ◽

Mauro Cardoso ◽

Michael Ostaric Palumbo ◽

Olivia Ishibashi ◽

Petr Kavan

Keyword(s):

Health Care ◽

Health Care System ◽

Symptom Onset ◽

Delay Time ◽

Treatment Delay ◽

Patient Delay ◽

Adolescent And Young Adult ◽

Diagnosis And Treatment ◽

System Delay ◽

Care System

9557 Background: Adolescent and young adult (AYA) cancer patients are faced with obstacles and challenges related to their diagnosis and treatment compared to children and older adults. The aim of this study was to explore the patient and health care system-related delays in the interval from cancer symptom onset to diagnosis and treatment as well as to identify the possible contributing factors to these delays in the AYA group. Methods: This study was based on a questionnaire conducted in 2010-2011 completed by patients diagnosed with a malignancy between the ages of 16 and 39 in addition to older patients diagnosed with a pediatric type malignancy. Four categories of delays: patient delay (time from patient symptom onset until first health care contact date), health care system delay (time from first health care contact until diagnosis date), treatment delay (time from diagnosis date until first treatment) and oncologist delay (time from first health care contact until first medical oncologist meeting) were calculated. Median delay (in days) with interquartile interval (IQI) was the main outcome measure. Median time for each category of delay was further analysed to explore how they vary with different patient characteristics. Results: We identified a median patient delay of 30 days (IQI 1-131), a median health care system delay of 53 days (IQI 1-213), a median treatment delay of 36 days (IQI 5-92) and a median oncologist delay of 77 days (IQI 30-281). Patient delay was affected by patient gender, age at diagnosis and type of first health care contact. Health care system delay was associated with patient marital status, financial situation and attitude of first health care professional. Treatment delay was related to type of cancer. Conclusions: The health care system delay (including oncologist delay) accounts for much of the delay from symptom onset to first treatment. Professional characteristics of frontline medical personnel as well as socioeconomic and biological characteristics of the patients may contribute to delay. Healthcare professionals and the general community as a whole need to be aware of the factors contributing to delay in diagnosis and treatment in the underserved patient population.

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Factors Associated With Americans' Ratings of Health Care Quality: What Do They Tell Us About the Raters and the Health Care System?

Journal of Health Communication ◽

10.1080/10810730.2010.522692 ◽

2010 ◽

Vol 15 (sup3) ◽

pp. 147-156 ◽

Cited By ~ 9

Author(s):

Wen-Ying Sylvia Chou ◽

Lin Chun Wang ◽

Lila J. Finney Rutten ◽

Richard P. Moser ◽

Bradford W. Hesse

Keyword(s):

Health Care ◽

Health Care System ◽

Health Care Quality ◽

Care Quality ◽

Factors Associated ◽

Care System

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Factors Associated with Perceived Abuse in the Health Care System Among Long-Term Opioid Users: A Cross-Sectional Study

Substance Use & Misuse ◽

10.3109/10826084.2016.1155605 ◽

2016 ◽

Vol 51 (6) ◽

pp. 763-776 ◽

Cited By ~ 6

Author(s):

Heather Palis ◽

Kirsten Marchand ◽

Defen Peng ◽

Jill Fikowski ◽

Scott Harrison ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Opioid Users ◽

Care System

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Health Care System-level Factors Associated With Performance on Medicare STAR Adherence Metrics in a Large, Integrated Delivery System

Medical Care ◽

10.1097/mlr.0000000000000328 ◽

2015 ◽

Vol 53 (4) ◽

pp. 332-337 ◽

Cited By ~ 21

Author(s):

Julie A. Schmittdiel ◽

Gregory A. Nichols ◽

Wendy Dyer ◽

John F. Steiner ◽

Andrew J. Karter ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Delivery System ◽

System Level ◽

Factors Associated ◽

Integrated Delivery System ◽

Integrated Delivery ◽

Care System

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Health care seeking behaviour for children with acute childhood illnesses and its relating factors in sub-Saharan Africa: evidence from 24 countries

Tropical Medicine and Health ◽

10.1186/s41182-021-00385-1 ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Sanni Yaya ◽

Emmanuel Kolawole Odusina ◽

Nicholas Kofi Adjei

Keyword(s):

Health Care ◽

Health Care Seeking ◽

Care Seeking ◽

African Countries ◽

Under Five ◽

Factors Associated ◽

Childhood Illnesses ◽

Health Care Seeking Behaviour ◽

Sub Saharan ◽

Care Seeking Behaviour

Abstract Background Childhood illnesses and mortality rates have declined over the past years in sub-Saharan African countries; however, under-five mortality is still high in the region. This study investigated the magnitude and factors associated with health care seeking behaviour for children with childhood illnesses in 24 sub-Saharan African countries. Methods We used secondary data from Demographic and Health Surveys (DHSs) conducted between 2013 and 2018 across the 24 sub-Saharan African countries. Binary logistic regression models were applied to identify the factors associated with health care seeking behaviour for children with acute childhood illnesses. The results were presented using adjusted odds ratios (aOR) with 95% confidence intervals (CIs). Results Overall, 45% of children under-5 years with acute childhood illnesses utilized health care facilities. The factors associated with health care seeking behaviour for children with acute illnesses were sex of child, number of living children, education, work status, wealth index, exposure to media and distance to a health facility. Conclusions Over half of mothers did not seek appropriate health care for under-five childhood illnesses. Effective health policy interventions are needed to enhance health care seeking behaviour of mothers for childhood illnesses in sub-Saharan African countries.

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Clinical, Behavioral and Social Factors Associated with Racial Disparities in Hospitalized and Ambulatory COVID-19 Patients from an Integrated Health Care System in Georgia

10.1101/2020.07.08.20148973 ◽

2020 ◽

Author(s):

Felipe Lobelo ◽

Alan X Bienvenida ◽

Serena Leung ◽

Armand N Mbanya ◽

Elizabeth J. Leslie ◽

...

Keyword(s):

Health Care ◽

Quality Of Care ◽

Health Care System ◽

Integrated Health Care ◽

Community Level ◽

Factors Associated ◽

Integrated Health ◽

Integrated Health Care System ◽

Care System

Introduction: Racial and ethnic minorities have shouldered a disproportioned burden of coronavirus disease 2019 (COVID-19) infection to date in the US, but data on the various drivers of these disparities is limited. Objectives: To describe the characteristics and outcomes of COVID-19 patients and explore factors associated with hospitalization risk by race. Methods: Case series of 448 consecutive patients with confirmed COVID-19 seen at Kaiser Permanente Georgia (KPGA), an integrated health care system serving the Atlanta metropolitan area, from March 3 to May 12, 2020. KPGA members with laboratory-confirmed COVID-19. Multivariable analyses for hospitalization risk also included an additional 3489 persons under investigation (PUI) with suspected infection. COVID-19 treatment and outcomes, underlying comorbidities and quality of care management metrics, socio-demographic and other individual and community-level social determinants of health (SDOH) indicators. Results: Of 448 COVID-19 positive members, 68,3% was non-Hispanic Black (n=306), 18% non-Hispanic White (n=81) and 13,7% Other race (n=61). Median age was 54 [IQR 43-63) years. Overall, 224 patients were hospitalized, median age 60 (50-69) years. Black race was a significant factor in the Confirmed + PUI, female and male models (ORs from 1.98 to 2.19). Obesity was associated with higher hospitalization odds in the confirmed, confirmed + PUI, Black and male models (ORs from 1.78 to 2.77). Chronic disease control metrics (diabetes, hypertension, hyperlipidemia) were associated with lower odds of hospitalization ranging from 48% to 35% in the confirmed + PUI and Black models. Self-reported physical inactivity was associated with 50% higher hospitalization odds in the Black and Female models. Residence in the Northeast region of Atlanta was associated with lower hospitalization odds in the Confirmed + PUI, White and female models (ORs from 0.22 to 0.64) Conclusions: We found that non-Hispanic Black KPGA members had a disproportionately higher risk of infection and, after adjusting for covariates, twice the risk of hospitalization compared to other race groups. We found no significant differences in clinical outcomes or mortality across race/ethnicity groups. In addition to age, sex and comorbidity burden, pre-pandemic self-reported exercise, metrics on quality of care and control of underlying cardio-metabolic diseases, and location of residence in Atlanta were significantly associated with hospitalization risk by race groups. Beyond well-known physiologic and clinical factors, individual and community-level social indicators and health behaviors must be considered as interventions designed to reduce COVID-19 disparities and the systemic effects of racism are implemented.

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