scholarly journals Sex-specific differences in physical health and health services use among Canadian Veterans: a retrospective cohort study using healthcare administrative data

2021 ◽  
pp. e001915
Author(s):  
Kate St Cyr ◽  
A B Aiken ◽  
H Cramm ◽  
M Whitehead ◽  
P Kurdyak ◽  
...  
Keyword(s):  
Health Services ◽  
Physical Health ◽  
Retrospective Cohort ◽  
Income Quintile ◽  
Median Income ◽  
Female Veterans ◽  
Health Services Use ◽  
Male And Female ◽  
Male Veterans ◽  
Services Use

IntroductionMilitary occupations have historically been, and continue to be, male dominated. As such, female military Veteran populations tend to be understudied, and comparisons of the physical health status and patterns of health services use between male and female Veterans are limited outside of US samples. This study aimed to compare the physical health and health services use between male and female Veterans residing in Ontario, Canada.MethodsA retrospective cohort of 27 058 male and 4701 female Veterans residing in Ontario whose military service ended between 1990 and 2019 was identified using routinely collected administrative healthcare data. Logistic and Poisson regression models were used to assess sex-specific differences in the prevalence of select physical health conditions and rates of health services use, after multivariable adjustment for age, region of residence, rurality, neighbourhood median income quintile, length of service in years and number of comorbidities.ResultsThe risk of rheumatoid arthritis and asthma was higher for female Veterans compared with male Veterans. Female Veterans had a lower risk of myocardial infarction, hypertension and diabetes. No sex-specific differences were noted for chronic obstructive pulmonary disease. Female Veterans were also more likely to access all types of health services than male Veterans. Further, female Veterans accessed primary, specialist and emergency department care at greater rates than male Veterans. No significant differences were found in the sex-specific rates of hospitalisations or home care use.ConclusionsFemale Veterans residing in Ontario, Canada have different chronic health risks and engage in health services use more frequently than their male counterparts. These findings have important healthcare policy and programme planning implications, in order to ensure female Veterans have access to appropriate health services.

scholarly journals Health Services Use and Health Outcomes among Informal Economy Workers Compared with Formal Economy Workers: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (6) ◽  
pp. 3189
Author(s):  
Nisha Naicker ◽  
Frank Pega ◽  
David Rees ◽  
Spo Kgalamono ◽  
Tanusha Singh
Keyword(s):  
Occupational Health ◽  
Health Services ◽  
Informal Economy ◽  
Odds Ratio ◽  
Health Services Use ◽  
Quality Of Evidence ◽  
Formal Economy ◽  
Relative Differences ◽  
Services Use

Background: There are approximately two billion workers in the informal economy globally. Compared to workers in the formal economy, these workers are often marginalised with minimal or no benefits from occupational health and safety regulations, labour laws, social protection and/or health care. Thus, informal economy workers may have higher occupational health risks compared to their formal counterparts. Our objective was to systematically review and meta-analyse evidence on relative differences (or inequalities) in health services use and health outcomes among informal economy workers, compared with formal economy workers. Methods: We searched PubMed and EMBASE in March 2020 for studies published in 1999–2020. The eligible population was informal economy workers. The comparator was formal economy workers. The eligible outcomes were general and occupational health services use, fatal and non-fatal occupational injuries, HIV, tuberculosis, musculoskeletal disorders, depression, noise-induced hearing loss and respiratory infections. Two authors independently screened records, extracted data, assessed risk of bias with RoB-SPEO, and assessed quality of evidence with GRADE. Inverse variance meta-analyses were conducted with random effects. Results: Twelve studies with 1,637,297 participants from seven countries in four WHO regions (Africa, Americas, Eastern Mediterranean and Western Pacific) were included. Compared with formal economy workers, informal economy workers were found to be less likely to use any health services (odds ratio 0.89, 95% confidence interval 0.85–0.94, four studies, 195,667 participants, I2 89%, low quality of evidence) and more likely to have depression (odds ratio 5.02, 95% confidence interval 2.72–9.27, three studies, 26,260 participants, I2 87%, low quality of evidence). We are very uncertain about the other outcomes (very-low quality of evidence). Conclusion: Informal economy workers may be less likely than formal economy workers to use any health services and more likely to have depression. The evidence is uncertain for relative differences in the other eligible outcomes. Further research is warranted to strengthen the current body of evidence and needed to improve population health and reduce health inequalities among workers.

scholarly journals Factors Associated with the Patient’s Decision to Avoid Healthcare during the COVID-19 Pandemic

2021 ◽  
Vol 18 (24) ◽  
pp. 13239
Author(s):  
Patrícia Soares ◽  
Andreia Leite ◽  
Sara Esteves ◽  
Ana Gama ◽  
Pedro Almeida Laires ◽  
...  
Keyword(s):  
Health Services ◽  
Healthcare Delivery ◽  
System Response ◽  
Healthcare Use ◽  
Health Services Use ◽  
Community Based ◽  
Societal Costs ◽  
Factors Associated ◽  
The Government ◽  
Services Use

The COVID-19 pandemic has resulted in changes in healthcare use. This study aimed to identify factors associated with a patient’s decision to avoid and/or delay healthcare during the COVID-19 pandemic. We used data from a community-based survey in Portugal from July 2020 to August 2021, “COVID-19 Barometer: Social Opinion”, which included data regarding health services use, risk perception and confidence in health services. We framed our analysis under Andersen’s Behavioural Model of Health Services Use and utilised Poisson regression to identify healthcare avoidance associated factors. Healthcare avoidance was high (44%). Higher prevalence of healthcare avoidance was found among women; participants who reported lower confidence in the healthcare system response to COVID-19 and non-COVID-19; lost income during the pandemic; experienced negative emotions due to physical distancing measures; answered the questionnaire before middle June 2021; and perceived having worse health, the measures implemented by the Government as inadequate, the information conveyed as unclear and confusing, a higher risk of getting COVID-19, a higher risk of complications and a higher risk of getting infected in a health institution. It is crucial to reassure the population that health services are safe. Health services should plan their recovery since delays in healthcare delivery can lead to increased or worsening morbidity, yielding economic and societal costs.

scholarly journals Health Services Use and Health Care Costs of Obese and Nonobese Individuals

2004 ◽  
Vol 164 (19) ◽  
pp. 2135 ◽  
Author(s):  
Marsha A. Raebel ◽  
Daniel C. Malone ◽  
Douglas A. Conner ◽  
Stanley Xu ◽  
Julie A. Porter ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Costs ◽  
Health Services Use ◽  
Care Costs ◽  
Services Use

The Applicability of the Lee-Carter Method to Forecast Health Services Use in Brazil

2013 ◽  
pp. 371-385 ◽  
Author(s):  
Cristina Guimarães Rodrigues ◽  
Mônica Viegas Andrade ◽  
Bernardo Lanza Queiroz ◽  
Carla Jorge Machado
Keyword(s):  
Health Services ◽  
Health Services Use ◽  
Services Use
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