scholarly journals Cohort profile: the Comparative Outcomes And Service Utilization Trends (COAST) Study among people living with and without HIV in British Columbia, Canada

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019115 ◽  
Author(s):  
Oghenowede Eyawo ◽  
Mark W Hull ◽  
Kate Salters ◽  
Hasina Samji ◽  
Angela Cescon ◽  
...  
Keyword(s):  
Health Care ◽  
British Columbia ◽  
General Population ◽  
Health Service ◽  
Service Utilization ◽  
Service Use ◽  
Data Linkage ◽  
Health Care Use ◽  
Health Service Use ◽  
People Living With Hiv

PurposeThe Comparative Outcomes And Service Utilization Trends (COAST) Study in British Columbia (BC), Canada, was designed to evaluate the determinants of health outcomes and health care services use among people living with HIV (PLHIV) as they age in the period following the introduction of combination antiretroviral therapy (cART). The study also assesses how age-associated comorbidities and health care use among PLHIV may differ from those observed in the general population.ParticipantsCOAST was established through a data linkage between two provincial data sources: The BC Centre for Excellence in HIV/AIDS Drug Treatment Program, which centrally manages cART dispensation across BC and contains prospectively collected data on demographic, immunological, virological, cART use and other clinical information for all known PLHIV in BC; and Population Data BC, a provincial data repository that holds individual event-level, longitudinal data for all 4.6 million BC residents. COAST participants include 13 907 HIV-positive adults (≥19 years of age) and a 10% random sample inclusive of 516 340 adults from the general population followed from 1996 to 2013.Findings to dateFor all participants, linked individual-level data include information on demographics, health service use (eg, inpatient care, outpatient care and prescription medication dispensations), mortality, and HIV diagnostic and clinical data. Publications from COAST have demonstrated the significant mortality reductions and dramatic changes in the causes of death among PLHIV from 1996 to 2012, differences in the amount of time spent in a healthy state by HIV status, and high levels of injury and mood disorder diagnosis among PLHIV compared with the general population.Future plansTo capture the dynamic nature of population health parameters, regular data updates and a refresh of the data linkage are planned to occur every 2 years, providing the basis for planned analysis to examine age-associated comorbidities and patterns of health service use over time.

Patterns of Care in Early-Stage Breast Cancer Survivors in the First Year After Cessation of Active Treatment

2006 ◽  
Vol 24 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Jeanne S. Mandelblatt ◽  
William F. Lawrence ◽  
Jennifer Cullen ◽  
Annette L. Stanton ◽  
Janice L. Krupnick ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Health Service ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Service Use ◽  
Health Care Use ◽  
Health Service Use ◽  
First Year ◽  
Surveillance Mammography

Purpose Patterns of health care use have not been well described for breast cancer survivors. The purpose of this study was to describe the health service use in a survivor cohort. Patients and Methods Women with stage I or II breast cancer were recruited (n = 558) after primary treatment for a multicenter, randomized trial of psychoeducational interventions for facilitating transition to survivorship; 418 women completed the study. Participants completed calendar diaries detailing health care use for 1 year after treatment. Services were coded using Current Procedural Terminology–Fourth Edition codes; costs were estimated using year 2000 Medicare reimbursements. Results Health care use diary data were available for 391 women (70% of the sample). On average, these survivors reported 30 episodes of health service use in the year after treatment. Total annual costs of care averaged more than $1,800 per survivor; medical office visits were the major component of costs. Type of cancer treatment, depression, and physical function and comorbid illness were independent predictors of the costs of services. There were geographic variations in initial local treatment patterns and in post-treatment costs. Notably, all women should have received surveillance mammography in the time period, but only 61.9% did so; the odds of mammogram receipt were higher for women who had a lumpectomy (v mastectomy) and women who were white (v nonwhite). Conclusion Use of health services is frequent and intensive in the first year after treatment for breast cancer. Despite frequent contact with the health care system, there is room for improvement in providing guideline-suggested surveillance mammography for survivors.

Health Status, Health Problems and Practices among Refugees from the Middle East, Eastern Europe and Southeast Asia

1987 ◽  
Vol 21 (3) ◽  
pp. 760-782 ◽  
Author(s):  
Rosalie F. Young ◽  
Allen Bukoff ◽  
John B. Waller ◽  
Stephen B. Blount
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Service Use ◽  
Dental Health ◽  
Health Problems ◽  
Health Service Use ◽  
Care Utilization ◽  
Barriers To Health

Recent refugees from Poland, Romania, Iraq, and Vietnam were extensively interviewed to assess their health, health care utilization and health service use barriers. Two hundred seventy-seven recent arrivals from these countries and sixty-three previously arrived Laotians comprised the sample. Results from a 195 item bilingual questionnaire indicated good overall health and little evidence of serious physical health symptoms. Dental health was the area of greatest reported need. Prenatal care and mental health services were additional areas of need noted by researchers. Barriers to health service utilization were primarily language related. There were major differences in both health problems and health service utilization among the four groups surveyed.

scholarly journals Racial segregation and mental health service use by older adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 957-958
Author(s):  
Kyeongmo Kim ◽  
Denise Burnette
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Care ◽  
Mental Health Service ◽  
Health Service ◽  
Service Use ◽  
Racial Segregation ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Race Ethnicity

Abstract Older adults living in racially segregated neighborhoods often lack access to mental health care. This study assessed the role of racial segregation in mental health service use and examined whether the relationship between segregation and mental health service use differs by race/ethnicity. We linked residential segregation data from the National Neighborhood Change Database to the 2015 Medical Expenditure Panel Survey. The sample included 4,023 adults aged 65 and older. We measured mental health service use as visit(s) to a mental health professional and/or use of prescribed medication for mental health (1=yes, 0=no) during the past year. Residential segregation was assessed using a combined measure of isolation (level of interaction with the same racial and ethnic group members) and dissimilarity (evenness of distribution of racial groups). Indices ranged from 0 (integrated) to 1 (segregated). We adjusted for age, sex, race/ethnicity, marital status, education, income, attitude toward health care, health insurance, and mental health status. Multiple logistic regression analyses showed that older adults living in more segregated counties were less likely to use a mental health service than those living in more integrated counties (OR=0.77, p=.04). The relationship did not differ by race/ethnicity. As expected, Blacks and Hispanics underused mental health services compared to Whites. The findings highlight that racial segregation limits access to mental health care. Practitioners and policy-makers should identify mental health needs and service use patterns to target services effectively and efficiently. Future research should explore the intersection of income and mental health care resources in segregated neighborhoods.

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