scholarly journals Cohort profile: The prospective study on Chinese elderly with multimorbidity in primary care in Hong Kong

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e027279
Author(s):  
Dexing Zhang ◽  
Regina Wing Shan Sit ◽  
Carmen Wong ◽  
Dan Zou ◽  
Stewart W Mercer ◽  
...  
Keyword(s):  
Primary Care ◽  
Hong Kong ◽  
Health Outcomes ◽  
Older Patients ◽  
Handgrip Strength ◽  
Severe Depression ◽  
Outpatient Clinics ◽  
Daycare Centre ◽  
Biopsychosocial Health ◽  
Health Profiles

PurposeThis is an ongoing prospective cohort aiming to examine the biopsychosocial health profiles and predictors of health outcomes of older patients with multimorbidity in primary care in Hong Kong.ParticipantsFrom April 2016 to October 2017, 1077 patients aged 60+ years with at least two chronic diseases were recruited in four public primary care clinics in the New Territories East Region of Hong Kong.Findings to dateAfter weighting, the patients had 4.1 (1.8) chronic conditions and 2.5 (1.9) medications on average; 37% forgot taking medication sometimes; 71% rated their health as fair or poor; 17% were frail; 73% reported one (21%) or two or more (52%) body pain areas; 62% were overweight/obese; 23% reported chewing difficulty, 18% reported incontinence; 36% had current stage 1/2 hypertension; 38% had handgrip strength below the cut-off; 10% screened positive in sarcopenia; 17% had mild or severer cognitive impairment; 17% had mild to severe depression; 16% had mild to severe anxiety; 50% had subthreshold to severe insomnia; 28% indicated being lonely; 12% needed help in at least one out of the five daily functions and the EuroQoL-5-Dimensions-5-Level index score was 0.81 (0.20) and its Visual Analogue Scale (VAS) score was 67.6 (14.6). In the past 12 months, 17% were hospitalised, 92% attended general outpatient clinics, 70% attended specialist outpatient clinics and 10% used elderly daycare centre services, the median out-of-pocket health cost was HK$1000 (US$150). Female and male patients showed significant differences in many biopsychosocial health aspects.Future plansWith assessments and clinical data, the cohort can be used for understanding longitudinal trajectories of biopsychosocial health profiles of Chinese older patients with multimorbidity in primary care. We are also initially planning cohort studies on factors associated with various health outcomes, as well as quality of life and healthcare use.Cohort registration numberChiCTR-OIC-16008477

scholarly journals Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Johnny T. K. Cheung ◽  
Samuel Y.S. Wong ◽  
Dicken C. C. Chan ◽  
Dexing Zhang ◽  
Lawrence H. F. Luk ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Hong Kong ◽  
Chronic Disease ◽  
Disease Management ◽  
Continuity Of Care ◽  
Chronic Disease Management ◽  
Outpatient Clinics ◽  
Cross Sectional ◽  
The Public

Abstract Background The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care. Methods This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong. We used multiple logistic regression to address the study objective. Results A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51–4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47–8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22–3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01–0.73). Conclusions While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care.

scholarly journals Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong

2020 ◽  
Author(s):  
Johnny Cheung ◽  
Samuel Y.S. Wong ◽  
Dicken C. C. Chan ◽  
Dexing Zhang ◽  
Lawrence H.F. Luk ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Hong Kong ◽  
Chronic Disease ◽  
Disease Management ◽  
Continuity Of Care ◽  
Chronic Disease Management ◽  
Outpatient Clinics ◽  
Cross Sectional ◽  
The Public

Abstract Background The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care.Methods This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong. We used multiple logistic regression to address the study objective.Results A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51–4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47–8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22–3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01–0.73).Conclusions While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care.

scholarly journals Primary Care and Health Outcomes among Older Patients with Diabetes

2011 ◽  
Vol 47 (1pt1) ◽  
pp. 46-67 ◽  
Author(s):  
Julia C. Prentice ◽  
B. Graeme Fincke ◽  
Donald R. Miller ◽  
Steven D. Pizer
Keyword(s):  
Primary Care ◽  
Health Outcomes ◽  
Older Patients ◽  
Patients With Diabetes

scholarly journals Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong

2020 ◽  
Author(s):  
Johnny Cheung ◽  
Samuel Y.S. Wong ◽  
Dicken C. C. Chan ◽  
Dexing Zhang ◽  
Lawrence H.F. Luk ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Hong Kong ◽  
Chronic Disease ◽  
Disease Management ◽  
Continuity Of Care ◽  
Chronic Disease Management ◽  
Outpatient Clinics ◽  
Cross Sectional ◽  
The Public

Abstract Background The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care.Methods This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong. We used multiple logistic regression to address the study objective.Results A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51–4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47–8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22–3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01–0.73).Conclusions While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care.

scholarly journals Comparison of quadriceps strength and handgrip strength in their association with health outcomes in older adults in primary care

AGE ◽  
2014 ◽  
Vol 36 (5) ◽  
Author(s):  
On Ying A. Chan ◽  
Anne H. van Houwelingen ◽  
Jacobijn Gussekloo ◽  
Jeanet W. Blom ◽  
Wendy P.J. den Elzen
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health Outcomes ◽  
Handgrip Strength ◽  
Quadriceps Strength

scholarly journals Comparison of primary care experiences among adults in general outpatient clinics and private general practice clinics in Hong Kong

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Samuel YS Wong ◽  
Kenny Kung ◽  
Sian M Griffiths ◽  
Tanya Carthy ◽  
Martin CS Wong ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Hong Kong ◽  
Outpatient Clinics

scholarly journals System Redesign: The Value of a Primary Care Liaison Model to Address Unmet Social Needs among Older Primary Care Patients

2021 ◽  
Vol 18 (21) ◽  
pp. 11135
Author(s):  
Jungyoon Kim ◽  
Valerie Pacino ◽  
Hongmei Wang ◽  
April Recher ◽  
Isha Jain ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Outcomes ◽  
Older Patients ◽  
Unmet Needs ◽  
Social Needs ◽  
Care Staff ◽  
Care Hospital ◽  
Patient Counseling ◽  
Caregiver Support ◽  
Primary Care Staff

Assessing and addressing social determinants of health can improve health outcomes of older adults. The Nebraska Geriatrics Workforce Enhancement Program implemented a primary care liaison (PCL) model of care, including training primary care staff to assess and address unmet social needs, patient counseling to identify unmet needs, and mapping referral services through cross-sectoral partnerships. A PCL worked with three patient-centered medical homes (PCMHs) that are part of a large integrative health system. A mixed-methods approach using a post-training survey and a patient tracking tool, was used to understand the reach, adoption, and implementation of the PCL model. From June 2020 to May 2021, the PCL trained 61 primary care staff to assess and address unmet social needs of older patients. A total of 327 patients, aged 65 years and older and within 3–5 days of acute-care hospital discharges, were counseled by the PCL. For patients with unmet needs, support services were arranged through community agencies: transportation (37%), in-home care (33%), food (16%), caregiver support (2%), legal (16%), and other (16%). Our preliminary results suggest that the PCL model is feasible and implementable within PCMH settings to address unmet social needs of older patients to improve their health outcomes.

scholarly journals Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong

2020 ◽  
Author(s):  
Johnny Cheung ◽  
Samuel Y.S. Wong ◽  
Dicken C. C. Chan ◽  
Dexing Zhang ◽  
Lawrence H.F. Luk ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Hong Kong ◽  
Chronic Disease ◽  
Disease Management ◽  
Private Sector ◽  
Continuity Of Care ◽  
Chronic Disease Management ◽  
Outpatient Clinics ◽  
Cross Sectional

Abstract Background The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care. Methods This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics in Hong Kong. We used multiple logistic regression to address the study objective. Results A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51–4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47–8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22–3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01–0.73). Conclusions While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care.

Specificity and detail in autobiographical memory retrieval: A multi-site (re)investigation.

2020 ◽  
Author(s):  
David John Hallford ◽  
Tom Joseph Barry ◽  
Eline Belmans ◽  
Filip Raes ◽  
Sam Dax ◽  
...  
Keyword(s):  
Hong Kong ◽  
Autobiographical Memory ◽  
Memory Retrieval ◽  
Severe Depression ◽  
Depression Symptoms ◽  
Autobiographical Memories ◽  
Memory Specificity ◽  
Specific Event ◽  
Meta Analyses ◽  
Cue Words

This investigation examined conflicting suggestions regarding the association between problems retrieving specific autobiographical memories and the tendency to retrieve the details of these memories. We also examined whether these tendencies are differentially related to depression symptoms. U.S., Belgian, Hong Kong and Japanese participants retrieved memories related to cue words. Responses were coded for if they referred to a specific event (i.e., an event lasting less than 24 hours) and their details (What? Where? Who?). Across sites, and in meta-analyses, the retrieval of more specific memories was associated with retrieval of more details. Memories that were specific included more detail than non-specific memories. Across sites, retrieval of more specific memories and more detail was associated with less severe depression symptoms. Episodic specificity and detailedness are related but separable constructs. Future investigations of autobiographical memory specificity, and methods for alleviating problematic specificity, should consider measures of episodic detailedness.

Sign in / Sign up

Export Citation Format

Share Document