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 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>

Health-related quality of life and health service use among older adults with osteoarthritis

2004 ◽  
Vol 51 (3) ◽  
pp. 326-331 ◽  
Author(s):  
Kelli L. Dominick ◽  
Frank M. Ahern ◽  
Carol H. Gold ◽  
Debra A. Heller
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Health Service ◽  
Service Use ◽  
Health Service Use ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Quality of Life and Health Service Use Among HIV-Infected Patients with Chronic Diarrhea

1993 ◽  
Vol 6 (5) ◽  
pp. 478???484 ◽  
Author(s):  
DEBORAH P. LUBECK ◽  
CHARLES L. BENNETT ◽  
PETER D. MAZONSON ◽  
SHEILA K. FIFER ◽  
JAMES F. FRIES
Keyword(s):  
Quality Of Life ◽  
Health Service ◽  
Service Use ◽  
Chronic Diarrhea ◽  
Health Service Use

FC21-07 - Trends in health-related quality of life and health service use associated with comorbid diabetes and major depression in South Australia, 1998–2008

2011 ◽  
Vol 26 (S2) ◽  
pp. 1933-1933
Author(s):  
E. Atlantis ◽  
R. Goldney ◽  
K. Eckert ◽  
A. Taylor ◽  
P. Phillips
Keyword(s):  
Quality Of Life ◽  
Major Depression ◽  
Health Service ◽  
Service Use ◽  
South Australia ◽  
Health Service Use ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

PurposeTo investigate trends in health-related quality of life and health service use associated with diabetes and/or major depression in South Australia from 1998 to 2008.MethodsData analyzed were from 9,059 persons aged ≥15 years who participated in representative surveys of the South Australian population in 1998, 2004 and 2008. Major depression was determined using the mood module of the Primary Care Evaluation of Mental Disorders (PRIME-MD). Diagnosed diabetes and health service use was determined by self-report. Health-related quality of life was assessed using the 36-item Short-Form Health Survey (SF-36) and the 15-item Assessment of Quality of Life (AQoL) instruments. Weighted age-standardized and multiple-adjusted means of dependent measures were computed.ResultsThe prevalence of diabetes only, major depression only, and comorbid diabetes and major depression increased by 74%, 36% and 53% from 1998 to 2008. Mean health-related quality of life scores were 9% to 41% lower (worse), and health service use was 49% higher for persons with comorbid diabetes and major depression than for those with diabetes only (all P-values < 0.05), consistently over the 10-year period.ConclusionsIf past trends continue, our results suggest that the population health and economic burden of comorbid diabetes and major depression will grow similarly over the next decade or so. These trends have important implications for making health policy and resource allocation decisions.

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