scholarly journals Looking beyond Administrative Health Care Data: The Role of Socioeconomic Status in Predicting Future High-cost Patients with Mental Health and Addiction: Voir au-delà des données administratives des soins de santé : le rôle du statut socio-économique pour prédire les patients à coût élevé en santé mentale et dépendance

2021 ◽  
pp. 070674372110048
Author(s):  
Claire de Oliveira ◽  
Luke Mondor ◽  
Walter P. Wodchis ◽  
Laura C. Rosella
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Socioeconomic Status ◽  
Mental Illness ◽  
Health Care System ◽  
Health Care Use ◽  
Public Health Care ◽  
Income Quintile ◽  
Health Care Data ◽  
Care System

Introduction: Previous research has shown that the socioeconomic status (SES)–health gradient also extends to high-cost patients; however, little work has examined high-cost patients with mental illness and/or addiction. The objective of this study was to examine associations between individual-, household- and area-level SES factors and future high-cost use among these patients. Methods: We linked survey data from adult participants (ages 18 and older) of 3 cycles of the Canadian Community Health Survey to administrative health care data from Ontario, Canada. Respondents with mental illness and/or addiction were identified based on prior mental health and addiction health care use and followed for 5 years for which we ascertained health care costs covered under the public health care system. We quantified associations between SES factors and becoming a high-cost patient (i.e., transitioning into the top 5%) using logistic regression models. For ordinal SES factors, such as income, education and marginalization variables, we measured absolute and relative inequalities using the slope and relative index of inequality. Results: Among our sample, lower personal income (odds ratio [ OR] = 2.11, 95% confidence interval [CI], 1.54 to 2.88, for CAD$0 to CAD$14,999), lower household income ( OR = 2.11, 95% CI, 1.49 to 2.99, for lowest income quintile), food insecurity ( OR = 1.87, 95% CI, 1.38 to 2.55) and non-homeownership ( OR = 1.34, 95% CI, 1.08 to 1.66), at the individual and household levels, respectively, and higher residential instability (OR = 1.72, 95% CI, 1.23 to 2.42, for most marginalized), at the area level, were associated with higher odds of becoming a high-cost patient within a 5-year period. Moreover, the inequality analysis suggested pro-high-SES gradients in high-cost transitions. Conclusions: Policies aimed at high-cost patients with mental illness and/or addiction, or those concerned with preventing individuals with these conditions from becoming high-cost patients in the health care system, should also consider non-clinical factors such as income as well as related dimensions including food security and homeownership.

Does Socioeconomic Status Affect Stage at Presentation for Larynx Cancer in Canada’s Universal Health Care System?

2018 ◽  
Vol 160 (3) ◽  
pp. 488-493 ◽  
Author(s):  
Diana Khalil ◽  
Martin J. Corsten ◽  
Margaret Holland ◽  
Adele Balram ◽  
James Ted McDonald ◽  
...  
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Health Care System ◽  
Laryngeal Cancer ◽  
Income Quintile ◽  
Universal Health Care ◽  
Urban Residence ◽  
Universal Health Care System ◽  
Universal Health ◽  
Care System

Objective Diagnosis of laryngeal cancer is dependent on awareness that persistent hoarseness needs to be investigated as well as access to an otolaryngologist. This study aimed to better classify and understand 3 factors that may lead to variability in stage at presentation of laryngeal cancer: (1) socioeconomic status (SES), (2) differences in access to health care by location of residence (rural vs urban or by province), and (3) access to an otolaryngologist (by otolaryngologists per capita). Study Design Registry-based multicenter cohort analysis. Setting This was a national study across Canada, a country with a single-payer, universal health care system. Subjects All persons 18 years or older who were diagnosed with laryngeal cancer from 2005 to 2013 inclusive were extracted from the Canadian Cancer Registry (CCR). Methods Ordered logistic regression was used to determine the effect of income, age, sex, province of residence, and rural vs urban residence on stage at presentation. Results A total of 1550 cases were included (1280 males and 265 females). The stage at presentation was earlier in the highest income quintile (quintile 5) compared to the lower income quintiles (quintiles 1-4) (odds ratio [OR], 0.68; P < .05). There was a statistically significant difference in stage at presentation based on rural or urban residence within the highest income quintile (OR, 1.73; P < .005). Conclusion There is a relationship between SES and stage at presentation for laryngeal cancer even in the Canadian universal health care system.

scholarly journals Peer Support in Mental Health: Literature Review (Preprint)

2019 ◽  
Author(s):  
Reham A Hameed Shalaby ◽  
Vincent I O Agyapong
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Lived Experience ◽  
Peer Support ◽  
Health Care System ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
Age Groups ◽  
Care System

BACKGROUND A growing gap has emerged between people with mental illness and health care professionals, which in recent years has been successfully closed through the adoption of peer support services (PSSs). Peer support in mental health has been variously defined in the literature and is simply known as the help and support that people with lived experience of mental illness or a learning disability can give to one another. Although PSSs date back to several centuries, it is only in the last few decades that these services have formally evolved, grown, and become an integral part of the health care system. Debates around peer support in mental health have been raised frequently in the literature. Although many authors have emphasized the utmost importance of incorporating peer support into the health care system to instill hope; to improve engagement, quality of life, self-confidence, and integrity; and to reduce the burden on the health care system, other studies suggest that there are neutral effects from integrating PSSs into health care systems, with a probable waste of resources. OBJECTIVE In this general review, we aimed to examine the literature, exploring the evolution, growth, types, function, generating tools, evaluation, challenges, and the effect of PSSs in the field of mental health and addiction. In addition, we aimed to describe PSSs in different, nonexhaustive contexts, as shown in the literature, that aims to draw attention to the proposed values of PSSs in such fields. METHODS The review was conducted through a general search of the literature on MEDLINE, Google Scholar, EMBASE, Scopus, Chemical Abstracts, and PsycINFO. Search terms included peer support, peer support in mental health, social support, peer, family support, and integrated care. RESULTS There is abundant literature defining and describing PSSs in different contexts as well as tracking their origins. Two main transformational concepts have been described, namely, intentional peer support and transformation from patients to peer support providers. The effects of PSSs are extensive and integrated into different fields, such as forensic PSSs, addiction, and mental health, and in different age groups and mental health condition severity. Satisfaction of and challenges to PSS integration have been clearly dependent on a number of factors and consequently impact the future prospect of this workforce. CONCLUSIONS There is an internationally growing trend to adopt PSSs within addiction and mental health services, and despite the ongoing challenges, large sections of the current literature support the inclusion of peer support workers in the mental health care workforce. The feasibility and maintenance of a robust PSS in health care would only be possible through collaborative efforts and ongoing support and engagement from all health care practitioners, managers, and other stakeholders.

scholarly journals Peer Support in Mental Health: Literature Review

10.2196/15572 ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. e15572 ◽  
Author(s):  
Reham A Hameed Shalaby ◽  
Vincent I O Agyapong
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Lived Experience ◽  
Peer Support ◽  
Health Care System ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
Age Groups ◽  
Care System

Background A growing gap has emerged between people with mental illness and health care professionals, which in recent years has been successfully closed through the adoption of peer support services (PSSs). Peer support in mental health has been variously defined in the literature and is simply known as the help and support that people with lived experience of mental illness or a learning disability can give to one another. Although PSSs date back to several centuries, it is only in the last few decades that these services have formally evolved, grown, and become an integral part of the health care system. Debates around peer support in mental health have been raised frequently in the literature. Although many authors have emphasized the utmost importance of incorporating peer support into the health care system to instill hope; to improve engagement, quality of life, self-confidence, and integrity; and to reduce the burden on the health care system, other studies suggest that there are neutral effects from integrating PSSs into health care systems, with a probable waste of resources. Objective In this general review, we aimed to examine the literature, exploring the evolution, growth, types, function, generating tools, evaluation, challenges, and the effect of PSSs in the field of mental health and addiction. In addition, we aimed to describe PSSs in different, nonexhaustive contexts, as shown in the literature, that aims to draw attention to the proposed values of PSSs in such fields. Methods The review was conducted through a general search of the literature on MEDLINE, Google Scholar, EMBASE, Scopus, Chemical Abstracts, and PsycINFO. Search terms included peer support, peer support in mental health, social support, peer, family support, and integrated care. Results There is abundant literature defining and describing PSSs in different contexts as well as tracking their origins. Two main transformational concepts have been described, namely, intentional peer support and transformation from patients to peer support providers. The effects of PSSs are extensive and integrated into different fields, such as forensic PSSs, addiction, and mental health, and in different age groups and mental health condition severity. Satisfaction of and challenges to PSS integration have been clearly dependent on a number of factors and consequently impact the future prospect of this workforce. Conclusions There is an internationally growing trend to adopt PSSs within addiction and mental health services, and despite the ongoing challenges, large sections of the current literature support the inclusion of peer support workers in the mental health care workforce. The feasibility and maintenance of a robust PSS in health care would only be possible through collaborative efforts and ongoing support and engagement from all health care practitioners, managers, and other stakeholders.

Pathways to psychiatric care and reform of the public health care system in Poland

2004 ◽  
Vol 19 (3) ◽  
pp. 168-171 ◽  
Author(s):  
T. Pawłowski ◽  
A. Kiejna
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care System ◽  
Mental Health Professionals ◽  
Psychiatric Service ◽  
Public Health Care ◽  
Catchment Areas ◽  
Primary Care Giver ◽  
Median Interval ◽  
Care System

AbstractObjectiveSince 01.01.1999 a reform of the health care system in Poland has been realised based on the general health insurance act. We attempt to use the pathway method, especially measuring of time intervals along pathways, as a way of making accessibility to mental health services operational.MethodIn a period of 2 months all patients aged 15 and over who had not sought care from any public or private psychiatric service during the previous 365 days, were interviewed by psychiatrists, using the Polish version of the WHO Encounter Form.ResultsA total of 228 patients were seen. The study reveals that the median interval between first seeing a primary care giver and arrival at a mental health service was 12 weeks, which is much longer than all other European centres in previous studies.ConclusionMaking use of the pathway method and, in particular, median interval analysis between the onset of the mental health problem and seeing mental health professionals (MHPs) has shown practically limited access of patients, with a new episode of care to psychiatric services in both epidemiological catchment areas. This method seems to be a simple and inexpensive way of monitoring the accessibility to MHP in the period of health care reform.

The effect of socioeconomic status on bone density testing in a public health-care system

2006 ◽  
Vol 18 (2) ◽  
pp. 153-158 ◽  
Author(s):  
S. Demeter ◽  
W. D. Leslie ◽  
L. Lix ◽  
L. MacWilliam ◽  
G. S. Finlayson ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Socioeconomic Status ◽  
Bone Density ◽  
Health Care System ◽  
Public Health Care ◽  
Public Health Care System ◽  
Bone Density Testing ◽  
Care System

The relationship between socioeconomic status and treatment for prostate cancer in a universal healthcare system: A population-based analysis.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 361-361
Author(s):  
Justin Oake ◽  
Oksana Harasemiw ◽  
Navdeep Tangri ◽  
Thomas Ferguson ◽  
Jeff W. Saranchuk ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Decision Making ◽  
Socioeconomic Status ◽  
Health Care System ◽  
Metastatic Prostate Cancer ◽  
Income Quintile ◽  
Nested Models ◽  
Treatment Type ◽  
Care System

361 Background: A large body of research has shown that there are strong socioeconomic disparities in access to cancer treatment. However, whether these inequalities persist among men with prostate cancer has not been previously explored in the equal-access, universal Canadian health care system. The aim of this study is to compare whether socioeconomic status is associated with the type of treatment received (radical prostatectomy (RP) versus radiation therapy (RT)) for men diagnosed with nonmetastatic prostate cancer in Manitoba, Canada. Methods: Men who were diagnosed with non-metastatic prostate cancer between 2004 and 2016 and subsequently treated with RP or RT were identified using the CancerCare Manitoba Registry and linked to provincial databases. SES was defined as neighbourhood income by postal code and divided into income quintiles (Q1-Q5, with Q1 the lowest quintile and Q5 the highest). Multivariable logistic regression nested models were used to compare whether socioeconomic status was associated with treatment type received. Results: We identified 4,560 individuals between 2004-2016 who were diagnosed with non-metastatic prostate cancer. 2,554 men were treated with RP and 2,006 with RT.As income quintile increased, men were more likely to undergo RP than RT (Q3 vs Q1: aOR 1.45 (1.09-1.92); Q5 vs. Q1: aOR 2.17, 95% CI 1.52-2.86). Conclusions: Despite a universal health care system, socioeconomic inequities are present for men seeking primary treatment for prostate cancer. Further investigation into the decision making process among patients diagnosed with prostate cancer may inform decision making to ameliorate these disparities.

scholarly journals A Primer on Integral Theory and Its Application to Mental Health Care

2020 ◽  
Vol 9 ◽  
pp. 216495612095273
Author(s):  
James D Duffy
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Health Care System ◽  
Integral Theory ◽  
Integral Model ◽  
Care Needs ◽  
Mental Health Care System ◽  
Care System

Contemporary psychiatry has become increasingly focused on biological treatments. Many critics claim that the current paradigm of psychiatry has failed to address the escalating mental health-care needs of our communities and may even be contributing to psychopathology and the burden of mental illness. This article describes the foundations of Integral Theory and proposes that this model offers a framework for developing integral psychiatry and a more effective and compassionate mental health-care system. An integral model of psychiatry extends biopsychosocial approaches and provides the scaffolding for more effective approaches to integrative mental health care. Furthermore, rather than focusing on psychopathology, the Integral theory model describes the emergence of human consciousness and supports a mental health-care system that addresses mental illness but also promotes human flourishing.

Patterns of use of the health care system by the elderly with mental illness

2005 ◽  
Author(s):  
Patricia Martens ◽  
◽  
Randy Fransoo ◽  
Elaine Burland ◽  
Charles Burchill ◽  
...  
Keyword(s):  
Health Care ◽  
Mental Illness ◽  
Health Care System ◽  
The Elderly ◽  
Patterns Of Use ◽  
Care System

scholarly journals Coping with Criticism and Embracing Change—Further Reflexions on the Debate on a Mental Health Care System without Coercion

Laws ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 22
Author(s):  
Sebastian von Peter ◽  
Martin Zinkler
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care System ◽  
Police Custody ◽  
Judicial Control ◽  
Mental Health Care System ◽  
The Will ◽  
Alternative Scenarios ◽  
Care System

In August 2019, a manuscript was published in this journal that aimed at imagining a mental health care system that renounces the judicial control to better focus on the will and preferences of those who require support. Alternative scenarios for dealing with risk, inpatient care, and police custody were presented that elicited strong and emotionally laden reactions. This article adds further reflections to this debate, aiming at contributing explanations for this unsettlement. A productive notion of criticism is discussed, and ways to achieve change toward a more human rights-oriented psychiatric practice are outlined.

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