scholarly journals Educational inequalities in hospital care for mortally ill patients in Norway

2017 ◽  
Vol 46 (1) ◽  
pp. 74-82 ◽  
Author(s):  
Jon Ivar Elstad
Keyword(s):  
Fixed Effects ◽  
Causes Of Death ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Negative Binomial Regression ◽  
Educational Inequalities ◽  
Residential Areas ◽  
Geographical Differences ◽  
Medical Needs ◽  
Low Educated

Aims: Health care should be allocated fairly, irrespective of patients’ social standing. Previous research suggests that highly educated patients are prioritized in Norwegian hospitals. This study examines this contentious issue by a design which addresses two methodological challenges. Control for differences in medical needs is approximated by analysing patients who died from same causes of death. Area fixed effects are used for avoiding that observed educational inequalities are contaminated by geographical differences. Methods: Men and women who died 2009–2011 at age 55–94 were examined ( N=103,000) with register data from Statistics Norway and the Norwegian Patient Registry. Educational differences in quantity of hospital-based medical care during the 12–24 months before death were analysed, separate for main causes of death. Multivariate negative binomial regression models were estimated, with fixed effects for residential areas. Results: High-educated patients who died from cancers had significantly more outpatient consultations at somatic hospitals than low-educated patients during an average observation period of 18 months prior to death. Similar, but weaker, educational inequalities appeared for outpatient visits for patients whose deaths were due to other causes. Also, educational inequalities in number of hospital admissions were marked for those who died from cancers, but insignificant for patients who died from other causes. Conclusions: Even when medical needs are similar for mortally ill patients, those with high education tend to receive more medical services in Norwegian somatic hospitals than patients with low education. The roles played by physicians and patients in generating these patterns should be explored further.

scholarly journals The association between a conditional cash transfer programme and malaria incidence: a longitudinal ecological study in the Brazilian Amazon between 2004 and 2015

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Layana Costa Alves ◽  
Mauro Niskier Sanchez ◽  
Thomas Hone ◽  
Luiz Felipe Pinto ◽  
Joilda Silva Nery ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Negative Binomial ◽  
Malaria Incidence ◽  
Panel Study ◽  
Negative Binomial Regression ◽  
Brazilian Amazon ◽  
Conditional Cash Transfer ◽  
Cash Transfer ◽  
Percentage Point Increase ◽  
The Impact

Abstract Background Malaria causes 400 thousand deaths worldwide annually. In 2018, 25% (187,693) of the total malaria cases in the Americas were in Brazil, with nearly all (99%) Brazilian cases in the Amazon region. The Bolsa Família Programme (BFP) is a conditional cash transfer (CCT) programme launched in 2003 to reduce poverty and has led to improvements in health outcomes. CCT programmes may reduce the burden of malaria by alleviating poverty and by promoting access to healthcare, however this relationship is underexplored. This study investigated the association between BFP coverage and malaria incidence in Brazil. Methods A longitudinal panel study was conducted of 807 municipalities in the Brazilian Amazon between 2004 and 2015. Negative binomial regression models adjusted for demographic and socioeconomic covariates and time trends were employed with fixed effects specifications. Results A one percentage point increase in municipal BFP coverage was associated with a 0.3% decrease in the incidence of malaria (RR = 0.997; 95% CI = 0.994–0.998). The average municipal BFP coverage increased 24 percentage points over the period 2004–2015 corresponding to be a reduction of 7.2% in the malaria incidence. Conclusions Higher coverage of the BFP was associated with a reduction in the incidence of malaria. CCT programmes should be encouraged in endemic regions for malaria in order to mitigate the impact of disease and poverty itself in these settings.

scholarly journals NATO between Exclusivity and Inclusivity: Measuring NATO’s Partnerships

2021 ◽  
pp. 1-32
Author(s):  
Branislav Mičko
Keyword(s):  
Human Rights ◽  
Fixed Effects ◽  
International Institutions ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Original Dataset ◽  
Strategic Approach ◽  
Binomial Regression ◽  
The Given ◽  
The Relationship

Building on an original dataset, this article focuses on the interactions between NATO and its declared worldwide partners. It argues that the analysis of these interactions can reveal NATO’s strategic approach to partnerships, but it can also provide a tool for its classification as an organisation that is either exclusive – defined by the focus on defence of its members, or inclusive – emphasising the global protection of democracies and human rights. The relationship between types of interactions and NATO categorisation is estimated using an unconditional negative binomial regression with fixed effects as well as a within-between (hybrid) model. Furthermore, they are illustrated on two brief case studies of Sweden and Japan. The results of the study suggest that NATO engages primarily with countries that are powerful relative to their neighbourhood, even though they are not the most powerful among the partners. The given country’s level of democracy, integration into the international institutions, and stability, do not seem to play any overarching role here.

scholarly journals THE US MIDLIFE MORTALITY CRISIS CONTINUES: INCREASED DEATH RATES FROM CAUSES OTHER THAN COVID-19 DURING 2020

2021 ◽  
Author(s):  
Dana A Glei
Keyword(s):  
Indirect Effect ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Negative Binomial ◽  
National Level ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Negative Binomial Regression Model ◽  
Age Group ◽  
External Causes

COVID-19 has prematurely ended many lives, particularly among the oldest Americans, but the pandemic has also had an indirect effect on health and non-COVID mortality among the working-age population, who have suffered the brunt of the economic consequences. This analysis quantifies the changes in mortality for selected causes of death during the COVID 19 pandemic up to December 31, 2020, and investigates whether the levels of excess mortality varied by age group. The data comprise national-level monthly death counts by age group and selected causes of death from January 1999 to December 2020 combined with annual mid-year population estimates over the same period. A negative binomial regression model was used to estimate monthly cause-specific excess mortality during 2020 controlling for the pre-pandemic mortality patterns by age, calendar year, and season. To determine whether excess mortality varied by age, we tested interactions between broad age groups and dichotomous indicators for the pre-pandemic (January-February) and the pandemic (March-December) portions of 2020. In relative terms, excess all cause mortality (including COVID-19) peaked in December at ages 25-44 (RR=1.58 relative to 2019, 95% CI=1.50-1.68). Excluding COVID-19, all of the excess mortality occurred between ages 15 and 64, peaking in July among those aged 25-44 (RR=1.45, 95% CI 1.37-1.53). We find notable excess mortality during March-December 2020 for many causes (i.e., influenza/pneumonia, other respiratory diseases, diabetes, heart disease, cerebrovascular disease, kidney disease, and external causes), but almost exclusively among young and midlife (aged 25-74) Americans. For those aged 75 and older, there was little excess mortality from causes other than COVID-19 except from Alzheimer's disease. Excess non-COVID mortality may have resulted, at least partly, from incorrectly classified COVID-19 deaths, but neither misclassification nor an atypical flu season that disproportionately affected younger people is likely to explain the increase in mortality from external causes, which was evident even during January-February 2020. Exploratory analyses suggest that drug-related mortality may be driving the early rise in external mortality. The growth in drug overdoses well before there was any hint of a pandemic suggests it is probably not solely an indirect effect of COVID-19, although the pandemic may have exacerbated the problem.

Civil society and exposure to domestic terrorist attacks: Evidence from a cross-national quantitative analysis, 1970–2010

2019 ◽  
Vol 60 (3) ◽  
pp. 173-189
Author(s):  
Andrew P Davis ◽  
Yongjun Zhang
Keyword(s):  
Civil Society ◽  
Fixed Effects ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Contentious Politics ◽  
Terrorist Attacks ◽  
Terrorist Organizations ◽  
National Perspective ◽  
Panel Fixed Effects ◽  
Cross National

This article examines the connection between a nation’s level of civil society organizational openness and the number of domestic terrorist attacks across 167 countries from 1970 to 2010. Following the contentious politics approach, we conceptualize terrorist organizations as engaged in high-risk movement activity and sensitive to organizational opportunities that make contention more likely. Panel fixed-effects negative binomial regression models support our hypothesis that a nation’s level of civil society openness increases exposure to domestic terrorist attacks. This work connects social movement theory with the cross-disciplinary literature working to understand terrorism by offering an explanation for terrorist attacks that are rooted in the organizational opportunity paradigm. It provides us a useful tool for future work on cross-national social movements in a cross-national perspective, as well as further work on terrorist organizations.

scholarly journals Progress against inequalities in mortality: register-based study of 15 European countries between 1990 and 2015

2019 ◽  
Vol 34 (12) ◽  
pp. 1131-1142 ◽  
Author(s):  
Johan P. Mackenbach ◽  
José Rubio Valverde ◽  
Matthias Bopp ◽  
Henrik Brønnum-Hansen ◽  
Giuseppe Costa ◽  
...  
Keyword(s):  
Health Care ◽  
Fixed Effects ◽  
Causes Of Death ◽  
Health Care Expenditure ◽  
European Countries ◽  
Mortality Data ◽  
Factors Associated ◽  
Country Level ◽  
Low Educated ◽  
Inequalities In Mortality

AbstractSocioeconomic inequalities in mortality are a challenge for public health around the world, but appear to be resistant to policy-making. We aimed to identify European countries which have been more successful than others in narrowing inequalities in mortality, and the factors associated with narrowing inequalities. We collected and harmonised mortality data by educational level in 15 European countries over the last 25 years, and quantified changes in inequalities in mortality using a range of measures capturing different perspectives on inequality (e.g., ‘relative’ and ‘absolute’ inequalities, inequalities in ‘attainment’ and ‘shortfall’). We determined which causes of death contributed to narrowing of inequalities, and conducted country- and period-fixed effects analyses to assess which country-level factors were associated with narrowing of inequalities in mortality. Mortality among the low educated has declined rapidly in all European countries, and a narrowing of absolute, but not relative inequalities was seen in many countries. Best performers were Austria, Italy (Turin) and Switzerland among men, and Spain (Barcelona), England and Wales, and Austria among women. Ischemic heart disease, smoking-related causes (men) and amenable causes often contributed to narrowing inequalities. Trends in income inequality, level of democracy and smoking were associated with widening inequalities, but rising health care expenditure was associated with narrowing inequalities. Trends in inequalities in mortality have not been as unfavourable as often claimed. Our results suggest that health care expansion has counteracted the inequalities widening effect of other influences.

scholarly journals Evaluation of community coalition training effects on youth hospital-admitted injury incidence in Victoria, Australia: 2001–2017

2019 ◽  
Vol 26 (5) ◽  
pp. 463-470 ◽  
Author(s):  
Janneke Berecki-Gisolf ◽  
Bosco Rowland ◽  
Nicola Reavley ◽  
Barbara Minuzzo ◽  
John Toumbourou
Keyword(s):  
Risk Factors ◽  
Injury Risk ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Intervention Strategy ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Injury Incidence ◽  
The Impact

BackgroundInjuries are one of the three leading causes of morbidity and mortality for young people internationally. Although community risk factors are modifiable causes of youth injury, there has been limited evaluation of community interventions. Communities That Care (CTC) offers a coalition training process to increase evidence-based practices that reduce youth injury risk factors.MethodUsing a non-experimental design, this study made use of population-based hospital admissions data to evaluate the impact on injuries for 15 communities that implemented CTC between 2001 and 2017 in Victoria, Australia. Negative binomial regression models evaluated trends in injury admissions (all, unintentional and transport), comparing CTC and non-CTC communities across different age groups.ResultsStatistically significant relative reductions in all hospital injury admissions in 0–4 year olds were associated with communities completing the CTC process and in 0–19 year olds when communities began their second cycle of CTC. When analysed by subgroup, a similar pattern was observed with unintentional injuries but not with transport injuries.ConclusionThe findings support CTC coalition training as an intervention strategy for preventing youth hospital injury admissions. However, future studies should consider stronger research designs, confirm findings in different community contexts, use other data sources and evaluate intervention mechanisms.

scholarly journals Retracted: Analysis of the Strength of Legal Firearms Restrictions for Perpetrators of Domestic Violence and Their Associations With Intimate Partner Homicide

2017 ◽  
Vol 187 (7) ◽  
pp. 1449-1455 ◽  
Author(s):  
April M Zeoli ◽  
Alexander McCourt ◽  
Shani Buggs ◽  
Shannon Frattaroli ◽  
David Lilley ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Fixed Effects ◽  
Negative Binomial ◽  
State Level ◽  
Negative Binomial Regression ◽  
Intimate Partner ◽  
Restraining Order ◽  
Level Data ◽  
Binomial Regression ◽  
Firearms Restrictions

Abstract In this research, we estimate the association of firearm restrictions for domestic violence offenders with intimate partner homicides (IPHs) on the basis of the strength of the policies. We posit that the association of firearm laws with IPHs depends on the following characteristics of the laws: 1) breadth of coverage of high-risk individuals and situations restricted; 2) power to compel firearm surrender or removal from persons prohibited from having firearms; and 3) systems of accountability that prevent those prohibited from doing so from obtaining guns. We conducted a quantitative policy evaluation using annual state-level data from 1980 through 2013 for 45 US states. Based on the results of a series of robust, negative binomial regression models with state fixed effects, domestic violence restraining order firearm-prohibition laws are associated with 10% reductions in IPH. Statistically significant protective associations were evident only when restraining order prohibitions covered dating partners (−11%) and ex parte orders (−12%). Laws prohibiting access to those convicted of nonspecific violent misdemeanors were associated with a 24% reduction in IPH rates; there was no association when prohibitions were limited to domestic violence. Permit-to-purchase laws were associated with 10% reductions in IPHs. These findings should inform policymakers considering laws to maximize protections against IPH.

scholarly journals Smoke-free legislation and childhood hospitalisations for respiratory tract infections

2015 ◽  
Vol 46 (3) ◽  
pp. 697-706 ◽  
Author(s):  
Jasper V. Been ◽  
Christopher Millett ◽  
John Tayu Lee ◽  
Constant P. van Schayck ◽  
Aziz Sheikh
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Negative Binomial Regression ◽  
Second Hand Smoke ◽  
Incidence Trends ◽  
Group Sex ◽  
Tract Infections ◽  
The Impact

Second-hand smoke exposure is a major risk factor for respiratory tract infections (RTIs). Although evidence suggests important early-life health benefits of smoke-free public environments, the impact on childhood RTIs is unclear. We investigated the association between England's smoke-free legislation and childhood RTI hospitalisations.We used the Hospital Episode Statistics database to obtain nationwide data on hospital admissions for acute RTIs among children (<15 years of age) from 2001 to 2012. Hospitalisation counts were disaggregated by month, age group, sex and small-area level, and linked to urbanisation, region, deprivation index and corresponding population estimates. Negative binomial regression analyses were adjusted for confounders, seasonal variation, temporal autocorrelation, population-size changes and underlying incidence trends. Models allowed for sudden and gradual changes following the smoke-free legislation. We performed sensitivity and subgroup analyses, and estimated number of events prevented.We analysed 1 651 675 hospital admissions. Introduction of smoke-free legislation was followed by an immediate reduction in RTI admissions (−3.5%, 95% CI −4.7– −2.3%), this mainly being attributable to a decrease in lower RTI admissions (−13.8%, 95% CI −15.6– −12.0%). The reductions in admissions for upper RTI were more incremental.The introduction of national smoke-free legislation in England was associated with ∼11 000 fewer hospital admissions per year for RTIs in children.

scholarly journals Education-related inequalities in cause-specific mortality: First estimates for Australia using individual-level linked census and mortality data

2020 ◽  
Author(s):  
Jennifer Welsh ◽  
Grace Joshy ◽  
Lauren Morgan ◽  
Kay Soga ◽  
Hsei-Di Law ◽  
...  
Keyword(s):  
High Education ◽  
Causes Of Death ◽  
Negative Binomial ◽  
International Comparisons ◽  
Negative Binomial Regression ◽  
Medical Intervention ◽  
Mortality Data ◽  
Individual Level ◽  
Specific Mortality ◽  
Inequalities In Mortality

Background: Socioeconomic inequalities in mortality are evident in all high-income countries and ongoing monitoring is recommended using linked census-mortality data. Using such data, we provide first estimates of education-related inequalities in cause-specific mortality in Australia, suitable for international comparisons. Methods: Using Australian Census (2016) linked to 13-months of Death Registrations data (2016-17), we estimated relative rates (RR) and rate differences (RD, per100 000 person-years), comparing rates in low (no qualifications) and intermediate (secondary school) with high education (tertiary), for individual causes of death (among those 25-84y) and grouped according to preventability (25-74y), separately by sex and age group, adjusting for age, using negative binomial regression. Results: Among 13.9M people contributing 14 452 732 person-years, 84 743 deaths occurred. We observed inequalities in most causes of death for each age-sex group. Among men aged 25-44y, absolute and relative inequalities (low versus high education) were largest for injuries, e.g. transport accidents (RR=10.1 [95%CI: 5.4-18.7], RD=21.1 [15.9-26.3]). Among those aged 45-64y, inequalities were greatest for chronic diseases, e.g. lung cancer (men RR=6.6 [4.9-8.9], RD=55.6 [51.1-60.1]) and ischaemic heart disease (women RR=5.8 [3.7-9.1], RD=19.2 [17.0-21.5]), with similar patterns for people aged 65-84y. When grouped according to preventability, inequalities were large for causes amenable to behaviour change and medical intervention for all ages and causes amenable to injury prevention among young men. Conclusions: Australian education-related inequalities in mortality are substantial, generally higher than international estimates, and related to preventability. Findings highlight opportunities to reduce them and the potential to improve the health of the population.

Description of Total Population Hospital Admissions for Treacher Collins Syndrome in Australia

2021 ◽  
pp. 105566562110366
Author(s):  
Mohammed Junaid ◽  
Linda Slack-Smith ◽  
Kingsley Wong ◽  
Gareth Baynam ◽  
Hanny Calache ◽  
...  
Keyword(s):  
Total Population ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Average Length ◽  
Phenotypic Variability ◽  
Length Of Hospital Stay ◽  
Negative Binomial Regression ◽  
Treacher Collins Syndrome ◽  
Annual Percent Change ◽  
Age And Sex

Objective To describe patterns and demographic characteristics of total-population hospital admissions with a diagnosis of Treacher Collins syndrome (TCS) in Australia. Data Source Population summary data for inpatient hospitals admissions (public and private) with a principal diagnosis of TCS (ICD10-AM-Q87.04) were obtained from the Australian Institute of Health and Welfare National Hospital Morbidity Database for a 11-year period (2002-2013). Main Outcome Measures The primary outcome was hospital separation rate (HSR), calculated by dividing the number of hospital separations by estimated resident population per year. Trends in HSR s adjusted for age and sex were investigated by negative binomial regression presented as annual percent change and the association of rates with age and sex was expressed as incidence rate ratio. Results In 244 admissions identified, we observed an increase of 4.55% (95% confidence interval [CI] −1.78, 11.29) in HSR's over the 11-year period. Rates were higher during infancy (1.87 [95% CI 1.42, 2.42]), declining markedly with increasing age. The average length of hospital stay was 6.09 days (95% CI 5.78, 6.40) per episode, but longer for females and infants. Conclusions Findings indicate an increase in hospitalization rates, especially among infants and females which potentially relates to early airway intervention procedures possibly influenced by sex specific-disease severity and phenotypic variability of TCS. Awareness of the TCS phenotype and improved access to genetic testing may support more personalized and efficient care. Total-population administrative data offers a potential to better understand the health burden of rare craniofacial diseases.

Sign in / Sign up

Export Citation Format

Share Document