scholarly journals Health service inequalities during the COVID-19 pandemic among elderly people living in large urban and non-urban areas in Florida, USA

2020 ◽  
Vol 8 ◽  
pp. 205031212097416
Author(s):  
Xinhua Yu
Keyword(s):  
Emergency Department ◽  
Elderly People ◽  
Rural Areas ◽  
Urban Areas ◽  
Metropolitan Areas ◽  
Elderly Women ◽  
Logistic Models ◽  
Emergency Department Visits ◽  
Hospitalization Rates ◽  
Adjusted Incidence

Objective: Health inequalities were often exacerbated during the emerging epidemic. This study examined urban and non-urban inequalities in health services among COVID-19 patients aged 65 years or above in Florida, USA, from 2 March to 27 May 2020. Methods: A retrospective time series analysis was conducted using individual patient records. Multivariable Poisson’s and logistic models were used to calculate adjusted incidence of COVID-19 and the associated rates of emergency department visits, hospitalizations, and deaths. Results: As of 27 May 2020, there were 13,659 elderly COVID-19 patients (people aged 65 years or above) in Florida and 14.9% of them died. Elderly people living in small metropolitan areas might be less likely to be confirmed with COVID-19 infection than those living in large metropolitan areas. The emergency department visit and hospitalization rates decreased significantly across metropolitan statuses for both men and women. Those patients living in small metropolitan or rural areas were less likely to be hospitalized than those living in large metropolitan areas (35% and 34% vs 41%). Elderly women aged 75 years or above living in rural areas had 113% higher adjusted incidence of COVID-19 than those living in large metropolitan areas, and the rates of hospitalizations were lower compared with those counterparts living in large metropolitan areas (29% vs 46%; odds ratio: 0.37 (0.25–0.54), p < 0.001). Conclusion: For elderly people living in Florida, USA, those living in small metropolitan or rural areas were less likely to receive adequate health care than those living in large or medium metropolitan areas during the COVID-19 pandemic.

scholarly journals Urban-rural inequalities during the COVID-19 pandemic among elderly people in Florida, US

2020 ◽  
Author(s):  
Xinhua Yu
Keyword(s):  
Elderly People ◽  
Rural Areas ◽  
Retrospective Cohort ◽  
Metropolitan Areas ◽  
Elderly Women ◽  
Logistic Models ◽  
Hospitalization Rates ◽  
Urban Rural ◽  
Ed Visits ◽  
Adjusted Incidence

AbstractObjectivesHealth inequalities were often exacerbated during the emerging epidemic. This study examined urban-rural inequalities among COVID-19 patients aged 65 or above in US Florida from March 2 to May 27, 2020.MethodsA retrospective cohort study was conducted using individual patient records. Multivariable Poisson and logistic models were used to calculate adjusted incidence of COVID- 19 and the associated rates of emergency department (ED) visits, hospitalizations and deaths.ResultsAs of May 27, 2020, there were 13,659 elderly COVID-19 patients (people aged 65 or above) in Florida and 14.9% of them died. Elderly people living in small metropolitan areas were less likely to be diagnosed with COVID-19 than those living in large metropolitan areas. There were significant decreasing trends of ED visit and hospitalization rates across metropolitan statuses for both men and women. Those patients living in small metropolitan or rural areas were less likely to be hospitalized than those living in large metropolitan areas (35% and 34% versus 41%). Elderly women aged 75 or above living in rural areas had 113% higher adjusted incidence of COVID-19 than those living in large metropolitan areas, and the rates of hospitalizations were lower compared with those living in large metropolitan areas ((29% versus 46%; OR: 0.37 [0.25- 0.54]; p <0.001).ConclusionsIn US Florida, elderly people living in small metropolitan or rural areas suffered heavier burden of COVID-19 than those living in large metropolitan areas.

The Rural-Urban Continuum of Polarization: Understanding the Geography of the 2018 Midterms

The Forum ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kenneth M. Johnson ◽  
Dante J. Scala
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Metropolitan Areas ◽  
Political Attitudes ◽  
The United States ◽  
Rural America ◽  
Rural Regions ◽  
Urban America ◽  
Urban And Rural Areas ◽  
The Continuum

Abstract This study of the 2018 congressional midterms demonstrates how voting patterns and political attitudes vary across a spectrum of urban and rural areas in the United States. Rural America is no more a monolith than is urban America. The rural-urban gradient is better represented by a continuum than a dichotomy. This is evident in the voting results in 2018, just as it was in 2016. We found that the political tipping point lies beyond major metropolitan areas, in the suburban counties of smaller metropolitan areas. Democrats enjoyed even greater success in densely populated urban areas in 2018 than in 2016. Residents of these urban areas display distinctive and consistent social and political attitudes across a range of scales. At the other end of the continuum in remote rural areas, Republican candidates continued to command voter support despite the challenging national political environment. Voters in these rural regions expressed social and political attitudes diametrically opposed to their counterparts in large urban cores.

scholarly journals Association between Public Assistance and Frequent Emergency Department Visits in Urban Areas of Japan: A Case-Control Study

2020 ◽  
Vol 32 (1) ◽  
pp. 73-80 ◽  
Author(s):  
Keiichiro IKEDA ◽  
Taku HARADA ◽  
Yoko TARUMI ◽  
Hirotaka OCHIAI ◽  
Takako SHIRASAWA ◽  
...  
Keyword(s):  
Emergency Department ◽  
Urban Areas ◽  
Case Control Study ◽  
Public Assistance ◽  
Case Control ◽  
Emergency Department Visits ◽  
Control Study

Abstract P168: Impact of Oral Anticoagulation Choice on Healthcare Utilization for the Primary Treatment of Venous Thromboembolism

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Rob F Walker ◽  
Richard F Maclehose ◽  
J'Neka Claxton ◽  
Terrence Adam ◽  
Alvaro Alonso ◽  
...  
Keyword(s):  
Emergency Department ◽  
Healthcare Utilization ◽  
Oral Anticoagulation ◽  
Primary Treatment ◽  
Emergency Department Visits ◽  
Office Visits ◽  
International Classification Of Disease ◽  
Hospitalization Rates ◽  
The Impact

Introduction: Little is known about the impact of oral anticoagulation (OAC) choice on healthcare encounters during the primary treatment of VTE. Hypothesis: Among anticoagulant-naïve VTE patients we tested the hypotheses that the number of hospitalizations, days hospitalized, emergency department visits, and outpatient office visits would be lower among users of rivaroxaban or apixaban than among users of warfarin. Methods: MarketScan databases for years 2016 and 2017 were used to identify VTE cases and comorbidities using international classification of disease codes, and prescriptions for OACs via outpatient pharmaceutical claims data. Healthcare utilization was identified in the first 6 months after initial VTE diagnoses. Results: The 23,864 individuals with VTE cases were on average (± standard deviation) 55.7 ± 16.1 years old and 50.6% female. Participants had on average 0.2 ± 0.5 hospitalizations, spent 1.3 ± 5.2 days in the hospital, had 5.7 ± 5.1 outpatient encounters, and visited an emergency department 0.4 ± 1.1 times. As compared to warfarin, rivaroxaban and apixaban were associated with fewer hospitalizations, days hospitalized, office visits and emergency department visits, after accounting for age, sex, comorbidities and medications (Table 1). For example, hospitalization rates were 24% lower [IRR: 0.76 (95% CI: 0.69, 0.83)] for patients prescribed rivaroxaban and 22% lower [IRR: 0.78 (95% CI: 0.71, 0.87)] for patients prescribed apixaban, as compared to those prescribed warfarin. When comparing apixaban to rivaroxaban, there were no differences in healthcare utilization. Conclusions: VTE patients prescribed rivaroxaban and apixaban had lower healthcare utilization than did those prescribed warfarin, while there was no difference when comparing apixaban to rivaroxaban. These findings complement existing literature supporting the use of direct OACs over warfarin given their similar effectiveness, slightly better safety profile, and perceived lower patient burden.

scholarly journals Analysis of Patients with Urolithiasis Visiting the Emergency Department between 2014 and 2016 in Korea: Data from the National Emergency Department Information System

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Jong Wook Kim ◽  
Jung-Youn Kim ◽  
Sun Tae Ahn ◽  
Mi Mi Oh ◽  
Du Geon Moon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Information System ◽  
Early Morning ◽  
Emergency Department Visits ◽  
Treatment Result ◽  
National Database ◽  
Annual Percent Change ◽  
Hospitalization Rates ◽  
Hot Season ◽  
National Emergency

Abstract This study investigated the characteristics of patients with urolithiasis visiting an emergency department based on a national database system in Korea. This study spanned a period of three years from January 1, 2014 to December 31, 2016. A retrospective census was conducted using the National Emergency Department Information System for urolithiasis patients. Patient data, including age, sex, insurance type, emergency department visit date and time, discharge date and time, emergency department treatment result, visit flow, and hospitalization route, were extracted and analyzed. Overall, 103,981, 112,083, and 120,647 patients/year during the 2014–2016 study period visited an emergency department with a diagnosis related to urolithiasis. Total monthly emergency department visits ranged from 35,927 in August (highest) to 24,008 in February. Overall, 13.2% of patients were hospitalized and the hospitalization rate was stable (estimated annual percent change) over the study period. Patients aged <9 years or ≥70 years and those with medical aid had higher hospitalization rates. A higher number of visits occurred in the hot season, on weekends, and in the 6 a.m. and 8 p.m. time slots. This nationwide study revealed that the percentage of patients visiting an emergency department with urolithiasis was higher in August, in the early morning, and at weekends.

scholarly journals Environmental Characteristics Associated with Older Adults’ Social Participation: The Contribution of Sociodemography and Transportation in Metropolitan, Urban, and Rural Areas

2020 ◽  
Vol 17 (22) ◽  
pp. 8399
Author(s):  
Mélanie Levasseur ◽  
Daniel Naud ◽  
Jean-François Bruneau ◽  
Mélissa Généreux
Keyword(s):  
Older Adults ◽  
Social Participation ◽  
Public Transportation ◽  
Rural Areas ◽  
Urban Areas ◽  
Social Deprivation ◽  
Metropolitan Areas ◽  
Secondary Data ◽  
Local Environment ◽  
Environmental Characteristics

Although social participation fosters older adults’ health, little is known about which environmental characteristics are related to greater participation in social activities. The Canadian Community Health Survey (n = 2737), a transportation survey, and multiple secondary data sources were used to identify the environmental characteristics associated with older Quebecers’ social participation according to living area. Greater social participation was associated with: (1) a higher concentration of older adults (IRR = 2.172 (95% CI 1.600, 2.948); p < 0.001), more kilometers traveled by paratransit (IRR = 1.714 (95% CI 1.286, 2.285); p < 0.01), a lack of medical clinics (IRR = 0.730 (95% CI 0.574, 0.930); p = 0.01), and more funded home adaptations (IRR = 1.170 (95% CI 1.036, 1.320); p = 0.01) in large metropolitan areas; (2) larger paratransit fleets (IRR = 1.368 (95% CI 1.044, 1.791); p = 0.02) and a lower density of road intersections (IRR = 0.862 (95% CI 0.756, 0.982); p = 0.03) in regular metropolitan areas; (3) less social deprivation (IRR = 1.162 (95% CI 1.025, 1.318); p = 0.02) in urban areas; and (4) a higher concentration of older populations (IRR = 2.386 (95% CI 1.817, 3.133); p < 0.001) in rural areas. According to these findings, social participation interventions should target the local environment—for example, by providing more social interaction opportunities for older adults living in younger neighborhoods and by improving access to public transportation, especially paratransit.

scholarly journals Using Rural–Urban Continuum Codes (RUCCS) to Examine Alcohol-Related Motor Vehicle Crash Injury and Enforcement in New York State

2019 ◽  
Vol 16 (8) ◽  
pp. 1346 ◽  
Author(s):  
Joyce C. Pressley ◽  
Leah M. Hines ◽  
Michael J. Bauer ◽  
Shin Ah Oh ◽  
Joshua R. Kuhl ◽  
...  
Keyword(s):  
New York ◽  
Rural Areas ◽  
Evaluation System ◽  
Motor Vehicle ◽  
Metropolitan Areas ◽  
New York State ◽  
Emergency Department Visits ◽  
Higher Alcohol ◽  
York State ◽  
Metropolitan Counties

Rural areas of New York State (NYS) have higher rates of alcohol-related motor vehicle (MV) crash injury than metropolitan areas. While alcohol-related injury has declined across the three geographic regions of NYS, disparities persist with rural areas having smaller declines. Our study aim was to examine factors associated with alcohol-related MV crashes in Upstate and Long Island using multi-sourced county-level data that included the Crash Outcome Data Evaluation System (CODES) with emergency department visits and hospitalizations, traffic citations, demographic, economic, transportation, alcohol outlets, and Rural–Urban Continuum Codes (RUCCS). A cross-sectional study design employed zero-truncated negative binominal regression models to assess relative risks (RR) with 95% confidence interval (CI). Counties (n = 57, 56,000 alcohol-related crashes over the 3 year study timeframe) were categorized by mean annual alcohol-related MV injuries per 100,000 population: low (24.7 ± 3.9), medium (33.9 ± 1.7) and high (46.1 ± 8.0) (p < 0.0001). In multivariable analyses, alcohol-related MV injury was elevated for non-adjacent, non-metropolitan counties (RR 2.5, 95% CI: 1.6–3.9) with higher citations for impaired driving showing a small, but significant protective effect. Less metropolitan areas had higher alcohol-related MV injury with inconsistent alcohol-related enforcement measures. In summary, higher alcohol-related MV injury rates in non-metropolitan counties demonstrated a dose–response relationship with proximity to a metropolitan area. These findings suggest areas where intervention efforts might be targeted to lower alcohol-related MV injury.

Patterns of acute poisoning among children admitted tomaternity and children,teaching hospital,Al Diwaniyah city,Iraq

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Adel J Hussein
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Rural Areas ◽  
Urban Areas ◽  
Food Poisoning ◽  
Acute Poisoning ◽  
Accidental Poisoning ◽  
Female Ratio ◽  
Level Of Education ◽  
At Home

Acute poisoning,a common pediatric emergency,is one of the important causes of morbidity and mortality in children,especially in developing countries. The patterns of poisoning usually differ from country to country and from province to another within the same country.The purpose of this study was to clarify the characteristics of acute chemical and drug poisoning.cases admitted to the emergency department (ED)ofmaternity and children,teaching hospital in Al- Diwaniyah city and to compare poisoning characteristics between different age groupsin the region. A review of medical records of 125 poisoningcases under 7 years of age, except for cases of food poisoning,snake bite,scorpion stings and cases with incomplete data were not included in this study,presenting to the Emergency Department (ED) during 2016 were determined.The mean age of all poisoned patients (mean ± standard deviation) was 2.26 ± 0.750.One hundred and twenty five children,forming 2.2% (125/5494) of total emergency unit admissions of all patients,were under seven years of age. Slightly more boys 71 (56.8%) than girls 54 (43.2%) were intoxicated with the male to female ratio of 1.3:1. The majority of all cases were due to accidental poisoning. In patients younger than one year of age 23 (18.4%),of all poisonings were due to therapeutically error,1 – 3 year 47 (37.6%),4 – 7 year 55 (44%). Chemical agents (58.4%) mostly kerosene (30.1%),agriculturalpesticides/insecticides (19.1%),were the most frequent offending agent,followed by drugs comprised (41.6%),mostly due to Cold and cough medication (15.3%),The vast majority of these materials was stored in non-original containers,These drugs were available at home,being used either by the child or the parents and grandparents.The most common route of poisoning was ingestion of the poison (118 patients; 94.4%) and most were ingested inside the house (73.6%). No deaths were reported.There were obvious seasonal variations and most cases were admitted during in summer (42.4%) and spring (29.6%). Patients from rural areas (57.6%) were more than the patients from the urban areas (42.4%). Effective health promotional programs for parents regarding poisoning hazards are needed to increase the awareness and reduce the incidence of poisoning among children in our region in addition correct dealing with the chemical materials. A relationship exists between the parents’ level of education and the occurrence of pediatric poisoning particularly mothers. Since the level of education in this study was lower in the mothers and for mothers are those who take primary care of children at home; they should be educated regarding care and prevention of lethal injuries to their children at home.

scholarly journals Mental health in Argentina

2011 ◽  
Vol 8 (3) ◽  
pp. 64-66 ◽  
Author(s):  
Daniel Moldavsky ◽  
Ceri Savage ◽  
Enrique Stein ◽  
Andy Blake
Keyword(s):  
Mental Health ◽  
South America ◽  
Rural Areas ◽  
Urban Areas ◽  
Buenos Aires ◽  
Metropolitan Areas ◽  
The World ◽  
The City

Argentina, the second largest country in South America is a federation of 23 provinces and its capital, the autonomous city of Buenos Aires. Its population is a little over 40 million, 50% of whom reside in its five largest metropolitan areas. The rural areas are extensively under-populated. The city of Buenos Aires and its suburb contain 15.5 million inhabitants, making it one of the largest urban areas in the world.

Respite care

2002 ◽  
Vol 12 (2) ◽  
pp. 181-186 ◽  
Author(s):  
Norman J Vetter
Keyword(s):  
Elderly People ◽  
Rural Areas ◽  
Urban Areas ◽  
Geographical Location ◽  
Respite Care ◽  
Focus Attention ◽  
Homogeneous Groups

Elderly people and their carers are not homogeneous groups, but are highly diverse in terms of their age, ethnicity, income, housing, education, geographical location and access to providers of health. In planning provision, particularly respite care, we need to focus attention on the needs and preferences of those who are not currently receiving help, as well as on the satisfaction with existing services of those who are. There been evidence for some years, for instance, that those in rural areas have different needs from those in urban areas.

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