scholarly journals Sex differences in health services and medication use among older adults with asthma

2019 ◽  
Vol 5 (4) ◽  
pp. 00242-2019
Author(s):  
Teresa To ◽  
Natasha Gray ◽  
Kandace Ryckman ◽  
Jingqin Zhu ◽  
Ivy Fong ◽  
...  
Keyword(s):  
Sex Differences ◽  
Health Services ◽  
Older Women ◽  
Negative Binomial ◽  
Relative Rate ◽  
Medication Use ◽  
Negative Binomial Regression ◽  
Office Visits ◽  
Health Services Use ◽  
Physician Office

Sex differences are well documented in chronic disease populations with cardiovascular disease and diabetes. Although recent research has suggested that asthma is more severe in older women compared to men, the extent of this difference remains poorly understood. The objective of this study was to compare rates of asthma-specific health services use (HSU) and medication use, between older women and men with asthma.This population-based cohort study included 209 054 individuals aged ≥66 years with asthma from health administrative data in Ontario, Canada. The primary exposure was sex. Outcomes included asthma-specific HSU (spirometry, emergency department (ED), hospitalisation, physician office and specialist visits) and medication use (asthma controller and reliever prescriptions). Negative binomial regression models adjusted for age, socioeconomic status and comorbidities were used to ascertain outcomes by sex from 2010 to 2016.Compared to men, women had lower rates of spirometry (adjusted relative rate (ARR) 0.87, 95% CI 0.85–0.89) and specialist visits for asthma (ARR 0.93, 95% CI 0.90–0.96), but higher rates of asthma-specific ED (ARR 1.43, 95% CI 1.33–1.53) and physician office visits (ARR 1.03, 95% CI 1.01–1.05). Women also had lower asthma controller (ARR 0.98, 95% CI 0.97–0.99) but higher asthma reliever (ARR 1.03, 95% CI 1.02–1.05) prescription fill rates, compared to men.These findings may indicate poorer disease control, greater asthma severity and poorer access to specialist asthma care in women.

scholarly journals PERCEIVED NEIGHBORHOOD SOCIAL DISORDER, FRIENDS’ SUPPORT, AND DEPRESSIVE SYMPTOMATOLOGY OF NON-MARRIED OLDER WOMEN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S312-S312
Author(s):  
Seungjong Cho ◽  
Aloen Townsend
Keyword(s):  
Depressive Symptoms ◽  
Older Women ◽  
Negative Binomial ◽  
Depressive Symptomatology ◽  
Negative Binomial Regression ◽  
Negative Binomial Regression Model ◽  
Social Disorder ◽  
Stress Buffering ◽  
Buffering Effect ◽  
Negative Perceptions

Abstract This study examined whether perceived neighborhood social disorder predicted depressive symptoms among non-married older women (N = 823) drawn from the 2016 Health and Retirement Study. It also tested the stress buffering effect of friends support. A negative binomial regression model showed that higher perceived neighborhood social disorder was associated with higher depressive symptoms. Presence of good friends in the same neighborhood and number of close friends were protective factors, but no stress buffering effect of friends support was identified. This study highlights the adverse effect of negative perceptions of the neighborhood social environment on non-married older women’s depressive symptoms.

How race affects health services use by older women

1997 ◽  
Vol 18 (3) ◽  
pp. 221-232 ◽  
Author(s):  
Betty J. Gale ◽  
Julie R. Erickson
Keyword(s):  
Health Services ◽  
Older Women ◽  
Health Services Use ◽  
Services Use

Health and Health Service Needs: Comparison of Older and Younger Women with Criminal−Legal Involvement in Three Cities

2021 ◽  
pp. 089826432110254
Author(s):  
Amanda Emerson ◽  
Ashlyn Lipnicky ◽  
Megan Comfort ◽  
Jennifer Lorvick ◽  
Karen Cropsey ◽  
...  
Keyword(s):  
Health Services ◽  
Older Women ◽  
Older Adult ◽  
Health Conditions ◽  
Service Needs ◽  
Adult Women ◽  
Access To Health Services ◽  
Health Services Use ◽  
Younger Women ◽  
Health Services Needs

Objectives: We profiled the health and health services needs of a sample of older adult women (age 50+) with criminal–legal system (CLS) involvement and compared them with younger women (age 18–49), also CLS-involved. Methods: Using survey data collected from January to June 2020 from adult women with CLS involvement in three US cities, we profiled and compared the older adult women with younger women on behavioral and structural risk factors, health conditions, and health services access and use. Results: One-third (157/510) were age 50+. We found significant differences ( p < .05) in health conditions and health services use: older women had more chronic conditions (e.g., hypertension and stroke) and more multimorbidity and reported more use of personalized care (e.g., private doctor, medical home, and health insurance). Discussion: Although older women with CLS involvement reported good access to health services compared with younger women, their chronic health conditions, multimorbidity, and functional declines merit attention.

scholarly journals Diminished Trust of Healthcare Providers, Risky Lifestyle Behaviors, and Low Use of Health Services: A Descriptive Study of Rural Adolescents

2017 ◽  
Vol 34 (6) ◽  
pp. 458-467 ◽  
Author(s):  
Heather K. Hardin ◽  
Valerie Lander McCarthy ◽  
Barbara J. Speck ◽  
Timothy N. Crawford
Keyword(s):  
Health Services ◽  
Rural Areas ◽  
Negative Binomial ◽  
Healthcare Providers ◽  
Negative Binomial Regression ◽  
Public High School ◽  
Lifestyle Behaviors ◽  
Marginalized Youth ◽  
Ed Visits ◽  
Use Of Health Services

The purpose of our study was to determine the extent to which individual characteristic variables predict trust of healthcare provider (HCP), lifestyle behaviors, and use of health services among adolescents attending public high school in rural Indiana. The sample included 224 individuals surveyed in 9th grade or 12th grade required courses. Trust of HCP and lifestyle behaviors were predicted using hierarchical multiple regression; number of HCP visits and emergency department (ED) visits in the past 12 months were predicted using negative binomial regression. This sample of adolescents living in a rural area reported riskier lifestyle behaviors than another sample of adolescents, lower trust of HCP than adults in general, and fewer HCP and ED visits than adolescents in general. Our study supports the need for school-based health services in rural areas and the opportunity for school nurses to act as care coordinators for marginalized youth.

scholarly journals Sex Differences in Comorbidity, Therapy, and Health Services’ Use of Heart Failure in Spain: Evidence from Real-World Data

2020 ◽  
Vol 17 (6) ◽  
pp. 2136 ◽  
Author(s):  
Anyuli Gracia Gutiérrez ◽  
Beatriz Poblador-Plou ◽  
Alexandra Prados-Torres ◽  
Fernando J Ruiz Laiglesia ◽  
Antonio Gimeno-Miguel
Keyword(s):  
Heart Failure ◽  
Sex Differences ◽  
Health Services ◽  
Emergency Services ◽  
Beta Blockers ◽  
Health Services Use ◽  
Real World Data ◽  
Cross Sectional ◽  
Men And Women ◽  
Services Use

Heart failure (HF) is becoming increasingly prevalent and affects both men and women. However, women have traditionally been underrepresented in HF clinical trials. In this study, we aimed to analyze sex differences in the comorbidity, therapy, and health services’ use of HF patients. We conducted a cross-sectional study in Aragón (Spain) and described the characteristics of 17,516 patients with HF. Women were more frequent (57.4 vs. 42.6%, p < 0.001) and older (83 vs. 80 years, p < 0.001) than men, and presented a 33% lower risk of 1-year mortality (p < 0.001). Both sexes showed similar disease burdens, and 80% suffered six or more diseases. Some comorbidities were clearly sex-specific, such as arthritis, depression, and hypothyroidism in women, and arrhythmias, ischemic heart disease, and COPD in men. Men were more frequently anti-aggregated and anti-coagulated and received more angiotensin-converting-enzyme (ACE) inhibitors and beta-blockers, whereas women had more angiotensin II antagonists, antiinflammatories, antidepressants, and thyroid hormones dispensed. Men were admitted to specialists (79.0 vs. 70.6%, p < 0.001), hospital (47.0 vs. 38.1%, p < 0.001), and emergency services (57.6 vs. 52.7%, p < 0.001) more frequently than women. Our results highlight the need to conduct future studies to confirm the existence of these differences and of developing separate HF management guidelines for men and women that take into account their sex-specific comorbidity.

scholarly journals The cost of treatment and its related complications for men who receive surgery or radiation therapy for prostate cancer

2018 ◽  
Vol 13 (8) ◽  
Author(s):  
Alaina Garbens ◽  
Christopher J.D. Wallis ◽  
Rano Matta ◽  
Ronald Kodama ◽  
Sender Herschorn ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Negative Binomial ◽  
Relative Rate ◽  
Multivariable Analysis ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Open Radical Prostatectomy ◽  
Medication Costs ◽  
Total Treatment

Introduction: We sought to examine the costs related to treatment and treatment-related complications for patients treated with surgery or radiation for localized prostate cancer.Methods: We performed a population-based, retrospective cohort study of men who underwent open radical prostatectomy or radiation from 2004‒2009 in Ontario, Canada. Costs, including initial treatment and inpatient hospitalization, emergency room visit, outpatient consultation, physician billings, and medication costs, were determined for five years following treatment using a validated costing algorithm. Multivariable negative binomial regression was used to assess the association between treatment modality and costs.Results: A total of 28 849 men underwent treatment for localized prostate cancer from 2004–2009. In the five years following treatment, men who underwent radiation (n=12 675) had 21% higher total treatment and treatment-related costs than men who underwent surgery ($16 716/person vs. $13 213/person). Based on multivariable analysis, while men who underwent XRT had a lower relative cost in their first year after treatment (relative rate [RR] 0.97; 95% confidence interval [CI] 0.94–1.0; p=0.025), after year 2, annual costs were significantly higher in the radiation group compared to the surgery group (total cost for year 5, RR 1.44; 95% CI 1.17–1.76; p<0.0001). Our results were similar when restricted to young, healthy men and to older men.Conclusions: Men who undergo radiation have significantly higher five-year total treatment-related costs compared to men who undergo open radical prostatectomy. While surgery was associated with slightly higher initial costs, radiotherapy had higher costs in subsequent years.

scholarly journals Asthma health services utilisation before, during and after pregnancy: a population-based cohort study

2018 ◽  
Vol 51 (4) ◽  
pp. 1800209 ◽  
Author(s):  
Teresa To ◽  
Laura Y. Feldman ◽  
Jingqin Zhu ◽  
Andrea S. Gershon
Keyword(s):  
Health Services ◽  
Repeated Measures ◽  
Population Based ◽  
Emergency Department Visits ◽  
Office Visits ◽  
Care Needs ◽  
Pregnant Females ◽  
Physician Office ◽  
Adjusted Rate ◽  
Rate Ratios

During pregnancy, females with asthma may be at higher risk of exacerbation. The objective of this study was to determine whether females with asthma in Ontario, Canada have increased health services utilisation (HSU) during pregnancy.Rates of asthma-specific, asthma-related and non-pregnancy-related HSU were calculated in a population-based cohort of pregnant females with asthma. Poisson regression with repeated measures was used to determine adjusted rate ratios and 95% confidence intervals of HSU during and 1 year after pregnancy, compared to the year before pregnancy.The cohort consisted of 103 976 pregnant females with asthma. Compared to the year prior to pregnancy, hospitalisation rates per 100 person-months during pregnancy increased 30% for asthma (from 0.016 to 0.020), 24% for asthma-related conditions (from 0.012 to 0.015) and decreased 37% for non-pregnancy-related conditions (from 0.24 to 0.15). Emergency department visits for asthma and asthma-related conditions did not increase significantly during pregnancy. During pregnancy, physician office visits decreased 19% for asthma (from 2.20 to 1.79), 10% for asthma-related conditions (from 9.44 to 8.47) and increased 74% for non-pregnancy-related conditions (from 56.4 to 98.2).Hospitalisations for asthma and asthma-related conditions increased during pregnancy, demonstrating that the overall increase in non-pregnancy-related physician office visits may not meet the primary care needs of pregnant females with asthma.

scholarly journals The Impact of Armed Conflict on Utilisation of Health Services in North-West Syria: An Observational Study

2021 ◽  
Author(s):  
Abdulkarim Ekzayez ◽  
Yasser Alhaj Ahmad ◽  
Hasan Alhaleb ◽  
Francesco Checchi
Keyword(s):  
Health Services ◽  
Observational Study ◽  
Antenatal Care ◽  
Negative Binomial ◽  
Panel Data Analysis ◽  
Negative Binomial Regression ◽  
North West ◽  
Distributed Lag ◽  
Accessibility Of Health Services ◽  
The Impact

Abstract BackgroundArmed conflicts are known to have detrimental impact on availability and accessibility of health services. Consequently, utilisation of healthcare is usually affected. However, little is known on the extent of these effects largely due to challenges facing research in such settings. This study examines whether exposure to war incidents affected utilisation of key health services in conflict affected areas of north west Syria between 1 October 2014 and 30 June 2017.MethodsThe study is an observational study using routinely collected data in 8 health facilities in north west Syria and a database on conflict incidents. Longitudinal panel data analysis was used with fixed effect negative binomial regression for the monthly analysis and distributed lag model with a lag period of 30 days for the daily analysis.ResultsThe study found strong evidence for a negative association between bombardments and both consultations and antenatal care visits. The monthly Risk Ratio was 0.95 (95%CI: 0.94-0.97) and 0.95 (95%CI: 0.93-0.98) respectively; and the cumulative daily RR at 30 days was 0·19 (95%CI: 0·15 - 0·25) and 0·42 (95%CI: 0·25 - 0·69) for consultations and antenatal care respectively. Explosions were found to be associated with an increase in the number of deliveries and C-sections. The data provides evidence that each one unit increase in explosions in a given month in a given village was associated with about 20% increase in deliveries and C-sections; RR was 1·22 (95%CI: 1·05-1·42) and 1·96 (95%CI: 1·03-3·74) respectively.ConclusionThe study found that access to healthcare in affected areas in Syria has been limited. The study also provides evidence that conflict incidents were associated negatively with the utilisation of health services. Based on this evidence, health actors in conflict settings need to adopt strategies that ensure availability and accessibility of health services such as decentralisation and outreach health services.

scholarly journals Use of health care services by people with substance use disorders in Belgium: a register-based cohort study

2020 ◽  
Author(s):  
Luk Van Baelen ◽  
Els Plettinckx ◽  
Jérôme Antoine ◽  
Karin De Ridder ◽  
Brecht Devleesschauwer ◽  
...  
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Health Services ◽  
Health Care Services ◽  
Crack Cocaine ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Negative Binomial Regression ◽  
Care Utilization ◽  
Use Of Health Services

Abstract Background To describe the frequencies of health-care utilization by people with substance use disorder (SUD), more specifically contacts with the general practitioner (GP), the psychiatrist, the emergency departments (ED) and hospital admissions and to compare this frequency to the general population.Methods Data from the national register of people who were in treatment for SUD between 2011–2014 was linked to health care data from the Belgian health insurance (N = 30,905). Four comparators were matched on age, sex and place of residence to each subject in treatment for SUD (N = 123,620). Cases were further divided in five mutually exclusive categories based on the main SUD (opiates, crack/cocaine, stimulants, cannabis and alcohol). We calculated the average number of contacts with GP, psychiatrists and ED, and hospital admissions per person over a ten year period (2008–2017), computed descriptive statistics for each of the SUD and used negative binomial regression models to compare cases and comparators.Results Over the ten-year period, people in treatment for SUD overall had on average 60 GP contacts, 3.9 psychiatrist contacts, 7.8 visits to the ED, and 16 hospital admissions. Rate ratios, comparing cases and corresponding comparators, showed that people in treatment for SUD had on average 1.9 more contacts with a GP (95% CI 1.9-2.0), 7.4 more contacts with a psychiatrist (95% CI 7.0-7.7), 4.2 more ED visits (95% CI 4.2–4.3), and 6.4 more hospital admissions (95% CI 6.3–6.5).Conclusion The use of health services for people with SUD is between almost two (GP) and seven times (psychiatrist) higher than for comparators. People in treatment for alcohol use disorders have a higher burden of disease than people in treatment for other SUD. The use of health services remained stable in the five years before and after the moment people with SUD entered into treatment for SUD.

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