scholarly journals Does an mHealth system reduce health service use for asthma?

2020 ◽  
Vol 6 (3) ◽  
pp. 00340-2019
Author(s):  
Teresa To ◽  
M. Diane Lougheed ◽  
Rachel McGihon ◽  
Jingqin Zhu ◽  
Samir Gupta ◽  
...  
Keyword(s):  
Health Services ◽  
Intervention Group ◽  
External Control ◽  
Control Group ◽  
Health Services Use ◽  
Physician Visits ◽  
Asthma Patients ◽  
Ed Visits ◽  
The Impact ◽  
Services Use

BackgroundBreathe is a mobile health (mHealth) application developed for the self-management of asthma in adults. There is evidence to suggest that mHealth interventions can be used for asthma control; however, their effects on the use of health services remain poorly understood. We sought to determine whether Breathe reduces health services use amongst asthma patients who used the app compared to controls who did not.MethodsThe impact of Breathe on health services use was estimated using a quasi-experimental approach. Two groups of subjects who had participated in a previous randomised clinical trial were included: an intervention group of asthma patients who used the app for 12 months, and a group of controls who did not use the app but received equivalent quality asthma care. A third, external control group of asthma patients were matched to the intervention participants. Generalised linear mixed models were used to determine relative changes in rates of asthma hospitalisations, emergency department (ED) visits, outpatient physician visits and completion of pulmonary function tests (PFTs) over time.ResultsA total of 677 individuals with asthma were included in the study: 132 in the intervention group, and 149 and 396 in the internal and external control groups, respectively. There were no statistically significant differences in the change of asthma hospitalisations, ED visits, physician office visits or completion of PFTs between the intervention group and either control group.ConclusionsUse of the Breathe app is not associated with changes in health services use in adults with asthma.

scholarly journals Effect of smoke-free legislation on respiratory health services use in children with asthma: a population-based open cohort study in Ontario, Canada

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048137
Author(s):  
Teresa To ◽  
Ivy Fong ◽  
Jingqin Zhu ◽  
Rachel McGihon ◽  
Kimball Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Services ◽  
Population Based ◽  
Respiratory Morbidity ◽  
Health Services Use ◽  
Children With Asthma ◽  
Ed Visits ◽  
The Impact ◽  
Sports Fields ◽  
Services Use

ObjectiveThis study will add to existing literature by examining the impact of smoke-free legislation in outdoor areas among children with asthma. We aimed to examine the effect of the 2015 Smoke-Free Ontario Act (SFOA) amendment, which prohibited smoking on patios, playgrounds and sports fields, on health services use (HSU) rates in children with asthma.MethodsWe conducted a population-based open cohort study using health administrative data from the province of Ontario, Canada. Each year, all Ontario residents aged 0–18 years with physician diagnosed asthma were included in the study. Annual rates of HSU (emergency department (ED) visits, hospitalisations and physician office visits) for asthma and asthma-related conditions (eg, bronchitis, allergic rhinitis, influenza and pneumonia) were calculated. Interrupted time-series analysis, accounting for seasonality, was used to estimate changes in HSU following the 2015 SFOA.ResultsThe study population ranged from 618 957 individuals in 2010 to 498 812 in 2018. An estimated average increase in ED visits for asthma in infants aged 0–1 years of 0.42 per 100 individuals (95% CI: 0.09 to 0.75) and a 57% relative increase corresponding to the 2015 SFOA was observed. A significant decrease in ED visits for asthma-related conditions of 0.19 per 100 individuals (95% CI: −0.37 to –0.01) and a 22% relative decrease corresponding to the 2015 SFOA was observed.ConclusionBased on the observed positive effect of restricting smoking on patios, playgrounds and sports fields on respiratory morbidity in children with asthma, other jurisdictions globally should consider implementing similar smoke-free policies.

scholarly journals The Effect of an Automated Phone Warning and Health Advisory System on Adaptation to High Heat Episodes and Health Services Use in Vulnerable Groups—Evidence from a Randomized Controlled Study

2018 ◽  
Vol 15 (8) ◽  
pp. 1581 ◽  
Author(s):  
Kaddour Mehiriz ◽  
Pierre Gosselin ◽  
Isabelle Tardif ◽  
Marc-André Lemieux
Keyword(s):  
Public Health ◽  
Treatment Group ◽  
Health Services ◽  
Warning System ◽  
Vulnerable Groups ◽  
Controlled Study ◽  
Control Group ◽  
Health Services Use ◽  
The Impact ◽  
Services Use

Automated phone warning systems are increasingly used by public health authorities to protect the population from the adverse effects of extreme heat but little is known about their performance. To fill this gap, this article reports the result of a study on the impact of an automated phone heat warning system on adaptation behaviours and health services use. A sample of 1328 individuals vulnerable to heat was constituted for this purpose and participants were randomly assigned to treatment and control groups. The day before a heat episode, a phone heat warning was sent to the treatment group. Data were obtained through two surveys before and one survey after the heat warning issuance. The results show that members of the treatment group were more aware of how to protect themselves from heat and more likely to adopt the recommended behaviours. Moreover, a much smaller proportion of women in this group used the health-care system compared to the control group. Thus, the exposure to an automated phone warning seems to improve the adaptation to heat and reduce the use of health services by some important at-risk groups. This method can thus be used to complement public health interventions aimed at reducing heat-related health risks.

scholarly journals Assessment of the impact of an opioid-specific education series on rates of medication-assisted treatment for opioid use disorder in veterans

2020 ◽  
Author(s):  
Taylor Kirby ◽  
Robert Connell ◽  
Travis Linneman
Keyword(s):  
Multivariate Analysis ◽  
Hospital Admission ◽  
Intervention Group ◽  
Opioid Use Disorder ◽  
Control Group ◽  
Opioid Use ◽  
Motivation To Change ◽  
Heroin Use ◽  
Ed Visits ◽  
The Impact

Abstract Purpose The impact of a focused inpatient educational intervention on rates of medication-assisted therapy (MAT) for veterans with opioid use disorder (OUD) was evaluated. Methods A retrospective cohort analysis compared rates of MAT, along with rates of OUD-related emergency department (ED) visits and/or hospital admission within 1 year, between veterans with a diagnosis of OUD who completed inpatient rehabilitation prior to implementation of a series of group sessions designed to engage intrinsic motivation to change behavior surrounding opioid abuse and provide education about MAT (the control group) and those who completed rehabilitation after implementation of the education program (the intervention group). A post hoc, multivariate analysis was performed to evaluate possible predictors of MAT use and ED and/or hospital readmission, including completion of the opioid series, gender, age (>45 years), race, and specific prior substance(s) of abuse. Results One hundred fifty-eight patients were included: 95 in the control group and 63 in the intervention group. Rates of MAT were 25% (24 of 95 veterans) and 75% (47 of 63 veterans) in control and intervention groups, respectively (P < 0.01). Gender, completion of the opioid series, prior heroin use, and marijuana use met prespecified significance criteria for inclusion in multivariate regression modeling of association with MAT utilization, with participation in the opioid series (odds ratio [OR], 9.56; 95% confidence interval [CI], 4.36-20.96) and prior heroin use (OR, 3.26; 95% CI, 1.18-9.01) found to be significant predictors of MAT utilization on multivariate analysis. Opioid series participation and MAT use were independently associated with decreased rates of OUD-related ED visits and/or hospital admission (hazard ratios of 0.16 [95% CI, 0.06-0.44] and 0.32 [95% CI, 0.14-0.77], respectively) within 1 year after rehabilitation completion. Conclusion Focused OUD-related education in a substance abuse program for veterans with OUD increased rates of MAT and was associated with a decrease in OUD-related ED visits and/or hospital admission within 1 year.

scholarly journals Impact of the COVID-19 Pandemic on the Intensity of Health Services Use in General Practice: A Retrospective Cohort Study

2021 ◽  
Vol 66 ◽  
Author(s):  
Yael Rachamin ◽  
Oliver Senn ◽  
Sven Streit ◽  
Julie Dubois ◽  
Michael J. Deml ◽  
...  
Keyword(s):  
General Practice ◽  
Health Services ◽  
Total Population ◽  
Age Groups ◽  
Risk Groups ◽  
Health Services Use ◽  
Care Needs ◽  
Hba1c Measurement ◽  
The Impact ◽  
Services Use

Objectives: We aimed to explore the impact of the Swiss shutdown in spring 2020 on the intensity of health services use in general practice.Methods: Based on an electronic medical records database, we built one patient cohort each for January-June 2019 (control, 173,523 patients) and 2020 (179,086 patients). We used linear regression to model weekly consultation counts and blood pressure (BP) and glycated hemoglobin (HbA1c) measurement counts per 100 patients and predicted non-shutdown values. Analyses were repeated for selected at-risk groups and different age groups.Results: During the shutdown, weekly consultation counts were lower than predicted by −17.2% (total population), −16.5% (patients with hypertension), −17.5% (diabetes), −17.6% (cardiovascular disease), −15.7% (patients aged <60 years), −20.4% (60–80 years), and −14.5% (>80 years). Weekly BP counts were reduced by −35.3% (total population) and −35.0% (hypertension), and HbA1c counts by −33.2% (total population) and −29.8% (diabetes). p-values <0.001 for all reported estimates.Conclusion: Our results document consequential decreases in consultation counts and chronic disease monitoring during the shutdown. It is crucial that health systems remain able to meet non-COVID-19-related health care needs.

scholarly journals The Canadian Registry for Pulmonary Fibrosis: Design and Rationale of a National Pulmonary Fibrosis Registry

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Christopher J. Ryerson ◽  
Benjamin Tan ◽  
Charlene D. Fell ◽  
Hélène Manganas ◽  
Shane Shapera ◽  
...  
Keyword(s):  
Natural History ◽  
Pulmonary Fibrosis ◽  
Health Services ◽  
Self Report ◽  
Administrative Databases ◽  
Health Services Use ◽  
Acute Exacerbations ◽  
History Of ◽  
The Impact ◽  
Services Use

Background. The relative rarity and diversity of fibrotic interstitial lung disease (ILD) have made it challenging to study these diseases in single-centre cohorts. Here we describe formation of a multicentre Canadian registry that is needed to describe the outcomes of fibrotic ILD and to enable detailed healthcare utilization analyses that will be the cornerstone for future healthcare planning.Methods. The Canadian Registry for Pulmonary Fibrosis (CARE-PF) is a prospective cohort anticipated to consist of at least 2,800 patients with fibrotic ILD. CARE-PF will be used to (1) describe the natural history of fibrotic ILD, specifically determining the incidence and outcomes of acute exacerbations of ILD subtypes and (2) determine the impact of ILD and acute exacerbations of ILD on health services use and healthcare costs in the Canadian population. Consecutive patients with fibrotic ILD will be recruited from five Canadian ILD centres over a period of five years. Patients will be followed up as clinically indicated and will complete standardized questionnaires at each clinic visit. Prespecified outcomes and health services use will be measured based on self-report and linkage to provincial health administrative databases.Conclusion. CARE-PF will be among the largest prospective multicentre ILD registries in the world, providing detailed data on the natural history of fibrotic ILD and the healthcare resources used by these patients. As the largest and most comprehensive cohort of Canadian ILD patients, CARE-PF establishes a network for future clinical research and early phase clinical trials and provides a platform for translational and basic science research.

scholarly journals Health services use by children identified as heterozygous hemoglobinopathy mutation carriers via newborn screening

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara D. Khangura ◽  
Beth K. Potter ◽  
Christine Davies ◽  
Robin Ducharme ◽  
A. Brianne Bota ◽  
...  
Keyword(s):  
Health Services ◽  
Newborn Screening ◽  
Service Use ◽  
Carrier Status ◽  
Health Services Use ◽  
Inpatient Hospitalization ◽  
Potential Health ◽  
Ed Visits ◽  
Rate Ratios ◽  
Services Use

Abstract Background Newborn screening (NBS) for sickle cell disease incidentally identifies heterozygous carriers of hemoglobinopathy mutations. In Ontario, Canada, these carrier results are not routinely disclosed, presenting an opportunity to investigate the potential health implications of carrier status. We aimed to compare rates of health services use among children identified as carriers of hemoglobinopathy mutations and those who received negative NBS results. Methods Eligible children underwent NBS in Ontario from October 2006 to March 2010 and were identified as carriers or as screen-negative controls, matched to carriers 5:1 based on neighbourhood and timing of birth. We used health care administrative data to determine frequencies of inpatient hospitalizations, emergency department (ED) visits, and physician encounters through March 2012, using multivariable negative binomial regression to compare rates of service use in the two cohorts. We analyzed data from 4987 carriers and 24,935 controls. Results Adjusted incidence rate ratios (95% CI) for service use in carriers versus controls among children < 1 year of age were: 1.11 (1.06–1.17) for ED visits; 0.97 (0.89–1.06) for inpatient hospitalization; and 1.02 (1.00–1.04) for physician encounters. Among children ≥1 year of age, adjusted rate ratios were: 1.03 (0.98–1.07) for ED visits; 1.14 (1.03–1.25) for inpatient hospitalization and 0.92 (0.90–0.94) for physician encounters. Conclusions While we identified statistically significant differences in health services use among carriers of hemoglobinopathy mutations relative to controls, effect sizes were small and directions of association inconsistent across age groups and health service types. Our findings are consistent with the assumption that carrier status is likely benign in early childhood.

scholarly journals Effectiveness of SMS (text message) reminders on adherence to inhaled therapy in patients with asthma: a prospective randomized multicenter study (Preprint)

2018 ◽  
Author(s):  
Carlos Almonacid ◽  
Carlos Melero ◽  
Antolin L�pez-Vi�a ◽  
Carolina Cisneros ◽  
Luis P�rez-Llano ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Intervention Group ◽  
Text Message ◽  
Study Groups ◽  
Control Group ◽  
Parallel Group ◽  
Inhaled Therapy ◽  
Asthma Patients ◽  
The Impact ◽  
Inhaled Medication

BACKGROUND Poor adherence to inhaled medication in asthma patients is of great concern due to the impact on poor asthma control resulting in more exacerbations and increasing the healthcare and economic burden of the disease. OBJECTIVE To determine in patients with asthma adequately treated and followed regularly, if a minimal intervention such as sending SMS text message reminders improved adherence to inhaled medication. METHODS A prospective randomized parallel-group and multicenter study was conducted in the outpatient clinics of specialized asthma units from the pneumology services of ten acute-care hospitals throughout Spain. Adherence was assessed with Smartinhaler™ connected to their current devices. Patients in the SMS group received reminders every 3 days for 6 months. RESULTS There were 53 patients in the SMS group and 88 controls. After 6 months, the mean (SD) electronic adherence was 70% (17%) in the intervention group and 69% (17%) in the control group (P = 0.817). Significant differences between the study groups in the percentages morning and evening adherence to inhaled therapy, control of asthma symptoms, FeNO levels, and improvement of lung function were not observed. CONCLUSIONS In the in the present study reinforcement of adherence to inhaled asthma medication using short message services (SMS) via cell phones was not effective to improve adherence. CLINICALTRIAL None

scholarly journals 0843 Prospective Associations of Insomnia Symptoms With Health Services Use in Community-Dwelling Older Adults

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A321-A321
Author(s):  
M Tzuang ◽  
J T Owusu ◽  
J Huang ◽  
O C Sheehan ◽  
G W Rebok ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Services ◽  
Home Health Care ◽  
Home Health ◽  
Community Dwelling ◽  
Health Services Use ◽  
Ed Visits ◽  
Insomnia Symptoms ◽  
Services Use

Abstract Introduction Limited research has examined links of insomnia with health services use, particularly using claims-based data. We investigated the association of insomnia symptoms with costly health services use, measured by Medicare claims, in a nationally representative sample of U.S. older adults. Methods Participants were 4,302 community-dwelling Medicare beneficiaries aged ≥65 years from Round 1 (2011) of the National Health and Aging Trends Study who had continuous fee-for-service Medicare coverage 1 year before and after the Round 1 interview. Participants reported past-month insomnia symptoms (i.e., sleep onset latency &gt;30 minutes, difficulty returning to sleep after early awakening) which we categorized as 0, 1, or 2 symptoms. Outcomes were linked Medicare claims occurring after Round 1 interviews: emergency department (ED) visits, all-cause hospitalizations, preventable hospitalizations, all-cause 30-day readmissions, home health care (all measured as yes/no); and number of hospitalizations and ED visits. Results Overall, 18.9% of participants were hospitalized, 29.3% visited the ED, 3.1% had a preventable hospitalization, 2.6% had a readmission, and 11.7% used home health care. After adjustment for demographics, compared to participants with no insomnia symptoms, those with 2 symptoms had a higher odds of ED visits (odds ratio (OR)=1.42, p&lt;0.001), all-cause hospitalizations (OR=1.30, p&lt;0.01), preventable hospitalizations (OR=1.83, p&lt;0.05), 30-day readmissions (OR=1.73, p&lt;0.05), and home health care use (OR=1.27, p&lt;0.05). These associations did not hold, however, upon further adjustment for health characteristics (i.e., depressive/anxiety symptoms, medical comorbidities and BMI). After full adjustment, reporting 2 insomnia symptoms, versus no insomnia symptoms, was associated with a greater number of ED visits (Incidence Rate Ratio=1.16, p&lt;0.05). Conclusion Among older adults, a greater number of insomnia symptoms is associated with greater health services use. Insomnia symptoms may be a marker of, or exacerbate, health conditions. Targeting insomnia may lower health services use. Support National Institute on Aging: R01AG050507 & R01AG050507-02S (PI: Spira); F31-AG058389; U01AG032947 (PI: Kasper) for the National Health and Aging Trends Study. Johns Hopkins Center on Aging and Health Data Use Agreement (PI: Roth, Co-I: Sheehan) with Centers for Medicare & Medicaid Services titled, “Potentially modifiable factors influencing outcomes in NHATS.”

The Impact of Integrated Case Management on Health Services Use and Spending Among Nonelderly Adult Medicaid Enrollees

Medical Care ◽  
2016 ◽  
Vol 54 (8) ◽  
pp. 758-764 ◽  
Author(s):  
Lindsay M. Sabik ◽  
Gloria J. Bazzoli ◽  
Patricia Carcaise-Edinboro ◽  
Priya Chandan ◽  
Spencer E. Harpe
Keyword(s):  
Health Services ◽  
Case Management ◽  
Health Services Use ◽  
The Impact ◽  
Integrated Case Management ◽  
Services Use

scholarly journals The Impact of Medicaid Enrollment on Veterans Health Administration Enrollees' Behavioral Health Services Use

2018 ◽  
Vol 53 ◽  
pp. 5238-5259 ◽  
Author(s):  
Megan E. Vanneman ◽  
Ciaran S. Phibbs ◽  
Sharon K. Dally ◽  
Amal N. Trivedi ◽  
Jean Yoon
Keyword(s):  
Health Services ◽  
Behavioral Health ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Behavioral Health Services ◽  
Health Services Use ◽  
Medicaid Enrollment ◽  
The Impact ◽  
Services Use
Sign in / Sign up

Export Citation Format

Share Document