scholarly journals Analysis of factors influencing the frequency of primary care visits among diabetic patients in two provinces in China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jinwen Wang ◽  
Huijuan Zuo ◽  
Xiaorong Chen ◽  
Lei Hou ◽  
Jixiang Ma
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Community Health ◽  
Household Income ◽  
Diabetic Patients ◽  
Urban Residence ◽  
Rural Patients ◽  
Household Visit ◽  
Significant Factors

Abstract Background Community health services have played an important role in the prevention and control of diabetes in China. The aims of this study were to examine the frequency of visits to community clinics for diabetic care services, to assess factors correlated with infrequent primary care visits and to identify barriers to regular follow-up visits for urban and rural patients. Methods Between October 2014 and November 2014, data were collected from 17 communities in two cities and four townships located in Shandong and Jiangsu Provinces in China. A total of 1598 diabetic patients aged 18 years or older who were registered with a primary health station in local communities were selected by simple random sampling. Each participant was required to complete an interviewer-led questionnaire. Univariate and multivariate analyses were used to identify significant factors for infrequent visitor status using multivariable logistic regression analysis. Results After being clearly informed of the study protocol, 1508/1598 (94.4%) patients agreed to participate in this survey. Among the 1508 subjects (mean age 64.4 ± 10.6), 683 (45.3%) were classified as infrequent visitors. The following were significant factors determining infrequent visitor status: urban residence, lack of health insurance, per-capita household income< 20,000 (yuan), lack of telephone follow-up and lack of household visit. From the patients’ perspectives, the reasons for infrequent visits among urban patients included drug scarcity and longer travel time to clinics. For rural patients, worries about medical expenses and drug scarcity were the most common barriers to clinic visits. Conclusion Determinants of infrequent community visits in diabetes patients include urban residence, lower household income, lack of health insurance, lack of telephone follow-up and lack of household visit services. Strategies aimed at enhancing the utilization of community health care should be implemented in China.

Abstract TP356: Post-Acute Stroke Experience Survey- Development and Pilot Testing

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jane A Anderson ◽  
Barbara Kimmel ◽  
Kirt Martin ◽  
Anette Ovalle ◽  
Chizoba Ifeorah ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Care Provider ◽  
Primary Care Provider ◽  
Claims Data ◽  
Stroke Care ◽  
Insurance Status ◽  
Stroke Survivors ◽  
Health Insurance Status

Background: Administrative claims data show variability in post-acute stroke care. Stroke survivors without health insurance are not included in claims data statistics. The PASES survey was developed and tested to describe stroke care experience of underserved survivors participating in V-STOP a telehealth self-management program. Methods: Semi-structured interviews were completed to elicit feedback from survivors on experiences during their stroke event, emergency and hospital care, and after discharge. Items on PASES were established based on participants’ responses and survey was piloted in a sample of underserved survivors (N=95). Descriptive statistics and Chi-square analysis were applied to describe stroke survivors’ experiences and differences based on health insurance status. Results: The sample was 45% female, mean age 57, 18% Black and 60% Hispanic. Most (60%) had an annual income of less than $25,000 and 44% had no insurance. Only 25% reported calling 911. However (60%) report presenting to a hospital within 2 hours of stroke symptoms recognition. Nearly half (42%) reported not knowing whether they received a “clot dissolving” medication. Fifty-four percent did not receive rehabilitation after discharge. Eighty-percent reported seeing a healthcare provider after discharge. Most (61%) saw a primary care provider and 22% saw a neurologist. However, only 24% reported seeing a provider within one month of hospital discharge. No significant differences were identified between insured vs. uninsured with respect to race, ethnicity, income, calling 911, receiving inpatient rehab, seeing a provider after discharge and follow up with primary care provider vs. neurologist. Significant differences were identified between insured vs. uninsured with respect to presenting to a hospital within 2 hours of stroke symptoms (35 vs 18 [p=0.023]) and in receiving no rehab after discharge (27 vs 12 [p=0.02]). Conclusion: Results suggest low utilization of EMS, delayed presentation to hospital, limited access to rehabilitation after discharge and limited access to timely follow-up with stroke specialist among underserved stroke survivors. Health insurance status may influence delayed hospital presentation and access to rehabilitation services.

scholarly journals Depression risk in patients with heart failure in primary care practices in Germany

2016 ◽  
Vol 28 (11) ◽  
pp. 1889-1894
Author(s):  
Marcel Konrad ◽  
Jens Bohlken ◽  
Michael A Rapp ◽  
Karel Kostev
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Health Insurance ◽  
Control Group ◽  
Patients With Heart Failure ◽  
Study Population ◽  
Care Practices ◽  
One Year ◽  
Primary Care Practices

ABSTRACTBackground:The goal of this study was to estimate the prevalence of and risk factors for diagnosed depression in heart failure (HF) patients in German primary care practices.Methods:This study was a retrospective database analysis in Germany utilizing the Disease Analyzer® Database (IMS Health, Germany). The study population included 132,994 patients between 40 and 90 years of age from 1,072 primary care practices. The observation period was between 2004 and 2013. Follow-up lasted up to five years and ended in April 2015. A total of 66,497 HF patients were selected after applying exclusion criteria. The same number of 66,497 controls were chosen and were matched (1:1) to HF patients on the basis of age, sex, health insurance, depression diagnosis in the past, and follow-up duration after index date.Results:HF was a strong risk factor for diagnosed depression (p < 0.0001). A total of 10.5% of HF patients and 6.3% of matched controls developed depression after one year of follow-up (p < 0.001). Depression was documented in 28.9% of the HF group and 18.2% of the control group after the five-year follow-up (p < 0.001). Cancer, dementia, osteoporosis, stroke, and osteoarthritis were associated with a higher risk of developing depression. Male gender and private health insurance were associated with lower risk of depression.Conclusions:The risk of diagnosed depression is significantly increased in patients with HF compared to patients without HF in primary care practices in Germany.

Medical expenditure for diabetic patients: A 10-year follow-up study of National Health Insurance in Shiga, Japan

Public Health ◽  
2008 ◽  
Vol 122 (11) ◽  
pp. 1226-1228 ◽  
Author(s):  
K. Nakamura ◽  
T. Okamura ◽  
H. Kanda ◽  
T. Hayakawa ◽  
Y. Murakami ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Medical Expenditure ◽  
Diabetic Patients ◽  
Follow Up Study

scholarly journals Substance use identification and follow-up rates among commercial and Medicare health insurance members in primary care and other settings

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
John G. Baker ◽  
David R. Doxbeck ◽  
Melanie E. Washington ◽  
Angela Horton ◽  
Adam Dunning
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Health Insurance ◽  
Substance Use Disorder ◽  
Alcohol Problems ◽  
Adult Males ◽  
Linear Regression Models ◽  
Short Term ◽  
Private Health Insurer

Abstract Background The objective of this study was to investigate factors associated with substance use disorder identification and follow-up rates among samples of members of a private health insurance plan. Methods In an observational study, samples of claims data for 2017 for Commercial and Medicare members from a private health insurer were accessed and analyzed using descriptive statistics, decision tree analysis, and linear regression models. Results Commercial and Medicare members differed in age. Medicare members had higher rates of inclusion in a measure of substance use disorder than Commercial members, lower rates of initial short term follow-up, more opioid prescriptions from primary care provides, fewer prescriptions for opioid treatment, and higher rates of selected comorbid conditions. Mental health diagnoses and substance use disorder co-occurred frequently and to a greater extent in the Medicare sample. Among commercial members, there were primarily alcohol problems that increased with age, while opioid problems at about 10% peaked in the mid-twenties. More males were included among all substance types. The overall rate for an initial short term follow-up visit indicating initiation of treatment was 30%. There were large differences in the follow-up rates across settings with a very low rate (4.6% for alcohol and 6.9% for opioid) in primary care settings. Conclusions These results suggest that increased attention in primary care to young adult males and to older adults, may help to reduce substance use disorder rates, especially alcohol use disorders.

scholarly journals Substance Use Identification and Follow-up Rates among Commercial and Medicare Health Insurance Members in Primary Care and Other Settings

2020 ◽  
Author(s):  
John G. Baker ◽  
David R. Doxbeck ◽  
Melanie E. Washington ◽  
Angela Horton ◽  
Adam Dunning
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Health Insurance ◽  
Substance Use Disorder ◽  
Alcohol Problems ◽  
Adult Males ◽  
Linear Regression Models ◽  
Short Term ◽  
Private Health Insurer

Abstract Background: The objective of this study was to investigate factors associated with substance use disorder identification and follow-up rates among samples of members of a private health insurance plan. Methods: In an observational study, samples of claims data for 2017 for Commercial and Medicare members from a private health insurer were accessed and analyzed using descriptive statistics, decision tree analysis, and linear regression models. Results: Commercial and Medicare members differed in age. Medicare members had higher rates of inclusion in a measure of substance use disorder than Commercial members, lower rates of initial short term follow-up, more opioid prescriptions from primary care provides, fewer prescriptions for opioid treatment, and higher rates of selected comorbid conditions. Mental health diagnoses and substance use disorder co-occurred frequently and to a greater extent in the Medicare sample. Among commercial members, there were primarily alcohol problems that increased with age, while opioid problems at about 10% peaked in the mid-twenties. More males were included among all substance types. The overall rate for an initial short term follow-up visit indicating initiation of treatment was 30%. There were large differences in the follow-up rates across settings with a very low rate (4.6% for alcohol and 6.9% for opioid) in primary care settings. Conclusions: These results suggest that increased attention in primary care to young adult males and to older adults, may help to reduce substance use disorder rates, especially alcohol use disorders.

scholarly journals The Efficacy of Follow-up Phone Calls for Capillary Blood Glucose Lowering in Diabetic Patients in Primary Care Unit

2021 ◽  
Vol 73 (12) ◽  
pp. 801-807
Author(s):  
Possatorn Wongwutthiwet ◽  
Tatree Bosittipichet ◽  
Thanakamon Leesri
Keyword(s):  
Primary Care ◽  
Capillary Blood ◽  
Mean Difference ◽  
Control Group ◽  
Diabetic Patients ◽  
Capillary Blood Glucose ◽  
Phone Calls ◽  
Significant Difference ◽  
Experimental Group

Objective: To study the effect of telephone call intervention on glycemic control in diabetic patients for 2 monthsMaterials and Methods: The quasi-experimental research included 130 Patients from January 2020 to March 2020 in primary care. The 115 patients were divided into 2 groups through a simple randomization process, 61 in experimental group and 54 in control group after exclusion. 115 Patients will be tested for Capillary blood glucose (CBG) level at a period of 0-month, 1-month and 2-months. CBG level were presented in mean ± SD, mean difference ± SD and analyzed by Independent t-test and Paired t-test.Results: The phone call intervention can lower CBG level compared to the control group. Mean difference of CBG between 0 month and 2 months follow-up in phone calls group vs control group (-6.80 ± 4.86 vs -2.96 ± 4.82 mg/dL) and mean difference CBG level between 1 month and 2 months follow-up in phone calls group vs control group (-5.77 ± 4.09 vs -4.22 ± 5.10 mg/dL) but had no significant difference (p >0.05)Conclusion: The follow-up phone calls can lower CBG level in the experimental group more than the control group, but there is no significant difference.

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