scholarly journals The effects of smoking, regular drinking, and unhealthy weight on health care utilization in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Changle Li ◽  
Zhengzhong Mao ◽  
Caixia Yu
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Outpatient Care ◽  
Inpatient Care ◽  
Fixed Effects ◽  
Care Utilization ◽  
Healthy Weight ◽  
Obese People ◽  
Former Smokers ◽  
Unhealthy Weight

Abstract Background Preventive risk factors such as smoking, drinking, and unhealthy weight have contributed to the accelerated rise in noncommunicable chronic diseases, which are dominant drivers of health care utilization and spending in China. However, few studies have been conducted using a large longitudinal dataset to explore the impact of such preventive risk factors on health care utilization. Therefore, this study aimed to ascertain the effects of smoking, regular drinking, and unhealthy weight on health care utilization in China. Methods This research was a longitudinal study using data from five waves of the China Family Panel Studies (CFPS) conducted between 2010 and 2018, and the final sample consisted of 63,260 observations (12,652 participants) across all five waves of data collection. Health care utilization was measured from two perspectives: outpatient utilization and inpatient utilization. Smoking status was categorized as never smoker, former smoker, or current smoker. Unhealthy weight was classified based on the participants’ body mass index. A fixed effects logistic regression model was used for the analysis. Results The results of fixed effects logistic regression showed that current and former smokers were approximately 1.9 times and 2.0 times more likely to use outpatient care than those who never smoked, respectively (odds ratio (OR) = 1.88, p < 0.05; OR = 2.03, p < 0.05). Obese people were approximately 1.3 times more likely to use outpatient care than healthy weight people (OR = 1.26, p < 0.05). Moreover, the results show that compared to those who never smoked, for current and former smokers, the odds of being hospitalized increased by 42.2 and 198.2%, respectively (OR = 1.42; p < 0.1, OR = 2.98; p < 0.05). Compared to healthy weight people, overweight and obese people were also more likely to be hospitalized (OR = 1.11; p < 0.1, OR = 1.18; p < 0.1, respectively). Conclusion Among Chinese adults, current and former smokers were more likely to use outpatient and inpatient care than those who had never smoked. Moreover, compared to healthy weight people, obese people were more likely to use outpatient and inpatient care, and overweight people were more likely to use inpatient care. These results may have important implications that support the government in making health care resource allocation decisions.

scholarly journals The Effects of Smoking, Regular Drinking, and Unhealthy Weight on Healthcare Utilization in China

2020 ◽  
Author(s):  
Changle Li ◽  
Zhengzhong Mao ◽  
Caixia Yu
Keyword(s):  
Healthcare Utilization ◽  
Inpatient Care ◽  
Fixed Effects ◽  
Health Care Use ◽  
Healthy Weight ◽  
Obese People ◽  
Data Set ◽  
Former Smokers ◽  
The Government ◽  
Unhealthy Weight

Abstract Background: The preventable risk factors such as smoking, harmful drinking, and unhealthy weight have contributed to the accelerated rise in non-communicable chronic diseases that are dominant drivers of health care use and spending in China. This study aimed to ascertain the effects of smoking, regular drinking, and unhealthy weight on healthcare utilization in China. Methods: The database used in this study was obtained from the China Family Panel Studies (CFPS), and the final sample consisted of 63,260 adults in all the five waves of data collection. The fixed effects logistic regression model was used for the analysis. Results: The current study found that among Chinese adults, current and former smokers were more likely to use outpatient and inpatient care compared to those who never smoked. Former smokers increased the odds of using outpatient and inpatient care than current smokers. Moreover, compared to healthy weight people, obese people increased the likelihood of using outpatient and inpatient care, and overweight people were more likely to be hospitalized. In contrast, people who regularly drank alcohol were less likely to use outpatient and inpatient care than non-regular drinkers. Conclusion: This study ascertained the effects of smoking, regular drinking, and unhealthy weight on healthcare utilization in China using a five-waves of balanced panel data set. These results may have important implications for supporting the government to make healthcare resources allocation decisions.

scholarly journals The Effects of Smoking, Regular Drinking, and Unhealthy Weight on Healthcare Utilization in China

2020 ◽  
Author(s):  
Changle Li ◽  
Zhengzhong Mao ◽  
Caixia Yu
Keyword(s):  
Healthcare Utilization ◽  
Inpatient Care ◽  
Fixed Effects ◽  
Health Care Use ◽  
Healthy Weight ◽  
Obese People ◽  
Data Set ◽  
Former Smokers ◽  
The Government ◽  
Unhealthy Weight

Abstract Background: The preventable risk factors such as smoking, harmful drinking, and unhealthy weight have contributed to the accelerated rise in non-communicable chronic diseases that are dominant drivers of health care use and spending in China. This study aimed to ascertain the effects of smoking, regular drinking, and unhealthy weight on healthcare utilization in China. Methods: The database used in this study was obtained from the China Family Panel Studies (CFPS), and the final sample consisted of 63,260 adults in all the five waves of data collection. The fixed effects logistic regression model was used for the analysis. Results: The current study found that among Chinese adults, current and former smokers were more likely to use outpatient and inpatient care compared to those who never smoked. Former smokers increased the odds of using outpatient and inpatient care than current smokers. Moreover, compared to healthy weight people, obese people increased the likelihood of using outpatient and inpatient care, and overweight people were more likely to be hospitalized. In contrast, people who regularly drank alcohol were less likely to use outpatient and inpatient care than non-regular drinkers. Conclusion: This study ascertained the effects of smoking, regular drinking, and unhealthy weight on healthcare utilization in China using a five-waves of balanced panel data set. These results may have important implications for supporting the government to make healthcare resources allocation decisions.

Receiving care according to national heart failure guidelines is associated with lower total costs: an observational study in Region Halland, Sweden

2020 ◽  
Author(s):  
Zayed M Yasin ◽  
Philip D Anderson ◽  
Markus Lingman ◽  
Japneet Kwatra ◽  
Awais Ashfaq ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Observational Study ◽  
Health Care Utilization ◽  
Inpatient Care ◽  
Quality Care ◽  
Prescribing Patterns ◽  
Care Utilization ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Abstract Aims Patients with heart failure (HF) have high costs, morbidity, and mortality, but it is not known if appropriate pharmacotherapy (AP), defined as compliance with international evidence-based guidelines, is associated with improved costs and outcomes. The purpose of this study was to evaluate HF patients’ health care utilization, cost and outcomes in Region Halland (RH), Sweden, and if AP was associated with lower costs. Methods and results A total of 5987 residents of RH in 2016 carried HF diagnoses. Costs were assigned to all health care utilization (inpatient, outpatient, emergency department, primary health care, and medications) using a Patient Encounter Costing methodology. Care of HF patients cost €58.6 M, (€9790/patient) representing 8.7% of RH’s total visit expenses and 14.9% of inpatient care (IPC) expenses. Inpatient care represented 57.2% of this expenditure, totalling €33.5 M (€5601/patient). Receiving AP was associated with significantly lower costs, by €1130 per patient (P &lt; 0.001, 95% confidence interval 574–1687). Comorbidities such as renal failure, diabetes, chronic obstructive pulmonary disease, and cancer were significantly associated with higher costs. Conclusion Heart failure patients are heavy users of health care, particularly IPC. Receiving AP is associated with lower costs even adjusting for comorbidities, although causality cannot be proven from an observational study. There may be an opportunity to decrease overall costs and improve outcomes by improving prescribing patterns and associated high-quality care.

Association of SHI coverage and level of healthcare utilization and costs in the Philippines: a 10-year pooled analysis

2019 ◽  
Vol 42 (4) ◽  
pp. e496-e505
Author(s):  
Nel Jason L Haw ◽  
Jhanna Uy ◽  
Beverly Lorraine Ho
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Utilization ◽  
Health Care Costs ◽  
Inpatient Care ◽  
The Philippines ◽  
Care Utilization ◽  
Health Coverage ◽  
Outpatient Services ◽  
Care Costs

Abstract Background The Philippine Health Insurance Corporation (PhilHealth), which manages the Philippine national health insurance program, is a critical actor in the country’s strategy for universal health coverage. Over the past decade, PhilHealth has passed significant coverage, benefits and payment reforms to contain costs and improve the affordability care for high-cost diseases, inpatient care and select outpatient services. Methods We studied the association of PhilHealth with health care utilization and health care costs using three rounds of the Philippine Demographic and Health Survey with data on individual outpatient and inpatient visits from 2008 to 2017. Results PhilHealth membership was associated with 42% greater odds of outpatient utilization and 47–100% greater odds inpatient utilization depending on survey year. Depending on facility type, use of PhilHealth to pay for care was associated with higher average health care costs of 244–865% for outpatient care and 135–206% for inpatient care. Conclusions PhilHealth has likely decreased barriers to health care utilization but may have inadvertently driven up health care costs in the country. Results align with past studies that suggest that reforms in the prior decade have done little to contain health care costs for Filipinos.

scholarly journals Does Gerofit Exercise Reduce Veterans’ Use of Emergency Department and Inpatient Care?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 771-771
Author(s):  
Lauren Abbate ◽  
Jiejin Li ◽  
Peter Veazie ◽  
Orna Intrator ◽  
Cathy Lee ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Department ◽  
Health Care Utilization ◽  
Inpatient Care ◽  
Nearest Neighbor ◽  
Group Differences ◽  
Care Utilization ◽  
Ed Visits ◽  
The Relationship

Abstract Little is known about the relationship between exercise and health care utilization in older adults. This study examined hospitalizations/emergency Department (ED) visits in the 12 months prior to and during 12 months of active Gerofit participation (across 5 sites). Data were compared for each outcome to a propensity matched nearest neighbor sample from the same site [Mean, 95% CI]. Of the 226 Veterans who were active in the program for ≥12 months and enrolled in VA and Traditional Medicare for 12 months prior to Gerofit participation, hospitalizations/ED visits were greater prior to (15.3%/42.0%) than during (6.8%/37.1%) Gerofit participation. Gerofit participants were 8% less likely to have a hospitalization in the 12 months following enrollment than controls [-0.08 (-0.14, -0.02)] but no between-group differences in ED use [-0.00 (-0.11, 0.10)] were observed. Participation in Gerofit may reduce hospitalizations, but its impact on ED use is inconclusive.

Long-term Effects of Disasters on Health Care Utilization: Hurricane Katrina and Older Individuals with Diabetes

2019 ◽  
Vol 13 (4) ◽  
pp. 724-731 ◽  
Author(s):  
Troy Quast ◽  
Lijuan Feng
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Hurricane Katrina ◽  
Fixed Effects ◽  
Care Utilization ◽  
Older Individuals ◽  
Control Groups ◽  
Short Term ◽  
Age Cohorts

ABSTRACTObjectiveWhile the short-term effects of disasters on health care utilization are well documented, less is known regarding potential longer-term effects. This study investigates the effects of Hurricane Katrina on the health care utilization of older individuals with diabetes.MethodsWe examined Medicare claims and enrollment data for the 2002-2004 and 2006-2008 time periods for older individuals with diabetes. Our quasi-experimental design analyzed utilization across 2 treated and 3 control groups. We compared the proportion of individuals who received a screen related to diabetes before and after Katrina in the treated groups to the proportions in the control groups. Our regression analysis employs individual and year fixed effects to control for factors specific to a given individual or to a given year.ResultsWe found that utilization rates in the 2002-2004 period exhibited roughly parallel trends for the treated and control groups, which provides support for our research design. The 2006-2008 utilization rates were generally lower for the treated groups than they were for the control groups. The differences were especially pronounced for older age cohorts.ConclusionsOur study suggests that the effects of disasters on health care utilization may persist for years after the event. Recovery efforts may be improved by addressing both short-term and long-term health care interruptions. (Disaster Med Public Health Preparedness. 2019;13:724–731)

scholarly journals Impact of COVID 19 Pandemic on Health Care Utilization for Patients with Sickle Cell Disease - a Specialty Treatment Center Experience

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4955-4955
Author(s):  
Akshat Jain ◽  
Amie Patel ◽  
Udochukwo Oyoyo ◽  
Seth Wiafe
Keyword(s):  
Health Care ◽  
Sickle Cell Disease ◽  
Length Of Stay ◽  
Health Care Utilization ◽  
Medical Care ◽  
Sickle Cell ◽  
Inpatient Care ◽  
Care Utilization ◽  
Cell Disease ◽  
Time Points

Abstract Introduction: Starting in March 2020, the coronavirus 19 disease (COVID-19) pandemic affected the United States (US) health care system. Many individuals were afraid to seek medical care due to fear of obtaining COVID-19; therefore, there was a high frequency of adults forgoing medical care. Chronic conditions including diabetes, COPD, mental health, and HTN outcomes worsened due to decrease in routine care during the pandemic. Sickle cell disease (SCD) is a chronic blood disorder that causes numerous complications including but not limited to vaso-occlusive crisis, strokes, and chronic kidney disease. Individuals who have routine follow up with a hematologist have been shown to have decreased hospitalizations, ER visits, length of stay, and opiate usage. The Inland Empire region of Southern California is one of the densest hot spots for patient's living with sickle cell disease in terms of disease burden and health care utilization. Therefore, we evaluated how the COVID-19 pandemic affected health care utilizations with individuals with SCD in this area. Methods: A retrospective analysis of the health care utilization in the inpatient setting was performed at three time points in line with the C.D.C. COVID pandemic declaration (Pre COVID: September 2019 to February 2020, Intra COVID 1: March 2020 to Sept 2020, Intra COVID 2: October 2020 to February 2021). Primary endpoints included emergency room visits, inpatient admissions, and length of stay, blood product utilization, and opioid utilization. Secondary endpoints and analyses included pediatric vs. adult health care utilization disparity and outcomes. Descriptive analysis was done by calculating frequency and percentages for categorical variables and mean and standard deviation for continuous variables. Results: Shown in Result TABLE attached .Patients seeking inpatient care for scheduled procedure's/ transfusion were excluded from this analysis. Patients with SCD diagnoses of acute SCD crises (pan crisis /chest syndrome / COVID infection / Pneumonia) were included in assessment. Absolute number of patients per ED visit, patient per Inpatient admission frequency has been shown in more detail in the bar chart in Figure and will be presented in the oral presentation along with detailed data analysis box plots and charts. Discussion: Fewer patients' sought timely care for acute SCD event leading to fewer but prolonged hospitalizations, a trend seen in our adult and pediatric patient's across the board during intra COVID 1 and 2 time points, likely due to the fear of contracting COVID infection at an acute health care setting in a declared pandemic . Similarly, we found there were less unique sickle cell patients using the ER for both pediatric and adult patients during the pandemic. There was a decrease in the amount of hospital admission related to sickle cell disease, which was similar to results published in the United Kingdom. More sickle cell vaso-occlusive crisis were being managed at home, likely due to avoidance of COVID exposures at health care facilities, likely thus leading to certain individuals having more severe crisis as shown by increased LOS in our adult population. Additionally, only a few individuals with likely more severe crisis needed more RBC transfusions. The general trend for different patients requiring RBCs and IV opiates decreased during the pandemic. Due to more people foregoing medical care especially in the minority populations who had restrictions to access to healthcare, there was an overall decrease in inpatient healthcare utilization in sickle cell population during the pandemic. Additionally care disparities in outcome of pediatric and adult SCD patients were highlighted by our study. Pediatric patients commonly cared at a center of excellence by the dedicated team of sickle cell stakeholders, seemed to do well overall as compared to adult SCD patients who notoriously have has inequitable access to comprehensive Sickle Cell care globally. Infrastructure around better outpatient support, care optimization with sickle cell disease modifying agents and timely access to inpatient care even in a pandemic, that is ongoing could be strategies to reduce stress on the health care systems and better utilization of scarce resources in current times of surge from an International health care crisis such as the SAR CoV2 pandemic. Figure 1 Figure 1. Disclosures Jain: GBT: Consultancy; CSL Behring: Consultancy, Speakers Bureau; Takeda: Consultancy, Speakers Bureau; Octapharma: Consultancy; Blue Bird Bio: Consultancy.

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