scholarly journals EMS utilization predictors in a Mobile Integrated Health (MIH) program

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Luis M. Pinet-Peralta ◽  
Lukas J. Glos ◽  
Evan Sanna ◽  
Brian Frankel ◽  
Ernest Lindqvist
Keyword(s):  
Fall Risk ◽  
Medication Compliance ◽  
Models Of Care ◽  
Urgent Care ◽  
Risk Scores ◽  
Access To Health Services ◽  
Emergency Department Overcrowding ◽  
Access To Health ◽  
The Us

Abstract Background The provision of unnecessary Emergency Medical Services care remains a challenge throughout the US and contributes to Emergency Department overcrowding, delayed services and lower quality of care. New EMS models of care have shown promise in improving access to health services for patients who do not need urgent care. The goals of this study were (1) to identify factors associated with EMS utilization (911) and (2) their effects on total EMS calls and transports in an MIH program. Methods The study sample included 110 MIH patients referred to the program or considered high-users of EMS services between November 2016 and September 2018. The study employed descriptive statistics and Poisson regressions to estimate the effects of covariates on total EMS calls and transports. Results The typical enrollee is a 60-year-old single Black male living with two other individuals. He has a PCP, takes 12 medications and is compliant with his treatment. The likelihood of calling and/or being transported by EMS was higher for males, patients at high risk for falls, patients with asthma/COPD, psychiatric or behavioral illnesses, and longer travel times to a PCP. Each prescribed medication increased the risk for EMS calls or transports by 4%. The program achieved clear reductions in 911 calls and transports and savings of more than 140,000 USD in the first month. Conclusions This study shows that age, marital status, high fall risk scores, the number of medications, psychiatric/behavioral illness, asthma/COPD, CHF, CVA/stroke and medication compliance may be good predictors of EMS use in an MIH setting. MIH programs can help control utilization of EMS care and reduce both EMS calls and transports.

scholarly journals EMS utilization predictors in a Mobile Integrated Health (MIH) program

2020 ◽  
Author(s):  
Luis Mauricio Pinet Peralta ◽  
Lukas Glos ◽  
Evan Sanna ◽  
Brian Frankel ◽  
Ernest Lindqvist
Keyword(s):  
Fall Risk ◽  
Medication Compliance ◽  
Models Of Care ◽  
Urgent Care ◽  
Risk Scores ◽  
Access To Health Services ◽  
Emergency Department Overcrowding ◽  
Access To Health ◽  
The Us

Abstract Background. The provision of unnecessary Emergency Medical Services care remains a challenge throughout the US and contributes to Emergency Department overcrowding, delayed services and lower quality of care. New EMS models of care have shown promise in improving access to health services for patients who do not need urgent care. The goals of this study were 1) to identify factors associated with EMS utilization (911) and 2) their effects on total EMS calls and transports in an MIH program. Methods. The study sample included 110 MIH patients referred to the program or considered high-users of EMS services between November 2016-September 2018. The study employed descriptive statistics and Poisson regressions to estimate the effects of covariates on total EMS calls and transports. Results. The typical enrollee is a 60-year-old single Black male living with two other individuals. He has a PCP, takes 12 medications and is compliant with his treatment. The likelihood of calling and/or being transported by EMS was higher for males, patients at high risk for falls, patients with asthma/COPD, psychiatric or behavioral illnesses, and longer travel times to a PCP. Each prescribed medication increased the risk for EMS calls or transports by 4%. The program achieved clear reductions in 911 calls and transports and savings of more than 140,000 USD in the first month. Conclusions. This study shows that age, marital status, high fall risk scores, the number of medications, psychiatric/behavioral illness, asthma/COPD, CHF, CVA/stroke and medication compliance may be good predictors of EMS use in an MIH setting. MIH programs can help control utilization of EMS care and reduce both EMS calls and transports.

scholarly journals EMS utilization predictors in a Mobile Integrated Health (MIH) program: A retrospective analysis

2020 ◽  
Author(s):  
Luis Mauricio Pinet Peralta ◽  
Evan Sanna ◽  
Brian Frankel ◽  
Ernest Lindqvist ◽  
Lukas Glos
Keyword(s):  
Fall Risk ◽  
African American Male ◽  
Medication Compliance ◽  
Models Of Care ◽  
Urgent Care ◽  
Risk Scores ◽  
Access To Health Services ◽  
Access To Health ◽  
The Us

Abstract Background. The provision of unnecessary Emergency Medical Services (EMS) care remains a challenge throughout the US and contributes to ER overcrowding, delayed services and lower quality of care. New EMS models of care have shown promise in improving access to health services for patients who do not need urgent care. The goals of this study were 1) to identify factors associated with EMS utilization (911) and 2) their effects on total EMS calls and transports in an MIH program. Methods. The study sample included 110 MIH patients referred to the program or considered high-users of EMS services between November 2016-September 2018. The study employed descriptive statistics and Poisson regression to estimate the effects of covariates on total EMS calls and transports. Results. The typical enrollee is a 60-year old single African-American male living with two other individuals. He has a PCP, takes 12 medications and is compliant with his treatment. The likelihood of calling and/or being transported by EMS was higher for males, patients at high risk for falls, patients with asthma/COPD, psychiatric or behavioral illnesses, and longer travel times to a PCP. Each prescribed medication increased the risk for EMS calls or transports by 4%. Conclusions. This study shows that age, marital status, high fall risk scores, the number of medications, psychiatric/behavioral illness, asthma/COPD, CHF, CVA/stroke and medication compliance may be good predictors of EMS use in an MIH setting. MIH programs can help control utilization of EMS care and reduce both EMS calls and transports.

scholarly journals Socioeconomic inequalities in the access to and quality of health care services

2014 ◽  
Vol 48 (6) ◽  
pp. 968-976 ◽  
Author(s):  
Bruno Pereira Nunes ◽  
Elaine Thumé ◽  
Elaine Tomasi ◽  
Suele Manjourany Silva Duro ◽  
Luiz Augusto Facchini
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Health Care Services ◽  
Access To Health Services ◽  
Socioeconomic Groups ◽  
Care Services ◽  
Access To Health ◽  
To Receive ◽  
Use Of Health Care

OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.

scholarly journals Factors associated with access to health services and quality of life in knee osteoarthritis patients: a multilevel cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Siriwan Choojaturo ◽  
Siriorn Sindhu ◽  
Ketsarin Utriyaprasit ◽  
Chukiat Viwatwongkasem
Keyword(s):  
Quality Of Life ◽  
Health Service ◽  
Health Services ◽  
Self Management ◽  
Access To Health Services ◽  
Patient Factors ◽  
Cross Sectional ◽  
Knee Oa ◽  
Access To Health

Abstract Background The main purpose of health service systems is to improve patients’ quality of life (QoL) and to ensure equitable access to health services. However, in reality, nearly half of knee osteoarthritis (OA) patients present to the health system do not have access to health services, and their QoL remains poor. These circumstances raise important questions about what (if any) factors can improve health care accessibility and QoL for knee OA patients. Methods A multicenter, cross-sectional survey was performed with 618 knee OA patients who received care at 16 hospitals in Thailand. Structural equation modeling (SEM) was conducted to investigate the association of health service factors and patient factors with access to health services and QoL. Results The QoL of knee OA patients was very poor (mean score = 33.8). Only 2.1% of the knee OA patients found it easy to obtain medical care when needed. Approximately 39.4% of them were able to access appropriate interventions before being referred for knee replacement. More than 85% of orthopedic health services had implemented chronic disease management (CDM) policy into practice. However, the implementation was basic, with an average score of 5.9. SEM showed that QoL was determined by both health system factors (β = .10, p = .01) and patient factors (β = .29, p = .00 for self-management and β = −.49, p = .00 for disease factors). Access to health services was determined by self-management (β = .10, p = .01), but it was not significantly associated with QoL (β = .00, p = 1.0). Conclusions This study provides compelling information about self-management, access to health services and QoL from the individual and health service system perspectives. Furthermore, it identifies a need to develop health services that are better attuned to the patient’s background, such as socioeconomic status, disease severity, and self-management skills.

scholarly journals Analisa dan Aplikasi Konsep Risiko pada Populasi Wanita Hamil

2014 ◽  
Vol 6 (1) ◽  
pp. 28-34
Author(s):  
Wiwin Wiarsih
Keyword(s):  
At Risk ◽  
Maternal Mortality ◽  
Well Being ◽  
Personal Health ◽  
Access To Health Services ◽  
Lack Of Information ◽  
Access To Health ◽  
Health And Development ◽  
The Impact

Angka kematian ibu ditentukasn oleh tingkat kesejahteraan individu wanita hamil dalam keluarga. Kondisi ini akan menentukan tingkat kesehtan dan perkembangan anak sebagai satu faktor yang menentukan kesehatan dan menjadi satu indicator dari keejahteraan suatu Negara. Penyebab utama tingginya angka kematian ibu di Negara-negara berkembang adalah belum optimalnya penanganan kasus-kasus berisiko. Penatalaksanaan kasus-kasus berisiko dilakukan terlambat karena kurangnya kesadaran klien untuk mengatasi masalah-masalah kesehatannya, kurangnya informasi, kurangnya jangkauan pelayanan kesehata, dan kurang berkualitasnya sumber daya manusia khususnya pada petugas pelayan kesehatan. Wanita hamil adalah salah satu populasi yang seharusnya diberikan perhatian lebh karena setiap wanita hamil mempunyai kesempatan yang sama untuk mendapatkan penanganan masalah-masalah kesehatan. Faktor-faktor risiko memungkinkanseorang wanita hamil menjadi berisiko tinggi untuk mempunyai masalah-masalah kesehatan, termasuk status sosial ekonomi dan sosio demografi, stress dan gaya hidup, dan praktek kesehatan personal. Untuk menurunkan pengaruh label atau stigma “risiko’ dalam masyarakat adalah suatu tantangan untuk profesi kesehatan mengembangkan pendekatan yang efektif dalam pelayanan kesehatan sehingga akan didapatkab suatu hasil yang optimal. The level of individual well being in a family determines the maternal mortality rate. This condition will determine the level of child health and development as an important determinant of health that is an indicator of well being in a country. The main cause of high levels of of maternal mortality in developing countries as a lack of case management of the “at risk’ individual or population; management of “at risk” cases is too late. This is because of lack awareness of “at risk” client in overcoming the problems, lack of information, lack of access to health services, and lack of quality of human resource especially of health care every pregnant woman has the same probability of developing problems. The risk factors enable of pregnant women to become hig risk to have the health problems including socioeconomic status, sociodemographic status, life style and life events, and personal health practices. To decrease the impact of the “at risk” label or stigma in the community, a challenge for the health professional is to develop partnership and multisectoral approach with community so that an optimal outcome will be attained.

Supporting older military veterans in the rural US

2018 ◽  
Vol 19 (4) ◽  
pp. 286-297
Author(s):  
Bret Hicken ◽  
Kimber Parry
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Access To Health Care ◽  
Veterans Health ◽  
Health Administration ◽  
Care Needs ◽  
Content Type ◽  
Access To Health ◽  
The Us

Purpose The purpose of this paper is to provide an overview of rural older veterans in the US and discuss how the US Department of Veterans Affairs (VA) is increasing access to health care for older veterans in rural areas. Design/methodology/approach This is a descriptive paper summarizing population and program data about rural veterans. Findings VA provides a variety of health care services and benefits for older veterans to support health, independence, and quality of life. With the creation of the Veterans Health Administration Office of Rural Health (ORH) in 2006, the needs of rural veterans, who are on average older than urban veterans, are receiving greater attention and support. ORH and VA have implemented several programs to specifically improve access to health care for rural veterans and to improve quality of care for older veterans in rural areas. Originality/value This paper is one of the first to describe how VA is addressing the health care needs of older, rural veterans.

The reported benefits of telehealth for rural Australians

2010 ◽  
Vol 34 (3) ◽  
pp. 276 ◽  
Author(s):  
Jennifer J. Moffatt ◽  
Diann S. Eley
Keyword(s):  
Professional Development ◽  
Cost Effectiveness ◽  
Health Services ◽  
Rural Health ◽  
Health Professionals ◽  
Access To Health Services ◽  
Rural And Remote ◽  
Remote Locations ◽  
Access To Health

Objective.A literature review was conducted to identify the reported benefits attributed to telehealth for people living and professionals working in rural and remote areas of Australia. Data sources.Scopus and relevant journals and websites were searched using the terms: telemedicine, telehealth, telepsychiatry, teledermatology, teleradiology, Australia, and each state and territory. Publications since 1998 were included. Study selection.The initial search resulted in 176 articles, which was reduced to 143 when research reporting on Australian rural, regional or remote populations was selected. Data synthesis.A narrative review was conducted using an existing ‘benefits’ framework. Patients are reported to have benefited from: lower costs and reduced inconvenience while accessing specialist health services; improved access to services and improved quality of clinical services. Health professionals are reported to have benefited from: access to continuing education and professional development; provision of enhanced local services; experiential learning, networking and collaboration. Discussion.Rural Australians have reportedly benefited from telehealth. The reported improved access and quality of clinical care available to rural Australians through telemedicine and telehealth may contribute to decreasing the urban–rural health disparities. The reported professional development opportunities and support from specialists through the use of telehealth may contribute to improved rural medical workforce recruitment and retention. What is known about the topic?An extensive international literature has reported on the efficacy of telehealth, and to a lesser extent the clinical outcomes and cost-effectiveness of telemedicine. Systematic reviews conclude that the quality of the studies preclude definitive conclusions being drawn about clinical and cost-effectiveness, although there is some evidence of effective clinical outcomes and the potential for cost-benefits. Little attention has been paid to the benefits reported for people who live in rural and remote Australia, despite this being a rationale for the use of telehealth in rural and remote locations. What does this paper add?Patients in rural and remote locations in Australia are reported to benefit from telehealth by increased access to health services and up-skilled health professionals. Health professionals are reported to benefit from telehealth by up-skilling from increased contact with specialists and increased access to professional development. The review findings suggest that one strategy, the increased use of telehealth, has the potential to reduce the inequitable access to health services and the poorer health status that many rural Australians experience, and contribute to addressing the on-going problem of the recruitment and retention of the rural health workforce. What are the implications for practitioners?The use of telehealth appears to be a path to up-skilling for rural and remote practitioners.

scholarly journals Fatigue, Physical Activity, Quality of Life, and Fall Risk in People with Multiple Sclerosis

2017 ◽  
Vol 19 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Eva Vister ◽  
Mylou E. Tijsma ◽  
Phu D. Hoang ◽  
Stephen R. Lord
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Risk Scores ◽  
Activity Levels ◽  
Physiological Profile ◽  
Walking Activity ◽  
Physiological Profile Assessment

Background: Fatigue, inactivity, and falls are major health issues for people with multiple sclerosis (MS). We examined the extent to which fatigue and low walking activity are associated with quality of life and increased fall risk in people with MS. Methods: People with MS (N = 210, aged 21–74 years) were categorized as having either high or low reported fatigue and walking activity levels and were then followed up for falls using monthly fall diaries for 6 months. Results: A high level of fatigue was significantly associated with higher MS Disease Steps scores, worse balance, high composite physiological (Physiological Profile Assessment) fall risk scores, greater fear of falling, lower World Health Organization Disability Assessment Schedule (WHODAS) quality of life scores, and more prospectively recorded falls. Low walking activity was significantly associated with higher MS Disease Steps scores, reduced proprioception, worse standing and leaning balance, slow stepping, slow gait speed, worse fine motor control, high Physiological Profile Assessment fall risk scores, more fear of falling, and lower WHODAS quality of life scores. Conclusions: Increased fatigue and low walking activity levels were significantly associated with increased fall risk and lower quality of life in people with MS. Interventions aimed at addressing fatigue and inactivity may have multiple benefits for this group.

scholarly journals Access of the black population to health services: integrative review

2020 ◽  
Vol 73 (4) ◽  
Author(s):  
Nelma Nunes da Silva ◽  
Veronica Batista Cambraia Favacho ◽  
Gabriella de Andrade Boska ◽  
Emerson da Costa Andrade ◽  
Neuri Pires das Merces ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Services ◽  
Literature Review ◽  
Black Population ◽  
Limiting Factors ◽  
Structural Factors ◽  
Access To Health Services ◽  
Fundamental Factor ◽  
Access To Health

ABSTRACT Objectives: demonstrate and discuss how the black population’s access to health services occurs Methods: integrative literature review with the following question: How does the black population’s access to health services occur? The search was carried out in the Scholar, LILACS and SciELO databases and used the descriptor “access to health services” and the term “population,” resulting in a sample with twelve articles. Results: studies show that the difficulty of access is a fundamental factor for the quality of life of people, directly compromising preventive services, especially for women’s health and, in addition, it has significant impact on the illness process of the black population within its particularities. Final Considerations: several limiting factors compromise the black population’s access to health services, including institutional and structural factors

scholarly journals Reliability of Online Information on Self-Examination and Oral Cancer

2020 ◽  
pp. 1-5
Author(s):  
Cristina Cangussu ◽  
Ana Katarine Almeida Rios ◽  
Cristina Cangussu ◽  
Jakeline Martins Novaes Pedreira ◽  
Mércia Sacramento dos Santos ◽  
...  
Keyword(s):  
Oral Cancer ◽  
Brazilian Population ◽  
Online Information ◽  
Access To Health Services ◽  
Access To Health ◽  
Complementary Nature ◽  
Self Examination ◽  
Google Search ◽  
The Web

Introduction: Periodic dental consultations and oral self-examination can increase the chances of an early diagnosis of oral cancer. However, the restricted population access to health services in Brazil added to the greater scope of the internet has increased the use of this resource as a source of information on signs, symptoms and treatments of several diseases, including oral cancer. Objective: To assess the reliability of the information on self-examination and oral cancer available on the web in Portuguese for Brazilian population. Methodology: In December 2018, independent searches were performed for the terms "mouth cancer", "oral cancer", "oral self- examination/ self-examination" and "buccal self- examination / self-examination", on Google Search (Portuguese terms). The first fifty pages were selected for each term, and those that included prevention, diagnosis of oral cancer or described verbally and visually the oral self-examination were included in the study. The quality of the information was assessed according to the criteria of the American Medical Association and Health on the Net. Of the 108 sites evaluated, 87% did not inform the author's training, 24.1% did not inform the complementary nature of the information and 64.8% provided guidance consult a doctor or dentist. Scientific references were not present in 39.8% of the sites and the “accurate and complete” content was observed in only 35.2% of the evaluated pages. Conclusion: The low quality of the information available on the evaluated pages, suggests low reliability of the content about oral cancer and oral self-examination available on the web, indicating that access to this content may bring risk to the health of the Brazilian population.

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