scholarly journals Outpatient physical therapy population has been aging faster than the general population: a total population register-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solveig A. Arnadottir ◽  
Brynjolfur Gauti Jonsson

Abstract Background The Icelandic population is aging like other populations in the world, the life expectancy is high, and the national focus is to help people to age in their own homes. The objectives of this research was to describe 17 years of demographic changes among outpatient physical therapy (OPT) clients and to determine if these changes reflect aging in the total population. Methods Data was obtained from a national registry with information on all OPT clients reimbursed by Icelandic Health Insurance from 1999 to 2015, and general population data from the Statistics Iceland registry covering the same 17 years. Simple counts, proportions, Rate Ratios (RR) and 95 % Confidence Intervals (CI) were used to describe and compare the two time-points (1999 and 2015) in both populations, and regression analyses were used to estimate linear changes for each of these 17 years. Results Comparing the endpoints of the 17-year period, the proportion of older adults within the total OPT clientele increased by 23 % (from 18.3 % to 1999 to 23.5 % in 2015; RR 1.23; 95 %CI 1.19–1.27).) while in the general Icelandic population, the proportion of older adults increased by 15 % (from 11.6 % to 1999 to 13.5 % in 2015; RR 1.15; 95 % CI 1.1–1.21). For each of these 17 years, there was an overall 5 % yearly increase in the rate of older adults from the general older Icelandic population who used an OPT (accounting for population aging), and an overall 3.5 % yearly increase in the proportional contribution of older adults to the total OPT clientele. Adjusting for sex and older age group revealed that this increase in rate and proportion was most pronounced among ≥ 85-year-old men. Conclusions This case of Iceland is an example of how health-related and population-based registers may potentially be used to routinely inform and facilitate optimal planning of future health care services for older adults.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 173-173
Author(s):  
Solveig Arnadottir

Abstract In Iceland, outpatient physical therapy (OPT) is traditionally not focused on older clients. Yet, the Icelandic population is aging as other populations in the world, and national policies endorse aging in place. The objective of this study was to explore 17 years of demographic information on OPT clients and to identify if this information reflects the total population aging. The research was built on 17 years (1999-2015) of complete data from: the Icelandic Health Insurances register with information on the total population of OPT clients (N=172071), and the Statistics Iceland register with demographic information on the total general population. The results revealed that in 1999, older adults comprised 18.3% of all OPT clients, and in 2015 it had increased to 23.5% Therefore, OPTs were 23% more likely to treat an older adult in 2015, compared to 1999 (Risk Ratio [RR] 1.23; 95% Confidence Interval [CI] 1.19-1.27). In the same time period older people became 15% more prevalent in the general population (RR 1.15; 95%CI 1.10-1.21). Linear modelling revealed a yearly 3.45% (95%CI 3.05-3.85) increase from 1999 to 2015 in the overall proportion of older OPT clients. This yearly trend, however, varied depending on age group and sex with the highest yearly increase in the ≥ 85 years old men (9.1%; 95%CI 7.90-10.35). This case of Iceland presents 17 years of continuous growth in older adults seeking OPT service. These findings reinforce an urgent need to enhance the geriatric competence of OPTs, who in their clinical practice frequently encounter older adults.


2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Fredrik Alexander Gregersen ◽  
Geir Godager

The aim of this paper is to contribute to the debate on population aging and growth in health expenditures, by providing precise estimates on how mortality related expenditures are influenced by age. Using a complete register of inpatient hospital admissions to create gender-cohort specific panels for each of the 430 Norwegian municipalities, we are able to identify mortality related hospital expenditures by separating the impact of mortality on current hospital expenditures from the impact of patients’ age and gender. We apply model estimates to quantify the mortality-related hospital expenditures for twenty age groups. The results suggest that mortality-related hospital expenditures are a decreasing function of age. Furthermore, the results clearly suggest that, both age and mortalities should be included when predicting future health care expenditures. The estimation results suggest that 9.2 % of all hospital expenditures is associated with treating individuals in their last year of life. Our results also suggest that the reduction in mortality rates in the period from 1998 to 2009 have, cet. par. contributed to an estimated reduction in total hospital expenditures of 0.6 billion NOK, a difference corresponding to 2 % of the expenditures in 2009. (The appendix can be found under "Supplementary Files" in the menu to the right)


2005 ◽  
Vol 39 (3) ◽  
pp. 194-197 ◽  
Author(s):  
Leslie R.H. Drew

Background: The finding by Lawrence, Holman and Jablensky (Duty to Care) that mortality among the mentally ill in Western Australia was 2.5 times that of the general population, seemingly, has great significance for public policy concerning the mentally ill. ‘Mortality’ could be a useful outcome measure for mental health services. Objectives: To replicate that study in the Australian Capital territory (ACT), comparing mortality rates in the mentally ill with those of the total population. Method: A list of all people who contacted the ACT mental health services between 1985 and 2000 was compiled. Using the national register of deaths (Australian Institute of Health and Welfare), persons known to the mental health services who died between 1990 and 2000 were identified and sex, date of birth, date of death, cause of death and place of death were noted. Using Australian Bureau of Statistics data for all deaths in the ACT, deaths in the total population and in the mentally ill population were tabulated for the period 1996–2000. With 1996 data as the base, using total population data from the ABS and mental health population data derived by amending ‘the list’ to remove duplications, pre1996 deaths and post1996 additions, mortality rates for the period 1996–2000 were compared. Results: The gender and age distribution of the mentally ill population and the total population, and of deaths in those populations, were very different. One third of all deaths in the mentally ill occurred outside of the ACT. Compared with the general population, mortality in the mentally ill (including deaths outside of the ACT) was only slightly excessive for ‘all causes’ and ischaemic heart disease but grossly excessive for ‘suicide’. Conclusions: This study did not confirm the excessive mortality rate in the mentally ill reported by Lawrence et al. except for suicide. Many methodological issues in using population studies to attempt to measure the size of the increase were identified. Differences in method between the ACT and WA studies probably explain the differences in results. Caution is urged in using the results of mortality studies as determinants of public policy or to evaluate services.


2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Shalini Singh ◽  
Nishat Afroz

The world's population is aging and all countries in the world are experiencing growth in the number and proportion of older persons. India is no exception to this demographic transition. With the rapidly increasing number of aged, the care of elderly has emerged as an important issue before the country. This change presents wide-ranging and complex health, social, and economic challenges, both current and future, to which this diverse and heterogeneous country must rapidly adapt. This paper is an attempt to review and discuss the context, scope, and magnitude of India's demographic changes. Further it elaborated the need and concerns of elderly, various psycho-social problems faced by them and impact of population aging on different sphere of country's resources. This paper also discussed the increasing inclination of elderly towards the old age homes and the possible reasons behind it. This chapter also presents an overview of several governmental, recent and ongoing efforts and initiatives, to adapt to population aging and provide support to older adults and their families. It concludes with recommendations that may serve as a productive next step forward, keeping in mind the need for urgent and timely action on the part of government, NGO's, researchers, and general population.


2020 ◽  
Vol 2 (2) ◽  
pp. 72-80
Author(s):  
Niluh Nita Silfia

Partographs are guidelines for childbirth observations that will facilitate labor assistants in first identifying emergency cases and complications for mothers and fetuses. Preliminary survey at the Sigi Community Health Sub-Center (Pustu) of the 8 Pustu midwives found two midwives (25%) to complete a complete partograph, six midwives (75%) incomplete. The purpose of this study was to determine the determinant factors associated with the use of partographs in labor. The design of this study used observational analytic methods with a cross-sectional approach. 24 BPM survey results were obtained with 30 samples of midwives who met the research criteria and data completeness. The sampling technique was by the total population. Data analysis used logistic regression. The multivariate analysis results showed that APN training was the most influential factor in the use of partographs in labor by midwives. Statistical test results obtained a POR value of 37.7 (95% CI 12.1 - 60.2). This study suggests that midwives must have APN certificates to be valid in providing services.


Author(s):  
Lucca Katrine Sciera ◽  
Lars Frost ◽  
Lars Dybro ◽  
Peter Bo Poulsen

Abstract Aims The objective was to evaluate the cost-effectiveness of one-time opportunistic screening for atrial fibrillation (AF) in general practice in citizens aged ≥65 years in Denmark compared to a no-screening alternative following current Danish practice. Methods and results A decision tree and a Markov model were designed to simulate costs and quality-adjusted life years (QALYs) in a hypothetical cohort of citizens aged ≥65 years equivalent to the Danish population (1 M citizens) over the course of 19 years, using a healthcare and societal perspective. Share of detected AF patients following opportunistic screening was retrieved from a recent Danish screening study, whereas the risk stroke and bleedings in AF patients were based on population data from national registries and their associated costs was obtained from published national registry studies. The present study showed that one-time opportunistic screening for AF was more costly, but also more effective compared to a no-screening alternative. The analysis predicts that one-time opportunistic screening of all Danes aged ≥65 years potentially can identify an additional 10 300 AF patients and prevent 856 strokes in the period considered. The incremental cost of such a screening programme is €56.4 M, with a total gain of 6000 QALYs, resulting in an incremental cost-effectiveness ratio of €9400 per QALY gained. Conclusion Opportunistic screening in general practice in citizens aged ≥65 years in Denmark is cost-effective compared to a willingness-to-pay threshold of €22 000. The study and its findings support a potential implementation of opportunistic screening for AF at the general practitioner level in Denmark.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 169-170
Author(s):  
Brittany Drazich ◽  
Breanna Crane ◽  
Kyle Moored ◽  
Karl Shieh ◽  
Janiece Taylor ◽  
...  

Abstract Due to generational mental illness stigma and under diagnosis of mental illness, older adults do not always receive the mental health help that they need. One unique technology that has the potential to improve mood in older adults is exergames, or exercise video games. The objective of this sub-study (main study: Stimulation With Intricate Movements “SWIM” Study) was to explore older adults’ mood following an exergame intervention called “Bandit the Dolphin,” created by the Johns Hopkins KATA Studio. Researchers conducted three focus groups with 14 community-dwelling older adult participants who took part in the SWIM Study exergame intervention. The semi-structured focus groups were transcribed, coded, and analyzed using deductive and inductive techniques described by Ray Maietta’s “sort and sift, think and shift” method. Three themes related to playing “Bandit the Dolphin” and mood emerged. First, participants described their perceived association between activity and mood. Participants felt that both active and passive activities, “Bandit the Dolphin” and otherwise, improved their mood through the “fun” factor, and through feelings of achievement. Second, the participants described that the competition and frustration of playing “Bandit the Dolphin” increased eventual feelings of achievement. Third, participants described how feelings of immersion, or being absorbed in the game, helped them forget their other life concerns. These findings provide a better understanding of older adults’ perceived relationship between an exergame intervention, “Bandit the Dolphin,” and short-term improved mood. Future health and engineering researchers should explore exergames as a potential tool to improve the mental health of older adults.


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