scholarly journals Health care utilization among patients with oesophageal and gastric cancer: the impact of initial treatment strategy and assignment of a contact nurse

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karin Dalhammar ◽  
Marlene Malmström ◽  
Magnus Sandberg ◽  
Dan Falkenback ◽  
Jimmie Kristensson
Keyword(s):  
Gastric Cancer ◽  
Health Care ◽  
Treatment Strategy ◽  
Outpatient Care ◽  
Initial Treatment ◽  
Palliative Treatment ◽  
Health Care Use ◽  
Curative Treatment ◽  
Hospital Stays ◽  
The Impact

Abstract Background Patients diagnosed with oesophageal and gastric cancer face a poor prognosis and numerous challenges of symptom management, lifestyle adjustments and complex treatment regimens. The multifaceted care needs and rapid disease progression reinforce the need for proactive and coherent health care. According to the national cancer strategy, providing coherent health care and palliative support is an area of priority. More knowledge is needed about health care utilization and the characteristics of the health care service in order to understand the readiness, accessibility and quality of current health care. The aim of this study was to describe individuals’ health care use from the time of treatment decision until death, and investigate the impact of the initial treatment strategy and assignment of a contact nurse (CN) on health care use among patients with oesophageal and gastric cancer. Methods This population-based cohort study included patients who died from oesophageal and gastric cancer in Sweden during 2014–2016. Through linking data from the National Register for Oesophageal and Gastric Cancer, the National Cause of Death Register, and the National Patient Register, 2614 individuals were identified. Associations between the initial treatment strategy and CN assignment, and health care use were investigated. Adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated using Poisson regression. Results Patients receiving palliative treatment and those receiving no tumour-directed treatment had a higher IRR for unplanned hospital stays and unplanned outpatient care visits compared with patients who received curative treatment. Patients receiving no tumour-directed treatment also had a lower IRR for planned hospital stays and planned outpatient care visits compared with patients given curative treatment. Compared with this latter group, patients with palliative treatment had a higher IRR for planned outpatient care visits. Patients assigned a CN had a higher IRR for unplanned hospital stays, unplanned outpatient care visits and planned outpatient care visits, compared with patients not assigned a CN. Conclusions A palliative treatment strategy and no tumour-directed treatment were associated with higher rates of unplanned health care compared with a curative treatment strategy, suggesting that a proactive approach is imperative to ensure quality palliative care.

scholarly journals Pain location matters: the impact of leg pain on health care use, work disability and quality of life in patients with low back pain

2014 ◽  
Vol 24 (3) ◽  
pp. 444-451 ◽  
Author(s):  
Samantha L. Hider ◽  
David G. T. Whitehurst ◽  
Elaine Thomas ◽  
Nadine E. Foster
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Low Back Pain ◽  
Work Disability ◽  
Health Care Use ◽  
Leg Pain ◽  
Low Back ◽  
Pain Location ◽  
The Impact

scholarly journals How Online Reviews and Services Affect Physician Outpatient Visits: Content Analysis of Evidence From Two Online Health Care Communities (Preprint)

2019 ◽  
Author(s):  
Wei Lu ◽  
Hong Wu
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Empirical Work ◽  
Basic Research ◽  
Online Reviews ◽  
Difference In Difference ◽  
Online Services ◽  
Outpatient Visits ◽  
Channel Effects ◽  
The Impact

BACKGROUND Online healthcare communities are changing the ways of physician-patient communication and how patients choose outpatient care physicians. Although a majority of empirical work has examined the role of online reviews in consumer decisions, less research has been done in health care, and endogeneity of online reviews has not been fully considered. Moreover, the important factor of physician online services has been neglected in patient decisions. OBJECTIVE In this paper, we addressed the endogeneity of online reviews and examined the impact of online reviews and services on outpatient visits based on theories of reviews and channel effects. METHODS We used a difference-in-difference approach to account for physician- and website-specific effects by collecting information from 474 physician homepages on two online health care communities. RESULTS We found that the number of reviews was more effective in influencing patient decisions compared with the overall review rating. An improvement in reviews leads to a relative increase in physician outpatient visits on that website. There are channel effects in health care: online services complement offline services (outpatient care appointments). Results further indicate that online services moderate the relationship between online reviews and physician outpatient visits. CONCLUSIONS This study investigated the effect of reviews and channel effects in health care by conducting a difference-in-difference analysis on two online health care communities. Our findings provide basic research on online health care communities.

The impact of an automatically generated survivorship care plan on patient reported outcomes (ROGY Care): Results of a pragmatic cluster randomized controlled trial among endometrial cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16517-e16517
Author(s):  
Lonneke V. van de Poll-Franse ◽  
Kim A.H. Nicolaije ◽  
Nicole P.M. Ezendam ◽  
M. Caroline Vos ◽  
Dorry Boll ◽  
...  
Keyword(s):  
Health Care ◽  
Endometrial Cancer ◽  
Usual Care ◽  
Cancer Patients ◽  
Health Care Use ◽  
Survivorship Care Plan ◽  
Satisfaction With Care ◽  
Survivorship Care ◽  
Cluster Randomized ◽  
The Impact

e16517 Background: More patient tailored information for cancer survivors is needed. Evidence on effects of implementing Survivorship Care Plans (SCPs), is limited. Aim of this pragmatic cluster randomized trial is to assess the impact of SCPs in routine clinical practice. Primary endpoint is patient satisfaction with information. Secondary endpoints are QoL and health care use. Methods: We built an SCP-application in the web-based Registrationsystem Oncological GYnecology (ROGY), used in our area since 2006. By clicking the SCP-icon in ROGY, a personalized SCP is automatically generated. Twelve hospitals were randomized to usual care or SCP care. In usual care, gynecologists did not have access to the SCP-icon. In SCP care, SCPs are personally discussed and handed to patients. All newly diagnosed endometrial cancer patients (age ≥ 18) were asked to complete a questionnaire after surgery, 6, 12 and 24 months after diagnosis. The questionnaire included the EORTC INFO25 and asked whether patients actually received an SCP. We expected 150 endometrial cancer patients: 75 per arm. We hypothesized that patients receiving SCP care are more satisfied with the information. Results: 201 patients (74%) returned a questionnaire after surgery: 109 SCP arm, 92 usual care arm. Of the patients in the SCP arm, 69% reported receiving an SCP. Analyses according to randomization arm showed that patients in both arms reported similar scores on all scales of the INFO25, including satisfaction with care (87% vs. 82%, SCP vs usual care, p=0.20). Analyses according to actual care received showed that patients who received SCP care reported significantly higher scores (4-18 points) on all scales of the INFO25, including satisfaction with care (91% vs. 78%, SCP vs usual care, p=0.046) compared to those who did not receive SCP care. Conclusions: Even in a situation where SCPs are automatically generated, still one third does not receive an SCP. But, those who receive SCP care report better information provision and satisfaction. Follow-up measures will show whether this ultimately results in better QoL and decreased health care use. Clinical trial information: NCT01185626.

A joint United Kingdom (UK) and Hong Kong (HK) study to determine prognostic factors for hepatocellular carcinoma (HCC) undergoing curative and palliative treatment.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 181-181
Author(s):  
Stephen Lam Chan ◽  
Philip James Johnson ◽  
Frankie Mo ◽  
Sarah Berhane ◽  
Brigette Ma ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Palliative Treatment ◽  
Curative Treatment ◽  
Multidisciplinary Teams ◽  
International Studies ◽  
Geographical Differences ◽  
Geographical Difference ◽  
Function Table ◽  
The Uk ◽  
The Impact

181 Background: There have been few international studies that systematically evaluate the impact of geographical region on the prognosis of HCC. Methods: Prospective cohorts of patients (pt) were accrued in UK (n=567; 2006-2011) and HK (n=517; 2007-2012). Clinical data were documented at baseline; treatments were decided by multidisciplinary teams at both centers. Results: The median follow-up time of the UK and HK cohort was 27.9 and 29.8 months, respectively. The median overall survival (OS) of the whole UK and HK cohort was 22.9 months and 8.6 months. In the HK cohort, 425 underwent palliative treatment (TACE, systemic agents or supportive care) and 92 had curative treatment (surgery and locoablation); in the UK cohort, 338 had palliative treatment and 228 underwent curative treatment. In the curative group, the median OS was 54.8 months in the UK cohort but has not yet been achieved in the HK cohort. For the palliative group, the median OS was 12.7 and 5.5 months in the UK and HK cohort respectively. In the palliative group, geographical difference was an independent prognostic factor (HK vs. UK, HR=2.0; p<0.0001). Other prognostic factors were mainly tumorous features and Child’s liver function (Table). In the curative group, neither geographical difference nor Child’s score were prognostic factors. Conclusions: Separate prognostic factors exist for curative and palliative treatment. Geographical differences need to be considered during design of clinical trials on novel agents where palliative treatments are investigated but not for surgery or locoablation. [Table: see text]

scholarly journals The impact of adverse childhood experiences on health service use across the life course using a retrospective cohort study

2017 ◽  
Vol 22 (3) ◽  
pp. 168-177 ◽  
Author(s):  
Mark Bellis ◽  
Karen Hughes ◽  
Katie Hardcastle ◽  
Kathryn Ashton ◽  
Kat Ford ◽  
...  
Keyword(s):  
Health Care ◽  
Life Course ◽  
Hospital Stay ◽  
Adverse Childhood Experiences ◽  
Service Use ◽  
Health Care Use ◽  
Life Course Perspective ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
The Impact

Objectives The lifelong health impacts of adverse childhood experiences are increasingly being identified, including earlier and more frequent development of non-communicable disease. Our aim was to examine whether adverse childhood experiences are related to increased use of primary, emergency and in-patient care and at what ages such impact is apparent. Methods Household surveys were undertaken in 2015 with 7414 adults resident in Wales and England using random probability stratified sampling (age range 18–69 years). Nine adverse childhood experiences (covering childhood abuse and household stressors) and three types of health care use in the last 12 months were assessed: number of general practice (GP) visits, emergency department (ED) attendances and nights spent in hospital. Results Levels of use increased with increasing numbers of adverse childhood experiences experienced. Compared to those with no adverse childhood experiences, odds (±95% CIs) of frequent GP use (≥6 visits), any ED attendance or any overnight hospital stay were 2.34 (1.88–2.92), 2.32 (1.90–2.83) and 2.67 (2.06–3.47) in those with ≥ 4 adverse childhood experiences. Differences were independent of socio-economic measures of deprivation and other demographics. Higher health care use in those with ≥ 4 adverse childhood experiences (compared with no adverse childhood experiences) was evident at 18–29 years of age and continued through to 50–59 years. Demographically adjusted means for ED attendance rose from 12.2% of 18-29 year olds with no adverse childhood experiences to 28.8% of those with ≥ 4 adverse childhood experiences. At 60–69 years, only overnight hospital stay was significant (9.8% vs. 25.0%). Conclusions Along with the acute impacts of adverse childhood experiences on child health, a life course perspective provides a compelling case for investing in safe and nurturing childhoods. Disproportionate health expenditure in later life might be reduced through childhood interventions to prevent adverse childhood experiences.

scholarly journals The impact of payor/provider type on health care use and expenditures among the frail elderly.

1997 ◽  
Vol 87 (2) ◽  
pp. 210-216 ◽  
Author(s):  
B Experton ◽  
Z Li ◽  
L G Branch ◽  
R J Ozminkowski ◽  
D M Mellon-Lacey
Keyword(s):  
Health Care ◽  
Frail Elderly ◽  
Health Care Use ◽  
Provider Type ◽  
The Impact

scholarly journals The Impacts Of A Free Health Insurance Policy In Vietnam

2021 ◽  
Author(s):  
◽  
Khoa Nguyen
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Outcomes ◽  
Social Health Insurance ◽  
Health Care Use ◽  
Social Health ◽  
Insurance Policy ◽  
Education Outcomes ◽  
Positive Effects ◽  
The Impact

<p>Social Health Insurance (SHI) is promoted as a policy that tackles the impoverishing effects of catastrophic spending that results from unexpected health shocks. This thesis contributes to the literature on the impact of social health insurance by examining the impact of a policy introduced in Vietnam in 2005. The new policy provided free health insurance for all children under six years. Using a difference-in-difference estimation strategy and eight national household surveys conducted between 2002 and 2016, I examine a variety of direct, indirect, and spill over effects of the policy. The direct effects of the policy are on insurance coverage, health care use, health care expenses, and self-reported morbidity of targeted children. The indirect effects are the persistent effects of the policy on the same set of health outcomes (and education outcomes) beyond the period of exposure to the policy. A third set of impacts cover spill over effects of the policy - on the health and education outcomes of older children living with targeted children, and a variety of household-level outcomes that reflect various dimensions of the wellbeing of household members. The results show that a free health insurance policy for young children has significant impacts on the health outcomes of children while they are covered by the policy and these persist, and also extend to educational outcomes beyond the age of eligibility. The policy also has positive spill over effects on older (untargeted) children living in targeted households, and positive effects on household wage income, and income per capita. On the other hand, the policy has no effects on the standard of living, household health expenditure, caloric consumption, and the likelihood of household spending on catastrophic healthcare.</p>

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