Associations of the COVID-19 pandemic with older individuals’ healthcare utilization and self-reported health status: a longitudinal analysis from Singapore

Abstract Background The COVID–19 pandemic has challenged the capacity of healthcare systems around the world and can potentially compromise healthcare utilization and health outcomes among non-COVID–19 patients. Objectives To examine the associations of the COVID-19 pandemic with healthcare utilization, out-of-pocket medical costs, and perceived health among middle-aged and older individuals in Singapore. Method Utilizing data collected from a monthly panel survey, a difference-in-differences approach was used to characterize monthly changes of healthcare use and spending and estimate the probability of being diagnosed with a chronic condition and self-reported health status before and during the COVID-19 outbreak in 2020. Subjects Data were analyzed from 7569 nationally representative individuals from 2019 January and 2020 December. Measures Healthcare utilization and healthcare spending by medical service categories as well as self-reported health status. Results Between January and April 2020 (the first peak period of COVID-19 in Singapore), doctor visits decreased by 30%, and out-of-pocket medical spending decreased by 23%, mostly driven by reductions in inpatient and outpatient care. As a result, the probability of any diagnosis of chronic conditions decreased by 19% in April 2020. The decreased healthcare utilization and spending recovered after lifting the national lockdown in June, 2020 and remained similar to the pre-pandemic level through the rest of 2020. Conclusions Middle-aged and older Singaporeans’ healthcare utilization and the diagnosis of chronic conditions substantially decreased during the first peak period of the COVID-19 outbreak. Further studies to track the longer-term health effect of the pandemic among non-COVID-19 patients are warranted.

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The More Educated, the Healthier: Evidence from Rural China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15122848 ◽

2018 ◽

Vol 15 (12) ◽

pp. 2848

Author(s):

Weidong Wang ◽

Yongqing Dong ◽

Xiaohong Liu ◽

Linxiu Zhang ◽

Yunli Bai ◽

...

Keyword(s):

Health Status ◽

Income Group ◽

High Income Group ◽

Economic Returns ◽

Middle Aged ◽

Old People ◽

Rural Residents ◽

Reported Health ◽

Self Reported Health Status ◽

The Impact

Education, as an important aspect of human capital, not only affects the economic returns of an individual, but also affects non-economic returns. This paper uses data from the China Family Panel Studies (CFPS) in 2014 and explores the impact of education on the health status of rural residents by using the family fixed-effect model. We find that education can improve the self-reported health status and reduce the possibility of depression of rural residents. We also find that the effect of education on self-reported health status of rural young people more significant than that of middle-aged and old people, but the effect on depression score was weaker than that of middle-aged and old people. Compared with the high-income group, education improved the health of the lowest income group more significantly. Finally, we explore the mechanism of education affecting the health of rural residents from a multi-dimensional perspective.

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Social participation and self-reported health in China: evidence from Chinese middle-aged and elderly adults

International Journal of Social Economics ◽

10.1108/ijse-03-2020-0139 ◽

2020 ◽

Vol 48 (1) ◽

pp. 85-103

Author(s):

MA. Xinxin

Keyword(s):

Mental Health ◽

Health Status ◽

Empirical Study ◽

Social Participation ◽

Health Effect ◽

Random Effects Model ◽

Middle Aged ◽

Content Type ◽

Reported Health ◽

Middle Aged Adults

PurposeSocial participation (SP) has been shown to have a favorable impact on health status, particularly among elders in developed countries. However, empirical study is scarce for China. This study explores the relation between social participation (SP) and health status among middle-aged adults and elders in China when controlled socioeconomic characteristics of individuals.Design/methodology/approachThis paper employs an empirical study based on the data from a three-wave national longitudinal survey: the Chinese Health and Retirement Longitudinal Study (CHARLS) from 2011, 2013 to 2015. It collects data from 28,895 individuals aged 45–84. It uses lagged variable method (LV) to address the reverse causality problem, and the random-effects model or fixed-effect model to address the heterogeneity problem.FindingsThe paper finds the social participation positively affect self-reported health statistically. The influence of social participation on self-reported health flows through two channels: the improved mental health effect (SP-MH-SRH channel) and the increased income effect (SP-income-SRH channel). In comparison with the SAP-income-SRH channel, the influence of the SP-MH-SRH channel l is greater.Research limitations/implicationsFirst, the absence of other measures of volunteering, such as hours of social participation that are not available in the employed dataset. Second, even though the LV model and FE model are used in the paper, there may remain the endogeneity problem in the results. Third, the influences of formal and informal social participation should be distinguished in the future research.Social implicationsSocial participation may improve the self-reported health status. The influence of SP on health may be due to the improved mental health effect (SP-MH-SRH channel). In order to improve the mental and physical health status of middle-aged adults and elders the government should consider even more promotion of social participation.Originality/valueFirst, this paper focuses on the correlation between social participation and well-being (self-reported health) of middle-aged adults and elderly in China, the previous studies on the issue for China are scarce. Second, this paper uses the lagged variable method (LV) to address the reverse causal relation problem, and the fixed-effects model or the random-effects model to address the heterogeneity problem. Third, the two channels (the improved mental health effect and the increased income effect) are firstly investigated in this study.

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Users and non-users of web-based health advice service among Finnish university students – chronic conditions and self-reported health status (a cross-sectional study)

BMC Medical Informatics and Decision Making ◽

10.1186/1472-6947-8-8 ◽

2008 ◽

Vol 8 (1) ◽

Cited By ~ 12

Author(s):

Johanna Castrén ◽

Teppo Huttunen ◽

Kristina Kunttu

Keyword(s):

Health Status ◽

Chronic Conditions ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Web Based ◽

Health Advice ◽

Reported Health ◽

Self Reported Health Status ◽

Advice Service

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Self-Care Confidence and eHealth Education in Adults with Asthma: Do They Reduce Healthcare Utilization?

10.35831/sor/phr/ba20 ◽

2020 ◽

Author(s):

Barbara Arnoldussen

Keyword(s):

Physical Activity ◽

Health Status ◽

Health Information ◽

Healthcare Utilization ◽

Self Care ◽

Personal Characteristics ◽

Activity Limitations ◽

Emergency Rooms ◽

Reported Health ◽

Self Reported Health Status

Abstract Introduction: The purpose of this research was to analyze personal characteristics and behaviors associated with adults with asthma. Does self-care confidence or eHealth education reduce their healthcare utilization to decrease medical costs? Methods: Using 2015 California Health Interview Survey (CHIS) data, the study examined the data of adults (n = 3380) with asthma. Chi-square tests calculated differences for eight personal characteristics and behaviors: gender, age, education, online health information searching, self-reported health status, physical activity limitations, emergency room visits, and hospitalization related to asthma. Individuals very confident to manage their asthma were compared to those feeling less empowered to manage their health. Individuals who recently used the Internet to find health information were compared to those who did not go online for resources. Results: CHIS data showed a lack of full self-care confidence in a quarter of surveyed asthmatics. Better self-reported health status correlated with increased self-care confidence. Women, those with less education, and those with physical activity limitations were less confident to manage their health. Fewer people who were fully self-confident visited emergency rooms for asthma. Self-confidence had no effect on the rate of hospitalization. The use of eHealth education was significantly more frequent in people under 70 years old, those with less than a high school education, and those without physical activity limitations. Better self-reported health status correlated with increased eHealth education use. More people who used eHealth education visited emergency rooms for asthma. eHealth education had no effect on the rate of hospitalization. Conclusions: It is possible to identify individuals with asthma with an increased risk of not feeling confident about their ability to manage their disease. Health care professionals can plan extra in-person efforts to educate asthmatics who feel insecure about managing their health. Women, individuals in poor or fair health, and those with physical activity limitations should be assessed for self-care confidence soon after diagnosis and monitored at regular intervals. Full self-care confidence correlated with fewer visits to ERs. eHealth education was not shown to play a role in reduced healthcare utilization. Keywords: Self-Care Confidence, Asthma, Health Promotion, eHealth Education, Physical Activity Limitations

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Association of regular leisure-time physical activity with self-reported body mass index and obesity risk among middle-aged and older adults in Taiwan

10.21203/rs.3.rs-729978/v1 ◽

2021 ◽

Author(s):

Yun-Tsung Chen ◽

Po-Fu Lee ◽

Chi-Fang Lin ◽

Andy Chang ◽

Yu-Chun Chung ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Mass Index ◽

Health Status ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Obesity Risk ◽

Middle Aged ◽

Reported Health ◽

Self Reported Health Status

Abstract Background Through this study, we aimed to determine the association of regular leisure-time physical activity (LTPA) with self-reported body mass index (BMI) and obesity risk among middle-aged and older adults in Taiwan. Methods We conducted a cross-sectional study and reviewed the data derived from the Taiwan’s National Physical Activity Survey (TNPAS). Responses from 12,687 participants aged 45–108 years from the database were collected in this study. All participants completed a standardized, structured questionnaire that solicitated information regarding their demographic characteristics (age, gender, education, occupation, and self-reported health status), physical activity behaviors (regular/nonregular LTPA), and self-reported anthropometrics (height, weight, and BMI). Multiple linear and logistic regression were used to examine the association between regular LTPA and BMI as well as between regular LTPA and obesity status, respectively. Results Regular LTPA was associated with a male preponderance, normal weight, excellent or good self-reported health status, and a lower rate of underweight compared with nonregular LTPA. Regular LTPA was significant negatively associated with underweight (OR = 0.71, p < 0.05), whereas it had no significant relationship with BMI and obesity (p > 0.05). Conclusions Regular LTPA was associated with a reduced risk of underweight among middle-aged and elderly adults in Taiwan. Further research on the relevant mechanism underlying this phenomenon is warranted.

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Association of Regular Leisure-Time Physical Activity with Self-Reported Body Mass Index and Obesity Risk among Middle-Aged and Older Adults in Taiwan

Healthcare ◽

10.3390/healthcare9121719 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1719

Author(s):

Yun-Tsung Chen ◽

Po-Fu Lee ◽

Chi-Fang Lin ◽

Andy Chang ◽

Yu-Chun Chung ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Mass Index ◽

Health Status ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Obesity Risk ◽

Middle Aged ◽

Reported Health ◽

Self Reported Health Status

Through this study, we aimed to determine the association of regular leisure-time physical activity (LTPA) with self-reported body mass index (BMI) and obesity risk among middle-aged and older adults in Taiwan. We conducted a cross-sectional study and reviewed the data derived from the Taiwan National Physical Activity Survey (TNPAS). Responses from 12,687 participants aged 45–108 years from the database were collected in this study. All the participants completed a standardized structured questionnaire that solicitated information regarding their demographic characteristics (age, gender, education, occupation, and self-reported health status), physical activity behaviors (regular/nonregular LTPA), and self-reported anthropometrics (height, weight, and BMI). Multiple linear and logistic regressions were used to examine the association between regular LTPA and BMI, and between regular LTPA and obesity status, respectively. Regular LTPA was associated with male gender, normal weight, excellent or good self-reported health status, and a lower rate of being underweight compared with nonregular LTPA. Regular LTPA was significant negatively associated with being underweight (OR = 0.71, p < 0.05), whereas it had no significant relationship with BMI and obesity (p > 0.05). Regular LTPA was associated with a reduced risk of being underweight among middle-aged and elderly adults in Taiwan. Further research on the relevant mechanism underlying this phenomenon is warranted.

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Opioid and Other Medication Use and General Health Status in a Cohort of Older Adults

Gerontology ◽

10.1159/000513731 ◽

2021 ◽

pp. 1-9

Author(s):

Paul F. Pinsky ◽

Danielle Durham ◽

Scott Strassels

Keyword(s):

Quality Of Life ◽

Health Status ◽

Chronic Conditions ◽

Medication Use ◽

Opioid Use ◽

Reported Health ◽

Chronic Opioid Use ◽

Self Reported Health Status ◽

Fair Poor

Objective: The aim of this study was to determine whether the use of opioids and other medications in a cohort of older adults was associated with self-reported health status. Methods: Among participants in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Screening Trial linked to Medicare Part D claims data and answering a quality-of-life questionnaire, we examined the relationship between medication use over a 5-year period and various self-reported health status variables assessed several years later, including overall health status (STATUS) and trouble with activities of daily living (TADL). Multivariable logistic regression was used to estimate odds ratios (ORs) for the health status variables and metrics of medication use, including >60-day use, and for opiates, chronic use, with models controlling for demographics (model I), additionally for chronic conditions (model II), and additionally for other medication use (model III). Results: The study cohort included 22,844 PLCO participants (56% women, 90% non-Hispanic whites); 4.2% had chronic opioid use and 12.5% used for >60 days. Fair-poor STATUS was reported in 37.9% of participants with chronic opioid use versus 15.0% of participants without (p < 0.001). ORs for chronic opioid use for fair-poor STATUS (compared to good-excellent) were significantly elevated in all models but decreased from model I (OR = 3.6; 95% CI :3.1–4.1) to model II (OR = 2.7; 95% CI :2.3–3.1) to model III (OR = 2.1; 95% CI :1.8–2.5). ORs for TADL were generally similar to those for STATUS. Other drug classes also had significantly elevated model III ORs for fair-poor versus good-excellent STATUS (range 1.1–1.6). Conclusion: Frequent use of various medication classes correlated with measures of future health status in an elderly population, with opioids having the strongest association. The magnitude of the association decreased after controlling for concurrent chronic conditions but remained elevated. Future research should consider how the use of opioids and other medications impact measures of health-related quality of life.

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