scholarly journals The evolution trend of availability of China’s community-based care services and its impact on the cognitive function of elderly people: 2008-2018

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhang Yue ◽  
Nan Xiang ◽  
Huwei Li ◽  
Erpeng Liu
Keyword(s):  
Cognitive Function ◽  
Health Services ◽  
Elderly People ◽  
Rural Areas ◽  
Urban Areas ◽  
Life Support ◽  
Medical Support ◽  
Community Based ◽  
Care Services ◽  
Evolution Trend

Abstract Background To address the challenge of the aging population, community-based care services (CBCS) have been developed rapidly in China as a new way of satisfying the needs of elderly people. Few studies have described the evolution trend of availability of CBCS in rural and urban areas and evaluated their effectiveness. This study aims to show the availability of China’s CBCS and further analyze the effect of the CBCS on the cognitive function of elderly people. Methods Longitudinal analysis was performed using data from the 2008 to 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 23937 observations from 8421 elderly people were included in the study. The Chinese version of the Mini-Mental State Examination (MMSE) was used to assess cognitive function. We aggregated similar CBCS to generate three binary variable categories (daily life support, emotional comfort and entertainment services, medical support and health services) indicating the availability of CBCS (1 = yes, 0 = no). Multilevel growth models were employed to estimate the association between CBCS and cognitive function while adjusting for many demographic and socioeconomic characteristics. Results The availability of CBCS increased a lot from 2008 to 2018 in China. Although the availability of CBCS in urban areas was higher than that in rural areas in 2008, by 2018 the gap narrowed significantly. Emotional comfort and entertainment services (B = 0.331, 95% CI = 0.090 to 0.572) and medical support and health services (B = 1.041, 95% CI = 0.854 to 1.228) were significantly and positively associated with cognitive function after adjusting for the covariates. Conclusion There was a significant increase in the availability of CBCS from 2008 to 2018 in China. This study sheds light on the positive correlation between CBCS and cognitive function among Chinese elderly individuals. The results suggest that policymakers should pay more attention to the development of CBCS and the equity of the supply of CBCS in urban and rural areas.

scholarly journals Multi-dimensional Accessibility Barriers in Care Services for the Rural Elderly with Disabilities: A Qualitative Study in China

2021 ◽  
Author(s):  
Yuan Wang ◽  
Cai Yun Qi
Keyword(s):  
Elderly People ◽  
Rural Areas ◽  
Urban Areas ◽  
Care Service ◽  
Rural China ◽  
People With Disabilities ◽  
Support Network ◽  
Care Services ◽  
Accessibility Barriers ◽  
Disabled Elderly

Abstract Background As the aging of the population increases, the number and growth rate of disabled elderly people in rural China are significant. However, their special care needs and barriers to accessibility have been neglected in existing research. This paper covers a multi-dimensional investigation into accessibility barriers in care services for elderly people with disabilities in rural China. Methods In-depth interviews with 13 rural disabled elderly people in China took place using qualitative methods. Results Based on a welfare pluralism approach, the results showed that in comparison with urban areas, care services for disabled elderly people in rural areas are more subject to social barriers. This can be seen in the limited state (lack of resources, rigorous qualification of eligibility, uneven distribution, and irregular implementation); the absent market (low levels of consumption, high cost pressures, self-exclusion, and traditional cultural constraints); absent NGOs and volunteers (difficulties in access for NGOs and volunteers outside the area and formation difficulties of local NGOs and volunteers); as well as low-quality care in households and communities (unprofessional care from the spouse, unsustainable care from offspring, and unavailable community-based care). Conclusion A multi-subject support network should be established to remove accessibility barriers to care service provision for elderly people with disabilities in rural areas through active intervention and interaction.

scholarly journals Urban-Rural Disparities in The Utilization of Primary Health Care Center Among Elderly in East Java, Indonesia

2019 ◽  
Author(s):  
Ratna Dwi Wulandari ◽  
Agung Dwi Laksono
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Elderly People ◽  
Rural Areas ◽  
Urban Areas ◽  
The Elderly ◽  
Utilization Of Health Services ◽  
Primary Health ◽  
Urban Rural

Introduction: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output. Aim: This study was intended to analyze urban-rural disparity in the utilization of primary health care or puskesmas use by the elderly.Methods: This study was used the 2013 Riskesdas (Indonesian Basic Health Survey) raw data. The 2013 Riskesdas was designed a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province were obtained. Data were analyzed using Multinomial Logistic Regression tests.Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). The elderly who have a primary school and under education have the possibility of 1.558 times more utilizing outpatients in the puskesmas than the elderly who have college education levels (OR 1.558; 95% CI 1.001-2.424). Conclusions: There was a disparity between urban and rural areas in the utilization of outpatient puskesmas in East Java by the elderly. Policy makers in East Java are recommended to improve facilities and infrastructure of the puskesmas in rural areas by paying attention to the results of this study.

Integrated community-based sexual health services for young people in urban areas: are we meeting the needs of the local community?

2008 ◽  
Vol 19 (10) ◽  
pp. 713-714 ◽  
Author(s):  
K M Forbes ◽  
N Rahman ◽  
S Mccrae ◽  
I Reeves
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Urban Areas ◽  
Local Community ◽  
Local Population ◽  
Nucleic Acid Amplification ◽  
Community Based ◽  
Transmitted Infection ◽  
Sti Testing ◽  
Hiv Test

Community-based sexual health services (SHS) are intended to improve access for people who may have difficulty attending traditional genitourinary medicine clinics. The objective of this study was to review uptake of sexually transmitted infection (STI) testing in an outreach clinic for those under 25 in an area where Black and minority ethnic groups comprise the majority of the local population. A retrospective case-notes review was undertaken of those attending. Standards were that Fraser guidelines should be completed in all under 16-year-old and all clients should be offered STI testing, HIV testing and contraception (if applicable) in accordance with local standards. One hundred and seventeen clients attended. Ten percent self-reported ethnicity was Asian. Thirty-six (31%) clients tested for chlamydia. Thirty (26%) had an HIV test. Five (14% of those tested) had a positive nucleic acid amplification test for chlamydia. Five (13%) of those requesting long term contraception had STI testing. This service has successfully improved access to STI screening. However, there may have been missed opportunities to offer tests in those requesting contraception. Under-representation of those of non-white ethnicity suggests access to SHS may be a particular problem and further work is required to improve the sexual health of the local community.

Structure of Medical Care Services in the U.S.S.R.

1972 ◽  
Vol 2 (2) ◽  
pp. 239-242
Author(s):  
J. Fry
Keyword(s):  
Health Services ◽  
Medical Care ◽  
Rural Areas ◽  
Free Choice ◽  
Work Load ◽  
Master Plan ◽  
Medical Assistants ◽  
Occupational Physicians ◽  
Care Services ◽  
Primary Physicians

The health services of the U.S.S.R. are organized and administered on a master plan based on central and monolithic planning according to Marxist socioeconomic principles. The health services have provided good available and accessible medical care to all its peoples. This has been a great and remarkable achievement. Primary medical services in the U.S.S.R. are provided by a series of specialists— uchastok (neighborhood) pediatricians, therapists (internists), occupational physicians, and dentists. Each has an allocated geographic locality and there is no free choice of physician. The uchastok physicians work from polyclinics with specialists. They also carry out daily home visits. There are no hospital facilities. The nature of the work and the work load is similar to that of primary physicians in other systems. In rural areas because of dispersal of populations, primary medical care is carried out by medical assistants (feldshers) who work under the supervision of physicians.

Pediatric Prehospital Care in Urban and Rural Areas

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 681-690 ◽  
Author(s):  
James S. Seidel ◽  
Deborah Parkman Henderson ◽  
Patrick Ward ◽  
Barbara Wray Wayland ◽  
Beverly Ness
Keyword(s):  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Pediatric Patients ◽  
Life Support ◽  
Prehospital Care ◽  
Advanced Life Support ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical

There are limited data concerning pediatric prehospital care, although pediatric prehospital calls constitute 10% of emergency medical services activity. Data from 10 493 prehospital care reports in 11 counties of California (four emergency medical services systems in rural and urban areas) were collected and analyzed. Comparison of urban and rural data found few significant differences in parameters analyzed. Use of the emergency medical services system by pediatric patients increased with age, but 12.5% of all calls were for children younger than 2 years. Calls for medical problems were most common for patients younger than 5 years of age; trauma was a more common complaint in rural areas (64%, P = .0001). Frequency of vital sign assessment differed by region, as did hospital contact (P < .0001). Complete assessment of young pediatric patients, with a full set of vital signs and neurologic assessment, was rarely performed. Advanced life support providers were often on the scene, but advanced life support treatments and procedures were infrequently used. This study suggests the need for additional data on which to base emergency medical services system design and some directions for education of prehospital care providers.

scholarly journals The effectiveness of hypertension management in China: a community-based intervention study

2019 ◽  
Vol 20 ◽  
Author(s):  
Xiaoguo Zheng ◽  
Feng Xiao ◽  
Ruili Li ◽  
Delu Yin ◽  
Qianqian Xin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Healthcare System ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Urban Areas ◽  
Blood Pressure Reduction ◽  
Hypertension Management ◽  
Hypertension Control ◽  
Community Based ◽  
One Year

Abstract Aim: This study aimed to evaluate the effectiveness of hypertension management and analyse the factors associated with blood pressure reduction within China’s primary healthcare system. Background: Hypertension is one of the leading risk factors for global disease burden and is strongly associated with cardiovascular diseases. In China, hypertension is a serious public health problem, but few studies have evaluated the effectiveness of hypertension management in China’s primary healthcare system. Methods: The study sites were 24 primary healthcare institutions, selected using multistage stratified random sampling method. In each institution, hypertension patients aged at least 35 years who agreed to participate and had no disabilities or mental health problems were enrolled for hypertension management. Participants received comprehensive interventions in the primary healthcare system via a team. After a one-year intervention, data from 6575 hypertension patients were analysed to check the effectiveness of hypertension management and examined factors associated with hypertension control. Findings: There was an overall mean reduction of 4.5 mmHg in systolic blood pressure (SBP) and 1.9 mmHg in diastolic blood pressure (DBP). The blood pressure reduction after one year was greater in rural patients than in urban patients, 6.6 mmHg versus 3.4 mmHg for SBP and 2.6 mmHg versus 1.6 mmHg for DBP, respectively. The hypertension control rate also increased more in rural areas (22.1%) than in urban areas (10.6%) after the one-year intervention. Age, body mass index, region and being in an urban area had a significant negative association with the reduction of SBP (P < 0.05). Education level and baseline SBP showed a significant positive association (P < 0.05). Conclusions: Community-based hypertension management by general practitioners was feasible and effective. The effectiveness of hypertension management in rural areas was greater than in urban areas. Intervention strategies should pay more attention to patients in rural areas and western China.

Innovative Mobility Solutions in Rural Areas With Case Studies

2020 ◽  
pp. 156-209 ◽  
Author(s):  
Marian Gogola ◽  
Dana Sitányiová
Keyword(s):  
Social Change ◽  
Health Services ◽  
Case Studies ◽  
Rural Areas ◽  
Urban Areas ◽  
Transport Services ◽  
Innovative Solutions ◽  
Important Challenge

Rural areas still have some disadvantages in comparison to urban areas. Access to jobs, education, or health services provided for inhabitants in rural areas are limited. Another important topic is mobility, which is crucial to meet the travel expectations of inhabitants in rural areas. Finding new forms of mobility capable of covering all areas and meeting the requirements of rural inhabitants is the most important challenge. This chapter deals with mobility in rural areas from the perspective of demographics, social change, and accessibility to transport services. Moreover, this chapter offers various case studies dealing with innovative solutions for mobility in rural areas resulting from the RUMOBIL project.

scholarly journals Health service inequalities during the COVID-19 pandemic among elderly people living in large urban and non-urban areas in Florida, USA

2020 ◽  
Vol 8 ◽  
pp. 205031212097416
Author(s):  
Xinhua Yu
Keyword(s):  
Emergency Department ◽  
Elderly People ◽  
Rural Areas ◽  
Urban Areas ◽  
Metropolitan Areas ◽  
Elderly Women ◽  
Logistic Models ◽  
Emergency Department Visits ◽  
Hospitalization Rates ◽  
Adjusted Incidence

Objective: Health inequalities were often exacerbated during the emerging epidemic. This study examined urban and non-urban inequalities in health services among COVID-19 patients aged 65 years or above in Florida, USA, from 2 March to 27 May 2020. Methods: A retrospective time series analysis was conducted using individual patient records. Multivariable Poisson’s and logistic models were used to calculate adjusted incidence of COVID-19 and the associated rates of emergency department visits, hospitalizations, and deaths. Results: As of 27 May 2020, there were 13,659 elderly COVID-19 patients (people aged 65 years or above) in Florida and 14.9% of them died. Elderly people living in small metropolitan areas might be less likely to be confirmed with COVID-19 infection than those living in large metropolitan areas. The emergency department visit and hospitalization rates decreased significantly across metropolitan statuses for both men and women. Those patients living in small metropolitan or rural areas were less likely to be hospitalized than those living in large metropolitan areas (35% and 34% vs 41%). Elderly women aged 75 years or above living in rural areas had 113% higher adjusted incidence of COVID-19 than those living in large metropolitan areas, and the rates of hospitalizations were lower compared with those counterparts living in large metropolitan areas (29% vs 46%; odds ratio: 0.37 (0.25–0.54), p < 0.001). Conclusion: For elderly people living in Florida, USA, those living in small metropolitan or rural areas were less likely to receive adequate health care than those living in large or medium metropolitan areas during the COVID-19 pandemic.

scholarly journals Do adult health outcomes in urban population reflect local health risk? A matched cohort analysis of migration effects in Ouagadougou, Burkina Faso

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029059
Author(s):  
Philippe Bocquier ◽  
Abdramane Bassiahi Soura ◽  
Souleymane Sanogo ◽  
Sara Randall
Keyword(s):  
Health Status ◽  
Health Services ◽  
Health Outcomes ◽  
Health Risks ◽  
Rural Areas ◽  
Urban Areas ◽  
Cohort Analysis ◽  
Local Health ◽  
Access To Health Services ◽  
Access To Health

BackgroundSelective migration may affect health indicators in both urban and rural areas. Sub-Saharan African urban areas show evidence of both negative and positive selection on health status at outmigration. Health outcomes as measured in urban populations may not reflect local health risks and access to health services.MethodsUsing the Ouagadougou Health and Demographic Surveillance System and a migrant follow-up survey, we measured differences in health between matched non-migrants and outmigrants. We applied Cox and competing risks models on migration and death.ResultsControlling for premigration health status, migrants who moved out of Ouagadougou have higher mortality (HR 3.24, 95% CI 1.23 to 8.58) than non-migrants and migrants moving to other Ouagadougou areas. However, these effects vanish in the matched sample controlling for all interactions between death determinants. These and other results show little evidence that migration led to higher mortality or worse health.ConclusionsHealth outcomes as measured in Ouagadougou population do reflect local health risks and access to health services despite high migration intensity. However, neither the hypothesis of effect of health on migration nor the hypothesis of negative effect of migration on health or survival was confirmed.

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