Factors influencing access and utilization of health services among older people during the COVID − 19 pandemic: a scoping review

Abstract Background Access to healthcare and service utilization are both considered essential factors for improving the general health and wellbeing of older people, especially at the time of COVID-19 pandemic. The aim of the study is to explore factors affecting healthcare access and health service utilization for older people during the pandemic. Methods PubMed, Web of Science, Scopus and Embase were systematically searched for relevant articles. Access, utilization, health, elderly and COVID-19 were used as keywords in the search strategy. A total of 4308 articles were identified through the initial database search; 50 articles were included in the review as passing the eligibility criteria. The searches were conducted up to August 2021. Data extraction was performed, and evidence was descriptively illustrated. Thematic analysis was used to explore factors influencing the elderly’s access and utilization of healthcare services, using Max QDA10, a qualitative analysis software. Results Among articles included in the review (n = 50), a majority of the studies were from the United States (36%), followed by India (8%). According to the main healthcare services, a large number of articles (18%) were related to mental health services, followed by digital health services (16%). Factors were identified at an individual, provider and systems level. Seven main themes emerged from the thematic analysis, as determinants of elderly’s access and utilization of healthcare services during COVID-19 pandemic. These included: access to non-COVID related services, access to COVID-related services, literacy and education, accommodation challenges, perceived attitudes of aging, and policies and structures, and social determinants. Conclusion Mental health and digital health services were identified as major issues influencing or contributing to or influencing older people’s health during the COVID-19 pandemic. We also argue on the importance of a rounded view, as attention to a range of factors is vital for policy decisions towards sustainable care and equitable interventions for improving the health of older people.

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Utilization Of Healthcare Services To General Patient At Inpatient Unit of Anutapura General Hospital, Palu City

Preventif : Jurnal Kesehatan Masyarakat ◽

10.22487/preventif.v10i1.118 ◽

2020 ◽

Vol 10 (1) ◽

pp. 35-44

Author(s):

Fausiah Fausiah

Keyword(s):

Health Services ◽

General Hospital ◽

Health Beliefs ◽

Secondary Data ◽

Healthcare Services ◽

Primary Data ◽

Utilization Of Health Services ◽

The People ◽

Quantitative Descriptive ◽

Utilization Of Healthcare

The number of inpatient visits in RSU Anutapura Palu, where in 2015 inpatient visits of 5,640, then in 2016 patient visits decreased to 5,451, in 2017 also decreased to 3,999 and in 2018 also decreased Drastic to 1,146 patient visits. This research aims to determine the utilization of health services in patients in general hospitalization in RSU Anutapura Palu. This type of research is quantitative descriptive. Research was conducted from May-June 2019. The population in the study is a visitor (number of hospitalizations) at the General Hospital (RSU) Anutapura Palu. In this case the people who use health services in the General Hospital (RSU) Anutapura Palu recorded as many as 1,146 visitors (patients) in the year 2018. Primary data collection is through questionnaires and secondary data through the study of patient record documents and other supporting documents. The utilization of health services in patients in general hospitalization in RSU Anutapura Palu is well from the aspects of health beliefs, abilities and needs. RSU Anutapura Palu is expected to be able to improve the promotion of health services so that people use the health services provided.

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Service innovations

Psychiatric Bulletin ◽

10.1017/s0955603600003007 ◽

2003 ◽

Vol 27 (09) ◽

pp. 346-348

Author(s):

Chris Simpson ◽

Prasanna De Silva

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Older People ◽

High Quality ◽

The Uk ◽

Multi Disciplinary Team

The increase in older people in the UK will increase the need for mental health services to run efficient, high-quality services. Multi-disciplinary team assessments, although not new, provide a method of increasing the capacity to see referrals. Two similar systems of multi-disciplinary team assessments from North Yorkshire are reported with evidence of improvement in quality.

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Implementing a digital health model of care in Australian youth mental health services: protocol for impact evaluation

BMC Health Services Research ◽

10.1186/s12913-021-06394-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sarah Piper ◽

Tracey A. Davenport ◽

Haley LaMonica ◽

Antonia Ottavio ◽

Frank Iorfino ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Impact Evaluation ◽

Digital Health ◽

Youth Mental Health ◽

Model Of Care ◽

Health Service Provision ◽

Industrial Grade ◽

The Impact

Abstract Background The World Economic Forum has recently highlighted substantial problems in mental health service provision and called for the rapid deployment of smarter, digitally-enhanced health services as a means to facilitate effective care coordination and address issues of demand. In mental health, the biggest enabler of digital solutions is the implementation of an effective model of care that is facilitated by integrated health information technologies (HITs); the latter ensuring the solution is easily accessible, scalable and sustainable. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution – delivered through the Youth Mental Health and Technology Program – which incorporates two components: 1) a highly personalised and measurement-based (data-driven) model of youth mental health care; and 2) an industrial grade HIT registered on the Australian Register of Therapeutic Goods. This paper describes a research protocol to evaluate the impact of implementing the BMC’s digital health solution into youth mental health services (i.e. headspace - a highly accessible, youth-friendly integrated service that responds to the mental health, physical health, alcohol or other substance use, and vocational concerns of young people aged 12 to 25 years) within urban and regional areas of Australia. Methods The digital health solution will be implemented into participating headspace centres using a naturalistic research design. Quantitative and qualitative data will be collected from headspace health professionals, service managers and administrators, as well as from lead agency and local Primary Health Network (PHN) staff, via service audits, Implementation Officer logs, online surveys, and semi-structured interviews, at baseline and then three-monthly intervals over the course of 12 months. Discussion At the time of publication, six headspace centres had been recruited to this study and had commenced implementation and impact evaluation. The first results are expected to be submitted for publication in 2021. This study will focus on the impact of implementing a digital health solution at both a service and staff level, and will evaluate digital readiness of service and staff adoption; quality, usability and acceptability of the solution by staff; staff self-reported clinical competency; overall impact on headspace centres as well as their lead agencies and local PHNs; and social return on investment.

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Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study

BMC Psychiatry ◽

10.1186/s12888-020-02961-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Johanna Frerichs ◽

Jo Billings ◽

Nick Barber ◽

Anjie Chhapia ◽

Beverley Chipp ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Thematic Analysis ◽

Narrative Analysis ◽

Mental Health Problems ◽

Severe Depression ◽

Feasibility Trial ◽

Structural Level ◽

Structured Interviews

Abstract Background Loneliness is associated with negative outcomes, including increased mortality and is common among people with mental health problems. This qualitative study, which was carried out as part of a feasibility trial, aimed to understand what enables and hinders people with severe depression and/or anxiety under the care of secondary mental health services in the United Kingdom to participate in the Community Navigator programme, and make progress with feelings of depression, anxiety and loneliness. The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. Methods Semi-structured interviews were carried out with participants (n = 19) shortly after programme completion. A co-produced two-stage qualitative approach, involving narrative and reflexive thematic analysis, was undertaken by members of the study’s working group, which included experts by experience, clinicians and researchers. Results The narrative analysis showed that individuals have varied goals, hold mixed feelings about meeting other people and define progress differently. From the thematic analysis, six themes were identified that explained facilitators and challenges to participating in the programme: desire to connect with others; individual social confidence; finding something meaningful to do; the accessibility of resources locally; the timing of the programme; and the participant’s relationship with the Community Navigator. Conclusions We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but find it emotionally effortful to do so and a major personal challenge. This emotional effort, which manifests in individuals differently, can make it hard for participants to engage with a loneliness programme, though it was through facing personal challenges that a significant sense of achievement was felt. Factors at the individual, interpersonal and structural level, that enable or hinder an individual’s participation should be identified early, so that people are able to make the best use out of the Community Navigator or other similar programmes.

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A realistic evaluation of evidence-based therapeutic processes in mental health services– Context-Mechanisms-Outcomes

10.21203/rs.3.rs-81487/v1 ◽

2020 ◽

Author(s):

Eric Badu ◽

Anthony Paul O’Brien ◽

Rebecca Mitchell ◽

Akwasi Osei

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Health Professional ◽

Therapeutic Alliance ◽

Thematic Analysis ◽

Mental Health Professional ◽

Evidence Based ◽

Realistic Evaluation ◽

Alliance Building

Abstract Background Evidence-based clinical practice is an inherent component of developed countries mental health professional practice, however, little is known about Ghana mental health professional perspectives on evidence-based practice. This paper outlines the processes involved in the delivery of best practice in Ghana. The paper describes a realistic evaluation of mental health nurses and allied health opinions regarding the evidenced-based therapeutic process in Ghana mental health facilities. Methods A purposive sample of 30 Mental Health Professionals (MHPs) was recruited to participate in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. A programme theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two CMO configurations: 1) technical competency stimulates evidence-based mental health services; and, 2) therapeutic alliance-building ensures effective interaction. The study demonstrated that contextual factors (technical competencies and therapeutic alliance building) together with mechanisms (intentional and unintentional) help to promote the quality of mental health services. However, contextual factor such as the lack of sign language interpreters yielded an unintended outcome such as consumer-provider communication barrier for consumers with hearing impaired and those from linguistically minority background. Conclusion We conclude that government stakeholders and policymakers should prioritize policy documents, periodic monitoring and adequate financial incentives to support the on-going mechanisms that promote mental health professional technical competence and therapeutic alliance building.

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Understanding barriers to accessing mental health services for newcomers to Canada using Peterborough, Ontario, as an illustrative example

10.32920/ryerson.14657181.v1 ◽

2021 ◽

Author(s):

Nurun Layla Chowdhury

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Help Seeking ◽

Mental Healthcare ◽

Healthcare Services ◽

Mental Illnesses ◽

Cultural Barriers ◽

Accurate Information

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.

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Digital Innovations for Aged Care: Impacts in the COVID-19 Pandemic

Healthier Lives, Digitally Enabled - Studies in Health Technology and Informatics ◽

10.3233/shti210010 ◽

2021 ◽

Author(s):

Alan Taylor ◽

Jennifer Tieman ◽

Anthony Maeder

Keyword(s):

Primary Care ◽

Health Services ◽

Older People ◽

Acute Care ◽

Digital Technology ◽

Healthcare Services ◽

Aged Care ◽

Care Provision ◽

Remote Interaction ◽

Healthcare Interventions

This paper describes the extent to which remote interaction healthcare interventions supported by digital technology are currently being used, or have recently been newly developed for use, in the care of older people in Australia within the context of the existing Australian aged care system and in conjunction with the COVID-19 pandemic. We place emphasis on those interventions associated with primary care provision, and associated healthcare services such as allied health, rather than outreach from jurisdictional health services and acute care. The primary purpose of this study was to gain an indication of the extent and range of such interventions, and provide a pragmatic commentary on their usage. This has enabled the understanding of some characteristics for success, and drivers for rapid adoption of further digital technology interventions, in the aged care sector.

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