Association of social support with overall survival and health care utilization in patients with aggressive hematologic malignancies.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18582-e18582
Author(s):  
Netana H. Markovitz ◽  
Tamryn Gray ◽  
Sunil Mahesh Bhatt ◽  
Ryan David Nipp ◽  
Nneka Ufere ◽  
...  
Keyword(s):  
Social Support ◽  
Health Care ◽  
Overall Survival ◽  
Length Of Stay ◽  
Health Care Utilization ◽  
Hematologic Malignancies ◽  
Hospitalized Patients ◽  
Care Utilization ◽  
Index Hospitalization ◽  
Prospective Longitudinal

e18582 Background: Social support plays a crucial role for patients with aggressive hematologic malignancies as they navigate their illness course. We examined associations of social support with overall survival and health care utilization in this population. Methods: We conducted a cross sectional secondary analysis using data from a prospective longitudinal cohort study of 251 hospitalized patients with aggressive hematologic malignancies at Massachusetts General Hospital from 2014 through 2017. We utilized Natural Language Processing (NLP) to identify extent of patients’ social support (limited versus adequate as defined by NLP-aided chart review of the Electronic Health Record (EHR)). We used multivariable regression models to examine associations of social support with: 1) overall survival; 2) death or readmission within 90 days of discharge from index hospitalization; 3) time to readmission within 90 days; and 4) index hospitalization length of stay. Results: Patients had a median age of 64 (range: 19-93) years, and most were white (89.6%), male (68.9%), and married (65.3%). A plurality of patients had leukemia (42.2%) followed by lymphoma (37.9%) and myelodysplastic syndrome/myeloproliferative neoplasm (19.9%). Using NLP, we identified that 8.8% (22/251) of patients had limited social support. In multivariable analyses, limited social support was associated with worse overall survival (HR = 2.00, p = 0.042) and higher likelihood of death or readmission within 90 days of discharge (OR = 3.11, P = 0.043), but not with time to readmission within 90 days, or index hospital length of stay. Conclusions: In this cohort of hospitalized patients with aggressive hematologic malignancies, we found associations of limited social support with lower overall survival and higher likelihood of death or readmission within 90 days of hospital discharge. These findings underscore the utility of NLP for evaluating extent of social support and the need for larger studies evaluating social support in patients with aggressive hematologic malignancies.

Trends in Health-Care Utilization at the End of Life Among Patients With Hematologic Malignancies in a Middle-Income Country: Challenges and Opportunities in Brazil

2019 ◽  
Vol 36 (9) ◽  
pp. 775-779 ◽  
Author(s):  
Luiz Guilherme L. Soares ◽  
Renato Vieira Gomes ◽  
André M. Japiassu
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
End Of Life ◽  
End Of Life Care ◽  
Hematologic Malignancies ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
Blood Transfusions ◽  
Life Care ◽  
To Receive

Patients with hematologic malignancies (HMs) often receive poor-quality end-of-life care. This study aimed to identify trends in end-of-life care among patients with HM in Brazil. We conducted a retrospective cohort study (2015-2018) of patients who died with HM, using electronic medical records linked to health insurance databank, to evaluate outcomes consistent with health-care resource utilization at the end of life. Among 111 patients with HM, in the last 30 days of life, we found high rates of emergency department visits (67%, n = 75), intensive care unit admissions (56%, n = 62), acute renal replacement therapy (10%, n = 11), blood transfusions (45%, n = 50), and medical imaging utilization (59%, n = 66). Patients received an average of 13 days of inpatient care and the majority of them died in the hospital (53%, n = 58). We also found that almost 40% of patients (38%, n = 42) used chemotherapy in the last 14 days of life. These patients were more likely to be male (64% vs 22%; P < .001), to receive blood transfusions (57% vs 38%; P = .05), and to die in the hospital (76% vs 39%; P = .009) than patients who did not use chemotherapy in the last 14 days of life. This study suggests that patients with HM have high rates of health-care utilization at the end of life in Brazil. Patients who used chemotherapy in the last 14 days of life were more likely to receive blood transfusions and to die in the hospital.

scholarly journals Mo1544 – Association of Cannabis and Health Care Utilization in Hospitalized Patients with Irritable Bowel Syndrome

2019 ◽  
Vol 156 (6) ◽  
pp. S-774-S-775
Author(s):  
Chimezie Mbachi ◽  
Parth Desai ◽  
Bashar Attar ◽  
Estefania Flores ◽  
Setri Fugar ◽  
...  
Keyword(s):  
Health Care ◽  
Irritable Bowel Syndrome ◽  
Health Care Utilization ◽  
Hospitalized Patients ◽  
Care Utilization ◽  
Irritable Bowel

Depression in Primary Care—More like Asthma Than Appendicitis: The Michigan Depression Project

1997 ◽  
Vol 42 (9) ◽  
pp. 966-973 ◽  
Author(s):  
Michael S Klinkman ◽  
Thomas L Schwenk ◽  
James C Coyne
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Health Care ◽  
Health Care Utilization ◽  
Family Practice ◽  
Care Setting ◽  
Primary Care Setting ◽  
Past History ◽  
Care Utilization ◽  
Primary Care Patients

Objective: To explore the relationships between detection, treatment, and outcome of depression in the primary care setting, based upon results from the Michigan Depression Project (MDP). Methods: A weighted sample of 425 adult family practice patients completed a comprehensive battery of questionnaires exploring stress, social support, overall health, health care utilization, treatment attitudes, self-rated levels of stress and depression, along with the Center for Epidemiologic Studies Depression Scale (CES-D), the Hamilton Rating Scale for Depression (HAM-D), and the Structured Clinical Interview for DSM-III (SCID), which served as the criterion standard for diagnosis. A comparison sample of 123 depressed psychiatric outpatients received the same assessment battery. Family practice patients received repeated assessment of depressive symptoms, stress, social support, and health care utilization over a period of up to 60 months of longitudinal follow-up. Results: The central MDP findings confirm that significant differences in past history, severity, and impairment exist between depressed psychiatric and family practice patients, that detection rates are significantly higher for severely depressed primary care patients, and that clinicians use clinical cues such as past history, distress, and severity of symptoms to “detect” depression in patients at intermediate and mild levels of severity. As well, there is a lack of association between detection and improved outcome in primary care patients. Conclusion: These results call into question the assumption that “depression is depression” irrespective of the setting and physician, and they are consistent with a model of depressive disorder as a subacute or chronic condition characterized by clinical parameters of severity, staging, and comorbidity, similar to asthma. This new model can guide further investigation into the epidemiology and management of mood disorders in the primary care setting.

Functional versus Structural Social Support and Health Care Utilization in a Family Medicine Outpatient Practice

Medical Care ◽  
1989 ◽  
Vol 27 (3) ◽  
pp. 221-233 ◽  
Author(s):  
W E Broadhead ◽  
Stephen H. Gehlbach ◽  
Frank V. deGruy ◽  
Berton H. Kaplan
Keyword(s):  
Social Support ◽  
Health Care ◽  
Family Medicine ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Functional Versus ◽  
Outpatient Practice

scholarly journals Exploring the Role of Co-worker Social Support on Health Care Utilization and Sickness Absence

2011 ◽  
Vol 53 (7) ◽  
pp. 751-757 ◽  
Author(s):  
Sara L. Tamers ◽  
Shirley A.A. Beresford ◽  
Beti Thompson ◽  
Yingye Zheng ◽  
Allen D. Cheadle
Keyword(s):  
Social Support ◽  
Health Care ◽  
Health Care Utilization ◽  
Sickness Absence ◽  
Care Utilization

Social Support, Health Literacy, and Health Care Utilization Among Older Adults

2019 ◽  
Vol 31 (4) ◽  
pp. 359-366 ◽  
Author(s):  
Yong-Bing Liu ◽  
Ping Hou ◽  
Hui-Ping Xue ◽  
Xin-E Mao ◽  
Yong-Nan Li
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Health Care ◽  
Health Literacy ◽  
Nursing Homes ◽  
Health Care Utilization ◽  
Hospital Admissions ◽  
Effective Means ◽  
Care Utilization ◽  
Cross Sectional Survey

The purpose of this study was to explore the relationship between social support, health literacy, and health care utilization in older Chinese adults. A cross-sectional survey design was employed. Data were collected from 32 nursing homes from Urumqi in Xinjiang of China. A total of 1486 respondents completed a pack of questionnaires. The average health literacy level of older adults in nursing homes was relatively low, only 73.68 ± 29.42 points; the average social support level was also relatively low, only 31.42 ± 7.12 points (lower than domestic norm of Chinese residents, P < .001). Both values were below the midpoint for the overall population, indicating a sample with below-average levels of healthy literacy and social support. Low social support levels are associated with poor health literacy and greater likelihood of hospital admission ( P < .05). Social support was significantly associated with health literacy. Improving the quantity and quality of social support may be an effective means to obtain better health literacy and lower hospital admissions.

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