scholarly journals Problems faced by patients and health service utilization experiences of gastrointestinal patients during lockdown due to COVID-19 pandemic

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Hamid Ali Kalwar ◽  
Lubna Kamani

Objectives: The COVID-19 pandemic undermined the health service delivery and utilization of essential health care services globally. The current study therefore aimed to explore the health-seeking behaviors and challenges faced by patients for the management of gastrointestinal diseases. Methods: A cross-sectional study was conducted at the outpatient department of Gastroenterology, Liaquat National Hospital, Karachi from March 2020 to July 2020 during the COVID-19 lockdown phase to explore patient experiences. Data was collected using a survey questionnaire. All patients of either gender were included after informed consent. Statistical analysis of the data was conducted using SPSS 21.0. Results: A total of 184 patients were included who visited the hospital to seek medical services during the COVID-19 lockdown phase. The mean age of the population was 42.7 years (±16.13). Of these, n=94 (51.1%) were males All patients had gastrointestinal issues with different comorbid conditions. One forty-seven n=147 (79.9%) presented with active complaints whereas, n=37 (20.1%) patients visited the hospital for their follow-up checkup. Out of 184 patients, n=33 (17.9%) patients reported of having fear of visiting hospital due to COVID-19 outbreak. A statistically significant difference p<0.001 was noted between the history of comorbidities and patient delaying a visit to the healthcare due to the fear of COVID-19. Additionally, 61 (73.5%) patients with co-morbidity faced difficulty in finding public transport (p=0.01). Nevertheless, n=171 (93.0%) patients expressed satisfaction with the services provided by the hospital during the lockdown phase. Conclusion: Patients with gastrointestinal conditions were largely affected by lockdown largely due to fear of contacting COVID-19 disease and inaccessibility to the public transportation. Widely available telemedicine service might overcome these shortcomings and ensure continuity of quality care. doi: https://doi.org/10.12669/pjms.38.3.4799 How to cite this:Kalwar HA, Kamani L. Problems faced by patients and health service utilization experiences of gastrointestinal patients during lockdown due to COVID-19 pandemic. Pak J Med Sci. 2022;38(3):---------.  doi: https://doi.org/10.12669/pjms.38.3.4799 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author(s):  
Kevin KC Hung ◽  
Joseph H. Walline ◽  
Emily Ying Yang Chan ◽  
Zhe Huang ◽  
Eugene Siu Kai Lo ◽  
...  

Background: As health systems across the world respond to the coronavirus disease 2019 (COVID-19), there is rising concern that patients without COVID-19 are not receiving timely emergency care, resulting in avoidable deaths. This study examined patterns of self-reported health service utilization, their socio-demographic determinants and association with avoidable deaths during the COVID-19 outbreak. Methods: A cross-sectional telephone survey was conducted between March 22 and April 1, 2020, during the peak rise in confirmed COVID-19 cases in Hong Kong. Cantonese-speaking Hong Kong residents over 18-years-old were recruited using a computerised random digital dialling (RDD) system. The RDD method used stratified random sampling to ensure a representative sample of the target population by age, gender, and residential district. A structured self-reported questionnaire was used. Results: Out of 1738 placed calls, 765 subjects responded to the questionnaire (44.0% response rate). The factors associated with avoiding medical consultation included being female (37.2% vs. 22.5%, P<.001), married (32.8% vs. 27%, P=.044), completing tertiary education (35.3% vs. 27.7% (secondary) vs. 14.8% (primary), P=.005), and those who reported a "large/very large" impact of COVID-19 on their mental health (36.1% vs 30.5% (neutral) vs. 19.7% (very small/small), P=.047) using logistic regression analysis. Conclusion: Married females with both higher educational attainment and concern about COVID-19 were associated with avoiding healthcare services. Timely public communication to encourage and promote early health seeking treatment even during extreme events such as pandemics are needed.


2020 ◽  
Author(s):  
Jing Guo ◽  
Dexia Kong ◽  
Anao Zhang ◽  
Liming Fang ◽  
Yingxue Zhu

Abstract Background: The prevalence of depressive symptoms has been steadily increasing in recent years, however middle aged and older adults was less likely to use mental health services. The aims of this study were to 1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and 2) evaluate whether there exists a rural-urban difference in such relationships. Methods: Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Multivariate logistic regression analyses were conducted to assess the cross-sectional and longitudinal relationship between depressive symptoms and health services utilization in the whole sample, and urban and rural subsamples respectively. Results: Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. In addition, the relationships between depressive symptoms and health service use were consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions: Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.


2019 ◽  
Author(s):  
Xiaoli Gao ◽  
Min Ding ◽  
Mengru Xu ◽  
Huijing Wu ◽  
Chunzi Zhang ◽  
...  

Abstract Background: This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen’s behavioural model to explore influencing factors, thereby providing a reference for future policy making. Methods: This study is a cross-sectional study. Data of 40,305 children aged 3-5 years were extracted from the Fourth National Oral Health Survey, which was performed from August 2015 to December 2016. Patient data were collected using a questionnaire, which was answered by the child’s parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and hierarchical logistic regression results were then analysed to find the factors associated with oral health service utilization. Results : The oral health service utilization prevalence during the prior 12 months were 9.5% (95%CI: 8.1%-11.1%) among 3-year-old children, 12.1% (95%CI: 10.8%-13.5%) among 4-year-old children, and 17.5% (95%CI: 15.6%-19.4%) among 5-year-old children. “No dental diseases” (71.3%) and “dental disease was not severe” (12.4%) were the principal reasons why children had not attended a dental visit in the past 12 months. The children whose parents had a bachelor’s degree or higher(OR: 2.29, 95%CI: 1.97-2.67, p <0.001), a better oral health attitude ranging from 5 to 8(OR: 1.64, 95%CI: 1.43-1.89, p <0.001), annual per capital income more than 25,000 CNY (OR: 1.40, 95%CI: 1.18-1.65, p <0.001),think their child have worse or bad oral health(OR: 3.54, 95%CI: 2.84-4.40, p <0.001), and children who often have toothaches (OR: 9.72 , 95%CI: 7.81-12.09, p <0.001) were more likely to go to the dentist in the past year. Conclusion: The prevalence of dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.


2019 ◽  
Author(s):  
Xiaoli Gao ◽  
Min Ding ◽  
Mengru Xu ◽  
Huijing Wu ◽  
Chunzi Zhang ◽  
...  

Abstract Background: This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen’s behavioural model to explore influencing factors, thereby providing a reference for future policy making.Methods: A cross-sectional study utilizing data from the Fourth National Oral Health Survey was performed from August 2015 to December 2016. Survey data for children in the 3- to 5-year-old age groups were extracted. Patient data were collected using a questionnaire answered by the child’s parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and logistic regression results were then analysed to assess associations.Results : The oral health service utilization rates during the prior 12 months were 9.5% among 3-year-old children, 12.1% among 4-year-old children, and 17.5% among 5-year-old children. “No dental diseases” and “dental disease was not severe” were the principal reasons that children had not attended a dental visit in the past 12 months. Greater child age, increased parental educational level, and good oral health brief by parents was associated with an increased likelihood that the child received dental services within the past 12 months. Children who lived in urban areas and who belonged to families with high annual per capita incomes tended to have relatively higher oral health service utilization rates in the past 12 months. In addition, dental pain, evaluated dental health, and decayed, missing, and filled surface (DMFS) scores were significantly linked to dental visits. The results also demonstrated that children were more likely to see a dentist if they brushed their teeth more frequently or brushed their teeth with their parents’ help.Conclusion: The rate of dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.


2021 ◽  
Author(s):  
Chris Brogly ◽  
Michael A. Bauer ◽  
Daniel J. Lizotte ◽  
MacLean L. Press ◽  
Arlene MacDougall ◽  
...  

BACKGROUND The COVID-19 pandemic is a public health emergency that poses challenges for the mental health of approximately 1.4 million university students in Canada. Preliminary evidence has shown that the COVID-19 pandemic had a detrimental impact on undergraduate student mental health and well-being, however existing data are predominantly limited to cross-sectional survey-based studies. Due to the evolving nature of the pandemic, longer-term prospective surveillance efforts are needed to better anticipate risk and protective factors during a pandemic. OBJECTIVE The overarching aim of this research is to use a mobile surveillance system to identify risk and protective factors for undergraduate mental health. Factors will be identified from weekly self-report data (e.g., affect, living accommodation) and device sensor data (e.g., physical activity, device usage) to prospectively predict self-reported mental health and service utilization. METHODS Undergraduate students at Western University, Canada, will be recruited via e-mail to complete an internet baseline questionnaire with the option to participate in the study on a weekly basis using the Student Pandemic Experience (SPE) mobile application (app) for Android/iOS. The app collects sensor samples (e.g., GPS coordinates, steps) and self-reported weekly mental health and wellness surveys. Student participants can opt-in to link their mobile data with campus-based administrative data capturing health service utilization. Risk and protective factors that predict mental health outcomes are expected to be estimated by 1) cross-sectional associations between student characteristics (e.g., demographics) and key psychosocial factors (e.g., affect, stress, social connection) and behaviors (e.g., physical activity, device usage) and 2) longitudinal associations between psychosocial and behavioral factors and campus-based health service utilization. RESULTS Data collection began November 9th, 2020 and will be ongoing through to at least August 31st, 2021. Retention from the baseline survey (N=427) to app sign-up was 315/427 (74%), with approximately 175-215 (55-68%) of app participants actively responding to weekly surveys. From November 9th, 2020 to May 1st, 2021, 3363 responses to the app surveys and 18914 sensor samples (consisting of up to 68 individual data items each, e.g., GPS coordinates, steps) were collected from the 315 participants that signed up for the app. CONCLUSIONS Identifying risk and resilience factors for student mental health during this public health crisis is critical for informing optimal campus-based strategies and program development during the pandemic and beyond.


Author(s):  
Jing Guo ◽  
Dexia Kong ◽  
Liming Fang ◽  
Yingxue Zhu ◽  
Bo Zhang

Abstract Objectives This study aimed to (1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and (2) evaluate whether there exists a rural–urban difference in such relationships. Methods Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Results Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. This association was consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaoli Gao ◽  
Min Ding ◽  
Mengru Xu ◽  
Huijing Wu ◽  
Chunzi Zhang ◽  
...  

Abstract Background This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen’s behavioural model to explore influencing factors, thereby providing a reference for future policy making. Methods This study is a cross-sectional study. Data of 40,305 children aged 3–5 years were extracted from the Fourth National Oral Health Survey, which was performed from August 2015 to December 2016. Patient data were collected using a questionnaire, which was answered by the child’s parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and hierarchical logistic regression results were then analysed to find the factors associated with oral health service utilization. Results The oral health service utilization prevalence during the prior 12 months were 9.5% (95%CI: 8.1–11.1%) among 3-year-old children, 12.1% (95%CI: 10.8–13.5%) among 4-year-old children, and 17.5% (95%CI: 15.6–19.4%) among 5-year-old children. “No dental diseases” (71.3%) and “dental disease was not severe” (12.4%) were the principal reasons why children had not attended a dental visit in the past 12 months. The children whose parents had a bachelor’s degree or higher (OR: 2.29, 95%CI: 1.97–2.67, p < 0.001), a better oral health attitude ranging from 5 to 8(OR: 1.64, 95%CI: 1.43–1.89, p < 0.001), annual per capital income more than 25,000 CNY (OR: 1.40, 95%CI: 1.18–1.65, p < 0.001),think their child have worse or bad oral health (OR: 3.54, 95%CI: 2.84–4.40, p < 0.001), and children who often have toothaches (OR: 9.72, 95%CI: 7.81–12.09, p < 0.001) were more likely to go to the dentist in the past year. Conclusion The prevalence of dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.


Author(s):  
Christopher M. Westgard ◽  
Ally Rogers ◽  
Giselle Bello ◽  
Natalia Rivadeneyra

Abstract Background Various factors influence health service utilization at the community level. Research on the barriers to uptake of local health services is essential to reduce maternal and child mortality and morbidity. The Amazon region of Peru has some of the poorest health indicators in the country. The current study set out to better understand the health-seeking behavior and perspectives of mothers in Amazonian communities, exploring individual- and contextual-level barriers for seeking care at local health facilities for common maternal and child health issues. Methods The study employed a mixed-methods design by conducting 50 structured interviews with mothers of children under the age of 4. The study took place in 5 communities in Loreto, Peru. The quantitative data was analyzed with descriptive statistics to identify participants’ socio-demographic characteristics and reported utilization of health services. The qualitative data was analyzed in three rounds: inductive codebook development, application of the codebook, and thematic synthesis to contextualize the quantitative results and better understand the perspectives of the mothers regarding maternal and child health issues and the local health services. Results Overall, reported health service utilization among study participants was relatively high. However, the mothers identified several individual- and contextual-level factors that may affect their experiences and the health-seeking behaviors of other mothers in their communities: (i) embarrassment, fear, and trust, (ii) insufficient number and poor attitudes of health personnel, (iii) limited supply of basic medicines and materials in the health facility, and (iv) low demand for family planning services and limited awareness of adolescent-specific services. Conclusion Several findings in the current study reflect the reduced conditions of health services, while others display that many mothers maintain a positive outlook on the health services available to them and are proactive in the care of their child. The study provides valuable insight into the use of local health services and the common perspectives that are hindering further uptake at the community level in the Amazon of Peru, with important implications for health policy.


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