scholarly journals ASSESSMENT OF HEALTH INEQUALITIES AMONG OLDER PEOPLE USING THE EPICES SCORE: A COMPOSITE INDEX OF SOCIAL DEPRIVATION

2016 ◽  
pp. 1-6
Author(s):  
B. BONGUE ◽  
A. COLVEZ ◽  
E. AMSALLEM ◽  
L. GERBAUD ◽  
C. SASS
Keyword(s):  
Health Care ◽  
Older People ◽  
Cognitive Decline ◽  
Health Inequalities ◽  
Social Deprivation ◽  
Composite Index ◽  
Health Indicators ◽  
Health Care Use ◽  
Assistive Device ◽  
Health Examination

Background: Most of the indicators commonly used to assess social deprivation are poorly suited to study health inequalities in older people. The EPICES (Evaluation of Deprivation and Inequalities in Health Examination Centres) score is a new composite index commonly used to measure individual deprivation. Objective: To assess the relationships between health indicators and the EPICES score in older people. Design, Setting, and participants: We performed a cross-sectional study using the data from the 2008 ESPS Survey (Health, HealthCare and Insurance Survey). Of the 4235 survey respondents aged 60 and over in 2008, 2754 completed the 11 items of the EPICES score and were included in the study. Main outcomes and measures: Deprivation was measured using the EPICES score. Health indicators were: Disability, physical performance, cognitive decline, self-perceived health status, and health-care use and participation in prevention programs (missing teeth not replaced, healthcare renunciation, no hemoccult test [60-75 years] and no mammography [60-75 years]). Results: Of the 4235 survey respondents aged 60 and over in 2008, 2754 completed the 11 items of the EPICES score and were included in the study. The mean age was 70.5± 8.2 years. 52.8% were women. 25.8% were living in poor households. According to the EPICES score, 35.1% were deprived. The EPICES score is linked to all the health indicators assessed in this study: Physical disability, cognitive decline; lifestyle and health care accessibility. These relationships increase steadily with the level of social deprivation. For example, the risk of having difficulties in walking 500m without help or an assistive device is multiplied by 13 (RR=13.5 [7.9-20.8]) in the elderly of quintile 5 (maximum precariousness). Limitations: The observational nature limits inferences about causality. Conclusion: The EPICES score is linked to health indicators. It could be a useful instrument to assess health inequalities in older people living in the community.

scholarly journals Prevalence and Patterns of Health Care Use Among Poor Older People Under the Livelihood Empowerment Against Poverty Program in the Atwima Nwabiagya District of Ghana

2019 ◽  
Vol 5 ◽  
pp. 233372141985545 ◽  
Author(s):  
Williams Agyemang-Duah ◽  
Charles Peprah ◽  
Francis Arthur-Holmes
Keyword(s):  
Health Care ◽  
Health Services ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Expenditure ◽  
Well Being ◽  
Health Care Use ◽  
Public Health Care ◽  
Care Providers ◽  
Health Lifestyle

In spite of the growing literature on prevalence and patterns of health care use in later life globally, studies have generally overlooked subjective standpoints of vulnerable Ghanaian older people obstructing the achievement of the United Nations’ health-related Sustainable Development Goals. We examined the prevalence and patterns of health care use among poor older people in the Atwima Nwabiagya District of Ghana. Cross-sectional data were obtained from an Aging, Health, Lifestyle and Health Services Survey conducted between June 1 and 20, 2018 ( N = 200). Chi-square and Fisher’s exact tests were carried out to estimate the differences between gender and health care utilization with significant level of less than or equal to 0.05. Whereas, 85% of the respondents utilized health care, females were higher utilizers (88% vs. 75%) but males significantly incurred higher health care expenditure. The majority utilized health services on monthly basis (38%) and consulted public health care providers (77%). While 68% utilized services from hospitals, most sourced health information from family members (54%) and financed their health care through personal income (45%). The study found that the Livelihood Empowerment Against Poverty grant played a little role in reducing health poverty. Stakeholders should review social programs that target poor older people in order to improve their well-being and utilization of health care.

Telephone communication between practice nurses and older patients with long term conditions – a systematic review

2016 ◽  
Vol 23 (1) ◽  
pp. 142-148 ◽  
Author(s):  
Deborah Raphael ◽  
Susan Waterworth ◽  
Merryn Gott
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Older People ◽  
Older Patients ◽  
Health Indicators ◽  
Long Term Conditions ◽  
Telephone Communication ◽  
Practice Nurses ◽  
Primary Health

Background and aims Long term conditions are a significant health problem faced by older people worldwide. Telephone communication is often used to deliver health care to patients and is an important tool in improving access to care. Previous research has shown that primary health care nurses communicate with patients by telephone, but little is known about the way in which telephone communication can be used to benefit older patients with long term conditions. The aims of this review were to identify the range and scope of telephone use between practice nurses working in primary health care and older people with long term conditions, explore which elements of this communication has been successful, and determine whether older people see telephone communication as useful for their needs. Methods A systematic search of the literature was conducted through CINAHL, Medline, Web of Science and EMBASE between July and August 2015. Included were English language articles containing older adults, primary care nurses and both qualitative and quantitative designs. Results Five studies met the inclusion criteria. All were intervention studies, and none looked at routine telephone communication between nurse and patient. Most studies showed that telephone based interventions were successful in improving pre-determined disease-specific health indicators. Conclusions All telephone communication interventions in this review focused on a specific long term condition, which they aimed to help patients self-manage. While all studies' samples included older patients, they did not consider them separately in relation to the effectiveness of the intervention. What was also lacking was the patient perspective regarding effectiveness in all but one study.

scholarly journals Hypoglycaemia in older home-dwelling people with diabetes- a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Monica Hermann ◽  
Lovise S. Heimro ◽  
Anne Haugstvedt ◽  
Ingvild Hernar ◽  
Arun K. Sigurdardottir ◽  
...  
Keyword(s):  
Health Care ◽  
Older People ◽  
Scoping Review ◽  
Emergency Situation ◽  
Developed Countries ◽  
Health Care Use ◽  
Original Research ◽  
Diabetes Knowledge ◽  
Older Individuals ◽  
Scoping Reviews

Abstract Background Hypoglycaemia is associated with cognitive and functional decline in older people with diabetes. Identification of individuals at risk and prevention of hypoglycaemia is therefore an important task in the management of diabetes in older home-dwelling individuals. The purpose of this scoping review was to map the literature on hypoglycaemia in home-dwelling older people with diabetes. Methods This scoping review included original research articles on hypoglycaemia in older (≥ 65 years) individuals with diabetes from developed countries. A broad search of the databases Cinahl, Embase and Medline was performed in July 2018. The report of the scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews. Results Our database search identified 577 articles of which 23 were eligible for inclusion. The identified literature was within four areas: 1) incidence of hypoglycaemia in older home-dwelling people with diabetes (11/23 articles), 2) risk factors of hypoglycaemia (9/23), 3) diabetes knowledge and self-management (6/23) and 4) consequences of hypoglycaemia for health care use (6/23). The majority of the literature focused on severe hypoglycaemia and the emergency situation. The literature on diabetes knowledge and management related to preventing adverse events relevant to older home-dwellers, was limited. We found no literature on long-term consequences of hypoglycaemia for the use of home health care services and the older persons’ ability to remain home-dwelling. Conclusions We identified a lack of studies on prevention and management of hypoglycaemia in the older individuals’ homes. Such knowledge is of utmost importance in the current situation where most western countries’ governmental policies aim to treat and manage complex health conditions in the patient’s home. Future studies addressing hypoglycaemia in older individuals with diabetes are needed in order to tailor interventions aiming to enable them to remain home-dwelling as long as possible.

Evolution of inequalities in health care use among older people in brazil: evidence for the period 1998-2019

2021 ◽  
pp. 100347
Author(s):  
Anderson Moreira Aristides dos Santos ◽  
Lívia Madeira Triaca ◽  
Cesar Augusto Oviedo Tejada
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Use ◽  
Inequalities In Health

scholarly journals Equity in health care use among older people in the UK: an analysis of panel data

2011 ◽  
Vol 43 (18) ◽  
pp. 2229-2239 ◽  
Author(s):  
Sara Allin ◽  
Cristina Masseria ◽  
Elias Mossialos
Keyword(s):  
Health Care ◽  
Panel Data ◽  
Older People ◽  
Health Care Use ◽  
Equity In Health ◽  
The Uk ◽  
Equity In Health Care

scholarly journals Cognitive performance of older adults with a low level of education with and without depression

2021 ◽  
Vol 15 (1) ◽  
pp. 121-127
Author(s):  
Ana Julia de Lima Bomfim ◽  
Natália Mota de Souza Chagas ◽  
Lívio Rodrigues Leal ◽  
Rebeca Mendes de Paula Pessoa ◽  
Bianca Letícia Cavalmoretti Ferreira ◽  
...  
Keyword(s):  
Older Adults ◽  
Major Depression ◽  
Older People ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Community Dwelling ◽  
Assessment Tools ◽  
Health Examination ◽  
Low Level ◽  
Community Dwelling Older Adults

ABSTRACT. Major depression can develop in individuals aged 60 years or older and is commonly associated with cognitive decline in this population, especially the domains of working memory, attention, executive functions, and processing speed. Schooling is a protective factor with regard to cognitive decline. Objective: To compare the cognitive performance of community-dwelling older adults with a low level of schooling with and without major depression. Methods: A descriptive, analytical, cross-sectional study was conducted with 22 community-dwelling older adults with depression and 187 without depression. The following assessment tools were employed: Mini Mental Health Examination, Brief Cognitive Screening Battery, Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), Digit Span Test (forward and backward), and an object similarity test. Results: No statistically significant differences were found between the groups with and without depression on any of the tests. Conclusions: This study demonstrated that there are no differences in the cognitive performance of older people with and without depression on neurocognitive tests commonly used in clinical practice. Future studies with different designs and methods as well as specific tests for older people with a low level of schooling could assist in the understanding of these relations and the mechanisms involved.

scholarly journals Parental income gradients in adult health: a national cohort study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Miriam Evensen ◽  
Søren Toksvig Klitkou ◽  
Mette C. Tollånes ◽  
Simon Øverland ◽  
Torkild Hovde Lyngstad ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Income Distribution ◽  
Health Inequalities ◽  
Access To Health Care ◽  
Parental Education ◽  
Universal Access ◽  
Health Care Use ◽  
Parental Income ◽  
Primary Health

Abstract Background Disparities in health by adult income are well documented, but we know less about the childhood origins of health inequalities, and it remains unclear how the shape of the gradient varies across health conditions. This study examined the association between parental income in childhood and several measures of morbidity in adulthood. Methods We used administrative data on seven complete Norwegian birth cohorts born in 1967–1973 (N = 429,886) to estimate the association between parental income from birth to age 18, obtained from tax records available from 1967, linked with administrative registries on health. Health measures, observed between ages 39 and 43, were taken from registry data on consultations at primary health care services based on diagnostic codes from the International Classification of Primary Care (ICPC-2) and hospitalizations and outpatient specialist consultations registered in the National Patient Registry (ICD-10). Results Low parental income during childhood was associated with a higher risk of being diagnosed with several chronic and pain-related disorders, as well as hospitalization, but not overall primary health care use. Absolute differences were largest for disorders related to musculoskeletal pain, injuries, and depression (7–9 percentage point difference). There were also differences for chronic disorders such as hypertension (8%, CI 7.9–8.5 versus 4%, CI 4.1–4.7) and diabetes (3.2%, CI 3.0–3.4 versus 1.4%, CI 1.2–1.6). There was no difference in consultations related to respiratory disorders (20.9%, CI 20.4–21.5 versus 19.7%, CI 19.2–20.3). Childhood characteristics (parental education, low birth weight, and parental marital status) and own adult characteristics (education and income) explained a large share of the association. Conclusions Children growing up at the bottom of the parental income distribution, compared to children in the top of the income distribution, had a two- to threefold increase in somatic and psychological disorders measured in adulthood. This shows that health inequalities by socioeconomic family background persist in a Scandinavian welfare-state context with universal access to health care.

scholarly journals Association of Low-Value Testing With Subsequent Health Care Use and Clinical Outcomes Among Low-risk Primary Care Outpatients Undergoing an Annual Health Examination

2020 ◽  
Vol 180 (7) ◽  
pp. 973 ◽  
Author(s):  
Zachary Bouck ◽  
Andrew J. Calzavara ◽  
Noah M. Ivers ◽  
Eve A. Kerr ◽  
Cherry Chu ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Clinical Outcomes ◽  
Health Care Use ◽  
Low Risk ◽  
Health Examination

scholarly journals Sleep in the Aging Brain

2021 ◽  
Vol 11 (2) ◽  
pp. 229
Author(s):  
Maurizio Gorgoni ◽  
Luigi De Gennaro
Keyword(s):  
Health Care ◽  
Older People ◽  
Cognitive Decline ◽  
Aging Process ◽  
Relative Number ◽  
Present Knowledge ◽  
Aging Brain ◽  
Special Issue ◽  
Main Factors ◽  
Sleep Alterations

We have entered an era of a steep increase in the absolute and relative number of older people. This well-come phenomenon represents a major challenge for health care. However, maturational changes in sleep associated with aging do not easily appear as main factors, even though sleep alterations in the aging process lead to many detrimental consequences. In this editorial paper, we summarize the present knowledge about the main aging-related sleep modifications and their relevance for health problems and cognitive decline. Then, we present the papers published in the Special Issue “Disturbances of Sleep Among Older People”.

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