Family-Rated Pediatric Health Status Is Associated With Unplanned Health Services Use

2021 ◽  
Author(s):  
Brian J. Steele ◽  
Kyle Kemp ◽  
Paul Fairie ◽  
Maria J. Santana
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Health Status ◽  
Health Services ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Health Services Use ◽  
Pediatric Health ◽  
Services Use

OBJECTIVE: Self-rated health is a common self-reported health measure associated with morbidity, mortality, and health care use. The objective was to investigate the association of family-rated health status (FRH) in pediatric care with administrative indicators, patient and respondent features, and unplanned health services use. PATIENTS AND METHODS: Data were taken from Child-Hospital Consumer Assessment of Healthcare Providers and Systems surveys collected between 2015 and 2019 in Alberta, Canada and linked with administrative health records. Three analyses were performed: correlation to assess association between administrative indicators of health status and FRH, logistic regression to assess respondent and patient characteristics associated with FRH, and automated logistic regression to assess the association between FRH and unplanned health services use within 90 days of discharge. RESULTS: A total of 6236 linked surveys were analyzed. FRH had small but significant associations with administrative indicators. Models of FRH had better fit with patient and respondent features. Respondent relationship to child, child age, previous hospitalizations, and number of comorbidities were significantly associated with ratings of FRH. Automated models of unplanned services use included FRH as a feature, and poor ratings of health were associated with increased odds of emergency department visits (adjusted odds ratio: 2.15, 95% confidence interval: 1.62–2.85) and readmission (adjusted odds ratio: 2.48, 95% confidence interval: 1.62–2.85). CONCLUSION: FRH is a simple, single-item global rating of health for pediatric populations that provides accessible and useful information about pediatric health care needs. The results of this article serve as a reminder that family members are valuable sources of information that can improve care and potentially prevent unplanned health services use.

scholarly journals Health Services Use and Health Outcomes among Informal Economy Workers Compared with Formal Economy Workers: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (6) ◽  
pp. 3189
Author(s):  
Nisha Naicker ◽  
Frank Pega ◽  
David Rees ◽  
Spo Kgalamono ◽  
Tanusha Singh
Keyword(s):  
Occupational Health ◽  
Health Services ◽  
Informal Economy ◽  
Odds Ratio ◽  
Health Services Use ◽  
Quality Of Evidence ◽  
Formal Economy ◽  
Relative Differences ◽  
Services Use

Background: There are approximately two billion workers in the informal economy globally. Compared to workers in the formal economy, these workers are often marginalised with minimal or no benefits from occupational health and safety regulations, labour laws, social protection and/or health care. Thus, informal economy workers may have higher occupational health risks compared to their formal counterparts. Our objective was to systematically review and meta-analyse evidence on relative differences (or inequalities) in health services use and health outcomes among informal economy workers, compared with formal economy workers. Methods: We searched PubMed and EMBASE in March 2020 for studies published in 1999–2020. The eligible population was informal economy workers. The comparator was formal economy workers. The eligible outcomes were general and occupational health services use, fatal and non-fatal occupational injuries, HIV, tuberculosis, musculoskeletal disorders, depression, noise-induced hearing loss and respiratory infections. Two authors independently screened records, extracted data, assessed risk of bias with RoB-SPEO, and assessed quality of evidence with GRADE. Inverse variance meta-analyses were conducted with random effects. Results: Twelve studies with 1,637,297 participants from seven countries in four WHO regions (Africa, Americas, Eastern Mediterranean and Western Pacific) were included. Compared with formal economy workers, informal economy workers were found to be less likely to use any health services (odds ratio 0.89, 95% confidence interval 0.85–0.94, four studies, 195,667 participants, I2 89%, low quality of evidence) and more likely to have depression (odds ratio 5.02, 95% confidence interval 2.72–9.27, three studies, 26,260 participants, I2 87%, low quality of evidence). We are very uncertain about the other outcomes (very-low quality of evidence). Conclusion: Informal economy workers may be less likely than formal economy workers to use any health services and more likely to have depression. The evidence is uncertain for relative differences in the other eligible outcomes. Further research is warranted to strengthen the current body of evidence and needed to improve population health and reduce health inequalities among workers.

scholarly journals Health Services Use and Health Care Costs of Obese and Nonobese Individuals

2004 ◽  
Vol 164 (19) ◽  
pp. 2135 ◽  
Author(s):  
Marsha A. Raebel ◽  
Daniel C. Malone ◽  
Douglas A. Conner ◽  
Stanley Xu ◽  
Julie A. Porter ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Costs ◽  
Health Services Use ◽  
Care Costs ◽  
Services Use

Filters on the pathway to mental health care, II. Sociodemographic factors

1995 ◽  
Vol 25 (6) ◽  
pp. 1149-1160 ◽  
Author(s):  
J. J. Gallo ◽  
S. Marino ◽  
D. Ford ◽  
J. C. Anthony
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Disorder ◽  
The United States ◽  
Sociodemographic Characteristics ◽  
Health Services Use ◽  
Relative Odds ◽  
Services Use

SynopsisThis study uses the prospectively gathered data of the Epidemiologic Catchment Area Program, a multi-site interview survey of mental disturbances among adult household residents in the United States, to compare health services use by individuals with different sociodemographic characteristics, accounting for the first-time occurrence of psychiatric disorder, over the course of a 1-year follow-up interval. Case ascertainment was by means of a standardized interview method, the Diagnostic Interview Schedule. In the present investigation, 13400 continuing participants in the household sample who reported no contact with mental health services in the 6 months prior to the initial interview were studied with regard to health services use and sociodemographic characteristics. Separately, and before the mental health assessments were made, respondents were asked about their use of health and mental health services. African-Americans were significantly less likely than whites to have consulted with a specialist in mental health (estimated relative odds, 0·22, 95% confidence interval 0·10 to 0·52), even accounting for coincident psychiatric disorder, gender, and other covariates known to be associated with differential use of health care services. Hispanics and other minorities were also less likely to have consulted a specialist in mental health (estimated relative odds, 0·37 and 0·26, respectively). This large community study extends previous work on mental health services and ethnicity.

scholarly journals Knowledge of preconception care and associated factors among maternal health care providers working in urban public health institutions of Eastern Ethiopia

2021 ◽  
Vol 17 ◽  
pp. 174550652110461
Author(s):  
Seboka Abebe Sori ◽  
Kedir Teji Roba ◽  
Tesfaye Assebe Yadeta ◽  
Hirut Dinku Jiru ◽  
Keyredin Nuriye Metebo ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Confidence Interval ◽  
Health Care Providers ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Preconception Care ◽  
Maternal Health Care ◽  
Good Knowledge ◽  
Care Providers

Background: Provision of preconception care is significantly affected by the health care provider’s knowledge of preconception care. In Ethiopia, preconception care is rare, if even available, as part of maternal health care services. Thus, this study aimed to determine the level of knowledge of preconception care and associated factors among health care providers working in public health facilities in Eastern Ethiopia. Methods: A multicenter cross-sectional study was conducted from 1 March to 1 April 2020. A simple random sampling technique was used to select a total of 415 maternal health care providers. We utilized a structured, pretested, and self-administered questionnaire to collect data. Data were entered into EpiData (version 3.1) and exported to STATA (version 16) for analysis. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. All covariates with a p value ⩽0.20 in bivariate logistic regression were entered into a multivariate logistic regression analysis to control the confounding variables; variables with a p value <0.05 were considered statistically significant. Results: Out of 410 respondents, 247 (60.2%; 95% confidence interval: 55.4–65.1) had good knowledge of preconception care. Having an educational level of Bachelor of Science degree and above (adjusted odds ratio: 6.97, 95% confidence interval: 3.85–12.60), 5 or more years work experience (adjusted odds ratio: 2.60, 95% confidence interval: 1.52–4.49), working in a hospital (adjusted odds ratio: 2.50, 95% confidence interval: 1.25–4.99), reading preconception care guidelines (adjusted odds ratio: 3.06, 95% confidence interval: 1.40–6.68), and training on preconception (adjusted odds ratio: 2.90, 95% confidence interval: 1.37–6.15) were significantly associated with good knowledge of preconception care. Conclusions and Recommendations: Three out of five maternal health care providers in this study had good knowledge of preconception care. Facilitating continuous refreshment training and continuous professional development for health workers, preparing comprehensive preconception care guidelines for health institutions, and reading preconception care guidelines were highly recommended.

Ethnic Disparities in the Use of Nicotine Replacement Therapy for Smoking Cessation in an Equal Access Health Care System

2005 ◽  
Vol 20 (2) ◽  
pp. 108-116 ◽  
Author(s):  
Steven S. Fu ◽  
Scott E. Sherman ◽  
Elizabeth M. Yano ◽  
Michelle van Ryn ◽  
Andy B. Lanto ◽  
...  
Keyword(s):  
Health Care ◽  
African American ◽  
Confidence Interval ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Health Care System ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Equal Access ◽  
Quit Attempt

Purpose. To examine ethnic variations in the use of nicotine replacement therapy (NRT) in an equal access health care system. Design. Cross-sectional survey. Setting. Eighteen Veterans Affairs medical and ambulatory care centers. Subjects. A cohort of male current smokers (n = 1606). Measures. Use of NRT (nicotine patch or nicotine gum), ethnicity, sociodemographics, health status, smoking-related history, and facility prescribing policy. Results. Overall, only 34% of African-American and 26% of Hispanic smokers have ever used NRT as a cessation aid compared with 50% of white smokers. In the past year, African-American smokers were most likely to have attempted quitting. During a serious past-year quit attempt, however, African-American and Hispanic smokers reported lower rates of NRT use than white smokers (20% vs. 22% vs. 34%, respectively, p = .001). In multivariate analyses, ethnicity was independently associated with NRT use during a past-year quit attempt. Compared with white smokers, African-American (adjusted odds ratio, .53; 95% confidence interval, .34–.83) and Hispanic (adjusted odds ratio, .55; 95% confidence interval, .28–1.08) smokers were less likely to use NRT. Conclusions. Assessment of variations in use of NRT demonstrates that African-American and Hispanic smokers are less likely to use NRT during quit attempts. Future research is needed on the relative contributions of patient, physician, and system features to gaps in guideline implementation to provide treatment for ethnic minority smokers.

Health professionals’ attitude and associated factors toward cytotoxic drug handling in University of Gondar specialized hospital: Institution-based cross-sectional study

2021 ◽  
pp. 107815522110404
Author(s):  
Wudneh Simegn ◽  
Baye Dagnew ◽  
Henok Dagne ◽  
Berhanemeskel Weldegerima
Keyword(s):  
Health Care ◽  
Confidence Interval ◽  
Health Professionals ◽  
Work Experience ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Cytotoxic Drug ◽  
Cytotoxic Drugs ◽  
Cross Sectional ◽  
Drug Handling

Background Studies have shown that cytotoxic drugs are dangerous to health care workers. Health care professionals’ attitude to cytotoxic drugs is vital to apply safety protocols in the prevention of cytotoxicity. The current study aimed to assess health professionals’ desirable attitude and associated factors toward cytotoxic drugs handling in the University of Gondar Specialized Hospital. Methods An institution-based cross-sectional study was conducted on 412 health professionals from June to August 2019. Simple random sampling was used to select participants and a self-administered questionnaire was used to collect data. Epi Info and SPSS 20 were used for data entry and analysis, respectively. Variables with a p value < 0.05 were declared as determinants. Results The number of health professionals included was approximately 412. The mean age of participants was 29.9 ± 5.4 years. The proportion of participants with desirable attitude toward cytotoxic drugs handling was 224 (54.4%) (95% confidence interval: 51.95–56.85). Male (adjusted odds ratio = 1.69, 95% confidence interval:[1.08–2.65]), work experience of 5–8 years (adjusted odds ratio = 1.92, 95% confidence interval: [1.10–3.34]), weekly working hours of 44–55 (adjusted odds ratio = 2.25, 95% confidence interval: [1.02–4.96]), medium work stress (adjusted odds ratio = 1.67, 95% confidence interval: [1.01–2.69]), and good practice of cytotoxic drug handling (adjusted odds ratio = 1.67, 95% confidence interval: [1.04–2.67]) were significantly associated with the attitude of health professionals. Conclusion A significant proportion of health care workers did not have desirable attitude to handle cytotoxic drugs. Thus, strategies are suggested to improve the positive attitude of health professionals to cytotoxic drug handling. Female health professionals, those who had work experience of less than 2 years and those with higher work stress demand special attention.

scholarly journals Dementia is Associated With Poorer Quality of Care and Outcomes After Stroke: An Observational Study

2020 ◽  
Author(s):  
Michele L Callisaya ◽  
Tara Purvis ◽  
Katherine Lawler ◽  
Amy Brodtmann ◽  
Dominique A Cadilhac ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Quality Of Care ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Processes Of Care ◽  
Pooled Data ◽  
People With Dementia ◽  
Assess Quality

Abstract Background To determine whether preexisting dementia is associated with poorer quality of care and outcomes after stroke in the acute hospital phase. Method This was a retrospective analysis of pooled data from the Australian Stroke Foundation national audit conducted in 2015 and 2017. Dementia status was obtained from the medical records. Processes of care to assess quality included: stroke unit care, time-dependent therapy, nursing/allied health assessments, and preparation for discharge. Outcomes included in-hospital complications, independence on discharge, and destination. Logistic regression was used to examine associations between dementia status and processes of care. Multilevel random effects logistic regression, with level defined as hospital, was used to examine associations between dementia status and outcomes. Results There were 683/7,070 (9.7%) audited patients with dementia included. Patients with dementia were less likely to be treated in stroke units (58.3% vs 70.6%), receive thrombolysis if an ischemic stroke (5.8% vs 11.1%), have access within 48 hours to physiotherapy (56.4% vs 69.7%) or occupational therapy (46.8% vs 55.6%), see a dietitian if problems with nutrition (64.4% vs 75.9%), or have mood assessed (2.6% vs 12.3%). Patients with dementia were more likely to receive no rehabilitation (adjusted odds ratio 1.88, 95% confidence interval 1.25, 2.83) and be discharged to residential care (adjusted odds ratio 2.36, 95% confidence interval 1.50, 3.72). Conclusion People with dementia received poorer quality of care and had worse outcomes after stroke. Our findings raise questions regarding equity and the need for better understanding of why the quality of care differs after stroke for people with dementia.

scholarly journals The Mobile Health Readiness of People Receiving In-Center Hemodialysis and Home Dialysis

2020 ◽  
Vol 16 (1) ◽  
pp. 98-106 ◽  
Author(s):  
Wael F. Hussein ◽  
Paul N. Bennett ◽  
Sloane Pace ◽  
Shijie Chen ◽  
Veronica Legg ◽  
...  
Keyword(s):  
High School ◽  
Health Care ◽  
Confidence Interval ◽  
Mobile Health ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
College Education ◽  
The Internet ◽  
Successful Implementation ◽  
Home Dialysis

Background and objectivesMobile health is the health care use of mobile devices, such as smartphones. Mobile health readiness is a prerequisite to successful implementation of mobile health programs. The aim of this study was to examine the status and correlates of mobile health readiness among individuals on dialysis.Design, setting, participants, & measurementsA cross-sectional 30-item questionnaire guided by the Khatun mobile health readiness conceptual model was distributed to individuals on dialysis from 21 in-center hemodialysis facilities and 14 home dialysis centers. The survey assessed the availability of devices and the internet, proficiency, and interest in using mobile health.ResultsIn total, 949 patients (632 hemodialysis and 317 home dialysis) completed the survey. Of those, 81% owned smartphones or other internet-capable devices, and 72% reported using the internet. The majority (70%) reported intermediate or advanced mobile health proficiency. The main reasons for using mobile health were appointments (56%), communication with health care personnel (56%), and laboratory results (55%). The main reported concerns with mobile health were privacy and security (18%). Mobile health proficiency was lower in older patients: compared with the 45- to 60-years group, respondents in age groups <45, 61–70, and >70 years had adjusted odds ratios of 5.04 (95% confidence interval, 2.23 to 11.38), 0.39 (95% confidence interval, 0.24 to 0.62), and 0.22 (95% confidence interval, 0.14 to 0.35), respectively. Proficiency was lower in participants with Hispanic/Latinx ethnicity (adjusted odds ratio, 0.49; 95% confidence interval, 0.31 to 0.75) and with less than college education (adjusted odds ratio for “below high school,” 0.09; 95% confidence interval, 0.05 to 0.16 and adjusted odds ratio for “high school only,” 0.26; 95% confidence interval, 0.18 to 0.39). Employment was associated with higher proficiency (adjusted odds ratio, 2.26; 95% confidence interval, 1.18 to 4.32). Although home dialysis was associated with higher proficiency in the unadjusted analyses, we did not observe this association after adjustment for other factors.ConclusionsThe majority of patients on dialysis surveyed were ready for, and proficient in, mobile health.Clinical Trial registry name and registration number: Dialysis mHealth Survey,NCT04177277

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