scholarly journals Absence of routine medical consultation among hypertensive and/or diabetic elders: an epidemiological study based on the Brazilian National Household Survey 2008

2015 ◽  
Vol 18 (3) ◽  
pp. 578-594 ◽  
Author(s):  
Daniela Nice Ferreira ◽  
Divane Leite Matos ◽  
Antônio Ignácio de Loyola Filho
Keyword(s):  
Insurance Coverage ◽  
Household Survey ◽  
Behavioral Model ◽  
Health Insurance Coverage ◽  
Population Based ◽  
Geographic Region ◽  
Medical Consultation ◽  
International Studies ◽  
Significance Level ◽  
National Household Survey

OBJECTIVE: This exploratory study aimed to investigate the predisposing, enabling and health need characteristics associated with lack of medical visits in the last 12 months, among 23,620 elderly hypertensive and/or diabetic individuals. METHODS: In this research, we used the theoretical behavioral model of Andersen and Newman for use of health services. The data analyzed were produced by the health supplement of the Brazilian National Household Survey (PNAD) 2008, nationwide. To identify the associations, we used the Poisson regression model, which estimates the prevalence ratios and confidence intervals of 95%, considering the significance level of 5%. RESULTS: The results showed that 10.6% of the study population did not consult the doctor in the period considered, and the prevalence was higher among hypertensive subjects (10.5%) than among diabetic ones (7.1%). The lack of medical consultation was negatively associated with female sex and increasing age (predisposing characteristics), with health insurance coverage (enabling characteristic), worse self-rated health, chronic health conditions selected and the presence of hypertension associated with diabetes (health needs), while the fact of living in the Northeast, North and Midwest appeared positively associated with the event under investigation. CONCLUSION: These results corroborate those observed in national and international studies and show evidence of inequality and inequity in the use of medical consultation for this population, based on the findings related to health plan coverage and geographic region.

scholarly journals Measuring the Protective Effect of Health Insurance Coverage on Out-of-Pocket Expenditures During the COVID-19 Pandemic in the Peruvian Population

2021 ◽  
Author(s):  
Akram Hernández-Vásquez ◽  
Carlos Rojas-Roque ◽  
Antonio Barrenechea-Pulache ◽  
Guido Bendezu-Quispe
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Household Survey ◽  
Interrupted Time Series ◽  
Health Insurance Coverage ◽  
Interrupted Time Series Analysis ◽  
Cross Sectional ◽  
Treatment Groups ◽  
Quasi Experimental ◽  
National Household Survey

Background: Health insurance coverage is expected to protect individuals from out-of-pocket (OOP) expenditures, potentially preventing them from falling into poverty. However, to date, the effect of health insurance on OOP spending during the COVID-19 pandemic has not been fully explored. This study aimed to estimate differences in the proportion and the amount of OOP expenditures among Peruvians during the pre- and post-mandatory lockdown response to COVID-19 in 2020 according to the health insurance coverage status. Methods: This study utilized repeated cross-sectional data from the National Household Survey on Living and Poverty Conditions from the first quarter of 2017 until the fourth quarter of 2020. The outcomes were i) the proportion of individuals who incurred OOP expenditures and ii) the monetary value of OOP expenditures. An interrupted time series analysis (ITS) and a quasi-experimental difference-in-difference (DID) analysis were performed to examine the outcomes among the control (individuals without health insurance) and treatment groups (individuals with health insurance) after the COVID-19 pandemic. Results: ITS analysis showed that the proportion of individuals reporting OOP expenditures after implementation of mandatory lockdown due to COVID-19 in Peru decreased in both groups, but no difference in the slope trend was found (p=0.916). The average quarterly amount of OOP spending increased in both groups, but no difference in the slope trend was found (p=0.073). Lastly, the DID analysis showed that the mandatory lockdown was associated with a higher amount of OOP, but there was no evidence to indicate that the higher amount was different between the control and treatment groups. Conclusion: The mandatory lockdown in response to the COVID-19 was associated with a higher amount of OOP expenditures and a lower likelihood of incurring OOP expenditures. However, our findings suggest that health insurance coverage does not lower OOP expenditures or reduce the likelihood of incurring OOP expenditures.

scholarly journals Trends in Glaucoma Medication Expenditures under Universal Health Coverage: A National Population-Based Longitudinal Survey in Taiwan

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Shin-Lin Chiu ◽  
Chiao-Lee Chu ◽  
Chih-Hsin Muo ◽  
Chiu-Liang Chen ◽  
Shou-Jen Lan
Keyword(s):  
High Efficiency ◽  
Low Cost ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Population Based ◽  
Medical Expenditures ◽  
Health Coverage ◽  
Blue Collar Workers ◽  
Universal Health Insurance Coverage ◽  
Universal Health

Medical care in Taiwan is well known for its low cost, high efficiency, high quality, excellent medical accessibility, and high equity. We investigate the trends in medication expenditures for glaucoma from 1997 to 2010. The results show that higher medical expenditures were incurred by patients who were aged ≥40 years, male patients, and patients in the highest salary population whereas lower medical expenditures were incurred by blue-collar workers. The medications with the most significant increases in expenditure were prostaglandin analogs (PGAs),α-agonists, and fixed combinations, whereas the medications with the most significant decreases in expenditure wereβ-blockers and cholinergic agonists. The number of trabeculectomies shows two downward break points in 1999 and 2000 when PGAs were listed and were reimbursed. These results suggest socioeconomic disparities in glaucoma care, as well as understanding of the changes in the expenditure of glaucoma medications under such universal health insurance coverage system.

scholarly journals The hidden harms of using alcohol for pain relief in older adults

2014 ◽  
Vol 26 (11) ◽  
pp. 1929-1930 ◽  
Author(s):  
Kim-Michelle Gilson ◽  
Christina Bryant ◽  
Fiona Judd
Keyword(s):  
Older Adults ◽  
Blood Alcohol Concentration ◽  
Age Groups ◽  
Household Survey ◽  
Population Based ◽  
Alcohol Concentration ◽  
Fatty Tissue ◽  
National Household Survey ◽  
Increased Sensitivity ◽  
Age Range

Estimates from population-based studies indicate that older adults drink more frequently than younger age groups. Data from the 2010 Australian national household survey reported that daily drinking was evident in 13.3% of older adults aged 60–69 years and in 14.8% of older adults aged 70+ years. These findings are compared to daily drinking rates reported by 10.1% of adults aged 50–59 years and 7.5% in the 40–49 years age range (Australian Institute of Health and Welfare, 2011). The study of alcohol consumption in older adults is particularly important because of their increased sensitivity to alcohol-related harms. With age, the body's ability to process alcohol decreases as a result of physiological changes, such as decreases in body mass and higher levels of fatty tissue, leading to a higher blood alcohol concentration for a given dose compared with younger adults (National Institute on Alcohol Abuse and Alcoholism, 1998). This greater vulnerability to the effects of alcohol necessitates a stronger understanding of drinking practices in older adults.

Why Do Hispanics Have So Little Employer-Sponsored Health Insurance?

2007 ◽  
Vol 44 (3) ◽  
pp. 257-279 ◽  
Author(s):  
James D. Reschovsky ◽  
Jack Hadley ◽  
Len Nichols
Keyword(s):  
Human Capital ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Household Survey ◽  
Health Insurance Coverage ◽  
Spanish Speakers ◽  
National Data ◽  
Spanish Speaking ◽  
English Speaking ◽  
Employer Health Insurance

This paper investigates low rates of employer health insurance coverage among Hispanics using national data from the Community Tracking Study Household Survey. Interview language served as a proxy for the degree of assimilation. Findings indicate that English-speaking Hispanics are more similar to whites in their labor market experiences and coverage than they are to Spanish-speaking Hispanics. Spanish-speakers' very low human capital (including their inability to speak English) results in much less access to job-based insurance. Though less important, Spanish-speaking Hispanics' demand for employer-sponsored insurance appears lower than that of English-speaking Hispanics or whites. Results suggest that language and job training may be the most effective way to bolster Hispanics' insurance coverage.

The Incidence of Health Shocks, Formal Health Insurance, and Informal Coping Mechanisms

2016 ◽  
Vol 15 (6) ◽  
pp. 665-695
Author(s):  
Samuel Amponsah
Keyword(s):  
Developing Countries ◽  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Household Survey ◽  
Health Insurance Coverage ◽  
Coping Mechanisms ◽  
Health Shocks ◽  
Economics Of Health ◽  
The Impact

In recent years, both theoretical and empirical research has accumulated in development economics literature regarding household behavior in response to shocks in developing countries. The literature especially has explored deeply the impact of weather-related shocks—such as droughts and floods—and the efficiency of informal mechanisms to cope with these shocks. In sharp contrast, our knowledge on the economics of health shocks in low-income developing countries is rather limited. A few studies have documented that low incomes and poor health insurance coverage account for catastrophic medical expenditures in the event of a health shock. This study uses a combination of Ghanaian household survey datasets to examine the different coping mechanisms employed by uninsured households to protect themselves from the incidence of health shocks. In addition, it explores the impact of formal health insurance (the National Health Insurance Scheme) on households’ out-of-pocket spending and catastrophic health expenditures.

Lack of Community Insurance and Mammography Screening Rates Among Insured and Uninsured Women

2008 ◽  
Vol 26 (11) ◽  
pp. 1865-1870 ◽  
Author(s):  
José A. Pagán ◽  
David A. Asch ◽  
Cynthia J. Brown ◽  
Carmen E. Guerra ◽  
Katrina Armstrong
Keyword(s):  
Health Insurance ◽  
Mammography Screening ◽  
Negative Impact ◽  
Insurance Coverage ◽  
Local Population ◽  
Household Survey ◽  
Health Insurance Coverage ◽  
Health Insurance Status ◽  
The Past ◽  
Individual Health

Purpose To evaluate whether the proportion of the local population without health insurance coverage is related to whether women undergo mammography screening. Methods Survey data on 12,595 women 40 to 69 years of age from the 2000 to 2001 Community Tracking Study Household Survey were used to analyze the relation between community lack of insurance and whether the respondent had a mammogram within the past year. Results Women age 40 to 69 were less likely to report that they had a mammogram within the last year if they resided in communities with a relatively high uninsurance rate, even after adjusting for other factors. After adjusting for individual insurance and other factors, a 10-percentage-point decrease in the proportion of the local insured population is associated with a 17% (95% CI, 13% to 21%) decrease in the odds that a woman age 40 to 69 years will undergo mammography screening within a year. Conclusion Women living in communities with high uninsurance are substantially less likely to undergo mammography screening. These results are consistent with the view that the negative impact of uninsurance extends to everyone in the community regardless of individual health insurance status.

scholarly journals Prevalence of Self-Reported Chronic Diseases and Health Services Utilization by Ethnic Minorities in Manaus Metropolitan Region

2018 ◽  
Vol 28 (1) ◽  
pp. 49 ◽  
Author(s):  
Raquel Rodrigues Ferreira Rocha de Alencar ◽  
Tais Freire Galvao ◽  
Bruno Vianei Real Antonio ◽  
Marcus Tolentino Silva
Keyword(s):  
Health Insurance ◽  
Chronic Diseases ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Population Based ◽  
Metropolitan Region ◽  
Care Utilization ◽  
Cross Sectional ◽  
Probabilistic Sampling ◽  
Significant Difference

<p class="Pa8"><strong>Objectives: </strong>To assess the prevalence of, and associated factors to, self-reported chronic diseases and health care utilization by eth­nicity in the Manaus Metropolitan Region.</p><p class="Pa8"><strong>Methods: </strong>We conducted a cross-sectional, population-based survey from May through August 2015. Using probabilistic sampling in three stages, we recruited adults aged ≥18 years. Ethnicity was self-identified as White, Black, Yellow, Brown (Brazilian mixed-race), and Indigenous. We calculated adjusted prevalence ratios (PR) and 95% CI of chronic diseases and health service utiliza­tion for each ethnic minority and compared the data using Poisson regression with data from White respondents.</p><p class="Pa8"><strong>Results: </strong>In this study, we interviewed 4,001 people. Of these, 15.9% were White, 7.5% Black, 3.4% Yellow, 72.1% Brown, and 1.0% Indigenous. Indigenous respondents had the highest prevalence of self-reported hypertension (29.4%), diabetes (12.3%) and hypercholesterolemia (17.0%) among the ethnic respondent groups. Compared with the White population, Browns had less health insurance coverage (PR=.76; 95% CI: .62-.93) and reported hypertension (PR=.84; 95% CI: .72-0.98) and diabetes (PR=.69; 95% CI: .51-.94) less frequently. Yellows visited the doctor more frequently than Whites (PR=1.13; 95% CI: 1.04-1.22), with no significant difference in prevalence of diseases.</p><p class="Default"><strong>Conclusions: </strong>Indigenous respondents had higher prevalence rates of the investigated diseases. Compared with Whites, Brown respondents had lower rates of self-reported arterial hypertension and diabetes, as well as lower rates of private health insurance coverage.</p><p class="Default"><em>Ethn Dis. </em>2018;28(1):49-54; doi:10.18865/ed.28.1.49</p>

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