The Bambuí Health and Aging Study (BHAS): private health plan and medical care utilization by older adults

The aim of this cross sectional study was to investigate whether holding a private health plan affects the consumption of medical services (hospitalization and visits to a doctor) and use of medications by older adults. All residents in Bambuí town (Minas Gerais, Brazil) aged > or = 60 years (n = 1,742) were selected. From these, 92.2% were interviewed and 85.9% were examined (blood tests and physical measurements). After adjustments for counfounders, those under exclusive public coverage (n = 1,296), compared with those holding a private health plan (n = 310), presented some evidence of having worse health status, reported less visits to a doctor, and used a small number of prescribed medications. The main explanation for the aged holding a private health plan was economic, not health. Even though those who had only public health coverage complained more in relation to medical care (70.9%), an important proportion of the aged with a private health care plan presented some kind of complaint (45.2%). Another worrying factor was the difficulty to acquire medication because of financial problems (47.2 and 25.2% reported, respectively). Further investigations are needed to verify whether our results can be generalized to other communities of the country.

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Impact of Depression on Health and Medical Care Utilization and Expenses in US Adults With Migraine: A Retrospective Cross Sectional Study

Headache The Journal of Head and Face Pain ◽

10.1111/head.12871 ◽

2016 ◽

Vol 56 (7) ◽

pp. 1147-1160 ◽

Cited By ~ 12

Author(s):

Jun Wu ◽

Mary L. Davis-Ajami ◽

Zhiqiang Kevin Lu

Keyword(s):

Medical Care ◽

Cross Sectional Study ◽

Care Utilization ◽

Sectional Study ◽

Cross Sectional ◽

Medical Care Utilization

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Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults

Nutrients ◽

10.3390/nu12082407 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2407

Author(s):

Konstantinos Gkiouras ◽

Stavros Cheristanidis ◽

Theopoula D. Papailia ◽

Maria G. Grammatikopoulou ◽

Nikolaos Karamitsios ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Food Insecurity ◽

Assessment Tool ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Cross Sectional Study ◽

Care Utilization ◽

Double Burden ◽

Cross Sectional

Although food insecurity has been associated with a disadvantageous socioeconomic status, especially in older adults, its association with comorbidities is less clear. The scope of the present cross-sectional study was to assess the prevalence of food insecurity among older adults and evaluate the association between food insecurity, malnutrition, chronic disease, multimorbidity and healthcare utilization. A total of 121 older adults (mean (standard deviation) age: 72.6 (8.1)) were recruited from a Primary Care Health Center from 10 August 2019 to 10 September 2019. Food insecurity and malnutrition status were assessed by the Household Food Insecurity Access Scale and Mini Nutritional Assessment tool, respectively. Recorded variables included financial, family data and comorbidities. The prevalence of food insecurity in the sample reached 50.4%, with men and older adults malnourished or at risk for malnutrition, exhibiting high risk for food insecurity. Multimorbidity, frequency of health care utilization and medication adherence were not associated with food insecurity, possibly due to the free health services and remunerated medications offered by the Greek government. However, male gender and malnutrition risk were significant predictors of food insecurity in the multiple logistic analyses. This study highlights the need for mainstreaming food insecurity assessment among older adults with comorbidities, especially those at risk for malnutrition.

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Accelerometer-Measured Physical Activity and Sedentary Behavior: A Cross-Sectional Study of Brazilian Older Adults

Journal of Physical Activity and Health ◽

10.1123/jpah.2017-0456 ◽

2018 ◽

Vol 15 (11) ◽

pp. 811-818 ◽

Cited By ~ 5

Author(s):

Carla Elane Silva dos Santos ◽

Sofia Wolker Manta ◽

Guilherme Pereira Maximiano ◽

Susana Cararo Confortin ◽

Tânia Rosane Bertoldo Benedetti ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sedentary Behavior ◽

Vigorous Physical Activity ◽

Cross Sectional Study ◽

Activity Levels ◽

Cross Sectional ◽

Aging Study ◽

Low Levels ◽

Adjusted Model

Background: To examine the level of physical activity and sedentary behavior (SB), measured with accelerometers, in older adults from a city in southern Brazil according to sociodemographic and health characteristics.Methods: The sample consisted of 425 older adults (≥63 y) from the EpiFloripa Aging Study. Light physical activity (LPA), moderate to vigorous physical activity (MVPA), and SB were measured with accelerometers over a period of 7 days.Results: The older adults spent two-thirds of the time of use in SB, one-third in LPA, and only 2.1% (95% confidence interval, 1.8–2.2) in MVPA. In the final adjusted model, lower levels of MVPA were observed for women, as well as higher SB and lower LPA and MVPA for those with higher age. There were also trends toward prolonged SB and lower LPA when participants had a higher educational level and toward lower MVPA with higher body mass index.Conclusions: Constant monitoring of physical activity levels and SB using objective measures is recommended and interventions should be directed at the groups most exposed to excessive SB and low levels of MVPA.

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Difficulties faced by older Rohingya (forcibly displaced Myanmar nationals) adults in accessing medical services amid the COVID-19 pandemic in Bangladesh

BMJ Global Health ◽

10.1136/bmjgh-2021-007051 ◽

2021 ◽

Vol 6 (12) ◽

pp. e007051

Author(s):

Sabuj Kanti Mistry ◽

ARM Mehrab Ali ◽

Uday Narayan Yadav ◽

Md. Nazmul Huda ◽

Saruna Ghimire ◽

...

Keyword(s):

Older Adults ◽

Medical Care ◽

Emergency Preparedness ◽

Health Centre ◽

Sampling Technique ◽

Cross Sectional Study ◽

Walking Distance ◽

Cross Sectional ◽

Factors Associated ◽

Routine Medical Care

BackgroundCOVID-19 has seriously disrupted health services in many countries including Bangladesh. This research aimed to explore whether Rohingya (forcefully displaced Myanmar nationals) older adults in Bangladesh faced difficulties accessing medicines and routine medical care services amid this pandemic.MethodsThis cross-sectional study was conducted among 416 Rohingya older adults aged 60 years and above residing in Rohingya refugee camps situated in the Cox’s Bazar district of Bangladesh and was conducted in October 2020. A purposive sampling technique was followed, and participants’ perceived difficulties in accessing medicines and routine medical care were noted through face-to-face interviews. Binary logistic regression models determined the association between outcome and explanatory variables.ResultsOverall, one-third of the participants reported difficulties in accessing medicines and routine medical care. Significant factors associated with facing difficulties accessing medicine included feelings of loneliness (adjusted OR (AOR) 3.54, 95% CI 1.93 to 6.48), perceptions that older adults were at the highest risk of COVID-19 (AOR 3.35, 95% CI 1.61 to 6.97) and required additional care during COVID-19 (AOR 6.89, 95% CI 3.62 to 13.13). Also, the notable factors associated with difficulties in receiving routine medical care included living more than 30 min walking distance from the health centre (AOR 3.57, 95% CI 1.95 to 6.56), feelings of loneliness (AOR 2.20, 95% CI 1.25 to 3.87), perception that older adults were at the highest risk of COVID-19 (AOR 2.85, 95% CI 1.36 to 5.99) and perception that they required additional care during the pandemic (AOR 4.55, 95% CI 2.48 to 8.35).ConclusionMany Rohingya older adults faced difficulties in accessing medicines and routine medical care during this pandemic. This call for policy-makers and relevant stakeholders to re-assess emergency preparedness plans including strategies to provide continuing care.

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Factors Associated With Positive Self-Rated Health: Comparing Older Adults in Brazil and in Portugal

Frontiers in Public Health ◽

10.3389/fpubh.2021.650294 ◽

2021 ◽

Vol 9 ◽

Author(s):

Meire Cachioni ◽

Gabriela Cabett Cipolli ◽

Flávia Silva Arbex Borim ◽

Samila Sathler Tavares Batistoni ◽

Mônica Sanches Yassuda ◽

...

Keyword(s):

Older Adults ◽

Old Age ◽

Handgrip Strength ◽

Secondary Data ◽

Cross Sectional Study ◽

Personality Factors ◽

Cross Sectional ◽

Brazilian Sample ◽

Self Rated Health ◽

Aging Study

Introduction: Self-rated health is a multidimensional health indicator and a predictor of adverse events in old age. Answers to this assessment are influenced by social, cultural and personality factors.Aim: Exploring common and distinctive characteristics of Brazilian and Portuguese older adults aged 70 and over regarding positive self-rated health according to sociodemographic variables, to functional capacity, to independent performance of basic activities of daily living and to neuroticism, as well as analyzing associations between positive self-rated health and these variables.Methods: The present paper is a comparative and cross-sectional study based on secondary data contained in the databases of the FIBRA (Frailty in Brazilian Older Adults) follow-up study, with 418 Brazilian older adults, and of the DIA (From Disability to Activity: The Challenge of Aging) study, with 380 Portuguese older adults. Both samples had higher percentages of women: 68.4% for Portugal and 69.9% for Brazil. The Brazilian sample had a higher average age (80.31 ± 4.67) than the Portuguese sample (76.80 ± 5.28).Results: The Portuguese older adults had better overall cognition scores, higher handgrip strength and higher neuroticism values than the Brazilian older adults. In the simple and multiple logistic regression analyses, it was found that among Brazilian older adults, subjects with higher scores in the MMSE (OR 1.16; 95% CI 1.08–1.24), regardless of ADL performance (OR 2.13; 95% CI 1.31–3.47) and with scores 24–29 (OR 1.92; 95% CI 1.07–3.43) or 11–23 (OR 2.09; 95% CI 1.15–3.79) in neuroticism were more likely to assess their health as very good/good. On the other hand, the Portuguese older adults with intermediate 24–9 (OR 2.38; 95% CI 1.31–4.33) or low 11–23 (OR 5.31; 95% CI 2.69–10.45) scores in neuroticism were more likely to evaluate their health as very good/good.Conclusion: Based on the findings of the present study and on the existing literature, it may be said that it is possible for people to age while keeping a positive perception of their own health, even in advanced old age; comparisons between the above-mentioned countries, however, point to the need for investments in healthcare systems so that older adults may enjoy greater physical independence and improved mental health.

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Association between depressive symptoms and medical care utilization in South Korean older adults with chronic diseases: A cross-sectional study

10.21203/rs.3.rs-676687/v1 ◽

2021 ◽

Author(s):

Yoon Sik Park ◽

Eun-Cheol Park

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Medical Care ◽

Chronic Diseases ◽

National Sample ◽

Care Utilization ◽

Cross Sectional ◽

South Korean ◽

Medical Care Utilization ◽

Outpatient Visits

Abstract BackgroundThis study examined the effects of depressive symptoms on medical care utilization among South Korean older adults with chronic diseases.MethodsA national sample of 3,921 elders with chronic diseases participated in the Korean Longitudinal Study of Aging. Using multiple logistic regression, odds ratios (ORs) were calculated for the effects of depressive symptoms on medical care utilization.ResultsOlder adults with depressive symptoms had fewer outpatient visits (OR = 0.81, 95% confidence interval [CI] = 0.67–0.98) and more inpatient hospitalizations (OR = 1.49, 95% CI = 1.13–1.97) than those who did not suffer depressive symptoms. Participants with depressive symptoms visited outpatient clinics less often (OR = 0.69, 95% CI = 0.48–0.97) and were hospitalized more frequently (OR = 1.81, 95% CI = 1.04–3.16) than were men without depressive symptoms. Patients with depressive symptoms with hypertension and diabetes were hospitalized more often (OR = 2.77, 95% CI = 1.45–5.30).ConclusionsDepressive symptoms and chronic diseases are common among elders in South Korea, often resulting in decreased outpatient visits and increased inpatient hospitalization. These findings suggest the necessity for management of chronic disease in elders with depressive symptoms.

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Doctor Retention in Ireland - What it may mean for the Global Health Workforce Reform Agenda Comment on "Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle"

International Journal of Health Policy and Management ◽

10.34172/ijhpm.2020.126 ◽

2020 ◽

Author(s):

Bernard Hope Taderera

Keyword(s):

Global Health ◽

Health Workforce ◽

Cross Sectional Study ◽

Early Career ◽

Healthcare Personnel ◽

Health Coverage ◽

Cross Sectional ◽

Middle Income ◽

Reform Agenda ◽

Medical Graduates

The study of healthcare personnel migration in Ireland reports that most medical graduates plan to leave the country’s health system. It may be possible to address this challenge by understanding and addressing the reasons why young doctors plan to leave. Future studies should contribute to the retention of early career doctors in highincome countries such as Ireland. This will help reduce the migration of doctors from low- and middle-income countries in order to address the global health workforce crisis and its impact on the attainment of universal health coverage in all health systems.

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Usability of a tablet computer designed for older adults: a qualitative approach based on an intra-hospital living-lab for healthcare (Preprint)

10.2196/preprints.25186 ◽

2020 ◽

Author(s):

Guillaume Sacco ◽

Pauline Carliez ◽

Frédéric Noublanche ◽

Romain Simon ◽

Anne Renaudin ◽

...

Keyword(s):

Older Adults ◽

Geriatric Patients ◽

Healthcare Professionals ◽

Cross Sectional Study ◽

Satisfaction Score ◽

Tablet Computer ◽

Sectional Study ◽

Cross Sectional ◽

System Usability Scale ◽

Perceived Usability

BACKGROUND Usability is the keystone in the evolution of tablet technology in healthcare. The Ardoiz® tablet has been designed with a simplified interface for older adults. OBJECTIVE To assess the perceived usability and satisfaction of the Ardoiz® tablet. METHODS We conducted a mixed methods with cross-sectional study using System Usability Scale (SUS), satisfaction score and workshops, including geriatric patients, healthcare professional and caregivers. RESULTS Between September 25, 2019 and March 11, 2020, 58 participants were included in a cross-sectional study (including 38 patients, mean ±SD 85±6 years, 66% women), 26 in workshops (including 5 patients, mean ±SD 86.4±2.9, 40% women). The SUS was 74±12/100, the satisfaction score was 2.8±0.9/4, with 59% of satisfied participants with the use of Ardoiz® pads. The intent to acquire remained low with 18% (n=6) of participants who would be interested in acquiring the tablet. This tablet computer seemed to be difficult to use by geriatric patients and healthcare professionals, mainly because of its complex homepage. Nevertheless, former caregivers and healthcare professionals thought that the tablet could be of great interest to hospitals for leisure and medical use. The main feedback in order to improve the tablet is to simplify the home page with fewer and more static icons (without switching). CONCLUSIONS Notwithstanding the usability of the tablet, the intent to acquire of Ardoiz® tablet remained low. The interface should be simplified for older adults in order to improve usability and adherence. CLINICALTRIAL NCT04091152

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