scholarly journals Funding and Service Delivery in Rural and Urban Local US Health Departments in 2010 and 2016

2020 ◽  
Vol 110 (9) ◽  
pp. 1293-1299 ◽  
Author(s):  
Kate Beatty ◽  
Megan Heffernan ◽  
Nathan Hale ◽  
Michael Meit
Keyword(s):  
Service Delivery ◽  
The United States ◽  
Cross Sectional Study ◽  
Local Health ◽  
Clinical Services ◽  
Health Departments ◽  
Cross Sectional ◽  
Care Services ◽  
Primary Care Services ◽  
Rural And Urban

Objectives. To investigate differences in funding and service delivery between rural and urban local health departments (LHDs) in the United States. Methods. In this repeated cross-sectional study, we examined rural–urban differences in funding and service provision among LHDs over time using 2010 and 2016 National Association of County and City Health Officials data. Results. Local revenue among urban LHDs (41.2%) was higher than that in large rural (31.3%) and small rural LHDs (31.2%; P < .05). Small (20.9%) and large rural LHDs (19.8%) reported greater reliance on revenue from Center for Medicare and Medicaid Services than urban LHDs (11.5%; P < .05). All experienced decreases in clinical revenue between 2010 and 2016. Urban LHDs provided less primary care services in 2016; rural LHDs provided more mental health and substance abuse services (P < .05). Conclusions. Urban LHDs generated more revenues from local sources, and rural LHDs generated more from the Center for Medicare and Medicaid Services and clinical services. Rural LHDs tended to provide more clinical services. Given rural LHDs’ reliance on clinical revenue, decreases in clinical services could have disproportionate effects on them. Public Health Implications. Differences in financing and service delivery by rurality have an impact on the communities. Rural LHDs rely more heavily on state and federal dollars, which are vulnerable to changes in state and national health policy.

Primary care services provided to adolescents in detention: a cross-sectional study using ICPC-2

2010 ◽  
Vol 99 (7) ◽  
pp. 1060-1064 ◽  
Author(s):  
DM Haller ◽  
P Sebo ◽  
B Cerutti ◽  
D Bertrand ◽  
A Eytan ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Primary Care Services

scholarly journals Correlates of Health Literacy Among Polish Immigrants With Chronic Health Conditions: Preliminary Results

2019 ◽  
Vol 5 ◽  
pp. 233372141989477
Author(s):  
Magdalena Leszko ◽  
Celina Timoszyk-Tomczak
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Care Services ◽  
Legal Status ◽  
Preventive Treatment ◽  
The United States ◽  
Cross Sectional Study ◽  
Functional Health ◽  
Cross Sectional ◽  
Care Services

The rapid increase in immigration to the United States in the past decades has resulted in an influx of individuals who have to familiarize themselves with a completely new health care system and practices, often in a new language. The purpose of this study was to assess health literacy and investigate its correlates among older U.S. Polish immigrants living in the Greater Chicago area. We conducted a cross-sectional study on 60 older adults (24 men, 36 women; mean age = 71.1 years) who completed the Short Test of Functional Health Literacy (S-TOFHLA) and a demographic survey. Scores on S-TOFHLA were lower among older and less-educated immigrants. Undocumented immigrants reported using health care services less frequently than those with legal status. These results confirm the findings of previous studies that older age and fewer years of education are associated with inadequate health literacy. Being familiar with at least the basic information about one’s condition will help patients to better understand a diagnosis, manage their symptoms, and improve any preventive treatment. The findings emphasize the importance of health education among older Polish immigrants. More research employing diverse groups of immigrants is needed to better understand the factors associated with health literacy.

Sociodemographic Characteristics and Preferences for Family (Informal) and Formal Caregiver Help With ADLs

2018 ◽  
Vol 31 (2) ◽  
pp. 120-127
Author(s):  
Merle R. Kataoka-Yahiro ◽  
James Davis ◽  
Lana Sue Ka’opua ◽  
Angela Sy
Keyword(s):  
Health Care Services ◽  
Secondary Data ◽  
The United States ◽  
Cross Sectional Study ◽  
Sociodemographic Characteristics ◽  
Cross Sectional ◽  
Formal Caregivers ◽  
Logistic Regression Models ◽  
Care Services ◽  
Aging Adults

The purpose of this article was to compare sociodemographic characteristics and various care preferences for family and formal caregivers help with activities of daily living (ADLs). The sample was 56,337 noninstutionalized U.S. civilian adults, 40 to 65 years of age. This is a cross-sectional study using secondary data from the National Health Interview Survey (NHIS)—2011 to 2014. Respondents’ sociodemographic characteristics and various care preferences for caregiver help with ADLs were analyzed. Subsequent analysis examined associations using adjusted multivariable logistic regression models. Preference for family caregivers help with ADLs was independently and significantly associated with race/ethnicity, age, gender, education, acculturation, and income. Future studies need to examine sociodemographic characteristics and caregiver preferences to tailor health care services for aging adults in the United States.

scholarly journals Experiences of adult patients using primary care services in Poland – a cross-sectional study in QUALICOPC study framework

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Marek Oleszczyk ◽  
Anna Krztoń-Królewiecka ◽  
Willemijn L. A. Schäfer ◽  
Wienke G. W. Boerma ◽  
Adam Windak
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Primary Care Services

scholarly journals Continuity of care and delivery of diabetes and hypertensive care among regular users of primary care services in Chile: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e027830
Author(s):  
Javiera Leniz ◽  
Martin C Gulliford
Keyword(s):  
Primary Care ◽  
Continuity Of Care ◽  
Cross Sectional Study ◽  
Self Report ◽  
Secondary Outcome ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Primary Care Services

ObjectivesExplore factors related to continuity of care and its association with diabetes and hypertensive care, and disease control.DesignCross-sectional study.SettingData from the Chilean Health National Survey 2009–2010.ParticipantsRegular users of primary care services aged 15 or older.Primary and secondary outcome measuresProportion of hypertensive and diabetic patients with a blood pressure <140/90 mm Hg and HbA1c<7.0% respectively, self-report of diagnosis, treatment and recent foot and ophthalmological exams. Associations between continuity of care, sociodemographic characteristics, and primary and secondary outcomes were explored using logistic regression.Results3887 primary care service users were included. 14.7% recognised a usual GP, 82.3% of them knew their name. Continuity of care was positively associated with age >65 years (OR 4.81, 95% CI 3.16 to 7.32), being female (OR 1.66, 95% CI 1.34 to 2.05), retired (OR 2.22, 95% CI 1.75 to 2.83), obese (OR 1.66, 95% CI 1.29 to 2.14), high cardiovascular risk (OR 2.98, 95% CI 2.13 to 4.17) and widowed (OR 1.50, 95% CI 1.13 to 1.99), and negatively associated with educational level (8–12 vs <8 years OR 0.79, 95% CI 0.64 to 0.97), smoking (OR 0.65, 95% CI 0.52 to 0.82) and physical activity (OR 0.76, 95% CI 0.61 to 0.95). Continuity of care was associated with diagnosis awareness (OR 2.83, 95% CI 1.21 to 6.63), pharmacological treatment (OR 2.04, 95% CI 1.15 to 3.63) and a recent foot (OR 3.17, 95% CI 1.84 to 5.45) and ophthalmological exam (OR 3.20, 95% CI 1.66 to 6.18) in diabetic but not in hypertensive patients.ConclusionsContinuity of care was associated with higher odds of having a recent foot and ophthalmological exam in patients with diabetes, but not with better diseases control. Findings suggest patients with chronic conditions have better continuity of care access.

Differences between incarcerated and non-incarcerated patients who die in community hospitals highlight the need for palliative care services for seriously ill prisoners in correctional facilities and in community hospitals: A cross-sectional study

2017 ◽  
Vol 32 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Alex Rothman ◽  
Shannon McConville ◽  
Renee Hsia ◽  
Lia Metzger ◽  
Cyrus Ahalt ◽  
...  
Keyword(s):  
Palliative Care ◽  
The United States ◽  
Cross Sectional Study ◽  
Correctional Facilities ◽  
Sectional Study ◽  
Community Hospitals ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services ◽  
Seriously Ill

Background: Incarcerated populations worldwide are aging dramatically; in the United States, prisoner mortality rates have reached an all-time high. Little is known about the incarcerated patients who die in community hospitals. Aim: Compare incarcerated and non-incarcerated hospital decedents in California. Design: Cross-sectional study. Setting/participants: All state hospital decedents ( N = 370,831) from 2009 to 2013, decedent age over time examined with additional data (2001–2013). Results: Overall, 745 incarcerated and 370,086 non-incarcerated individuals died in California hospitals. Incarcerated decedents were more often male (93% vs 51%), Black (19% vs 8%) Latino (27% vs 19%), younger (55 vs 73 years), had shorter hospitalizations (13 vs 16 days), and fewer had an advance care plan (23% vs 36%, p < 0.05). Incarcerated decedents had higher rates of cancer, liver disease, HIV/AIDs, and mental health disorders. Cause of death was disproportionately missing for incarcerated decedents. The average age of incarcerated decedents rose between 2001 and 2013, while it remained stable for others. Conclusion: Palliative care services in correctional facilities should accommodate the needs of relatively young patients and those with mental illness. Given the simultaneous growth in the older prisoner population with the rising age of incarcerated hospital decedents, community hospital clinicians should be prepared to care for seriously ill, incarcerated patients. Significant epidemiologic differences between incarcerated and non-incarcerated decedents in this study suggest the importance of examining the differential palliative care needs of incarcerated patients in all communities.

scholarly journals Analysis of vaccine loss due to temperature change

2021 ◽  
Vol 74 (1) ◽  
Author(s):  
Flávia dos Santos Patine ◽  
Luciano Garcia Lourenção ◽  
Anneliese Domingues Wysocki ◽  
Maria de Lourdes Sperli Geraldes Santos ◽  
Isabela Cristina Rodrigues ◽  
...  
Keyword(s):  
Temperature Change ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Epidemiological Surveillance ◽  
Cross Sectional ◽  
Significance Level ◽  
Temperature Changes ◽  
Care Services ◽  
Primary Care Services ◽  
Change Notification

ABSTRACT Objectives: to analyze vaccine losses in a Health Region in the Northwest of São Paulo. Methods: retrospective cross-sectional study with secondary data obtained from Temperature Change Notification Forms used by the Epidemiological Surveillance Group XXIX of São José do Rio Preto between 2010 and 2017. Descriptive and inferential analysis were performed using multiple linear regression and significance level of 95%. Results: in total, 341 notifications of temperature changes were analyzed, of which 70.1% were caused by structural reasons, 57.8% in industrial refrigerators and 91.2% in primary care services. Of the doses that suffered a change in temperature, 41.4% were lost and 58.6% were administered to the population. The highest percentage of lost doses compared to those applied occurred in smaller municipalities, although they reported less. Conclusions: nursing workers who work in vaccination rooms should make efforts to prevent temperature changes and avoid losses and higher public expenses.

scholarly journals Performance evaluation of primary care services for the treatment of tuberculosis

2014 ◽  
Vol 48 (6) ◽  
pp. 1044-1053 ◽  
Author(s):  
Daiane Medeiros da Silva ◽  
Jordana de Almeida Nogueira ◽  
Lenilde Duarte de Sá ◽  
Anneliese Domingues Wysocki ◽  
Lucia Marina Scatena ◽  
...  
Keyword(s):  
Primary Care ◽  
Professional Training ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Professional Qualification ◽  
Process Indicators ◽  
Care Services ◽  
Primary Care Services ◽  
Directly Observed Treatment ◽  
Structural Indicators

Objective Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. Method An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). Results The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. Conclusion The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.



scholarly journals Use of oral health care services in the United States: unequal, inequitable—a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiangqun Ju ◽  
Gloria C. Mejia ◽  
Qiang Wu ◽  
Huabin Luo ◽  
Lisa M. Jamieson
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Care Services ◽  
The United States ◽  
Oral Health Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Index Of Inequality ◽  
Concentration Curves

Abstract Background Social determinants drive disparities in dental visiting. Disparities can be measured simply by comparing outcomes between groups (inequality) but can also consider concepts of social justice or fairness (inequity). This study aimed to assess differences in dental visiting in the United States in terms of both social inequality and inequity. Methods Data were obtained from a cross-sectional study—the National Health and Nutrition Examination Survey (NHANES) 2015–2016, and participants were US adults aged 30+ years. The outcome of interest, use of oral health care services, was measured in terms of dental visiting in the past 12 months. Disparity was operationalized through education and income. Other characteristics included age, gender, race/ethnicity, main language, country of birth, citizenship and oral health status. To characterize existing inequality in dental service use, we examined bivariate relationships using indices of inequality: the absolute and relative concentration index (ACI and RCI), the slope index of inequality (SII) and relative index of inequality (RII) and through concentration curves (CC). Indirect standardization with a non-linear model was used to measure inequity. Results A total of 4745 US adults were included. Bivariate analysis showed a gradient by both education and income in dental visiting, with a higher proportion (> 60%) of those with lower educational attainment /lower income having not visited a dentist. The concentration curves showed pro-higher education and income inequality. All measures of absolute and relative indices were negative, indicating that from lower to higher socioeconomic position (education and income), the prevalence of no dental visiting decreased: ACI and RCI estimates were approximately 8% and 20%, while SII and RII estimates were 50% and 30%. After need-standardization, the group with the highest educational level had nearly 2.5 times- and the highest income had near three times less probability of not having a dental visit in the past 12 months than those with the lowest education and income, respectively. Conclusion The findings indicate that use of oral health care is threatened by existing social inequalities and inequities, disproportionately burdening disadvantaged populations. Efforts to reduce both oral health inequalities and inequities must start with action in the social, economic and policy spheres.

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