scholarly journals Healthcare Service Use, Costs, and Treatment Patterns within a Cohort of Experienced and New Users of Preventive Migraine Medications

2020 ◽  
Author(s):  
Machaon Bonafede ◽  
Sandhya Sapra ◽  
Stewart Tepper ◽  
Katherine Cappell ◽  
Pooja Desai
Keyword(s):  
Healthcare Costs ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Patient Functioning ◽  
Treatment Regimens ◽  
Level Of Functioning ◽  
Healthcare Service Use ◽  
Improve Patient

Abstract Background: Migraine is a debilitating disease associated with increased use of healthcare services. Pharmacological interventions include acute medications to reduce symptoms and restore patient functioning, and preventive migraine medications (PMM), to reduce frequency, duration, and intensity of migraine symptoms . This study examined treatment and associated healthcare service use and costs between PMM naïve and experienced patients.Methods: Migraine patients initiating treatment with a PMM from January 1, 2010-June 30,2014 were identified in the IBM MarketScan Commercial and Medicare Supplemental Databases. Migraine medication use, service utilization, and costs were examined over the 12 months following PMM initiation; outcomes were compared between patients experienced with and naïve to PMM treatment.Results: Adherence and persistence with PMMs was low, with only 24% of patients adherent to their index PMM. Rates of discontinuation were high, with 71.4% of the sample discontinuing their PMM over the 12-month follow up. Utilization of acute medications was common, as was PMM switching in experienced patients. Annual healthcare costs were $12,044 and $19,093 for the PMM naïve and experienced populations respectively. Migraine-specific service use accounted for approximately 20% of all-cause healthcare costs. The PMM experienced cohort consistently evidenced higher service use and costs than the PMM naïve cohort.Conclusion: Utilization of PMM remains suboptimal and is accompanied by both lack of PMM adherence and high use of acute medications. Rates of PMM switching and use of acute medications suggest that patients have unmet needs regarding migraine management. Improved treatment regimens that effectively manage migraine symptoms are needed to improve patient level of functioning while reducing healthcare costs associated with migraine management.

Gender Differences in Youth Suicide and Healthcare Service Use

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 290-298 ◽  
Author(s):  
Samantha Gontijo Guerra ◽  
Helen-Maria Vasiliadis
Keyword(s):  
Mental Health ◽  
Gender Differences ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Outpatient Services ◽  
Health Related ◽  
Healthcare Service Use ◽  
Ed Visits

Abstract. Background: Healthcare service use among suicide decedents must be well characterized and understood since a key strategy for preventing suicide is to improve healthcare providers' ability to effectively detect and treat those in need. Aims: To determine gender differences in healthcare service use 12 months prior to suicide. Method: Data for 1,231 young Quebec residents (≤ 25 years) who died by suicide between 2000 and 2007 were collected from public health insurance agency databases and coroner registers. Healthcare visits were categorized according to the setting (emergency department [ED], outpatient, and hospital) and their nature (mental health vs. non-mental health). Results: Girls were more likely than boys (82.5% vs. 74.9%, p = .011) to have used healthcare services in the year prior to death. A higher proportion of girls had used outpatient services (79.0% vs. 69.5%, p = .003), had been hospitalized (25.7% vs. 15.6%, p < .001) and had received a mental health-related diagnosis (46.7% vs. 33.1%, p < .001). However, no gender differences were observed in ED visits (59.5% vs. 54.5%, p = .150). Conclusion: There is an important proportion of suicide decedents who did not receive a mental health diagnosis and healthcare services in the year prior to death. Future studies should focus on examining gender-specific individual and health system barriers among suicide decedents as well as the quality of care offered regarding detection and treatment.

scholarly journals Trends in the utilization of youth primary healthcare services and psychological distress

2020 ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract BackgroundPsychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need.MethodsThis study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. ResultsWe found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 500 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.ConclusionsOur findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

scholarly journals Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data

2021 ◽  
pp. tobaccocontrol-2021-056522
Author(s):  
Dolly Baliunas ◽  
Peter Selby ◽  
Claire de Oliveira ◽  
Paul Kurdyak ◽  
Laura Rosella ◽  
...  
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Healthcare Service ◽  
Service Use ◽  
Smoking Cessation Treatment ◽  
Outpatient Visits ◽  
Cessation Treatment ◽  
Healthcare Service Use ◽  
Ed Visits

BackgroundNo research has assessed the individual-level impact of smoking cessation treatment delivered within a general primary care patient population on multiple forms of subsequent healthcare service use.ObjectiveWe aimed to compare the rate of outpatient visits, emergency department (ED) visits and hospitalisations during a 5-year follow-up period among smokers who had and had not accessed a smoking cessation treatment programme.MethodsThe study was a retrospective matched cohort study using linked demographic and administrative healthcare databases in Ontario, Canada. 9951 patients who accessed smoking cessation services between July 2011 and December 2012 were matched to a smoker who did not access services, obtained from the Canadian Community Health Survey, using a combination of hard matching and propensity score matching. Outcomes were rates of healthcare service use from index date (programme enrolment or survey response) to March 2017.ResultsAfter controlling for potential confounders, patients in the overall treatment cohort had modestly greater rates of the outcomes: outpatient visits (rate ratio (RR) 1.10, 95% CI: 1.06 to 1.14), ED visits (RR 1.08, 95% CI: 1.03 to 1.13) and hospitalisations (RR 1.09, 95% CI: 1.02 to 1.18). Effect modification of the association between smoking cessation treatment and healthcare service use by prevalent comorbidity was found for outpatient visits (p=0.006), and hospitalisations (p=0.050), but not ED visits.ConclusionsPatients who enrolled in smoking cessation treatment offered through primary care clinics in Ontario displayed a modest but significantly greater rate of outpatient visits, ED visits and hospitalisations over a 5-year follow-up period.

scholarly journals Trends in the utilization of youth primary healthcare services and psychological distress

2020 ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract Background Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need.Methods This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. Results We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 300 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.Conclusions Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

scholarly journals Trends in the utilization of youth primary healthcare services for psychological distress

2020 ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract Background Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the relationship between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need. Methods This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 ( n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time.Results We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 300 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.Conclusions Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

scholarly journals Trends in the utilization of youth primary healthcare services and psychological distress

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract Background Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need. Methods This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13–19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. Results We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 500 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16 and 66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend. Conclusions Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

scholarly journals Comparison of data sources on alcohol problems: An exploratory exercise using surveys vs. national healthcare registers

2020 ◽  
pp. 145507252096802
Author(s):  
Pia Mäkelä ◽  
Kristiina Kuussaari ◽  
Airi Partanen ◽  
Elina Rautiainen
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Healthcare Service ◽  
Service Use ◽  
Basic Education ◽  
Alcohol Problems ◽  
Register Data ◽  
Data Sources ◽  
National Healthcare ◽  
Healthcare Service Use

Aims: Both survey and healthcare register data struggle as data sources to capture the phenomenon of alcohol problems. We study a large group of people for whom survey data and two types of register data are available, and examine the overlaps of similar or related measures in the different data sources to learn about potential weaknesses in each. We also examine how register-based data on the prevalence of alcohol problems change depending on which register data are used. Design: We use data from the Regional Health and Wellbeing Study (ATH) of the adult Finnish population collected in 2013 and 2014 ( n = 69,441), individually linked with data on two national healthcare registers (Care Register for Health Care; Register of Primary Health Care visits) for the survey year and previous year. Results: The prevalence of substance-abuse-related healthcare was almost two-fold if data on outpatient primary care visits were included in addition to hospitalisations. Forty-six per cent of the survey respondents self-reporting substance-abuse-related healthcare service use were identified in the registers, and 22% of all respondents with such service use according to registers reported this in the survey. Records of substance-abuse-related healthcare service use, controlled for self-reported alcohol use and self-reported substance-abuse-related service use, were found more often for men, the middle-aged, people with basic education only, and the non-employed. Conclusions: The results are suggestive of underreporting in both data sources. There is an evident need to develop recording practices in the healthcare registers regarding substance use disorders.

scholarly journals Health and work disability outcomes in parents of patients with schizophrenia associated with antipsychotic exposure by the offspring

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Heidi Taipale ◽  
Syed Rahman ◽  
Antti Tanskanen ◽  
Juha Mehtälä ◽  
Fabian Hoti ◽  
...  
Keyword(s):  
Sickness Absence ◽  
Work Disability ◽  
Healthcare Service ◽  
Service Use ◽  
Antipsychotic Treatment ◽  
Healthcare Use ◽  
Swedish Population ◽  
Increased Risk ◽  
Healthcare Service Use

AbstractThis study aimed to identify if antipsychotic exposure in offspring is associated with psychiatric and non-psychiatric healthcare service use and work disability of their parents. This Swedish population-based cohort study was based on data comprising 10,883 individuals with schizophrenia, who had at least one identifiable parent in the nationwide registers, and their parents (N = 18,215). The register-based follow-up during 2006–2013 considered the level of antipsychotic exposure and persistence of use of the offspring, further categorized into first (FG) and second generation (SG) antipsychotics, and orals versus long-acting injections (LAIs). The main outcome measure was parental psychiatric healthcare service use, secondary outcomes were non-psychiatric healthcare use and long-term sickness absence. SG-LAI use was associated with a decreased risk (relative risks [RR] 0.81-0.85) of parental psychiatric healthcare use compared with not using SG-LAI, whereas oral antipsychotics were associated with an increased risk (RRs 1.10–1.29). Both FG- and SG-LAI use by the offspring were associated with a lower risk of long-term sickness absence (range of odds ratios 0.34–0.47) for the parents, compared with non-use of these drugs. The choice of antipsychotic treatment for the offspring may have an impact on work disability and healthcare service use of their parents.

Sign in / Sign up

Export Citation Format

Share Document