scholarly journals Interaction Between Income, Health Insurance, and Self-rated Health: a Path Analysis

2021 ◽  
Author(s):  
Atalie Ashley West ◽  
Lynn Unruh
Keyword(s):  
Health Insurance ◽  
Path Analysis ◽  
Secondary Data ◽  
Future Research ◽  
Cross Sectional ◽  
The Public ◽  
Health Insurance Status ◽  
Self Rated Health ◽  
Interview Survey ◽  
Demographic Covariates

Abstract Aim: The public health literature suggests health insurance and socioeconomic status (SES) are independent predictors of health outcomes; few studies have explored the interrelationships between these predictors and health. This study explores relationships between income, health insurance, and health, testing the following hypotheses: 1) people with health insurance have higher self-rated health than those who do not; 2) people who have higher income are more likely to have both insurance and higher self-rated health.Subject and Methods: This is retrospective, cross-sectional, secondary data analysis of 39,450 records from the 2016 National Health Interview Survey (NHIS). The design utilizes path analysis to simultaneously assess relationships between health insurance status, income, and self-rated health, along with several socio-demographic covariates.Results: We find that higher income and having insurance were both significant predictors of higher self-rated health. Income had a stronger direct effect on health than being insured, as indicated by standardized coefficients. Higher income was also related to having health insurance, thereby influencing health indirectly through its relationship with health insurance. Several socio-demographic variables were also related to self-rated health, income, and insurance. Conclusions: Future research should explore effects of both insurance and income and their interrelationships on health. Health policies should consider that growing poverty and income inequality in the U.S. limit the effectiveness of health insurance and other social programs if larger social conditions are not addressed.

scholarly journals A Path Analysis of Latino Parental, Teenager and Cultural Variables in Teenagers' Sexual Attitudes, Norms, Self-Efficacy, and Sexual Intentions

2015 ◽  
Vol 23 (3) ◽  
pp. 500-511 ◽  
Author(s):  
Vanessa Pirani Gaioso ◽  
Antonia Maria Villarruel ◽  
Lynda Anne Wilson ◽  
Andres Azuero ◽  
Gwendolyn Denice Childs ◽  
...  
Keyword(s):  
Path Analysis ◽  
Self Efficacy ◽  
Sexual Communication ◽  
Sexual Attitudes ◽  
Secondary Data ◽  
Subjective Norms ◽  
Future Research ◽  
Cross Sectional ◽  
Cultural Variables ◽  
Correlational Design

OBJECTIVE: to test a theoretical model based on the Parent-Based Expansion of the Theory of Planned Behavior examining relation between selected parental, teenager and cultural variables and Latino teenagers' intentions to engage in sexual behavior.METHOD: a cross-sectional correlational design based on a secondary data analysis of 130 Latino parent and teenager dyads.RESULTS: regression and path analysis procedures were used to test seven hypotheses and the results demonstrated partial support for the model. Parent familism and knowledge about sex were significantly associated with parents' attitudes toward sexual communication with their teenagers. Parent Latino acculturation was negatively associated with parents' self-efficacy toward sexual communication with their teenagers and positevely associated with parents' subjective norms toward sexual communication with their teenagers. Teenager knowledge about sex was significantly associated with higher levels of teenagers' attitudes and subjective norms about sexual communication with parents. Only the predictor of teenagers' attitudes toward having sex in the next 3 months was significantly associated with teenagers' intentions to have sex in the next 3 months.CONCLUSION: the results of this study provide important information to guide future research that can inform development of interventions to prevent risky teenager sexual behavior among Latinos.

scholarly journals Self-rated health among undocumented and newly regularized migrants in Geneva: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julien Fakhoury ◽  
Claudine Burton-Jeangros ◽  
Idris Guessous ◽  
Liala Consoli ◽  
Aline Duvoisin ◽  
...  
Keyword(s):  
Social Support ◽  
Social Networks ◽  
Cross Sectional Study ◽  
Future Research ◽  
Undocumented Migrants ◽  
Long Term Effects ◽  
Residence Permit ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Self Rated Health

Abstract Background In Europe, knowledge about the social determinants of health among undocumented migrants is scarce. The canton of Geneva, Switzerland, implemented in 2017–2018 a pilot public policy aiming at regularizing undocumented migrants. We sought to test for associations between self-rated health, proven eligibility for residence status regularization and social and economic integration. Methods This paper reports data from the first wave of the Parchemins Study, a prospective study whose aim is to investigate the effect of residence status regularization on undocumented migrants’ living conditions and health. The convenience sample included undocumented migrants living in Geneva for at least 3 years. We categorized them into those who were in the process of receiving or had just been granted a residence permit (eligible or newly regularized) and those who had not applied or were ineligible for regularization (undocumented). We conducted multivariate regression analyses to determine factors associated with better self-rated health, i.e., with excellent/very good vs. good/fair/poor self-rated health. Among these factors, measures of integration, social support and economic resources were included. Results Of the 437 participants, 202 (46%) belonged to the eligible or newly regularized group. This group reported better health more frequently than the undocumented group (44.6% versus 28.9%, p-value < .001), but the association was no longer significant after adjustment for social support and economic factors (odds ratio (OR): 1.12; 95% confidence interval (CI): 0.67–1.87). Overall, better health was associated with larger social networks (OR: 1.66; 95% CI: 1.04–2.64). This association remained significant even after adjusting for health-related variables. Conclusion At the onset of the regularization program, access to regularization was not associated with better self-rated health. Policies aiming at favouring undocumented migrants’ inclusion and engagement in social networks may promote better health. Future research should investigate long-term effects of residence status regularization on self-rated health.

scholarly journals Economic cost of congenital CMV in the UK

2018 ◽  
Vol 104 (6) ◽  
pp. 559-563 ◽  
Author(s):  
Jenny Retzler ◽  
Nick Hex ◽  
Chris Bartlett ◽  
Anne Webb ◽  
Sharon Wood ◽  
...  
Keyword(s):  
Public Sector ◽  
Vaccine Development ◽  
Cost Model ◽  
Financial Burden ◽  
Secondary Data ◽  
Economic Cost ◽  
Future Research ◽  
The Public ◽  
The Uk

ObjectiveCongenital cytomegalovirus (cCMV) is the most common infectious cause of congenital disability. It can disrupt neurodevelopment, causing lifelong impairments including sensorineural hearing loss and developmental delay. This study aimed, for the first time, to estimate the annual economic burden of managing cCMV and its sequelae in the UK.DesignThe study collated available secondary data to develop a static cost model.SettingThe model aimed to estimate costs of cCMV in the UK for the year 2016.PatientsIndividuals of all ages with cCMV.Main outcome measuresDirect (incurred by the public sector) and indirect (incurred personally or by society) costs associated with management of cCMV and its sequelae.ResultsThe model estimated that the total cost of cCMV to the UK in 2016 was £732 million (lower and upper estimates were between £495 and £942 million). Approximately 40% of the costs were directly incurred by the public sector, with the remaining 60% being indirect costs, including lost productivity. Long-term impairments caused by the virus had a higher financial burden than the acute management of cCMV.ConclusionsThe cost of cCMV is substantial, predominantly stemming from long-term impairments. Costs should be compared against investment in educational strategies and vaccine development programmes that aim to prevent virus transmission, as well as the value of introducing universal screening for cCMV to both increase detection of children who would benefit from treatment, and to build a more robust evidence base for future research.

scholarly journals Faktor-faktor yang berhubungan dengan pemberian air susu ibu eksklusif di Kabupaten Sleman

2017 ◽  
Vol 33 (8) ◽  
pp. 391
Author(s):  
Safitri Dwicahyani ◽  
Yayi Suryo Prabandari
Keyword(s):  
Health Insurance ◽  
Exclusive Breastfeeding ◽  
Maternal Education ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Dominant Factor ◽  
Cross Sectional ◽  
Lactating Mothers ◽  
Health Promotion Programs ◽  
To Receive

Determinants of exclusive breastfeeding in SlemanPurposeThe purpose of this paper was to determine the factors associated with the exclusive provision of breast milk in Sleman.MethodsA cross-sectional study was conducted using secondary data derived from HDSS Sleman Cycles I and II. The sample in this study were 218 mothers with children aged 7 to <24 months.ResultsThe ownership of health insurance and the use of bottles and pacifiers were significantly associated with exclusive breastfeeding. Maternal age, maternal education, and maternal occupation were not significantly associated with exclusive breastfeeding. Mothers with health insurance are 2.14 times more likely to exclusively breastfeed than those without health insurance. Infants who never use bottles, and pacifiers before the age of 6 months are 5.14 times more likely to receive exclusive breastfeeding than those who used bottles / dots before the age of 6 months.ConclusionThe use of bottles, and pacifiers is the most dominant factor associated with exclusive breastfeeding. Coverage of health insurance, especially in pregnant and lactating mothers and effective health promotion programs related to exclusive breastfeeding needs to be improved. HDSS Sleman needs to analyze the data more in-depth on exclusive breast-feeding.

scholarly journals Retesting for verification of HIV diagnosis before antiretroviral therapy initiation in Harare, Zimbabwe: Is there a gap between policy and practice?

2019 ◽  
Vol 113 (10) ◽  
pp. 610-616
Author(s):  
Beatrice Dupwa ◽  
Ajay M V Kumar ◽  
Jaya Prasad Tripathy ◽  
Owen Mugurungi ◽  
Kudakwashe C Takarinda ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Secondary Data ◽  
Future Research ◽  
Hiv Positive ◽  
National Guidelines ◽  
Hiv Diagnosis ◽  
Policy And Practice ◽  
The Public ◽  
Art Initiation ◽  
Study Participants

Abstract Background WHO recommends retesting of HIV-positive patients before starting antiretroviral therapy (ART). There is no evidence on implementation of retesting guidelines from programmatic settings. We aimed to assess implementation of HIV retesting among clients diagnosed HIV-positive in the public health facilities of Harare, Zimbabwe, in June 2017. Methods This cohort study involved analysis of secondary data collected routinely by the programme. Results Of 1729 study participants, 639 (37%) were retested. Misdiagnosis of HIV was found in six (1%) of the patients retested—all were infants retested with DNA-PCR. There was no HIV misdiagnosis among adults. Among those retested, 95% were retested on the same day and two-thirds were tested by a different provider as per national guidelines. Among those retested and found positive, 95% were started on ART, while none of those with negative retest results were started on ART. Of those not retested, about half (51%) were started on ART. The median (IQR) time to ART initiation from diagnosis was 0 (0–1) d. Conclusion The implementation of HIV-retesting policy in Harare was poor. While most HIV retest positives were started on ART, only half non-retested received ART. Future research is needed to understand the reasons for non-retesting and non-initiation of ART among those not retested.

scholarly journals Self-Rated Health and Health Care Access Associated With African American Men’s Health Self-Efficacy

2015 ◽  
Vol 11 (5) ◽  
pp. 1385-1387 ◽  
Author(s):  
Terry Thompson ◽  
Jamie A. Mitchell ◽  
Vicki Johnson-Lawrence ◽  
Daphne C. Watkins ◽  
Charles S. Modlin
Keyword(s):  
Health Care ◽  
African American ◽  
Health Insurance ◽  
Health Care Access ◽  
Self Efficacy ◽  
African American Men ◽  
Good Care ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Care Access

Health self-efficacy, a measure of one’s self-assurance in taking care of their own health, is known to contribute to a range of health outcomes that has been under examined among African American men. The purpose of this investigation was to identify and contextualize predictors of general health self-efficacy in this population. A cross-sectional sample of surveys from 558 African American was examined. These men were older than 18 years, could read and write English, and attended a hospital-based community health fair targeting minority men in 2011. The outcome of interest was health self-efficacy, which was assessed by asking, “Overall, how confident are you in your ability to take good care of your health?” Responses ranged from 1 ( not confident at all) to 5 ( completely confident). Covariates included age, self-rated health, health insurance status, having a regular physician, and being a smoker. The mean age of participants was 54.4 years, and 61.3% of participants indicated confidence in their ability to take good care of their health. Older age and being a smoker were inversely associated with the outcome. Good self-rated health, having health insurance, and having a regular doctor were positively associated with reports of health self-efficacy. Findings suggest that multiple points of connection to the health care system increase the likelihood of health self-efficacy for this sample and interventions to support older African American men who may evaluate their own health status as poor and who may face barriers to health care access are implicated.

scholarly journals ANALISIS IMPLEMENTASI PROGRAM JAMINAN KESEHATAN NASIONAL BERDASARKAN ANGGOTA KEPESERTAAN BPJS (STUDI DI PUSKESMAS WIYUNG, KOTA SURABAYA TAHUN 2017)

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Satriya Wijaya
Keyword(s):  
Health Insurance ◽  
Health Center ◽  
Health Care Providers ◽  
Secondary Data ◽  
Care Providers ◽  
Cross Sectional ◽  
Stake Holder ◽  
The Government ◽  
Document Review ◽  
The Impact

Abstrak Pelaksanaan JKN di Indonesia menghadapi berbagai tantangan, dari sisi pemberi layanan kesehatan, pengelola jaminan kesehatan, masyarakat sebagai pengguna, serta pemerintah sebagai regulator program. Berbagai studi telah dilakukan untuk menelaah dampak JKN pada pelayanan kesehatan di Indonesia, namun pemanfaatan hasil studi tersebut untuk menyempurnakan kebijakan masih terbatas. Jenis penelitian ini adalah penelitian deskriptif eksploratif, yang menggunakan metode deskriptif kualitatif serta penelaahan dokumen. Desain penelitian adalah cross-sectional dengan pendekatan retrospektif. Sampel penelitian ini adalah seluruh stakeholder kunci yang berada di wilayah kerja Puskesmas Wiyung yang terkait erat dengan pelaksanaan JKN. Analisa dan pengumpulan data dilakukan untuk memvalidasi: informasi dari institusi responden, indepth interview dengan stake holder kebijakan dan pelaksana program, kemudian cek silang oleh enumerator lapangan ke beberapa responden untuk temuan yang memerlukan, dan refleksi tim dalam bentuk pertemuan validasi data. Informasi yang diperoleh dari hasil indepth interview stake holder kebijakan dan pelaksana program, informasi cek silang dari enumerator lapangan maupun data sekunder akan diintegrasikan dengan informasi kualitatif yang terkumpul. Hasil analisis menunjukkan tidak semua pengunjung Puskesmas Wiyung telah menjadi peserta BPJS. Sistem administrasi dianggap rumit untuk dipahami dengan mudah oleh masyarakat.  Perlu sosialisasi kepada masyarakat tentang kepesertaan BPJS dan penguatan koordinasi dengan pihak BPJS apabila ada masalah anggota kepesertaan pasien BPJS.   Kata kunci: implementasi JKN, program JKN, kepesertaan BPJS Abstract   Implementation of National Health Insurance (JKN) in Indonesia faces various challenges, from the side of health care providers, health insurance managers, the community as users, and the government as the program regulator. Various studies have been conducted to examine the impact of JKN on health services in Indonesia, but the use of the results of these studies to improve policies is still limited. This type of research is explorative descriptive research, which uses qualitative descriptive methods and document review. The study design was cross-sectional with a retrospective approach. The sample of this study is all key stakeholders in the Wiyung Health Center working area which are closely related to JKN implementation. Analysis and data collection were carried out to validate: information from the respondent's institution, in-depth interviews with policy stakeholders and program implementers, then cross-check by field enumerators to several respondents for findings that needed, and team reflection in the form of data validation meetings. Information obtained from the results of an in-depth interview of policy stakeholders and program implementers, cross check information from field enumerators and secondary data will be integrated with qualitative information collected. The results of the analysis showed that not all visitors to the Wiyung Health Center had become BPJS participants. The administrative system is considered complicated to be easily understood by the community. Need to disseminate information to the public about BPJS membership and strengthening coordination with BPJS if there are problems with membership of BPJS patients.  Keywords: implementation of JKN, JKN program, BPJS membership

scholarly journals The Role of the Public Health Service Equalization Program in the Control of Hypertension in China: Results from a Cross-sectional Health Interview Survey

2019 ◽  
Author(s):  
Jiangmei Qin ◽  
Yanchun Zhang ◽  
Masha Fridman ◽  
Kim Sweeny ◽  
Lifang Zhang ◽  
...  
Keyword(s):  
Public Health ◽  
Health Service ◽  
Primary Healthcare ◽  
Public Health Service ◽  
Hypertension Control ◽  
Regional Variability ◽  
Cross Sectional ◽  
The Public ◽  
Interview Survey ◽  
The Impact

AbstractObjectivesNon-communicable diseases (NCDs) have become the main cause of mortality in China. In 2009, the Chinese government introduced the Public Health Service Equalization (PHSE) program to restore the primary healthcare system in both essential medical care and public health service provision. This study evaluates the impact of management on hypertension control and evaluate how the program works.MethodsThe China National Health Development Research Centre (CNHDRC) undertook the Cross-sectional Health Service Interview Survey (CHSIS) of 62,097 people from primary healthcare reform pilot areas, across 17 provinces from eastern, central and western parts of China in 2014. This study is based on CHSIS survey responses from 9,607 participants, who had been diagnosed with hypertension. Regression analysis was used to estimate the impact of management provided under PHSE on hypertension control adjusting for the effects of other known determinants of hypertension control.FindingsUncontrolled hypertension was markedly lower among respondents, whose hypertension had been managed (22.4% in managed patients versus 31.1% in unmanaged patients, p<0.001). The interaction between PHSE management and the geographical region was highly significant in the model (p<0.001), suggesting that the PHSE program was not equally effective in all regions. Further analysis suggested that approximately 10% of regional variability was attributed to differences in administrative systems, as there was a significant association (P=0.014) between the presence of established regional Information Management Systems (IMS) and increased PHSE effectiveness. Insurance (χ2(5)=4.4, p=0.496) and Hukou (χ2(1)=2.4, p=0.121), which denote social security and urban rural differences, respectively, were not significant predictor of hypertension control.ConclusionActive management of hypertension through the PHSE program was effective with 7.31 million more patients receiving hypertension control and equalization of service delivery was reflected to some extent. The link between established IMS and regional variability in the impact of PHSE highlights the importance of effective management of patient referrals and follow-up. Further investigation is needed to explore the factors that influence the effectiveness of PHSE.

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