Socioeconomic Disparities in the demand for and use of virtual visits among senior adults during the COVID-19 pandemic: A cross-sectional study (Preprint)

2021 ◽  
Author(s):  
Ellie Yu
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Services ◽  
Socioeconomic Disparities ◽  
Cross Sectional ◽  
Secure Messaging ◽  
Negatively Associated ◽  
Care Services ◽  
Virtual Care ◽  
Virtual Visits

BACKGROUND The COVID-19 pandemic has limited the provision of in-person care and accelerated the need for virtual care. Older adults (65+) were one of the highest user groups of in-person health care services prior to the pandemic. Social-distancing guidelines and high rates of mortality from coronavirus infections among older adults made receiving in-person health care services challenging for older adults. The provision of virtual care technologies can help to ensure continuity of care and provide essential health care services during the pandemic to those in high-risk groups at contracting the COVID-19 coronavirus including older adults. It is also essential to understand and address potential socioeconomic, demographic, and health disparities in the demand for use of virtual care technologies among older adults. OBJECTIVE The objective of this study is to investigate socioeconomic disparities in the demand for and use of virtual visit during the COVID-19 pandemic among older adults in Canada. METHODS A cross-sectional web survey was conducted with 12,052 Canadians over the age of 16, selected from Leger’s LEO panel between July 14th to August 6th, 2021. Associations between socioeconomic factors and the demand for and use of virtual visits were tested using the χ2 tests and logistic regression models. Weighting was applied using the 2016 census reference variables to render a representative sample of the Canadian population. RESULTS Approximately 20% (n=2,303) of the survey sample were older adults above the age of 65. The proportion of older adults who expressed demand for telephone visit, video visits, and secure messaging were 69.6%, 49.2%, and 47.2%, respectively. The proportion of older adults in our sample who have used telephone visit in the past 12 months was 47.3%, 9.2%, and 8.4%, respectively. eHealth literacy was positively associated with use of telephone visits (OR 1.03, p=0.01), use of video visits (OR 1.04, p=0.00), and the use of secure messaging (OR 1.03, p=0.00). Income was negatively associated with the use of video visits (OR 0.65, p=0.03). Having no private insurance coverage was negatively associated with use of secure messaging (OR 0.73, p=0.04) but living in a rural community (OR 1.72, p=0.01) and being born outside of Canada (OR 1.50, p=0.03) were positively associated with the use of secure messaging. Education (OR 0.78, p=0.02) and being non-White (OR=0.54, p=0.02) were negatively associated with the use of telephone visits. CONCLUSIONS This study found that demand for and use of telephone visit services were more prevalent among older adults during the pandemic. Although demand for secure messaging and video visit is high, usage for these modalities remains low. The results highlight several socioeconomic factors that are associated with demand for virtual visits including language, community size, and health coverage.

scholarly journals The Relations between Disability and Environmental Factors: A Pilot Study in Iranian Older Adults

2016 ◽  
Vol 8 (12) ◽  
pp. 87 ◽  
Author(s):  
Mohammadreza Shahbazi ◽  
Mahshid Foroughan ◽  
Mahdi Rahgozar ◽  
Reza Salmanroghani
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Environmental Factors ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
World Health ◽  
Structural Barriers ◽  
Cross Sectional ◽  
Care Services ◽  
Health Organization

<p><strong>OBJECTIVE: </strong>This study explored disability and its correlations with the environmental factors in a group of Iranian older adults.</p><p><strong>MATERIALS &amp; METHODS</strong><strong>:</strong> A cross sectional study was performed. One hundred participants receiving adult day care services in Kahrizak center in Iran were selected by using the complete enumeration method. The World Health Organization Disability Assessment Schedule 2 (WHODAS II) and the Craig Hospital Inventory of Environmental Factors (CHIEF) questionnaires were used to collect data.</p><p><strong>RESULTS:</strong> The mean score of disability was 20.61±13.66, and the scores were higher in women compared to men (P=0.001). Among the CHIEF-25 items‚ the most frequently perceived barrier by the participants was transportation followed by home design and unavailability of health care services. There was a significant association between the disability scores and the environmental factors (P&lt;0.001). Also, significant relationships were found between the disability and all the subscales investigated in the study (polices‚ physical/structural‚ attitude/support‚ services/assistance) (P&lt;0.001).<strong></strong></p><p><strong>CONCLUSION: </strong>Appropriate transportation‚ availability to health care services and removing physical/structural barriers should be taken in consideration.</p>

scholarly journals Older adults with non-communicable chronic conditions and their health care access amid COVID-19 pandemic in Bangladesh: Findings from a cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255534
Author(s):  
Sabuj Kanti Mistry ◽  
A. R. M. Mehrab Ali ◽  
Uday Narayan Yadav ◽  
Saruna Ghimire ◽  
Md. Belal Hossain ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Services ◽  
Medical Care ◽  
Chronic Conditions ◽  
Health Care Services ◽  
Care Delivery ◽  
Cross Sectional ◽  
Care Services ◽  
Routine Medical Care

Background Burgeoning burden of non-communicable disease among older adults is one of the emerging public health problems. In the COVID-19 pandemic, health services in low- and middle-income countries, including Bangladesh, have been disrupted. This may have posed challenges for older adults with non-communicable chronic conditions in accessing essential health care services in the current pandemic. The present study aimed at exploring the challenges experienced by older Bangladeshi adults with non-communicable chronic conditions in receiving regular health care services during the COVID-19 pandemic. Materials and methods The study followed a cross-sectional design and was conducted among 1032 Bangladeshi older adults aged 60 years and above during October 2020 through telephone interviews. Self-reported information on nine non-communicable chronic conditions (osteoarthritis, hypertension, heart disease, stroke, hypercholesterolemia, diabetes, chronic respiratory diseases, chronic kidney disease, cancer) was collected. Participants were asked if they faced any difficulties in accessing medicine and receiving routine medical care for their medical conditions during the COVID-19 pandemic. The association between non-communicable chronic conditions and accessing medication and health care was analysed using binary logic regression model. Results Most of the participants aged 60–69 years (77.8%), male (65.5%), married (81.4%), had no formal schooling (58.3%) and resided in rural areas (73.9%). Although more than half of the participants (58.9%) reported having a single condition, nearly one-quarter (22.9%) had multimorbidity. About a quarter of the participants reported difficulties accessing medicine (23%) and receiving routine medical care (27%) during the pandemic, and this was significantly higher among those suffering from multimorbidity. In the adjusted analyses, participants with at least one condition (AOR: 1.95, 95% CI: 1.33–2.85) and with multimorbidity (AOR: 4.75, 95% CI: 3.17–7.10) had a higher likelihood of experiencing difficulties accessing medicine. Similarly, participants with at least one condition (AOR: 3.08, 95% CI: 2.11–4.89) and with multimorbidity (AOR: 6.34, 95% CI: 4.03–9.05) were significantly more likely to face difficulties receiving routine medical care during the COVID-19 pandemic. Conclusions Our study found that a sizeable proportion of the older adults had difficulties in accessing medicine and receiving routine medical care during the pandemic. The study findings highlight the need to develop an appropriate health care delivery pathway and strategies to maintain essential health services during any emergencies and beyond. We also argue the need to prioritise the health of older adults with non-communicable chronic conditions in the centre of any emergency response plan and policies of Bangladesh.

Impact of restricting access to health care services on Syrian refugees in Jordan: evidence from cross-sectional surveys

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ibraheem Khaled Abu Siam ◽  
María Rubio Gómez
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Care Cost ◽  
Syrian Refugees ◽  
Cross Sectional ◽  
Content Type ◽  
Care Access ◽  
Care Services

Purpose Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan. Design/methodology/approach This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact. Findings The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake. Originality/value Understanding access barriers to health services and its negative short-term and long-term impact on refugees’ health status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.

scholarly journals Pharmaceutical care in Brazil’s primary health care

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Patricia Sodré Araújo ◽  
Ediná Alves Costa ◽  
Augusto Afonso Guerra Junior ◽  
Francisco de Assis Acurcio ◽  
Ione Aquemi Guibu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Pharmaceutical Care ◽  
Health Care Services ◽  
Cross Sectional ◽  
Educational Activities ◽  
Health Team ◽  
Care Services ◽  
Primary Health

OBJECTIVE: To characterize the activities of clinical nature developed by pharmacists in basic health units and their participation in educational activities aiming at health promotion. METHODS: This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015), a cross-sectional and exploratory study, of evaluative nature, consisting of a survey of information in a representative sample of cities, stratified by the Brazilian regions that constitute domains of study, and a subsample of primary health care services. The interviewed pharmacists (n=285) were responsible for the delivery of medicines and were interviewed in person with the use of a script. The characterization of the activities of clinical nature was based on information from pharmacists who declared to perform them, and on participation in educational activities aiming at health promotion, according to information from all pharmacists. The results are presented in frequency and their 95% confidence intervals. RESULTS: From the interviewed subjects, 21.3% said they perform activities of clinical nature. Of these, more than 80% considered them very important; the majority does not dispose of specific places to perform them, which hinders privacy and confidentiality in these activities. The main denominations were “pharmaceutical guidance” and “pharmaceutical care.” The registration of activities is mainly made in the users’ medical records, computerized system, and in a specific document filed at the pharmacy, impairing the circulation of information among professionals. Most pharmacists performed these activities mainly along with physicians and nurses; 24.7% rarely participated in meetings with the health team, and 19.7% have never participated. CONCLUSIONS: Activities of clinical nature performed by pharmacists in Brazil are still incipient. The difficulties found point out to the professionals’ improvisation and effort. The small participation in educational activities of health promotion indicates little integration of pharmacists with the health team and of pharmaceutical services with other health actions

Later Life Care Planning and Concerns of Transgender Older Adults in Canada

2019 ◽  
Vol 89 (1) ◽  
pp. 39-56 ◽  
Author(s):  
Celeste Pang ◽  
Gloria Gutman ◽  
Brian de Vries
Keyword(s):  
Older Adults ◽  
Health Care ◽  
End Of Life Care ◽  
Health Care Services ◽  
Later Life ◽  
Care Planning ◽  
Life Care ◽  
Transgender People ◽  
Care Services ◽  
Transgender Persons

While the particular health-care concerns of transgender people have been documented and transgender aging is an emerging area of scholarship, little is known about planning for later and end-of-life care among transgender older adults. As part of a larger project, focus groups and interviews were conducted with 24 transgender older adults (average age 70 years) living in five cities in Canada exploring their concerns and explicit plans for later life care. Three primary themes emerged: (a) “dealing with the day-to-day” reflecting economic precarity and transitioning in later life, (b) fractures and support within family and community, and (c) “there’s a huge gap between principle and practice” reflecting mixed experiences and perceptions of health-care services. These themes suggest that effective promotion of care planning among older transgender persons requires an appreciation of the daily exigencies of their lives and the extent and nature of social support available to them.

P3-610: USE OF HEALTH CARE SERVICES AMONG OLDER ADULTS PARTICIPATING IN A MULTIDOMAIN LIFESTYLE INTERVENTION TO PREVENT COGNITIVE IMPAIRMENT (FINGER)

2006 ◽  
Vol 14 (7S_Part_25) ◽  
pp. P1363-P1363
Author(s):  
Tiia Ngandu ◽  
Jenni Kulmala ◽  
Riitta Antikainen ◽  
Tiina Laatikainen ◽  
Hilkka Soininen ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cognitive Impairment ◽  
Lifestyle Intervention ◽  
Health Care Services ◽  
Care Services ◽  
Use Of Health Care

scholarly journals The ecology of medical care in Norway: wide use of general practitioners may not necessarily keep patients out of hospitals

2012 ◽  
Vol 1 (2) ◽  
pp. 28 ◽  
Author(s):  
Anne Helen Hansen ◽  
Peder A. Halvorsen ◽  
Olav Helge Førde
Keyword(s):  
Health Care ◽  
General Practitioner ◽  
General Practitioners ◽  
Health Care Services ◽  
Medical Providers ◽  
Specialist Care ◽  
Cross Sectional ◽  
Care Services ◽  
And Gender ◽  
Complementary And Alternative

<em>Background</em>. Our aim was to investigate the pattern of self reported symptoms and utilisation of health care services in Norway. <em>Design and methods.</em> With data from the cross-sectional Tromsø Study (2007-8), we estimated population proportions reporting symptoms and use of seven different health services. By logistic regression we estimated differences according to age and gender. <em>Results</em>. 12,982 persons aged 30-87 years participated, 65.7% of those invited. More than 900/1000 reported symptoms or health problems in a year as well as in a month, and 214/1000 and 816/1000 visited a general practitioner once or more in a month and a year, respectively. The corresponding figures were 91/1000 and 421/1000 for specialist outpatient visits, and 14/1000 and 116/1000 for hospitalisations. Physiotherapists were visited by 210/1000, chiropractors by 76/1000, complementary and alternative medical providers by 127/1000, and dentists by 692/1000 in a year. Women used most health care services more than men, but genders used hospitalisations and chiropractors equally. Utilisation of all services increased with age, except chiropractors, dentists and complementary and alternative medical providers. <em>Conclusions</em>. Almost the entire population reported health related problems during the previous year, and most residents visited a general practitioner. Yet there were high rates of inpatient and outpatient specialist utilisation. We suggest that wide use of general practitioners may not necessarily keep patients out of specialist care and hospitals.

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