scholarly journals Identifying superusers of health services with mental health and addiction problems

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Jacqueline Quail ◽  
Maureen Anderson ◽  
Meric Osman ◽  
Claire De Oliveira ◽  
Walter Wodchis ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
Early Childhood ◽  
Health Services ◽  
Health Care Costs ◽  
Hypodermic Needle ◽  
Notifiable Disease ◽  
Care Costs

ABSTRACT ObjectiveThe objective of this research is to identify people with mental health and/or addiction (MHA) problems and determine characteristics that led to them becoming a superuser of health services (i.e., the most expensive 10% of all health service users). ApproachIn Saskatchewan, Canada, we used hospital and physician administrative data spanning 2005 to 2014 to identify the MHA cohort. We will calculate total health care costs for each individual and assign them to one of three groups: low cost users (<50th percentile), moderate cost users (50-<90th percentile), and superusers (90th percentile and above). For each group, we will describe sociodemographic characteristics, disease characteristics, and use of health services, and describe their trajectory towards becoming a superuser. Predictors of becoming a superuser will be identified. A novel aspect of this research is the inclusion of sociobehavioural risk factors by linking 4 population and public health administrative datasets obtained from the Saskatoon Health Region to the provincial administrative health services data. Sociobehavioral factors are widely accepted as strongly influencing health. Each database was selected because it captures data on a sociobehavioral factor. The Oral Health Database contains data on early childhood development, including early childhood tooth decay, dental health status, and tobacco use in elementary school-aged children. The Integrated Public Health Information System contains data on self-reported ethnicity, the occurrence of an infectious notifiable disease, and behavioural and social risk factors for the notifiable disease. The Sexually Transmitted Infection (STI) Clinic Data contains data on exposure to and contraction of STIs, as well as referrals given for mental health and/or addiction services. Finally, the Street Outreach Program provides services to individuals living a high-risk lifestyle on the street. Their database contains information on self-reported ethnicity, hypodermic needle exchange, and homelessness. ResultsIn a province of approximately 1.1 million people, we identified 417,724 people as having at least 1 MHA diagnosis, of which two-thirds were depression and/or anxiety. Substance abuse was found in 9.4%, and schizotypal and psychotic disorders were found in 7.9%, of the MHA cohort, ConclusionIndividuals with severe MHA problems account for a disproportionate amount of health care costs. Identifying predictors of becoming an MHA superuser may afford an opportunity to intervene, possibly years in the future, to prevent a person from becoming a superuser. If true, this has significant implications for health care costs, wait times to access health services, and quality of life for this vulnerable population.

scholarly journals Etiology, Pathology, and Classification of Atrial Fibrillation

2020 ◽  
Vol 29 (02) ◽  
pp. 065-071
Author(s):  
Srishti Nayak ◽  
Balaji Natarajan ◽  
Ramdas G. Pai
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Atrial Fibrillation ◽  
Health Care ◽  
Health Care Costs ◽  
High Morbidity ◽  
Public Health Importance ◽  
Significant Public Health ◽  
Care Costs

AbstractAtrial fibrillation (AF) is a disorganized tachyarrhythmia with significant public health importance due to high morbidity, mortality, and health-care costs. Incidence rate of AF is on the rise and there are several modifiable and nonmodifiable risk factors that are responsible. Exact mechanisms and pathogenesis of AF are still poorly understood, yet they still have great implications in management. The aim of this article is to summarize the epidemiology, major risk factors, and their role in the pathogenesis of AF. Finally, we have reviewed the classification of AF as per professional society guidelines.

scholarly journals Health Services Use and Health Care Costs of Obese and Nonobese Individuals

2004 ◽  
Vol 164 (19) ◽  
pp. 2135 ◽  
Author(s):  
Marsha A. Raebel ◽  
Daniel C. Malone ◽  
Douglas A. Conner ◽  
Stanley Xu ◽  
Julie A. Porter ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Costs ◽  
Health Services Use ◽  
Care Costs ◽  
Services Use

scholarly journals Direct Health Care Costs of Treating Seasonal Affective Disorder: A Comparison of Light Therapy and Fluoxetine

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Amy Cheung ◽  
Carolyn Dewa ◽  
Erin E. Michalak ◽  
Gina Browne ◽  
Anthony Levitt ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Affective Disorder ◽  
Health Care Costs ◽  
Seasonal Affective Disorder ◽  
Light Therapy ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Care Costs

Objective.To compare the direct mental health care costs between individuals with Seasonal Affective Disorder randomized to either fluoxetine or light therapy.Methods.Data from the CANSAD study was used. CANSAD was an 8-week multicentre double-blind study that randomized participants to receive either light therapy plus placebo capsules or placebo light therapy plus fluoxetine. Participants were aged 18–65 who met criteria for major depressive episodes with a seasonal (winter) pattern. Mental health care service use was collected for each subject for 4 weeks prior to the start of treatment and for 4 weeks prior to the end of treatment. All direct mental health care services costs were analysed, including inpatient and outpatient services, investigations, and medications.Results.The difference in mental health costs was significantly higher after treatment for the light therapy group compared to the medication group—a difference of $111.25 (z=−3.77,P=0.000). However, when the amortized cost of the light box was taken into the account, the groups were switched with the fluoxetine group incurring greater direct care costs—a difference of $75.41 (z=−2.635,P=0.008).Conclusion.The results suggest that individuals treated with medication had significantly less mental health care cost after-treatment compared to those treated with light therapy.

Criminal Justice and Behavioral Health Care Costs of Mental Health Court Participants: A Six-Year Study

2014 ◽  
Vol 65 (9) ◽  
pp. 1100-1104 ◽  
Author(s):  
Henry J. Steadman ◽  
Lisa Callahan ◽  
Pamela Clark Robbins ◽  
Roumen Vesselinov ◽  
Thomas G. McGuire ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Criminal Justice ◽  
Behavioral Health ◽  
Health Care Costs ◽  
Behavioral Health Care ◽  
Mental Health Court ◽  
Care Costs

scholarly journals Public Attitudes Toward Psychiatric Hospitals: A Rural-Urban Comparative Public Survey in Odisha State, India

2021 ◽  
Vol 12 ◽  
Author(s):  
Sunita Jena ◽  
Aron Zieger ◽  
Kerem Böge ◽  
Gayatri Salunkhe ◽  
Georg Schomerus ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Rural Areas ◽  
Psychiatric Hospitals ◽  
Urban Setting ◽  
Negative Attitudes

Background: Integration of psychiatric care with public health services and offering mental health care services to patients from lower socioeconomic status remains a global challenge. Scarcity of funds and professional workforce in psychiatric hospitals contribute to this situation. However, negative attitudes in the population are also a known impediment to patients seeking mental health services. This study aimed to assess the attitudes toward psychiatric hospitals among the urban and rural population in India.Subjects and Methods: The study was carried out amongst the general population in Odisha, India. The total sample (n = 988) includes 496 respondents from an urban-setting, and 492 respondents from rural parts of the district. Participants were selected by using simple random-sampling from the Asian Institute of Public Health (AIPH) data base. A standardized seven-item questionnaire was adopted, with responses indicated on a 5-point Likert-scale. Interviews were fully structured and conducted face-to-face.Results: Level of education (B = −0.192, ß = −0.320, p &lt; 0.000) and urban-rural comparison (B = −0.272, ß = −0.189, p &lt; 0.000) significantly influenced attitudes toward psychiatric hospitals. Gender, age, and religious beliefs did not show any significant effect on attitudes toward psychiatric hospitals. Individuals in rural areas and those with lower education levels showed more negative attitudes toward psychiatric hospitals.Conclusion: Negative attitudes toward psychiatric hospitals from those living in rural areas as well as those with lesser education may be reflective of the lack of availability, accessibility, affordability, and credibility of such mental health services. The Mental Health Care Act in India is a progressive legislation which might improve the situation of the provided services and, consequently, reduce negative attitudes in the years to come.

scholarly journals Academic health services and health needs of college students around the era of the Covid-19 pandemic

2021 ◽  
Vol 8 (4) ◽  
pp. 193-197
Author(s):  
Eirini Kotsalou ◽  
Evanthia Sakellari ◽  
Areti Lagiou ◽  
Evaggelia Kotsalou
Keyword(s):  
Public Health ◽  
Mental Health ◽  
College Students ◽  
Health Care ◽  
Health Services ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Health Problems ◽  
Health Needs ◽  
Public Health Care

Objective: The university medical services vary around the world (even within each university), but there are only a few publications on the utilization of these services by the students. The available on-campus services of public health care might include general health care, women’s centers, mental health care, disability services, wellness resource centers, career counseling, and alcohol and other drug education programs. Evidence Acquisition: This paper reviews the current literature on the overtime and current (due to Covid-19 pandemic) public health needs of college students based on studies that report the commonest specific diagnostic reasons for using the on-campus health care services. Results: Special reference is done on mental health problems among students generally and the students of health professions fields (a specific category themselves). Besides, other issues of interest are the substance-related problems among students and their perceptions about mental health problems and on- campus help- seeking services. Conclusions: It is unanimous that we need further educational and promotional campaigns to enhance the students; help-seeking behaviors, reduce stigmatizing behaviors and create more preventive public health services on campus, but also out-campus due to the Covid-19 pandemic. 

scholarly journals Burden of health behaviours and socioeconomic position on health care expenditure in Ontario

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 303
Author(s):  
Douglas G. Manuel ◽  
Carol Bennett ◽  
Richard Perez ◽  
Andrew S. Wilton ◽  
Adrian Rohit Dass ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Health Care Costs ◽  
Health Behaviour ◽  
Socioeconomic Position ◽  
Healthcare Costs ◽  
Cost Model ◽  
Health Care Expenditure ◽  
Health Behaviours ◽  
Care Costs

Background: Smoking, unhealthy alcohol consumption, poor diet and physical inactivity are leading risk factors for morbidity and mortality, and contribute substantially to overall healthcare costs. The availability of health surveys linked to health care provides population-based estimates of direct healthcare costs. We estimated health behaviour and socioeconomic-attribute healthcare costs, and how these have changed during a period when government policies have aimed to reduce their burden.  Methods: The Ontario samples of the Canadian Community Health Surveys (conducted in 2003, 2005, and 2007-2008) were linked at the individual level to all records of health care use of publicly funded healthcare. Generalized linear models were estimated with a negative binomial distribution to ascertain the relationship of health behaviours and socioeconomic risk factors on health care costs. The multivariable cost model was applied to unlinked, Ontario CCHS samples for each year from 2004 to 2013 to examine the evolution of health behaviour and socioeconomic-attributable direct health care expenditures over a 10-year period. Results: We included 80,749 respondents, aged 25 years and older, and 312,952 person-years of follow-up. The cost model was applied to 200,324 respondents aged 25 years and older (CCHS 2004 to 2013). During the 10-year period from 2004 to 2013, smoking, unhealthy alcohol consumption, poor diet and physical inactivity attributed to 22% of Ontario’s direct health care costs. Ontarians in the most disadvantaged socioeconomic position contributed to 15% of the province’s direct health care costs. Combined, these health behaviour and socioeconomic risk factors were associated with 34% ($134 billion) of direct health care costs (2004 to 2013). Over this time period, we estimated a 1.9% reduction in health care expenditure ($5.0 billion) attributable to improvements in some health behaviours, most importantly reduced rates of smoking. Conclusions: Adverse health behaviours and socioeconomic position cause a large direct health care system cost burden.

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