scholarly journals Exploring the use of emergency health services for stroke: what is known about when to seek emergency help and how transport decisions impact in-hospital emergency care

2021 ◽  
Author(s):  
◽  
Damanpreet Kandola
Keyword(s):  
Decision Making ◽  
British Columbia ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Service Use ◽  
Stroke Care ◽  
Health Service Delivery ◽  
Health Service Use ◽  
Emergency Health Services

Transport practices for seeking emergency stroke care remain largely underresearched and poorly understood, particularly for individuals living in small urban, rural, and remote regions. This multi-method study aims to address this knowledge gap and explores the impact of mode of transport on in-hospital stroke care and the decision-making process of seeking emergency medical attention for patients and their caregivers. Data from the Discharge Abstract Database provide information on stroke-related use of emergency health services across British Columbia. Data from the Canadian Institutes for Health Information Special Project 340 provide information on if calling emergency health services impacts the delivery of care, including the completion of neuroimaging, the administration of acute thrombolysis, and the prescription of antithrombotics upon discharge across a northern health region. Focused, semi-structured interviews provide contextual insight into the decision-making processes for seeking emergency stroke care among patient and caregiver participants in a northern health region. Stroke-related emergency health service use across British Columbia from January 2015 to March 2018 was 67.9% (N=19,849), ranging from 58.8% in Northern Health to 70.2% in Fraser Health. In Northern Health (N=784), there were differences between health service delivery areas for stroke-related emergency health service use ranging from 53.7% in the Northwest to 64.8% in the Northern Interior from January 2015 to March 2018. Similar differences in thrombolytic therapy administration and the prescription of antithrombotics were noted. The odds of emergency health service use were greater for those 65 years of age and older than those younger than 65 and lower for those in the Northwest health service delivery area than those in the Northern Interior health service delivery area. Differences were found for the completion of neuroimaging between males and females. Interviews for patient (n=12) and caregiver (n=7) participants provide complementary contextual insights and yielded three key themes, including the decision-making process following a stroke, experiences of care, and perceived gaps and areas in need of further support. This integrated knowledge translation-informed and practice-driven research addresses health services and policy priorities. Findings are anticipated to help inform the development and refinement of emergency health services in British Columbia by highlighting differences in emergency health services use across geographies and identifying factors that inform patient decisionmaking when seeking emergency medical attention.

Influence of living arrangements on health services utilisation in Australia

2012 ◽  
Vol 36 (1) ◽  
pp. 34 ◽  
Author(s):  
M. Afzal Mahmood ◽  
Anna E. Bauze ◽  
Justin T. Lokhorst ◽  
Peng Bi ◽  
Arthur Saniotis
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Health Service ◽  
Health Services ◽  
Informal Care ◽  
Living Arrangements ◽  
Service Use ◽  
Household Composition ◽  
Health Service Use ◽  
Use Of Health Services

Background. The number of people living alone is increasing markedly. Others live as couples only, couples with child(ren) and single adult with child(ren). Health service utilisation could differ for people in different living arrangements as a result of varying levels of risk factors, health status, access to informal care and decision-making for accessing care. Objective. To identify the association between living arrangements and health service use. Methods. The Australian Bureau of Statistics’ National Health Survey 2001 data for people 18–65 years old were analysed for household composition and service use. Results. People in various household types differ in terms of their overall use of health services and their use of services by general practitioners. Sex, rurality, socioeconomic status and status of heart condition significantly influenced the use of health services. Conclusion. There are implications for health services provision and planning within the context of rapid changes in living arrangements. Additional research is required to explore the reasons to such differences, level of access to informal care, healthcare decision-making processes and consequences of under- or over-utilisation of services. What is known about the topic? Health service use is influenced by the disease burden and pattern, demography, economic factors, access to social support, quality of care and satisfaction with standards of care. These factors may influence access to and use of care. What does this paper add? This research points to the potential role of living arrangements on health services use. Many people now live alone and may not have access to informal care, and access to health information and education. People in different living arrangements appear to have different health service use. What are the implications for practitioners? Practitioners, in both primary care and acute care sectors, need to consider that patients, including younger people, may not have access to informal care, may present with delays and may not have the needed adequate support during convalescence. Health education needs to consider that people in different living arrangements may be exposed to different levels of risk factors in terms of their healthcare use.

scholarly journals Higher Rates of Untreated Distress in Older Versus Younger Adults With Indolent Lymphoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 466-466
Author(s):  
Kelly Trevino ◽  
Peter Martin ◽  
John Leonard
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Younger Adults

Abstract Indolent lymphomas are incurable but slow-growing cancers, resulting in a large number of older adults living with these diseases. Patients typically live with their illness for years with the knowledge that disease progression is likely. Yet, little is known about psychological distress in this population. This study examined rates of and the relationship between distress and mental health service use in older and younger adults with indolent lymphomas. Adult patients diagnosed with an indolent lymphoma (e.g., follicular lymphoma, marginal zone lymphoma) within the past six months completed self-report surveys of distress (Hospital Anxiety and Depression Scale; HADS) and mental health service use since the cancer diagnosis (yes/no). Descriptive statistics, t-tests, and chi-square analyses were used to examine study questions. The sample (n=84) included 35 patients 65 years or older. Across the entire sample, 21.4% screened positive for distress on the HADS; 58.8% of these patients did not receive mental health services. Older adults reported lower distress levels than younger adults (17.1% v. 24.5%; p=.038). Among younger adults, 50% of distressed patients received mental health services; only 20% of distressed older adults received mental health services. Distress was associated with mental health service use in younger adults (p=.004) but not in older adults (p=.17). Older adults with indolent lymphomas have higher levels of untreated distress than younger adults. Research on the mechanisms underlying these age differences (e.g., stigma toward mental health services, ageism) would inform interventions to increase rates of mental health service use and reduce care disparities due to age.

The Use of Information and Communication Technologies for Health Service Delivery in Namibia

2010 ◽  
pp. 191-206
Author(s):  
Meke I. Shivute ◽  
Blessing M. Maumbe
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Information And Communication Technologies ◽  
Mobile Phones ◽  
Communication Technologies ◽  
Health Service Delivery ◽  
Health Service Providers ◽  
Information And Communication ◽  
Sub Saharan

Information and communication technologies (ICT) have transformed health service delivery (HSD) in developing countries although the benefits are not yet fully understood. This chapter examines the use of ICT for HSD in the Namibian context. To obtain insights into the extent and degree of the current ICT uses, the chapter begins by mapping a HSD landscape for Namibia. The reported ICT use patterns are based on a primary survey of 134 patients and key informant interviews held with 27 health service providers (HSPs) in Khomas and Oshana regions of Namibia. The results from the survey indicate that Namibian patients use diverse range of ICT to access health services including the traditional television and radio, and the more modern mobile phones and computers to a limited extent. HSPs reported the growing use of ICT in various functional areas such as admissions, clinical support, family planning, maternity, and emergency services. The chapter identifies key challenges and policy implications to enhance the uptake of ICT-based health services in Namibia. The relatively high penetration rates of traditional ICT such as televisions and radios coupled with a growing use of mobile phones presents new alternative opportunities for expanding HSD to Namibian patients in remote settings. The chapter will benefit HSP and patients as they decide on affordable technology choices; and policy makers as they design interventions to stimulate the use of ICT in HSD in Namibia. The results provide key insights for other Sub-Saharan African countries contemplating ICT integration in health services.

The Use of Information and Communication Technologies for Health Service Delivery in Namibia

2011 ◽  
pp. 1074-1089
Author(s):  
Meke I. Shivute ◽  
Blessing M. Maumbe
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Information And Communication Technologies ◽  
Mobile Phones ◽  
Communication Technologies ◽  
Health Service Delivery ◽  
Health Service Providers ◽  
Information And Communication ◽  
Sub Saharan

Information and communication technologies (ICT) have transformed health service delivery (HSD) in developing countries although the benefits are not yet fully understood. This chapter examines the use of ICT for HSD in the Namibian context. To obtain insights into the extent and degree of the current ICT uses, the chapter begins by mapping a HSD landscape for Namibia. The reported ICT use patterns are based on a primary survey of 134 patients and key informant interviews held with 27 health service providers (HSPs) in Khomas and Oshana regions of Namibia. The results from the survey indicate that Namibian patients use diverse range of ICT to access health services including the traditional television and radio, and the more modern mobile phones and computers to a limited extent. HSPs reported the growing use of ICT in various functional areas such as admissions, clinical support, family planning, maternity, and emergency services. The chapter identifies key challenges and policy implications to enhance the uptake of ICT-based health services in Namibia. The relatively high penetration rates of traditional ICT such as televisions and radios coupled with a growing use of mobile phones presents new alternative opportunities for expanding HSD to Namibian patients in remote settings. The chapter will benefit HSP and patients as they decide on affordable technology choices; and policy makers as they design interventions to stimulate the use of ICT in HSD in Namibia. The results provide key insights for other Sub-Saharan African countries contemplating ICT integration in health services.

Mental health service use decision‐making among young adults at clinical high risk for developing psychosis

2018 ◽  
Vol 13 (5) ◽  
pp. 1050-1055 ◽  
Author(s):  
Shelly Ben‐David ◽  
Andrea Cole ◽  
Gary Brucato ◽  
Ragy R. Girgis ◽  
Michelle R. Munson
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Young Adults ◽  
Mental Health Service ◽  
High Risk ◽  
Health Service ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Clinical High Risk

scholarly journals Mental Health Services in Childhood: The Role of Family Adversity

2019 ◽  
Vol 134 (2) ◽  
pp. 180-188
Author(s):  
Héctor E. Alcalá ◽  
Rajesh Balkrishnan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Childhood Adversity ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Continuous Measure

Objective: Much of the research on the effects of childhood adversity on mental health has focused on adults. The objective of our study was to examine the individual and cumulative effect of childhood adversity on mental health service use among children. Methods: We used data from the 2011-2012 National Survey of Children’s Health (n = 79 834) to determine the use of mental health services in the past 12 months among children aged 2-17. The independent variables of interest were experiencing any 1 of 9 adverse family experiences (AFEs). We used logistic regression models to determine if each AFE was associated with mental health service use. We also examined AFEs as a continuous measure, representing the number of AFEs (ranging from 0 to 9) that summed them individually, and we examined age-by-AFE and age-by-need interaction terms. We adjusted all models for confounders. Results: Compared with not experiencing an AFE, experiencing all AFEs was associated with higher odds of mental health service use. Neighborhood violence was associated with the greatest increase in odds of mental health service use (adjusted odds ratio [aOR] = 2.35; 95% confidence interval [CI], 2.00-2.77). When measured as a continuous scale, each additional AFE was associated with higher odds of mental health service use (aOR = 1.33; 95% CI, 1.28-1.37). The effect of AFEs on mental health service use decreased with age. Conclusions: The observed association between AFEs and use of mental health services may be attributable to more severe or poorly managed mental illness among these children. Efforts are needed to increase access to and quality of mental health care among children affected by AFEs.

Examining Models of Mental Health Service Delivery in the Emergency Department

2007 ◽  
Vol 41 (10) ◽  
pp. 784-791 ◽  
Author(s):  
Timothy Wand ◽  
Kathryn White
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Emergency Department ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Health Service Delivery ◽  
Mental Health Service Delivery

The purpose of the present paper was to review the current models of mental health service delivery used in the emergency department (ED) setting. A search was conducted of the nursing and medical literature from 1990 to 2007 for relevant articles and reports. Consideration was also given to the global and local context influencing contemporary mental health services. Wider sociopolitical and socioeconomic influences and systemic changes in health-care delivery have dictated a considerable shift in attention for mental health services worldwide. The ED is a topical location that has attracted interest and necessitated a response. The mental health liaison nurse (MHLN) role embedded within the ED structure has demonstrated the most positive outcomes to date. This model aims to raise mental health awareness and address concerns over patient-focused outcomes such as reduced waiting times, therapeutic intervention and more efficient coordination of care and follow up for individuals presenting to the ED in psychological distress. Further research is required into all methods of mental health service delivery to the ED. The MHLN role is a cost-effective approach that has gained widespread approval from ED staff and mental health patients and is consistent with national and international expectations for mental health services to become fully integrated within general health care. The mental health nurse practitioner role situated within the ED represents a potentially promising alternative for enhanced public access to specialized mental health care.

scholarly journals Timing of Health Service Use Among Truck Drivers After a Work-Related Injury or Illness

2021 ◽  
Author(s):  
Ting Xia ◽  
Alex Collie ◽  
Sharon Newnam ◽  
Dan I. Lubman ◽  
Ross Iles
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Truck Drivers ◽  
Health Service Use ◽  
Work Related ◽  
Work Related Injury ◽  
Service Type ◽  
Compensation Claims

AbstractPurposes Timely delivery of treatment and rehabilitation is generally acknowledged to support injury recovery. This study aimed to describe the timing of health service use by injured truck drivers with work-related injury and to explore the association between demographic and injury factors and the duration of health service use. Methods Retrospective cohort study of injured truck drivers with accepted workers’ compensation claims in the state of Victoria, Australia. Descriptive analyses examined the percentage of injured truck drivers using health services by service type. Logistic regression model examined predictors of any service use versus no service use, and predictors of extended service use (≥ 52 weeks) versus short-term use. Results The timing of health service use by injured truck drivers with accepted workers’ compensation claims varies substantially by service type. General practitioner, specialist physician, and physical therapy service use peaks within the 14 weeks after compensation claim lodgement, whilst the majority of mental health services were accessed in the persistent phase beyond 14 weeks after claim lodgement. Older age, being employed by small companies, and claiming compensation for mental health conditions were associated with greater duration of health service use. Conclusions Injured truck drivers access a wide range of health services during the recovery and return to work process. Delivery of mental health services is delayed, including for those making mental health compensation claims. Health service planning should take into account worker and employer characteristics in addition to injury type.

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