scholarly journals COVID-19 and Dispositions of the Chilean Healthcare System: Sociomedical Networks in Care Decisions of Chronic Illnesses

2021 ◽  
Vol 6 ◽  
Author(s):  
Nicolás Schöngut-Grollmus ◽  
María-Alejandra Energici ◽  
Natalia Zuñiga
Keyword(s):  
Health System ◽  
Chronic Diseases ◽  
Empirical Work ◽  
Chronically Ill ◽  
Chronic Illnesses ◽  
Medical Decisions ◽  
Health Decisions ◽  
Chronically Ill Patients ◽  
The Impact ◽  
Care System

This article is an empirical work on decision-making processes in the case of persons with chronic illnesses in the COVID19 pandemic context, regarding their medical care and self-care. Medical decisions are processes that guide the production of a health diagnosis or treatment, using the available information, where the patients’ preferences are often incorporated. This article tackles the impact of the pandemic on chronically ill patients’ medical decisions when the care system has been significantly altered by it. Considering that health decisions are importantly embedded in social and economic conditions, the pandemic affects a precarious care system and constrains individual possibilities. Chile has a weak support infrastructure for caregivers and a health care system that promotes private health and a low-quality public health system. Hence, the pandemic is an adverse context for chronically ill patients and it alters the conditions in which medical decisions are taken. We performed 10 interviews with chronically ill patients who took responsibility for their own health decisions: five patients diagnosed with common chronic diseases and five patients diagnosed with rare chronic diseases. After Reflexive Thematic Analysis, the results show that the Chilean health system is extremely precarious and that not many alternatives are or have been offered to chronically ill patients in the COVID19 context.

scholarly journals Chronic patient care at North West Province clinics

2009 ◽  
Vol 1 (1) ◽  
Author(s):  
Claire Van Deventer ◽  
Ian Couper ◽  
Nontsikelelo Sondzaba
Keyword(s):  
Patient Care ◽  
Chronically Ill ◽  
Chronic Illnesses ◽  
Chronic Patient ◽  
Flow Measurements ◽  
North West ◽  
The North ◽  
Southern District ◽  
North West Province ◽  
Chronically Ill Patients

Background: Chronic illnesses are a significant burden to the health services in South Africa. There is a specific national health plan whereby chronically ill patients who are acceptably controlled should be managed at clinic level. The perception has emerged that the management of primary care has not been optimal in the Southern District of the North West Province. This provided the motivation to initiate this research, namely consideration of chronic patient care at clinics in the North West Province of South Africa.Method: A cross-sectional descriptive study was carried out at four randomly selected clinics covering four sub-districts in the Southern District (North West Province). This was done using charts and registers at the clinics. Inclusion criteria were patients older than 18, and presenting with the following chronic illnesses: asthma/chronic obstructive airways disease (COAD), hypertension, diabetes and epilepsy. The major focus areas were the regular assessment of the patients, the level of control of the illness and the use of the Essential Drugs List and Standard Treatment Guidelines (EDL/STG).Results: In the cases of all the chronic illnesses it was found that regular assessments were poorly done, with asthma (peak flow measurements) being the most poorly done. Control was generally less than 50% for all the illnesses, although the EDL was followed fairly well by the personnel at the clinics.Conclusion: In the light of the burden of chronic illness the results give cause for great concern about the quality of care for chronically ill patients, and reasons were sought for some of the poor results. A subsequent decision was taken to carry out comprehensive quality improvement projects on each of the illnesses over the following five years.

scholarly journals The Impact of the eHealth Technologies on the Chronically-ill Patient�s choice of Same Hospital Again (Preprint)

2018 ◽  
Author(s):  
Zhendong Li ◽  
Huiying Zhang ◽  
Ke Jiang ◽  
Wei Wei ◽  
Mitchell Mainstone
Keyword(s):  
Chronically Ill ◽  
Medical Costs ◽  
Public Hospitals ◽  
Medical Expenditure ◽  
Treatment Level ◽  
Ageing Population ◽  
Medical Field ◽  
Positive Correlation ◽  
Chronically Ill Patients ◽  
The Impact

BACKGROUND The rapidly-increasing numbers representing China’s ageing population necessarily results in increased medical expenditure following the needs of elderly people, particularly patients with chronic diseases. However, China’s healthcare system is struggling with this as a major issue: famous public hospitals are overcrowded, while community and rural hospitals find it difficult to attract enough patients. OBJECTIVE To examine how and whether the application of eHealth technologies in medical field influences chronically ill patients’ choice of same hospital on next visit. METHODS From July to October 2016, we conducted a survey in nine hospitals in Northern China. This study used regression analysis to compare the difference between high and low levels of application of eHealth technologies in the medical field. We constructed a hospital choice model in order to assist with this. According to the model, we analysed the relationship between relevant, influential factors and the chronically-ill patient’s choice of same hospital on next visit. RESULTS Empirical findings suggest that the chronically-ill patient’s choice of hospital on next visit is positively affected by the treatment level (β= 0.682, P < 0.001) and level of hospital convenience (β= 0.311, P < 0.001), and negatively affected by the medical costs (β= -0.124, P < 0.001). Additionally, Our findings suggest that the application of eHealth technologies in the medical field can significantly enhance the positive correlation between level of hospital convenience and the chronically-ill patients’ choice of same hospital on next visit (β= 0.269, P < 0.001), as well as the negative correlation between medical costs incurred and the chronically-ill patients’ choice of same hospital on next visit (β= -0.135, P < 0.001) . By contrast, the application of eHealth technologies weakens the positive correlation between the hospital’s treatment level and chronically-ill patients’ choice of same hospital on next visit (β= -0.241, P < 0.001). CONCLUSIONS The introduction of the eHealth technologies significantly closes the gap between levels of treatment provided by differing hospitals, while prompting hospital to improve the level of convenience for patients with chronic disease, as well as reducing any medical expense incurred. CLINICALTRIAL This study protocol was approved by the Ethics Committee of Tianjin University of Traditional Chinese Medicine. The reference number is TJUTCM-EC20160005.

Adaptation of the Questionnaire of Hahn, Cella, Bode, and Hanrahan in Spanish Patients Affected by Asbestos Poisoning

2013 ◽  
Vol 16 ◽  
Author(s):  
Miguel Clemente ◽  
Adela Reig-Botella
Keyword(s):  
High Reliability ◽  
Chronically Ill ◽  
Well Being ◽  
Chronic Illnesses ◽  
Future Directions ◽  
The Social ◽  
Male Patients ◽  
Chronically Ill Patients ◽  
Social Companionship ◽  
Very High

AbstractThe purpose of this study was to assess whether or not the questionnaire developed by Hahn, Cella, Bode, and Hanharan (2010) for use with cancer patients accurately measures the social well-being of individuals suffering from chronic illnesses associated with asbestos poisoning. One hundred ten male patients with asbestos poisoning were age-matched in blocks to a comparison group of 70 “healthy” controls, all of whom were current or retired employees of the largest naval company in Spain. The results indicate very high reliability of the Hahn et al. (2010) test to assess social well-being in these chronically ill patients, and a high concurrent validity of the measured outcomes with regard to results of the SCL-90 Derogatis questionnaire, especially on the social well-being dimensions of negative emotional support, negative social companionship, and satisfaction. Limitations of the study and possible future directions are discussed.

Managing Chronic Illness

2016 ◽  
Vol 36 (4) ◽  
pp. 462-479 ◽  
Author(s):  
Mark Toles ◽  
Helene Moriarty ◽  
Ken Coburn ◽  
Sherry Marcantonio ◽  
Alexandra Hanlon ◽  
...  
Keyword(s):  
Older Adults ◽  
Care Coordination ◽  
Chronically Ill ◽  
Well Being ◽  
Models Of Care ◽  
Chronic Illnesses ◽  
Demonstration Program ◽  
Health Quality ◽  
The Impact ◽  
Improve Health

Models of care coordination can significantly improve health outcomes for older adults with chronic illnesses if they can engage participants. The purpose of this study was to examine the impact of nursing contact on the rate of participants’ voluntary disenrollment from a care coordination program. In this retrospective cohort study using administrative data for 1,524 participants in the Health Quality Partners Medicare Care Coordination Demonstration Program, the rate of voluntary disenrollment was approximately 11%. A lower risk of voluntary disenrollment was associated with a greater proportion of in-person (vs. telephonic) nursing contact (Hazard Ratio [HR] 0.137, confidence interval [CI] [0.050, 0.376]). A higher risk of voluntary disenrollment was associated with lower continuity of nurses who provided care (HR 1.964, CI [1.724, 2.238]). Findings suggest that in-person nursing contact and care continuity may enhance enrollment of chronically ill older adults and, ultimately, the overall health and well-being of this population

scholarly journals Resistance Training Exercise Program for Intervention to Enhance Gait Function in Elderly Chronically Ill Patients: Multivariate Multiscale Entropy for Center of Pressure Signal Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Ming-Shu Chen ◽  
Bernard C. Jiang
Keyword(s):  
Resistance Training ◽  
Chronic Diseases ◽  
Postural Stability ◽  
Center Of Pressure ◽  
Chronically Ill ◽  
The Elderly ◽  
Multiscale Entropy ◽  
Gait Function ◽  
Multivariate Multiscale Entropy ◽  
Chronically Ill Patients

Falls are unpredictable accidents, and the resulting injuries can be serious in the elderly, particularly those with chronic diseases. Regular exercise is recommended to prevent and treat hypertension and other chronic diseases by reducing clinical blood pressure. The “complexity index” (CI), based on multiscale entropy (MSE) algorithm, has been applied in recent studies to show a person’s adaptability to intrinsic and external perturbations and widely used measure of postural sway or stability. The multivariate multiscale entropy (MMSE) was advanced algorithm used to calculate the complexity index (CI) values of the center of pressure (COP) data. In this study, we applied the MSE & MMSE to analyze gait function of 24 elderly, chronically ill patients (44% female; 56% male; mean age,67.56±10.70years) with either cardiovascular disease, diabetes mellitus, or osteoporosis. After a 12-week training program, postural stability measurements showed significant improvements. Our results showed beneficial effects of resistance training, which can be used to improve postural stability in the elderly and indicated that MMSE algorithms to calculate CI of the COP data were superior to the multiscale entropy (MSE) algorithm to identify the sense of balance in the elderly.

scholarly journals The Effect of Chronic Diseases on the Use of Health Technology and Digital Services in the Elderly Population in Finland

2020 ◽  
Author(s):  
Jukka Mielonen ◽  
Ulla-Mari Kinnunen ◽  
Kaija Saranto ◽  
Anssi Kemppi ◽  
Hanna Kuusisto
Keyword(s):  
Health Care ◽  
Chronic Diseases ◽  
Elderly People ◽  
Elderly Population ◽  
Chronically Ill ◽  
The Elderly ◽  
Health Technology ◽  
Digital Services ◽  
Care Technology ◽  
The Impact

Digital services are growing in the health-care field. The population in Europe is aging, and digital services are on the rise. There are also plenty of new health-care devices on the market. The aim of this study was to survey how elderly people cope with digital services or devices, especially if they are chronically ill. This quantitative study focuses on the impact of chronic diseases on the use of health technology and digital services. The target group of this study is Finnish people aged 65 or over. Based on the results, a chronic disease or disability is not an obstacle to the use of digital services or health-care technology in the Finnish elderly population. The main obstacles to the use of health technology or digital services are complexity, obscure text, or small font size. According to this study, elderly people seem to trust the device or application. Devices, applications, and online services should be designed so that elderly people’s diseases or ability to function are considered.

scholarly journals The out-of-pocket burden of chronic diseases: the cases of Belgian, Czech and German older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Veronika Kočiš Krůtilová ◽  
Lewe Bahnsen ◽  
Diana De Graeve
Keyword(s):  
Older Adults ◽  
Czech Republic ◽  
Chronic Diseases ◽  
Emotional Disorders ◽  
Outpatient Care ◽  
Chronically Ill ◽  
The Czech Republic ◽  
Care Burden ◽  
Out Of Pocket Payments ◽  
The Impact

Abstract Background Out-of-pocket payments have a diverse impact on the burden of those with a higher morbidity or the chronically ill. As the prevalence of chronic diseases increases with age, older adults are a vulnerable group. The paper aims to evaluate the impact of chronic diseases on the out-of-pocket payments burden of the 50+ populations in Belgium, the Czech Republic and Germany. Methods Data from the sixth wave of the Survey of Health, Ageing and Retirement in Europe is used. A two-part model with a logit model in the first part and a generalised linear model in the second part is applied. Results The diseases increasing the burden in the observed countries are heart attacks, high blood pressure, cancer, emotional disorders, rheumatoid arthritis and osteoarthritis. Reflecting country differences Parkinson’s disease and its drug burden is relevant in Belgium, the drugs burden related to heart attack and outpatient care burden to chronic kidney disease in the Czech Republic and the outpatient care burden of cancer and chronic lung disease in Germany. In addition, we confirm the regressive character of out-of-pocket payments. Conclusions We conclude that the burden is not equitably distributed among older adults with chronic diseases. Identification of chronic diseases with a high burden can serve as a supplementary protective feature.

The experience of caregivers of chronically ill patients during the COVID-19: A Systematic Review

2021 ◽  
pp. 174239532110648
Author(s):  
Suebsarn Ruksakulpiwat ◽  
Wendie Zhou ◽  
Lalipat Phianhasin ◽  
Chitchanok Benjasirisan ◽  
Yuying Fan ◽  
...  
Keyword(s):  
Personal Experience ◽  
Healthcare Providers ◽  
Chronically Ill ◽  
Future Research ◽  
Future Studies ◽  
Quantitative Studies ◽  
Meta Analyses ◽  
Chronically Ill Patients ◽  
The Impact ◽  
Appraisal Tool

Objectives This study aimed to identify the difficulties that caregivers of chronically ill patients experienced during the COVID-19 pandemic and to provide directions for future studies. Methods Five electronic databases, including PubMed, Web of Science, CINAHL Plus Full Text, EMBASE, and Scopus, were systematically searched from January 2019 to February 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were employed for the literature screening, inclusion, and exclusion. The Mixed Methods Appraisal Tool was adopted for qualifying appraisal. Results Six studies met the study criteria, including three quantitative studies, two qualitative studies, and one mixed-method study. Mental health, personal experience, financial problems, physical health, and improvement approaches were the major five themes that participants reported regarding the impact of COVID-19 they encountered during the pandemic. Discussion The results could heighten healthcare providers, stakeholders, and policy leaders' awareness of providing appropriate support for caregivers. Future research incorporating programs that support caregivers’ needs is recommended.

scholarly journals Mental health of patients with chronic diseases during the Coronavirus disease 2019 pandemic in Serbia - A cross-sectional study

2020 ◽  
Vol 73 (7-8) ◽  
pp. 212-220
Author(s):  
Darko Mikic ◽  
Jelena Zvekic-Svorcan ◽  
Ljubisa Jovanovic ◽  
Vera Vucicevic
Keyword(s):  
Mental Health ◽  
Chronic Illness ◽  
Confidence Interval ◽  
Chronic Diseases ◽  
Fatal Outcome ◽  
Chronically Ill ◽  
World Health ◽  
Linear Regression Models ◽  
Multiple Variables ◽  
The Impact

Introduction. Since the coronavirus disease 2019 outbreak was declared a pandemic by the World Health Organization on March 11, 2020, it has become the greatest public health threat worldwide. People with chronic diseases were identified as the group at risk for fatal outcome. The purpose of this research is to estimate the mental health of patients with chronic diseases during the coronavirus disease 2019 pandemic. Material and Methods. A total of 463 individuals (50.8% female), with the average age of 46.63 years (SD = 14.29, ranging from 20 to 75 years of age) participated in the research. The subjects were divided into two groups, based on the existence of at least one chronic disease. The Depression, Anxiety and Stress Scale-21 was used to assess the mental health of the participants. The research was conducted in August 2020. The impact of chronic illness on depression, anxiety, and stress levels was assessed using linear regression models. Results. The prevalence of chronic diseases among the participants was 44.3%. The participants with chronic diseases presented with higher levels of depression (p < 0.05), anxiety (p < 0.001), and stress (p < 0.001) compared to healthy participants. The presence of chronic illness remains a significant predictor of all the dependent variables, even after the inclusion of multiple variables in the final regression model: depression (Beta [?] 0.37; 95% confidence interval: 2.67 - 4.42; p < 0.01), anxiety (Beta [?] 0.19; 95% confidence interval: 0.80 - 2.55; p < 0.01), and stress (Beta [?] 0.09; 95% confidence interval: 0.01 - 2.13; p < 0.05). Conclusion. About five months after the coronavirus disease 2019 pandemic was declared, the investigation of mental health of chronically ill adults in Serbia shows an increased amount of stress, anxiety, and depression in this subpopulation.

Sign in / Sign up

Export Citation Format

Share Document