scholarly journals The Impact of Economic Crisis on Chronic Patients’ Self-Rated Health, Health Expenditures and Health Services Utilization

Diseases ◽  
2014 ◽  
Vol 2 (2) ◽  
pp. 93-105 ◽  
Author(s):  
Anastasios Skroumpelos ◽  
Elpida Pavi ◽  
Katerina Mylona ◽  
John Kyriopoulos
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Gary Cheung ◽  
Claudia Rivera-Rodriguez ◽  
Adrian Martinez-Ruiz ◽  
Etuini Ma’u ◽  
Brigid Ryan ◽  
...  

Abstract Background Many countries around the world have adopted social distancing as one of the public health measures to reduce COVID-19 transmissions in the community. Such measures could have negative effects on the mental health of the population. The aims of this study are to (1) track the impact of COVID-19 on self-reported mood, self-rated health, other health and psychosocial indicators, and health services utilization of people who have an interRAI assessment during the first year of COVID-19; (2) compare these indicators with the same indicators in people who had an interRAI assessment in the year before COVID-19; and (3) report these indicators publicly as soon as data analysis is completed every 3 months. Methods interRAI COVID-19 Study (iCoS) is an observational study on routinely collected national data using the interRAI Home Care and Contact Assessment, which are standardized geriatric assessment tools mandated for all people assessed for publicly funded home support services and aged residential care in New Zealand. Based on the 2018/19 figures, we estimated there are 36,000 interRAI assessments per annum. We will compare the four post-lockdown quarters (from 25th March 2020) with the respective pre-lockdown quarters. The primary outcomes are self-reported mood (feeling sad, depressed or hopeless: 0 = no, 1 = yes) and self-rated health (0 = excellent, 1 = good, 2 = fair, 3 = poor). We will also analyze sociodemographics, other secondary health and psychosocial indicators, and health services utilization. Descriptive statistics will be conducted for primary outcomes and other indicators for each of the eight quarters. We will compare the quarters using regression models adjusted for demographic characteristics using weights or additional variables. Key health and psychosocial indicators will be reported publicly as soon as data analysis is completed for each quarter in the 12-month post-lockdown period by using a data visualization tool. Discussion This rapid translation of routinely collected national interRAI data will provide a means to monitor the health and psychosocial well-being of vulnerable older New Zealanders. Insights from this study can be shared with other countries that use interRAI and prepare health and social services for similar epidemics/pandemics in the future.


2014 ◽  
Vol 9 (4) ◽  
pp. 359-382 ◽  
Author(s):  
G. Emmanuel Guindon

AbstractIn recent years, a number of low- and middle-income country governments have introduced health insurance schemes. Yet not a great deal is known about the impact of such policy shifts. Vietnam’s recent health insurance experience including a health insurance scheme for the poor in 2003 and a compulsory scheme that provides health insurance to all children under six years of age combined with Vietnam’s commitment to universal coverage calls for research that examines the impact of health insurance. Taking advantage of Vietnam’s unique policy environment, data from the 2002, 2004 and 2006 waves of the Vietnam Household Living Standard Survey and single-difference and difference-in-differences approaches are used to assess whether access to health insurance – for the poor, for children and for students – impacts on health services utilization and health outcomes in Vietnam. For the poor and for students, results suggest health insurance increased the use of inpatient services but not of outpatient services or health outcomes. For young children, results suggest health insurance increased the use of outpatient services (including the use of preventive health services such as vaccination and check-up) but not of inpatient services.


Author(s):  
J.E. Tranmer ◽  
R. Croxford ◽  
P.C. Coyte

ABSTRACTTo understand the impact of ongoing reform of mental health and dementia care in Ontario, an examination of prevalence and health services utilization rates is needed. However, there exists a gap in current prevalence and health services research specific to dementia care in Ontario. The objective of this study was to address these concerns using linked administrative databases to determine the incremental use of health services by elderly Ontarians with dementia. Overall, study results demonstrated that individuals with dementia used services in a pattern similar to non-demented persons, albeit at a higher level. Exceptions were women's use of hospital and home care services, where the most elderly women received significantly fewer services. Thus, the study provided important insight regarding the relative levels of health services used by demented Ontarians. Research in this area will become increasingly important as the population ages and the settings integral to dementia care and management shift and evolve.


2003 ◽  
Vol 30 (1-2) ◽  
pp. 365-390 ◽  
Author(s):  
Deborah Podus ◽  
Nancy Barron ◽  
Eunice Chang ◽  
Katherine Watkins ◽  
Joseph Guydish ◽  
...  

This article examines the impact of the elimination of the Supplemental Security Income (SSI) drug addiction and alcoholism (DA&A) disability category–-and the consequent loss of Medicaid benefits by most of those terminated from SSI–-on the medical and mental health services utilization of affected individuals. Data are from a two-year, five-wave panel study of a random sample of 1,764 former DA&A recipients in nine sites. Respondents were grouped into three categories: those who requalified for SSI on other grounds: those who lost SSI but obtained alternative health coverage: and those who lost SSI and were uninsured. We found, after controlling for covariates, that the uninsured were significantly less likely than those who requalified for SSI to receive any medical or mental health care. Disparities in care were less pronounced between those who requalified for SSI and those who lost SSI but obtained other coverage. Lack of insurance was associated with greater difficulty in accessing care in four sites, but it was not associated with higher emergency room use.


2020 ◽  
Author(s):  
Moctar TOUNKARA ◽  
Oumar Sangho ◽  
Madeleine Beebe ◽  
Lillian Joyce Whiting-Collins ◽  
Rebecca R. Goins ◽  
...  

Abstract Introduction. Maternal mortality is one of the main causes of death for women of childbearing age in Mali, and improving this outcome is slow, even in high geographic-access regions. Disparities in maternal health services utilization can constitute a major obstacle in the reduction of maternal mortality and denotes a lack of equity in the Malian health system.Literature on maternal health inequity has explored structural and individual factors influencing outcomes but has not examined inequities in health facility distribution within moderate geographic access districts in Mali. The purpose of this article is to examine disparities in education and geographic distance and how they affect utilization of maternal care within the Sélingué health district, a district with moderate geographic access to care, near Bamako, Mali.Methods. We conducted a cross sectional survey with cluster sampling in the Sélingué health district. Maternal health services characteristics and indicators were described. Association between dependent and independent variables was verified using Kendall’s tau-b correlation, Chi square, logistic regression with odds ratio and 95% confidence interval. Gini index and concentration curve were used to measure inequity.Results. The majority of the participants were 20 to 24 years old. Over 68% of our sample had some education, 65% completed at least four ANC visits, and 60.8% delivered at a health facility. Despite this evidence of healthcare access in Sélingué, disparities within the health district impede the other roughly 40% of our sample from utilizing maternal healthcare. The concentration index demonstrated the impact of inequity in geographic access comparing women residing near and far from the referral care facility.Conclusion. Maternal health services underutilization, within a district with moderate geographic access, indicates that deliberate attention should be paid to addressing geographic access even in such a district.


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