scholarly journals Determinants of Frequent Attendance of Outpatient Physicians: A Longitudinal Analysis Using the German Socio-Economic Panel (GSOEP)

2019 ◽  
Vol 16 (9) ◽  
pp. 1553 ◽  
Author(s):  
Moritz Hadwiger ◽  
Hans-Helmut König ◽  
André Hajek
Keyword(s):  
Fixed Effects ◽  
Outcome Measure ◽  
Behavioral Model ◽  
Population Based ◽  
Health Care Use ◽  
Physician Visits ◽  
Outpatient Physician ◽  
Frequent Attendance ◽  
Nationally Representative ◽  
Mental And Physical Health

There is a lack of population-based longitudinal studies which investigates the factors leading to frequent attendance of outpatient physicians. Thus, the purpose of this study was to analyze the determinants of frequent attendance using a longitudinal approach. The used dataset comprises seven waves (2002 to 2014; n = 28,574 observations; ranging from 17 to 102 years) from the nationally representative German Socio-Economic Panel (GSOEP). The number of outpatient physician visits in the last three months was used to construct the dependent variable “frequent attendance”. Different cut-offs were used (top 25%; top 10%; top 5%). Variable selection was based on the “behavioral model of health care use” by Andersen. Accordingly, variables were grouped into predisposing, enabling, and need characteristics as well as health behavior, which are possible determinants of frequent attendance. Conditional fixed effects logistic regressions were used. As for predisposing characteristics, regressions showed that getting married and losing one’s job increased the likelihood of frequent attendance. Furthermore, age was negatively associated with the outcome measure. Enabling characteristics were not significantly associated with the outcome measure, except for the onset of the “practice fee”. Decreases in mental and physical health were associated with an increased likelihood of frequent attendance. Findings were robust across different subpopulations. The findings of this study showed that need characteristics are particularly important for the onset of frequent attendance. This might indicate that people begin to use health services frequently when medically indicated.

scholarly journals Temporal Trends in Mental Health Service Utilization across Outpatient and Acute Care Sectors: A Population-Based Study from 2006 to 2014

2018 ◽  
Vol 63 (2) ◽  
pp. 94-102 ◽  
Author(s):  
Maria Chiu ◽  
Evgenia Gatov ◽  
Simone N. Vigod ◽  
Abigail Amartey ◽  
Natasha R. Saunders ◽  
...  
Keyword(s):  
Mental Health ◽  
Acute Care ◽  
Service Use ◽  
Care Service ◽  
Temporal Trends ◽  
Population Based ◽  
Physician Visits ◽  
Outpatient Physician ◽  
Health Related ◽  
Number Of Individuals

Objective: Although evidence suggests that treatment seeking for mental illness has increased over time, little is known about how the health system is meeting the increasing demand for services. We examined trends in physician-based mental health service use across multiple sectors. Method: In this population-based study, we used linked health-administrative databases to measure annual rates of mental health–related outpatient physician visits to family physicians and psychiatrists, emergency department visits, and hospitalizations in adults aged 16+ from 2006 to 2014. We examined absolute and relative changes in visit rates, number of patients, and frequency of visits per patient, and assessed temporal trends using linear regressions. Results: Among approximately 11 million Ontario adults, age- and sex-standardized rates of mental health–related outpatient physician visits declined from 604.8 to 565.5 per 1000 population over the study period ( Ptrend = 0.04). Over time, the rate of visits to family physicians/general practitioners remained stable ( Ptrend = 0.12); the number of individuals served decreased, but the number of visits per patient increased. The rate of visits to psychiatrists declined ( Ptrend < 0.001); the number of individuals served increased, but the number of visits per patient decreased. Concurrently, visit rates to emergency departments and hospitals increased (16.1 to 19.7, Ptrend < 0.001 and 5.6 to 6.0, Ptrend = 0.01, per 1000 population, respectively). Increases in acute care service use were greatest for anxiety and addictions. Conclusions: The increasing acute care service use coupled with the reduction in outpatient visits suggest, overall, an increase in demand for mental health care that is not being met in ambulatory care settings.

scholarly journals Identifying Children with Persistent Asthma from Health Care Administrative Records

2004 ◽  
Vol 11 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Anita L Kozyrskyj ◽  
Cameron A Mustard ◽  
Allan B Becker
Keyword(s):  
Health Care ◽  
Prescription Drugs ◽  
Winter Season ◽  
Persistent Asthma ◽  
Population Based ◽  
Health Care Use ◽  
Physician Visits ◽  
Administrative Records ◽  
Beta Agonists ◽  
Children With Asthma

BACKGROUND:Investigation into the origins of asthma is contingent on definitions of asthma, which can differentiate asthma from transient wheezing syndromes in children.OBJECTIVES:This research was undertaken to develop a definition for asthma derived from health care administrative records, which would identify children with persistent asthma.PATIENTS AND METHODS:Using population-based, health care administrative data, children with possible asthma were identified as having one or more physician visits or hospitalizations for asthma or bronchitis diagnoses from January 1995 to December 1995, or, in the absence of asthma-like diagnoses, one or more prescriptions for asthma prophylaxis drugs or ketotifen concomitant with a betaagonist, or two or more prescriptions for beta-agonists.RESULTS:The likelihood of persistent asthma, defined as repeated health care and prescription use for asthma from 1996 to 1998, was assessed for various asthma markers and risk factors in 29,198 children with possible asthma. Children with asthma prescription drugs or asthma health care use not limited to the winter season were three to six times more likely than children without these characteristics to have persistent asthma. The likelihood of persistent asthma was elevated to a substantial degree in the presence of both of these markers.CONCLUSIONS:The inclusion of these measures in a diagnosisbased definition improves the ability to identify persistent asthma in children.

scholarly journals Population-based screening for functional disability in older adults

2020 ◽  
Author(s):  
Claire K Ankuda ◽  
Vicki A Freedman ◽  
Kenneth E Covinsky ◽  
Amy S Kelley
Keyword(s):  
Older Adults ◽  
Daily Living ◽  
Functional Disability ◽  
Population Based ◽  
Health Care Use ◽  
Leaving Home ◽  
Promising Strategy ◽  
Nationally Representative ◽  
Adl Disability ◽  
Design And Methods

Abstract Background and Objectives Screening for functional disability is a promising strategy to identify high-need older adults. We compare two disability measures, activities of daily living (ADLs) and life space constriction (LSC), in predicting hospitalization and mortality in older adults. Research Design and Methods We used the nationally-representative National Health and Aging Trends Study of 30,885 observations of adults ≥65 years old. Outcomes were 1-year mortality and hospitalization. Predictors were ADLs (receiving help with bathing, eating, dressing, toileting, getting out of bed, walking inside) and LSC (frequency of leaving home). Results Of respondents, 12.4% reported 3+ ADLs and 10.8% reported rarely/never leaving home. ADL disability and LSC predicted high rates of 1-year mortality and hospitalization: of those with 3+ ADLs, 46.4% died and 41.0% were hospitalized; of those who never/rarely left home, 40.7% died and 37.0% were hospitalized. Of those with both 3+ ADLs and who never/rarely left home, 58.4% died. ADL and LSC disability combined was more predictive of 1-year mortality and hospitalization than either measure alone. ADL disability and LSC screens identified overlapping but distinct populations. LSC identified more women (72.6% vs. 63.8% with ADL disability), more people who live alone (40.7% vs. 30.7%), fewer who were white (71.7% vs. 76.2%) with cancer (27.6% vs. 32.4), and reported pain (67.1% vs. 70.0%). Discussion and Implications LSC and ADLs both independently predicted mortality and hospitalization but using both screens was most predictive. Routine screening for ADLs and LSC could help health systems identify those at high risk for mortality and health care use.

scholarly journals Acute and longer-term psychological distress associated with testing positive for COVID-19: longitudinal evidence from a population-based study of US adults

2021 ◽  
Author(s):  
Michael Daly ◽  
Eric Robinson
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Fixed Effects ◽  
Population Based ◽  
Initial Increase ◽  
Public Health Burden ◽  
Patient Health ◽  
Nationally Representative ◽  
Novel Coronavirus ◽  
The Impact

AbstractBackgroundThe novel coronavirus (SARS-CoV-2) has produced a considerable public health burden but the impact that contracting the disease has on mental health is unclear. In this observational population-based cohort study, we examined longitudinal changes in psychological distress associated with testing positive for COVID-19.MethodsParticipants (N = 8,002; Observations = 139,035) were drawn from 23 waves of the Understanding America Study, a nationally representative survey of American adults followed-up every two weeks from April 1 2020 to February 15 2021. Psychological distress was assessed using the standardized total score on the Patient Health Questionnaire-4 (PHQ-4).ResultsOver the course of the study 576 participants reported testing positive for COVID-19. Using regression analysis including individual and time fixed effects we found that psychological distress increased by 0.29 standard deviations (p <.001) during the two-week period when participants first tested positive for COVID-19. Distress levels remained significantly elevated (d = 0.16, p <.01) for a further two weeks, before returning to baseline levels. Coronavirus symptom severity explained changes in distress attributable to COVID-19, whereby distress was more pronounced among those whose symptoms were more severe and were slower to subside.ConclusionsThis study indicates that testing positive for COVID-19 is associated with an initial increase in psychological distress that diminishes quickly as symptoms subside. While COVID-19 may not produce lasting psychological distress among the majority of the general population it remains possible that a minority may suffer longer-term mental health consequences.

scholarly journals Healthcare Use and Direct Cost of Giant Cell Arteritis: A Population-based Study

2017 ◽  
Vol 44 (7) ◽  
pp. 1044-1050 ◽  
Author(s):  
Matthew J. Koster ◽  
Sara J. Achenbach ◽  
Cynthia S. Crowson ◽  
Hilal Maradit-Kremers ◽  
Eric L. Matteson ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Regression Models ◽  
Population Based ◽  
Cost Of Care ◽  
Healthcare Use ◽  
Population Based Study ◽  
Physician Visits ◽  
Outpatient Physician ◽  
Signed Rank

Objective.To determine the healthcare use and direct medical cost of giant cell arteritis (GCA) in a population-based cohort.Methods.A well-defined, retrospective population-based cohort of Olmsted County, Minnesota, USA, residents diagnosed with GCA from 1982–2009 was compared to a matched referent cohort from the same population. Standardized cost data (inflation-adjusted to 2014 US dollars) for 1987–2014 and outpatient use data for 1995–2014 were obtained. Use and costs were compared between cohorts through signed-rank paired tests, McNemar’s tests, and quantile regression models.Results.Significant annual differences in outpatient costs were observed for patients with GCA in each of the first 4 years (median differences: $2085, $437, $382, $388, respectively). In adjusted analyses, median incremental cost attributed to GCA over a 5-year period was $4662. Compared with matched referent subjects, patients with GCA had higher use of laboratory visit-days annually for each of the first 3 years following incidence/index date, and increased outpatient physician visits for years 0–1, 1–2, and 3–4. Patients with GCA had significantly more radiology visit-days in years 0–1, 3–4, and 4–5, and more ophthalmologic procedures/surgery in years 0–1, 1–2, 2–3, and 4–5 compared to non-GCA. Emergency medicine visits, musculoskeletal, and cardiovascular procedures/surgery were similar between GCA and non-GCA groups throughout the study period.Conclusion.Direct medical outpatient costs were increased in the month preceding and in the first 4 years following GCA diagnosis. Higher use of outpatient physician, laboratory, and radiology visits, and ophthalmologic procedures among these patients accounts for the increased cost of care.

scholarly journals Cervical cancer survivors and health care use: A Danish population-based register study

2021 ◽  
Vol 161 (2) ◽  
pp. 565-572
Author(s):  
Malene Skorstengaard ◽  
Maria Eiholm Frederiksen ◽  
Miguel Vázquez-Prada Baillet ◽  
Anna-Belle Beau ◽  
Pernille Tine Jensen ◽  
...  
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Cancer Survivors ◽  
Population Based ◽  
Health Care Use ◽  
Register Study ◽  
Danish Population

Loneliness in Malta: Findings from the first National Prevalence Study

2021 ◽  
pp. 026540752110201
Author(s):  
Marilyn Clark ◽  
Jamie Bonnici ◽  
Andrew Azzopardi
Keyword(s):  
Physical Health ◽  
Early Adulthood ◽  
Age Groups ◽  
Sociodemographic Factors ◽  
Household Composition ◽  
Prevalence Studies ◽  
Mortgage Payment ◽  
Nationally Representative ◽  
Mental And Physical Health ◽  
National Prevalence

Loneliness has been examined by an increasing number of scholars, being implicated in numerous detrimental outcomes for mental and physical health. However, most loneliness prevalence studies have focused on particular age groups, thus overlooking how loneliness differs across the lifespan. This study assessed loneliness prevalence in a nationally representative sample ( n = 1,009) of the Maltese population aged 11 years and above using the 11-item De Jong Gierveld Loneliness Scale, while also identifying associations between loneliness and sociodemographic factors. Results demonstrate that 43.5% of the Maltese population experiences some form of loneliness. The association between loneliness and age demonstrates a nonlinear relationship, with elevated loneliness rates among adolescents, which decrease slightly in early adulthood, before slowly increasing from age 35 onward. Loneliness is also significantly associated with education level, employment status, household composition, mortgage payment status, perception of income, presence of a disability, active citizenship, as well as self-rated physical health, coping ability, and subjective wellbeing. These findings indicate that loneliness is experienced in significant rates across the lifespan, and intervention efforts should be targeted toward individuals of all ages.

scholarly journals Ultra-processed food consumption in Barbados: evidence from a nationally representative, cross-sectional study

2021 ◽  
Vol 10 ◽  
Author(s):  
Rachel M. Harris ◽  
Angela M. C. Rose ◽  
Suzanne Soares-Wynter ◽  
Nigel Unwin
Keyword(s):  
Communicable Disease ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Targeted Interventions ◽  
Sweetened Beverages ◽  
Group 4 ◽  
The Mean ◽  
Nationally Representative

Abstract Our objective was to describe, for the first time in an English-speaking Caribbean country, the contribution of ultra-processed foods (UPFs) to nutrients linked to non-communicable disease. Using a cross-sectional study design, dietary data were collected from two non-consecutive 24-h dietary recalls. Recorded food items were then classified according to their degree of processing by the NOVA system. The present study took place in Barbados (2012–13). A representative population-based sample of 364 adult Barbadians (161 males and 203 females) aged 25–64 years participated in the study. UPFs represented 40⋅5 % (838 kcal/d; 95 % CI 791, 885) of mean energy intake. Sugar-sweetened beverages made the largest contribution to energy within the UPF category. Younger persons (25–44 years) consumed a significantly higher proportion of calories from UPF (NOVA group 4) compared with older persons (45–64 years). The mean energy shares of UPF ranged from 22⋅0 to 58⋅9 % for those in the lowest tertile to highest tertile. Within each tertile, the energy contribution was significantly higher in the younger age group (25–44 years) compared with the older (45–64 years). One-quarter of persons consume ≥50 % of their daily calories from UPF, this being significantly higher in younger persons. The ultra-processed diet fraction contained about six times the mean of free sugars and about 0⋅8 times the dietary fibre of the non-ultra-processed fraction (NOVA groups 1–3). Targeted interventions to decrease the consumption of UPF especially in younger persons is thus of high priority to improve the diet quality of Barbadians.

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