scholarly journals Structure and Distribution of Health Care Costs across Age Groups of Patients with Multimorbidity in Lithuania

2021 ◽  
Vol 18 (5) ◽  
pp. 2767
Author(s):  
Laura Nedzinskienė ◽  
Elena Jurevičienė ◽  
Žydrūnė Visockienė ◽  
Agnė Ulytė ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Chronic Disease ◽  
National Health Insurance ◽  
Health Care Services ◽  
Age Groups ◽  
Age Group ◽  
Resource Usage ◽  
Care Services ◽  
Care Costs

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.

scholarly journals Assessment of satisfaction and utilization of health-care services by National Health Insurance Scheme enrolees at Aminu Kano Teaching Hospital, Kano, Nigeria

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Abubakar Yusuf ◽  
Abubakar M. Jibo ◽  
Sanusi Abubakar ◽  
Bukar A. Grema ◽  
Auwal U. Gajida ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Access To Care ◽  
National Health Insurance ◽  
National Health ◽  
Health Care Services ◽  
National Health Insurance Scheme ◽  
Service Improvement ◽  
Insurance Scheme ◽  
Care Services

The National Health Insurance Scheme (NHIS) aims at universal health coverage through access to high-quality health-care to all enrolees. To achieve this goal, it is necessary to incorporate feedbacks from periodic patient-surveys into service improvement plans. This study therefore, assessed satisfaction and utilization of health-care services by enrolees of a Nigerian tertiary hospital. This was a crosssectional study of 399 respondents randomly selected from enrolees attending the NHIS-clinic of Aminu Kano Teaching Hospital, Kano. Using an intervieweradministered questionnaire, it assessed their sociodemographics, medical history, number of and reason for clinic visits, satisfaction with- access to care, patient-provider relationships and hospital facilities/environment. Respondents’ mean age was 38.3 ± 9.2 years and females accounted for 55.9% of respondents. Most respondents (60.4%, 69.8%, 96.0%) were satisfied with the ease of accessing care, waiting-time and hospital facilities/environment respectively. Most respondents (94.8%, 81.1%, 73.3%, 74.5%, 83.1%, 91.1%) were satisfied with their relationship with physicians, nurses, laboratory staff, pharmacists, record officers and other hospital-staff respectively. Overall, 80.5% of respondents were satisfied with the hospital’s services. All respondents had visited the clinic at least once in the preceding 12-weeks. Although 49.1% visited for non-communicable diseases, more respondents who were for antenatal-care (followed by non-communicable and communicable diseases) had had ≥ 2 clinic visits (c2 =15.5%, df=2, P=0.0001). This study observed a high utilization of and overallsatisfaction with the hospital’s services; however, there is a need for service improvement plans to address the challenges of patient access to care and waitingtime.

Brief Reports: Use of Health Care Services and Costs of Psychiatric Disorders Among National Health Insurance Enrollees in Taiwan

2004 ◽  
Vol 55 (12) ◽  
pp. 1427-1430 ◽  
Author(s):  
I-Chia Chien ◽  
Yiing-Jenq Chou ◽  
Ching-Heng Lin ◽  
Shin-Huey Bih ◽  
Hong-Jen Chang ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Psychiatric Disorders ◽  
National Health Insurance ◽  
National Health ◽  
Health Care Services ◽  
Care Services ◽  
Use Of Health Care

scholarly journals Health status of female Moldovan immigrants to Italy by health literacy level and age group

2020 ◽  
Author(s):  
Francesca Alice Vianello ◽  
Federica Zaccagnini ◽  
Carlo Pinato ◽  
Pietro Maculan ◽  
Alessandra Buja
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Care Services ◽  
Age Groups ◽  
Age Group ◽  
Care Services ◽  
Health Literacy Level ◽  
Care Workers ◽  
Access To Health ◽  
Literacy Level

Abstract Background: Migration flows from Eastern Europe to Italy have been large and continue to grow. The purpose of this study was to examine the health status of a population of Moldovan immigrant women, and their access to health care services in northern Italy, by age group and health literacy level. Methods: We administered an ad-hoc questionnaire to adult Moldovan women. A bivariate analysis was conducted to test the association between health literacy and age groups with other variables ( lifestyles, symptoms and diseases, access to health services). A stepwise logistic regression analysis was run to test the association between access to primary care and health literacy. Moreover, the study compare Moldovan women data with a sample of Italian women of the same age range living in North-Eastern region. Results: Our sample included 170 Moldovan women (aged 46.5 ± 12.3) in five occupational categories: home care workers (28.2%); cleaners (27.1%); health care workers (5.9%); other occupations (28.8%); and unemployed (10%). Active smokers were twice as prevalent among the women with a low health literacy. Health literacy level also determined access to primary healthcare services. For all age groups, the Moldovan sample reported a higher prevalence of allergies, lumbar disorders and depression than the Italian controls. Conclusions: The reported prevalence of some diseases was higher among Moldovan immigrant women than among Italian resident women. Health literacy was associated with the immigrant women’s lifestyle and the use of primary health care services, as previously seen for the autochthonous population.

scholarly journals Health status of female Moldovan immigrants to Italy by health literacy level and age group

2020 ◽  
Author(s):  
Francesca Alice Vianello ◽  
Federica Zaccagnini ◽  
Carlo Pinato ◽  
Pietro Maculan ◽  
Alessandra Buja
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Care Services ◽  
Age Groups ◽  
Age Group ◽  
Care Services ◽  
Health Literacy Level ◽  
Care Workers ◽  
Access To Health ◽  
Literacy Level

Abstract Background: Migration flows from Eastern Europe to Italy have been large and continue to grow. The purpose of this study was to examine the health status of a population of Moldovan immigrant women, and their access to health care services in northern Italy, by age group and health literacy level.Methods: We administered an ad-hoc questionnaire to adult Moldovan women. A bivariate analysis was conducted to test the association between health literacy and age groups with other variables ( lifestyles, symptoms and diseases, access to health services). A stepwise logistic regression analysis was run to test the association between access to primary care and health literacy. Moreover, the study compare Moldovan women data with a sample of Italian women of the same age range living in North-Eastern region. Results: Our sample included 170 Moldovan women (aged 46.5 ± 12.3) in five occupational categories: home care workers (28.2%); cleaners (27.1%); health care workers (5.9%); other occupations (28.8%); and unemployed (10%). Active smokers were twice as prevalent among the women with a low health literacy. Health literacy level also determined access to primary healthcare services. For all age groups, the Moldovan sample reported a higher prevalence of allergies, lumbar disorders and depression than the Italian controls.Conclusions: The reported prevalence of some diseases was higher among Moldovan immigrant women than among Italian resident women. Health literacy was associated with the immigrant women’s lifestyle and the use of primary health care services, as previously seen for the autochthonous population.

scholarly journals Health status of female Moldovan immigrants to Italy by health literacy level and age group

2020 ◽  
Author(s):  
Francesca Alice Vianello ◽  
Federica Zaccagnini ◽  
Carlo Pinato ◽  
Pietro Maculan ◽  
Alessandra Buja
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Care Services ◽  
Age Groups ◽  
Age Group ◽  
Care Services ◽  
Health Literacy Level ◽  
Care Workers ◽  
Access To Health ◽  
Literacy Level

Abstract Background: Migration flows from Eastern Europe to Italy have been large and continue to grow. The purpose of this study was to examine the health status of a population of Moldovan immigrant women, and their access to health care services in northern Italy, by age group and health literacy level.Methods: We administered an ad-hoc questionnaire to adult Moldovan women. A bivariate analysis was conducted to test the association between health literacy and age groups with other variables ( lifestyles, symptoms and diseases, access to health services). A stepwise logistic regression analysis was run to test the association between access to primary care and health literacy. Moreover, the study compare Moldovan women data with a sample of Italian women of the same age range living in North-Eastern region. Results: Our sample included 170 Moldovan women (aged 46.5 ± 12.3) in five occupational categories: home care workers (28.2%); cleaners (27.1%); health care workers (5.9%); other occupations (28.8%); and unemployed (10%). Active smokers were twice as prevalent among the women with a low health literacy. Health literacy level also determined access to primary healthcare services. For all age groups, the Moldovan sample reported a higher prevalence of allergies, lumbar disorders and depression than the Italian controls.Conclusions: The reported prevalence of some diseases was higher among Moldovan immigrant women than among Italian resident women. Health literacy was associated with the immigrant women’s lifestyle and the use of primary health care services, as previously seen for the autochthonous population.

scholarly journals Analyzes of health profiles of patients receiving home health care services over last five years in Diyarbakir, Turkey

2016 ◽  
Vol 5 (6) ◽  
pp. 69
Author(s):  
Rojan Gumus ◽  
Seyfettin Sarıbaş
Keyword(s):  
Health Care ◽  
Neurodegenerative Diseases ◽  
Home Health Care ◽  
Health Care Services ◽  
Respiratory Diseases ◽  
Age Groups ◽  
Home Health ◽  
Age Group ◽  
Care Services ◽  
Health Profiles

Objective: To determine the health profiles of patients who have been delivered home health care services by public hospitals in over the last five years.Methods: Data which were recorded by the Ministry of Health and the Diyarbakır Directorate of Health Services had been provided from 1,826 patients from three city center and five district hospitals located in Diyarbakir, Turkey.Results: Of 1,826 patients, 989 (54%) were female and 837 (46%) were male. The patients were divided into three age groups: 0-18 years 467 (25%), 19-64 years 511 (28%) and +65 years 848 (47%). There were more female patients in +65 age group and male in 0-18 age group (χ2 = 89.923, p < .001). In 2015, there was an increase in the number of people who received services in all age groups (χ2 = 164.344, p < .001). It was found that neurodegenerative diseases were more widespread in +65 age group (χ2 = 44.823, p < .001). Neurogenetic dieases were more seen in the 0-18 age group (χ2 = 97.800, p < .001). In the +65 age group, musculoskeletal (χ2 = 16.037, p < .001) and respiratory diseases (χ2 = 6.054, p < .05) were detected to be more widespread. There were no significant sex-based differences between the years involved (χ2 = 2.246, p > .05). Neurodegenerative diseases (χ2 = 4.07, p < .05), neurogenetic diseases (χ2 = 6.043, p < .05) and respiratory diseases (χ2 = 5.254, p < .05) were determined to be more widespread in male patients. Musculoskeletal (χ2 = 17.943, p < .001)and cardiovascular diseases (χ2 = 11.994, p < .001) were seen more in female groups.Conclusions: Over the last five years, there has been an increase in the utilization of home health care services. Policy legislation for health care services to be provided at home is generating succesful results.

scholarly journals To: Plos One Knowledge, experiences and perceptions of the Ghana National Health Insurance Scheme in three districts

2018 ◽  
Author(s):  
Sataru Fuseini ◽  
Seddoh Anthony
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Care Services ◽  
National Health Insurance Scheme ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Public And Private ◽  
Care Services

Background Ghana’s National Health Insurance Scheme is a demand side programme where the governing authority registers clients and purchases health care services for them from public and private providers. Access of services is high across a broad Benefits Package with no parallel enrolment necessary for any type of service at the point of access. Nonetheless, there is evidence of difficulty in acquiring and use of the NHIS card to access health care services. Objective While studies had been conducted into general awareness, there was no linkage between awareness, uptake and experiences with registration and use of the card. This study fills this gap. Methods This is a descriptive study. A mix of qualitative (39 Focus Group Discussions) and quantitative (625 household interviews) methods were used to collect the data. Qualitative data was analysed manually using a thematic approach while a frequency analysis was done for the quantitative data. Results Knowledge about the Scheme was near universal. Enrolment was lower among FGD discussants, 38.7% had valid cards, than for household respondents, 62.9% valid cards. While mixed experiences with the registration process was observed among FGD discussants, 74% of the households’ ranked attitudes of Scheme staff as positive. The study found the NHIS card facilitates access to facility based health care. Satisfaction levels with use of the card were mixed and contextual among discussants. However, 90% of households reported their cards were readily accepted at health facilities. Expired card (51.4%) and health facility had stopped accepting NHIS cards (14.3%) were mentioned as reasons for non-acceptance. Conclusion People’s experience during registration and use of the NHIS card to access health care has lasting effect on their perceptions of the Scheme. This can be harnessed to manage the high expectations, grow membership, discourage frivolous use and address artificial barriers of access.

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