scholarly journals A Longitudinal Change Patterns of Depression and Its Relationship with Socioeconomic Deprivation among Middle-Aged Adults in South Korea

2021 ◽  
Vol 18 (24) ◽  
pp. 12957
Author(s):  
Soo-Bi Lee ◽  
Min-Ji Yu ◽  
Myeong-Sook Yoon
Keyword(s):  
Latent Class ◽  
Reference Group ◽  
Multinomial Logistic Regression ◽  
Healthcare Services ◽  
Socioeconomic Deprivation ◽  
Longitudinal Change ◽  
Middle Aged ◽  
Mild Depression ◽  
Reduction Group ◽  
The Impact

This study aimed to identify the longitudinal pattern changes of South Koreans’ midlife depression and determine the impact of socioeconomic deprivation on the observed change in patterns. In total, 3975 middle-aged individuals were examined by conducting a latent class growth analysis and multinomial logistic regression analysis on seven years of Korea Welfare Panel data (2012–2018) using STATA 16.0 (StataCorp LLC, College Station, TX, USA). The change patterns of midlife depression were classified into normal depression reduction group, mild depression maintenance group, and serious depression increase group. The impact of the experience of socioeconomic deprivation on the classified change patterns was examined using the normal depression reduction group as the reference group. It was found that the higher an individual’s nutritional, housing, occupational/economic, and healthcare deprivation, the higher their risk of mild depression maintenance or serious depression increase. The serious depression increase group showed higher relative risk ratios in all domains. Comprehensive and integrated social welfare services, such as stable income, housing welfare, and healthcare services, should be provided along with appropriate clinical interventions for depression alleviation that account for the pattern changes in midlife depression.

scholarly journals Comparison of Factors Affecting Crash Severities in Hit-and-Run and Non-Hit-and-Run Crashes

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Bei Zhou ◽  
Zongzhi Li ◽  
Shengrui Zhang
Keyword(s):  
Comparison Group ◽  
Reference Group ◽  
Multinomial Logistic Regression ◽  
Crash Severity ◽  
Property Damage ◽  
Average Percentage ◽  
Crash Data ◽  
Hit And Run ◽  
The Impact ◽  
Average Percentage Deviation

A hit-and-run (HR) crash occurs when the driver of the offending vehicle flees the crash scene without reporting it or aiding the victims. The current study aimed at contributing to existing literatures by comparing factors which might affect the crash severity in HR and non-hit-and-run (NHR) crashes. The data was extracted from the police-reported crash data from September 2017 to August 2018 within the City of Chicago. Two multinomial logistic regression models were established for the HR and NHR crash data, respectively. The odds ratio (OR) of each variable was used to quantify the impact of this variable on the crash severity. In both models, the property damage only (PDO) crash was selected as the reference group, and the injury and fatal crash were chosen as the comparison group. When the injury crash was taken as the comparison group, it was found that 12 variables contributed to the crash severities in both HR and NHR model. The average percentage deviation of OR for these 12 variables was 34%, indicating that compared with property damage, HR crashes were 34% more likely to result in injuries than NHR crashes on average. When fatal crashes were chosen as the comparison group, 2 variables were found to be statistically significant in both the HR and the NHR model. The average percentage deviation of OR for these 2 variables was 127%, indicating that compared with property damage, HR crashes were 127% more likely to result in fatalities than NHR crashes on average.

scholarly journals Driving Factors for the Utilisation of Healthcare Services by People with Osteoarthritis: Results from A Nationwide Population-Based study

2021 ◽  
Author(s):  
Daniela Costa ◽  
Ana M Rodrigues ◽  
Eduardo B Cruz ◽  
Helena Canhão ◽  
Jaime da Cunha Branco ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Multinomial Logistic Regression ◽  
Healthcare Utilisation ◽  
Healthcare Services ◽  
Structured Interview ◽  
Population Based ◽  
Enabling Factors ◽  
Population Based Study ◽  
The Impact

Abstract Background: Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the profiles of healthcare services utilisation by people with knee osteoarthritis, and to analyse their determinants, according to Andersen’s behavioural model. Methods: We analysed a sample of 978 participants diagnosed with knee osteoarthritis from the population-based study EpiReumaPt . Data was collected with a structured interview, and the diagnosis of knee osteoarthritis was validated by a rheumatologist team. With the Two-step Cluster procedure, we primarily identified different profiles of healthcare utilisation according to the services most used by patients with knee osteoarthritis. Secondly, we analysed the determinants of each profile, using multinomial logistic regression, according to the predisposing characteristics, enabling factors and need variables.Results: In our sample, a high proportion of participants are overweight or obese (82,6%, n=748) and physically inactive (20,6%, n=201) and a small proportion had physiotherapy management (14,4%, n=141). We identified three profiles of healthcare utilisation: “HighUsers”; “GPUsers”; “LowUsers”. “HighUsers” represents more than 35% of the sample, and are also the participants with higher utilisation of medical appointments. "GPUsers" represent the participants with higher utilisation of general practitioner appointments. Within these profiles, age and geographic location – indicated as predisposing characteristics; employment status and healthcare insurance - as enabling factors; number of comorbidities, physical function, health-related quality of life, anxiety and physical exercise - as need variables, showed associations ( p <0,05) with the higher utilisation of healthcare services profiles. Conclusions: Healthcare utilisation by people with knee osteoarthritis is not driven only by clinical needs. The predisposing characteristics and enabling factors associated with healthcare utilisation reveal inequities in the access to healthcare and variability in the management of people with knee osteoarthritis. Research and implementation of whole-system strategies to improve equity in the access and quality of care are paramount in order to diminish the impact of osteoarthritis at individual-, societal- and economic-level.

scholarly journals Trajectories and Determinants of Physical Activity during COVID-19 Pandemic: A Population-Based Study of Middle-Aged and Elderly Individuals in The Netherlands

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3832
Author(s):  
Amy Hofman ◽  
Marlou A. M. Limpens ◽  
Tosca O. E. de Crom ◽  
Mohammad Arfan Ikram ◽  
Annemarie I. Luik ◽  
...  
Keyword(s):  
Physical Activity ◽  
The Netherlands ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Public Health Problem ◽  
Population Based ◽  
World Health ◽  
Major Public Health Problem ◽  
Middle Aged ◽  
Health Organization

Physical inactivity is a major public health problem, and there are concerns this might have increased during the COVID-19 pandemic. We aimed to identify distinct trajectories of physical activity over a 6-week period after the first restrictive measures and to explore determinants of these trajectories in a population-based cohort of middle-aged and elderly in the Netherlands (n = 5777). We observed that at least 59% of participants did not meet the World Health Organization recommendations for physical activity. Using latent class trajectory analyses over three time points, we identified five distinct trajectories, including four steady trajectories at different levels (very low, low, medium and high) and one increasing trajectory. Using multinomial logistic regression analyses, we observed that, compared to the ‘steadily high’ trajectory, participants in the ‘steadily very low’ trajectory were more often older, lower educated, reporting poorer physical health, more depressive symptoms, consuming a less healthy diet, smoking, and lower alcohol use, and were less often retired. A similar pattern of determinants was seen for those in the increasing trajectory, albeit with smaller effect sizes. Concluding, we observed low levels of physical activity that generally remained during the pandemic. The determinants we described can help identify groups that require additional preventive interventions.

scholarly journals Driving factors for the utilisation of healthcare services by people with osteoarthritis in Portugal: results from a nationwide population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniela Costa ◽  
Ana M. Rodrigues ◽  
Eduardo B. Cruz ◽  
Helena Canhão ◽  
Jaime Branco ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Multinomial Logistic Regression ◽  
Healthcare Utilisation ◽  
Healthcare Services ◽  
Structured Interview ◽  
Population Based ◽  
Enabling Factors ◽  
Population Based Study ◽  
The Impact

Abstract Background Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the profiles of healthcare services utilisation by people with knee osteoarthritis, and to analyse their determinants, according to Andersen’s behavioural model. Methods We analysed a sample of 978 participants diagnosed with knee osteoarthritis from the population-based study EpiReumaPt, in Portugal. Data was collected with a structured interview, and the diagnosis of knee osteoarthritis was validated by a rheumatologist team. With the Two-step Cluster procedure, we primarily identified different profiles of healthcare utilisation according to the services most used by patients with knee osteoarthritis. Secondly, we analysed the determinants of each profile, using multinomial logistic regression, according to the predisposing characteristics, enabling factors and need variables. Results In our sample, a high proportion of participants are overweight or obese (82,6%, n = 748) and physically inactive (20,6%, n = 201) and a small proportion had physiotherapy management (14,4%, n = 141). We identified three profiles of healthcare utilisation: “HighUsers”; “GPUsers”; “LowUsers”. “HighUsers” represents more than 35% of the sample, and are also the participants with higher utilisation of medical appointments. “GPUsers” represent the participants with higher utilisation of general practitioner appointments. Within these profiles, age and geographic location – indicated as predisposing characteristics; employment status and healthcare insurance - as enabling factors; number of comorbidities, physical function, health-related quality of life, anxiety and physical exercise - as need variables, showed associations (p < 0,05) with the higher utilisation of healthcare services profiles. Conclusions Healthcare utilisation by people with knee osteoarthritis is not driven only by clinical needs. The predisposing characteristics and enabling factors associated with healthcare utilisation reveal inequities in the access to healthcare and variability in the management of people with knee osteoarthritis. Research and implementation of whole-system strategies to improve equity in the access and quality of care are paramount in order to diminish the impact of osteoarthritis at individual-, societal- and economic-level.

scholarly journals Patient Input in Regional Healthcare Planning—A Meaningful Contribution

2019 ◽  
Vol 16 (19) ◽  
pp. 3754
Author(s):  
Heidrun Sturm ◽  
Miriam Colombo ◽  
Teresa Hebeiss ◽  
Stefanie Joos ◽  
Roland Koch
Keyword(s):  
Logistic Regression ◽  
Multinomial Logistic Regression ◽  
Healthcare Services ◽  
Multivariate Model ◽  
Decision Makers ◽  
Financial Resources ◽  
Regional Factors ◽  
Model Region ◽  
User Perspectives ◽  
The Impact

Background: There are well-known methodological and analytical challenges in planning regional healthcare services (HCS). Increasingly, the need for data-derived planning, including user-perspectives, is discussed. This study aims to better understand the possible contribution of citizen experience in the assessment of regional HCS needs in two regions of Germany. Methods: We conducted a written survey in two regions of differing size—a community (3653 inhabitants) and a county (165,211 inhabitants). Multinomial logistic regression was used to assess the impact of sociodemographic and regional factors on the assessment of HCS provided by general practitioners (GPs) and specialists. Results: Except for age and financial resources available for one’s own health, populations did not differ significantly between the regions. However, citizens’ perception of HCS (measured by satisfaction with 1 = very good to 5 = very poor) differed clearly between different services (e.g., specialists: 3.8–4.3 and pharmacies: 1.7–2.5) as well as between regions (GPs: 1.7–3.1; therapists: 2.9–4). In the multivariate model, region (next to income and age) was a consistent predictor of the perception of GP- and specialist-provided care. Discussion: Citizens’ perceptions of HCS correspond to regional provider density (the greater the density, the better the perception) and add insights into citizens’ needs. Therefore, they can provide valuable information on regional HCS strengths and weaknesses and are a valid resource to support decision makers in shaping regional care structures.

scholarly journals Does the Health Insurance Program Reduce Health-Induced Poverty?: New Evidence From the China Household Income Project

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 355-355
Author(s):  
Yalu Zhang ◽  
Qin Gao
Keyword(s):  
Older Adults ◽  
Household Income ◽  
Fixed Effects ◽  
Financial Burden ◽  
Experimental Studies ◽  
Estimation Method ◽  
Healthcare Services ◽  
Catastrophic Health Expenditure ◽  
Middle Aged ◽  
The Impact

Abstract The growing cost of healthcare services has been a concern for many countries in the world. In China, medical expenditures can account for as much as 65% of per capita income in some low-GDP counties in 2011. One of the primary goals of the New Rural Cooperative Medical Insurance (NRCMI) is to provide financial protection and alleviate the financial burdens of rural residents in China. This paper examined whether NRCMI participation impacted the incidence of catastrophic health expenditure (CHE) among middle-aged and older adults (45 years old and above) using the China Household Income Project 2007 rural data and an instrumental variable estimation method in two provinces where there was heterogeneity in NRCMI implementation schedule. The results show that NRCMI enrollment could not impact the likelihood of experiencing CHE among middle-aged and older adults. However, NRCMI participation increased the actual amount of medical expenses in one province but not in the other. Although none of the prior studies have used instruments and village fixed effects or take endogeneity issues into account to investigate the impact of NRCMI on relative financial burden among recipients, the results found in this study are generally aligned with the prior findings, especially with those using quasi-experimental studies. Findings from this study provide empirical evidence to the policymakers that the effect of NRCMI participation on financial protections is limited despite its broad population coverage. The limited effects are probably due to the low reimbursement rate and more utilization of expensive healthcare services.

scholarly journals Everyday Discrimination Typologies Among Older African Americans: Gender and Socioeconomic Status

2019 ◽  
Vol 75 (9) ◽  
pp. 1951-1960 ◽  
Author(s):  
Dawne M Mouzon ◽  
Robert Joseph Taylor ◽  
Ann W Nguyen ◽  
Mosi Adesina Ifatunji ◽  
Linda M Chatters
Keyword(s):  
African Americans ◽  
Latent Class ◽  
African American Men ◽  
Multinomial Logistic Regression ◽  
Past Research ◽  
Frequency Discrimination ◽  
Lower Probability ◽  
Demographic Correlates ◽  
High Discrimination ◽  
The Impact

Abstract Objectives Discrimination is associated with several negative social, economic, and health consequences. Past research focuses on the impact of discrimination while less is known about both the type and correlates of discrimination, particularly among older adults. Methods Using the National Survey of American Life, we used latent class analysis to identify discrimination typologies (frequency and type) among African Americans aged 55 and older. We then used multinomial logistic regression to identify demographic correlates of discrimination types, including a statistical interaction between gender and educational attainment. Results We identified three discrimination typologies. Increasing age was associated with lower probability of belonging to the high discrimination and disrespect and condescension subtypes. Men and non-Southern residents were most likely to belong in the high discrimination subtype. Higher levels of education increased the probability of belonging in the high discrimination and disrespect and condescension subtypes for older men, but not women. Discussion Older African American men, particularly those with more education, are vulnerable to both high-frequency discrimination and discrimination characterized by disrespect and condescension. This finding suggests that, for men with more years of education, increased exposure to discrimination reflects efforts to maintain social hierarchies (male target hypothesis).

International Remittances and Private Healthcare in Kerala, India

2020 ◽  
Vol 17 (3) ◽  
pp. 445-460
Author(s):  
Mohd Imran Khan ◽  
Valatheeswaran C.
Keyword(s):  
Instrumental Variable ◽  
Capital Investment ◽  
Healthcare Expenditure ◽  
Healthcare Services ◽  
Private Healthcare ◽  
International Remittances ◽  
Variable Approach ◽  
Using Data ◽  
The Impact ◽  
Instrumental Variable Approach

The inflow of international remittances to Kerala has been increasing over the last three decades. It has increased the income of recipient households and enabled them to spend more on human capital investment. Using data from the Kerala Migration Survey-2010, this study analyses the impact of remittance receipts on the households’ healthcare expenditure and access to private healthcare in Kerala. This study employs an instrumental variable approach to account for the endogeneity of remittances receipts. The empirical results show that remittance income has a positive and significant impact on households’ healthcare expenditure and access to private healthcare services. After disaggregating the sample into different heterogeneous groups, this study found that remittances have a greater effect on lower-income households and Other Backward Class (OBC) households but not Scheduled Caste (SC) and Scheduled Tribe (ST) households, which remain excluded from reaping the benefit of international migration and remittances.

Healthcare System in the Arctic Zone of Russia. Known and Emerging Issues and Solutions to Them

2019 ◽  
pp. 3-20
Author(s):  
V.N. Leksin
Keyword(s):  
Metallurgical Industry ◽  
Healthcare Services ◽  
The Arctic ◽  
Russian Arctic ◽  
Arctic Zone ◽  
Shift Workers ◽  
The North ◽  
Medical Institutions ◽  
Emerging Issues ◽  
The Impact

The impact on healthcare organization on the territory of Russian Arctic of unique natural and climatic, demographic, ethnic, settlement and professional factors of influencing the health of population, constantly or temporarily living on this territory is studied. The necessity is substantiated of various forms and resource provision with healthcare services such real and potential patients of Arctic medical institutions, as representatives of indigenous small peoples of the North, workers of mining and metallurgical industry, military personnel, sailors and shift workers. In this connection a correction of a number of All-Russian normative acts is proposed.

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