scholarly journals Co-Occurring Depression and Associated Healthcare Utilization and Expenditure in Individuals with Respiratory Condition: A Population-Based Study

Pharmacy ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 157
Author(s):  
Prashant Sakharkar ◽  
Thanh Mai

The existing literature is limited on the prevalence of depression among people with respiratory conditions and person-level factors that are associated with increased healthcare utilization and expenditures. The aim of this study was to explore the prevalence, pattern of healthcare use, and expenditures in noninstitutionalized individuals having co-occurring depression with respiratory conditions. The Medical Expenditure Panel Survey (MEPS) data from 2011 to 2017 was used in this study. Our sample included individuals having respiratory conditions (asthma, emphysema, and chronic bronchitis) with and without depression. Healthcare use and expenditure data were analyzed using a chi-square test, t-tests, and multiple linear regression analyses. There were 8848 individuals in the study. The prevalence of comorbid depression was 20%. Individuals with co-occurring depression with respiratory conditions differed significantly from individuals without co-occurring depression for age ≥ 45 years, white, and with ≤2 chronic disease conditions. Depressed individuals with respiratory conditions had higher healthcare utilization and expenditures. The presence of co-occurring depression with respiratory conditions increases the treatment complexity, healthcare utilization, and expenditure. Better treatment and management of these patients may reduce healthcare use and expenditures in the future.

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Ami Vyas ◽  
Xiaoyun Pan ◽  
Usha Sambamoorthi

Objective. The primary objective of the study was to estimate the rates of polypharmacy among individuals with multimorbidity defined as chronic condition clusters and examine their associations with polypharmacy. Methods. Cross-sectional analysis of 10,528 individuals of age above 21, with at least one physical condition in cardiometabolic (diabetes or heart disease or hypertension), musculoskeletal (arthritis or osteoporosis), and respiratory (chronic obstructive pulmonary disease (COPD) or asthma) clusters from the 2009 Medical Expenditure Panel Survey. Chi-square tests and logistic regressions were performed to analyze the association between polypharmacy and multimorbidity. Results. Polypharmacy rates varied from a low of 7.2% among those with respiratory cluster to a high of 64.1% among those with all three disease clusters. Among those with two or more disease clusters, the rates varied from 28.3% for musculoskeletal and respiratory clusters to 41.8% for those with cardiometabolic and respiratory clusters. Individual with cardiometabolic conditions alone or in combination with other disease clusters were more likely to have polypharmacy. Compared to those with musculoskeletal and respiratory conditions, those with cardiometabolic and respiratory conditions had 1.68 times higher likelihood of polypharmacy. Conclusions. Rates of polypharmacy differed by specific disease clusters. Individuals with cardiometabolic condition were particularly at high risk of polypharmacy, suggesting greater surveillance for adverse drug interaction in this group.


2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Noora Knaappila ◽  
Mauri Marttunen ◽  
Sari Fröjd ◽  
Nina Lindberg ◽  
Riittakerttu Kaltiala

Abstract Background Despite reduced sanctions and more permissive attitudes toward cannabis use in the USA and Europe, the prevalences of adolescent cannabis use have remained rather stable in the twenty-first century. However, whether trends in adolescent cannabis use differ between socioeconomic groups is not known. The aim of this study was to examine trends in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015. Methods A population-based school survey was conducted biennially among 14–16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for any and frequent cannabis use over time according to socioeconomic adversities were calculated using crosstabs and chi-square test. Associations between any and frequent cannabis use, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95% confidence intervals. Results At the overall level, the prevalences of lifetime and frequent cannabis use varied only slightly between 2000 and 2015. Cannabis use was associated with socioeconomic adversities (parental unemployment in the past year, low parental education, and not living with both parents). The differences in any and frequent cannabis use between socioeconomic groups increased significantly over the study period. Conclusions Although the overall changes in the prevalence of adolescent cannabis use were modest, cannabis use increased markedly among adolescents with the most socioeconomic adversities. Socioeconomic adversities should be considered in the prevention of adolescent cannabis use.


Author(s):  
Zhenzhen Rao ◽  
Junjie Hua ◽  
Ruotong Li ◽  
Yanhong Fu ◽  
Jie Li ◽  
...  

Recent changes in population-based prevalence for circulatory system diseases (CSDs) remain unreported either nationally or locally for China. Data were from the two-round health service household interview survey of Hunan Province, China, in 2013 and 2018. A Rao–Scott chi-square test was performed to examine prevalence differences across socio-demographic variables. The overall age-standardized prevalence of CSDs increased substantially between 2013 and 2018 for inhabitants aged 20 years and older (14.25% vs. 21.25%; adjusted odds ratio (OR) = 1.59, 95% CI: 1.24–2.04). Hypertensive disease was the most prevalent type of CSD, accounting for 87.24% and 83.83% of all CSDs in 2013 and in 2018, respectively. After controlling for other socio-demographic factors, the prevalence of CSDs was significantly higher in 2018 (adjusted OR = 1.40), urban residents (adjusted OR = 1.43), females (adjusted OR = 1.12) and older age groups (adjusted OR = 5.36 for 50–59 years, 9.51 for 60–69 years, 15.19 for 70–79 years, and 12.90 for 80 years and older) than in 2013, rural residents, males and the youngest age group (20–49 years). The recent increase in the overall age-standardized CSD prevalence and the large prevalence disparities across urban/rural residents, sex and age groups merit the attention of policymakers and researchers. Further prevention efforts are needed to curb the increasing tendency and to reduce the prevalence of disparities across socio-demographic groups.


Author(s):  
Joonho Ahn ◽  
So-Jung Ryu ◽  
Jihun Song ◽  
Hyoung-Ryoul Kim

This study aimed to evaluate the association between shift work and dry eye disease (DED) in the general population. The 2011 Korea Health Panel (KHP) was used. Chi-square test and multivariate logistic regression were used to assess the relationship between shift work and DED. Stratification analysis was conducted by sex and age. Overall, the odds ratio (OR) of DED according to shift work did not showed significant results (adjusted OR = 1.230, 95% CI 0.758–1.901). When findings were stratified based on age older or younger than 40 years, the OR of DED increased to 2.85 (95% CI: 1.25–5.90) in shift workers under 40 years of age. Our results show an association between shift work and DED in a group of younger subjects.


2021 ◽  
Vol 3 (2) ◽  
pp. 92-101
Author(s):  
Adi Zayd Bintang ◽  
Ayik Mirayanti Mandagi

ABSTRACTDepression is a mental health problem that mostly occurs during adolescence. Physical, cognitive and emotional changes experienced during adolescence can cause stress. The prevalence of depression in adolescence has a very high increase compared to the age of children and adults. The main factor in being able to cure depression in adolescents is social support (Depkes, 2007). This study aims to identify depressive symptoms in adolescents and to find out the relationship between social support factors and depression incidence. This research is a quantitative research, with the type of observational analytic research with a cross sectional approach involving students at SMA XY in Jember Regency in May 2020. The analytical method uses the Chi Square test to see the relationship between independent and dependent variables with a significance level of α ≤ 0, 05. Data collection tool using google form. Determination of respondents by random sampling with a total of 158 respondents. The results of this study indicate that the distribution of women is 76.58% more than that of men. Based on the distribution of social support, 56.96% received good social support, while based on the incidence of depression, 54.43% did not experience depression. From the statistical test, the significance value of <0.05 indicates that there is a relationship between social support factors and the incidence of depression. Social support plays an effective role in overcoming depression experienced by adolescents.Keywords: Depression, Teens, social support. ABSTRAKDepresi merupakan salah satu masalah kesehatan mental yang sebagian besar terjadi pada masa remaja. Perubahan fisik, kognitif dan emosional yang dialami pada masa remaja dapat menimbulkan stress. Prevalensi depresi pada usia remaja memiliki peningkatan yang sangat tinggi dibandingkan dengan usia anak-anak dan usia dewasa. Faktor utama untuk dapat menyembuhkan depresi pada remaja yaitu dukungan sosial (Depkes, 2007). Penelitian bertujuan untuk mengidentifikasi gejala depresi pada remaja dan mengetahui mengenai Hubungan Faktor Dukungan Sosial dengan Kejadian Depresi. Penelitian ini adalah penelitian kuantitatif, dengan jenis penelitian analitik observasional dengan pendekatan cross sectional yang melibatkan siswa di SMA XY di Kabupaten Jember pada Bulan Mei tahun 2020. Metode analisis menggunakan uji Chi Square untuk melihat hubungan variabel independen dan dependen dengan tingkat kemaknaan α ≤ 0,05. Alat pengumpulan data menggunakan google form. Penentuan responden secara random sampling dengan jumlah 158 reponden. Hasil penelitian ini menunjukan distribusi perempuan 76,58% lebih banyak daripada laki-laki, berdasarkan distribusi dukungan sosial sebesar 56,96% mendapatkan dukungan sosial yang baik, sedangkan berdasarkan kejadian depresi sebesar 54,43% tidak mengalami depresi. Dari uji statistik nilai signifikansi sebesar < 0,05 menunjukkan bahwa ada hubungan antara faktor dukungan sosial dengan kejadian depresi. Dukungan sosial berperan efektif dalam mengatasi depresi yang dialami remaja.Kata Kunci: Depresi, Remaja, Dukungan Sosial.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036162
Author(s):  
Md Mostaured Ali Khan ◽  
Md Golam Mustagir ◽  
Md Rafiqul Islam ◽  
Md Sharif Kaikobad ◽  
Hafiz TA Khan

ObjectiveThis study is concerned with helping to improve the health and care of newborn babies in Bangladesh by exploring adverse maternal circumstances and assessing whether these are contributing towards low birth weight (LBW) in neonates.Study designs and settingsData were drawn and analysed from the Bangladesh Demographic and Health Survey, 2014. Any association between LBW and adverse maternal circumstances were assessed using a Chi-square test with determinants of LBW identified by multivariate logistic regression analysis.ParticipantsThe study is based on 4728 children aged below 5 years and born to women from selected households.ResultsThe rate of LBW was around 19.9% (199 per 1000 live births) with the highest level found in the Sylhet region (26.2%). The rate was even higher in rural areas (20.8%) and among illiterate mothers (26.6%). Several adverse maternal circumstances of the women included in the survey were found to be significant for increasing the likelihood of giving birth to LBW babies. These circumstances included the women being underweight (adjusted odds ratio (AOR) 1.26, 95% CI 1.06 to 1.49); having unwanted births (AOR 1.22, 95% CI 1.03 to 1.44); had previous pregnancies terminated (AOR 1.28, 95% CI 1.05 to 1.57); were victims of intimate partner violence (AOR 1.23, 95% CI 1.05 to 1.45) and taking antenatal care <4 times (AOR 1.23, 95% CI 1.03 to 1.48). Other important risk factors that were revealed included age at birth <18 years (AOR 1.42, 95% CI 1.11 to 1.83) and intervals between the number of births <24 months (AOR 1.25, 95% CI 1.01 to 1.55). When taking multiple fertility behaviours together such as, the ages of the women at birth (<18 years with interval <24 months (AOR 1.26, 95% CI 1.02 to 1.57) and birth order (>3 with interval <24 months (AOR 1.68, 95% CI 1.18 to 2.37), then the risk of having LBW babies significantly increased.ConclusionThis study finds that adverse maternal circumstances combined with high-risk fertility behaviours are significantly associated with LBW in neonates. This situation could severely impede progress in Bangladesh towards achieving the sustainable development goal concerned with the healthcare of newborns.


Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 847
Author(s):  
Xingyun Liu ◽  
Xiaoqian Liu

Background: Suicide is a serious social problem. Substantial efforts have been made to prevent suicide for many decades. The internet has become an important arena for suicide prevention and intervention. However, to the best of our knowledge, only one study has analyzed suicidal comments online from the perspective of rhetorical structure with incomplete rhetorical relations. We aimed to examine the rhetorical differences between Chinese social media users who died by suicide and those without suicidal ideation. Methods: The posts of 15 users who died by suicide and 15 not suffering from suicide ideation were annotated by five postgraduates with expertise in analyzing suicidal posts based on rhetorical structure theory (RST). Group differences were compared via a chi-square test. Results: Results showed that users who died by suicide posted significantly more posts and used more rhetorical relations. Moreover, the two groups displayed significant differences in 17 out of 23 rhetorical relations. Limitations: Because this study is largely exploratory and tentative, caution should be taken in generalizing our findings. Conclusions: Our results expand the methods of RST to the online suicidal identification field. There are implications for population-based suicide prevention by combining rhetorical structures with context analysis.


2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 245-245
Author(s):  
Safiya Karim ◽  
Jina Zhang-Salomons ◽  
James Joseph Biagi ◽  
Tim Asmis ◽  
Christopher M. Booth

245 Background: While FOLFIRINOX is a standard treatment option for advanced pancreas cancer there is little data describing utilization and effectiveness in routine clinical practice. Here we report practice patterns and outcomes in the general population of Ontario, Canada. Methods: Using the Ontario Cancer Registry and New Drug Funding Program we identified all patients with pancreas cancer treated with palliative intent gemcitabine or FOLFIRINOX in Ontario during 2006-2014. FOLFIRINOX became available in Ontario’s single-payer health system in November 2011. Gemcitabine cases were classified as pre-FOLFIRINOX era (2006-2010) or post-FOLFIRINOX era (2011-2014). Cases treated with peri-operative chemotherapy were excluded. Comparisons of proportions between study groups were made using the chi-square test. Overall survival (OS) was measured from date of chemotherapy initiation. Results: During 2006-2014, 3826 patients in Ontario were treated with Gemcitabine (n=3042) or FOLFIRINOX (n=784) chemotherapy for advanced pancreas cancer. Uptake of FOLFIRINOX increased from 41% (206/505) of treated cases in 2012 to 56% (274/486) of treated cases in 2014. Among patients treated after 2011, median age was 69 and 63 years for Gemcitabine and FOLFIRINOX respectively (p<0.001). The proportion of treated cases who received FOLFIRINOX varied considerably across geographic regions (from 26% to 58%, p<0.001). Median number of FOLFIRINOX cycles delivered was 6 (median 10 cycles in pivotal RCT). Median OS of patients treated with Gemcitabine was 5.0 months in 2006-2010 and 4.8 months in 2011-2014. Median OS of FOLFIRINOX patients treated in 2011-2014 was 8.2 months (median 11.1 months in pivotal RCT). Conclusions: Use of FOLFIRINOX in the general population has increased since 2011 with a resulting decrease in use of Gemcitabine. However, outcomes achieved with FOLFIRINOX in Ontario demonstrate a substantial efficacy-effectiveness gap between survival in the pivotal clinical trial and survival in routine practice.


2020 ◽  
Vol 13 (12) ◽  
Author(s):  
Mohammad Ali Ganji Jameshouran ◽  
Farzad Allameh ◽  
Mohammad Mersad Mansouri Tehrani ◽  
Mohammad Ali Tasharrofi ◽  
Babak Javanmard ◽  
...  

Background: Sarcomas of the genitourinary tract are rare clinical entities with relatively few studies conducted on their prevalence and characteristics globally. Previous literature has established the effects of ethnicity and race on soft tissue sarcomas’ clinical attributes and prognosis. Objectives: To provide researchers and clinicians with a better understanding of the matter, this study aims at providing descriptive data regarding urologic sarcoma among the Iranian population. Methods: All patients diagnosed with genitourinary sarcoma registered in the Cancer Research Center (CRC) between 2009 and 2014 were enrolled in this national population-based study. Basic patient data including their gender, age, city, and province of origin, as well as each patient’s tumor characteristics were retrieved from CRC’s database. Chi-square test was utilized in determining a possible relationship between patient data and the tumor characteristics. Results: A total of 337 patients with primary genitourinary sarcoma were selected for this study. More than half of the patients were classified in the 15 to 65-year-old group. The most common primary site of involvement was the kidneys with the most prevalent histological subtype being liposarcoma. Conclusions: This study found sarcomas of the genitourinary tract to be more prevalent among the adult Iranian population, with liposarcoma, leiomyosarcoma, and rhabdomyosarcoma being the most commonly observed subtype, and factors such as age, gender, and tumor grading all related to the anatomical distribution of the tumors.


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