scholarly journals Regional and gender variation in mortality amenable to health care services in Italy

2013 ◽  
Vol 2 (3) ◽  
pp. 28 ◽  
Author(s):  
Jacopo Lenzi ◽  
Paola Rucci ◽  
Giuseppe Franchino ◽  
Gianfranco Domenighetti ◽  
Gianfranco Damiani ◽  
...  
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Health Care Services ◽  
National Level ◽  
Total Mortality ◽  
Linear Increase ◽  
Amenable Mortality ◽  
Care Services ◽  
All Cause Mortality ◽  
And Gender

Background: Mortality amenable to health care services (“amenable mortality”) has been defined as “premature deaths that should not occur in the presence of timely and effective health care” and as “conditions for which effective clinical interventions exist”. Although it proved to be a reliable indicator of performance of health care services in the European countries at national level, evidence about its regional variation is limited. We analyzed the regional and gender variability in the performance of health care services using the amenable mortality rate and its contribution to all-cause mortality under age 75 for the period 2006–2009. Methods: The national amenable mortality rate was calculated as the average annual number of deaths for specific causes defined according to the list of Nolte and McKee over the average population aged 0–74 years per 100,000 inhabitants in Italy. The contribution of amenable mortality to all-cause mortality (%AM) was calculated as the ratio of amenable mortality rate to all-cause mortality rate. Results were then stratified by gender, region, and year. Data were drawn from national mortality statistics for the period 2006–2009 provided by the Italian Institute of Statistics (ISTAT). Results: During the index period, in Italy the age and sex-standardized death rate amenable to health care services (SDR) was 62.4 per 100,000 inhabitants: 65.8 per 100,000 for males and 59.0 for females. Amenable mortality accounted for about one-quarter (25.3%) of total mortality under age 75: one-fifth (20.1%) for males and one-third (32.9%) for females. Southern Italy generally had higher levels of amenable mortality, both in terms of SDR and %AM, except for Puglia. However, SDRs and %AM had a different geographical pattern, which was consistent for men and women. Examination of temporal trends revealed that SDR linearly declined between 2006 and 2009 (63.9 to 61.7 per 100,000; % change = –3.4%; p = 0.021), while %AM was almost stable (25.1% to 25.7%; % change = +2.4%; p = 0.120). Piedmont, Lombardy, the autonomous province of Trento, Veneto and Campania had a linear decrease in SDR, while Abruzzo had a linear increase in SDR. Puglia had a linear increase in %AM. Conclusions: The present study contributes additional evidence on the role of amenable mortality as a synthetic indicator of the effectiveness of health care services. We argue that, in a decentralized health care system such as the Italian one, regional stratification is needed to put amenable mortality into the context of the regional specificities of health care provision. We also demonstrated that it is important to consider both SDRs and %AM, because this latter measure can give an insight on the extent to which health services can contribute to ameliorating the health of a population. Thus, consideration of both SDRs and %AM can be useful for national and regional comparisons, and can constitute the basis for evidence-based policy decision making.

scholarly journals Mortality amenable to health care services and health inequalities across the regions of Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
Y Adja ◽  
C Reno ◽  
J Lenzi ◽  
M P Fantini
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Health Services ◽  
Health Inequalities ◽  
Health Care Services ◽  
Care Quality ◽  
Amenable Mortality ◽  
Care Services ◽  
Italian Regions ◽  
And Performance

Abstract Background Amenable mortality is an indicator that measures the extent to which health services contribute to the improvement of the health of a population. It can also highlight geographical and socioeconomic inequalities. Therefore, it is used to assess quality and performance of health care systems, both at national and subnational level. The Italian National Health Service sets the essential levels of care (Livelli Essenziali di Assistenza, LEA), a health-benefit package for all citizens. Because every region is responsible for providing the LEA and can offer additional health care, monitoring the performance of the Regional Health Services (RHSs) is of increasing interest. Methods We used Nolte and McKee's list of amenable conditions to analyze the temporal trend of the standardized mortality rate (per 100.000) in Italy from 2006 to 2015, overall and by gender. We also examined the standardized rate at regional level by comparing the two-year periods 2006/7 and 2014/5, overall and by gender. Results Between 2006 and 2015, the overall mortality rate decreased from 81 to 68 per 100.000 population; this reduction was more pronounced in men (91 to 76 per 100.000, -16.5%) than in women (72 to 62 per 100.000, -13.9%). The decreasing trend in amenable mortality affected Italian regions differently, with northern regions showing steeper reductions as compared to southern regions. As a result, 2014/5 was the first time men's mortality in North Italy (68 per 100.000) was lower than women's mortality in South Italy (72 per 100.000). Conclusions The overall reduction of amenable mortality shows that Italy's health care services keep contributing to the improvement of population health. Nevertheless, by analyzing RHS performance we saw that differences in organization of care lead to differences in health care quality and performance across regions. Deaths amenable to health care services contribute to inequalities between Northern and Southern Italy. Key messages Because universal health coverage is necessary but not sufficient to reduce health inequalities, investing into better-quality services should be recognized as a priority. Amenable mortality can highlight areas of intervention to reduce inequalities in the provision of health care services.

scholarly journals Regional variations of amenable mortality rate in Latvia

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Skrule ◽  
J Lepiksone
Keyword(s):  
Health Care ◽  
Death Rate ◽  
Health Care Services ◽  
National Level ◽  
Regional Level ◽  
Regional Variations ◽  
Reduce Health Inequality ◽  
Amenable Mortality ◽  
Care Services ◽  
Time Period

Abstract Background Death can be considered as amenable if all or most deaths from that cause (at certain age group if appropriate) could be avoided through optimal quality of health care. Amenable mortality is one of indicators to use for assessing health system performance and outcome. Methods For amenable death causes using list of diseases and conditions from Office for National Statistics of United Kingdom (used by Eurostat). Calculation of amenable death rate (per 100000 population) for ages 0 to 74 years at regional level (six statistical regions) for time period 2015-2017, direct age-standardization to the overall national population. Results accompanied by confidence intervals (95%). Results There is a slight decline in amenable mortality of Latvia at national level over the period 2015-2017. Amenable death rate of Latvia in 2017 was 309 per 100 000 (95% CI, 308.95 - 309.05). Death rates at regional level varies from 274.34 (274.23 - 274.44) in Pieriga region to 375.49 (375.37 - 375.62) per 100 000 in Latgale region. There are no significant changes in ranking of regions for three years period. Conclusions Results shows that there are differences of amenable mortality rates between regions of Latvia. There are health inequalities between regions: Pieriga region show the best health care services performance, while Latgale displays the worst performance. There is field for deeper analysis and find better interventions for improvements at national level and reducing variability between regions. Key messages There are regional variations of amenable mortality in Latvia. Regional variations show places to reduce health inequality.

Race and gender as factors in access to health insurance and utilization of health care services

2014 ◽  
Author(s):  
Susana J. Ferradas ◽  
G. Nicole Rider ◽  
Johanna D. Williams ◽  
Brittany J. Dancy ◽  
Lauren R. Mcghee
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Race And Gender ◽  
Care Services ◽  
Access To Health ◽  
And Gender

scholarly journals The ecology of medical care in Norway: wide use of general practitioners may not necessarily keep patients out of hospitals

2012 ◽  
Vol 1 (2) ◽  
pp. 28 ◽  
Author(s):  
Anne Helen Hansen ◽  
Peder A. Halvorsen ◽  
Olav Helge Førde
Keyword(s):  
Health Care ◽  
General Practitioner ◽  
General Practitioners ◽  
Health Care Services ◽  
Medical Providers ◽  
Specialist Care ◽  
Cross Sectional ◽  
Care Services ◽  
And Gender ◽  
Complementary And Alternative

<em>Background</em>. Our aim was to investigate the pattern of self reported symptoms and utilisation of health care services in Norway. <em>Design and methods.</em> With data from the cross-sectional Tromsø Study (2007-8), we estimated population proportions reporting symptoms and use of seven different health services. By logistic regression we estimated differences according to age and gender. <em>Results</em>. 12,982 persons aged 30-87 years participated, 65.7% of those invited. More than 900/1000 reported symptoms or health problems in a year as well as in a month, and 214/1000 and 816/1000 visited a general practitioner once or more in a month and a year, respectively. The corresponding figures were 91/1000 and 421/1000 for specialist outpatient visits, and 14/1000 and 116/1000 for hospitalisations. Physiotherapists were visited by 210/1000, chiropractors by 76/1000, complementary and alternative medical providers by 127/1000, and dentists by 692/1000 in a year. Women used most health care services more than men, but genders used hospitalisations and chiropractors equally. Utilisation of all services increased with age, except chiropractors, dentists and complementary and alternative medical providers. <em>Conclusions</em>. Almost the entire population reported health related problems during the previous year, and most residents visited a general practitioner. Yet there were high rates of inpatient and outpatient specialist utilisation. We suggest that wide use of general practitioners may not necessarily keep patients out of specialist care and hospitals.

scholarly journals Use of health care services in seasonal affective disorder

2002 ◽  
Vol 180 (5) ◽  
pp. 449-454 ◽  
Author(s):  
John M. Eagles ◽  
Fiona L. Howie ◽  
Isobel M. Cameron ◽  
Samantha M. Wileman ◽  
Jane E. Andrew ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Affective Disorder ◽  
Help Seeking ◽  
Health Care Services ◽  
Seasonal Affective Disorder ◽  
Care Services ◽  
Help Seeking Behaviour ◽  
And Gender ◽  
Use Of Health Care

BackgroundLittle is known about the presentation and management of seasonal affective disorder (SAD) in primary care.AimsTo determine the use of health care services by people suffering from SAD.MethodFollowing a screening of patients consulting in primary care, 123 were identified as suffering from SAD. Each was age— and gender-matched with two primary care consulters with minimal seasonal morbidity yielding 246 non-seasonal controls. From primary care records, health care usage over a 5-year period was established.ResultsPatients with SAD consulted in primary care significantly more often than controls and presented with a wider variety of symptoms. They received more prescriptions, under went more investigations and had more referrals to secondary care.ConclusionsPatients with SAD are heavy users of health care services. This may reflect the condition itself, its comorbidity or factors related to the personality or help-seeking behaviour of sufferers.

scholarly journals Gender minority stress and access to health care services among transgender women and transfeminine people: results from a cross-sectional study in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yongjie Sha ◽  
Willa Dong ◽  
Weiming Tang ◽  
Lingling Zheng ◽  
Xi Huang ◽  
...  
Keyword(s):  
Health Care ◽  
Minority Stress ◽  
Access To Health Care ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Gender Minority ◽  
Care Services ◽  
Access To Health ◽  
And Gender

Abstract Background Transgender and gender diverse individuals often face structural barriers to health care because of their gender minority status. The aim of this study was to examine the association between gender minority stress and access to specific health care services among transgender women and transfeminine people in China. Methods This multicenter cross-sectional study recruited participants between January 1st and June 30th 2020. Eligible participants were 18 years or older, assigned male at birth, not currently identifying as male, and living in China. Gender minority stress was measured using 45 items adapted from validated subscales. We examined access to health care services and interventions relevant to transgender and gender diverse people, including gender affirming interventions (hormones, surgeries), human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Multivariable regression was used to measure correlations between gender minority stress and access to health care service. Results Three hundred and twenty-four people completed a survey and data from 277 (85.5%) people were analyzed. The mean age was 29 years old (standard deviation [SD] = 8). Participants used hormones (118/277, 42.6%), gender affirming surgery (26/277, 9.4%), HIV testing (220/277, 79.4%), STI testing (132/277, 47.7%), PrEP (24/276, 8.7%), and PEP (29/267, 10.9%). Using gender affirming hormones was associated with higher levels of discrimination (adjusted odds ratio [aOR] 1.41, 95% confidence interval [CI] 1.17–1.70) and internalized transphobia (aOR 1.06, 95%CI 1.00–1.12). STI testing was associated with lower levels of internalized transphobia (aOR 0.91, 95%CI 0.84–0.98). Conclusions Our data suggest that gender minority stress is closely related to using health services. Stigma reduction interventions and gender-affirming medical support are needed to improve transgender health.

scholarly journals Community Health Workers and The Promotion of Health Care Services in Gasabo District, Rwanda

2019 ◽  
Vol 9 (10) ◽  
pp. 1-5
Author(s):  
Moses Kamanzi
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Services ◽  
Health Workers ◽  
Psychosocial Support ◽  
Infant Mortality Rate ◽  
Primary Data ◽  
Care Services

Health care is a primary need of human being. Life expectancy as an indicator of Human Development is below 40 years in most developing countries due to high Maternal Mortality Rate, HIV prevalence, Infant Mortality rate, Malaria prevalence and many other related diseases. This study examined the importance of Community Health Workers (CHWs) role in promoting Health Care services in Gasabo District of Rwanda.  A simple random sampling method with the use of a self-administered questionnaire to get primary data was used as well as a literature review for secondary data. The target population was 1500 CHWs with a sample size of 183 CHWs.  55.6% of CHWs have a role of monitoring Malnutrition & growth for children under the age of 5years, 43.2% monitor women during their pregnancy period and diagnose and treat Malaria, Diarrhoea & Pneumonia for children under 5 years old. Other roles of CHWs include; providing health education (43% of CHWs), providing Family Planning services to women (24%), and sensitizing the community for HIV/AIDS testing (14.3%), psychosocial support (11%) and Vaccination (9.8%). The challenges faced by CHWs to accomplish their roles include; transportation facilitation (39.9%), limited time (32.8%), negative perception by communities (37.7%) and no monthly salary pay (38.8%). Although the work of CHWs in Rwanda is voluntary, however, the Ministry of Health should invest more in their work through the provision of transportation facilitation and motivational incentives CHWs.

Diversity or Dilemma

2016 ◽  
pp. 1-19
Author(s):  
Aumio Srizan Samya
Keyword(s):  
Health Care ◽  
Human Rights ◽  
Gender Roles ◽  
Cultural Values ◽  
Health Care Services ◽  
Men And Women ◽  
Care Services ◽  
And Gender ◽  
Sex With Men

Sexuality, masculinities and gender roles are interconnected in many aspects. The construction of gender among men and women is influenced by sexuality. Bangladesh is predominantly influenced by Muslim socio-cultural values as more than 85% people follow Islam as their religion. Islam does not allow the space for homosexuality. Hence, MSM (Men who have Sex with Men) people are perceived, viewed and identified as deviant, outcast and sinners. They are deprived of basic human rights, access to proper education, health care services and so on. MSM people are often forced to marry a woman as it is believed that it will ‘cure' their ‘problem' and mainstream them into society. Hence, they are forced to compromise not only as a citizen but also an individual. Such oppression is pushing MSM people in Dhaka not only to the edges but also making them silent and almost invisible from the society.

Sign in / Sign up

Export Citation Format

Share Document