Impact of the Covid-19 pandemic on primary care utilization: evidence from Sweden using national register data

Objective To analyze changes in primary care utilization as a result of the Covid-19 pandemic. Swedish national register data from 2019 to 2020 on utilization of services were used to compare overall utilization levels and across types of contacts and patient groups. A specific objective was to assess the extent to which remote types of patient consultations were able to compensate for any observed fall in on-site visits. Data were stratified by sex and age to investigate any demographic pattern. Results Findings show significant reductions in overall utilization of services as the pandemic occurred in the first quarter of 2020. On-site visits fell during the first wave of the pandemic and rebounded thereafter. Patients over 65 years of age appear to have reduced utilization to a larger extent compared with younger groups. Simultaneously, remote contacts increased from around 12% before the pandemic to 17% of the total number of consultations. However, the net effect of changes in service utilization suggests an overall reduction of around 12 percent in the number of primary care consultations as a result of the pandemic. No differences between men and women were observed. Further research will continue to monitor changes in primary care utilization as the pandemic continues.

The diagnostic trajectory of infants and children with clinical features of genetic disease

We characterized US pediatric patients with clinical indicators of genetic diseases, focusing on the burden of disease, utilization of genetic testing, and cost of care. Curated lists of diagnosis, procedure, and billing codes were used to identify patients with clinical indicators of genetic disease in healthcare claims from Optum’s de-identified Clinformatics® Database (13,076,038 unique patients). Distinct cohorts were defined to represent permissive and conservative estimates of the number of patients. Clinical phenotypes suggestive of genetic diseases were observed in up to 9.4% of pediatric patients and up to 44.7% of critically-ill infants. Compared with controls, patients with indicators of genetic diseases had higher utilization of services (e.g., mean NICU length of stay of 31.6d in a cohort defined by multiple congenital anomalies or neurological presentations compared with 10.1d for patients in the control population (P < 0.001)) and higher overall costs. Very few patients received any genetic testing (4.2–8.4% depending on cohort criteria). These results highlight the substantial proportion of the population with clinical features associated with genetic disorders and underutilization of genetic testing in these populations.

Inovasi Perpustakaan Perguruan Tinggi Muhammadiyah–‘Aisyiyah (PTMA) Menghadapi Pandemi Covid-19: Sebuah Studi Literatur Bunga Rampai

Introduction. The COVID-19 pandemic has had an impact on education systems around the world, including Indonesia. The government carried out temporary closure of public services to reduce the number of additional cases. One of the community services affected is the library as a support for education. As a supporter of education, the perceived impact is the non-utilization of services in the library. Efforts made by the library to continue to provide services are by changing the system and management mechanism in the library. This paper aims to find out the innovations and strategies implemented in several PTMA libraries in the era of the covid-19 pandemic.Methodology. This study uses a literature review to collect data and documentation to support the analysis.Result. The result of this paper is that PTMA library librarians must be able to use facilities or technology to serve the academic community.Conclusion. The COVID-19 pandemic has not only hurt society. The other side of the Covid-19 pandemic is being able to develop competence through online seminars. In addition, the handling of the COVID-19 pandemic, which is gradually improving, has forced libraries to reopen services while still implementing health protocols to suppress the rate of transmission.

Impact of the Covid-19 Pandemic on Primary Care Utilization: Evidence From Sweden Using National Register Data

Objective: To analyze changes in primary care utilization as a result of the Covid-19 pandemic. Swedish national register data from 2019 and 2020 on utilization of services were used to compare overall utilization levels and across types of contacts and patient groups. A specific objective was to assess the extent to which remote types of patient consultations were able to compensate for any observed fall in on-site visits. Data were stratified by sex and age to investigate any demographic pattern. Results: Findings show significant reductions in overall utilization of services as the pandemic occurred the first quarter of 2020. On-site visits fell during the first wave of the pandemic and rebounded thereafter. Patients over 65 years of age appear to have reduced utilization to a larger extent compared with younger groups. Simultaneously, remote contacts increased from around 12% before the pandemic to 17% of total number of consultations. However, the net effect of changes in service utilization suggests an overall reduction of around 12 percent in the number of primary care consultations as a result of the pandemic. No differences between men and women were observed. Further research will continue to monitor changes in primary care utilization as the pandemic continues.

A New Perspective of Urban-rural Differences: the Impact of Supply and Demand on Healthcare Services for the Older Adults: a Case Study of Shaanxi Province

Background: With the rapidly aging of Chinese society and the change of Chinese residents’ disease spectrum, the older adults utilization of the healthcare services surges as well. Studies on factors that potentially influence the utilization of healthcare services for the older adults becomes increasing important, which could benefit improving the service effect and the quality of life of the older adults in later life. This article compares and analyzes the differences in the using of healthcare services by the older adults in urban and rural areas based on the supply and demand of healthcare services for the older adults and analyzes the reasons for potential differences. Methods: Using data from a survey conducted in three cities in Shaanxi Province in 2019. All authors participated in the questionnaire survey. We obtained a total of 948 questionnaires. Multivariate regression model and Oaxaca-Blinder decomposition model are used to analyze the difference between the supply and demand of medical services for the older adults in urban and rural areas.Results: The results find that age, household register, living activities of daily living (ADL), (P<0.01) and healthcare treatment insurance significantly impact the older adults use of healthcare services. Meanwhile, factors from the supply and demand factors have a significant correlation with the utilization of services for the older adults, including the healthcare service quality(P<0.01), the diversity of service content(P<0.01), the rationality of service charge(P<0.01), service satisfaction(P<0.01), family support (P<0.1) level and the main illness(P<0.05). Moreover, the results show a significant difference in the use of healthcare services for the older adults between urban and rural areas. Specifically, in urban areas, the influences of service quality, the diversity of service content and the rationality of service from the supply have a significant correlation with the utilization of services for the older adults. The service satisfaction, service demand and family support in the demand factors have a significant correlation with the utilization of services for the older adults. In comparisons, for the older adults in rural areas, the diversity of service content from the supply factors as well as economic level and main illness from the demand factors have a significant correlation with the utilization of services for the older adults.Conclusions: From the perspective of supply and demand, this paper constructs an analytical framework of the determinants of healthcare services for the older adults from a new perspective. Based on the analysis framework and from the perspective of supply and demand of healthcare services utilization, the differences between urban and rural areas in the utilization of medical care for the older adults and the influencing factors are studied. It provides a new research perspective to explore the influencing factors of healthcare services utilization for the older adults. Supply factors and demand factors have a significant correlation with the utilization of healthcare services for the older adults. There are also significant differences in the factors influencing the utilization of health services by urban and rural older adults. When strengthening and improving the supply of healthcare services for the older adults, the previous thinking of “top-down” and “service-centered” should be changed, and gradually transformed into “bottom-up” and “demand-centered”.

Assessment of Integrated Child Development Services (ICDS) at Grass Root Level in an Urban Area, Raigad District, Maharashtra

Background: ICDS is an integrated program intended for Maternal and Child Care which adopts a holistic, lifecycle approach. Its main focus is on health, nutrition and education. Urban ICDS caters to the vulnerable urban slum population. Despite the program running for four decades its impact on its beneficiaries is still slow. The Anganwadi worker and helper are the grass-root functionaries running this program through Anganwadi centre. Hence this study was conducted to assess the functioning of the Anganwadi centre. Methodology: A Descriptive Cross-sectional study was conducted at all 15 urban-ICDS Anganwadi Centres of Khopoli during September-November 2019. The Anganwadi workers and helpers were interviewed regarding their sociodemographic details, knowledge and challenges perceived to run the centre. Observational Checklist designed based on guidelines and standard proforma for monitoring of the ICDS projects was used to assess infrastructure, equipment and registers. Results: Out of 14, 11(78.57%) Anganwadi workers had more than a decade experience. Indoor space of 600 sq.ft was available in 7(46.67%) centres. Toilets with running water were available in 9(60%) Anganwadi Centres and 6(40%) were linked to the school. Functional Salter’s weighing scale was available in 11(73.33%) Anganwadi centres. All 12 registers were available in 9(60%) Anganwadi centres. The utilization of services by pregnant women was the highest. Partially immunized children were present in 2(13.33%) Anganwadi centres. The service gap was highest (100%) with health check-up. Conclusions: There is a gap in the availability of infrastructure and utilization of some services. Keywords: urban ICDS, Maharashtra, Service gap.

The Canadian Armed Forces (CAF) members' experience with social services in the military: an exploratory study

The aim of this study was to critically explore the strengths, limitations, barriers and gaps in social services within the CAF in relation to delivery, access and uptake of social services while employed in the CAF. The study provided CAF members an opportunity to express their thoughts, ideas and opinions based on their lived experiences, and to explore creative responses and solutions to issues members face with social services in the CAF. Presented are the findings from data collected through semi-structured, in-depth interviews with recently released CAF members. Themes that emerged from the research captured the lived experiences of the participants and were related to: differences between components (Regular Force vs. Reserve Force), perceived need and its effect on utilization of services, significant improvements in services post 9/11 and Afghanistan, organizational and systemic influence, impact of service providers, and better promotion of social services to the greater CAF community.

The Canadian Armed Forces (CAF) members' experience with social services in the military: an exploratory study

The aim of this study was to critically explore the strengths, limitations, barriers and gaps in social services within the CAF in relation to delivery, access and uptake of social services while employed in the CAF. The study provided CAF members an opportunity to express their thoughts, ideas and opinions based on their lived experiences, and to explore creative responses and solutions to issues members face with social services in the CAF. Presented are the findings from data collected through semi-structured, in-depth interviews with recently released CAF members. Themes that emerged from the research captured the lived experiences of the participants and were related to: differences between components (Regular Force vs. Reserve Force), perceived need and its effect on utilization of services, significant improvements in services post 9/11 and Afghanistan, organizational and systemic influence, impact of service providers, and better promotion of social services to the greater CAF community.

Development Of A Realistic Smart Information Guide Solution To Support Multi-Devices

: In this study, a realistic smart information guide solution to support multi-devices was developed. The upload of diverse realistic contents, as well as the support of smart devices with specific characteristics and the management of integrated contents, was made possible. Additionally, it was important to guarantee the quality of the contents (AR, VR) alongside the realistic smart information guide solution. Recently, there have been many positive responses from the expansion on and utilization of services of the fourth Industrial Revolution such as AR technologies, which include image recognition-based information services, and VR technologies, which include hands-on information services using motion recognition sensors. In the future, the development and planning of AR and VR content for visitors and tourists for locations such as museums and exhibition halls will be actively required.

Desigualdades na utilização de serviços odontológicos do SUS entre adultos de 35-44 anos, em Salvador, Bahia.

Com o objetivo de caracterizar o perfil dos usuários do SUS na faixa etária de 35–44 anos e a utilização dos serviços odontológicos de Salvador, Bahia, por essa população, foi realizado um estudo de corte transversal utilizando dados secundários do Inquérito de Saúde Bucal realizado no município, em 2015. Foram analisadas as variáveis da entrevista realizada com 1.321 usuários de unidades básicas de saúde dos 12 Distritos Sanitários. Observou-se predominância do sexo feminino (78,1%), pardos e pretos (88,1%), alfabetizados (99,2%), que não recebiam benefício social (70,4%) e com necessidade de tratamento percebida (80,8%). Quanto ao uso dos serviços odontológicos no último ano observou-se: 62,4% de acesso ao dentista (consultas), 26,1% de exodontia, 31,3% de restauração, 10,2% de endodontia, 8,0% de prótese, 8,8% de cirurgia/periodontia e 23% participaram de atividades educativas. Prevaleceu a utilização dos serviços de financiamento público (p=0,02), exceto para as especialidades de endodontia e prótese (p<0,00). Verificou-se baixa utilização dos serviços e participação em atividades educativas. Há diferenças importantes na distribuição e cobertura dos serviços odontológicos entre os Distritos, que promovem desigualdades no acesso e utilização dos serviços públicos. Sugere-se a ampliação da oferta de serviços odontológicos, reorganização dos serviços quanto à marcação de consultas, horário de funcionamento, distribuição dos profissionais e modelo de atenção. INEQUALITIES IN SUS DENTAL SERVICES UTILIZATION AMONG ADULTS AGED 35–44 YEARS, IN SALVADOR, BAHIA ABSTRACTAiming to characterize the profile of users of the Unified Health System (SUS) aging 35–44 years old and the use of dental services in Salvador, Bahia, a cross-sectional study was conducted using secondary data from the Oral Health Survey taken in 2015 in the city. Interview variables with 1.321 users of basic health units in the 12 Health Districts about service utilization were analyzed. There was predominance of females (78.1%), brown and black (88.1%), literate (99.2%), who received no social assistance (70.4%) and in need of perceived treatment (80.8%). Regarding the use of dental services in the last year we obtained: 62.4% dental access (consultations), 26.1% dental extraction, 31.3% restoration, 10.2% endodontics, 8.0% prosthesis, 8.8% of surgery/ periodontics and 23% participated in educational activities. The use of publicly-funded services prevailed (p = 0.02), except for the specialties of endodontics and prosthesis (p < 0.00). There was low utilization of services and participation in educational activities. It is suggested to expand the offer of dental services, reorganization of services regarding appointment scheduling, opening hours, distribution of professionals and care model.