The Big Five personality traits and regularity of lifetime dental visit attendance: evidence of the Survey of Health, Ageing, and Retirement in Europe (SHARE)

Background Regular dental visits are essential for the prevention, early detection and treatment of worldwide highly prevalent oral diseases. Personality traits were previously associated with treatment compliance, medication adherence and regular doctor visits, however, the link between personality traits and regular dental visit attendance remains largely unexplored. Thus, the objective of this study is to clarify this link. Methods Data (wave 7) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used, focusing on Germany (n = 2822). Personality was assessed using the 10-item Big Five Inventory (BFI-10). Regular dental visits were assessed. Multiple logistic regressions were used, adjusting for various covariates. Results Majority of the participants (84%) reported to attend regular dental visits during lifetime. Regularity of lifetime dental visit attendance was positively and significantly associated with increased extraversion [OR 1.13, 95% CI (1.01–1.26)], increased conscientiousness [OR 1.26, 95% CI (1.10–1.44)], and increased openness to experience [OR 1.12, 95% CI (1.01–1.26)]. However, there was a lack of association with agreeableness and neuroticism. Moreover, the outcome measure was positively associated with younger age, being female, born in Germany, being married, higher education, being retired (compared to being homemaker), whereas it was not associated with obesity or chronic diseases. Conclusions Identification of personality traits that are associated with regular dental visits can support prevention, screening and clinical management of oral diseases. Further research in this field may facilitate the development and increase the incorporation of individualized concepts to enhance patient compliance and attendance, and thus the provision of oral and dental care services.

Burden of Care for Children with Bronchiectasis from Parents/Carers Perspective

Bronchiectasis is a neglected chronic respiratory condition. In children optimal appropriate management can halt the disease process, and in some cases reverse the radiological abnormality. This requires many facets, including parental/carer bronchiectasis-specific knowledge, for which there is currently no such published data. Further, the importance of patient voices in guiding clinical research is becoming increasingly appreciated. To address these issues, we aimed to describe the voices of parents of children with bronchiectasis relating to (a) burden of illness and quality of life (QoL), (b) their major worries/concerns and (c) understanding/management of exacerbations. The parents of 152 children with bronchiectasis (median age = 5.8 years, range 3.5–8.4) recruited from the Queensland Children’s Hospital (Australia) completed questionnaires, including a parent-proxy cough-specific QoL. We found that parents of children with bronchiectasis had impaired QoL (median 4.38, range 3.13–5.63) and a high disease burden with median 7.0 (range 4.0–10.0) doctor visits in 12-months. Parental knowledge varied with only 41% understanding appropriate management of an exacerbation. The highest worry/concern expressed were long-term effects (n = 42, 29.8%) and perceived declining health (n = 36, 25.5%). Our study has highlighted the need for improved education, high parental burden and areas of concern/worry which may inform development of a bronchiectasis-specific paediatric QoL tool.

Do Individuals Skimp on Health Care After Spouse’s Dementia Diagnosis?

Dementia is a costly disease that places great burden on individuals and families. The substantial time and financial resources taken away by living with persons with dementia (PWDs) may make their spouses forgo essential health care, thus deteriorating long-term health and increasing downstream healthcare costs. However, such negative externality is understudied. This paper studied the impacts of spouse's incident dementia diagnosis on an individual's use of needed care, defined as annual flu shot and regular doctor visits for those with preexisting conditions. Using HRS linked to Medicare claims, I employed a fixed effects approach to compare the use of flu shot and doctor visit during 1 year before and after the index, for individuals whose spouse had dementia (N=691) and otherwise similar controls (N=5,073). After adjusting for time-varying health, caregiving roles, and other socio-demographic factors, spouse’s dementia onset was associated with greater likelihood of getting flu shot and seeing doctors. Among those transitioning into caregiving, spouses of PWDs had a marginally higher risk of skimping on doctor visits, compared to controls (p=0.053). In this broadly representative sample, there lacks evidence for rationed health care ensuing spouse’s dementia incidence, at least within a 1-year time frame. However, for new spousal caregivers, the impact of dementia is more profound and complex than deprivation of time. This group may face a trade-off between caring for spouses with dementia and caring for themselves, for whom policy support merits further study and consideration.

COVID-19 Vaccination and Healthcare Demand

One of the driving concerns during any epidemic is the strain on the healthcare system. As we have seen many times over the globe with the COVID-19 pandemic, hospitals and ICUs can quickly become overwhelmed by cases. While strict periods of public health mitigation have certainly helped decrease incidence and thus healthcare demand, vaccination is the only clear long-term solution. In this paper, we develop a two-module model to forecast the effects of relaxation of non-pharmaceutical intervention and vaccine uptake on daily incidence, and the cascade effects on healthcare demand. The first module is a simple epidemiological model which incorporates non-pharmaceutical intervention, the relaxation of such measures and vaccination campaigns to predict caseloads into the the Fall of 2021. This module is then fed into a healthcare module which can forecast the number of doctor visits, the number of occupied hospital beds, number of occupied ICU beds and any excess demand of these. From this module we can also estimate the length of stay of individuals in ICU. For model verification and forecasting, we use the four most populous Canadian provinces as a case study.

Factors associated with non-adoption of healthy behavior among individuals with diabetes: a population-based study in Brazil

Background The non-adoption of behavioral changes to control diabetes mellitus contributes to a low adherence to self-care. This study aimed to investigate the factors associated with non-adoption of healthy behaviors among diabetic individuals. Methods Cross-sectional study using data from the National Health Survey (Pesquisa Nacional de Saúde) carried out in 2013 in Brazil, with adults (≥18 years) (n = 3098). The outcome variable was the non-adoption—two or fewer—of healthy behaviors. Logistic regression model was used to identify the factors associated with non-adoption of healthy behaviors. Results Approximately, 50% of the participants adopted two or fewer healthy habits and the most frequently mentioned were not drinking excessively (94.1%) and not smoking (89.1%). Not using diabetic medication (odds ratio (OR) = 1.37, 95% confidence interval (CI) = 1.02–1.85), not making regular doctor visits (OR = 1.42, 95% CI = 1.08–1.87), no limitation of usual activities (OR = 1.39, 95% CI = 1.01–1.94) and good self-rated health (OR = 1.47, 95% CI = 1.09–1.98) increased the chance of individuals non-adoption of healthy behaviors independently of gender, age, schooling and economic status. Conclusions Health professionals need to be aware of issues, such as diabetic medication use, frequency of doctor visits, limitation of usual activities and good self-rated health, which are factors that can interfere with the adoption of healthy behaviors of diabetic patients.

Effects of Parental Public Health Insurance Eligibility on Parent and Child Health Outcomes

Many states expanded their Medicaid programs to low-income adults under the Affordable Care Act (ACA). These expansions increased Medicaid coverage among low-income parents and their children. Whether these improvements in coverage and healthcare use lead to better health outcomes for parents and their children remains unanswered. We used longitudinal data on a large, nationally representative cohort of elementary-aged children from low-income households from 2010-2016. Using a difference-in-differences approach in state Medicaid policy decisions, we estimated the effect of the ACA Medicaid expansions on parent and child health. We found that parents’ self-reported health status improved significantly post-expansion in states that expanded Medicaid through the ACA by 4 percentage points (p < 0.05), a 4.7% improvement. We found no significant changes in children’s utilization of routine doctor visits or parents’ assessment of their children’s health status. We observed modest decreases in children’s body mass index (BMI) of about 2% (p < 0.05), especially for girls.

How do individuals with alcohol problems use social and healthcare services in Finland? Comparison of service use patterns between two high-need patient groups

Aims: Alcohol use disorders (AUDs) are associated with high risk of comorbidities and excess use of social and healthcare services. We examined health service use (HSU) frequencies of patients with AUD in comparison to those with type 2 diabetes mellitus (T2DM). Design: A random sample of individuals with AUD ( n = 396) were identified based on ICD-10 codes and HSU patterns, morbidity and mortality were compared with age- and gender-matched T2DM controls ( n = 792) using logistic regression analysis. Six years (2011–2016) of electronic health record (EHR) data from the North Karelia district in Finland were used. Results: Similarities in comorbidity patterns existed, although mental health comorbidity (odds ratio [ OR] 1.86) was more prevalent in the AUD group. The average annual HSU varied according to the groups: T2DM patients had more continuous contact with public health nurses in primary care, whereas AUD patients were more likely to experience somatic specialised care hospitalisations ( OR 11.30) and have frequent somatic primary healthcare doctor visits ( OR 3.30) and frequent emergency room doctor visits in specialised care ( OR 8.89). Furthermore, patients with AUD had a 7.5 times higher risk of death compared with T2DM patients. Conclusions: This study identified rather similar comorbidity status for the AUD and T2DM patients, but their HSU patterns differed noticeably. AUD patients had higher frequencies of hospitalisation periods and emergency service use and were at a higher risk of death compared with T2DM patients, indicating greater challenges in the organisation of care for AUD patients compared with those having T2DM.

Impacts of health insurance on healthcare in the poor and near-poor households in Vietnam

Improving health and reducing catastrophic healthcare expenditure for the poor and near-poor are the major concerns of the Vietnam Government. This research analyses the impacts of health insurance schemes for the poor and near-poor households in Vietnam on two aspects, including healthcare utilization and out-of-pocket expenditure. The study applies the zero-inflated model and pooled OLS regression on the data that is extracted from the Vietnam Household Living Standard Surveys in two years 2014 and 2016. The findings show that health insurance significantly increases the probability of having a doctor visit and the number of doctor visits for a health check or outpatient treatment. For inpatient treatment, insurance does not increase the probability of having a doctor visit or the number of doctor visits. Having insurance significantly reduces out-of-pocket expenditures for both inpatients and outpatients.