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Sample records for health status utilities

  1. [Health-care utilization in elderly (Spain 2006-2012): Influence of health status and social class].

    Science.gov (United States)

    Aguilar-Palacio, Isabel; Carrera-Lasfuentes, Patricia; Solsona, Sofía; Sartolo, M Teresa; Rabanaque, M José

    2016-04-01

    to explore health-care utilization (primary and specialized health-care, hospitalizations, day hospital and emergency services) and overuse in elderly in Spain, considering the influence of health status, sex, social class and its temporal trend. cross sectional study in two phases. Spain. people surveyed in the National Health Surveys 2006 and 2011-12. Health status was measured using self-rated and diagnosed health (number and diagnoses). Social class was obtained from the last occupation of the main supporter (manual and non-manual workers). Logistic regression analyses were conducted adjusting by sex, age, health status, social class and year, obtaining its predictive capacity. the percentage of elderly population with health-care utilization decreased during the period analyzed. Women who belonged to the manual workers category presented the highest prevalence of low health (low self-rated health in 2006: 70.6%). Low health status was associated with a higher utilization of health-care services. Self-rated health was a better predictor of health-care utilization and overuse than diagnosed health, getting the highest predictive capacity for specialized health-care (C = 0.676). Old people from low social class used with higher frequency primary health-care and emergency services. On the other hand, specialized health-care and day hospital were more used by high social classes. inequalities in health and health-care utilization have been observed in elderly according social class. It is necessary to consider self-rated health as a health-care utilization predictor and to review our health-care services accessibility and equity. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  2. Health and functional status and utilization of health care services among holocaust survivors and their counterparts in Israel.

    Science.gov (United States)

    Iecovich, Esther; Carmel, Sara

    2010-01-01

    To examine differences in health and functional status and in utilization of health services between holocaust survivors and their counterparts; and (b) to investigate if holocaust survivor status is a significant predictor of health status, functional status, and utilization of health services. The study included 1255 respondents of whom 272 were holocaust survivors. Interviews were conducted face-to-face at the respondents' homes. Participants were asked about their health (self-rated health and comorbidity) and functional (ADL and IADL) status, utilization of inpatient and outpatient health care services, age, gender, education, marital status, length of residence in Israel, and if they were holocaust survivors. Holocaust survivors, who were frailer and more chronically ill compared to their counterparts, visited their family physician and the nurse at the health care clinic more often than their counterparts did, and received more homecare services. Yet, there were no differences between them in the utilization of other health care services such as visits to specialists, emergency department, and hospitalizations. Holocaust survivors are more homebound due to more morbidity and functional limitations and therefore receive more health home care services that offset the utilization of other health services. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Perceived Health Status and Utilization of Specialty Care: Racial and Ethnic Disparities in Patients with Chronic Diseases

    Science.gov (United States)

    Glover, Saundra; Bellinger, Jessica D.; Bae, Sejong; Rivers, Patrick A.; Singh, Karan P.

    2010-01-01

    Objective: The objective of this study is to determine racial and ethnic variations in specialty care utilization based on (a) perceived health status and (b) chronic disease status. Methods: Variations in specialty care utilization, by perceived health and chronic disease status, were examined using the Commonwealth Fund Health Care Quality…

  4. Socio-economic status and health care utilization in rural Zimbabwe: findings from Project Accept (HPTN 043).

    Science.gov (United States)

    Kevany, Sebastian; Murima, Oliver; Singh, Basant; Hlubinka, Daniel; Kulich, Michal; Morin, Stephen F; Sweat, Michael

    2012-03-07

    Zimbabwe's HIV epidemic is amongst the worst in the world, and disproportionately effects poorer rural areas. Access to almost all health services in Zimbabwe includes some form of cost to the client. In recent years, the socio-economic and employment status of many Zimbabweans has suffered a serious decline, creating additional barriers to HIV treatment and care. We aimed to assess the impact of i) socio-economic status (SES) and ii) employment status on the utilization of health services in rural Zimbabwe. Data were collected from a random probability sample household survey conducted in the Mutoko district of north-western Zimbabwe in 2005. We selected variables that described the economic status of the respondent, including: being paid to work, employment status, and SES by assets. Respondents were also asked about where they most often utilized healthcare when they or their family was sick or hurt. Of 2,874 respondents, all forms of healthcare tended to be utilized by those of high or medium-high SES (65%), including private (65%), church-based (61%), traditional (67%), and other providers (66%) (P=0.009). Most respondents of low SES utilized government providers (74%) (P=0.009). Seventy-one percent of respondents utilizing health services were employed. Government (71%), private (72%), church (71%), community-based (78%) and other (64%) health services tended to be utilized by employed respondents (P=0.000). Only traditional health services were equally utilized by unemployed respondents (50%) (P=0.000). A wide range of health providers are utilized in rural Zimbabwe. Utilization is strongly associated with SES and employment status, particularly for services with user fees, which may act as a barrier to HIV treatment and care access. Efforts to improve access in low-SES, high HIV-prevalence settings may benefit from the subsidization of the health care payment system, efforts to improve SES levels, political reform, and the involvement of traditional

  5. The impact of age-related macular degeneration on health status utility values.

    Science.gov (United States)

    Espallargues, Mireia; Czoski-Murray, Carolyn J; Bansback, Nicholas J; Carlton, Jill; Lewis, Grace M; Hughes, Lindsey A; Brand, Christopher S; Brazier, John E

    2005-11-01

    To estimate health status utility values in patients with age-related macular degeneration (ARMD) associated with visual impairments, by using preference-based measures of health. This was a cross-sectional study involving patients with unilateral or bilateral ARMD who attended a large teaching hospital. Patients underwent visual tests (near and distant visual acuity [VA] and contrast sensitivity [CS]) and completed health status questionnaires including the Index of Visual Function (VF)-14 and three preference-based measures (the Health Utilities Index Mark III [HUI-3], the EuroQoL Health Questionnaire [EQ-5D], and the Short Form 6D Health Status Questionnaire [SF-6D]) and the time tradeoff (TTO). The mean health status is presented for five groups, defined according to the VA in the better-seeing eye and for four CS groups. Two hundred nine patients were recruited with substantial loss of visual function as obtained by visual tests (mean decimal VA in the better-seeing eye: 0.2) and self-report (mean VF-14 score: 41.5). The mean (+/-SD) utilities were 0.34 +/- 0.28 for HUI-3, 0.66 +/- 0.14 for SF-6D, 0.72 +/- 0.22 for EQ-5D, and 0.64 +/- 0.31 for TTO. The HUI-3 had the highest correlation with VA and CS (0.40 and -0.34), followed by TTO (0.25 and -0.21). Across the VA and CS groups, only HUI3 and TTO had a significant linear trend (P preference-based measures used. The HUI-3 seems to be the instrument of choice for use in economic evaluations in which community data are needed. It may be more appropriate to base economic models on CS or some combination of CS and VA rather than on VA alone.

  6. The relationship between health literacy with health status and healthcare utilization in 18-64 years old people in Isfahan.

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    Karimi, Saeed; Keyvanara, Mahmoud; Hosseini, Mohsen; Jazi, Marzie Jafarian; Khorasani, Elahe

    2014-01-01

    Today, much attention has been paid to the patient role as the central factor in the management of their own health. It is focused on the issue that the patient has a more critical role compared with the health-care provider in controlling the patient own health. defines health literacy as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. The objective of this study was to determine health literacy, health status, healthcare utilization and the relationship between them in 18 - 64 years old people in Isfahan. This study was a descriptive analytical survey, which was conducted on 300 subjects of 18-64 years old in Isfahan with Multi-stage sampling method proportional to selected sample size. For collecting the data, questionnaire adapted from CHAP (Consumer Assessment of Healthcare Providers and Systems) health literacy questionnaire was used. Health status was measured based on an assessment of the physical and mental health over the past 6 months by 5° Likert scale. Data analysis was performed by using SPSS 18, descriptive statistics, Chi-square test and multivariate analysis of variance. There was no significant correlation between health literacy, health status and healthcare utilization. Utilization was less in the urban area No. 6 of the city. In the bachelor's degree group, the health status was lower than the other groups in these cases: Older ages, married, women, large family size, undergraduates, and urban area No. 14. Due to the average prevalence of health literacy in 18-64 years old individuals in Isfahan and low- healthcare utilization, the followings are recommended: Necessity of more attention to the issue of health literacy, improving the physician-patient relationship and community awareness, whether through health promotion programs or media for the optimum use of available resources.

  7. Estimation of EuroQol 5-Dimensions health status utility values in hereditary angioedema

    DEFF Research Database (Denmark)

    Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen

    2016-01-01

    OBJECTIVE: To estimate health status utility (preference) weights for hereditary angioedema (HAE) during an attack and between attacks using data from the Hereditary Angioedema Burden of Illness Study in Europe (HAE-BOIS-Europe) survey. Utility measures quantitatively describe the net impact of a...

  8. What limits the utilization of health services among china labor force? analysis of inequalities in demographic, socio-economic and health status.

    Science.gov (United States)

    Lu, Liming; Zeng, Jingchun; Zeng, Zhi

    2017-02-02

    Inequalities in demographic, socio-economic and health status for China labor force place them at greater health risks, and marginalized them in the utilization of healthcare services. This paper identifies the inequalities which limit the utilization of health services among China labor force, and provides a reference point for health policy. Data were collected from 23,505 participants aged 15 to 65, from the 2014 China Labor Force Dynamic Survey (a nationwide cross-sectional survey covering 29 provinces with a multi-stage cluster, and stratified, probability sampling strategy) conducted by Sun Yat-sen University. Logistic regression models were used to study the effects of demographic (age, gender, marital status, type of hukou and migration status), socio-economic (education, social class and insurance) and health status (self-perceived general health and several chronic illnesses) variables on the utilization of health services (two-week visiting and hospitalization during the past 12 months). Goodness of fit was assessed using Hosmer-Lemeshow test. Discrimination ability was assessed based on the area under the receiver operating curve (AUC). Migrants with more than 1 (OR 2.80, 95% CI 1.01 ~ 7.82) or none chronic illnesses (OR 1.26, 95% CI 1.01 ~ 7.82) are more likely to be two week visiting to the clinic than non-migrants; migrants with none chronic illnesses (OR 0.61, 95% CI 0.45 ~ 0.82) are less likely to be in hospitalization during the past 12 months than non-migrants. Female, elder, hukou of non-agriculture, higher education level, higher social class, purchasing more insurance and poorer self-perceived health were predictors for more utilization of health service. More insurance benefited more two-week visiting (OR 1.12, 95% CI 1.06 ~ 1.17) and hospitalization during the past 12 months (OR 1.12, 95% CI 1.07 ~ 1.18) for individuals with none chronic illness but not ≥1 chronic illnesses. All models achieved good calibration

  9. Estimation of EuroQol 5-Dimensions health status utility values in hereditary angioedema.

    Science.gov (United States)

    Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen; Hautamaki, Emily; Sisic, Zlatko; Boysen, Henrik B; Caballero, Teresa

    2016-01-01

    To estimate health status utility (preference) weights for hereditary angioedema (HAE) during an attack and between attacks using data from the Hereditary Angioedema Burden of Illness Study in Europe (HAE-BOIS-Europe) survey. Utility measures quantitatively describe the net impact of a condition on a patient's life; a score of 0.0 reflects death and 1.0 reflects full health. The HAE-BOIS-Europe was a cross-sectional survey conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective. Survey items that overlapped conceptually with the EuroQol 5-Dimensions (EQ-5D) domains (pain/discomfort, mobility, self-care, usual activities, and anxiety/depression) were manually crosswalked to the corresponding UK population-based EQ-5D utility weights. EQ-5D utilities were computed for each respondent in the HAE-BOIS-Europe survey for acute attacks and between attacks. Overall, a total of 111 HAE-BOIS-Europe participants completed all selected survey items and thus allowed for computation of EQ-5D-based utilities. The mean utilities for an HAE attack and between attacks were 0.44 and 0.72, respectively. Utilities for an acute attack were dependent on the severity of pain of the last attack (0.61 for no pain or mild pain, 0.47 for moderate pain, and 0.08 for severe pain). There were no significant differences across countries. Mean utilities derived from the study approach compare sensibly with other disease states for both acute attacks and between attacks. The impacts of HAE translate into substantial health status disutilities associated with acute attacks as well as between attacks, documenting that the detrimental effects of HAE are meaningful from the patient perspective. Results were consistent across countries with regard to pain severity and in comparison to similar disease states. The results can be used to raise awareness of HAE as a serious disease with wide-ranging personal and social impacts.

  10. Internalized HIV and Drug Stigmas: Interacting Forces Threatening Health Status and Health Service Utilization Among People with HIV Who Inject Drugs in St. Petersburg, Russia

    Science.gov (United States)

    Burke, Sara E.; Dovidio, John F.; Levina, Olga S.; Uusküla, Anneli; Niccolai, Linda M.; Heimer, Robert

    2016-01-01

    Marked overlap between the HIV and injection drug use epidemics in St. Petersburg, Russia, puts many people in need of health services at risk for stigmatization based on both characteristics simultaneously. The current study examined the independent and interactive effects of internalized HIV and drug stigmas on health status and health service utilization among 383 people with HIV who inject drugs in St. Petersburg. Participants self-reported internalized HIV stigma, internalized drug stigma, health status (subjective rating and symptom count), health service utilization (HIV care and drug treatment), sociodemographic characteristics, and health/behavioral history. For both forms of internalized stigma, greater stigma was correlated with poorer health and lower likelihood of service utilization. HIV and drug stigmas interacted to predict symptom count, HIV care, and drug treatment such that individuals internalizing high levels of both stigmas were at elevated risk for experiencing poor health and less likely to access health services. PMID:26050155

  11. Impact of socioeconomic status and medical conditions on health and healthcare utilization among aging Ghanaians.

    Science.gov (United States)

    Saeed, Bashiru Ii; Xicang, Zhao; Yawson, Alfred Edwin; Nguah, Samuel Blay; Nsowah-Nuamah, Nicholas N N

    2015-03-20

    This study attempts to examine the impact of socioeconomic and medical conditions in health and healthcare utilization among older adults in Ghana. Five separate models with varying input variables were estimated for each response variable. Data (Wave 1 data) were drawn from the World Health Organization Global Ageing and Adult Health (SAGE) conducted during 2007-2008 and included a total of 4770 respondents aged 50+ and 803 aged 18-49 in Ghana. Ordered logits was estimated for self-rated health, and binary logits for functional limitation and healthcare utilization. Our results show that the study provides enough grounds for further research on the interplay between socioeconomic and medical conditions on one hand and the health of the aged on the other. Controlling for socioeconomic status substantially contributes significantly to utilization. Also, aged women experience worse health than men, as shown by functioning assessment, self-rated health, chronic conditions and functional limitations. Women have higher rates of healthcare utilization, as shown by significantly higher rates of hospitalization and outpatient encounters. Expansion of the national health insurance scheme to cover the entire older population--for those in both formal and informal employments--is likely to garner increased access and improved health states for the older population.

  12. Economic status, education and empowerment: implications for maternal health service utilization in developing countries.

    Directory of Open Access Journals (Sweden)

    Saifuddin Ahmed

    2010-06-01

    Full Text Available Relative to the attention given to improving the quality of and access to maternal health services, the influence of women's socio-economic situation on maternal health care use has received scant attention. The objective of this paper is to examine the relationship between women's economic, educational and empowerment status, introduced as the 3Es, and maternal health service utilization in developing countries.The analysis uses data from the most recent Demographic and Health Surveys conducted in 31 countries for which data on all the 3Es are available. Separate logistic regression models are fitted for modern contraceptive use, antenatal care and skilled birth attendance in relation to the three covariates of interest: economic, education and empowerment status, additionally controlling for women's age and residence. We use meta-analysis techniques to combine and summarize results from multiple countries. The 3Es are significantly associated with utilization of maternal health services. The odds of having a skilled attendant at delivery for women in the poorest wealth quintile are 94% lower than that for women in the highest wealth quintile and almost 5 times higher for women with complete primary education relative to those less educated. The likelihood of using modern contraception and attending four or more antenatal care visits are 2.01 and 2.89 times, respectively, higher for women with complete primary education than for those less educated. Women with the highest empowerment score are between 1.31 and 1.82 times more likely than those with a null empowerment score to use modern contraception, attend four or more antenatal care visits and have a skilled attendant at birth.Efforts to expand maternal health service utilization can be accelerated by parallel investments in programs aimed at poverty eradication (MDG 1, universal primary education (MDG 2, and women's empowerment (MDG 3.

  13. Economic status, education and empowerment: implications for maternal health service utilization in developing countries.

    Science.gov (United States)

    Ahmed, Saifuddin; Creanga, Andreea A; Gillespie, Duff G; Tsui, Amy O

    2010-06-23

    Relative to the attention given to improving the quality of and access to maternal health services, the influence of women's socio-economic situation on maternal health care use has received scant attention. The objective of this paper is to examine the relationship between women's economic, educational and empowerment status, introduced as the 3Es, and maternal health service utilization in developing countries. The analysis uses data from the most recent Demographic and Health Surveys conducted in 31 countries for which data on all the 3Es are available. Separate logistic regression models are fitted for modern contraceptive use, antenatal care and skilled birth attendance in relation to the three covariates of interest: economic, education and empowerment status, additionally controlling for women's age and residence. We use meta-analysis techniques to combine and summarize results from multiple countries. The 3Es are significantly associated with utilization of maternal health services. The odds of having a skilled attendant at delivery for women in the poorest wealth quintile are 94% lower than that for women in the highest wealth quintile and almost 5 times higher for women with complete primary education relative to those less educated. The likelihood of using modern contraception and attending four or more antenatal care visits are 2.01 and 2.89 times, respectively, higher for women with complete primary education than for those less educated. Women with the highest empowerment score are between 1.31 and 1.82 times more likely than those with a null empowerment score to use modern contraception, attend four or more antenatal care visits and have a skilled attendant at birth. Efforts to expand maternal health service utilization can be accelerated by parallel investments in programs aimed at poverty eradication (MDG 1), universal primary education (MDG 2), and women's empowerment (MDG 3).

  14. Estimation of EuroQol 5-Dimensions health status utility values in hereditary angioedema

    Directory of Open Access Journals (Sweden)

    Aygören-Pürsün E

    2016-09-01

    Full Text Available Emel Aygören-Pürsün,1 Anette Bygum,2 Kathleen Beusterien,3 Emily Hautamaki,4 Zlatko Sisic,5 Henrik B Boysen,6 Teresa Caballero7 1Angioedema Centre, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany; 2Hereditary Angioedema Centre Denmark, Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark; 3Outcomes Research Strategies in Health, Washington, DC, 4Patient Reported Outcomes, Oxford Outcomes Inc., an ICON plc company, Bethesda, MD, USA; 5ViroPharma Incorporated, Chatsworth House, Maidenhead, UK; 6HAEi – Hereditary Angioedema International Patient Organization for C1 Inhibitor Deficiencies, Skanderborg, Denmark; 7Allergy Department, Hospital La Paz Institute for Health Research (IdiPaz, Biomedical Research Network on Rare Diseases U754 (CIBERER, University Hospital La Paz, Madrid, Spain Objective: To estimate health status utility (preference weights for hereditary angioedema (HAE during an attack and between attacks using data from the Hereditary Angioedema Burden of Illness Study in Europe (HAE-BOIS-Europe survey. Utility measures quantitatively describe the net impact of a condition on a patient’s life; a score of 0.0 reflects death and 1.0 reflects full health.Study design and methods: The HAE-BOIS-Europe was a cross-sectional survey conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective. Survey items that overlapped conceptually with the EuroQol 5-Dimensions (EQ-5D domains (pain/discomfort, mobility, self-care, usual activities, and anxiety/depression were manually crosswalked to the corresponding UK population-based EQ-5D utility weights. EQ-5D utilities were computed for each respondent in the HAE-BOIS-Europe survey for acute attacks and between attacks.Results: Overall, a total of 111 HAE-BOIS-Europe participants completed all selected survey items and thus allowed for computation

  15. Health status, quality of life, residential stability, substance use, and health care utilization among adults applying to a supportive housing program.

    Science.gov (United States)

    Hwang, Stephen W; Gogosis, Evie; Chambers, Catharine; Dunn, James R; Hoch, Jeffrey S; Aubry, Tim

    2011-12-01

    Supportive housing, defined as subsidized housing in conjunction with site-based social services, may help improve the health and residential stability of highly disadvantaged individuals. This study examined changes in health status, quality of life, substance use, health care utilization, and residential stability among 112 homeless and vulnerably housed individuals who applied to a supportive housing program in Toronto, Canada, from December 2005 to June 2007. Follow-up interviews were conducted every 6 months for 18 months. Comparisons were made between individuals who were accepted into the program (intervention) and those who were wait-listed (usual care) using repeated-measures analyses. Individuals who were accepted into the housing program experienced significantly greater improvements in satisfaction with living situation compared with individuals in the usual care group (time, F(3,3,261) = 47.68, p life measures, health status, health care utilization, or substance use between the two groups over time. Significant improvement in residential stability occurred over time, independent of assigned housing group (time, F(3,3,261) = 9.96, p housing on homeless individuals was limited by the small number of participants who were literally homeless at baseline and by the large number of participants who gained stable housing during the study period regardless of their assigned housing status. Nonetheless, this study shows that highly disadvantaged individuals with a high prevalence of poor physical and mental health and substance use can achieve stable housing.

  16. Cognitive status is a determinant of health resource utilization among individuals with a history of falls: a 12-month prospective cohort study.

    Science.gov (United States)

    Davis, J C; Dian, L; Khan, K M; Bryan, S; Marra, C A; Hsu, C L; Jacova, P; Chiu, B K; Liu-Ambrose, T

    2016-03-01

    Falls are a costly public health problem worldwide. The literature is devoid of prospective data that identifies factors among fallers that significantly drive health care resource utilization. We found that cognitive function--specifically, executive functions--and cognitive status are significant determinants of health resource utilization among older fallers. Although falls are costly, there are no prospective data examining factors among fallers that drive health care resource utilization. We identified key determinants of health resource utilization (HRU) at 6 and 12 months among older adults with a history of falls. Specifically, with the increasing recognition that cognitive impairment is associated with increased falls risk, we investigated cognition as a potential driver of health resource utilization. This 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 319) included participants with a history of at least one fall in the previous 12 months. Based on their cognitive status, participants were divided into two groups: (1) no mild cognitive impairment (MCI) and (2) MCI. We constructed two linear regression models with HRU at 6 and 12 months as the dependent variables for each model, respectively. Predictors relating to mobility, global cognition, executive functions, and cognitive status (MCI versus no MCI) were examined. Age, sex, comorbidities, depression status, and activities of daily living were included regardless of statistical significance. Global cognition, comorbidities, working memory, and cognitive status (MCI versus no MCI ascertained using the Montreal Cognitive Assessment (MoCA)) were significant determinants of total HRU at 6 months. The number of medical comorbidities and global cognition were significant determinants of total HRU at 12 months. MCI status was a determinant of HRU at 6 months among older adults with a history of falls. As such, efforts to minimize health care resource use related to falls

  17. Utilization and Impact of Electronic and Print Media on the Patients’ Health Status: Physicians’ Perspectives

    OpenAIRE

    Shakeel, Sadia; Nesar, Shagufta; Rahim, Najia; Iffat, Wajiha; Ahmed, Hafiza Fouzia; Rizvi, Mehwish; Jamshed, Shazia

    2017-01-01

    Aims: Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors’ opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients. Setting and Design: The current research is a cross-sectional study conducted from January 2015 to July 2015. The study p...

  18. Utilization and impact of electronic and print media on the patients’ health status: Physicians’ perspectives

    OpenAIRE

    Sadia Shakeel; Shagufta Nesar; Najia Rahim; Wajiha Iffat; Hafiza Fouzia Ahmed; Mehwish Rizvi; Shazia Jamshed

    2017-01-01

    Aims: Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors’ opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients. Setting and Design: The current research is a cross-sectional study conducted from January 2015 to July 2015. The study p...

  19. Parental immigration status is associated with children's health care utilization: findings from the 2003 new immigrant survey of US legal permanent residents.

    Science.gov (United States)

    Yun, Katherine; Fuentes-Afflick, Elena; Curry, Leslie A; Krumholz, Harlan M; Desai, Mayur M

    2013-12-01

    Our objective was to examine the association between parental immigration status and child health and health care utilization. Using data from a national sample of immigrant adults who had recently become legal permanent residents (LPR), children (n = 2,170) were categorized according to their parents' immigration status prior to LPR: legalized, mixed-status, refugee, temporary resident, or undocumented. Logistic regression with generalized estimating equations was used to compare child health and health care utilization by parental immigration status over the prior 12 months. Nearly all children in the sample were reported to be in good to excellent health. Children whose parents had been undocumented were least likely to have had an illness that was reported to have required medical attention (5.4 %). Children whose parents had been either undocumented or temporary residents were most likely to have a delayed preventive annual exam (18.2 and 18.7 %, respectively). Delayed dental care was most common among children whose parents had come to the US as refugees (29.1 %). Differences in the preventive annual exam remained significant after adjusting for socioeconomic characteristics. Parental immigration status before LPR was not associated with large differences in reported child health status. Parental immigration status before LPR was associated with the use of preventive annual exams and dental services. However, no group of children was consistently disadvantaged with respect to all measures.

  20. Wage differences according to health status in France.

    Science.gov (United States)

    Ben Halima, Mohamed Ali; Rococo, Emeline

    2014-11-01

    Many OECD countries have implemented anti-discrimination laws in recent decades. However, according to the annual report published in 2010 by the French High Authority for the Fight against Discrimination and for Equality, the second most commonly cited factor in discrimination claims since 2005 is a handicap or health status. The aim of this research is to estimate the level of unexplained components in the wage gap that can be attributed to wage discrimination based on health status in France in 2010 utilizing data from the Health, Healthcare and Insurance survey among 1594 individuals. Three health indicators are used: self-perceived health status, activity limitations and long-term chronic illness. To measure the wage gap according to an individual's health status, the analysis considers the endogenous selection of health status and unobserved differences in productivity. The results demonstrate that wage discrimination is experienced by individuals in poor health regardless of the health indicator utilized. The hourly wage rate among individuals with poor self-assessed health status is on average 14.2% lower than among individuals with good self-assessed health status. However, for individuals suffering from a long-term chronic illness or an activity limitation, the gap is 6.3% and 4.5%, respectively. The decomposition performed on wage differences according to health status by correcting for health status selection bias and controlling for unobserved differences in productivity indicates that the 'unexplained component' that can be attributed to wage discrimination is equal to 50%. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. The Health Utilities Index (HUI®: concepts, measurement properties and applications

    Directory of Open Access Journals (Sweden)

    Horsman John

    2003-10-01

    Full Text Available Abstract This is a review of the Health Utilities Index (HUI® multi-attribute health-status classification systems, and single- and multi-attribute utility scoring systems. HUI refers to both HUI Mark 2 (HUI2 and HUI Mark 3 (HUI3 instruments. The classification systems provide compact but comprehensive frameworks within which to describe health status. The multi-attribute utility functions provide all the information required to calculate single-summary scores of health-related quality of life (HRQL for each health state defined by the classification systems. The use of HUI in clinical studies for a wide variety of conditions in a large number of countries is illustrated. HUI provides comprehensive, reliable, responsive and valid measures of health status and HRQL for subjects in clinical studies. Utility scores of overall HRQL for patients are also used in cost-utility and cost-effectiveness analyses. Population norm data are available from numerous large general population surveys. The widespread use of HUI facilitates the interpretation of results and permits comparisons of disease and treatment outcomes, and comparisons of long-term sequelae at the local, national and international levels.

  2. Resource utilization for observation-status stays at children's hospitals.

    Science.gov (United States)

    Fieldston, Evan S; Shah, Samir S; Hall, Matthew; Hain, Paul D; Alpern, Elizabeth R; Del Beccaro, Mark A; Harding, John; Macy, Michelle L

    2013-06-01

    Observation status, in contrast to inpatient status, is a billing designation for hospital payment. Observation-status stays are presumed to be shorter and less resource-intensive, but utilization for pediatric observation-status stays has not been studied. The goal of this study was to describe resource utilization characteristics for patients in observation and inpatient status in a national cohort of hospitalized children in the Pediatric Health Information System. This study was a retrospective cohort from 2010 of observation- and inpatient-status stays of ≤2 days; all children were admitted from the emergency department. Costs were analyzed and described. Comparison between costs adjusting for age, severity, and length of stay were conducted by using random-effect mixed models to account for clustering of patients within hospitals. Observation status was assigned to 67 230 (33.3%) discharges, but its use varied across hospitals (2%-45%). Observation-status stays had total median costs of $2559, including room costs and $678 excluding room costs. Twenty-five diagnoses accounted for 74% of stays in observation status, 4 of which were used for detailed analyses: asthma (n = 6352), viral gastroenteritis (n = 4043), bronchiolitis (n = 3537), and seizure (n = 3289). On average, after risk adjustment, observation-status stays cost $260 less than inpatient-status stays for these select 4 diagnoses. Large overlaps in costs were demonstrated for both types of stay. Variability in use of observation status with large overlap in costs and potential lower reimbursement compared with inpatient status calls into question the utility of segmenting patients according to billing status and highlights a financial risk for institutions with a high volume of pediatric patients in observation status.

  3. Dental services utilization by women of childbearing age by socioeconomic status.

    Science.gov (United States)

    Kaylor, Mary B; Polivka, Barbara J; Chaudry, Rosemary; Salsberry, Pamela; Wee, Alvin G

    2010-04-01

    For women of childbearing age, oral health not only affects their physical and psychological well-being but also that of their children. This study used the 2003-2004 Ohio Family Health Survey (N = 9,819) to examine dental need and utilization by women in Ohio. Predisposing, enabling, and need variables were examined as they effect dental health service utilization by women of childbearing age at different socioeconomic status (SES) levels. The proportion of women in the low SES group self reporting a dental need (18%) was 3 times that of the proportion of women in the higher SES group with a self reported need (6%). Results of bivariate analysis showed that having a dental visit in the past year varied significantly by SES, race, insurance status, provider density, and need. A racial disparity in dental service utilization was noted in the bivariate analysis of the middle SES group. While dental need and type of dental coverage varied by SES, both were significantly associated with utilization of dental services within all 3 SES categories in the logistic regressions. These results suggest that measures need to be implemented to meet the goal of increasing access and utilization of dental health services by low-income populations.

  4. Income-related inequality in health and health care utilization in Chile, 2000-2009.

    Science.gov (United States)

    Vásquez, Felipe; Paraje, Guillermo; Estay, Manuel

    2013-02-01

    To measure and explain income-related inequalities in health and health care utilization in the period 2000 - 2009 in Chile, while assessing variations within the country and determinants of inequalities. Data from the National Socioeconomic Characterization Survey for 2000, 2003, and 2009 were used to measure inequality in health and health care utilization. Income-related inequality in health care utilization was assessed with standardized concentration indices for the probability and total number of visits to specialized care, generalized care, emergency care, dental care, mental health care, and hospital care. Self-assessed health status and physical limitations were used as proxies for health care need. Standardization was performed with demographic and need variables. The decomposition method was applied to estimate the contribution of each factor used to calculate the concentration index, including ethnicity, employment status, health insurance, and region of residence. In Chile, people in lower-income quintiles report worse health status and more physical limitations than people in higher quintiles. In terms of health service utilization, pro-rich inequities were found for specialized and dental visits with a slight pro-rich utilization for general practitioners and all physician visits. All pro-rich inequities have decreased over time. Emergency room visits and hospitalizations are concentrated among lower-income quintiles and have increased over time. Higher education and private health insurance contribute to a pro-rich inequity in dentist, general practitioner, specialized, and all physician visits. Income contributes to a pro-rich inequity in specialized and dentist visits, whereas urban residence and economic activity contribute to a pro-poor inequity in emergency room visits. The pattern of health care utilization in Chile is consistent with policies implemented in the country and in the intended direction. The significant income inequality in the

  5. WOMEN'S EDUCATION AND UTILIZATION OF MATERNAL HEALTH SERVICES IN AFRICA: A MULTI-COUNTRY AND SOCIOECONOMIC STATUS ANALYSIS.

    Science.gov (United States)

    Tsala Dimbuene, Zacharie; Amo-Adjei, Joshua; Amugsi, Dickson; Mumah, Joyce; Izugbara, Chimaraoke O; Beguy, Donatien

    2017-11-06

    There is an abundant literature on the relationship between women's education and maternal and child outcomes, including antenatal and postnatal care, onset of antenatal care and skilled birth attendance. However, few studies have adopted the 'equity' lens, despite increasing evidence that inequities between rich and poor are increasing although maternal and child mortality is declining. This study examined the differential effects of women's education within different socioeconomic strata in Africa. The most recent Demographic and Health Surveys (DHS) conducted in the Democratic Republic of the Congo, Egypt, Ghana, Nigeria and Zimbabwe were used. In each country, the original sample was stratified into three socioeconomic groups: poor, middle and rich. For each maternal health service utilization variable, the gross and net effects of women's education, controlling for age, parity, religion, marital status, health insurance, access to health facilities, partner's education and current place of residence, were estimated using logistic regression, taking into account the complex sampling design of the DHS. The findings revealed country-specific variations in maternal health service utilization, and for most indicators there was a clear gradient among socioeconomic strata: women living in better-off households exhibited greater access to, and utilization of, maternal health services. Multivariate analyses revealed that women's education had a positive association with type of antenatal care provider, timing and frequency of antenatal care visits, place of delivery and presence of a skilled birth attendant at delivery. Many other factors were found to be significantly associated with maternal health service utilization. For instance, parity had a negative and significant association with timing of first antenatal care visit. Likewise, partner's education was positively and statistically associated with timing of first antenatal care visit. It is argued that an over

  6. Socio-economic inequalities in health services utilization: a cross-sectional study.

    Science.gov (United States)

    Ranjbar Ezzatabadi, Mohammad; Khosravi, Ameneh; Bahrami, Mohammad Amin; Rafiei, Sima

    2018-02-12

    Purpose Developing country workers mainly face important challenges when examining equality in health services utilization among the population and identifying influential factors. The purpose of this paper us to: understand health service use among households with different socio-economic status in Isfahan province; and to investigate probable inequality determinants in service utilization. Design/methodology/approach Almost 1,040 households living in Isfahan province participated in this cross-sectional study in 2013. Data were collected by a questionnaire with three sections: demographic characteristics; socio-economic status; and health services utilization. The concentration index was applied to measure inequality. Analysts used STATA 11. Findings Economic status, educational level, insurance coverage and household gender were the most influential factors on health services utilization. Those with a high socio-economic level were more likely to demand and use such services; although self-medication patterns showed an opposite trend. Practical implications Female-headed families face with more difficulties in access to basic human needs including health. Supportive policies are needed to meet their demands. Originality/value The authors used principle component analysis to assess households' economic situation, which reduced the variables into a single index.

  7. Do dialysis- and transplantation-related medical factors affect perceived health status?

    NARCIS (Netherlands)

    Rosenberger, J.; van Dijk, J.P.; Nagyova, I.; Roland, R.; Geckova, A.M.; van den Heuvel, W.J.; Groothoff, J.W.

    2005-01-01

    Background. Quality of life and perceived health status (PHS) are important indicators of patient care together with morbidity, mortality and health-care resource utilization. The aim of this study is to explore how various medical conditions might influence perceived health status. Methods. The

  8. Probabilistic mapping of descriptive health status responses onto health state utilities using Bayesian networks: an empirical analysis converting SF-12 into EQ-5D utility index in a national US sample.

    Science.gov (United States)

    Le, Quang A; Doctor, Jason N

    2011-05-01

    As quality-adjusted life years have become the standard metric in health economic evaluations, mapping health-profile or disease-specific measures onto preference-based measures to obtain quality-adjusted life years has become a solution when health utilities are not directly available. However, current mapping methods are limited due to their predictive validity, reliability, and/or other methodological issues. We employ probability theory together with a graphical model, called a Bayesian network, to convert health-profile measures into preference-based measures and to compare the results to those estimated with current mapping methods. A sample of 19,678 adults who completed both the 12-item Short Form Health Survey (SF-12v2) and EuroQoL 5D (EQ-5D) questionnaires from the 2003 Medical Expenditure Panel Survey was split into training and validation sets. Bayesian networks were constructed to explore the probabilistic relationships between each EQ-5D domain and 12 items of the SF-12v2. The EQ-5D utility scores were estimated on the basis of the predicted probability of each response level of the 5 EQ-5D domains obtained from the Bayesian inference process using the following methods: Monte Carlo simulation, expected utility, and most-likely probability. Results were then compared with current mapping methods including multinomial logistic regression, ordinary least squares, and censored least absolute deviations. The Bayesian networks consistently outperformed other mapping models in the overall sample (mean absolute error=0.077, mean square error=0.013, and R overall=0.802), in different age groups, number of chronic conditions, and ranges of the EQ-5D index. Bayesian networks provide a new robust and natural approach to map health status responses into health utility measures for health economic evaluations.

  9. Hypochondriasis, somatization, and perceived health and utilization of health care services.

    Science.gov (United States)

    Hollifield, M; Paine, S; Tuttle, L; Kellner, R

    1999-01-01

    The authors determined the different effects of hypochondriasis and somatization on health perceptions, health status, and service utilization in a primary care population. The subjects with hypochondriacal responses (HR) on the Illness Attitudes Scales or high somatic concern (HSC) on the Symptom Questionnaire had a worse perception of health and variably used more health services than the control subjects, even though the HR and HSC subjects had the same level of chronic medical disorders. Regression analyses determined that somatization contributed more to negative health perception and service utilization than did hypochondriasis, although an interaction between the two contributed to the use of psychiatric care. The authors discuss the boundary between hypochondriasis and somatization for its implications for research and clinical practice.

  10. Health insurance and health services utilization in Ireland.

    Science.gov (United States)

    Harmon, C; Nolan, B

    2001-03-01

    The numbers buying private health insurance in Ireland have continued to grow, despite a broadening in entitlement to public care. About 40% of the population now have insurance, although everyone has entitlement to public hospital care. In this paper, we examine in detail the growth in insurance coverage and the factors underlying the demand for insurance. Attitudinal responses reveal the importance of perceptions about waiting times for public care, as well as some concerns about the quality of that care. Individual characteristics, such as education, age, gender, marital status, family composition and income all influence the probability of purchasing private insurance. We also examine the relationship between insurance and utilization of hospital in-patient services. The positive effect of private insurance appears less than that of entitlement to full free health care from the state, although the latter is means-tested, and may partly represent health status. Copyright 2001 John Wiley & Sons, Ltd.

  11. prevalence and correlates of utilization of health facilities in ...

    African Journals Online (AJOL)

    Musumali

    2007-10-11

    Oct 11, 2007 ... of the expectant women did not deliver at a health facility ... health service utilization for childbirth such as education5-8, maternal age 3,6, parity6,8, economic status7, cultural factors and beliefs, lack of skilled staff at primary.

  12. An economy-ralated equity analysis of health service utilization by women in economically underdeveloped regions of western China.

    Science.gov (United States)

    Qian, Yuyan; Zhou, Zhongliang; Yan, Ju'e; Gao, Jianmin; Wang, Yuping; Yang, Xiaowei; Xu, Yongjian; Li, Yanli

    2017-10-27

    The Chinese government has long been committed to eliminating the inequality in the utilization of health services; however, it still lacks an analysis or measurement of the economy-related inequality in the utilization of women's health services. The economy-related utilization of health services in women aged 15 years and above was assessed by the horizontal inequity index of a two-week outpatient rate and annual inpatient rate from the 5th National Health Service Survey of Shaanxi Province. The concentration index of each factor was decomposed into the contribution of each factor to the economic-related inequality of health service utilization based on the Probit regression model. The horizontal inequity indexes of the two-week outpatient rate was 0.0493, and the horizontal inequity indexes of the annual impatient rate was 0.0869. The contributions of economic status to the two indexes were 190.71% and 115.80%, respectively. Economic status, age, basic medical insurance, educational status, marital status, urban/rural area, and self-rated health were the main impact factors that affected the inequality in women's health services utilization in Shaanxi. Health service utilization was different between women with different social demographic characteristics, and unequal health service utilization is evident among women in Shaanxi.

  13. Utilization and impact of electronic and print media on the patients’ health status: Physicians’ perspectives

    Directory of Open Access Journals (Sweden)

    Sadia Shakeel

    2017-01-01

    Full Text Available Aims: Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors’ opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients. Setting and Design: The current research is a cross-sectional study conducted from January 2015 to July 2015. The study population comprised physicians rendering their services in different hospitals of Karachi, Pakistan, selected by the nonprobability convenience sampling technique. In this study, 500 questionnaires were distributed through email or direct correspondence. Methods and Materials: Physicians’ perception toward the impact of electronic and print media on the health status of patients was assessed with a 20-item questionnaire. Different demographic characteristics, such as age, gender, institution, position, and experience of respondents, were recorded. Quantitative data were analyzed with the use of Statistical Package for Social Sciences, version 20.0 (SPSS, Chicago, IL. The association of the demographic characteristics of the responses of physicians was determined by one-way ANOVA using 0.05 level of significance. Results: In this study, 254 physicians provided consent to show their responses for research purposes. A response rate of 50.8% was obtained. Nearly one-third of the respondents negated that patients get health benefit using electronic and print media. The majority did not consider electronic and print media as lifestyle-modifying factors. Physicians thought that patients particularly do not rely on mass media for acquiring health information and consider healthcare professionals as unswerving information resource. Conclusions: Mass media can be productive resources to augment awareness among patients, although physicians seem unconvinced about

  14. Utilization and Impact of Electronic and Print Media on the Patients' Health Status: Physicians' Perspectives.

    Science.gov (United States)

    Shakeel, Sadia; Nesar, Shagufta; Rahim, Najia; Iffat, Wajiha; Ahmed, Hafiza Fouzia; Rizvi, Mehwish; Jamshed, Shazia

    2017-01-01

    Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors' opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients. The current research is a cross-sectional study conducted from January 2015 to July 2015. The study population comprised physicians rendering their services in different hospitals of Karachi, Pakistan, selected by the nonprobability convenience sampling technique. In this study, 500 questionnaires were distributed through email or direct correspondence. Physicians' perception toward the impact of electronic and print media on the health status of patients was assessed with a 20-item questionnaire. Different demographic characteristics, such as age, gender, institution, position, and experience of respondents, were recorded. Quantitative data were analyzed with the use of Statistical Package for Social Sciences, version 20.0 (SPSS, Chicago, IL). The association of the demographic characteristics of the responses of physicians was determined by one-way ANOVA using 0.05 level of significance. In this study, 254 physicians provided consent to show their responses for research purposes. A response rate of 50.8% was obtained. Nearly one-third of the respondents negated that patients get health benefit using electronic and print media. The majority did not consider electronic and print media as lifestyle-modifying factors. Physicians thought that patients particularly do not rely on mass media for acquiring health information and consider healthcare professionals as unswerving information resource. Mass media can be productive resources to augment awareness among patients, although physicians seem unconvinced about the extended usage of print/electronic media.

  15. Telemedicine, the effect of nurse-initiated telephone follow up, on health status and health-care utilization in COPD patients: a randomized trial.

    Science.gov (United States)

    Berkhof, Farida F; van den Berg, Jan W K; Uil, Steven M; Kerstjens, Huib A M

    2015-02-01

    Telemedicine, care provided by electronic communication, may serve as an alternative or extension to traditional outpatient visits. This pilot study determined the effects of telemedicine on health-care utilization and health status of chronic obstructive pulmonary disease (COPD) patients. One hundred and one patients were randomized, 52 patients received telemedicine care and 49 had traditional outpatient visits. The primary outcome was COPD-specific health status, measured with the Clinical COPD Questionnaire (CCQ). Secondary outcomes included St. George's Respiratory Questionnaire (SGRQ) and the Short Form-36 (SF-36) and resource use in primary and secondary care. The mean age of the participants was 68 ± 9 years and the mean per cent of predicted forced expiratory volume in 1 s was 40.4 ± 12.5. The CCQ total score deteriorated by 0.14 ± 0.13 in the telemedicine group, and improved by -0.03 ± 0.14 in the control group (difference 0.17 ± 0.19, 95% confidence interval (CI): -0.21-0.55, P = 0.38). The CCQ symptom domain showed a significant and clinically relevant difference in favour of the control group, 0.52 ± 0.24 (95% CI: 0.04-0.10, P = 0.03). Similar results were found for the SGRQ, whereas results for SF-36 were inconsistent. Patients in the control group had significantly fewer visits to the pulmonologist in comparison to patients in the telemedicine group (P = 0.05). The same trend, although not significant, was found for exacerbations after 6 months. This telemedicine model of initiated phone calls by a health-care provider had a negative effect on health status and resource use in primary and secondary care, in comparison with usual care and therefore cannot be recommended in COPD patients in its current form. © 2014 Asian Pacific Society of Respirology.

  16. Correlates of maternal health care utilization in Rohilkhand region ...

    African Journals Online (AJOL)

    Maternal health care service utilization from health personnel was significantly associated with age at marriage ≥18 years, family size ≤3, birth order ≤2, nuclear family and higher socio‑economic status. Most of the pregnancy related complications were found among women aged >30 years, with birth order ≥3, having ...

  17. Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers.

    Science.gov (United States)

    Shaikh, Babar T; Hatcher, Juanita

    2005-03-01

    There is a growing literature on health seeking behaviours and the determinants of health services utilization especially in the context of developing countries. However, very few focused studies have been seen in Pakistan in this regard. This paper presents an extensive literature review of the situation in developing countries and relates the similar factors responsible for shaping up of a health seeking behaviour and health service utilization in Pakistan. The factors determining the health behaviours may be seen in various contexts: physical, socio-economic, cultural and political. Therefore, the utilization of a health care system, public or private, formal or non-formal, may depend on socio-demographic factors, social structures, level of education, cultural beliefs and practices, gender discrimination, status of women, economic and political systems environmental conditions, and the disease pattern and health care system itself. Policy makers need to understand the drivers of health seeking behaviour of the population in an increasingly pluralistic health care system. Also a more concerted effort is required for designing behavioural health promotion campaigns through inter-sectoral collaboration focusing more on disadvantaged segments of the population.

  18. [Current status of costs and utilizations of hospital based home health nursing care in Korea].

    Science.gov (United States)

    Ryu, Hosihn

    2006-12-01

    The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequela of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won ( approximately 48 $, 1 $=960 Won). The costs ranged from 74,523 Won ( approximately 78 $, loss of chronic kidney function, N18) to 32,270 Won ( approximately 34 $, other cerebrovascular diseases, I67). Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.

  19. Correlates of Maternal Health Care Utilization in Rohilkhand Region ...

    African Journals Online (AJOL)

    Bareilly district, Uttar Pradesh to cover maximum number of women. All currently ... inequalities in the utilization of maternal health care services have been ..... With regard to work status, one study made in four Indian states supports our ...

  20. Development of the multi-attribute Adolescent Health Utility Measure (AHUM

    Directory of Open Access Journals (Sweden)

    Beusterien Kathleen M

    2012-08-01

    Full Text Available Abstract Objective Obtain utilities (preferences for a generalizable set of health states experienced by older children and adolescents who receive therapy for chronic health conditions. Methods A health state classification system, the Adolescent Health Utility Measure (AHUM, was developed based on generic health status measures and input from children with Hunter syndrome and their caregivers. The AHUM contains six dimensions with 4–7 severity levels: self-care, pain, mobility, strenuous activities, self-image, and health perceptions. Using the time trade off (TTO approach, a UK population sample provided utilities for 62 of 16,800 AHUM states. A mixed effects model was used to estimate utilities for the AHUM states. The AHUM was applied to trial NCT00069641 of idursulfase for Hunter syndrome and its extension (NCT00630747. Results Observations (i.e., utilities totaled 3,744 (12*312 participants, with between 43 to 60 for each health state except for the best and worst states which had 312 observations. The mean utilities for the best and worst AHUM states were 0.99 and 0.41, respectively. The random effects model was statistically significant (p  Discussion The AHUM health state classification system may be used in future research to enable calculation of quality-adjust life expectancy for applicable health conditions.

  1. Impact of Individual-, Environmental-, and Policy-Level Factors on Health Care Utilization Among US Farmworkers

    Science.gov (United States)

    Mayer, Joni A.; Gabbard, Susan; Kronick, Richard G.; Roesch, Scott C.; Malcarne, Vanessa L.; Zuniga, Maria L.

    2011-01-01

    Objectives. We examined individual-, environmental-, and policy-level correlates of US farmworker health care utilization, guided by the behavioral model for vulnerable populations and the ecological model. Methods. The 2006 and 2007 administrations of the National Agricultural Workers Survey (n = 2884) provided the primary data. Geographic information systems, the 2005 Uniform Data System, and rurality and border proximity indices provided environmental variables. To identify factors associated with health care use, we performed logistic regression using weighted hierarchical linear modeling. Results. Approximately half (55.3%) of farmworkers utilized US health care in the previous 2 years. Several factors were independently associated with use at the individual level (gender, immigration and migrant status, English proficiency, transportation access, health status, and non-US health care utilization), the environmental level (proximity to US–Mexico border), and the policy level (insurance status and workplace payment structure). County Federally Qualified Health Center resources were not independently associated. Conclusions. We identified farmworkers at greatest risk for poor access. We made recommendations for change to farmworker health care access at all 3 levels of influence, emphasizing Federally Qualified Health Center service delivery. PMID:21330594

  2. The impact of a patient support program for multiple sclerosis on patient satisfaction and subjective health status.

    Science.gov (United States)

    Kohlmann, Thomas; Wang, Cheng; Lipinski, Jens; Hadker, Nandini; Caffrey, Elizabeth; Epstein, Michael; Sadasivan, Ravi; Gondek, Kathleen

    2013-06-01

    Leading multiple sclerosis (MS) therapies have patient support programs (PSPs) aimed at improving patients' lives. There is limited knowledge about what drives patient satisfaction with PSPs and little evidence about its impact on patient-reported health status or health-related quality of life. The aims of this study were to evaluate patient needs and the PSP's role in meeting those needs; understand the drivers of PSP satisfaction and loyalty; and assess whether a MS PSP provides quantifiable, incremental benefit to patients, as measured by patient-reported health status, health state utility, and/or health-related quality of life. An Internet survey was conducted among 1,123 adult German MS patients currently enrolled in Bayer's German BETAPLUS PSP. Health status, health state utility, and health-related quality of life were measured using the EQ-5D Visual Analog Scale, the EQ-5D Index, and Short Form-12 Health Survey, respectively. MS patient needs vary by disease severity, duration of disease, and gender. Patients with greater self-reported needs and lower health status, health state utility, and health-related quality of life value and use the PSP more than other patients. Drivers of PSP satisfaction include use of patient hotline, nurse telephone calls, and mail education. Patients estimate that their health status would be 15 points lower if the PSP ceased to exist (translating to 0.15 on the time trade-off utility scale). This impact is significant, as it is nearly two times the minimally important difference. MS patients place inherent value on PSPs. From a patient's viewpoint, PSPs provide real incremental benefit in patient-reported health status at all stages of MS.

  3. The Relation between Food Insecurity and Mental Health Care Service Utilization in Ontario.

    Science.gov (United States)

    Tarasuk, Valerie; Cheng, Joyce; Gundersen, Craig; de Oliveira, Claire; Kurdyak, Paul

    2018-01-01

    To determine the relationship between household food insecurity status over a 12-month period and adults' use of publicly funded health care services in Ontario for mental health reasons during this period. Data for 80,942 Ontario residents, 18 to 64 years old, who participated in the Canadian Community Health Survey in 2005, 2007-2008, 2009-2010, or 2011-2012 were linked to administrative health care data to determine individuals' hospitalizations, emergency department visits, and visits to psychiatrists and primary care physicians for mental health reasons. Household food insecurity over the past 12 months was assessed using the Household Food Security Survey Module. Logistic regression models were used to estimate the odds of mental health service utilization in the past 12 months by household food insecurity status, adjusting for sociodemographic factors and prior use of mental health services. In our fully adjusted models, in comparison to food-secure individuals, the odds of any mental health care service utilization over the past 12 months were 1.15 (95% confidence interval [CI], 1.04 to 1.29) for marginally food-insecure individuals, 1.39 (95% CI, 1.19 to 1.42) for moderately food-insecure individuals, and 1.50 (95% CI, 1.35 to 1.68) for severely food-insecure individuals. A similar pattern persisted across individual types of services, with odds of utilization highest with severe food insecurity. Household food insecurity status is a robust predictor of mental health service utilization among working-age adults in Ontario. Policy interventions are required to address the underlying causes of food insecurity and the particular vulnerability of individuals with mental illness.

  4. The effects of citizenship status on service utilization and general satisfaction with healthcare: a cross-cultural study.

    Science.gov (United States)

    Khaled, Salma M; Shockley, Bethany; Abdul Rahim, Hanan F

    2017-02-01

    To explore the role of citizenship status as a predictor of general satisfaction with healthcare services in Qatar, including potential interaction with utilization and health insurance coverage type. A cross-sectional survey conducted in 2012. A household survey in the State of Qatar in the Arab Gulf. A nationally representative sample of 2750 citizens and noncitizens aged 18 years and older. General satisfaction status with Qatar's healthcare system. Citizenship status, healthcare utilization, health insurance type. Citizens were significantly less likely to be satisfied with Qatar's healthcare system than noncitizens (odds ratio (OR) = 0.30, P citizenship (P citizenship groups. These differences may stem from different expectations with respect to healthcare services. Understanding these expectations may have important policy implications for cross-cultural contexts. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  5. Utilization of Dental Services in Public Health Center: Dental Attendance, Awareness and Felt Needs.

    Science.gov (United States)

    Pewa, Preksha; Garla, Bharath K; Dagli, Rushabh; Bhateja, Geetika Arora; Solanki, Jitendra

    2015-10-01

    In rural India, dental diseases occur due to many factors, which includes inadequate or improper use of fluoride and a lack of knowledge regarding oral health and oral hygiene, which prevent proper screening and dental care of oral diseases. The objective of the study was to evaluate the dental attendance, awareness and utilization of dental services in public health center. A cross-sectional study was conducted among 251 study subjects who were visiting dental outpatient department (OPD) of public health centre (PHC), Guda Bishnoi, and Jodhpur using a pretested proforma from month of July 2014 to October 2014. A pretested questionnaire was used to collect the data regarding socioeconomic status and demographic factors affecting the utilization of dental services. Pearson's Chi-square test and step-wise logistic regression were applied for the analysis. Statistically significant results were found in relation to age, educational status, socioeconomic status and gender with dental attendance, dental awareness and felt needs. p-value dental services, thereby increasing the oral health status of the population.

  6. Trends in inequalities in utilization of reproductive health services from 2000 to 2011 in Vietnam.

    Science.gov (United States)

    Duc, Nguyen Huu Chau; Nakamura, Keiko; Kizuki, Masashi; Seino, Kaoruko; Rahman, Mosiur

    2015-01-01

    This study aimed to examine changes in utilization of reproductive health services by wealth status from 2000 to 2011 in Vietnam. Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. The subjects were 550, 1023, and 1363 women, respectively, aged between 15 and 49 years who had given birth in the previous one or two years. The wealth index, a composite measure of a household's ownership of selected assets, materials used for housing construction, and types of water access and sanitation facilities, was used as a measure of wealth status. Main utilization indicators were utilization of antenatal care services, receipt of a tetanus vaccine, receipt of blood pressure measurement, blood examination and urine examination during antenatal care, receipt of HIV testing, skilled birth attendance at delivery, health-facility-based delivery, and cesarean section delivery. Inequalities by wealth index were measured by prevalence ratios, concentration indices, and multivariable adjusted regression coefficients. Significant increase in overall utilization was observed in all indicators (all p skilled birth attendance, 0.29 in 2006 and 0.12 in 2011 for blood examination, and 0.18 in 2006 and 0.09 in 2011 for health-facility-based delivery. The multivariable adjusted regression coefficients of reproductive health service utilization by wealth category were 0.06 in 2000 and 0.04 in 2011 for antenatal care, 0.07 in 2000 and 0.05 in 2011 for skilled birth attendance, and 0.07 in 2006 and 0.05 in 2011 for health-facility-based delivery. More women utilized reproductive health services in 2011 than in 2000. Inequality by wealth status in utilization of antenatal care, skilled birth attendance, and health-facility-based delivery had been reduced.

  7. Perception and Utilization of Primary Health Care Services in a Semi ...

    African Journals Online (AJOL)

    Objective: The health status of most people living in developing countries of the world remains poor. Linked to this are some factors, of which low utilization of PHC facilities remain a major issue. This study therefore aimed to determine the utilization of PHC services in a sub-urban community in a developing country in West ...

  8. A comparison of the health status and health care utilization patterns between foreigners and the national population in Spain: new evidence from the Spanish National Health Survey.

    Science.gov (United States)

    Hernández-Quevedo, Cristina; Jiménez-Rubio, Dolores

    2009-08-01

    The increasing proportion of immigrants in Spanish society is placing pressure on the National Health Care System to accommodate the needs of this population group while keeping costs under control. In the year 2000, a law was approved in Spain according to which all people, regardless of their nationality, are entitled to use health care services under the same conditions as Spanish citizens, provided that they are registered in the local population census. However, empirical evidence about differences in health status and health care utilization between the immigrant and the Spanish population is insufficient. This paper uses the 2003 and 2006 Spanish National Health Surveys to explore the existence of inequalities in health and in the access to health services for the immigrant population living in Spain, relative to that of Spaniards. Our results show that there are different patterns in the level of health and the medical care use between the national and the foreign population in Spain: while immigrants' self-reported health relative to that of the Spanish population depends upon individual nationality, all immigrants, regardless of their nationality, seem to face barriers of entry to specialized care. Further research is needed to understand the nature of these barriers in order to design more effective health policies.

  9. On Medical Progress and Health Care Demand: A Ces Perspective Using the Grossman Model of Health Status.

    Science.gov (United States)

    Batinti, Alberto

    2015-12-01

    I propose an application of the pure-consumption version of the Grossman model of health care demand, where utility depends on consumption and health status and health status on medical care and health technology. I derive the conditions under which an improvement in health care technology leads to an increase/decrease in health care consumption. In particular, I show how the direction of the effect depends on the relationship between the constant elasticity of substitution parameters of the utility and health production functions. I find that, under the constancy assumption, the ratio of the two elasticity of substitution parameters determines the direction of a technological change on health care demand. On the other hand, the technology share parameter in the health production function contributes to the size but not to the direction of the technological effect. I finally explore how the ratio of the elasticity of substitution parameters work in measurement and practice and discuss how future research may use the theoretical insight provided here. Copyright © 2014 John Wiley & Sons, Ltd.

  10. Periodontal health, perceived oral health, and dental care utilization of breast cancer survivors.

    Science.gov (United States)

    Taichman, L Susan; Griggs, Jennifer J; Inglehart, Marita R

    2015-01-01

    This population-based analysis examined the prevalence of periodontal diseases along with the self-perceived oral health and patterns of dental care utilization of breast cancer survivors in the United States. Data from the 1999-2004 National Health and Nutrition Surveys were utilized, examining information from 3,354 women between 50 and 85 years of age. Primary outcomes were gingivitis and periodontitis, self-perceived oral health, and dental care utilization. Logistic regression analyses were used to estimate relationships of breast cancer diagnosis and primary outcomes while controlling for confounding factors. Breast cancer survivors were more likely to be older than 55 years, white, nonsmokers, have higher levels of education and income, and a higher prevalence of osteoporosis. Breast cancer survivors were significantly less likely to have dental insurance (P = 0.04). Utilization of dental services and reason for last dental visit did not significantly differ between groups. A history of a breast cancer diagnosis did not increase the odds of gingivitis [odds ratio (OR):  1.32; 95 percent confidence interval (CI): 0.53-3.63], periodontitis (OR: 1.82; 95 percent CI:  0.89-4.01), or poor self-perceived oral health (OR: 0.89; 95 percent CI: 0.61-1.33) after adjusting for age, race, education, dental care utilization, and smoking status. In this sample, a history of breast cancer does not significantly impact periodontal health, self-perceived oral health, and dental care utilization. However, efforts should be made to assure that breast cancer survivors have dental insurance. © 2015 American Association of Public Health Dentistry.

  11. The impact of health insurance on maternal health care utilization: evidence from Ghana, Indonesia and Rwanda.

    Science.gov (United States)

    Wang, Wenjuan; Temsah, Gheda; Mallick, Lindsay

    2017-04-01

    While research has assessed the impact of health insurance on health care utilization, few studies have focused on the effects of health insurance on use of maternal health care. Analyzing nationally representative data from the Demographic and Health Surveys (DHS), this study estimates the impact of health insurance status on the use of maternal health services in three countries with relatively high levels of health insurance coverage-Ghana, Indonesia and Rwanda. The analysis uses propensity score matching to adjust for selection bias in health insurance uptake and to assess the effect of health insurance on four measurements of maternal health care utilization: making at least one antenatal care visit; making four or more antenatal care visits; initiating antenatal care within the first trimester and giving birth in a health facility. Although health insurance schemes in these three countries are mostly designed to focus on the poor, coverage has been highly skewed toward the rich, especially in Ghana and Rwanda. Indonesia shows less variation in coverage by wealth status. The analysis found significant positive effects of health insurance coverage on at least two of the four measures of maternal health care utilization in each of the three countries. Indonesia stands out for the most systematic effect of health insurance across all four measures. The positive impact of health insurance appears more consistent on use of facility-based delivery than use of antenatal care. The analysis suggests that broadening health insurance to include income-sensitive premiums or exemptions for the poor and low or no copayments can increase use of maternal health care. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  12. Analysis of status of radiation/radioisotopes utilization

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Hee; Lee, Seung Hyun; Kim, Na Kyung; Kim, Kon Wuk [Business Innovation Office, Korean Association for Radiation Application, Seoul (Korea, Republic of)

    2017-03-15

    The use of radiation and radioisotopes in Korea has been increasing each year, and its impact on economy and industry is expected to be increasing progressively following the development of industrial technology and the expansion of their usage. To establish and supporting policies for industries using radiation and radioisotopes, it is necessary to check the status of related industries accurately, as well as to gather data required to establish plans for industrial development by studying both revenues and economic scale (contributing to revenue). o analyze the status of utilization, surveys were carried out on 6,621 organizations engaged in nuclear operations handling radiation and radioisotopes pursuant to the Nuclear Safety Act as of end 2014, on 33,471 medical institutions using radiation generators for medical and diagnostic purposes pursuant to the Medical Service Act, and on 2,218 organizations using radiation generators for animal diagnostics pursuant to the Veterinary License Act. he overall status of the domestic radiation market including the number of user organizations, that of employees, and the size of distributions (imports, productions, and exports) with which the scale of domestic radiation market can be judged showed a growth trend compared to the previous year, though the number of employees for radiation operation in industrial sector, research sector, education sector, military sector, and power plants (nuclear power plants) and the size of imports was reduced somewhat. t is expected that data acquired through periodic surveys on the status of utilization would be utilized practically in establishing governmental policies related to the promotion of usage of radiation and radioisotopes, and also be utilized widely in cultivating and developing the industry efficiently to invigorate the related industries.

  13. Analysis of status of radiation/radioisotopes utilization

    International Nuclear Information System (INIS)

    Park, Chan Hee; Lee, Seung Hyun; Kim, Na Kyung; Kim, Kon Wuk

    2017-01-01

    The use of radiation and radioisotopes in Korea has been increasing each year, and its impact on economy and industry is expected to be increasing progressively following the development of industrial technology and the expansion of their usage. To establish and supporting policies for industries using radiation and radioisotopes, it is necessary to check the status of related industries accurately, as well as to gather data required to establish plans for industrial development by studying both revenues and economic scale (contributing to revenue). o analyze the status of utilization, surveys were carried out on 6,621 organizations engaged in nuclear operations handling radiation and radioisotopes pursuant to the Nuclear Safety Act as of end 2014, on 33,471 medical institutions using radiation generators for medical and diagnostic purposes pursuant to the Medical Service Act, and on 2,218 organizations using radiation generators for animal diagnostics pursuant to the Veterinary License Act. he overall status of the domestic radiation market including the number of user organizations, that of employees, and the size of distributions (imports, productions, and exports) with which the scale of domestic radiation market can be judged showed a growth trend compared to the previous year, though the number of employees for radiation operation in industrial sector, research sector, education sector, military sector, and power plants (nuclear power plants) and the size of imports was reduced somewhat. t is expected that data acquired through periodic surveys on the status of utilization would be utilized practically in establishing governmental policies related to the promotion of usage of radiation and radioisotopes, and also be utilized widely in cultivating and developing the industry efficiently to invigorate the related industries

  14. Factors Associated with Mental Health Service Utilization among Korean American Immigrants

    Science.gov (United States)

    Park, So-Youn; Cho, Sunhee; Park, Yeddi; Bernstein, Kunsook S.; Shin, Jinah K.

    2014-01-01

    This study adapted Andersen's Health Belief Model to examine the predictors of mental health services utilization among Korean American (KA) immigrants. A cross-sectional survey was used to gather data on 363 KA immigrants 18 years and older residing in New York City. Predisposing factors included gender, age, marital status, education, length of stay in the US, and religion; the need factor was depression; and enabling factors included health insurance, English proficiency, income, and perceived need for help. Approximately 8.5 % of participants reported having utilized mental health services, while 23 % reported having depressive symptoms. Shorter duration of residence in the US, lower income, and the presence of perceived need for help were significantly related to use of mental health services. The perceived need for help mediated the relationship between depression and mental health service utilization. Failure to perceive the need for psychological help continues to be a major reason that KA immigrants do not use mental health services. PMID:23417654

  15. Is Dental Utilization Associated with Oral Health Literacy?

    Science.gov (United States)

    Burgette, J M; Lee, J Y; Baker, A D; Vann, W F

    2016-02-01

    The objectives of this study were to examine the pattern of association between dental utilization and oral health literacy (OHL). As part of the Carolina Oral Health Literacy Project, clients in the Women, Infants, and Children's Special Supplemental Nutrition Program completed a structured 30-min in-person interview conducted by 2 trained interviewers at 9 sites in 7 counties in North Carolina. Data were collected on clients' OHL, sociodemographics, dental utilization, self-efficacy, and dental knowledge. The outcome, OHL, was measured with a dental word recognition test (30-item Rapid Estimate of Adult Literacy in Dentistry). Descriptive and multiple linear regression methods were used to examine the distribution of OHL and its association with covariates. After adjusting for age, education, race, marital status, self-efficacy, and dental knowledge, multiple linear regression showed that dental utilization was not a significant predictor of OHL (P > 0.05). Under the conditions of this study, dental utilization was not a significant predictor of OHL. © International & American Associations for Dental Research 2015.

  16. Health Status and Health Dynamics in an Empirical Model of Expected Longevity*

    Science.gov (United States)

    Benítez-Silva, Hugo; Ni, Huan

    2010-01-01

    Expected longevity is an important factor influencing older individuals’ decisions such as consumption, savings, purchase of life insurance and annuities, claiming of Social Security benefits, and labor supply. It has also been shown to be a good predictor of actual longevity, which in turn is highly correlated with health status. A relatively new literature on health investments under uncertainty, which builds upon the seminal work by Grossman (1972), has directly linked longevity with characteristics, behaviors, and decisions by utility maximizing agents. Our empirical model can be understood within that theoretical framework as estimating a production function of longevity. Using longitudinal data from the Health and Retirement Study, we directly incorporate health dynamics in explaining the variation in expected longevities, and compare two alternative measures of health dynamics: the self-reported health change, and the computed health change based on self-reports of health status. In 38% of the reports in our sample, computed health changes are inconsistent with the direct report on health changes over time. And another 15% of the sample can suffer from information losses if computed changes are used to assess changes in actual health. These potentially serious problems raise doubts regarding the use and interpretation of the computed health changes and even the lagged measures of self-reported health as controls for health dynamics in a variety of empirical settings. Our empirical results, controlling for both subjective and objective measures of health status and unobserved heterogeneity in reporting, suggest that self-reported health changes are a preferred measure of health dynamics. PMID:18187217

  17. Estimation of utility weights for human papilloma virus-related health states according to disease severity.

    Science.gov (United States)

    Ock, Minsu; Park, Jeong-Yeol; Son, Woo-Seung; Lee, Hyeon-Jeong; Kim, Seon-Ha; Jo, Min-Woo

    2016-11-28

    A cost-utility study of a human papilloma virus (HPV) vaccine requires that the utility weights for HPV-related health states (i.e., cervical intraepithelial neoplasia (CIN), cervical cancer, and condyloma) be evaluated. The aim of the present study was to determine the utility weights for HPV-related health states. Hypothetical standardised health states related to HPV were developed based on patient education material and previous publications. To fully reflect disease progression from diagnosis to prognosis, each health state comprised four parts (diagnosis, symptoms, treatment, and progression and prognosis). Nine-hundred members from the Korean general population evaluated the HPV-related health states using a visual analogue scale (VAS) and a standard gamble (SG) approach, which were administered face-to-face via computer-assisted interview. The mean utility values were calculated for each HPV-related health state. According to the VAS, the highest utility (0.73) was HPV-positive status, followed by condyloma (0.66), and CIN grade I (0.61). The lowest utility (0.18) was cervical cancer requiring chemotherapy without surgery, followed by cervical cancer requiring chemoradiation therapy (0.42). SG revealed that the highest utility (0.83) was HPV-positive status, followed by condyloma (0.78), and CIN grade I (0.77). The lowest utility (0.43) was cervical cancer requiring chemotherapy without surgery, followed by cervical cancer requiring chemoradiation therapy (0.60). This study was based on a large sample derived from the general Korean population; therefore, the calculated utility weights might be useful for evaluating the economic benefit of cancer screening and HPV vaccination programs.

  18. Urban poverty and utilization of maternal and child health care services in India.

    Science.gov (United States)

    Prakash, Ravi; Kumar, Abhishek

    2013-07-01

    Drawing upon data from the third round of the National Family Health Survey (NFHS-3) conducted in India during 2005-06, this study compares the utilization of selected maternal and child health care services between the urban poor and non-poor in India and across selected Indian states. A wealth index was created, separately for urban areas, using Principal Component Analysis to identify the urban poor. The findings suggest that the indicators of maternal and child health care are worse among the urban poor than in their non-poor counterparts. For instance, the levels of antenatal care, safe delivery and childhood vaccinations are much lower among the urban poor than non-poor, especially in socioeconomically disadvantageous states. Among all the maternal and child health care indicators, the non-poor/poor difference is most pronounced for delivery care in the country and across the states. Other than poverty status, utilization of antenatal services by mothers increases the chances of safe delivery and child immunization at both national and sub-national levels. The poverty status of the household emerged as a significant barrier to utilization of health care services in urban India.

  19. Using "big data" to capture overall health status: properties and predictive value of a claims-based health risk score.

    Science.gov (United States)

    Hamad, Rita; Modrek, Sepideh; Kubo, Jessica; Goldstein, Benjamin A; Cullen, Mark R

    2015-01-01

    Investigators across many fields often struggle with how best to capture an individual's overall health status, with options including both subjective and objective measures. With the increasing availability of "big data," researchers can now take advantage of novel metrics of health status. These predictive algorithms were initially developed to forecast and manage expenditures, yet they represent an underutilized tool that could contribute significantly to health research. In this paper, we describe the properties and possible applications of one such "health risk score," the DxCG Intelligence tool. We link claims and administrative datasets on a cohort of U.S. workers during the period 1996-2011 (N = 14,161). We examine the risk score's association with incident diagnoses of five disease conditions, and we link employee data with the National Death Index to characterize its relationship with mortality. We review prior studies documenting the risk score's association with other health and non-health outcomes, including healthcare utilization, early retirement, and occupational injury. We find that the risk score is associated with outcomes across a variety of health and non-health domains. These examples demonstrate the broad applicability of this tool in multiple fields of research and illustrate its utility as a measure of overall health status for epidemiologists and other health researchers.

  20. Can the Medical-nursing Combined Care Promote the Accessibility of Health Services for the Elderly in Nursing Home? A Study Protocol of Analysis of the Effectiveness Regarding Health Service Utilization, Health Status and Satisfaction with Care.

    Science.gov (United States)

    Bao, J; Wang, X-J; Yang, Y; Dong, R-Q; Mao, Z-F

    2015-12-01

    Currently, segmentation of healthcare and daily care for the elderly living in nursing homes usually results in the elderly not getting medical treatment timely and effectively. The medical-nursing combined care, which has been put into practice in several areas in China, is developed to enhance the accessibility of healthcare for the elderly. The aim of the study is to explore the effectiveness of the new care service, based on Andersen model, regarding health service utilization, health status and service satisfaction. The effectiveness of medical-nursing combined care will be measured in a cross-sectional study in nine nursing homes in Jianghan District, Wuhan, China, with 1067 old residents expected to participate. The questionnaire containing items of demographics, health service use, service satisfaction and instrument of SF-36 V2 is developed based on the conceptual framework of Andersen behaviour model of health service utilization. Descriptive analysis, variance analysis, multiple factors analysis, and correlation analysis will be performed to compare the sociological characteristics, health service use, health status and service satisfaction of the elderly living in different modes of nursing homes, to explore the influence factors of care effectiveness, as well as to study the relationship between health behaviour and health outcomes. The study design of analysing the effects of medical-nursing combined care and performing the horizontal comparison among the nursing homes under the framework of Andersen model is blazing new trails. Recruitment and design of questionnaire are important issues. Successful data collection and quality control are also necessary. Taking these into account, this study is estimated to provide evidence for the effectiveness of medical-nursing combined care service in China.

  1. Present status of radiation utilization in Thailand

    International Nuclear Information System (INIS)

    Chongkum, S.

    1994-01-01

    Present development of radiation utilization in Thailand covers two main areas, i.e. (1) production and utilization of radioisotopes and (2) radiation processing and technology. Radioisotope production from 2 megawatts Thai Research Reactor (TRR1/M1) is being studied, directed toward expanding the varieties of radioisotopes, improvement of quality, and technological development on quantity producing to meet the total national needs. However a large amount of radioisotopes is also imported mainly for industrial and medical applications. Radioisotopes and radiations are utilized in nuclear medicine for diagnosis and therapy from 30 hospitals and institutions. X-ray photographing, X-ray computer tomography and others are typical use for medical examination purposes, while Co-60 gamma rays and electron beam are in used for curing. Since 1972, Thailand has been participated to the IAEA/RCA Industrial Project, through the liaison of the Office of Atomic Energy for Peace (OAEP), and increases the awareness of industry to the economic benefits through the uses of nuclear technology. More than 60 companies are using radioisotopes for gauging, examination purposes and production controls, while these radioisotopes are mostly imported. Nuclear techniques in agriculture are addressed concerns with optimizing fertilizer application, determination soil-water-nitrogen fixation relationships, improving animal health and reproduction, measurement of toxic residues, appropriated food preservation techniques and breeding plant for better yield and disease resistance. The eradication of fruit flies by Sterile Insect Technique (SIT) with gamma rays has been successfully applied in northern and middle part of Thailand. The progress and present status of radiation utilization and processing in Thailand will be introduced. (author)

  2. Socioeconomic disparities in home health care service access and utilization: a scoping review.

    Science.gov (United States)

    Goodridge, Donna; Hawranik, Pamela; Duncan, Vicky; Turner, Hollie

    2012-10-01

    Home health care services are expanding at a rapid pace in order to meet the needs of the growing population of older adults and those with chronic illnesses. Because of current restrictions on home health care as an insured service in some countries, individuals may be required to pay for some or all of their home care services out of pocket. These payments may potentially limit access to needed home care services for persons in the lowest socioeconomic strata. Previous research demonstrates a clear socioeconomic gradient in access to acute and primary care services, where those most in need of services are the most disadvantaged and under-serviced. There has been little attention paid thus far, however, to the way in which socioeconomic status may affect the receipt of home health care services. To determine what is known from existing literature about socioeconomic disparities in home health care access and utilization. A scoping review was used to map the extent and nature of the literature in this area. A search of the databases CINAHL, Medline, SocIndex and Sociological Abstracts as well as Dissertations International. A total of 206 potentially relevant articles were published between 2000 and April 2011. Two reviewers independently reviewed the articles, leaving 15 research articles to be included in the scoping review. The majority of articles reported secondary analyses of administrative datasets related to utilization of home health care. Several studies examined access and utilization using qualitative approaches. The distinction between professional and supportive home care services was not always clear in the articles. Individual and composite measures of socioeconomic status were reported, with the most frequently used indicator being income. Several studies used more complex composite ecological indicators of socieconomic status. There was general agreement that utilization of home health services favored persons with greater economic disadvantage

  3. Impact of socioeconomic status on the course of rheumatoid arthritis and on related use of health care services

    NARCIS (Netherlands)

    Jacobi, Catharina E.; Mol, Geert D.; Boshuizen, Hendriek C.; Rupp, Ines; Dinant, Huibert J.; van den Bos, Geertrudis A. M.

    2003-01-01

    Objective. To quantify the impact of socioeconomic status (SES) among patients with rheumatoid arthritis on 1) health outcomes and related health care utilization in relation to disease duration and 2) changes in health outcomes and related health care utilization over a 2-year period. Methods. A

  4. Utilization of Mental Health Services and Mental Health Status Among Children Placed in Out-of-Home Care: A Parallel Process Latent Growth Modeling Approach.

    Science.gov (United States)

    Yampolskaya, Svetlana; Sharrock, Patty J; Clark, Colleen; Hanson, Ardis

    2017-10-01

    This longitudinal study examined the parallel trajectories of mental health service use and mental health status among children placed in Florida out-of-home care. The results of growth curve modeling suggested that children with greater mental health problems initially received more mental health services. Initial child mental health status, however, had no effect on subsequent service provision when all outpatient mental health services were included. When specific types of mental health services, such as basic outpatient, targeted case management, and intensive mental health services were examined, results suggested that children with compromised functioning during the baseline period received more intensive mental health services over time. However, this increased provision of intensive mental health services did not improve mental health status, rather it was significantly associated with progressively worse mental health functioning. These findings underscore the need for regular comprehensive mental health assessments focusing on specific needs of the child.

  5. Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations.

    Science.gov (United States)

    Whitehead, J; Shaver, John; Stephenson, Rob

    2016-01-01

    Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.

  6. Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations.

    Directory of Open Access Journals (Sweden)

    J Whitehead

    Full Text Available Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers.LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas.Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men.The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.

  7. Integrating Multiple Social Statuses in Health Disparities Research: The Case of Lung Cancer

    Science.gov (United States)

    Williams, David R; Kontos, Emily Z; Viswanath, K; Haas, Jennifer S; Lathan, Christopher S; MacConaill, Laura E; Chen, Jarvis; Ayanian, John Z

    2012-01-01

    Objective To illustrate the complex patterns that emerge when race/ethnicity, socioeconomic status (SES), and gender are considered simultaneously in health care disparities research and to outline the needed research to understand them by using disparities in lung cancer risks, treatment, and outcomes as an example. Principal Findings SES, gender, and race/ethnicity are social categories that are robust predictors of variations in health and health services utilization. These are usually considered separately, but intersectionality theory indicates that the impact of each depends on the others. Each reflects historically and culturally contingent variations in social, economic, and political status. Distinct patterns of risk and resilience emerge at the intersections of multiple social categories and shape the experience of health, health care access, utilization, quality, and outcomes where these categories intersect. Intersectional approaches call for greater attention to understand social processes at multiple levels of society and require the collection of relevant data and utilization of appropriate analytic approaches to understand how multiple risk factors and resources combine to affect the distribution of disease and its management. Conclusions Understanding how race/ethnicity, gender, and SES are interactive, interdependent, and social identities can provide new knowledge to enhance our efforts to effectively address health disparities. PMID:22568674

  8. Maternal autonomy and child health care utilization in India: results from the National Family Health Survey.

    Science.gov (United States)

    Malhotra, Chetna; Malhotra, Rahul; Østbye, Truls; Subramanian, S V

    2014-07-01

    The objective of this study was to examine the association of maternal autonomy with preventive and curative child health care utilization in India. Data from the National Family Health Survey 2005-2006 were used to ascertain association of maternal autonomy (in 3 dimensions: decision making, access to financial resources, freedom of movement) with child's primary immunization status (indicative of preventive health care use) and treatment seeking for child's acute respiratory infection (indicative of curative health care use). Low maternal freedom of movement was associated with higher odds of incomplete primary immunization of the child and for not seeking treatment for the child's acute respiratory infection. Low maternal financial access was associated with increased odds for incomplete primary immunization of the child. The findings show that improvement in autonomy of Indian mothers, especially their freedom of movement, may help improve utilization of health care for their children. © 2012 APJPH.

  9. [Health status of elderly persons in Korea].

    Science.gov (United States)

    Choi, Y H; Kim, M S; Byon, Y S; Won, J S

    1990-12-01

    This Study was done to design and test an instrument to measure the health status of the elderly including physical, psychological and social dimensions. Data collection was done from July 18 to August 17, 1990. Subjects were 412 older persons in Korea. A convenience sample was used but the place of residence was stratified into large, medium and small city and rural areas. Participants located in Sudaemun-Gu, Mapo-Gu, and Kangnam-Gu, Seoul were interviewed by brained nursing students, and those in Chungju, Jonju, Chuncheon, and Jinju by professors of nursing colleges. Rural residents were interviewed by community health practitioners working in Kungsang-Buk-Do, Kyngsang-Nam-Do, Jonla Buk-Do, and Kyung Ki-Do. The tool developed for this study was a structured questionnaire based on previous literature and then tested for reliability and validity. This tool contained 20 physical health status items, 17 mental-emotional health status items and 38 social health status items. Physical health status items clustered in to six factors such as personal hygiene, activity, home management, digestive, sexual, sensory, and climatization functions. Mental-emotional health status items clustered into two factors, mental health and emotional health. Social health status items clustered into seven factors, grandparent, parent, spouse, friend, kinships, group member and religious role functions. Data analysis included percentage, average, S.D., t-test and ANOVA. The results of the analysis were as follows: 1. The tool measuring the health status of the elderly and developed for this research had a relatively high reliability indicated by a Cronbach = 0.97793. 2. Average score of the subjects physical health status was 4,054 in a 5 point likert scale, mental-emotional health status was 3.803, social health status was 2.939 and the total average was 3.521. The social status of the subjects was the lowest and the next was mental-emotional health status; physical health status was the

  10. Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations

    Science.gov (United States)

    Whitehead, J.; Shaver, John; Stephenson, Rob

    2016-01-01

    Background Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. Methodology LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and “outness,” and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals’ demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Results Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. Conclusions The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients’ disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas. PMID:26731405

  11. Migration, remittances, and health care utilization in Ecuador.

    Science.gov (United States)

    López-Cevallos, Daniel F; Chi, Chunhuei

    2012-01-01

    To examine the relationship between migration and migrant remittances and health care utilization in Ecuador, and to identify any potential equalizing effects. Using data from the 2004 National Demographic and Maternal & Child Health Survey (ENDEMAIN), a multilevel multivariate analysis was conducted to assess the relationship of two migrant predictors (households with an international migrant; use of migrant remittances) with use of preventive care, number of curative visits, hospitalization, and use of antiparasitic medicines. Relevant predisposing, enabling, and need factors were included following Andersen's Model of Health Care Utilization Behavior. Interaction terms were included to assess the potential equalizing effects of migration and remittances by ethnicity, area of residence, and economic status. Migrant predictors were strongly associated with use of antiparasitic medicines, and to a lesser extent, with curative visits, even after adjusting for various predisposing, enabling, and need factors. Interaction models showed that having an international migrant increased use of these services among low-income Ecuadorians (quintiles 1 and 2). No significant relationship was found between migrant predictors and use of preventive services. Migration and remittances seem to have an equalizing effect on access to antiparasitic medicines, and to a lesser extent, curative health care services. Health care reform efforts should take into account the scope of this effect when developing public policy.

  12. Alcohol dependence and health care utilization in African Americans.

    Science.gov (United States)

    Marshall, Vanessa J; Kalu, Nnenna; Kwagyan, John; Scott, Denise M; Cain, Gloria E; Hill, Karen; Hesselbrock, Victor; Ferguson, Clifford L; Taylor, Robert E

    2013-01-01

    Ethnic and cultural differences in patterns of alcohol use disorders must be understood in order to address improvement in prevention of such disorders and accessibility to health care services. The purpose of this study was to evaluate factors that influence the utilization of medical and mental health services among alcohol-dependent and non-alcohol-dependent African Americans. A cohort of 454 African Americans was evaluated. Alcohol-dependent participants were recruited from various inpatient treatment facilities in the Washington, DC, metropolitan area and through advertisement and word of mouth. Non-alcohol-dependent participants were recruited by advertisements. Each participant was administered the Semi-Structured Assessment for the Genetics of Alcoholism to assess alcohol dependency and the Family History Assessment module to access family history of alcoholism. Xl Test and analysis of variance were used to analyze the data. Alcohol dependence was more prevalent among men, those with lower income, those with less education, and they utilized mental health counseling as opposed to medical-based therapy. Increased reports of medical conditions such as migraine (p<.001), loss of consciousness (p=.001), and sexually transmitted diseases: (p<.001) were also associated with alcohol dependency. Other factors, including visits to inpatient treatment programs, were directly related to incidence of alcohol dependency regardless of gender status (p<.001). This study suggests an association exists among alcohol dependence, medical conditions, health care, and mental care utilization among African Americans. Future research may benefit from investigating if an association exists between alcohol use disorders and health care utilization for other ethnic groups.

  13. Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese

    Science.gov (United States)

    Liu, Yong-Bing; Liu, Liu; Li, Yan-Fei; Chen, Yan-Li

    2015-01-01

    Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p 0.05). Multiple linear regression analysis showed that the independent influencing factors of health literacy included education level, race, former occupation, household income, age, physical exercise, health examination, smoking, and health information access (p

  14. Acculturation and cross-border utilization of health services.

    Science.gov (United States)

    Su, Dejun; Wang, Daphne

    2012-08-01

    Health services from Mexico constitute an important source of care for U.S. residents living along the U.S.-Mexico border. Data from The Cross-Border Utilization of Health Care Survey (n = 966) were used to estimate logit models that related acculturation, as measured by generational status, to the use of medication, physician, dental, and inpatient services from Mexico by U.S. residents in the Texas border region. Relative to first-generation Mexican immigrants, later-generation Mexican-Americans were progressively less likely to go to Mexico for health services. This finding holds with or without adjusting for the effects of selected demographic and socioeconomic variables. Addressing unmet needs in medical care in the southwestern U.S. border area should go beyond a simple expansion of health insurance coverage--it is also important to deliver health services that are sensitive to generational differences within the population in terms of linguistic and cultural barriers to health care access.

  15. Present status and prospects of radioisotopes and radiation utilization in Indonesia

    International Nuclear Information System (INIS)

    Baiquni, A.

    1982-01-01

    The present status and prospects of RI and radiation utilization in Indonesia, which developed under the Government's assistance and supervision since the opening of the research reactor in 1965, was reviewed. Utilization of short half-life RI in various fields was described. Utilization in medicine, sterilization of medical supplies, the industrial world and hydrology was detailed. Annual changes in these fields were shown and tables were presented. The status of various types of radiation and RI utilization in Indonesia, which included nuclear analytical techniques in industry and various laboratories in agriculture, industry and biology, was reported. Finally, the plan of construction of a third research reactor was referred to. (Chiba, N.)

  16. The impact of demographic, health-related and social factors on dental services utilization: Systematic review and meta-analysis.

    Science.gov (United States)

    Reda, Seif Magdy; Krois, Joachim; Reda, Sophie Franziska; Thomson, William Murray; Schwendicke, Falk

    2018-04-16

    Regular and/or preventive dental services utilization is an indicator of healthcare access and associated with improved health outcomes. We assessed the proportion of individuals regularly/preventively utilizing dental services, and how this was affected by demographic, health-related and social factors. Three electronic databases (Medline, Embase, Central) were searched (2005-2017). We included observational studies investigating the association between preventive/regular dental service utilization and age, oral and general health, edentulism, family structure and health literacy. The proportion of individuals with regular/preventive utilization overall and in different sub-groups were extracted. Random-effects meta-analyses, with subgroup analyses by region, were performed. Meta-regression was used to assess whether and how associations changed with time and countries' human developmental status (HDI). 103 studies on 7,395,697 participants from 28 countries were included. The global mean (95% CI) proportion of individuals regularly/preventively utilizing dental services was 54% (50-59%). In countries with higher HDI, more individuals regularly/preventively utilized services (p Age did not have a significant impact on utilization in adults (OR = 1.00; 0.89-1.12). Utilization was significantly lower in younger than older children (OR = 0.52; 0.46-0.59), individuals with poorer general health (OR = 0.73; 0.65-0.80) and poorer oral health (OR = 0.64; 0.52-0.75), edentulous individuals (OR = 0.32; 0.23-0.41), and individuals with less supportive family structures (OR = 0.81; 0.73-0.89) or poor health literacy (OR = 0.41; 0.01-0.81). The observed differences within populations did not significantly change with time and were universally present. Regular/preventive utilization varied widely between and within countries. Understanding and tackling the reasons underlying this may help to consistently improve utilization. Higher developmental

  17. Health care utilization

    DEFF Research Database (Denmark)

    Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren

    An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...

  18. Differences in Health Care Needs, Health Care Utilization, and Health Care Outcomes Among Children With Special Health Care Needs in Ohio: A Comparative Analysis Between Medicaid and Private Insurance.

    Science.gov (United States)

    Sarkar, Madhurima; Earley, Elizabeth R; Asti, Lindsey; Chisolm, Deena J

    This study explores comparative differentials in health care needs, health care utilization, and health status between Medicaid and private/employer-sponsored insurance (ESI) among a statewide population of children with special health care needs (CSHCN) in Ohio. We used data from the 2012 Ohio Medicaid Assessment Survey to examine CSHCN's health care needs, utilization, status, and health outcomes by insurance type. Adjusted multivariable logistic regression models were used to explore associations between public and private health insurance, as well as the utilization and health outcome variables. Bivariate analyses indicate that the Medicaid population had higher care coordination needs (odds ratio [OR] = 1.6; 95% confidence interval [CI], 1.1-2.2) as well as need for mental/educational health care services (OR = 1.5; 95% CI; 1.1-2.0). They also reported higher unmet dental care needs (OR = 2.2; 95% CI, 1.2-4.0), higher emergency department (ED) utilization (OR = 2.3; 95% CI, 1.7-3.2), and worse overall health (OR = 0.6; 95% CI, 0.4-0.7), oral health (OR = 0.4; 95% CI, 0.3-0.5), and vision health (OR = 0.4; 95% CI, 0.2-0.6). After controlling for demographic variables, CSHCN with Medicaid insurance coverage were more likely to need mental health and education services (adjusted odds ratio [AOR] = 1.8; 95% CI; 1.2-2.6), had significantly more ED visits (AOR = 2.3; 95% CI, 1.5-3.5), and were less likely to have excellent overall health (AOR = 0.64; 95% CI, 0.4-0.9), oral health (AOR = 0.43; 95% CI, 0.3-0.7), and vision health (AOR = 0.38; 95% CI, 0.2-0.6) than those with private insurance/ESI. The CSHCN population is a highly vulnerable population. While Ohio's Medicaid provides greater coverage to CSHCN, disparities continue to exist within access and services that Medicaid provides versus the ones provided by private insurance/ESI.

  19. Disease Patterns and Socioeconomic Status Associated with Utilization of Computed Tomography in Taiwan, 1997–2003

    Directory of Open Access Journals (Sweden)

    Pei-Tseng Kung

    2008-02-01

    Conclusion: Neoplasm, diseases of the circulatory system, congenital malformations, and poor socioeconomic status were significantly associated with a higher rate of CT utilization. The distribution of disease patterns varied with gender, age groups, salary levels, and health care region's household income levels. Further study is needed to better understand the nature of the findings.

  20. Utilization of outpatient services in refugee settlement health facilities: a comparison by age, gender, and refugee versus host national status

    Directory of Open Access Journals (Sweden)

    Meyer Sarah

    2011-09-01

    Full Text Available Abstract Background Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR Health Information System (HIS. Methods Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Results Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5 was higher than in Africa on average (1.8. Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1. The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient

  1. Utilization of outpatient services in refugee settlement health facilities: a comparison by age, gender, and refugee versus host national status.

    Science.gov (United States)

    Weiss, William M; Vu, Alexander; Tappis, Hannah; Meyer, Sarah; Haskew, Christopher; Spiegel, Paul

    2011-09-21

    Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR) Health Information System (HIS). Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population) were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5) was higher than in Africa on average (1.8). Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1). The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD) visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient visits attributable to host community members

  2. Utilization of outpatient services in refugee settlement health facilities: a comparison by age, gender, and refugee versus host national status

    Science.gov (United States)

    2011-01-01

    Background Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR) Health Information System (HIS). Methods Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population) were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Results Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5) was higher than in Africa on average (1.8). Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1). The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD) visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient visits attributable

  3. Health status among elderly Hungarians and Americans.

    Science.gov (United States)

    Buss, T F; Beres, C; Hofstetter, C R; Pomidor, A

    1994-07-01

    Selected health status data for elderly populations from similar industrial cities-Youngstown, Ohio, USA, and Debrecen, Hungary-were compared. Because of their impoverished health care system, unregulated heavily industrialized society, and unhealthful life-styles Hungarians were hypothesized to have poorer health status than Americans, even after taking into account demographic mediating factors. The study provides a health status baseline for elderly Hungarians shortly after communism's fall in 1989-1990 and shows how great a gap exists between Hungarian health status and that in the West. Hungarians were in much poorer health as measured by functional status, symptomatology, medical condition, depression, and subjective health status. Distinctions persisted when controlling for gender, age, and education. Poverty-level (and income) did not explain health status differences. The paper concludes that Hungary should pay more attention to health promotion, prevention, and primary care, as well as to reforming patient management in hospitals, nursing homes, and home care programs.

  4. Utilization of Mental Health Services in School-Based Health Centers.

    Science.gov (United States)

    Bains, Ranbir M; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

    2017-08-01

    We summarize utilization patterns for mental health services in school-based health centers. Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%-49%) in the 13-15 age range. Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8-year-old boys. © 2017, American School Health Association.

  5. Urban women's socioeconomic status, health service needs and utilization in the four weeks after postpartum hospital discharge: findings of a Canadian cross-sectional survey.

    Science.gov (United States)

    Kurtz Landy, Christine; Sword, Wendy; Ciliska, Donna

    2008-10-03

    Postpartum women who experience socioeconomic disadvantage are at higher risk for poor health outcomes than more advantaged postpartum women, and may benefit from access to community based postpartum health services. This study examined socioeconomically disadvantaged (SED) postpartum women's health, and health service needs and utilization patterns in the first four weeks post hospital discharge, and compared them to more socioeconomically advantaged (SEA) postpartum women's health, health service needs and utilization patterns. Data collected as part of a large Ontario cross-sectional mother-infant survey were analyzed. Women (N = 1000) who had uncomplicated vaginal births of single 'at-term' infants at four hospitals in two large southern Ontario, Canada cities were stratified into SED and SEA groups based on income, social support and a universally administered hospital postpartum risk screen. Participants completed a self-administered questionnaire before hospital discharge and a telephone interview four weeks after discharge. Main outcome measures were self-reported health status, symptoms of postpartum depression, postpartum service needs and health service use. When compared to the SEA women, the SED women were more likely to be discharged from hospital within the first 24 hours after giving birth [OR 1.49, 95% CI (1.01-2.18)], less likely to report very good or excellent health [OR 0.48, 95% CI (0.35-0.67)], and had higher rates of symptoms of postpartum depression [OR 2.7, 95% CI(1.64-4.4)]. No differences were found between groups in relation to self reported need for and ability to access services for physical and mental health needs, or in use of physicians, walk-in clinics and emergency departments. The SED group were more likely to accept public health nurse home visits [OR 2.24, 95% CI(1.47-3.40)]. Although SED women experienced poorer mental and overall health they reported similar health service needs and utilization patterns to more SEA women

  6. Urban women's socioeconomic status, health service needs and utilization in the four weeks after postpartum hospital discharge: findings of a Canadian cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Ciliska Donna

    2008-10-01

    Full Text Available Abstract Background Postpartum women who experience socioeconomic disadvantage are at higher risk for poor health outcomes than more advantaged postpartum women, and may benefit from access to community based postpartum health services. This study examined socioeconomically disadvantaged (SED postpartum women's health, and health service needs and utilization patterns in the first four weeks post hospital discharge, and compared them to more socioeconomically advantaged (SEA postpartum women's health, health service needs and utilization patterns. Methods Data collected as part of a large Ontario cross-sectional mother-infant survey were analyzed. Women (N = 1000 who had uncomplicated vaginal births of single 'at-term' infants at four hospitals in two large southern Ontario, Canada cities were stratified into SED and SEA groups based on income, social support and a universally administered hospital postpartum risk screen. Participants completed a self-administered questionnaire before hospital discharge and a telephone interview four weeks after discharge. Main outcome measures were self-reported health status, symptoms of postpartum depression, postpartum service needs and health service use. Results When compared to the SEA women, the SED women were more likely to be discharged from hospital within the first 24 hours after giving birth [OR 1.49, 95% CI (1.01–2.18], less likely to report very good or excellent health [OR 0.48, 95% CI (0.35–0.67], and had higher rates of symptoms of postpartum depression [OR 2.7, 95% CI(1.64–4.4]. No differences were found between groups in relation to self reported need for and ability to access services for physical and mental health needs, or in use of physicians, walk-in clinics and emergency departments. The SED group were more likely to accept public health nurse home visits [OR 2.24, 95% CI(1.47–3.40]. Conclusion Although SED women experienced poorer mental and overall health they reported similar

  7. Validity of Self-reported Healthcare Utilization Data in the Community Health Survey in Korea

    Science.gov (United States)

    Rim, Hwayoung; Lee, Kunsei; Chang, Sounghoon; Hovell, Melbourne F; Kim, Young-Taek; Kim, Yuna; Kang, Gilwon; Tak, Yangju; Im, Jeehye

    2011-01-01

    To evaluate the sensitivity and specificity of Community Health Survey (CHS), we analyzed data from 11,217 participants aged ≥ 19 yr, in 13 cities and counties in 2008. Three healthcare utilization indices (admission, outpatient visits, dental visits) as comparative variables and the insurance benefit claim data of the Health Insurance Review & Assessment Service as the gold-standard were used. The sensitivities of admission, outpatient visits, and dental visits in CHS were 54.8%, 52.1%, and 61.0%, respectively. The specificities were 96.4%, 85.6%, and 82.7%, respectively. This is the first study to evaluate the validity of nationwide health statistics resulting from questionnaire surveys and shows that CHS needs a lot of efforts to reflect the true health status, health behavior, and healthcare utilization of the population. PMID:22065895

  8. Expected utility violations evolve under status-based selection mechanisms.

    Science.gov (United States)

    Dickson, Eric S

    2008-10-07

    The expected utility theory of decision making under uncertainty, a cornerstone of modern economics, assumes that humans linearly weight "utilities" for different possible outcomes by the probabilities with which these outcomes occur. Despite the theory's intuitive appeal, both from normative and from evolutionary perspectives, many experiments demonstrate systematic, though poorly understood, patterns of deviation from EU predictions. This paper offers a novel theoretical account of such patterns of deviation by demonstrating that EU violations can emerge from evolutionary selection when individual "status" affects inclusive fitness. In humans, battles for resources and social standing involve high-stakes decision making, and assortative mating ensures that status matters for fitness outcomes. The paper therefore proposes grounding the study of decision making under uncertainty in an evolutionary game-theoretic framework.

  9. Health care utilization of refugee children after resettlement.

    Science.gov (United States)

    Watts, Delma-Jean; Friedman, Jennifer F; Vivier, Patrick M; Tompkins, Christine E A; Alario, Anthony J

    2012-08-01

    Refugee children can have significant health problems. Our objective was to describe health status and health care utilization of refugee children after resettlement. A retrospective chart review of refugee children was performed. Initial laboratory data was extracted. Primary care visits, emergency room visits, and subspecialty referrals in the first 15 months from arrival were recorded. The sample included 198 refugees, many with positive initial screening tests. After arrival, 21% had an emergency department visit, 40% had a primary care sick visit, and 71% had a primary care follow-up. Mean number of visits ranged from 0.3 for emergency department to 1.9 for follow-up. Fifty-seven percent were referred to at least one subspecialist. Refugee children had substantial disease burden at arrival. Most had primary care follow-up visits and subspecialty referral after resettlement. These visits were largely for problems identified on initial screening and for general pediatric illnesses.

  10. Does the Universal Health Insurance Program Affect Urban-Rural Differences in Health Service Utilization among the Elderly? Evidence from a Longitudinal Study in Taiwan

    Science.gov (United States)

    Liao, Pei-An; Chang, Hung-Hao; Yang, Fang-An

    2012-01-01

    Purpose: To assess the impact of the introduction of Taiwan's National Health Insurance (NHI) on urban-rural inequality in health service utilization among the elderly. Methods: A longitudinal data set of 1,504 individuals aged 65 and older was constructed from the Survey of Health and Living Status of the Elderly. A difference-in-differences…

  11. Perspectives on utilization of community based health information systems in Western Kenya.

    Science.gov (United States)

    Flora, Otieno Careena; Margaret, Kaseje; Dan, Kaseje

    2017-01-01

    Health information systems (HIS) are considered fundamental for the efficient delivery of high quality health care. However, a large number of legal and practical constraints influence the design and introduction of such systems. The inability to quantify and analyse situations with credible data and to use data in planning and managing service delivery plagues Africa. Establishing effective information systems and using this data for planning efficient health service delivery is essential to district health systems' performance improvement. Community Health Units in Kenya are central points for community data collection, analysis, dissemination and use. In Kenya, data tend to be collected for reporting purposes and not for decision-making at the point of collection. This paper describes the perspectives of local users on information use in various socio-economic contexts in Kenya. Information for this study was gathered through semi-structured interviews. The interviewees were purposefully selected from various community health units and public health facilities in the study area. The data were organized and analysed manually, grouping them into themes and categories. Information needs of the community included service utilization and health status information. Dialogue was the main way of information utilization in the community. However, health systems and personal challenges impeded proper collection and use of information. The challenges experienced in health information utilization may be overcome by linkages and coordination between the community and the health facilities. The personal challenges can be remedied using a motivational package that includes training of the Community Health Workers.

  12. Health status, activity limitations, and disability in work and housework among Latinos and non-Latinos with arthritis: an analysis of national data.

    Science.gov (United States)

    Abraído-Lanza, Ana F; White, Kellee; Armbrister, Adria N; Link, Bruce G

    2006-06-15

    To document disparities in health status, activity limitations, and disability in work and housework between Latinos and non-Latino whites with arthritis. We examined whether sociodemographic factors (age, income, and education) account for the disparities between the ethnic groups, and whether comorbid conditions, disease duration, health care utilization, and functional abilities predict health status, activity limitations, and work and housework disability after controlling for sociodemographic variables. We analyzed data from the Condition file of the 1994 National Health Interview Survey on Disability, Phase I. The risk of worse health, activity limitations, and work and housework disability was >2 times greater among Latinos compared with non-Latino whites. In the regression models accounting for potential confounders, Latino ethnicity remained significantly associated with poorer health status, but not activity limitations or disability in work or housekeeping. Of the socioeconomic status variables, education had a significant protective effect on work disability and health status. Comorbid conditions and health care utilization increased the likelihood of worse health, activity limitations, and work disability. Limitations in physical function were associated with poorer health and disability in work and homemaking. Social status differences between Latinos and non-Latinos may account for disparities in activity limitations and disability in work and housework. Education may provide various health benefits, including access to a range of occupations that do not require physical demands. The findings help to address the great gap in knowledge concerning factors related to the health and disability status of Latinos with arthritis.

  13. Differentials in reproductive and child health status in India

    Directory of Open Access Journals (Sweden)

    Nikhilesh Parchure

    2011-12-01

    Full Text Available

    Background: Inequalities in reproductive and child health (RCH exist, in general, in different regions of India. The present study aims to investigate the current status of RCH and examine the factors responsible for it in different parts of India.

    Methods: This study utilized data obtained from two Indian studies – (i National Family Health Survey – 3 (NFHS- 2005-06 and (ii District Level Household Survey (DLHS – 2002-04. Reproductive Health Index was computed on the basis of five variables such as total fertility rate, infant mortality rate, birth order, delivery care and female educational attainment.

    Results: In terms of reproductive and child health, a wide range of variation exists in India in its different regions. The study reveals that among Indian states, 13 states have an index value less than the national average. On the basis of the reproductive health index, the Indian states can be divided into three categories, namely; progressive states, semi progressive states and backward states.

    Conclusions: The interstate differences in healthcare utilization are partly due to variations in the implementation of maternal health care programs as well as differences in availability of and accessibility to healthcare between Indian states.

  14. The predictive validity of prospect theory versus expected utility in health utility measurement.

    Science.gov (United States)

    Abellan-Perpiñan, Jose Maria; Bleichrodt, Han; Pinto-Prades, Jose Luis

    2009-12-01

    Most health care evaluations today still assume expected utility even though the descriptive deficiencies of expected utility are well known. Prospect theory is the dominant descriptive alternative for expected utility. This paper tests whether prospect theory leads to better health evaluations than expected utility. The approach is purely descriptive: we explore how simple measurements together with prospect theory and expected utility predict choices and rankings between more complex stimuli. For decisions involving risk prospect theory is significantly more consistent with rankings and choices than expected utility. This conclusion no longer holds when we use prospect theory utilities and expected utilities to predict intertemporal decisions. The latter finding cautions against the common assumption in health economics that health state utilities are transferable across decision contexts. Our results suggest that the standard gamble and algorithms based on, should not be used to value health.

  15. Health promotion behaviors in adolescents: prevalence and association with mental health status in a statewide sample.

    Science.gov (United States)

    Adrian, Molly; Charlesworth-Attie, Sarah; Vander Stoep, Ann; McCauley, Elizabeth; Becker, Linda

    2014-04-01

    The purpose of this study is to estimate the proportion of adolescents meeting Healthy People 2020 health behavior recommendations for the prevention of chronic disease and to determine the association between mental health status (depression and/or conduct problems) and the likelihood of meeting these recommendations. The data used for this study are from the 2010 Washington State Healthy Youth Survey. Descriptive statistics and linear regression were utilized to estimate the proportion of adolescents meeting recommendations and associations between youth mental health status indicators and health-promoting behaviors. A small minority (5.8 %) of youth met all six recommendations in domains of tobacco abstinence, substance use abstinence, daily physical activity, breakfast consumption, weight below obese levels, and adequate sleep, though most (84.3 %) met at least three. At the aggregate level, the proportion of Washington State youth who met Healthy People 2020 guidelines exceeded targets, with the exception of substance use abstinence. A minority of youth reported guideline levels of daily physical activity (23.3 %) and sleep (39.8 %). Mental health status was strongly associated with the number of health-promoting behaviors adolescents endorsed. Interventions to increase the adoption of sleep hygiene and exercise habits should be added to an integrative positive youth development framework within school-, community-, and primary care-based adolescent health initiatives. Attention to adolescent mental health and shared risk factors may be critical for reducing barriers to healthy behavior.

  16. [Adapting health services to the specific needs and utilization patterns of the new Spaniards. 2008 SESPAS Report].

    Science.gov (United States)

    Ribera, Berta; Casal, Bruno; Cantarero, David; Pascual, Marta

    2008-04-01

    Because of the progressive increase in the number of immigrants and the uncertainty about the capacity of the Spanish health service to deal with the quantitative and qualitative increases in demand, the possibility of introducing changes to adapt our services to the new situation should be considered. Beginning with an analysis of the factors that influence health status and use of the health service, based on the National Health Survey (NHS), the European Statistics on Income and Living Conditions (EU-SILC) and the European Community Household Panel (ECHP), we compare the health profiles and patterns of medical resources utilization between the national and foreign populations. The pattern of demand for health services in the immigrant population corresponds basically to the needs of a young population in good health. According to NHS data, resource utilization among immigrants can even be lower than that among the national population. Assessing the link between health status and demand for healthcare from a dynamic point of view, by identifying variations in patterns of health and patterns of demand for healthcare, is important to identify imbalances in resources and to establish an appropriate hierarchy of preventive and treatment priorities.

  17. Utilization of health facilities and predictors of health-seeking behavior for under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia: a community-based cross-sectional study

    OpenAIRE

    Adane, Metadel; Mengistie, Bezatu; Mulat, Worku; Kloos, Helmut; Medhin, Girmay

    2017-01-01

    Background Information on health-seeking behavior and utilization of health facilities in slums of Addis Ababa is scarce, impeding the implementation of effective interventions. The purpose of this study is to assess the status of health facilities utilization and predictors for health-seeking behavior of mothers/caregivers of under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia. Methods A community-based cross-sectional study design was employed in five rounds of surveys...

  18. Language proficiency and health status: are bilingual immigrants healthier?

    Science.gov (United States)

    Schachter, Ariela; Kimbro, Rachel T; Gorman, Bridget K

    2012-03-01

    Bilingual immigrants appear to have a health advantage, and identifying the mechanisms responsible for this is of increasing interest to scholars and policy makers in the United States. Utilizing the National Latino and Asian American Study (NLAAS; n = 3,264), we investigate the associations between English and native-language proficiency and usage and self-rated health for Asian and Latino U.S. immigrants from China, the Philippines, Vietnam, Mexico, Cuba, and Puerto Rico. The findings demonstrate that across immigrant ethnic groups, being bilingual is associated with better self-rated physical and mental health relative to being proficient in only English or only a native language, and moreover, these associations are partially mediated by socioeconomic status and family support but not by acculturation, stress and discrimination, or health access and behaviors.

  19. Factors associated with the utilization and costs of health and social services in frail elderly patients

    Directory of Open Access Journals (Sweden)

    Kehusmaa Sari

    2012-07-01

    Full Text Available Abstract Background Universal access is one of the major aims in public health and social care. Services should be provided on the basis of individual needs. However, municipal autonomy and the fragmentation of services may jeopardize universal access and lead to variation between municipalities in the delivery of services. This paper aims to identify patient-level characteristics and municipality-level service patterns that may have an influence on the use and costs of health and social services of frail elderly patients. Methods Hierarchical analysis was applied to estimate the effects of patient and municipality-level variables on services utilization. Results The variation in the use of health care services was entirely due to patient-related variables, whereas in the social services, 9% of the variation was explained by the municipality-level and 91% by the patient-level characteristics. Health-related quality of life explained a major part of variation in the costs of health care services. Those who had reported improvement in their health status during the preceding year were more frequent users of social care services. Low informal support, poor functional status and poor instrumental activities of daily living, living at a residential home, and living alone were associated with higher social services expenditure. Conclusions The results of this study showed municipality-level variation in the utilization of social services, whereas health care services provided for frail elderly people seem to be highly equitable across municipalities. Another important finding was that the utilization of social and health services were connected. Those who reported improvement in their health status during the preceding year were more frequently also using social services. This result suggests that if municipalities continue to limit the provision of support services only for those who are in the highest need, this saving in the social sector may, in

  20. Effects of a randomized controlled intervention trial on return to work and health care utilization after long-term sickness absence

    DEFF Research Database (Denmark)

    Momsen, Anne-Mette H.; Stapelfeldt, Christina Malmose; Nielsen, Claus Vinther

    2016-01-01

    ) and odds ratio (OR) were used as measures of associations. Results were adjusted for gender, age, educational level, work ability and previous sick leave. Results: Among all responders we found no effect of the intervention on RTW. Among participants with low health anxiety, the one-year probability of RTW......Background: The aim of the RCT study was to investigate if the effect of a multidisciplinary intervention on return to work (RTW) and health care utilization differed by participants’ self-reported health status at baseline, defined by a) level of somatic symptoms, b) health anxiety and c) self......-reported general health. Methods: A total of 443 individuals were randomized to the intervention (n = 301) or the control group (n = 142) and responded to a questionnaire measuring health status at baseline. Participants were followed in registries measuring RTW and health care utilization. Relative risk (RR...

  1. Predictors of Adolescent Health Care Utilization

    Science.gov (United States)

    Vingilis, Evelyn; Wade, Terrance; Seeley, Jane

    2007-01-01

    This study, using Andersen's health care utilization model, examined how predisposing characteristics, enabling resources, need, personal health practices, and psychological factors influence health care utilization using a nationally representative, longitudinal sample of Canadian adolescents. Second, this study examined whether this process…

  2. Do place of residence and ethnicity affect health services utilization? evidence from greece.

    Science.gov (United States)

    Lahana, Eleni; Pappa, Evelina; Niakas, Dimitris

    2011-04-26

    Equal utilization of health services for equal need, is one of the main targets for public health systems. Given the public-private structure of the Greek NHS, the main aim of the study was to investigate the impact of underlying factors, such as health care needs, socio-demographic characteristics and ethnicity, on the utilization of primary and hospital health care in an urban and rural population of the Greek region, Thessaly. A cross-sectional study was carried out in 2006 in Thessaly, a Greek region of Central Greece, in a representative sample of 1372 individuals (18+ years old, response rate 91.4%) via face-to-face interview. Health care needs were determined by self-perceived health status estimated by the SF-36 Health Survey, using the summary scores of physical and mental health. The utilization of primary care was measured by last month visits to 1) primary public services and 2) private practitioners visits and utilization of secondary care was measured by past year visits to 3) public hospital emergency departments and 4) admissions to public hospitals. Multivariable stepwise logistic regression analysis was applied in the whole sample and separately for the urban and rural population, in order to determine the predictors of health services utilization. Statistical significance was determined with a p value services utilization in both the urban and rural areas. Poor physical and mental health was associated with higher likelihood of use. In the urban areas middle-aged, elderly and Greeks were more likely to use primary health services, whereas primary education was associated with more visits to the emergency departments. Wealthier individuals were two times more likely to be admitted to hospitals. Individuals from the rural areas with university education visited more the public primary services, while wealthier individuals visited more the private practitioners. Immigrants had a higher likelihood of visiting emergency departments. Although health

  3. Health care access and utilization among children of single working and nonworking mothers in the United States.

    Science.gov (United States)

    Clarke, Tainya C; Arheart, Kristopher L; Muennig, Peter; Fleming, Lora E; Caban-Martinez, Alberto J; Dietz, Noella; Lee, David J

    2011-01-01

    To examine indicators of health care access and utilization among children of working and nonworking single mothers in the United States, the authors used data on unmarried women participating in the 1997-2008 National Health Interview Survey who financially supported children under 18 years of age (n = 21,842). Stratified by maternal employment, the analyses assessed health care access and utilization for all children. Outcome variables included delayed care, unmet care, lack of prescription medication, no usual place of care, no well-child visit, and no doctor's visit. The analyses reveal that maternal employment status was not associated with health care access and utilization. The strongest predictors of low access/utilization included no health insurance and intermittent health insurance in the previous 12 months, relative to those with continuous private health insurance coverage (odds ratio ranges 3.2-13.5 and 1.3-10.3, respectively). Children with continuous public health insurance compared favorably with those having continuous private health insurance on three of six access/utilization indicators (odds ratio range 0.63-0.85). As these results show, health care access and utilization for the children of single mothers are not optimal. Passage of the U.S. Healthcare Reform Bill (HR 3590) will probably increase the number of children with health insurance and improve these indicators.

  4. Sarcopenia and Health Care Utilization in Older Women

    Science.gov (United States)

    Lui, Li-Yung; McCulloch, Charles E.; Cauley, Jane A.; Paudel, Misti L.; Taylor, Brent; Schousboe, John T.; Ensrud, Kristine E.

    2017-01-01

    Background: Although there are several consensus definitions of sarcopenia, their association with health care utilization has not been studied. Methods: We included women from the prospective Study of Osteoporotic Fractures with complete assessment of sarcopenia by several definitions at the Study of Osteoporotic Fractures Year 10 (Y10) exam (1997–1998) who also had available data from Medicare Fee- For-Service Claims (N = 566) or Kaiser Encounter data (N = 194). Sarcopenia definitions evaluated were: International Working Group, European Working Group for Sarcopenia in Older Persons, Foundation for the NIH Sarcopenia Project, Baumgartner, and Newman. Hurdle models and logistic regression were used to assess the relation between sarcopenia status (the summary definition and the components of slowness, weakness and/or lean mass) and outcomes that included hospitalizations, cumulative inpatient days/year, short-term (part A paid) skilled nursing facility stay in the 3 years following the Y10 visit. Results: None of the consensus definitions, nor the definition components of weakness or low lean mass, was associated with increased risk of hospitalization or greater likelihood of short-term skilled nursing facility stay. Women with slowness by any criterion definition were about 50% more likely to be hospitalized; had a greater rate of hospitalization days amongst those hospitalized; and had 1.8 to 2.1 times greater likelihood of a short-term skilled nursing facility stay than women without slowness. There was the suggestion of a protective association of low lean mass by the various criterion definitions on short-term skilled nursing facility stay. Conclusion: Estimated effects of sarcopenia on health care utilization were negligible. However, slowness was associated with greater health care utilization. PMID:27402050

  5. Public Health Services Utilization and Its Determinants among Internal Migrants in China: Evidence from a Nationally Representative Survey.

    Science.gov (United States)

    Zhang, Jingya; Lin, Senlin; Liang, Di; Qian, Yi; Zhang, Donglan; Hou, Zhiyuan

    2017-09-01

    There have been obstacles for internal migrants in China in accessing local public health services for some time. This study aimed to estimate the utilization of local public health services and its determinants among internal migrants. Data were from the 2014 and 2015 nationally representative cross-sectional survey of internal migrants in China. Multivariate logistic regressions were used to estimate the relationship between socioeconomic, migration, and demographic characteristics and public health services utilization. Our results showed that internal migrants in more developed eastern regions used less public health services. Those with higher socioeconomic status were more likely to use public health services. The years of living in the city of residence were positively associated with the utilization of public health services. Compared to migration within the city, migration across provinces significantly reduced the probability of using health records (OR = 0.88, 95% CI: 0.86-0.90), health education (OR = 0.97, 95% CI: 0.94-1.00), and health education on non-communicable diseases (OR = 0.92, 95% CI: 0.89-0.95) or through the Internet (OR = 0.96, 95% CI: 0.94-0.99). This study concludes that public health services coverage for internal migrants has seen great improvement due to government subsidies. Internal migrants with lower socioeconomic status and across provinces need to be targeted. More attention should be given to the local government in the developed eastern regions in order to narrow the regional gaps.

  6. Physical therapists familiarity and beliefs about health services utilization and health seeking behaviour.

    Science.gov (United States)

    Clewley, Derek; Rhon, Dan; Flynn, Tim; Koppenhaver, Shane; Cook, Chad

    2018-02-21

    Physical therapists' familiarity, perceptions, and beliefs about health services utilization and health seeking behaviour have not been previously assessed. The purposes of this study were to identify physical therapists' characteristics related to familiarity of health services utilization and health seeking behaviour, and to assess what health seeking behaviour factors providers felt were related to health services utilization. We administered a survey based on the Andersen behavioural model of health services utilization to physical therapists using social media campaigns and email between March and June of 2017. In addition to descriptive statistics, we performed binomial logistic regression analysis. We asked respondents to rate familiarity with health services utilization and health seeking behaviour and collected additional characteristic variables. Physical therapists are more familiar with health services utilization than health seeking behaviour. Those who are familiar with either construct tend to be those who assess for health services utilization, use health services utilization for a prognosis, and believe that health seeking behaviour is measurable. Physical therapists rated need and enabling factors as having more influence on health services utilization than predisposing and health belief factors. Physical therapists are generally familiar with health services utilization and health seeking behaviour; however, there appears to be a disconnect between what is familiar, what is perceived to be important, and what can be assessed for both health services utilization and health seeking behaviour. Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. All rights reserved.

  7. Utilization Status of Electronic Information Sources (EIS) for HIV ...

    African Journals Online (AJOL)

    Tesfa

    HIV/AIDS Care and Treatment in Specialized Teaching Hospitals of. Ethiopia, 2016. Senait Samuel Bramo. 1. , Tesfamichael Alaro Agago. 2*. OPEN ACCESS. Citation: Senait Samuel Bramo,. Tesfamichael Alaro Agago. Utilization. Status of Electronic Information Sources. (EIS) for HIV/AIDS Care and Treatment.

  8. Effects of a consumer driven health plan on pharmaceutical spending and utilization.

    Science.gov (United States)

    Parente, Stephen T; Feldman, Roger; Chen, Song

    2008-10-01

    To compare pharmaceutical spending and utilization in a consumer driven health plan (CDHP) with a three-tier pharmacy benefit design, and to examine whether the CDHP creates incentives to reduce pharmaceutical spending and utilization for chronically ill patients, generic or brand name drugs, and mail-order drugs. Retrospective insurance claims analysis from a large employer that introduced a CDHP in 2001 in addition to a point of service (POS) plan and a preferred provider organization (PPO), both of which used a three-tier pharmacy benefit. Difference-in-differences regression models were estimated for drug spending and utilization. Control variables included the employee's income, age, and gender, number of covered lives per contract, election of flexible spending account, health status, concurrent health shock, cohort, and time trend. Results. CDHP pharmaceutical expenditures were lower than those in the POS cohort in 1 year without differences in the use of brand name drugs. We find limited evidence of less drug consumption by CDHP enrollees with chronic illnesses, and some evidence of less generic drug use and more mail-order drug use among CDHP members. The CDHP is cost-neutral or cost-saving to both the employer and the employee compared with three-tier benefits with no differences in brand name drug use. © Health Research and Educational Trust.

  9. The Influence of Individual and Contextual Socioeconomic Status on Obstetric Care Utilization in the Democratic Republic of Congo: A Population-based Study

    Directory of Open Access Journals (Sweden)

    Olatunde Aremu

    2012-01-01

    Full Text Available Background: Maternal health care utilization continues to focus on the agenda of health care planners around the world, with high attention being paid to the developing countries. The devastating effect of maternal death at birth on the affected families is untold. This study examines the utilization of obstetric care in the Democratic Republic of Congo. Methods: We have used the nationally representative data from the 2007. Democratic Republic of Congo Demographic and Health Survey. Multilevel regression analysis has been applied to a nationally representative sample of 6,695 women, clustered around 299 communities in the country. Results: The results show that there are variations in the use of antenatal care and delivery care. Individual-level characteristics, such as women′s occupation and household wealth status are shown to be associated with the use of antenatal care. Uptake of facility-based delivery has been seen to be dependent on the household wealth status, women′s education, and partner′s education. The effect of the neighborhoods′ socioeconomic disadvantage on the use of antenatal care and facility-based delivery are the same. Women from highly socioeconomically disadvantaged communities, compared to their counterparts from less socioeconomically disadvantaged neighborhoods, are less likely to utilize both the antenatal services and healthcare facility for child delivery. The result of this study has shown that both individual and contextual socioeconomic status play an important role in obstetric care uptake. Conclusion: Thus, intervention aimed at improving the utilization of obstetrics care should target both the individual economic abilities of the women and that of their environment when considering the demand side.

  10. Health Status and Health Care Experiences among Homeless Patients in Federally Supported Health Centers: Findings from the 2009 Patient Survey

    Science.gov (United States)

    Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen

    2013-01-01

    Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588

  11. Health status of Russian minorities in former Soviet Republics.

    Science.gov (United States)

    Groenewold, W G F; van Ginneken, J K

    2011-08-01

    To examine if, and to what extent, disparities in health status exist between ethnic Russians and the native majority populations of four former Soviet Republics; and to determine to what extent indicators of socio-economic status and lifestyle behaviours explain variations in health status. Data from the World Health Organization's World Health Surveys of former Soviet Republics that include information on ethnicity (i.e. Estonia, Latvia, Ukraine, Kazakhstan and Russia) were used. Russia was included as the benchmark population as it is the country of origin of ethnic Russians. Data were collected from respondents aged ≥25 years in 2001-2003. Principal component analysis was used to derive the Health Status Index and Household Wealth Index. Multiple classification analysis was applied to examine the effects of the determinants on health status, including ethnic group membership. In Estonia and Kazakhstan, ethnic Russians have, on average, a lower health status than members of the majority population, while their health status is higher in Ukraine. Higher levels of material wealth, educational attainment and physical activity were associated with a higher health status. The association of these variables with health status was often stronger than the association between ethnic group membership and health status. Differences in health status between Russian ethnic minorities and the majority populations were found in Estonia and Kazakhstan, but were non-existent in Latvia and were the opposite of what was expected in Ukraine. Use of the Health Status Index in combination with multiple classification analysis proved to be a useful approach to examine health status differentials, and to identify and profile vulnerable groups in a society. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. The relationship of five boarding school experiences and physical health status among Northern Plains Tribes.

    Science.gov (United States)

    Running Bear, Ursula; Croy, Calvin D; Kaufman, Carol E; Thayer, Zaneta M; Manson, Spero M

    2018-01-01

    American Indian (AI) boarding school attendance is related to poor physical health status; however, little is known about how specific aspects of this experience contribute to poor health. Five experiences (age of first attendance, limited family visits, forced church attendance, prohibition on practicing AI culture and traditions, and punishment for use of AI language) may be independently associated with physical health status in adulthood. We expected the effect to be greater for those who began boarding school at older ages. Data on AI boarding school attenders (n = 771) came from the AI-Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project. Multiple linear regression models examined the association of these five experiences with physical health status. Additionally, we conducted a separate set of regressions to test for an interaction effect of age of first attendance. Each of the five experiences noted above were independently associated with poorer physical health status compared to those who did not have these experiences. An interaction effect for those punished for use of AI language and who were aged 8 or older was confirmed. Findings are consistent with reports that boarding school attendance is related to poor AI adult health. To inform AI health programs, the relationship of specific diseases and boarding school attendance should be considered.

  13. Determinants of Subjective Social Status and Health Among Latin American Women Immigrants in Spain: A Qualitative Approach.

    Science.gov (United States)

    Sanchón-Macias, Ma Visitación; Bover-Bover, Andreu; Prieto-Salceda, Dolores; Paz-Zulueta, María; Torres, Blanca; Gastaldo, Denise

    2016-04-01

    This qualitative study was carried out to better understand factors that determine the subjective social status of Latin Americans in Spain. The study was conducted following a theoretical framework and forms part of broader study on subjective social status and health. Ten immigrant participants engaged in semi-structured interviews, from which data were collected. The study results show that socioeconomic aspects of the crisis and of policies adopted have shaped immigrant living conditions in Spain. Four major themes that emerged from the analysis were related to non-recognition of educational credentials, precarious working conditions, unemployment and loneliness. These results illustrate the outcomes of current policies on health and suggest a need for health professionals to orient practices toward social determinants, thus utilizing evaluations of subjective social status to reduce inequalities in health.

  14. The utility of health and wealth.

    Science.gov (United States)

    Levy, Moshe; Nir, Adi Rizansky

    2012-03-01

    Tradeoffs between health and wealth are among the most important decisions individuals make, and are central to social and economic policy. Yet, only a few studies have investigated the utility of health and wealth empirically. This paper investigates this utility function both theoretically and empirically. We conduct detailed personal interviews with 180 cancer patients, and also obtain questionnaires from 132 diabetes patients. We find strong support for the utility function U(h, w)=h·log(w), where h denotes health and w denotes wealth. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Does health status influence intention regarding screening mammography?

    International Nuclear Information System (INIS)

    Park, Keeho; Park, Jong-Hyock; Park, Jae-Hyun; Kim, Hui-Jeong; Park, Bo-Yoon

    2010-01-01

    We analyzed information surveyed from a community-based sample of Korean women older than 40 years of age to understand the relationships between health status and screening behavior. In a cross-sectional population-based study, a two-stage, geographically stratified household-based sampling design was used for assembly of a probability sample of women aged 40-69 years living in Gunpo in Korea, resulting in a total sample size of 503 women. The primary outcome variable for this analysis was the respondent's intention to obtain a mammogram. Predictor variables included health status and other factors known to influence the use of cancer screening, such as age, education, income, marital status and the presence of co-morbid illnesses. Health status was assessed by using the EuroQol (EQ-5D). The median EQ visual analogue scale score was 75.0, ranging from 20 to 100. In bivariate analyses, the percentage of women reporting to have intention toward mammography use decreased with worsening health status. Women who had problems with mobility or anxiety/depression showed lower intention to undergo future screening mammography. Multivariate logistic regression confirmed that health status was significantly associated with intention toward mammography use. Anxiety or depression was an independent predictor of future screening mammography use. Health status is significantly associated with intention regarding screening mammography use. Physicians or other health professionals should be aware that health status is an important component for health promotion, and should pay more attention to clients' possible vulnerability in screening mammography use due to their poor health status. (author)

  16. Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese

    Directory of Open Access Journals (Sweden)

    Yong-Bing Liu

    2015-08-01

    Full Text Available Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008 and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452. Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points. There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001. The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001. The elderly with higher health literacy scores were significantly less likely to have risky behaviors

  17. The effects of citizenship status on service utilization and general satisfaction with healthcare: a cross-cultural study

    OpenAIRE

    Khaled, Salama M.; Shockley, Bethany; Abdul Rahim, Hanan F.

    2016-01-01

    Objective: To explore the role of citizenship status as a predictor of general satisfaction with healthcare services in Qatar, including potential interaction with utilization and health insurance coverage type. Design: A cross-sectional survey conducted in 2012. Setting: A household survey in the State of Qatar in the Arab Gulf. Participants: A nationally representative sample of 2750 citizens and noncitizens aged 18 years and older. Main Outcome: General satisfaction st...

  18. Decoupling social status and status certainty effects on health in macaques: a network approach

    Directory of Open Access Journals (Sweden)

    Jessica J. Vandeleest

    2016-09-01

    Full Text Available Background Although a wealth of literature points to the importance of social factors on health, a detailed understanding of the complex interplay between social and biological systems is lacking. Social status is one aspect of social life that is made up of multiple structural (humans: income, education; animals: mating system, dominance rank and relational components (perceived social status, dominance interactions. In a nonhuman primate model we use novel network techniques to decouple two components of social status, dominance rank (a commonly used measure of social status in animal models and dominance certainty (the relative certainty vs. ambiguity of an individual’s status, allowing for a more complex examination of how social status impacts health. Methods Behavioral observations were conducted on three outdoor captive groups of rhesus macaques (N = 252 subjects. Subjects’ general physical health (diarrhea was assessed twice weekly, and blood was drawn once to assess biomarkers of inflammation (interleukin-6 (IL-6, tumor necrosis factor-alpha (TNF-α, and C-reactive protein (CRP. Results Dominance rank alone did not fully account for the complex way that social status exerted its effect on health. Instead, dominance certainty modified the impact of rank on biomarkers of inflammation. Specifically, high-ranked animals with more ambiguous status relationships had higher levels of inflammation than low-ranked animals, whereas little effect of rank was seen for animals with more certain status relationships. The impact of status on physical health was more straightforward: individuals with more ambiguous status relationships had more frequent diarrhea; there was marginal evidence that high-ranked animals had less frequent diarrhea. Discussion Social status has a complex and multi-faceted impact on individual health. Our work suggests an important role of uncertainty in one’s social status in status-health research. This work also

  19. Neighborhood socioeconomic status, depression, and health status in the Look AHEAD (Action for health in diabetes) study

    Science.gov (United States)

    Depression and diminished health status are common in adults with diabetes, but few studies have investigated associations with socio-economic environment. The objective of this manuscript was to evaluate the relationship between neighborhood-level SES and health status and depression. Individual-le...

  20. Multiattribute health utility scoring for the computerized adaptive measure CAT-5D-QOL was developed and validated.

    Science.gov (United States)

    Kopec, Jacek A; Sayre, Eric C; Rogers, Pamela; Davis, Aileen M; Badley, Elizabeth M; Anis, Aslam H; Abrahamowicz, Michal; Russell, Lara; Rahman, Md Mushfiqur; Esdaile, John M

    2015-10-01

    The CAT-5D-QOL is a previously reported item response theory (IRT)-based computerized adaptive tool to measure five domains (attributes) of health-related quality of life. The objective of this study was to develop and validate a multiattribute health utility (MAHU) scoring method for this instrument. The MAHU scoring system was developed in two stages. In phase I, we obtained standard gamble (SG) utilities for 75 hypothetical health states in which only one domain varied (15 states per domain). In phase II, we obtained SG utilities for 256 multiattribute states. We fit a multiplicative regression model to predict SG utilities from the five IRT domain scores. The prediction model was constrained using data from phase I. We validated MAHU scores by comparing them with the Health Utilities Index Mark 3 (HUI3) and directly measured utilities and by assessing between-group discrimination. MAHU scores have a theoretical range from -0.842 to 1. In the validation study, the scores were, on average, higher than HUI3 utilities and lower than directly measured SG utilities. MAHU scores correlated strongly with the HUI3 (Spearman ρ = 0.78) and discriminated well between groups expected to differ in health status. Results reported here provide initial evidence supporting the validity of the MAHU scoring system for the CAT-5D-QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Financial costs due to excess health risks among active employees of a utility company.

    Science.gov (United States)

    Yen, Louis; Schultz, Alyssa; Schnueringer, Elaine; Edington, Dee W

    2006-09-01

    The objective of this study was to examine the health risk-related excess costs of time away from work, medical claims, pharmacy claims, and total costs with and without considering the prevalence of health risks. A total of 2082 of 4266 employees of a Midwest utility participated in a health risk appraisal (HRA). Individuals were classified by their HRA participation status and also by 15 health risks. Total and excess costs were analyzed for all employees. There were significant excess costs due to individual risks and overall excess health risks in all cost measures. Both excess cost per risk and prevalence of the risk were important factors in determining the excess costs in the population. As compared with low-risk participants, HRA nonparticipants and the medium- and high-risk participants were 1.99, 2.22, and 3.97 times more likely to be high cost status. Approximately one third of corporate costs in medical claims, pharmacy claims, and time away from work could be defined as excess costs associated with excess health risks.

  2. Dental health status and oral health behavior among university students from five ASEAN countries.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa

    2017-02-01

    The aim of this study was to investigate dental health status and oral health behavior and associated factors among university students in five ASEAN countries (Indonesia, Malaysia, Myanmar, Thailand and Vietnam). Using anonymous questionnaires, data were collected from 3,344 undergraduate university students (mean age 20.5, SD=1.6; 58.3% female) from five ASEAN countries. Results indicate that 27.7% of students reported to have sometimes, most of the time or always having tooth ache in the past 12 months, 39.4% reported to have one or more cavities, 20.3% did not brush their teeth twice or more times a day, and 30.9% had never been to a dentist (or did not know it). In multivariate logistic regression analysis, older age, living in a lower middle income country, consumption of chocolate or candy, having made a dental care visit, and poor mental health was associated with tooth ache in the past 12 months. Being male, being 20 to 21 years old, coming from a wealthier family background, living in a lower middle income country, frequent consumption of soft drinks, not having consulted with a dentist in the past 12 months and weak beliefs in the benefits of tooth brushing were associated with inadequate tooth brushing frequency (health status and oral health behaviors were found and various risk factors identified that can be utilized to guide interventions to improve oral health programs among university students.

  3. Health Status Measurement Instruments in Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Yves Lacasse

    1997-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is associated with primary respiratory impairment, disability and handicap, as well as with secondary impairments not necessarily confined to the respiratory system. Because the primary goals of managing patients with COPD include relief of dyspnea and the improvement of health-related quality of life (HRQL, a direct measurement of HRQL is important. Fourteen disease-specific and nine generic questionnaires (four health profiles and five utility measures most commonly used to measure health status in patients with COPD were reviewed. The measures were classified according to their domain of interest, and their measurement properties - specifications, validity, reliability, responsiveness and interpretability - were described. This review suggests several findings. Currently used health status instruments usually refer to the patients’ perception of performance in three major domains of HRQL - somatic sensation, physical and occupational function, and psychological state. The choice of a questionnaire must be related to its purpose, with a clear distinction being made between its evaluative and discriminative function. In their evaluative function, only a few instruments fulfilled the criteria of responsiveness, and the interpretability of most questionnaires is limited. Generic questionnaires should not be used alone in clinical trials as evaluative instruments because of their inability to detect change over time. Further validation and improved interpretability of existing instruments would be of greater benefit to clinicians and scientists than the development of new questionnaires.

  4. Status and prospects of radioisotope supply and utilization in Canada

    International Nuclear Information System (INIS)

    Ratz, R.G.

    1982-01-01

    The status and prospects of radioisotope utilization in Canada was reviewed. It consisted of the history of 60 Co utilization in the past 30-year period and the increase in the annual export of 60 Co in a period 1965-80 and the areas of utilization, such as food irradiation, radiation treatment of human and animal waste, and radiation inactivation of bacteria and viruses in the bioeffluent. The progress of application to nuclear medicine was described in reference to the use of RI including 60 Co and recently developed Canadian positron ECT and Therascan 3128. (Chiba, N.)

  5. Health-related quality of life of cataract patients: cross-cultural comparisons of utility and psychometric measures.

    Science.gov (United States)

    Lee, Jae Eun; Fos, Peter J; Zuniga, Miguel A; Kastl, Peter R; Sung, Jung Hye

    2003-07-01

    This study was conducted to assess the presence and/or absence of cross-cultural differences or similarities between Korean and United States cataract patients. A systematic assessment was performed using utility and psychometric measures in the study population. A cross-sectional study design was used to examine the comparison of preoperative outcomes measures in cataract patients in Korea and the United States. Study subjects were selected using non-probabilistic methods and included 132 patients scheduled for cataract surgery in one eye. Subjects were adult cataract patients at Samsung and Kunyang General Hospital in Seoul, Korea, and Tulane University Hospital and Clinics in New Orleans, Louisiana. Preoperative utility was assessed using the verbal rating scale and standard reference gamble techniques. Current preoperative health status was assessed using the SF-36 and VF-14 surveys. Current preoperative Snellen visual acuity was used as a clinical measure of vision status. Korean patients were more likely to be younger (p = 0.001), less educated (p = 0.001), and to have worse Snellen visual acuity (p = 0.002) than United States patients. Multivariate analysis of variance (MANOVA) revealed that in contrast to Korean patients, United States patients were assessed to have higher scoring in general health, vitality, VF-14, and verbal rating for visual health. This higher scoring trend persisted after controlling for age, gender, education and Snellen visual acuity. The difference in health-related quality of life (HRQOL) between the two countries was quite clear, especially in the older age and highly educated group. Subjects in Korea and the United States were significantly different in quality of life, functional status and clinical outcomes. Subjects in the United States had more favorable health outcomes than those in Korea. These differences may be caused by multiple factors, including country-specific differences in economic status, health care system

  6. Variations in health status within and between socioeconomic strata

    OpenAIRE

    Ferrer, R; Palmer, R

    2004-01-01

    Objectives: To analyse the variability in health status within as well as between socioeconomic groups. What is the range of individual variability in the health effects of socioeconomic status? Is the adverse effect of lower socioeconomic status uniform across the entire distribution of health status?

  7. The current status of utilization of research reactors in China

    International Nuclear Information System (INIS)

    Luzheng, Yuan

    2004-01-01

    Seminars on utilization of research reactors were held to enhance experience exchanging among institutes and universities in China. The status of CARR (China Advanced Research Reactor) project is briefly described. The progress in BNCT program in China is introduced. (author)

  8. Marital status, health and mortality.

    Science.gov (United States)

    Robards, James; Evandrou, Maria; Falkingham, Jane; Vlachantoni, Athina

    2012-12-01

    Marital status and living arrangements, along with changes in these in mid-life and older ages, have implications for an individual's health and mortality. Literature on health and mortality by marital status has consistently identified that unmarried individuals generally report poorer health and have a higher mortality risk than their married counterparts, with men being particularly affected in this respect. With evidence of increasing changes in partnership and living arrangements in older ages, with rising divorce amongst younger cohorts offsetting the lower risk of widowhood, it is important to consider the implications of such changes for health in later life. Within research which has examined changes in marital status and living arrangements in later life a key distinction has been between work using cross-sectional data and that which has used longitudinal data. In this context, two key debates have been the focus of research; firstly, research pointing to a possible selection of less healthy individuals into singlehood, separation or divorce, while the second debate relates to the extent to which an individual's transitions earlier in the life course in terms of marital status and living arrangements have a differential impact on their health and mortality compared with transitions over shorter time periods. After reviewing the relevant literature, this paper argues that in order to fully account for changes in living arrangements as a determinant of health and mortality transitions, future research will increasingly need to consider a longer perspective and take into account transitions in living arrangements throughout an individual's life course rather than simply focussing at one stage of the life course. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. The impact of smoking status on the health status of heart failure patients.

    LENUS (Irish Health Repository)

    Conard, Mark W

    2012-02-01

    Smoking is a major risk factor for the development of heart failure (HF). Yet, little is known about smoking\\'s effects on the health status of established HF patients. HF patients were recruited from outpatient clinics across North America. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was used to assess disease-specific health status. Smoking behaviors were classified as never having smoked, prior smoker, and as having smoked within the past 30 days. Risk-adjusted multivariable regression was used to evaluate the association of smoking status with baseline and 1-year KCCQ overall summary scores. Smoking was not associated with baseline health status. However, a significant effect was observed on 1-year health status among outpatients with HF with current smokers reporting significantly lower KCCQ scores than never smokers or ex-smokers. These findings highlight an additional adverse consequence of smoking in HF patients not previously discussed.

  10. Estimating health state utility values for comorbid health conditions using SF-6D data.

    Science.gov (United States)

    Ara, Roberta; Brazier, John

    2011-01-01

    When health state utility values for comorbid health conditions are not available, data from cohorts with single conditions are used to estimate scores. The methods used can produce very different results and there is currently no consensus on which is the most appropriate approach. The objective of the current study was to compare the accuracy of five different methods within the same dataset. Data collected during five Welsh Health Surveys were subgrouped by health status. Mean short-form 6 dimension (SF-6D) scores for cohorts with a specific health condition were used to estimate mean SF-6D scores for cohorts with comorbid conditions using the additive, multiplicative, and minimum methods, the adjusted decrement estimator (ADE), and a linear regression model. The mean SF-6D for subgroups with comorbid health conditions ranged from 0.4648 to 0.6068. The linear model produced the most accurate scores for the comorbid health conditions with 88% of values accurate to within the minimum important difference for the SF-6D. The additive and minimum methods underestimated or overestimated the actual SF-6D scores respectively. The multiplicative and ADE methods both underestimated the majority of scores. However, both methods performed better when estimating scores smaller than 0.50. Although the range in actual health state utility values (HSUVs) was relatively small, our data covered the lower end of the index and the majority of previous research has involved actual HSUVs at the upper end of possible ranges. Although the linear model gave the most accurate results in our data, additional research is required to validate our findings. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. A Cross-Sectional Study to Examine Factors Associated with Primary Health Care Service Utilization among Older Adults in the Irbid Governorate of Jordan

    Directory of Open Access Journals (Sweden)

    Abdullah Alkhawaldeh

    2014-01-01

    Full Text Available Background. Recently, the percentage of older adults in developing countries has increased significantly. Objective. This study examined patterns and factors associated with primary health care services utilization in the past 1, 6, and 12 months. Method. A cross-sectional study design was used to collect data from 190 older adults in the Irbid governorate of Jordan. Results. Primary health care services were used by less than half of the participants in the past 1 month, by 68.4% in the past 6 months, and by 73.8% in the past 12 months. Primary health care (PHC services use was associated with age, education level, tobacco use, chronic illnesses, perceived general health status today, a physical component summary score, employment, and perceived general health status in the past 6 and 12 months. The primary predictor of PHC services use at 1, 6, and 12 months was chronic illnesses (OR=13.32, (OR=19.63, and (OR=17.91, respectively. Conclusion. Although many factors were associated with PHC service utilization, the strongest predictor of PHC service utilization was chronic illnesses.

  12. Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian Demographic and Health Survey.

    Science.gov (United States)

    Tarekegn, Shegaw Mulu; Lieberman, Leslie Sue; Giedraitis, Vincentas

    2014-05-07

    health service utilization in Ethiopia is very low. Socio-demographic and accessibility related factors are major determinants of service utilization. There is a high inequality in service utilization among women with differences in education, household wealth, autonomy and residence. ANC is an important entry point for subsequent use of delivery and PNC services. Strategies that aim improving maternal health service utilization should target improvement of education, economic status and empowerment of women.

  13. Socioeconomic status and health of immigrants.

    Science.gov (United States)

    Vacková, Jitka; Brabcová, Iva

    2015-01-01

    The aim of this article is to acquaint the general public with select socioeconomic status (SES) parameters (type of work, education level, employment category, and net monthly income) of select nationalities (Ukrainians, Slovaks, Vietnamese, Poles, and Russians) from a total of 1,014 immigrants residing in the Czech Republic. It will also present a subjective assessment of socioeconomic status and its interconnection with subjective assessment of health status. This work was carried out as part of the "Social determinants and their impact on the health of immigrants living in the Czech Republic" project (identification number LD 13044), which was conducted under the auspices of the European Cooperation in Science and Technology (COST) agency. Quantitative methodology in the form of a questionnaire was selected to facilitate the research aim. Data was processed using the Statistical Package for Social Sciences (SPSS), version 16.0 (SPSS, Inc., Chicago, IL, USA). Statistical analyses were performed using the Pearson chi-square test, adjusted residual analysis, and multivariate correspondence analysis. The results of these tests demonstrated a statistically significant relationship between subjective assessments of socioeconomic status and the following related select characteristics: type of work performed (manual/intellectual), employment categories, education, and net monthly income. Results indicate that those situated lowest on the socioeconomic ladder feel the poorest in terms of health; not only from a subjective perspective, but also in terms of objective parameter comparisons (e.g. manual laborers who earn low wages). As the level of subjective SES assessment increases, the level of subjective health assessment increases, as well. Thus, the relationship has a natural gradient, as was described by Wilkinson and Marmot in 2003. Our study found no evidence of a healthy immigrant effect. Therefore, it was not possible to confirm that health status deteriorates

  14. SUBJECTIVE SOCIOECONOMIC STATUS AND HEALTH: RELATIONSHIPS RECONSIDERED

    Science.gov (United States)

    Nobles, Jenna; Ritterman Weintraub, Miranda; Adler, Nancy

    2013-01-01

    Subjective status, an individual’s perception of her socioeconomic standing, is a robust predictor of physical health in many societies. To date, competing interpretations of this correlation remain unresolved. Using longitudinal data on 8,430 older adults from the 2000 and 2007 waves of the Indonesia Family Life Survey, we test these oft-cited links. As in other settings, perceived status is a robust predictor of self-rated health, and also of physical functioning and nurse-assessed general health. These relationships persist in the presence of controls for unobserved traits, such as difficult-to-measure aspects of family background and persistent aspects of personality. However, we find evidence that these links likely represent bi-directional effects. Declines in health that accompany aging are robust predictors of declines in perceived socioeconomic status, net of observed changes to the economic profile of respondents. The results thus underscore the social value afforded good health status. PMID:23453318

  15. Demand for Health Care Services and Child Health Status in Nigeria ...

    African Journals Online (AJOL)

    Toshiba

    poverty aside from physical capital (Strauss J and Thomas D, 1998). ... factors on health status of children across poverty groups and sector. ...... Decomposing Inequalities in Nutritional Status of ... The causal effect of health on social and.

  16. Gender differences in the utilization of health-care services among the older adult population of Spain

    Directory of Open Access Journals (Sweden)

    Banegas José

    2006-06-01

    Full Text Available Abstract Background Compared to men, women report greater morbidity and make greater use of health-care services. This study examines potential determinants of gender differences in the utilization of health-care services among the elderly. Methods Cross-sectional study covering 3030 subjects, representative of the non-institutionalized Spanish population aged 60 years and over. Potential determinants of gender differences in the utilization of health services were classified into predisposing factors (age and head-of-family status, need factors (lifestyles, chronic diseases, functional status, cognitive deficit and health-related quality of life (HRQL and enabling factors (educational level, marital status, head-of-family employment status and social network. Relative differences in the use of each service between women and men were summarized using odds ratios (OR, obtained from logistic regression. The contribution of the variables of interest to the gender differences in the use of such services was evaluated by comparing the OR before and after adjustment for such variables. Results As compared to men, a higher percentage of women visited a medical practitioner (OR: 1.24; 95% confidence limits (CL: 1.07–1.44, received home medical visits (OR: 1.67; 95% CL: 1.34–2.10 and took ≥3 medications (OR: 1.54; 95% CL: 1.34–1.79, but there were no gender differences in hospital admission or influenza vaccination. Adjustment for need or enabling factors led to a reduction in the OR of women compared to men for utilization of a number of services studied. On adjusting for the number of chronic diseases, the OR (95% CL of women versus men for ingestion of ≥3 medications was 1.24 (1.06–1.45. After adjustment for HRQL, the OR was 1.03 (0.89–1.21 for visits to medical practitioners, 1.24 (0.98–1.58 for home medical visits, 0.71 (0.58–0.87 for hospitalization, and 1.14 (0.97–1.33 for intake of ≥3 medications. After adjustment for the

  17. Mothers' health services utilization and health care seeking ...

    African Journals Online (AJOL)

    Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...

  18. Access to health care in relation to socioeconomic status in the Amazonian area of Peru

    DEFF Research Database (Denmark)

    Kristiansson, Charlotte; Gotuzzo, Eduardo; Rodriguez, Hugo

    2009-01-01

    ABSTRACT: BACKGROUND: Access to affordable health care is limited in many low and middle income countries and health systems are often inequitable, providing less health services to the poor who need it most. The aim of this study was to investigate health seeking behavior and utilization of drug...... be indicated. Caregivers frequently paid for health services as well as antibiotics, even though all children in the study qualified for free health care and medicines. The implementation of the Seguro Integral de Salud health insurance must be improved.......ABSTRACT: BACKGROUND: Access to affordable health care is limited in many low and middle income countries and health systems are often inequitable, providing less health services to the poor who need it most. The aim of this study was to investigate health seeking behavior and utilization of drugs...... in Yurimaguas and 793 children of the same age in Moyobamba were included in the study. Caregivers were interviewed on health care seeking strategies (public/private sectors; formal/informal providers), and medication for their children in relation to reported symptoms and socio-economic status. Self...

  19. Obesity, health-care utilization, and health-related quality of life after fracture in postmenopausal women: Global Longitudinal Study of Osteoporosis in Women (GLOW).

    Science.gov (United States)

    Compston, Juliet E; Flahive, Julie; Hooven, Frederick H; Anderson, Frederick A; Adachi, Jonathan D; Boonen, Steven; Chapurlat, Roland D; Cooper, Cyrus; Díez-Perez, Adolfo; Greenspan, Susan L; LaCroix, Andrea Z; Lindsay, Robert; Netelenbos, J Coen; Pfeilschifter, Johannes; Roux, Christian; Saag, Kenneth G; Silverman, Stuart; Siris, Ethel S; Watts, Nelson B; Gehlbach, Stephen H

    2014-02-01

    Fractures may be associated with higher morbidity in obese postmenopausal women than in nonobese women. We compared health-care utilization, functional status, and health-related quality of life (HRQL) in obese, nonobese, and underweight women with fractures. Information from the GLOW study, started in 2006, was collected at baseline and at 1, 2, and 3 years. In this subanalysis, self-reported incident clinical fractures, health-care utilization, HRQL, and functional status were recorded and examined. Women in GLOW (n = 60,393) were aged ≥55 years, from 723 physician practices at 17 sites in 10 countries. Complete data for fracture and body mass index were available for 90 underweight, 3,270 nonobese, and 941 obese women with one or more incident clinical fractures during the 3-year follow-up. The median hospital length of stay, adjusted for age, comorbidities, and fracture type, was significantly greater in obese than nonobese women (6 vs. 5 days, p = 0.017). Physical function and vitality score were significantly worse in obese than in nonobese women, both before and after fracture; but changes after fracture were similar across groups. Use of antiosteoporosis medication was significantly lower in obese than in nonobese or underweight women. In conclusion, obese women with fracture undergo a longer period of hospitalization for treatment and have poorer functional status and HRQL than nonobese women. Whether these differences translate into higher economic costs and adverse effects on longer-term outcomes remains to be established.

  20. Assessment of health care needs and utilization in a mixed public-private system: the case of the Athens area

    Directory of Open Access Journals (Sweden)

    Niakas Dimitris

    2006-11-01

    Full Text Available Abstract Background Given the public-private mix of the Greek health system, the purpose of this study was to assess whether variations in the utilisation of health services, both primary and inpatient care, were associated with underlying health care needs and/or various socio-economic factors. Methods Data was obtained from a representative sample (N = 1426 residing in the broader Athens area (response rate 70.6%. Perceived health-related quality of life (HRQOL, as measured by the physical and mental summary component scores of the SF-36 Health Survey, was used as a proxy of health care need. Health care utilization was measured by a last-month visits to public sector physicians, b last-month visits to private sector physicians, c last-year visits to hospital emergency departments and d last-year hospital admissions. Statistical analysis involved the implementation of logistic regression models. Results Health care need was the factor most strongly associated with all measures of health care utilization, except for visits to public physicians. Women, elderly, less wealthy and individuals of lower physical health status visited physicians contracted to their insurance fund (public sector. Women, well educated and those once again of lower physical health status were more likely to visit private providers. Visits to hospital emergency departments and hospital admissions were related to need and no socio-economic factor was related to the use of those types of care. Conclusion This study has demonstrated a positive relationship between health care need and utilisation of health services within a mixed public-private health care system. Concurrently, interesting differences are evident in the utilization of various types of services. The results have potential implications in health policy-making and particularly in the proper allocation of scarce health resources.

  1. Assessment of health care needs and utilization in a mixed public-private system: the case of the Athens area.

    Science.gov (United States)

    Pappa, Evelina; Niakas, Dimitris

    2006-11-02

    Given the public-private mix of the Greek health system, the purpose of this study was to assess whether variations in the utilisation of health services, both primary and inpatient care, were associated with underlying health care needs and/or various socio-economic factors. Data was obtained from a representative sample (N = 1426) residing in the broader Athens area (response rate 70.6%). Perceived health-related quality of life (HRQOL), as measured by the physical and mental summary component scores of the SF-36 Health Survey, was used as a proxy of health care need. Health care utilization was measured by a) last-month visits to public sector physicians, b) last-month visits to private sector physicians, c) last-year visits to hospital emergency departments and d) last-year hospital admissions. Statistical analysis involved the implementation of logistic regression models. Health care need was the factor most strongly associated with all measures of health care utilization, except for visits to public physicians. Women, elderly, less wealthy and individuals of lower physical health status visited physicians contracted to their insurance fund (public sector). Women, well educated and those once again of lower physical health status were more likely to visit private providers. Visits to hospital emergency departments and hospital admissions were related to need and no socio-economic factor was related to the use of those types of care. This study has demonstrated a positive relationship between health care need and utilisation of health services within a mixed public-private health care system. Concurrently, interesting differences are evident in the utilization of various types of services. The results have potential implications in health policy-making and particularly in the proper allocation of scarce health resources.

  2. Subjective social status and health.

    Science.gov (United States)

    Euteneuer, Frank

    2014-09-01

    Subjective social status (SSS) predicts health outcomes above and beyond traditional objective measures of social status, such as education, income and occupation. This review summarizes and integrates recent findings on SSS and health. Current studies corroborate associations between low SSS and poor health indicators by extending previous findings to further populations and biological risk factors, providing meta-analytic evidence for adolescents and by demonstrating that negative affect may not confound associations between SSS and self-rated health. Recent findings also highlight the relevance of SSS changes (e.g. SSS loss in immigrants) and the need to consider cultural/ethnical differences in psychological mediators and associations between SSS and health. SSS is a comprehensive measure of one's social position that is related to several poor health outcomes and risk factors for disease. Future investigation, particularly prospective studies, should extend research on SSS and health to further countries/ethnic groups, also considering additional psychological and biological mediators and dynamic aspects of SSS. Recently developed experimental approaches to manipulate SSS may also be promising.

  3. The impact of migraine on health status

    NARCIS (Netherlands)

    Essink-Bot, M L; van Royen, L; Krabbe, P; Bonsel, G J; Rutten, F F

    PROBLEMS: What is the effect of migraine on health status, defined as the patient's physical, psychological, and social functioning? And, suppose that the health status of migraine sufferers appears to be impaired, to what extent is this a consequence of migraine-associated comorbidity rather than

  4. The impact of migraine on health status

    NARCIS (Netherlands)

    Essink-Bot, M. L.; van Royen, L.; Krabbe, P.; Bonsel, G. J.; Rutten, F. F.

    1995-01-01

    PROBLEMS--What is the effect of migraine on health status, defined as the patient's physical, psychological, and social functioning? And, suppose that the health status of migraine sufferers appears to be impaired, to what extent is this a consequence of migraine-associated comorbidity rather than

  5. A systematic review of health status, health seeking behaviour and healthcare utilisation of low socioeconomic status populations in urban Singapore.

    Science.gov (United States)

    Chan, Catherine Qiu Hua; Lee, Kheng Hock; Low, Lian Leng

    2018-04-02

    It is well-established that low socioeconomic status (SES) influences one's health status, morbidity and mortality. Housing type has been used as an indicator of SES and social determinant of health in some studies. In Singapore, home ownership is among the highest in the world. Citizens who have no other housing options are offered heavily subsidised rental housings. Residents staying in such rental housings are characterised by low socioeconomic status. Our aim is to review studies on the association between staying in public rental housing in Singapore and health status. A PubMed and Scopus search was conducted in January 2017 to identify suitable articles published from 1 January 2000 to 31 January 2017. Only studies that were done on Singapore public rental housing communities were included for review. A total of 14 articles including 4 prospective studies, 8 cross-sectional studies and 2 retrospective cohort studies were obtained for the review. Topics addressed by these studies included: (1) Health status; (2) Health seeking behaviour; (3) Healthcare utilisation. Staying in public rental housing was found to be associated with poorer health status and outcomes. They had lower participation in health screening, preferred alternative medicine practitioners to western-trained doctors for primary care, and had increased hospital utilisation. Several studies performed qualitative interviews to explore the causes of disparity and concern about cost was one of the common cited reason. Staying in public rental housing appears to be a risk marker of poorer health and this may have important public health implications. Understanding the causes of disparity will require more qualitative studies which in turn will guide interventions and the evaluation of their effectiveness in improving health outcome of this sub-population of patients.

  6. Relationships among veteran status, gender, and key health indicators in a national young adult sample.

    Science.gov (United States)

    Grossbard, Joel R; Lehavot, Keren; Hoerster, Katherine D; Jakupcak, Matthew; Seal, Karen H; Simpson, Tracy L

    2013-06-01

    Although many risk behaviors peak during young adulthood, little is known about health risk factors and access to care. This study assessed health indicators and health care access in a national sample of young adult veterans and civilians. Data were from the 2010 Behavioral Risk Factor Surveillance System, a national telephone survey. Of 27,471 participants, ages 19-30 years, 2.2% were veterans (74.6% were male) and 97.7% were civilians (37.6% were male). Gender-stratified comparisons assessed health indicators and health care access by veteran status. Multivariate logistic regression was used to examine health indicators and health care access as a function of gender and veteran status. In the overall sample, women were more likely than men to have insurance, to have a regular physician, and to have had a routine checkup and yet were more likely to report financial barriers to care. Women also were more likely than men to report general medical and mental distress and higher lifetime anxiety and depressive disorders, whereas men were more likely to be overweight or obese and to report tobacco use and high-risk drinking. Adjusted analyses revealed a higher likelihood of general medical distress and higher rates of lifetime anxiety disorders among veterans compared with civilians, although there were no differences between veterans and civilians regarding health care utilization and hazardous drinking. Findings extend the literature on health care status and modifiable risk factors for young adults by identifying differences between men and women and between veterans and civilians. Interventions may need to be tailored on the bases of gender and veteran status because of several differences in mental health and general health needs.

  7. Availability and utilization of health data among council health ...

    African Journals Online (AJOL)

    Availability and utilization of health data among council health management teams for health care ... Open Access DOWNLOAD FULL TEXT ... The study focused on knowledge, and skills in data analysis, the level at which ... If this phenomena is not immidiately addressed Health Care Planning will not meet intended results.

  8. Describing the population health burden of depression: health-adjusted life expectancy by depression status in Canada

    Directory of Open Access Journals (Sweden)

    C. Steensma

    2016-10-01

    Full Text Available Introduction: Few studies have evaluated the impact of depression in terms of losses to both premature mortality and health-related quality of life (HRQOL on the overall population. Health-adjusted life expectancy (HALE is a summary measure of population health that combines both morbidity and mortality into a single summary statistic that describes the current health status of a population. Methods: We estimated HALE for the Canadian adult population according to depression status. National Population Health Survey (NPHS participants 20 years and older (n = 12 373 were followed for mortality outcomes from 1994 to 2009, based on depression status. Depression was defined as having likely experienced a major depressive episode in the previous year as measured by the Composite International Diagnostic Interview Short Form. Life expectancy was estimated by building period abridged life tables by sex and depression status using the relative risks of mortality from the NPHS and mortality data from the Canadian Chronic Disease Surveillance System (2007-2009. The Canadian Community Health Survey (2009/10 provided estimates of depression prevalence and Health Utilities Index as a measure of HRQOL. Using the combined mortality, depression prevalence and HRQOL estimates, HALE was estimated for the adult population according to depression status and by sex. Results: For the population of women with a recent major depressive episode, HALE at 20 years of age was 42.0 years (95% CI: 40.2-43.8 compared to 57.0 years (95% CI: 56.8-57.2 for women without a recent major depressive episode. For the population of Canadian men, HALE at 20 was 39.0 years (95% CI: 36.5-41.5 for those with a recent major depressive episode compared to 53.8 years (95% CI: 53.6-54.0 for those without. For the 15.0-year difference in HALE between women with and without depression, 12.3 years can be attributed to the HRQOL gap and the remaining 2.7 years to the mortality gap. The 14.8 fewer

  9. The influence of women's empowerment on maternal health care utilization: evidence from Albania.

    Science.gov (United States)

    Sado, Lantona; Spaho, Alma; Hotchkiss, David R

    2014-08-01

    Women in Albania receive antenatal care and postnatal care at lower levels than in other countries in Europe. Moreover, there are large socio-economic and regional disparities in maternal health care use. Previous research in low- and middle-income countries has found that women's status within the household can be a powerful force for improving the health, longevity, and mental and physical capacity of mothers and the well-being of children, but there is very little research on this issue in the Balkans. The aim of this paper is to investigate the influence of women's empowerment within the household on antenatal and postnatal care utilization in Albania. The research questions are explored through the use of bivariate and multivariate analyses based on nationally representative data from the 2008-09 Albania Demographic and Health Survey. The linkages between women's empowerment and maternal health care utilization are analyzed using two types of indicators of women's empowerment: decision making power and attitudes toward domestic violence. The outcome variables are indicators of the utilization of antenatal care and postnatal care. The findings suggest that use of maternal health care services is influenced by women's roles in decision-making and the attitudes of women towards domestic violence, after controlling for a number of socio-economic and demographic factors which are organized at individual, household, and community level. The study results suggest that policy actions that increase women's empowerment at home could be effective in helping assure good maternal health. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Employee Health Behaviors, Self-Reported Health Status, and Association With Absenteeism: Comparison With the General Population.

    Science.gov (United States)

    Yun, Young Ho; Sim, Jin Ah; Park, Eun-Gee; Park, June Dong; Noh, Dong-Young

    2016-09-01

    To perform a comparison between health behaviors and health status of employees with those of the general population, to evaluate the association between employee health behaviors, health status, and absenteeism. Cross-sectional study enrolled 2433 employees from 16 Korean companies in 2014, and recruited 1000 general population randomly in 2012. The distribution of employee health behaviors, health status, and association with absenteeism were assessed. Employees had significantly worse health status and low rates of health behaviors maintenance compared with the general population. Multiple logistic regression model revealed that regular exercise, smoking cessation, work life balance, proactive living, religious practice, and good physical health status were associated with lower absenteeism. Maintaining health behaviors and having good health status were associated with less absenteeism. This study suggests investment of multidimensional health approach in workplace health and wellness (WHW) programs.

  11. Correlation of sense of coherence with oral health behaviors, socioeconomic status, and periodontal status.

    Science.gov (United States)

    Reddy, Kommuri Sahithi; Doshi, Dolar; Kulkarni, Suhas; Reddy, Bandari Srikanth; Reddy, Madupu Padma

    2016-01-01

    The sense of coherence (SOC) has been suggested to be highly applicable concept in the public health area because a strong SOC is stated to decrease the likelihood of perceiving the social environment as stressful. This reduces the susceptibility to the health-damaging effect of chronic stress by lowering the likelihood of repeated negative emotions to stress perception. The demographic data and general information of subjects' oral health behaviors such as frequency of cleaning teeth, aids used to clean teeth, and dental attendance were recorded in the self-administered questionnaire. The SOC-related data were obtained using the short version of Antonovsky's SOC scale. The periodontal status was recorded based on the modified World Health Organization 1997 pro forma. The total of 780 respondents comprising 269 (34.5%) males and 511 (65.5%) females participated in the study. A significant difference was noted among the subjects for socioeconomic status based on gender ( P = 0.000). The healthy periodontal status (community periodontal index [CPI] code 0) was observed for 67 (24.9%) males and 118 (23.1%) females. The overall SOC showed statistically negative correlation with socioeconomic status scale ( r = -0.287). The CPI and loss of attachment (periodontal status) were significantly and negatively correlated with SOC. The present study concluded that a high level of SOC was associated with good oral health behaviors, periodontal status, and socioeconomic status.

  12. Association Between a Wider Availability of Health Information and Health Care Utilization in Vietnam: Cross-Sectional Study.

    Science.gov (United States)

    Nguyen, Hoang Thuy Linh; Nakamura, Keiko; Seino, Kaoruko; Vo, Van Thang

    2017-12-18

    The rapid and widespread development of mass media sources including the Internet is occurring worldwide. Users are being confronted with a flood of health information through a wide availability of sources. Studies on how the availability of health information has triggered users' interest in utilizing health care services remain limited within the Vietnamese population. This study examined the associations between the wider availability of sources for health information and health care utilization in Vietnam after adjusting for potential confounding variables. The data for this study were drawn from a cross-sectional study conducted over a 6-month period in Hue, a city in central Vietnam. The participants were 993 randomly selected adults aged between 18 and 60 years. Information was collected through face-to-face interviews on the types of information sources that were consulted, including traditional media (television), Internet, and health education courses, as well as the impact of such information on health care use (emergency department visits, hospitalizations, doctor visits). Multivariable logistic regression analyses were performed at a 95% confidence level. The prevalence of watching television, using the Internet, and attending health education courses to obtain health information were 50.9% (505/993), 32.9% (327/993), and 8.7% (86/993), respectively. After further adjustments for self-reported health status, the presence of health insurance, and monthly income, respondents who watched television and used the Internet to obtain health information were 1.7 times more likely to visit a doctor (television: adjusted odds ratio [AOR] 1.69, 95% CI 1.30-2.19; Internet: AOR 1.64, 95% CI 1.23-2.19), and also significantly associated with inpatient hospitalization (P=.003). The use of widely available mass media sources (eg, television and the Internet) to obtain health information was associated with higher health care utilization. How this interest in health

  13. Health status as a risk factor in cardiovascular disease

    DEFF Research Database (Denmark)

    Mommersteeg, Paula M C; Denollet, Johan; Spertus, John A

    2009-01-01

    Patient-perceived health status is receiving increased recognition as a patient-centered outcome in chronic heart failure (CHF) and coronary artery disease (CAD), but poor health status is also associated with adverse prognosis. In this systematic review, we examined current evidence...... on the influence of health status on prognosis in CHF and CAD....

  14. association between health status and visual functioning

    African Journals Online (AJOL)

    2014-01-31

    Jan 31, 2014 ... High blood pressure and abnormal body mass have been observed to correlate negatively with health status. Of interest in this study, is the impact such health status have on visual function indicated by near point of convergence. In this community based cross sectional study, 250 randomly selected ...

  15. Health and Care Utilization of Transgender and Gender Nonconforming Youth: A Population-Based Study.

    Science.gov (United States)

    Rider, G Nicole; McMorris, Barbara J; Gower, Amy L; Coleman, Eli; Eisenberg, Marla E

    2018-02-05

    Transgender and gender nonconforming (TGNC) adolescents have difficulty accessing and receiving health care compared with cisgender youth, yet research is limited by a reliance on small and nonrepresentative samples. This study's purpose was to examine mental and physical health characteristics and care utilization between youth who are TGNC and cisgender and across perceived gender expressions within the TGNC sample. Data came from the 2016 Minnesota Student Survey, which consisted of 80 929 students in ninth and 11th grade ( n = 2168 TGNC, 2.7%). Students self-reported gender identity, perceived gender expression, 4 health status measures, and 3 care utilization measures. Chi-squares and multiple analysis of covariance tests (controlling for demographic covariates) were used to compare groups. We found that students who are TGNC reported significantly poorer health, lower rates of preventive health checkups, and more nurse office visits than cisgender youth. For example, 62.1% of youth who are TGNC reported their general health as poor, fair, or good versus very good or excellent, compared with 33.1% of cisgender youth (χ 2 = 763.7, P presentation was perceived as very congruent with their birth-assigned sex were less likely to report poorer health and long-term mental health problems compared with those with other gender presentations. Health care utilization differs between TGNC versus cisgender youth and across gender presentations within TGNC youth. With our results, we suggest that health care providers should screen for health risks and identify barriers to care for TGNC youth while promoting and bolstering wellness within this community. Copyright © 2018 by the American Academy of Pediatrics.

  16. Coping skills and mental health status in adolescents when a parent has cancer: a multicenter and multi-perspective study.

    Science.gov (United States)

    Krattenmacher, Thomas; Kühne, Franziska; Führer, Daniel; Beierlein, Volker; Brähler, Elmar; Resch, Franz; Klitzing, Kai v; Flechtner, Hans-Henning; Bergelt, Corinna; Romer, Georg; Möller, Birgit

    2013-03-01

    Parental cancer increases the risk of psychosocial problems in adolescents. We investigated the frequency and efficacy of adolescents' coping strategies and relationships between those strategies and mental health status. Age and gender differences regarding coping and mental health were also investigated. In total, 214 adolescents from 167 families participated in a cross-sectional, multicenter study. All participants were recruited from standard oncological care. Among the participants, 52% utilized a child-centered intervention program. Adolescents' coping skills were measured using KIDCOPE. Mental health status was rated by adolescents and parents by the SDQ for symptomatology and the KIDSCREEN for well-being. We found that 29% of the adolescents showed emotional and behavioral problems. We found gender differences in mental health status but not in coping. Adolescents used a broad spectrum of coping strategies. Active problem-solving, distraction, acceptance, wishful thinking and seeking social support were the most frequently used coping strategies. The utilization of certain coping skills was mediated by their perceived efficacy. Problem-focused or approach-oriented coping strategies generally are associated with better mental health, while avoidance-oriented coping are associated with worse mental health. Emotion-focused coping was associated with both lower and higher mental health. The strategies used by adolescents to cope with parental cancer are associated with their mental health. Problem-solving and approach-oriented coping strategies should be facilitated by psychological interventions regardless of age and gender. Age and gender differences in adolescents' mental health should be further investigated because these differences are not explained by differences in coping strategies. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Predictors of subjective health status 10 years post-PCI.

    Science.gov (United States)

    van den Berge, Jan C; Dulfer, Karolijn; Utens, Elisabeth M W J; Hartman, Eline M J; Daemen, Joost; van Geuns, Robert J; van Domburg, Ron T

    2016-06-01

    Subjective health status is an increasingly important parameter to assess the effect of percutaneous coronary intervention (PCI) in clinical practice. Aim of this study was to determine medical and psychosocial predictors of poor subjective health status over a 10 years' post-PCI period. We included a series of consecutive PCI patients (n = 573) as part of the RESEARCH registry, a Dutch single-center retrospective cohort study. These patients completed the 36-item Short-Form Health Survey (SF-36) at baseline and 10 years post-PCI. We found 6 predictors of poor subjective health status 10 years post-PCI: SF-36 at baseline, age, previous PCI, obesity, acute myocardial infarction as indication for PCI, and diabetes mellitus (arranged from most to least numbers of sub domains). SF-36 scores at baseline, age, and previous PCI were significant predictors of subjective health status 10 years post-PCI. Specifically, the SF-36 score at baseline was an important predictor. Thus assessment of subjective health status at baseline is useful as an indicator to predict long-term subjective health status. Subjective health status becomes better by optimal medical treatment, cardiac rehabilitation and psychosocial support. This is the first study determining predictors of subjective health status 10 years post-PCI.

  18. Health status of refugees settled in Alberta: changes since arrival.

    Science.gov (United States)

    Maximova, Katerina; Krahn, Harvey

    2010-01-01

    This paper sought to examine which pre- and post-migration factors might be associated with changes in refugees' health status. Using linear regression, the associations between pre- and post-migration factors and changes in self-rated mental and physical health status were examined in 525 refugees from the 1998 Settlement Experiences of Refugees in Alberta study. Having spent time in a refugee camp and having held professional/managerial jobs in one's home country were associated with a greater decline in mental health status since arrival in Canada. Having completed a university degree in one's home country was associated with a greater decline in physical health status. Being employed was associated with greater improvements in mental health status. Perceived economic hardship was associated with greater declines in physical health status. A higher number of settlement services received during the first year in Canada was associated with greater improvements in both mental and physical health status. Longer residence in Canada was associated with greater declines in physical health status but not in mental health status. While little can be done to alter refugees' pre-migration experiences, public policies can affect many post-migration experiences in order to mitigate the negative health consequences associated with resettlement. Results of this study point to the need for continued provision of settlement services to assist refugees with job training, labour market access, and credential recognition, as well as counseling for refugees who experienced the trauma of living in a refugee camp.

  19. Oral health status in diabetic children

    International Nuclear Information System (INIS)

    Iqbal, S.; Qureshi, A.; Iqbal, N.; Khan, A.A.

    2006-01-01

    Diabetes causes numerous oral and salivary changes leading to cariogenic and gingival lesions. The present study was designed to elucidate the role of diabetes mellitus in oral health. A cross-sectional study including 60 diabetic children (case group) and 30 non diabetic children (control group) of age 3-14 years was conducted. HbA1c and blood glucose level was measured along with the oral health including gingival status and dental caries status was visually assessed. Gingival status was coded for healthy, marginal gingivitis and calculus. Dental caries status (decayed and filled) for both deciduous and permanent dentition was assessed. Data was recorded in a pre-coded oral health proforma, which was then entered and analyzed in SPSS version 10.0. Descriptive analysis such as percentage frequencies and means was performed. Exact Chi-square test was used to analyze any significant changes observed amongst the study population, where level of significance was p < 0.05 with confidence interval 95%. The results show important difference between both groups of children. Dental caries level is significantly higher in diabetic children both in deciduous and permanent dentition than in non-diabetic children (p <0.05). Gingival health was also observed to be debilitated in diabetic children than nondiabetic children (p < 0.05). Conclusion: The study highlights that special preventive measures must be adopted to maintain a good oral health of the diabetic children. (author)

  20. Factors affecting maternal health care services utilization in rural ...

    African Journals Online (AJOL)

    Results: Mother's age at birth, mother's educational level, sex of head of household, household wealth status, employment/work status of mothers, region, religion, birth order and partner's/husband's level of educational were found to be predictors of utilization of delivery care and postnatal care services. Religion and sex of ...

  1. Mental Health Utilization Among Diverse Parenting Young Couples.

    Science.gov (United States)

    Albritton, Tashuna; Angley, Meghan; Gibson, Crystal; Sipsma, Heather; Kershaw, Trace

    2015-09-01

    Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social-personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor-Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow-up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse's influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.

  2. Self-rated health in rural Appalachia: health perceptions are incongruent with health status and health behaviors

    Directory of Open Access Journals (Sweden)

    Pyle Donald N

    2011-04-01

    Full Text Available Abstract Background Appalachia is characterized by poor health behaviors, poor health status, and health disparities. Recent interventions have not demonstrated much success in improving health status or reducing health disparities in the Appalachian region. Since one's perception of personal health precedes his or her health behaviors, the purpose of this project was to evaluate the self-rated health of Appalachian adults in relation to objective health status and current health behaviors. Methods Appalachian adults (n = 1,576 were surveyed regarding health behaviors - soda consumer (drink ≥ 355 ml/d, or non-consumer (drink 30 min > 1 d/wk and sedentary (exercise Results Respondents reported being healthy, while being sedentary (65%, hypertensive (76%, overweight (73%, or hyperlipidemic (79%. Between 57% and 66% of the respondents who considered themselves healthy had at least two disease conditions or poor health behaviors. Jaccard Binary Similarity coefficients and odds ratios showed the probability of reporting being healthy when having a disease condition or poor health behavior was high. Conclusions The association between self-rated health and poor health indicators in Appalachian adults is distorted. The public health challenge is to formulate messages and programs about health and health needs which take into account the current distortion about health in Appalachia and the cultural context in which this distortion was shaped.

  3. The occupational health status of African-American women health care workers.

    Science.gov (United States)

    Arnold, C W

    1996-01-01

    Race, ethnicity, and gender are significant indicators of occupational status, general health status, and thus, occupational health status. Although African-American women constitute only 6.8% of the total U.S. labor force, they hold 20% of the jobs in the health care industry and are disproportionately represented in those jobs that have the highest levels of workplace exposure to hazards. As a result, they are therefore more likely to be at greater exposure and risk to the spectrum of occupational health problems. In order to gain insight into the effects of race and gender on the occupational health status of African-American women health care workers, this article uses three data sources that provide different but complementary sources of information on the demographic characteristics of workers, location of categories of occupations, working conditions of jobs, and other job and worker characteristics. Given the concentration of African-American women in health care positions where there exists a greater likelihood of being exposed to occupational hazards, it is therefore both logical and appropriate for primary care physicians, especially those engaged in office-based practices, to identify this target population for special services and to be more aware of the type of health issues with which these patients are more likely to present and to experience during their working lives. Health care providers have a responsibility to assess occupational factors related to a patient's health problems and to incorporate this information into their treatment protocols and into the design and explanation of each patient's care plan.

  4. Resource utilization in home health care: results of a prospective study.

    Science.gov (United States)

    Trisolini, M G; Thomas, C P; Cashman, S B; Payne, S M

    1994-01-01

    Resource utilization in home health care has become an issue of concern due to rising costs and recent initiatives to develop prospective payment systems for home health care. A number of issues remain unresolved for the development of prospective reimbursement in this sector, including the types of variables to be included as payment variables and appropriate measures of resource use. This study supplements previous work on home health case-mix by analyzing the factors affecting one aspect of resource use for skilled nursing visits--visit length--and explores the usefulness of several specially collected variables which are not routinely available in administrative records. A data collection instrument was developed with a focus group of skilled nurses, identifying a range of variables hypothesized to affect visit length. Five categories of variables were studied using multiple regression analysis: provider-related; patient's socio-economic status; patient's clinical status; patient's support services; and visit-specific. The final regression model identifies 9 variables which significantly affect visit time. Five of the 9 are visit-specific variables, a significant finding since these are not routinely collected. Case-mix systems which include visit time as a measure of resource use will need to investigate visit-specific variables, as this study indicates they could have the largest influence on visit time. Two other types of resources used in home health care, supplies and security drivers, were also investigated in less detail.

  5. Associations of recent weight loss with health care costs and utilization among older women.

    Directory of Open Access Journals (Sweden)

    John T Schousboe

    Full Text Available The association of weight loss with health care costs among older women is uncertain. Our study aim was to examine the association of objectively measured weight change with subsequent total health care (THC costs and other health care utilization among older women. Our study population included 2,083 women (mean age 80.2 years enrolled in the Study of Osteoporotic Fractures and U.S. Medicare Fee for Service. Weight loss and gain were defined, respectively, as ≥5% decrease and ≥5% increase in body weight, and weight maintenance as <5% change in body weight over a period of 4.5 years. THC costs, outpatient costs, hospitalizations, and skilled nursing facility [SNF] utilization were estimated from Medicare claims for 1 year after the period during which weight change was measured. The associations of weight change with THC and outpatient costs were estimated using generalized linear models with gamma variance and log link functions, and with hospitalizations and SNF utilization using logistic models. Adjusted for age and current body mass index (BMI, weight loss compared with weight maintenance was associated with a 35% increase in THC costs ($2148 [95% CI, 745 to 3552], 2014 U.S. dollars, a 15% increase in outpatient costs ($329 [95% C.I. -1 to 660], and odds ratios of 1.42 (95% CI, 1.14 to 1.76 for ≥1 hospital stay and 1.45 (95% CI, 1.03 to 2.03 for ≥1 SNF stay. These associations did not vary by BMI category. After additional adjustment for multi-morbidity and functional status, associations of weight loss with all four outcomes were no longer significant. In conclusion, ≥5% weight loss among older women is not associated with increased THC and outpatient costs, hospitalization, and SNF utilization, irrespective of BMI category after accounting for multi-morbidity and impaired functional status that accompany weight loss.

  6. Health status of rural population in Ialomita county

    Directory of Open Access Journals (Sweden)

    ANA-MARIA TALOS

    2014-10-01

    Full Text Available Health is an issue that manages to provide many top ics in various fields (medicine, geography, sociology, psychology. This study aims to highlight the territorial disparities in health status of Ialomi ţ a county, to identify the health determinants and to make a preliminary analysis of the relationships between the lifestyle and the health status, using an objective assessment (statistics and a subjective evaluation (health surveys. There were analyzed elements such as mortality and morbidity, using health indic ators (mortality rate, infant mortality rate, specific mortality rate and specific morbidity rate and an aggregate index (health index. Combining statistic analysis and spatial analysis, t he study offers the possibility of comparing the rural areas with urban area, and it can be a base f or further studies. The health services, ageing and the characteristics of lifestyle could explain the territorial disparities in health status. A health study can reveal important details about eco nomic features, social behavior, mentality and social environment.

  7. Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization among a Cohort of Homeless and Vulnerably Housed Persons in Canada.

    Science.gov (United States)

    Jaworsky, Denise; Gadermann, Anne; Duhoux, Arnaud; Naismith, Trudy E; Norena, Monica; To, Matthew J; Hwang, Stephen W; Palepu, Anita

    2016-08-01

    This study examined the association of housing status over time with unmet physical health care needs and emergency department utilization among homeless and vulnerably housed persons in Canada. Homeless and vulnerably housed individuals completed interviewer-administered surveys on housing, unmet physical health care needs, health care utilization, sociodemographic characteristics, substance use, and health conditions at baseline and annually for 4 years. Generalized logistic mixed effects regression models examined the association of residential stability with unmet physical health care needs and emergency department utilization, adjusting for potential confounders. Participants were from Vancouver (n = 387), Toronto (n = 390), and Ottawa (n = 396). Residential stability was associated with lower odds of having unmet physical health needs (adjusted odds ratio (AOR), 0.82; 95 % confidence interval (CI), 0.67, 0.98) and emergency department utilization (AOR, 0.74; 95 % CI, 0.62, 0.88) over the 4-year follow-up period, after adjusting for potential confounders. Residential stability is associated with fewer unmet physical health care needs and lower emergency department utilization among homeless and vulnerably housed individuals. These findings highlight the need to address access to stable housing as a significant determinant of health disparities.

  8. Young adults with hemophilia in the U.S.: demographics, comorbidities, and health status.

    Science.gov (United States)

    Curtis, Randall; Baker, Judith; Riske, Brenda; Ullman, Megan; Niu, Xiaoli; Norton, Kristi; Lou, Mimi; Nichol, Michael B

    2015-12-01

    Improvements in hemophilia care over the last several decades might lead to expectations of a near-normal quality of life for young adults with hemophilia. However, few published reports specifically examine health status indicators in this population. To remedy this knowledge gap, we examined the impact of hemophilia on physical and social functioning and quality of life among a national US cohort of 141 young men with hemophilia aged 18-34 years of age who received care at 10 geographically diverse, federally funded hemophilia treatment centers in 11 states between 2005 and 2013 and enrolled in the Hemophilia Utilization Group Studies. Indicators studied included educational achievement, employment status, insurance, health-related quality of life, and prevalence of the following comorbidities: pain, range of motion limitation, overweight/obesity, and viral status. The cohort was analyzed to compare those aged 18-24 to those aged 25-34 years. When compared to the general US adult population, this nationally representative cohort of young US adults with hemophilia experienced significant health and social burdens: more liver disease, joint damage, joint pain, and unemployment as well as lower high-school graduation rates. Nearly half were overweight or obese. Conversely, this cohort had higher levels of health insurance and equivalent mental health scores. While attention has typically focused on newborns, children, adolescents, and increasingly, on older persons with hemophilia, our findings suggest that a specific focus on young adults is warranted to determine the most effective interventions to improve health and functioning for this apparently vulnerable age group. © 2015 Wiley Periodicals, Inc.

  9. Determinants of self-rated health: could health status explain the association between self-rated health and mortality?

    Science.gov (United States)

    Murata, Chiyoe; Kondo, Takaaki; Tamakoshi, Koji; Yatsuya, Hiroshi; Toyoshima, Hideaki

    2006-01-01

    The purpose of this study was to investigate factors related to self-rated health and to mortality among 2490 community-living elderly. Respondents were followed for 7.3 years for all-cause mortality. To compare the relative impact of each variable, we employed logistic regression analysis for self-rated health and Cox hazard analysis for mortality. Cox analysis stratified by gender, follow-up periods, age group, and functional status was also employed. Series of analysis found that factors associated with self-rated health and with mortality were not identical. Psychological factors such as perceived isolation at home or 'ikigai (one aspect of psychological well-being)' were associated with self-rated health only. Age, functional status, and social relations were associated both with self-rated health and mortality after controlling for possible confounders. Illnesses and functional status accounted for 35-40% of variances in the fair/poor self-rated health. Differences by gender and functional status were observed in the factors related to self-rated health. Overall, self-rated health effect on mortality was stronger for people with no functional impairment, for shorter follow-up period, and for young-old age group. Although, illnesses and functional status were major determinants of self-rated health, economical, psychological, and social factors were also related to self-rated health.

  10. Perceived health status is associated with hours of exercise per week in older adults independent of physical health.

    Science.gov (United States)

    McHugh, Joanna Edel; Lawlor, Brian A

    2013-11-01

    Perceived health status does not always reflect actual health status. We investigated the association between objective and self-rated measures of health status and hours of exercise per week in older adults. As part of the TRIL clinic assessment, we gathered information from 473 community dwelling adults over the age of 65, regarding hours spent per week exercising, depression, personality, perceived health status, and objective health status (in the form of a comorbidity count). Regression analyses were performed on these data to investigate whether perceived health status, objective health status, personality and mood are associated with hours of exercise per week. Perceived and objective health status were significantly but weakly correlated. Both perceived and objective health status, as well as depression, were independently associated with hours of exercise per week. We conclude that exercise uptake in older adults is contingent on both perceived and objective health status, as well as depression. Perceived health status has a stronger association with exercise uptake in older adults with lower depression levels. The current findings have implications for designing exercise interventions for older adults.

  11. Is subjective social status a unique correlate of physical health? A meta-analysis.

    Science.gov (United States)

    Cundiff, Jenny M; Matthews, Karen A

    2017-12-01

    Both social stratification (e.g., social rank) as well as economic resources (e.g., income) are thought to contribute to socioeconomic health disparities. It has been proposed that subjective socioeconomic status (an individual's perception of his or her hierarchical rank) provides increased predictive utility for physical health over and above more traditional, well-researched socioeconomic constructs such as education, occupation, and income. PsycINFO and PubMed databases were systematically searched for studies examining the association of subjective socioeconomic status (SES) and physical health adjusting for at least 1 measure of objective SES. The final sample included 31 studies and 99 unique effects. Meta-analyses were performed to: (a) estimate the overlap among subjective and objective indicators of SES and (b) estimate the cumulative association of subjective SES with physical health adjusting for objective SES. Potential moderators such as race and type of health indicator assessed (global self-reports vs. more specific and biologically based indicators) were also examined. Across samples, subjective SES shows moderate overlap with objective indicators of SES, but associations are much stronger in Whites than Blacks. Subjective SES evidenced a unique cumulative association with physical health in adults, above and beyond traditional objective indicators of SES (Z = .07, SE = .01, p Subjective SES may provide unique information relevant to understanding disparities in health, especially self-rated health. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Impact of secondary cardiovascular events on health status

    NARCIS (Netherlands)

    van Stel, Henk F.; Busschbach, Jan J. V.; Hunink, M. G. Myriam; Buskens, Erik

    2012-01-01

    Objectives: Estimates regarding the impact of secondary cardiovascular events on health status in patients treated for cardiovascular disease are scarce and of limited accuracy. Methods: We obtained individual patient data on health status (EuroQol five-dimensional questionnaire) and secondary

  13. 18 CFR 366.7 - Procedures for obtaining exempt wholesale generator and foreign utility company status.

    Science.gov (United States)

    2010-04-01

    ... definition of exempt wholesale generator or foreign utility company (including stating the location of its... obtaining exempt wholesale generator and foreign utility company status. 366.7 Section 366.7 Conservation of... THE PUBLIC UTILITY HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT BOOKS AND...

  14. Oral health status and oral health behaviors of 12-year-old urban and rural school children in Udupi, Karnataka, India: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Arun Singh Thakur

    2017-01-01

    Full Text Available Objectives: The objective of this study is to assess the oral health status and oral health behavior among 12-year-old urban and rural school children and to evaluate the relative effect of sociobehavioral risk factors on caries experience. Materials and Methods: A cross-sectional study was conducted which included urban and rural subgroups of 12-year-old school children. The final study population covered two groups: 12 years rural (n = 261 and urban school children (n = 264. Data were collected and compared using Chi-square test. Logistic regression analysis was done to assess the importance of variables associated with dental caries. Results: Highly significant differences (P < 0.001 were observed between rural and urban school children for the use of oral hygiene aids, frequency of tooth brushing, and dental services utilization. Dental caries level was significantly higher (P < 0.03 for rural children. Decayed teeth (DT component constituted majority of decayed, missing, and filled teeth (FT in both population. 55.6% of the rural school children required treatment compared to 42.4% of urban school children. Mean Oral Hygiene Index-Simplified values, mean DT, and FT were statistically significant for urban and rural school children. Logistic regression analysis showed that government or private school, dental care utilization, socioeconomic status, and malocclusion status were significantly associated with dental caries. Conclusion: Poor oral health and high treatment needs of children belonging to low socioeconomic background is an alarming situation. Strengthening of oral health care in the rural and underprivileged section should be priority of the policymakers.

  15. The association of employment status and family status with health among women and men in four Nordic countries.

    Science.gov (United States)

    Roos, E; Lahelma, E; Saastamoinen, P; Elstad, J-I

    2005-01-01

    The Nordic countries have relatively equal employment participation between men and women, but some differences between countries exist in labour market participation. The aim was to examine the association between employment status and health among women and men in Denmark, Finland, Norway, and Sweden, and analyse whether this association is modified by marital status and parental status. The data come from nationally representative cross-sectional surveys carried out in Denmark (n = 2,209), Finland (n = 4,604), Norway (n = 1,844) and Sweden (n = 5,360) in 1994-95. Women and men aged 25-49 were included. Employment status was categorized into full-time employed, part-time employed, unemployed, and housewives among women and into employed and unemployed among men. Health was measured by perceived health and limiting longstanding illness. Logistic regression analysis was used, adjusting for age and education. Marital status and parental status were analysed as modifying factors. The non-employed were more likely to report perceived health as below good and limiting longstanding illness than the employed among both women and men. The association between employment status and perceived health remained unchanged when marital status and parental status were adjusted for among all men and Finnish women, but the association was slightly strengthened among Danish and Swedish women, with the housewives becoming more likely to report ill health than employed women. The association between employment status and limiting longstanding illness was slightly strengthened among women, and slightly weakened among Norwegian men when marital and parental status were adjusted for. Non-employment was associated with poorer health in all countries, although there are differences in the employment patterns between the countries. Among women marital status and parental status showed a modest or no influence on the association between employment status and health. Among men there was no

  16. The association between insomnia and perceived health status

    NARCIS (Netherlands)

    Donners, A.; Bury, D.; Fernstrand, A.; Garssen, J.; Roth, T.; Verster, J.

    2015-01-01

    Introduction: Impaired sleep can have a significant impact on perceived health status. The aim of the current study was to examine the relationship between perceived health status and sleep quality, total sleep time, and insomnia. Materials and methods: A survey was conducted among Dutch university

  17. A Canadian Indian Health Status Index.

    Science.gov (United States)

    Connop, P J

    1983-01-01

    Health care services for registered "band" Indians in Ontario are provided primarily by the Canadian Federal Government. Complex management methods preclude the direct involvement of Indian people in the decisions for their health resource allocation. Health indicators, need, and health status indexes are reviewed. The biostatistics of mortality and demography of the Indian and reference populations are aggregated with hospitalization/morbidity experience as the Chen G'1 Index, as an indicator of normative and comparative need. This is weighted by linear measurements of perceived need for preventive medicine programs, as ranked and scaled values of priorities, Zj. These were determined by community survey on 11 Indian reserves using a non-probabilistic psychometric method of "pair comparisons," based upon "Thurstone's Law of Comparative Judgement.," The calculation of the aggregate single unit Indian Health Status Index [Log.G'1].Zj and its potential application in a "zero-base" budget is described.

  18. Identifying role of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

    Science.gov (United States)

    Karim, Rizwanul M; Abdullah, Mamun S; Rahman, Anisur M; Alam, Ashraful M

    2016-06-24

    Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 community clinics. Since most of the outcome indicators focus mainly on women and children, women having children less than 2 years of age were randomly assigned and interviewed for the study purpose. Data were collected through FGD, Key informants interview and a pretested semi- structured questionnaire. About 95 % of the respondents were Muslims and 5 % were Hindus. The average age of the respondents was 23.38 (SD 4.15) and almost all of them are home makers. The average monthly expenditure of their family was 95US $ (SD 32US$). At the beginning of the study, two psychometric research instruments; 24 items perceived quality of primary care services PQPCS scale (chronbach's α = .89) and 22 items community clinic service satisfaction CCSS scale (chronbach's α = .97), were constructed and validated. This study showed less educated, poor, landless mothers utilized the community clinic services more than their educated and wealthier counterpart. Women who lived in their own residence used the community clinic services more frequently than those who lived in a rental house. Perceptions concerning skill and competence of the health care provider and satisfaction indicating interpersonal communication and attitude of the care provider were important predictors for community clinic service utilization

  19. A sequential model for the structure of health care utilization.

    NARCIS (Netherlands)

    Herrmann, W.J.; Haarmann, A.; Baerheim, A.

    2017-01-01

    Traditional measurement models of health care utilization are not able to represent the complex structure of health care utilization. In this qualitative study, we, therefore, developed a new model to represent the health care utilization structure. In Norway and Germany, we conducted episodic

  20. A comparative study of family functioning, health, and mental health awareness and utilization among female Bedouin-Arabs from recognized and unrecognized villages in the Negev.

    Science.gov (United States)

    Al-Krenawi, Alean; Graham, John R

    2006-02-01

    A good portion of geography is contested by the Israeli state and the country's Bedouin-Arab population. There are two categories of Bedouin villages: those areas that are "officially" recognized by the state and those that are not. In this article we determine utilization and awareness of health and mental health services among 376 Bedouin-Arab women in recognized and unrecognized villages in the Negev. Although there are differences between them, primary health care (PHC) services usually are available within recognized villages, accessible to those from unrecognized villages, and tend to precipitate user satisfaction. We conclude with various suggestions for improving health service delivery and making PHC and mental health delivery more accessible. Through this article we intend to help mental health practitioners on two levels: the policy level, regarding the design of mental health services for societies in transition, such as the Bedouin Arab, and the practical level by helping practitioners better appreciate the psychosocial status of women in Bedouin-Arab societies and the factors associated with Bedouin-Arab PHC utilization.

  1. Health Literacy, Social Support, and Health Status among Older Adults

    Science.gov (United States)

    Lee, Shoou-Yih D.; Arozullah, Ahsan M.; Cho, Young Ik; Crittenden, Kathleen; Vicencio, Daniel

    2009-01-01

    The study examines whether social support interacts with health literacy in affecting the health status of older adults. Health literacy is assessed using the short version of the Test of Functional Health Literacy in Adults. Social support is measured with the Medical Outcome Study social support scale. Results show, unexpectedly, that rather…

  2. A theoretical framework of the good health status of Jamaicans: using econometric analysis to model good health status over the life course.

    Science.gov (United States)

    Bourne, Paul A

    2009-07-01

    In recent times, the World Health Organization has increasing drawn attention to the pivotal role of social conditions in determining health status. The non-biological factors produced inequalities in health and need to be considered in health development. In spite of this, extensive review of health Caribbean revealed that no study has examined health status over the life course of Jamaicans. With the value of research in public health, this study is timely and will add value to understand the elderly, middle age and young adults in Jamaica. The aim of this study is to develop models that can be used to examine (or evaluate) health of Jamaicans, elderly, middle age and young adults. The current study used data from a cross-sectional survey which was conducted between July and October 2002. Stratified random probability sampling technique was used to collect the data from 25,018 respondents across the island. The non-response rate for the survey was 29.7% with 20.5% who did not respond to particular questions, 9.0% did not participated in the survey and another 0.2% was rejected due to data cleaning. Logistic regression analyses were used to model health status of Jamaicans, young adults, middle age adults and elderly. The predictive power of the model was tested using Omnibus Test of Model and Hosmer and Lemeshow (24) was used to examine goodness of fit of the model. The correlation matrix was examined in order to ascertain whether autocorrelation (or multi-collinearity) existed between variables. Using logistic regression analysis, eleven variables emerged as statistically significant predictors of current good health Status of Jamaicans (p<0.05). The factors are retirement income (95%CI=0.487-0.958), logged medical expenditure (95% Confidence Interval, CI =0.907-0.993), marital status (Separated or widowed or divorced: 95%CI=0.309-0.464; married: 95%CI=0.495-0.667; Never married), health insurance (95%CI=0.029-0.046), area of residence (other towns:, 95%CI=1

  3. The Impact of Socioeconomic Status on the Utilization of Spinal Imaging.

    Science.gov (United States)

    Derakhshan, Adeeb; Miller, Jacob; Lubelski, Daniel; Nowacki, Amy S; Wells, Brian J; Milinovich, Alex; Benzel, Edward C; Mroz, Thomas E; Steinmetz, Michael P

    2015-11-01

    Few studies have examined the general correlation between socioeconomic status and imaging. This study is the first to analyze this relationship in the spine patient population. To assess the effect of socioeconomic status on the frequency with which imaging studies of the lumbar spine are ordered and completed. Patients that were diagnosed with lumbar radiculopathy and/or myelopathy and had at least 1 subsequent lumbar magnetic resonance imaging (MRI), computed tomography (CT), or X-ray ordered were retrospectively identified. Demographic information and the number of ordered and completed imaging studies were among the data collected. Patient insurance status and income level (estimated based on zip code) served as representations of socioeconomic status. A total of 24,105 patients met the inclusion criteria for this study. Regression analyses demonstrated that uninsured patients were significantly less likely to have an MRI, CT, or X-ray study ordered (P socioeconomic characteristics such as insurance status and income level highlight a critical gap in access to health care. Physicians should work to mitigate the influence of such factors when deciding whether to order imaging studies, especially in light of the ongoing shift in health policy in the United States.

  4. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review.

    Science.gov (United States)

    Fitzpatrick-Lewis, Donna; Ganann, Rebecca; Krishnaratne, Shari; Ciliska, Donna; Kouyoumdjian, Fiona; Hwang, Stephen W

    2011-08-10

    Research on interventions to positively impact health and housing status of people who are homeless has received substantially increased attention over the past 5 years. This rapid review examines recent evidence regarding interventions that have been shown to improve the health of homeless people, with particular focus on the effect of these interventions on housing status. A total of 1,546 articles were identified by a structured search of five electronic databases, a hand search of grey literature and relevant journals, and contact with experts. Two reviewers independently screened the first 10% of titles and abstracts for relevance. Inter-rater reliability was high and as a result only one reviewer screened the remaining titles and abstracts. Articles were included if they were published between January 2004 and December 2009 and examined the effectiveness of an intervention to improve the health or healthcare utilization of people who were homeless, marginally housed, or at risk of homelessness. Two reviewers independently scored all relevant articles for quality. Eighty-four relevant studies were identified; none were of strong quality while ten were rated of moderate quality. For homeless people with mental illness, provision of housing upon hospital discharge was effective in improving sustained housing. For homeless people with substance abuse issues or concurrent disorders, provision of housing was associated with decreased substance use, relapses from periods of substance abstinence, and health services utilization, and increased housing tenure. Abstinent dependent housing was more effective in supporting housing status, substance abstinence, and improved psychiatric outcomes than non-abstinence dependent housing or no housing. Provision of housing also improved health outcomes among homeless populations with HIV. Health promotion programs can decrease risk behaviours among homeless populations. These studies provide important new evidence regarding

  5. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review

    Directory of Open Access Journals (Sweden)

    Kouyoumdjian Fiona

    2011-08-01

    Full Text Available Abstract Background Research on interventions to positively impact health and housing status of people who are homeless has received substantially increased attention over the past 5 years. This rapid review examines recent evidence regarding interventions that have been shown to improve the health of homeless people, with particular focus on the effect of these interventions on housing status. Methods A total of 1,546 articles were identified by a structured search of five electronic databases, a hand search of grey literature and relevant journals, and contact with experts. Two reviewers independently screened the first 10% of titles and abstracts for relevance. Inter-rater reliability was high and as a result only one reviewer screened the remaining titles and abstracts. Articles were included if they were published between January 2004 and December 2009 and examined the effectiveness of an intervention to improve the health or healthcare utilization of people who were homeless, marginally housed, or at risk of homelessness. Two reviewers independently scored all relevant articles for quality. Results Eighty-four relevant studies were identified; none were of strong quality while ten were rated of moderate quality. For homeless people with mental illness, provision of housing upon hospital discharge was effective in improving sustained housing. For homeless people with substance abuse issues or concurrent disorders, provision of housing was associated with decreased substance use, relapses from periods of substance abstinence, and health services utilization, and increased housing tenure. Abstinent dependent housing was more effective in supporting housing status, substance abstinence, and improved psychiatric outcomes than non-abstinence dependent housing or no housing. Provision of housing also improved health outcomes among homeless populations with HIV. Health promotion programs can decrease risk behaviours among homeless populations

  6. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review

    Science.gov (United States)

    2011-01-01

    Background Research on interventions to positively impact health and housing status of people who are homeless has received substantially increased attention over the past 5 years. This rapid review examines recent evidence regarding interventions that have been shown to improve the health of homeless people, with particular focus on the effect of these interventions on housing status. Methods A total of 1,546 articles were identified by a structured search of five electronic databases, a hand search of grey literature and relevant journals, and contact with experts. Two reviewers independently screened the first 10% of titles and abstracts for relevance. Inter-rater reliability was high and as a result only one reviewer screened the remaining titles and abstracts. Articles were included if they were published between January 2004 and December 2009 and examined the effectiveness of an intervention to improve the health or healthcare utilization of people who were homeless, marginally housed, or at risk of homelessness. Two reviewers independently scored all relevant articles for quality. Results Eighty-four relevant studies were identified; none were of strong quality while ten were rated of moderate quality. For homeless people with mental illness, provision of housing upon hospital discharge was effective in improving sustained housing. For homeless people with substance abuse issues or concurrent disorders, provision of housing was associated with decreased substance use, relapses from periods of substance abstinence, and health services utilization, and increased housing tenure. Abstinent dependent housing was more effective in supporting housing status, substance abstinence, and improved psychiatric outcomes than non-abstinence dependent housing or no housing. Provision of housing also improved health outcomes among homeless populations with HIV. Health promotion programs can decrease risk behaviours among homeless populations. Conclusions These studies

  7. Utilization of Mental Health Services in School-Based Health Centers

    Science.gov (United States)

    Bains, Ranbir M.; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

    2017-01-01

    Background: We summarize utilization patterns for mental health services in school-based health centers. Methods: Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were…

  8. Effect of health development assistance on health status in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Negeri KG

    2016-04-01

    Full Text Available Keneni Gutema Negeri,1 Damen Halemariam,21School of Public and Environmental Health, Health Service Management Unit, College of Medicine and Health Sciences, Hawassa University, Hawassa, 2College of Medicine and Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Data on the effect of health aid on the health status in developing countries are inconclusive. Moreover, studies on this issue in sub-Saharan Africa are scarce. Therefore, this study aims to analyze the effect of health development aid in sub-Saharan Africa. Methods: Using panel data analytic method, as well as infant mortality rate as a proxy for health status, this study examines the effect of health aid on infant mortality rate in sub-Saharan Africa. The panel was constructed from data on 43 countries for the period 1990–2010. Fixed effect, random effect, and first difference generalized method of moments estimator were used for estimation. Results: Health development aid has a statistically significant positive effect. A 1% increase of health development assistance per capita saves the lives of two infants per 1,000 live births (P=0.000 in the region. Conclusion: Contrary to health aid pessimists’ view, this study observes the fact that health development assistance has strong favorable effect in improving health status in sub-Saharan Africa. Keywords: health aid, infant mortality, developing countries, panel data

  9. Employment characteristics and health status among men and women.

    Science.gov (United States)

    Hibbard, J H; Pope, C R

    1987-01-01

    This study examines the characteristics of jobs held by women as compared to men during the 1970s and assesses associations between job characteristics and family status with health status by sex. Sex differences in perceptions about the meaning of work, commitment to the work role, and stresses and rewards are considered. Survey data on 1490 employed men and women, ages 18-64, drawn from a random sample of enrollees of a large health maintenance organization in 1970-71 are linked with medical record data covering seven years of outpatient and inpatient services. The findings suggest important differences in the characteristics of jobs held by men and women and in the relative importance of these job characteristics in relation to health. Men held jobs with higher quality intrinsic work characteristics and perceived their jobs to be less stressful and less physically and mentally tiring than did women. Social support and integration through work and occupational status were significantly related to health status for both sexes, however, family responsibilities interact with job characteristics to affect health status for women. Single motherhood, in combination with low social support and integration through work, was related to poor health among women.

  10. Effect of information seeking and avoidance behavior on self-rated health status among cancer survivors.

    Science.gov (United States)

    Jung, Minsoo; Ramanadhan, Shoba; Viswanath, Kasisomayajula

    2013-07-01

    Social determinants, such as socioeconomic status (SES) and race/ethnicity are linked to striking health disparities across the cancer continuum. One important mechanism linking social determinants and health disparities may be communication inequalities that are caused by differences in accessing, processing and utilizing cancer information. In this context, we examined health information-seeking/avoidance as a potential mediator between social determinants and self-rated health (SRH) status among cancer survivors. Data came from the 2008 well-informed, thriving and surviving (WITS) study of post-treatment cancer survivors (n=501). We examined the mediating effect of health communication-related behavior between SES and disparities in SRH. The likelihood of belonging to the Low SRH group was higher among patients who had avoided health information and whose family members had not sought health information on behalf of the survivor, those in the lowest household income bracket, and those who had high school or less education after adjusting for potential confounders. Differences in SRH among cancer survivors are associated with SES as well as communication inequalities. It is necessary to provide a supportive environment in which health information is made available if disparities in health-related quality of life among cancer survivors are to be reduced. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. A prospective randomized trial examining health care utilization in individuals using multiple smartphone-enabled biosensors

    Directory of Open Access Journals (Sweden)

    Cinnamon S. Bloss

    2016-01-01

    short-term increases or decreases in health care costs or utilization associated with monitoring chronic health conditions using mobile health or digital medicine technologies. Among secondary outcomes there was some evidence of improvement in health self-management which was characterized by a decrease in the propensity to view health status as due to chance factors in the intervention group.

  12. Patterns of Mental Health Care Utilization Among Sexual Orientation Minority Groups.

    Science.gov (United States)

    Platt, Lisa F; Wolf, Julia Kay; Scheitle, Christopher P

    2018-01-01

    Prior studies of the utilization of mental health professionals by sexual minority populations have relied on data that are now dated or not nationally representative. These studies have also provided mixed findings regarding gender differences in the utilization of mental health professionals among sexual minority individuals. Using data from the 2013-2015 National Health Interview Surveys, this study investigates (1) how sexual minority individuals compare to heterosexual participants in their utilization of mental health professionals; and (2) gender differences in that utilization. The results indicate sexual minority individuals utilize mental health care professionals at higher rates than heterosexual individuals even after controlling for measures of mental health and other demographic characteristics; this is true for both men and women. However, gender moderates the sexual minority effect on utilization rates. Sexual minority men utilize mental health professionals at a high rate, such that their utilization rates are similar to sexual minority women, contrary to the gender gap seen among heterosexuals.

  13. A study on the status of nuclear development and utilization in North Korea

    International Nuclear Information System (INIS)

    Choi, Young Myung; Oh, Keun Bae; Lee, Kwang Seok; Ham, Cheol Hoon; Lee, Byeong Uk; Lee, Jae Seong; Choi, Yeong Rok; Ko, Han Seong

    1994-01-01

    The objective of this project is to propose strategies and tactics for nuclear cooperation between the South and the North in the perspective of the unification of the Korean Peninsula, based on proper and objective understanding of the status of nuclear development and utilization activities in North Korea, especially those for peaceful purposes. This study analyzes the nuclear development and utilization status of North Korea in terms of nuclear development history and policies, nuclear research and development, nuclear power generation, nuclear fuel cycle, production and uses of radiation and isotopes, manufacturing of equipment and components of nuclear power plants, and international nuclear cooperation. Based on the analysis, this study proposes basic directions for nuclear cooperation between South and North Korea. (Author)

  14. Developing health status index using factor analysis | Mohamad ...

    African Journals Online (AJOL)

    This paper intends to develop health status index among drug abuse prison inmates in Malaysia. A self-admistered questionnaire distributed to 1753 respondents. In this study, to calculate the health status index number of drug abuse inmates, descriptive and factor analyses applied. The data based on 10 indicators of ...

  15. Association between nutritional status and subjective health status in chronically ill children attending special schools.

    Science.gov (United States)

    Joosten, Koen; van der Velde, Kelly; Joosten, Pieter; Rutten, Hans; Hulst, Jessie; Dulfer, Karolijn

    2016-04-01

    In hospitalized children with a chronic disease, malnutrition was associated with a lower subjective health status. In outpatient children with a chronic disease attending special schools, this association has never been studied. The aim of this study was to assess the association between nutritional status and subjective health status in chronically ill children attending special schools. Overall, 642 children, median age 9.8 years (IQR 7.7-11.5), 60 % male, 72 % Caucasian, were included in this prospective study in nine special schools for chronically ill children in the Netherlands. Overall malnutrition was assessed as: acute malnutrition (nutritional risk-screening tool STRONGkids. Subjective health status was assessed with EQ-5D. Overall, 16 % of the children had overall malnutrition: 3 % acute and 13 % chronic malnutrition. Nurses reported 'some/severe problems' on the health status dimensions mobility (15 %), self-care (17 %), usual activities (19 %), pain/discomfort (22 %), and anxiety/depression (22 %) in chronically ill children. Their mean visual analogue scale score (VAS) was 73.0 (SD 11.1). Malnutrition, medication usage, and younger age explained 38 % of the variance of the VAS score. The presence of overall malnutrition in chronically ill children attending special schools was associated with lower subjective health status, especially in younger children and in those with chronic medication usage. Therefore, it is important to develop and use profile-screening tools to identify these children.

  16. Horizontal Inequity in Elderly Health Care Utilization: Evidence from India

    Science.gov (United States)

    Rudra, Shalini; Subramanian, S V

    2015-01-01

    Against the backdrop of population aging, this paper presents the analysis of need-standardised health care utilization among elderly in India. Based on nationally representative morbidity and health care survey 2004, we demonstrate that the need for health care utilization is indeed pro-poor in nature. However, the actual health care utilization is concentrated among richer sections of the population. Further, the decomposition analysis reveals that income has a very strong role in shifting the distribution of health care away from the poor elderly. The impact of income on utilization is well-demonstrated even at the ecological-level as states with higher per capita incomes have higher elderly health care utilization even as the levels of need-predicted distribution across these states are similar. We also find that the distribution of elderly across social groups and their educational achievements favours the rich and significantly contributes to overall inequality. Nevertheless, contribution of need-related self-assessed health clearly favours pro-poor inequality. In concluding, we argue that to reduce such inequities in health care utilization it is necessary to increase public investments in health care infrastructure including geriatric care particularly in rural areas and underdeveloped regions to enhance access and quality of health care for the elderly. PMID:26617450

  17. Health Service Utilization in Amhara Region of Ethiopia | Fantahun ...

    African Journals Online (AJOL)

    Background: Information on health service utilization is crucial for planning, organizing and evaluation of health services. Objective: Assess perceived morbidity and examine the factors associated with utilization of health services by a sample of the population of the Amhara Region. Methods: Questionnaire was ...

  18. A Systematic Review and Meta-analysis of Childhood Health Utilities.

    Science.gov (United States)

    Kwon, Joseph; Kim, Sung Wook; Ungar, Wendy J; Tsiplova, Kate; Madan, Jason; Petrou, Stavros

    2018-04-01

    A common feature of most reviews or catalogues of health utilities has been their focus on adult health states or derivation of values from adult populations. More generally, utility measurement in or on behalf of children has been constrained by several methodological concerns. The objective of this study was to conduct the first comprehensive systematic review and meta-analysis of primary utility data for childhood conditions and descriptors, and to determine the effects of methodological factors on childhood utilities. The review followed PRISMA guidelines. PubMed, Embase, Web of Science, PsycINFO, EconLit, CINAHL and Cochrane Library were searched for primary studies reporting health utilities for childhood conditions or descriptors using direct or indirect valuation methods. The Paediatric Economic Database Evaluation (PEDE) Porject was also searched for cost-utility analyses with primary utility values. Mean or median utilities for each of the main samples were catalogued, and weighted averages of utilities for each health condition were estimated, by valuation method. Mixed-effects meta-regression using hierarchical linear modeling was conducted for the most common valuation methods to estimate the utility decrement for each health condition category relative to general childhood population health, as well as the independent effects of methodological factors. The literature searches resulted in 272 eligible studies. These yielded 3,414 utilities when all sub-groups were considered, covering all ICD-10 chapters relevant to childhood health, 19 valuation methods, 12 respondent types, 8 modes of administration, and data from 36 countries. A total of 1,191 utility values were obtained when only main study samples were considered, and these were catalogued by health condition or descriptor, and methodological characteristics. 1,073 mean utilities for main samples were used for fixed-effects meta-analysis by health condition and valuation method. Mixed

  19. Utilization of maternal health services in rural primary health centers ...

    African Journals Online (AJOL)

    Utilization of maternal health services in rural primary health centers in Sub- Saharan Africa. ... their pregnancies were normal during antenatal care visits, hostile attitude of health workers, poverty and mode of payment. Majority of the PHCs provided antenatal, normal delivery, and post natal services. Rural mothers lacked ...

  20. [Systematic review of health-related utilities in Spain: the case of mental health].

    Science.gov (United States)

    García-Pérez, Lidia; Aguiar-Ibáñez, Raquel; Pinilla-Domínguez, Pilar; Arvelo-Martín, Alejandro; Linertová, Renata; Rivero-Santana, Amado

    2014-01-01

    Currently, there is no registry of utility values for the Spanish population that could potentially be used in economic evaluations. Consequently, a systematic review of utilities or preferences for health states in the Spanish population was conducted. The results related to mental health are reported. A systematic review of the literature was conducted. The main databases searched were MEDLINE, CRD, Embase, PsycINFO, CINAHL, and Cochrane. The search strategy combined terms related to utilities and Spain. The inclusion criteria comprised the resident population in Spain, whether affected by any disease or not; the reported utilities had to be evaluated through a tool validated in Spain (i.e., EQ-5D, HUI, SF-6D) and/or following accepted techniques (e.g., time trade-off, standard gamble, or the visual analog scale). A narrative synthesis of articles was undertaken and the results related to mental health summarized. A total of 103 articles were finally included, from which 742 utility values were extracted. Sixty-nine utility values related to mental health and behavioral disorders were extracted from 12 studies. The most widely used tool was the E5-QD questionnaire. Most of the excluded articles evaluated quality of life but did not provide an estimation of utilities. This review adds value to research on utilities in Spain by gathering values to be included in economic evaluations, as well as by identifying research gaps in this field. The utility values related to mental health identified in this study are similar to those reported in international publications. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  1. Anxiety, Depression, and Functional Status Are the Best Predictors of Health Status Patients With Heart Failure

    National Research Council Canada - National Science Library

    DeJong, Marla

    2004-01-01

    .... Therefore, health status is an increasingly important concept in the management of HF. In fact, most symptomatic patients are more concerned about their everyday health status than the length of their life...

  2. Distribution and Utilization of Health Facilities in Calabar Metropolis ...

    African Journals Online (AJOL)

    The level of accessibility increases with increasing utilization. Distance was a barrier to the utilization of health facilities due to the uneven distribution of health facilities and the inability of patients to overcome economic distance. Greater investment by government in the health sector would guarantee more equitable access ...

  3. Favorable Cardiovascular Health Is Associated With Lower Health Care Expenditures and Resource Utilization in a Large US Employee Population: The Baptist Health South Florida Employee Study.

    Science.gov (United States)

    Osondu, Chukwuemeka U; Aneni, Ehimen C; Valero-Elizondo, Javier; Salami, Joseph A; Rouseff, Maribeth; Das, Sankalp; Guzman, Henry; Younus, Adnan; Ogunmoroti, Oluseye; Feldman, Theodore; Agatston, Arthur S; Veledar, Emir; Katzen, Barry; Calitz, Chris; Sanchez, Eduardo; Lloyd-Jones, Donald M; Nasir, Khurram

    2017-03-13

    To examine the association of favorable cardiovascular health (CVH) status with 1-year health care expenditures and resource utilization in a large health care employee population. Employees of Baptist Health South Florida participated in a health risk assessment from January 1 through September 30, 2014. Information on dietary patterns, physical activity, blood pressure, blood glucose level, total cholesterol level, and smoking were collected. Participants were categorized into CVH profiles using the American Heart Association's ideal CVH construct as optimal (6-7 metrics), moderate (3-5 metrics), and low (0-2 metrics). Two-part econometric models were used to analyze health care expenditures. Of 9097 participants (mean ± SD age, 42.7±12.1 years), 1054 (11.6%) had optimal, 6945 (76.3%) had moderate, and 1098 (12.1%) had low CVH profiles. The mean annual health care expenditures among those with a low CVH profile was $10,104 (95% CI, $8633-$11,576) compared with $5824 (95% CI, $5485-$6164) and $4282 (95% CI, $3639-$4926) in employees with moderate and optimal CVH profiles, respectively. In adjusted analyses, persons with optimal and moderate CVH had a $2021 (95% CI, -$3241 to -$801) and $940 (95% CI, -$1560 to $80) lower mean expenditure, respectively, than those with low CVH. This trend remained even after adjusting for demographic characteristics and comorbid conditions as well as across all demographic subgroups. Similarly, health care resource utilization was significantly lower in those with optimal CVH profiles compared with those with moderate or low CVH profiles. Favorable CVH profile is associated with significantly lower total medical expenditures and health care utilization in a large, young, ethnically diverse, and fully insured employee population. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  4. Health status of people of slums in Nairobi, Kenya

    International Nuclear Information System (INIS)

    Gulis, Gabriel; Mulumba, J.A.A.; Juma, Olivia; Kakosova, Beatrica

    2004-01-01

    The objective of this study was to describe the health status of people living in the slums of Nairobi. It was designed as a cross-sectional study based on data from visitors at a clinic at Trnava University located in Mukuru slum in Nairobi. There were about 16,000 visits registered at Mary Immaculate Clinic of Trnava University in Nairobi during 2 years of operation. A random 5% sample was drawn from the paper-card database of this clinic to assess basic characteristics and health complaints of visitors. Both self-reported health complaints and diagnoses written by physicians were used to assess health status of participants. More females with average age (by slum) ranging from 20.46 to 21.30 years than males with average age ranging from (by slum) 15.86 to 19.49 years are the visitors of the clinic. The major self-reported health complaints of visitors were cough, abdominal pain, and headache for both sexes. The most frequent diagnoses were consequently virosis, acute respiratory infections, and bronchitis. Differences in health complaints by slums were observed and are described herein. The major health complaints and diagnoses in addition to the differences in health complaints and diagnoses by slum show that environmental conditions can have major influences on health status. Therefore, environmental improvements are important in the improvement of health status. A very high prevalence of respiratory complaints and gastrointestinal problems signify that improvements in air pollution reduction, drinking water provision, and waste management in slums can lead to more significant and sustainable improvements in health status than just simple treatment. This fact should be taken into account when planning future relief programs

  5. Determining Community Health Status Priorities in an Online Analytic Processing (OLAP) Environment

    Science.gov (United States)

    Studnicki, James; Fisher, John W.

    2013-01-01

    Introduction: The determination of priorities is an essential component of community health status assessment. Yet, there is an acknowledged need for a systematic method which will utilize data in standardized comparisons to yield priorities based on objective analyses. Method: We have deployed a web-based system with: a flexible online analytic processing (OLAP) interface; multiple sources of event-level data conformed to common definitions in a data warehouse structure; and, centralized technical infrastructure with distributed analytical capabilities. The PRIORITIZATION TOOL integrated into the system takes full advantage of the granularity of multidimensional sources of data to: apply a series of defined objective criteria; vary the weight of those criteria and detect the reordering of the rankings in real-time; and, apply the prioritization algorithm to different categories of health status outcomes. Results: In our example, mortality outcomes for Miami-Dade County, Florida, were considered with three different weighting combinations of the four primary ranking criteria. The resultant analyses return markedly different mortality priority rankings based upon the selection and weighting of the criteria. Conclusion: Rankings of community health outcomes based on a static set of criteria with fixed weighting factors may not provide sufficient information necessary for priority setting and may, in fact, be misleading. PMID:23923094

  6. Determining Community Health Status Priorities in an Online Analytic Processing (OLAP) Environment.

    Science.gov (United States)

    Studnicki, James; Fisher, John W

    2013-01-01

    The determination of priorities is an essential component of community health status assessment. Yet, there is an acknowledged need for a systematic method which will utilize data in standardized comparisons to yield priorities based on objective analyses. We have deployed a web-based system with: a flexible online analytic processing (OLAP) interface; multiple sources of event-level data conformed to common definitions in a data warehouse structure; and, centralized technical infrastructure with distributed analytical capabilities. The PRIORITIZATION TOOL integrated into the system takes full advantage of the granularity of multidimensional sources of data to: apply a series of defined objective criteria; vary the weight of those criteria and detect the reordering of the rankings in real-time; and, apply the prioritization algorithm to different categories of health status outcomes. In our example, mortality outcomes for Miami-Dade County, Florida, were considered with three different weighting combinations of the four primary ranking criteria. The resultant analyses return markedly different mortality priority rankings based upon the selection and weighting of the criteria. Rankings of community health outcomes based on a static set of criteria with fixed weighting factors may not provide sufficient information necessary for priority setting and may, in fact, be misleading.

  7. Rethinking the relationship between socioeconomic status and health: Challenging how socioeconomic status is currently used in health inequality research.

    Science.gov (United States)

    Gagné, Thierry; Ghenadenik, Adrian E

    2018-02-01

    The Scandinavian Journal of Public Health recently reiterated the importance of addressing social justice and health inequalities in its new editorial policy announcement. One of the related challenges highlighted in that issue was the limited use of sociological theories able to inform the complexity linking the resources and mechanisms captured by the concept of socioeconomic status. This debate article argues that part of the problem lies in the often unchallenged reliance on a generic conceptualization and operationalization of socioeconomic status. These practices hinder researchers' capacity to examine in finer detail how resources and circumstances promote the unequal distribution of health through distinct yet intertwined pathways. As a potential way forward, this commentary explores how research practices can be challenged through concrete publication policies and guidelines. To this end, we propose a set of recommendations as a tool to strengthen the study of socioeconomic status and, ultimately, the quality of health inequality research. Authors, reviewers, and editors can become champions of change toward the implementation of sociological theory by holding higher standards regarding the conceptualization, operationalization, analysis, and interpretation of results in health inequality research.

  8. One-year change in health status and subsequent outcomes in COPD

    DEFF Research Database (Denmark)

    Wilke, Sarah; Jones, Paul W; Müllerova, H

    2015-01-01

    BACKGROUND: Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown. AIMS: To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalis...

  9. Status of simulation in health care education: an international survey

    Science.gov (United States)

    Qayumi, Karim; Pachev, George; Zheng, Bin; Ziv, Amitai; Koval, Valentyna; Badiei, Sadia; Cheng, Adam

    2014-01-01

    Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current findings to support simulation in the next developmental stages. PMID:25489254

  10. Interrelationships of adult attachment orientations, health status and worrying among fibromyalgia patients.

    Science.gov (United States)

    Oliveira, Paula; Costa, Maria Emilía

    2009-11-01

    This study examined associations between adult attachment dimensions, perceived health status and worrying (coping strategy with chronic pain), and explored whether worrying mediated observed relationships between attachment dimensions and health outcomes within a sample of 128 Portuguese female fibromyalgia patients. Physical health status was inversely correlated with dependence and worrying; mental health status was positively correlated with trust, and inversely related to attachment-related ambivalence, dependence and worrying. Finally, worrying mediated relationships between dependence and both physical and mental health status; moreover, worrying partially mediated the relationship between ambivalence and mental health status. Implications of the findings are discussed.

  11. The Effect of Childhood Health Status on Adult Health in China.

    Science.gov (United States)

    Wang, Qing; Zhang, Huyang; Rizzo, John A; Fang, Hai

    2018-01-26

    Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good nutrition was more variable, with potentially important implications, not only for childhood health, but also for adult health, because of its long-term effects lasting into adulthood. To shed light on these issues, this study examined the long-run association between childhood health and adult health outcomes among a middle-aged Chinese population and addresses the endogeneity of childhood health. A nationwide database from the 2011 China Health and Retirement Longitudinal Study (CHARLS) was employed. Three adult health outcomes variables were used: self-reported health status, cognition, and physical function. The local variation in grain production in the subjects' fetal period and the first 24 months following birth was employed as an instrument for childhood health in order to correct for its endogeneity. Childhood health recalled by the respondents was positively and significantly associated with their adult health outcomes in terms of self-reported health status, cognition, and physical function in single-equation estimates that did not correct for the endogeneity of childhood health. A good childhood health status increased the probabilities of good adult health, good adult cognitive function, and good adult physical function by 16% (95% CI: 13-18%), 13% (95% CI: 10-15%), and 14% (95% CI: 12-17%), respectively. After correcting for endogeneity, the estimated effects of good childhood health were consistent but stronger. We also studied the male and female populations separately, finding that the positive effects of childhood health on adult health were larger for males. In China, childhood health significantly affects adult health. This suggests that early interventions to promote

  12. Health Care Access, Utilization, and Cancer Screening Among Low-Income Latina Women.

    Science.gov (United States)

    Mojica, Cynthia M; Flores, Bertha; Ketchum, Norma S; Liang, Yuanyuan

    2017-12-01

    Cancer screening reduces mortality rates for breast, cervical, and colon cancer. Yet cancer screening rates for Latina women are lower than for non-Latino Whites, and below Healthy People 2020 goals. Additionally, Latinos face many health care access barriers. This study examined health care access and utilization in relation to cancer screening among low-income Latina women recruited from a high-risk area and enrolled in a navigation-plus-education intervention. Latina women considered rarely or never screened for breast, cervical, or colorectal cancer were recruited from community-based organizations and events (N = 691). We gathered self-reported survey data on insurance status, usual source of care, health care utilization, and cancer screening behavior. We conducted multivariable logistic regression models to estimate odds ratios of receipt of at least one cancer screening test. Overall, 28% of women received at least one cancer screening test. Results indicated that women without insurance (odds ratio [OR] = 2.08; confidence interval [CI] = 1.09, 3.98) and without a doctor's visit in the past year (OR = 2.02; CI = 1.28, 3.18), compared with their counterparts, had greater odds of receiving at least one screening test. Findings highlight the continued need to explore ways to support uninsured individuals' screening efforts and further investigate barriers among insured women who are not up-to-date with screenings.

  13. Assimilation and health service utilization of Korean immigrant women.

    Science.gov (United States)

    Son, Juyeon

    2013-11-01

    In this case study, I present descriptive findings with regard to immigrant incorporation and health service utilization. Using focus groups and survey of Korean immigrant women in Wisconsin, I examine whether the ways in which they adapt to the U.S. society is relevant to their health services utilization and the alternatives they seek when available health services are less than satisfactory. The findings suggest that adherence to Korean identity appears to be associated with health service utilization. This is evident in the immigrants' evaluation of the U.S. health services as compared to those of Korea, and the consideration given by these immigrants to seeking health services in Korea instead of the United States. Such concerns on the part of these immigrants have important implications for health researchers, as they highlight the significance of immigrants' transnational experiences and their sense of personal agency in the use of health care.

  14. Perceived Socioeconomic Status: A New Type of Identity which Influences Adolescents’ Self Rated Health

    Science.gov (United States)

    Goodman, Elizabeth; Huang, Bin; Schafer-Kalkhoff, Tara; Adler, Nancy E.

    2007-01-01

    Purpose The cognitive, social, and biological transitions of adolescence suggest that subjective perceptions of social position based on the socioeconomic hierarchy may undergo important changes during this period, yet how such perceptions develop is poorly understood and no studies assess if changes in such perceptions influence adolescents’ health. This study describes adolescents’ subjective perceptions of familial socioeconomic status (SSS), how SSS changes over time, and how age, race, and objective socioeconomic status (SES) indicators influence SSS. In addition, the study determines if SSS independently influences adolescents’ self-rated health, an important predictor of morbidity and health service utilization. Methods 1179 non-Hispanic black and white baseline 7–12th graders from a Midwestern public school district completed a validated, teen-specific measure of SSS annually for 4 consecutive years. A parent provided information on SES. Markov modeling assessed transitions in SSS over time. Results SSS declined with age (p=.001) and stabilized among older teens. In addition to age, SES and race, but not gender, were significant correlates of SSS, but the relationships between these factors were complex. In cross-sectional and longitudinal analyses, black teens from families with low parent education had higher SSS than white teens from similarly educated families, while white teens from highly educated families had higher SSS than black teens from highly educated families. Lower SSS and changes in SSS predicted poor self rated health even when adjusting for race and objective SES measures. Conclusion Subjective evaluations of socioeconomic status predict adolescents’ global health ratings even when adjusting for the sociodemographic factors which shape them. PMID:17950168

  15. Workplace health promotion and utilization of health services: follow-up data findings.

    Science.gov (United States)

    Deitz, Diane; Cook, Royer; Hersch, Rebekah

    2005-01-01

    This article reports findings from a workplace substance abuse prevention program designed to investigate best practices. The study sought to assess the effects of the worksite wellness program and employee assistance program (EAP) on healthcare utilization and costs, identify predictors of outpatient costs and visits, and assess the effect of the intervention on health attitudes, behaviors, and behavioral health-related costs and visits. Results indicated that visits to the EAP increased as did overall healthcare visits, that utilization of healthcare services and costs were higher in the population receiving substance abuse prevention intervention, and that employees in the substance abuse prevention intervention reported lower heavy drinking and binge drinking. Data suggest that substance abuse prevention may result in higher healthcare costs and utilization in the short term, but a reduction in health risk behaviors such as heavy drinking may result in lower healthcare costs and utilization in the long term.

  16. Health And Social Status Of Senior Citizens In Rural Areas

    Directory of Open Access Journals (Sweden)

    Sunder Lal

    1997-12-01

    Full Text Available Research Problem: What is the quality of life of the elderly people, as also the available support system, in rural areas? Objectives:i To determine the demographic profile of eld­erly ii To assess the socio-economic, nutritional, health, morbidity and dependency status, and health care utilization. Study Design: Population based cross sectional study. Setting: Community Development   Block - Lakhanmajra Participants: Persons above the age of 65 years. Sample Size: 809 elderly above the age of 65 years. Study Variables: Demographic profile, Literacy, Oc­cupation, Health, Nutrition, Mobility, Dependency, Substance abuse, Support system. Statistical Analysis: By simple proportions. Result: In this study, majority ofthe elderly were self reliant and mobile, being an asset to the family and led socially useful and productive lives. Their pre­dominant problems were visual impairment, joint pains, respiratory diseases and hearing impairment. Joint family and government pension was the major support system to the elderly. However, there is an imperative need to organize education, training and special service programmes for the elderly at the village level.

  17. Predictors of Healthcare Service Utilization for Mental Health Reasons

    Directory of Open Access Journals (Sweden)

    Marie-Josée Fleury

    2014-10-01

    Full Text Available This study was designed to identify: (1 predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2 correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.

  18. Dietary Amino Acid Deficiency Reduces the Utilization of Amino Acids for Growth in Growing Pigs after a Period of Poor Health

    NARCIS (Netherlands)

    Hoek, van de E.; Jansman, A.J.M.; Borne, van den J.J.G.C.; Peet-Schwering, van der C.M.C.; Beers-Schreurs, van H.M.G.; Gerrits, W.J.J.

    2016-01-01

    Background: During immune system activation, partitioning of amino acids (AAs) changes between protein gain and use by the immune system. Objective: We determined the effects of health status and dietary AA deficiency on nitrogen retention and AA utilization in pigs. Methods: Barrows (55 d of age)

  19. Mental Health Service Utilization Among Lesbian, Gay, Bisexual, and Questioning or Queer College Students.

    Science.gov (United States)

    Dunbar, Michael S; Sontag-Padilla, Lisa; Ramchand, Rajeev; Seelam, Rachana; Stein, Bradley D

    2017-09-01

    College students are at high risk for mental health problems, yet many do not receive treatment even when services are available. Treatment needs may be even higher among sexual minority students, but little is known about how these students differ from heterosexual peers in terms of mental health needs and service utilization. A total of 33,220 California college students completed an online survey on mental health needs (e.g., current serious psychological distress and mental health-related academic impairment) and service utilization. Using logistic regressions, we examined differences in student characteristics, mental health service use, and perceived barriers to using on-campus services by sexual minority status. Approximately 7% of students self-identified as sexual minorities. Compared with heterosexual students, sexual minority students endorsed higher rates of psychological distress (18% vs. 26%, p mental health-related academic impairment (11% vs. 17%, p mental health services. Sexual minority students were also more likely to report using off-campus services and to endorse barriers to on-campus service use (e.g., embarrassed to use services and uncertainty over eligibility for services). Sexual minority individuals represent a sizeable minority of college students; these students use mental health services at higher rates than heterosexual peers but have high rates of unmet treatment need. Efforts to address commonly reported barriers to on-campus service use, foster sexual minority-affirmative campus environments, and promote awareness of campus services may help reduce unmet treatment need in this population. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Identifying influence of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

    Science.gov (United States)

    Karim, R M; Abdullah, M S; Rahman, A M; Alam, A M

    2015-04-01

    Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic (CC) services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 Community Clinics (CCs). Since most of the outcome indicators focus mainly on women and children, women having children less than two years of age were randomly assigned and interviewed for the study purpose. Data for the development of perceived service quality and satisfaction tools were collected through Focus Group Discussion (FGD), key informants interview and data for measuring the utilization status were collected by an interviewer administered pretested semi-structured questionnaire. About 95% of the respondents were Muslims and 5% were Hindus. The average age of the respondents was 23.38 (SD ± 4.15) years and almost all of them are home makers. The average monthly expenditure of their family was 7462.92 (SD ± 2545) BDT equivalent to 95 (SD ± 32) US$. To measure lay peoples' perception and satisfaction regarding primary health care service quality two scales e.g. Slim Haddad's 20-item scale for measuring perceived quality of primary health care services (PQPCS) validated in Guinea and Burkina Fuso and primary care satisfaction survey for women (PCSSW) developed by Scholle and colleagues 2004; is a 24-item survey tool validated in Turkey were chosen as a reference tools. Based on those, two psychometric research instruments; 24 items PQPCS scale (chronbach's α =0.89) and 22-items Community Clinic

  1. Health status of Russian minorities in former Soviet Republics

    NARCIS (Netherlands)

    Groenewold, W.G.F.; van Ginneken, J.K.S.

    2011-01-01

    Objectives: To examine if, and to what extent, disparities in health status exist between ethnic Russians and the native majority populations of four former Soviet Republics; and to determine to what extent indicators of socio-economic status and lifestyle behaviours explain variations in health

  2. Predictors of subjective health status 10 years post-PCI

    NARCIS (Netherlands)

    van den Berge, Jan C.; Dulfer, Karolijn; Utens, Elisabeth M. W. J.; Hartman, Eline M. J.; Daemen, Joost; van Geuns, Robert J.; van Domburg, Ron T.

    2016-01-01

    Subjective health status is an increasingly important parameter to assess the effect of percutaneous coronary intervention (PCI) in clinical practice. Aim of this study was to determine medical and psychosocial predictors of poor subjective health status over a 10 years' post-PCI period. We included

  3. Marital Satisfaction and Depression as Predictors of Physical Health Status.

    Science.gov (United States)

    Weiss, Robert L.; Aved, Barbara M.

    1978-01-01

    Results indicate correlation between physical health status and depression was greater for wives than husbands. For wives, marital satisfaction and depression were related through uncontrolled variance in physical health status. For husbands, significant relationship between marital satisfaction and depression remained when physical health was…

  4. User-fee-removal improves equity of children's health care utilization and reduces families' financial burden: evidence from Jamaica.

    Science.gov (United States)

    Li, Zhihui; Li, Mingqiang; Fink, Günther; Bourne, Paul; Bärnighausen, Till; Atun, Rifat

    2017-06-01

    The impact of user-fee policies on the equity of health care utilization and households' financial burdens has remained largely unexplored in Latin American and the Caribbean, as well as in upper-middle-income countries. This paper assesses the short- and long-term impacts of Jamaica's user-fee-removal for children in 2007. This study utilizes 14 rounds of data from the Jamaica Survey of Living Conditions (JSLC) for the periods 1996 to 2012. JSLC is a national household survey, which collects data on health care utilization and among other purposes for planning. Interrupted time series (ITS) analysis was used to examine the immediate impact of the user-fee-removal policy on children's health care utilization and households' financial burdens, as well as the impact in the medium- to long-term. Immediately following the implementation of user-fee-removal, the odds of seeking for health care if the children fell ill in the past 4 weeks increased by 97% (odds ratio 2.0, 95% confidence interval (CI) 1.1 to 3.5, P  = 0.018). In the short-term (2007-2008), health care utilization increased at a faster rate among children not in poverty than children in poverty; while this gap narrowed after 2008. There was minimal difference in health care utilization across wealth groups in the medium- to long-term. The household's financial burden (health expenditure as a share of household's non-food expenditures) reduced by 6 percentage points (95% CI: -11 to -1, P  = 0.020) right after the policy was implemented and kept at a low level. The difference in financial burden between children in poverty and children not in poverty shrunk rapidly after 2007 and remained small in subsequent years. User-fee-removal had a positive impact on promoting health care utilization among children and reducing their household health expenditures in Jamaica. The short-term and the medium- to long-term results have different indications: In the short-term, the policy deteriorated the equity of

  5. Effect of adaptive abilities on utilities, direct or mediated by mental health?

    NARCIS (Netherlands)

    Peeters, Yvette; Ranchor, Adelita V.; Vlieland, Thea P. M. Vliet; Stiggelbout, Anne M.

    2010-01-01

    Background: In cost-utility analyses gain in health can be measured using health state utilities. Health state utilities can be elicited from members of the public or from patients. Utilities given by patients tend to be higher than utilities given by members of the public. This difference is often

  6. Domestic Violence and its Effect on Oral Health Behaviour and Oral Health Status

    Science.gov (United States)

    P, Basavaraj; Singla, Ashish; Kote, Sunder; Singh, Shilpi; Jain, Swati; Singh, Khushboo; Vashishtha, Vaibhav

    2014-01-01

    Introduction: Violence against women is one of the major public health and human rights problem in the world today. Hence, the present study was conducted with the aim to assess the effect of domestic violence on oral health behavior and oral health status of females attending community outreach programmes in and around Modinagar. Materials and Methods: A cross-sectional study was conducted through the community outreach programmes organized in Modinagar. A structured questionnaire was used to illicit information regarding socio demographic characteristics, oral health behavior and domestic violence. The dental health examination was done to record dental health status, intraoral and extraoral soft tissue injury, tooth fracture and tooth avulsion due to the injury. Results: Out of the total 304 women, 204(67.1%) reported positive domestic violence. Psychological violence was found to be severe whereas sexual violence was found to be mild in most of the cases. Significant difference was found between oral hygiene aids used , frequency of tooth brushing, periodontal status, missing teeth, intraoral soft tissue injuries and fractures between both the groups (p<0.05). Conclusion: The present study confirmed that domestic violence had significant influence on oral health behavior and oral health status of women. Thus, the dental professionals also should make an attempt to help victims gain access to support and referral services and to provide adequate treatment to them so as to make a positive difference in their lives. PMID:25584297

  7. Utilization of dental health care services in context of the HIV epidemic- a cross-sectional study of dental patients in the Sudan.

    Science.gov (United States)

    Nasir, Elwalid Fadul; Astrøm, Anne Nordrehaug; David, Jamil; Ali, Raouf Wahab

    2009-11-16

    HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors. Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH) and University of Science and Technology (UST) during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH) were examined clinically (DMFT) and participated in an interview. A total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5) were associated with lower odds and females were associated with higher odds (OR = 2.0) for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6) and higher HIV related experience (OR = 0.7) were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3) were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8). Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to minimize avoidance behaviour and help establish dental

  8. Utilization of medical services in the public health system in the Southern Brazil.

    Science.gov (United States)

    Bastos, Gisele Alsina Nader; Duca, Giovâni Firpo Del; Hallal, Pedro Curi; Santos, Iná S

    2011-06-01

    To estimate the prevalence and analyze factors associated with the utilization of medical services in the public health system. Cross-sectional population-based study with 2,706 individuals aged 20-69 years carried out in Pelotas, Southern Brazil, in 2008. A systematic sampling with probability proportional to the number of households in each sector was adopted. The outcome was defined by the combination of the questions related to medical consultation in the previous three months and place. The exposure variables were: sex, age, marital status, level of schooling, family income, self-reported hospital admission in the previous year, having a regular physician, self-perception of health, and the main reason for the last consultation. Descriptive analysis was stratified by sex and the analytical statistics included the use of the Wald test for tendency and heterogeneity in the crude analysis and Poisson regression with robust variance in the adjusted analysis, taking into consideration cluster sampling. The prevalence of utilization of medical services in the three previous months was 60.6%, almost half of these (42.0%, 95%CI: 36.6;47.5) in public services. The most utilized public services were the primary care units (49.5%). In the adjusted analysis stratified by sex, men with advanced age and young women had higher probability of using the medical services in the public system. In both sexes, low level of schooling, low per capita family income, not having a regular physician and hospital admission in the previous year were associated with the outcome. Despite the expressive reduction in the utilization of medical health services in the public system in the last 15 years, the public services are now reaching a previously unassisted portion of the population (individuals with low income and schooling).

  9. The relationship between physical and psychological symptoms and health care utilization in hospitalized patients with advanced cancer.

    Science.gov (United States)

    Nipp, Ryan D; El-Jawahri, Areej; Moran, Samantha M; D'Arpino, Sara M; Johnson, P Connor; Lage, Daniel E; Wong, Risa L; Pirl, William F; Traeger, Lara; Lennes, Inga T; Cashavelly, Barbara J; Jackson, Vicki A; Greer, Joseph A; Ryan, David P; Hochberg, Ephraim P; Temel, Jennifer S

    2017-12-01

    Patients with advanced cancer often experience frequent and prolonged hospitalizations; however, the factors associated with greater health care utilization have not been described. We sought to investigate the relation between patients' physical and psychological symptom burden and health care utilization. We enrolled patients with advanced cancer and unplanned hospitalizations from September 2014-May 2016. Upon admission, we assessed physical (Edmonton Symptom Assessment System [ESAS]) and psychological symptoms (Patient Health Questionnaire 4 [PHQ-4]). We examined the relationship between symptom burden and healthcare utilization using linear regression for hospital length of stay (LOS) and Cox regression for time to first unplanned readmission within 90 days. We adjusted all models for age, sex, marital status, comorbidity, education, time since advanced cancer diagnosis, and cancer type. We enrolled 1,036 of 1,152 (89.9%) consecutive patients approached. Over one-half reported moderate/severe fatigue, poor well being, drowsiness, pain, and lack of appetite. PHQ-4 scores indicated that 28.8% and 28.0% of patients had depression and anxiety symptoms, respectively. The mean hospital LOS was 6.3 days, and the 90-day readmission rate was 43.1%. Physical symptoms (ESAS: unstandardized coefficient [B], 0.06; P cancer experience a high symptom burden, which is significantly associated with prolonged hospitalizations and readmissions. Interventions are needed to address the symptom burden of this population to improve health care delivery and utilization. Cancer 2017;123:4720-4727. © 2017 American Cancer Society. © 2017 American Cancer Society.

  10. Oral health status among 12 and 15 year old children from ...

    African Journals Online (AJOL)

    Background: The assessment of oral health status of children in government and private schools provide data on the oral health status of children from different socio‑economic background. Aim: The aim of the following study is to assess and to compare the oral hygiene status, gingival status and caries experience between ...

  11. Utilization of Antenatal HealthCare Services among Fishermen Population in Kanchipuram District, Tamil Nadu: A Cross-sectional Study.

    Science.gov (United States)

    Danasekaran, Raja; Raja, Pavithra; Ranganathan, Karnaboopathy

    2017-01-01

    Considering the global and national level commitments in improving the maternal health as well as reducing the maternal mortality, assessment of factors influencing the delivery of antenatal healthcare services becomes essential. The aim is to assess the utilization of antenatal health services and to identify the factors influencing their utilization among women of fishermen population in Kanchipuram district, Tamil Nadu. The cross-sectional study was carried out among the mothers in Kovalam area of Kanchipuram district. Details were collected using a pretested questionnaire and analyzed using statistical software. The study included 284 mothers, of which 35% were illiterates. Nearly 60.21% have got registered with the Government sector, 59.51% of the mothers had three or more antenatal visits, 64.08% have received two doses of tetanus toxoid, and 73.24% have taken iron and folic acid tablets. Factors which were identified to have statistically significant association with better utilization of antenatal health services were age >30 years, higher educational status, skilled workers, those having their first child, and higher socioeconomic class. This study has reported the fact that antenatal healthcare services were not utilized fully by the community and the fishermen population being a special group has to be given the needed attention from the healthcare delivery system.

  12. Racial/Ethnic Disparities in Mental Health Care Utilization among U.S. College Students: Applying the Institution of Medicine Definition of Health Care Disparities.

    Science.gov (United States)

    Hunt, Justin B; Eisenberg, Daniel; Lu, Liya; Gathright, Molly

    2015-10-01

    The authors apply the Institute of Medicine's definition of health care disparities to college students. The analysis pools data from the first two waves of the Healthy Minds Study, a multicampus survey of students' mental health (N = 13,028). A probit model was used for any past-year service utilization, and group differences in health status were adjusted by transforming the entire distribution for each minority population to approximate the white distribution. Disparities existed between whites and all minority groups. Compared to other approaches, the predicted service disparities were greater because this method included the effects of mediating SES variables. Health care disparities persist in the college setting despite improved access and nearly universal insurance coverage. Our findings emphasize the importance of investigating potential sources of disparities beyond geography and coverage.

  13. Does mobile phone ownership predict better utilization of maternal and newborn health services? a cross-sectional study in Timor-Leste.

    Science.gov (United States)

    Nie, Juan; Unger, Jennifer Anna; Thompson, Susan; Hofstee, Marisa; Gu, Jing; Mercer, Mary Anne

    2016-07-23

    Increasingly popular mobile health (mHealth) programs have been proposed to promote better utilization of maternal, newborn and child health services. However, women who lack access to a mobile phone are often left out of both mHealth programs and research. In this study, we determine whether household mobile phone ownership is an independent predictor of utilization of maternal and newborn health services in Timor-Leste. The study included 581 women aged 15-49 years with a child under the age of two years from the districts of Manufahi and Ainaro in Timor-Leste. Participants were interviewed via a structured survey of knowledge, practices, and coverage of maternal and child health services, with additional questions related to ownership and utilization of mobile phones. Mobile phone ownership was the exposure variable, and the dependent variables included having at least four antenatal care visits, skilled birth attendance, health facility delivery, a postnatal checkup within 24 h, and a neonatal checkup within 24 h for their youngest child. Logistic regression models were applied to assess for associations. Sixty-seven percent of women reported having at least one mobile phone in the family. Women who had a mobile phone were significantly more likely to be of higher socioeconomic status and to utilize maternal and newborn health services. However, after adjusting socioeconomic factors, household mobile phone ownership was not independently associated with any of the dependent variables. Evaluations of the effects of mHealth programs on health in a population need to consider the likelihood of socioeconomic differentials indicated by mobile phone ownership.

  14. Utilization of health care services by migrants in Europe

    DEFF Research Database (Denmark)

    Graetz, V.; Rechel, B.; Groot, W.

    2017-01-01

    : Compared with previous systematic reviews, the results indicate a clearer picture of the differences in health service utilization between migrants and non-migrants in Europe. Areas timely for developing research: A comprehensive comparison across European countries is impossible because the number......Introduction: Our study reviewed the empirical evidence on the utilization of health care services by migrants in Europe, and on differences in health service utilization between migrants and non-migrants across European countries. Sources of data: A systematic literature review was performed......, searching the databases Medline, Cinahl and Embase and covering the period from January 2009 to April 2016. The final number of articles included was 39. Areas of agreement: Utilization of accident and emergency services and hospitalizations were higher among migrants compared with non-migrants in most...

  15. International Students: A Comparison of Health Status and Physical Health before and after Coming to the United States

    Science.gov (United States)

    Msengi, Clementine M.; Msengi, Israel G.; Harris, Sandra; Hopson, Michael

    2011-01-01

    The purpose of this study was to assess the health status and physical health of international students at five American universities. International students in the United States were asked to compare the status of their health before and after coming to the United States. Findings suggested that health status of international students declined…

  16. Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam

    Directory of Open Access Journals (Sweden)

    Liu Xiaoyun

    2012-02-01

    Full Text Available Abstract Introduction Health care financing reforms in both China and Vietnam have resulted in greater financial difficulties in accessing health care, especially for the rural poor. Both countries have been developing rural health insurance for decades. This study aims to evaluate and compare equity in access to health care in rural health insurance system in the two countries. Methods Household survey and qualitative study were conducted in 6 counties in China and 4 districts in Vietnam. Health insurance policy and its impact on utilization of outpatient and inpatient service were analyzed and compared to measure equity in access to health care. Results In China, Health insurance membership had no significant impact on outpatient service utilization, while was associated with higher utilization of inpatient services, especially for the higher income group. Health insurance members in Vietnam had higher utilization rates of both outpatient and inpatient services than the non-members, with higher use among the lower than higher income groups. Qualitative results show that bureaucratic obstacles, low reimbursement rates, and poor service quality were the main barriers for members to use health insurance. Conclusions China has achieved high population coverage rate over a short time period, starting with a limited benefit package. However, poor people have less benefit from NCMS in terms of health service utilization. Compared to China, Vietnam health insurance system is doing better in equity in health service utilization within the health insurance members. However with low population coverage, a large proportion of population cannot enjoy the health insurance benefit. Mutual learning would help China and Vietnam address these challenges, and improve their policy design to promote equitable and sustainable health insurance.

  17. Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam

    Science.gov (United States)

    2012-01-01

    Introduction Health care financing reforms in both China and Vietnam have resulted in greater financial difficulties in accessing health care, especially for the rural poor. Both countries have been developing rural health insurance for decades. This study aims to evaluate and compare equity in access to health care in rural health insurance system in the two countries. Methods Household survey and qualitative study were conducted in 6 counties in China and 4 districts in Vietnam. Health insurance policy and its impact on utilization of outpatient and inpatient service were analyzed and compared to measure equity in access to health care. Results In China, Health insurance membership had no significant impact on outpatient service utilization, while was associated with higher utilization of inpatient services, especially for the higher income group. Health insurance members in Vietnam had higher utilization rates of both outpatient and inpatient services than the non-members, with higher use among the lower than higher income groups. Qualitative results show that bureaucratic obstacles, low reimbursement rates, and poor service quality were the main barriers for members to use health insurance. Conclusions China has achieved high population coverage rate over a short time period, starting with a limited benefit package. However, poor people have less benefit from NCMS in terms of health service utilization. Compared to China, Vietnam health insurance system is doing better in equity in health service utilization within the health insurance members. However with low population coverage, a large proportion of population cannot enjoy the health insurance benefit. Mutual learning would help China and Vietnam address these challenges, and improve their policy design to promote equitable and sustainable health insurance. PMID:22376290

  18. Health Status of Current National Guard Members

    National Research Council Canada - National Science Library

    Proctor, Susan P

    2005-01-01

    .... The objectives are to: 1) describe the current health status of this ARNG cohort, 2) examine to what extent the job strain of ARNG service affects the relationship between Civilian job strain and health and job performance outcomes and, 3...

  19. Measuring the Influence of Legally Recognized Partnerships on the Health and Well-Being of Same-Sex Couples: Utility of the California Health Interview Survey

    Science.gov (United States)

    Irvin, Veronica L.; Sun, Qiankun; Breen, Nancy

    2017-01-01

    Abstract Purpose: This study explored the utility of the California Health Interview Survey (CHIS) to compare health-related outcomes among gay men, lesbians, and heterosexuals who reported being in a legally recognized partnership. Methods: We regressed sexual identity and marriage/legally recognized partnership status on seven different outcomes related to health insurance coverage, medical services access and use, and general health and well-being using CHIS data collected between 2009 and 2013. Results: There were 1432 respondents who identified as gay, lesbian, or homosexual, and 67,746 who identified as heterosexual. The percentage of participants who reported being married/legally partnered was 54.06% for heterosexual women, 52.93% for heterosexual men, 38.83% for lesbians, and 23.56% for gay men. Legally partnered/married gay and lesbian respondents were more likely to have health insurance and use healthcare than their counterparts not in such partnerships; few trends were statistically significant. Gay men in legally recognized partnerships were more likely than their heterosexual counterparts to report continuous health insurance coverage, a usual medical care source, and at least one provider visit within the past 12 months. We found statistically significant poorer health status outcomes among lesbians in legally recognized partnerships compared to married heterosexual women. Conclusions: Lesbians in legally recognized partnerships did not fare as well as married heterosexual women. Gay men in legally recognized partnerships fared better than married heterosexual men on some measures. CHIS questionnaire structures limited our sample and analyses. We recommend that CHIS and other researchers ask partnered status-, marriage-, and sexual identity-related questions en bloc to ensure more robust representation, analyses, recommendations, and policy resolutions. PMID:28207297

  20. Comparison of relative and non-relative adoptive parent health status.

    Science.gov (United States)

    Foli, Karen J; Lim, Eunjung; Sands, Laura P

    2015-03-01

    Across the United States, kinship parents, extended family members and close friends, render care to the 2.7 million children who have been removed from their birth parents' care. However, differences between relative and non-relative parents reported health statuses have not been explored. The National Survey of Adoptive Parents data were used to investigate the health status of relative (n = 469) and non-relative (n = 1,599) adoptive parents. Perceived happiness in the parent-child relationship and the parents' ability to cope appear to affect parental health status. Only non-related mothers of children younger than 6 years reported better emotional health than those mothers who were related to their children. With this exception, and despite caring for children who have a greater likelihood of abuse, neglect, and exposure to drugs and alcohol prior to birth, the reported health statuses of relative parents did not differ from non-relative parents. © The Author(s) 2013.

  1. Self-Esteem, Oral Health Behaviours, and Clinical Oral Health Status in Chinese Adults: An Exploratory Study

    Science.gov (United States)

    Chin, Luzy Siu-Hei; Chan, Joanne Chung-Yan

    2013-01-01

    Objectives: This is an exploratory study to examine the relations among self-esteem, oral health behaviours and clinical oral health status in Chinese adults. In addition, gender differences in clinical oral health status and oral health behaviours were explored. Methods: Participants were 192 patients from a private dental clinic in Hong Kong…

  2. Research utilization among children's mental health providers

    Directory of Open Access Journals (Sweden)

    Ferguson H Bruce

    2008-04-01

    Full Text Available Abstract Background Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH service provider organizations in Ontario, Canada. Methods A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. Results There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use – access, assess, adapt, and apply – research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. Conclusion These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

  3. Research utilization among children's mental health providers.

    Science.gov (United States)

    Barwick, Melanie A; Boydell, Katherine M; Stasiulis, Elaine; Ferguson, H Bruce; Blase, Karen; Fixsen, Dean

    2008-04-09

    Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use - access, assess, adapt, and apply - research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

  4. Effects of TCMC on Transformation of Good Health Status to Suboptimal Health Status: A Nested Case-Control Study

    Science.gov (United States)

    Wang, Tian; Chen, Jieyu; Sun, Xiaomin; Xiang, Lei; Zhou, Lin; Li, Fei; Lin, Changsong; Jiang, Pingping; Wu, Shengwei; Xiao, Ya; Cheng, Jingru; Luo, Ren; Liu, Yanyan; Zhao, Xiaoshan

    2015-01-01

    To explore the effects of traditional Chinese medicine constitution (TCMC) on transformation of good health status to suboptimal health status (SHS), we conducted a nested case-control study among college students in China. During the 18-month mean follow-up time, 543 cases of SHS (42.7%) occurred in 1273 healthy students. There was a significant (P = 0.000) and marked reduction in SHMS V1.0 total score in the case group at the 18-month follow-up (69.32 ± 5.45) compared with baseline (78.60 ± 4.70), but there was no significant change in the control group. Conditional logistic regression analysis showed that respondents reporting Yin-deficiency and Qi-deficiency were, respectively, 2.247 and 2.198 times more likely to develop SHS, while tendency to Yin-deficiency and tendency to Damp-heat were, respectively, 1.642 and 1.506 times more likely to develop SHS. However, the Balanced Constitution was a significant protective factor (OR 0.649; P < 0.05). Altogether, these findings demonstrate that Yin-deficiency, Qi-deficiency, tendency to Yin-deficiency, and tendency to Damp-heat appeared to induce a change in health status to SHS, while the Balanced Constitution seemed to restrain this change. We conclude that regulating the unbalanced TCMC (such as Yin-deficiency and Qi-deficiency) may prevent a healthy status developing into SHS or lead to the regression of SHS. PMID:26346320

  5. Effects of TCMC on Transformation of Good Health Status to Suboptimal Health Status: A Nested Case-Control Study

    Directory of Open Access Journals (Sweden)

    Tian Wang

    2015-01-01

    Full Text Available To explore the effects of traditional Chinese medicine constitution (TCMC on transformation of good health status to suboptimal health status (SHS, we conducted a nested case-control study among college students in China. During the 18-month mean follow-up time, 543 cases of SHS (42.7% occurred in 1273 healthy students. There was a significant (P=0.000 and marked reduction in SHMS V1.0 total score in the case group at the 18-month follow-up (69.32 ± 5.45 compared with baseline (78.60 ± 4.70, but there was no significant change in the control group. Conditional logistic regression analysis showed that respondents reporting Yin-deficiency and Qi-deficiency were, respectively, 2.247 and 2.198 times more likely to develop SHS, while tendency to Yin-deficiency and tendency to Damp-heat were, respectively, 1.642 and 1.506 times more likely to develop SHS. However, the Balanced Constitution was a significant protective factor (OR 0.649; P<0.05. Altogether, these findings demonstrate that Yin-deficiency, Qi-deficiency, tendency to Yin-deficiency, and tendency to Damp-heat appeared to induce a change in health status to SHS, while the Balanced Constitution seemed to restrain this change. We conclude that regulating the unbalanced TCMC (such as Yin-deficiency and Qi-deficiency may prevent a healthy status developing into SHS or lead to the regression of SHS.

  6. Community perceptions and factors influencing utilization of health services in Uganda

    Directory of Open Access Journals (Sweden)

    Galea Sandro

    2009-07-01

    Full Text Available Abstract Background Healthcare utilization has particular relevance as a public health and development issue. Unlike material and human capital, there is little empirical evidence on the utility of social resources in overcoming barriers to healthcare utilization in a developing country context. We sought to assess the relevance of social resources in overcoming barriers to healthcare utilization. Study Objective To explore community perceptions among three different wealth categories on factors influencing healthcare utilization in Eastern Uganda. Methods We used a qualitative study design using Focus Group Discussions (FGD to conduct the study. Community meetings were initially held to identify FGD participants in the different wealth categories, ('least poor', 'medium' and 'poorest' using poverty ranking based on ownership of assets and income sources. Nine FGDs from three homogenous wealth categories were conducted. Data from the FGDs was analyzed using content analysis revealing common barriers as well as facilitating factors for healthcare service utilization by wealth categories. The Health Access Livelihood Framework was used to examine and interpret the findings. Results Barriers to healthcare utilization exist for all the wealth categories along three different axes including: the health seeking process; health services delivery; and the ownership of livelihood assets. Income source, transport ownership, and health literacy were reported as centrally useful in overcoming some barriers to healthcare utilization for the 'least poor' and 'poor' wealth categories. The 'poorest' wealth category was keen to utilize free public health services. Conversely, there are perceptions that public health facilities were perceived to offer low quality care with chronic gaps such as shortages of essential supplies. In addition to individual material resources and the availability of free public healthcare services, social resources are perceived as

  7. Exploring the differences in general practitioner and health care specialist utilization according to education, occupation, income and social networks across Europe: findings from the European social survey (2014) special module on the social determinants of health.

    Science.gov (United States)

    Fjær, Erlend L; Balaj, Mirza; Stornes, Per; Todd, Adam; McNamara, Courtney L; Eikemo, Terje A

    2017-02-01

    Low socioeconomic position (SEP) tends to be linked to higher use of general practitioners (GPs), while the use of health care specialists is more common in higher SEPs. Despite extensive literature in this area, previous studies have, however, only studied health care use by income or education. The aim of this study is, therefore, to examine inequalities in GP and health care specialist use by four social markers that may be linked to health care utilization (educational level, occupational status, level of financial strain and size and frequency of social networks) across 20 European countries and Israel. Logistic regression models were employed using data from the seventh round of the European Social Survey; this study focused upon people aged 25–75 years, across 21 countries. Health care utilization was measured according to self-reported use of GP or specialist care within 12 months. Analyses tested four social markers: income (financial strain), occupational status, education and social networks. We observed a cross-national tendency that countries with higher or equal probability of GP utilization by lower SEP groups had a more consistent probability of specialist use among high SEP groups. Moreover, countries with inequalities in GP use in favour of high SEP groups had comparable levels of inequalities in specialist care utilization. This was the case for three social markers (education, occupational class and social networks), while the pattern was less pronounced for income (financial strain). There are significant inequalities associated with GP and specialist health care use across Europe—with higher SEP groups more likely to use health care specialists, compared with lower SEP groups. In the context of health care specialist use, education and occupation appear to be particularly important factors. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  8. Health status in women with Turner syndrome: a questionnaire study on health status, education, work participation and aspects of sexual functioning.

    Science.gov (United States)

    Naess, Eva Elisabeth; Bahr, David; Gravholt, Claus H

    2010-05-01

    Turner syndrome (TS) is a complex medical condition with specific cognitive and psychosocial characteristics and frequent medical morbidity. Few studies have investigated the influence this has on health status, education and ability to work. To explore health status, level of education, work participation, medical conditions, physical activity, satisfaction with life and aspects of sexual functioning in adult TS women and compare with a matched control group. A questionnaire was sent to 168 adult women with TS >18 years registered in a database of Frambu Resource Centre for Rare Disorders and The TS Association in Norway. We assessed health status with Short Form 36, education with Norwegian Standard Classification of Education, and employment with The General Nordic Questionnaire. Life satisfaction was measured with LiSat-9, and questions on psychological strain during life phases were included. Eighty women with TS (34.0 +/- 11.7 years) and 214 controls (32.9 +/- 10.6) responded. The TS group reported significantly more health problems and impaired health status in the two subscales "physical functioning" and "general health" (P education and work participation was similar among TS and controls. TS moved away from their parents' home later than controls (20.4 +/- 4.0 vs. 18.7 +/- 2.1, P = 0.001). Age at sexual debut differed significantly (21.2 +/- 4.3 vs. 17.3 +/- 2.4 years, P education and level of employment as controls, they report more frequent occurrence of medical conditions, but scored lower on only two subscales in the SF-36. Despite considerable medical morbidity, TS seem to cope well with life.

  9. User–fee–removal improves equity of children’s health care utilization and reduces families’ financial burden: evidence from Jamaica

    Science.gov (United States)

    Li, Zhihui; Li, Mingqiang; Fink, Günther; Bourne, Paul; Bärnighausen, Till; Atun, Rifat

    2017-01-01

    Background The impact of user–fee policies on the equity of health care utilization and households’ financial burdens has remained largely unexplored in Latin American and the Caribbean, as well as in upper–middle–income countries. This paper assesses the short– and long–term impacts of Jamaica’s user–fee–removal for children in 2007. Methods This study utilizes 14 rounds of data from the Jamaica Survey of Living Conditions (JSLC) for the periods 1996 to 2012. JSLC is a national household survey, which collects data on health care utilization and among other purposes for planning. Interrupted time series (ITS) analysis was used to examine the immediate impact of the user–fee–removal policy on children’s health care utilization and households’ financial burdens, as well as the impact in the medium– to long–term. Results Immediately following the implementation of user–fee–removal, the odds of seeking for health care if the children fell ill in the past 4 weeks increased by 97% (odds ratio 2.0, 95% confidence interval (CI) 1.1 to 3.5, P = 0.018). In the short–term (2007–2008), health care utilization increased at a faster rate among children not in poverty than children in poverty; while this gap narrowed after 2008. There was minimal difference in health care utilization across wealth groups in the medium– to long–term. The household’s financial burden (health expenditure as a share of household’s non–food expenditures) reduced by 6 percentage points (95% CI: –11 to –1, P = 0.020) right after the policy was implemented and kept at a low level. The difference in financial burden between children in poverty and children not in poverty shrunk rapidly after 2007 and remained small in subsequent years. Conclusions User–fee–removal had a positive impact on promoting health care utilization among children and reducing their household health expenditures in Jamaica. The short–term and the medium– to long

  10. Association between oral health status and nutritional status in south Brazilian independent-living older people.

    Science.gov (United States)

    De Marchi, Renato José; Hugo, Fernando Neves; Hilgert, Juliana Balbinot; Padilha, Dalva Maria Pereira

    2008-06-01

    Evidence suggests that older people with partial tooth loss and edentulism change their diet and lack specific nutrients, but few studies have assessed whether poor oral status is associated with risk of malnutrition and malnutrition in independent-living older people. We evaluated if poor oral status was associated with risk of malnutrition and malnutrition in this population. A random sample of 471 south Brazilians > or =60 y of age was evaluated. Measurements included a questionnaire to assess sociodemographic, behavioral, general, and oral health data; nutritional status assessment, according to the Mini-Nutritional Assessment (MNA); and oral status assessment, by means of oral examinations assessing the number of teeth and use of dental prostheses. Correlates of risk of malnutrition/malnutrition according to the MNA were assessed by means of multivariate logistic regression. Participants who reported dissatisfaction with their gingival health and edentulous persons wearing only one denture were more likely to be at risk of malnutrition, according to the screening MNA. Dissatisfaction with gingival health was a risk indicator, whereas having one to eight natural teeth was protective against the risk of malnutrition/malnutrition according to the full MNA. In the present study, older people with a compromised oral status had higher odds for risk of malnutrition. The maintenance of a few teeth had a crucial role in increasing the chance of maintaining an adequate nutritional status in the studied population. In cases where edentulism was present, complete dental prosthetic use was associated with better nutritional status.

  11. Effects of Parent Immigration Status on Mental Health Service Use Among Latino Children Referred to Child Welfare.

    Science.gov (United States)

    Finno-Velasquez, Megan; Cardoso, Jodi Berger; Dettlaff, Alan J; Hurlburt, Michael S

    2016-02-01

    Latino families may be at risk of experiencing stressors resulting from the immigration process, such as those related to documentation status and acculturation, that may increase their need for mental health services. However, little research exists on the mental health needs and service use of Latino children. This study examined how parental nativity and legal status influence mental health needs and service utilization among children in Latino families investigated by child welfare. Data from the second National Survey of Child and Adolescent Well-Being, a nationally representative, prospective study of families investigated by child welfare agencies for maltreatment, were used to examine mental health need and service use in a subset of Latino children who remained in the home following a maltreatment investigation (N=390). Although children of immigrants did not differ from children of U.S.-born parents in levels of clinical need, they had lower rates of mental health service receipt. After the analyses accounted for other relevant variables, the odds of receiving services were significantly lower (odds ratio=.09) for children whose parents were undocumented compared with children whose parents were U.S. citizens. This study contributes to growing discourse on Latino family needs within the child welfare system. Analyses support earlier research regarding the effects of parent nativity on mental health service use and advance the literature by identifying parent legal status as a unique barrier to child service receipt.

  12. Associations between hours worked, symptoms and health resource utilization among full-time male Japanese workers.

    Science.gov (United States)

    Sato, Keiko; Yamazaki, Shin; Hayashino, Yasuaki; Takegami, Misa; Tokuda, Yasuharu; Takahashi, Osamu; Shimbo, Takuro; Hinohara, Shigeaki; Fukui, Tsuguya; Fukuhara, Shunichi

    2011-01-01

    To investigate the association between hours worked, symptoms experienced, and health resource utilization. Data were collected from a nationally representative sample of households in Japan. We studied full-time male workers aged 18-65 yr who worked 100 h or more per month. First, we examined the association between hours worked and symptoms experienced. Second, we examined the association between hours worked and the type of health resource utilized, such as physician visits, over-the-counter (OTC) medication use, dietary supplement use, and complementary and alternative medicine (CAM) provider visits. We used a multivariable negative binominal model in each analysis. Of the 762 male workers, 598 reported experiencing symptoms at least once a month. We categorized participants based on the number of hours worked per month (h/mo): 100-200 h/mo, 201-250 h/mo, and over 250 h/mo. Compared with those working 201-250 h/mo, those working 100-200 h/mo had more frequent physician visits (rate ratio:1.67, 95% CI: 1.17 to 2.38) and those working over 250 h/mo had significantly lower rates of CAM provider visits and tended to use dietary supplements for symptoms. Participants who worked 201-250 h/mo used OTC medication most frequently. No significant association was observed between the number of hours worked and number of symptoms experienced. The more hours worked by full-time male workers, the more likely they were to use health resources that had a lower time requirement. Greater attention should be paid to patterns of health resource utilization among workers and their consequent influence on long-term health status.

  13. Health status and air pollution related socioeconomic concerns in urban China.

    Science.gov (United States)

    Jiao, Kaishan; Xu, Mengjia; Liu, Meng

    2018-02-05

    China is experiencing environmental issues and related health effects due to its industrialization and urbanization. The health effects associated with air pollution are not just a matter of epidemiology and environmental science research, but also an important social science issue. Literature about the relationship of socioeconomic factors with the environment and health factors is inadequate. The relationship between air pollution exposure and health effects in China was investigated with consideration of the socioeconomic factors. Based on nationwide survey data of China in 2014, we applied the multilevel mixed-effects model to evaluate how socioeconomic status (represented by education and income) contributed to the relationship between self-rated air pollution and self-rated health status at community level and individual level. The findings indicated that there was a non-linear relationship between the community socioeconomic status and community air pollution in urban China, with the highest level of air pollution presented in the communities with moderate socioeconomic status. In addition, health effects associated air pollution in different socioeconomic status groups were not equal. Self-rated air pollution had the greatest impact on self-rated health of the lower socioeconomic groups. With the increase of socioeconomic status, the effect of self-rated air pollution on self-rated health decreased. This study verified the different levels of exposure to air pollution and inequality in health effects among different socioeconomic groups in China. It is imperative for the government to urgently formulate public policies to enhance the ability of the lower socioeconomic groups to circumvent air pollution and reduce the health damage caused by air pollution.

  14. WEIGHT AND HEALTH STATUS OF BLACK FEMALE STUDENTS

    African Journals Online (AJOL)

    address not only the problems of undernutrition, but also to monitor the weight and health ..... women of low socio-economic status were found to be at the greatest risk of an .... Public Health, Harvard University Press. 1996. 2. World Health ...

  15. [Self-perceived health status: an approach of the elderly in Mexico].

    Science.gov (United States)

    Gallegos-Carrillo, Katia; García-Peña, Carmen; Duran-Muñoz, Carlos; Reyes, Hortensia; Durán-Arenas, Luis

    2006-10-01

    To evaluate health status of the elderly in Mexico through their self-perception and to describe social, organizational and health-related factors. A study was carried out on secondary data from the 2000 National Health Survey in Mexico. Multiple logistic regression models were used. The dependent variable health status was measured through self-perception. The independent variables included were: sociodemographic characteristics, risk behaviors, accidents, disease diagnosis and clinical measures. A total of 7,322 adults aged 60 years and older were studied, which represents 7% of the total population in that age group in Mexico. Of them, 19.8% reported poor or very poor health status. Factors found to be associated to poor health were age, female sex, having no social security, being divorced, homemaker, disabled, unemployed, tobacco consumption, having a health condition, accidents and diagnosed with chronic diseases. The study allowed to identifying factors that may contribute to poor health status in the elderly. These findings could be taken into account in the development of actions and health care programs for this population in Mexico.

  16. The effect of perceived health status on patient satisfaction.

    Science.gov (United States)

    Xiao, Hong; Barber, Janet P

    2008-01-01

    To examine the effect of perceived health status on three components of patient satisfaction. The Household Component of the 1999 Medical Expenditure Panel Survey for people 35-64 years of age was used to examine the effect of perceived health status on patient satisfaction measured in terms of access to care, provider quality and quality of care. Descriptive statistics and multivariate regression were used to describe the subjects and to examine the relationship between patient satisfaction and perceived health status controlling for patient demographic factors, health factors and provider characteristics. All analyses used STATA 8.0 which is designed to analyze weighted data. A total of 4,417 patients (71% women) met the inclusion criteria for the study. Patients who rated their health excellent or good scored higher on the three dimensions of patient satisfaction. Higher scores on one or more components of patient satisfaction were associated with being older, married, better educated and having higher income, health insurance and good mental health. Seeing the health-care provider for an old problem resulted in lower levels of patient satisfaction. Provider characteristics significantly related to patient satisfaction were listening to the patient, being a specialist, seeing patients in an office setting and being located in the South. This study has shown that patient satisfaction is influenced by a person's self-perceived health status and other personal characteristics that are external to the delivery of health care. These findings suggest that patient satisfaction data should be used judiciously because a significant portion of the variation may be attributed to factors endogenous to the patient and therefore are not amenable to provider intervention.

  17. Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review.

    Science.gov (United States)

    Prinja, Shankar; Chauhan, Akashdeep Singh; Karan, Anup; Kaur, Gunjeet; Kumar, Rajesh

    2017-01-01

    Several publicly financed health insurance schemes have been launched in India with the aim of providing universalizing health coverage (UHC). In this paper, we report the impact of publicly financed health insurance schemes on health service utilization, out-of-pocket (OOP) expenditure, financial risk protection and health status. Empirical research studies focussing on the impact or evaluation of publicly financed health insurance schemes in India were searched on PubMed, Google scholar, Ovid, Scopus, Embase and relevant websites. The studies were selected based on two stage screening PRISMA guidelines in which two researchers independently assessed the suitability and quality of the studies. The studies included in the review were divided into two groups i.e., with and without a comparison group. To assess the impact on utilization, OOP expenditure and health indicators, only the studies with a comparison group were reviewed. Out of 1265 articles screened after initial search, 43 studies were found eligible and reviewed in full text, finally yielding 14 studies which had a comparator group in their evaluation design. All the studies (n-7) focussing on utilization showed a positive effect in terms of increase in the consumption of health services with introduction of health insurance. About 70% studies (n-5) studies with a strong design and assessing financial risk protection showed no impact in reduction of OOP expenditures, while remaining 30% of evaluations (n-2), which particularly evaluated state sponsored health insurance schemes, reported a decline in OOP expenditure among the enrolled households. One study which evaluated impact on health outcome showed reduction in mortality among enrolled as compared to non-enrolled households, from conditions covered by the insurance scheme. While utilization of healthcare did improve among those enrolled in the scheme, there is no clear evidence yet to suggest that these have resulted in reduced OOP expenditures or

  18. [Home health resource utilization measures using a case-mix adjustor model].

    Science.gov (United States)

    You, Sun-Ju; Chang, Hyun-Sook

    2005-08-01

    The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.

  19. The effect of special health care needs and health status on school functioning.

    Science.gov (United States)

    Reuben, Cynthia A; Pastor, Patricia N

    2013-10-01

    Past studies have shown that specific child conditions are associated with poor school outcomes. A national health survey with noncategorical measures of health and indicators of school functioning offers the opportunity to examine this association. To compare links between two health measures (children with special health care needs and general health status) and multiple school outcomes. The analysis was based on 59,440 children aged 6-17 years from the 2007 National Survey of Children's Health. Child health was assessed using the Children with Special Health Care Needs (CSHCN) screener and a question on general health status. CSHCN were classified by the complexity of their health care needs. Indicators of school functioning included special education use, many problem reports, repeated a grade, lack of school engagement, and many missed school days. Overall 22% of children were identified as CSHCN: 13% with more complex needs (C-CSHCN) and 9% with medication use only (CSHCN-RX). Approximately 17% of children were in less than optimal health. After controlling for a child's sociodemographic characteristics C-CSHCN had an increased risk of all of the negative school outcomes compared to children without SHCN, while CSHCN-RX had an increased risk of only one school outcome (many missed school days). Children in less than optimal health were at an increased risk of all negative school outcomes compared to children in optimal health. The CSHCN screener and health status question identify related, but distinct, groups of children with worse outcomes on the indicators of school functioning. Published by Elsevier Inc.

  20. A Health Assessment Survey of Veteran Students: Utilizing a Community College-Veterans Affairs Medical Center Partnership.

    Science.gov (United States)

    Misra-Hebert, Anita D; Santurri, Laura; DeChant, Richard; Watts, Brook; Sehgal, Ashwini R; Aron, David C

    2015-10-01

    To assess health status among student veterans at a community college utilizing a partnership between a Veterans Affairs Medical Center and a community college. Student veterans at Cuyahoga Community College in Cleveland, Ohio, in January to April 2013. A health assessment survey was sent to 978 veteran students. Descriptive analyses to assess prevalence of clinical diagnoses and health behaviors were performed. Logistic regression analyses were performed to assess for independent predictors of functional limitations. 204 students participated in the survey (21% response rate). Self-reported depression and unhealthy behaviors were high. Physical and emotional limitations (45% and 35%, respectively), and pain interfering with work (42%) were reported. Logistic regression analyses confirmed the independent association of self-reported depression with functional limitation (odds ratio [OR] = 3.3, 95% confidence interval [CI] 1.4-7.8, p statistic 0.72) and of post-traumatic stress disorder with pain interfering with work (OR 3.9, CI 1.1-13.6, p statistic 0.75). A health assessment survey identified priority areas to inform targeted health promotion for student veterans at a community college. A partnership between a Veterans Affairs Medical Center and a community college can be utilized to help understand the health needs of veteran students. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  1. [Current status and trends in the health of the Moscow population].

    Science.gov (United States)

    Tishuk, E A; Plavunov, N F; Soboleva, N P

    1997-01-01

    Based on vast comprehensive medical statistical database, the authors analyze the health status of the population and the efficacy of public health service in Moscow. The pre-crisis tendencies and the modern status of public health under modern socioeconomic conditions are noted.

  2. The Effect of Antiretroviral Treatment on Health Care Utilization in Rural South Africa: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Jan A C Hontelez

    Full Text Available The effect of the rapid scale-up of vertical antiretroviral treatment (ART programs for HIV in sub-Saharan Africa on the overall health system is under intense debate. Some have argued that these programs have reduced access for people suffering from diseases unrelated to HIV because ART programs have drained human and physical resources from other parts of the health system; others have claimed that the investments through ART programs have strengthened the general health system and the population health impacts of ART have freed up health care capacity for the treatment of diseases that are not related to HIV. To establish the population-level impact of ART programs on health care utilization in the public-sector health system, we compared trends in health care utilization among HIV-infected people receiving and not receiving ART with HIV-uninfected people during a period of rapid ART scale-up.We used data from the Wellcome Trust Africa Centre for Population Health, which annually elicited information on health care utilization from all surveillance participants over the period 2009-2012 (N = 32,319. We determined trends in hospitalization, and public-sector and private-sector primary health care (PHC clinic visits for HIV-infected and -uninfected people over a time period of rapid ART scale-up (2009-2012 in this community. We regressed health care utilization on HIV status and ART status in different calendar years, controlling for sex, age, and area of residence. The proportion of people who reported to have visited a public-sector primary health care (PHC clinic in the last 6 months increased significantly over the period 2009-2012, for both HIV-infected people (from 59% to 67%; p<0.001, and HIV-uninfected people (from 41% to 47%; p<0.001. In contrast, the proportion of HIV-infected people visiting a private-sector PHC clinic declined from 22% to 12% (p<0.001 and hospitalization rates declined from 128 to 82 per 1000 PY (p<0.001. For HIV

  3. The Effect of Antiretroviral Treatment on Health Care Utilization in Rural South Africa: A Population-Based Cohort Study.

    Science.gov (United States)

    Hontelez, Jan A C; Tanser, Frank C; Naidu, Kevindra K; Pillay, Deenan; Bärnighausen, Till

    2016-01-01

    The effect of the rapid scale-up of vertical antiretroviral treatment (ART) programs for HIV in sub-Saharan Africa on the overall health system is under intense debate. Some have argued that these programs have reduced access for people suffering from diseases unrelated to HIV because ART programs have drained human and physical resources from other parts of the health system; others have claimed that the investments through ART programs have strengthened the general health system and the population health impacts of ART have freed up health care capacity for the treatment of diseases that are not related to HIV. To establish the population-level impact of ART programs on health care utilization in the public-sector health system, we compared trends in health care utilization among HIV-infected people receiving and not receiving ART with HIV-uninfected people during a period of rapid ART scale-up. We used data from the Wellcome Trust Africa Centre for Population Health, which annually elicited information on health care utilization from all surveillance participants over the period 2009-2012 (N = 32,319). We determined trends in hospitalization, and public-sector and private-sector primary health care (PHC) clinic visits for HIV-infected and -uninfected people over a time period of rapid ART scale-up (2009-2012) in this community. We regressed health care utilization on HIV status and ART status in different calendar years, controlling for sex, age, and area of residence. The proportion of people who reported to have visited a public-sector primary health care (PHC) clinic in the last 6 months increased significantly over the period 2009-2012, for both HIV-infected people (from 59% to 67%; p<0.001), and HIV-uninfected people (from 41% to 47%; p<0.001). In contrast, the proportion of HIV-infected people visiting a private-sector PHC clinic declined from 22% to 12% (p<0.001) and hospitalization rates declined from 128 to 82 per 1000 PY (p<0.001). For HIV

  4. Health utilities in gynecological oncology and mastology in Germany.

    Science.gov (United States)

    Hildebrandt, Thomas; Thiel, Falk C; Fasching, Peter A; Graf, Christiane; Bani, Mayada R; Loehberg, Christian R; Schrauder, Michael G; Jud, Sebastian M; Hack, Carolin C; Beckmann, Matthias W; Lux, Michael P

    2014-02-01

    Cost increases in the healthcare system are leading to a need to distribute financial resources in accordance with the value of each service performed. Health-economic decision-making models can support these decisions. Due to the previous unavailability of health utilities in Germany (scored states of health as a basis for calculating quality-adjusted life-years, QALYs) for women undergoing treatment, international data are often used for such models. However, these may widely deviate from the values for a woman actually living in Germany. It is, therefore, necessary to collect and analyze health utilities in Germany. In a questionnaire survey, health utilities were collected, along with data for a healthy control group, for 580 female patients receiving treatment in the fields of mastology and gynecological oncology using a German version of the EuroQol questionnaire (EQ-5D) and a visual analogue scale (VAS). Data were also collected for the patients' medical history, tumor disease, and treatment. Significant differences with regard to quality of life were measured in relation to the individual tumor entities and in comparison to the controls. Apart from the healthy control group, patients with breast or cervical carcinoma had the best quality of life. In patients with recurrent and metastatic disease, those with breast carcinoma experienced the greatest impairment of their quality of life. According to current treatment, the most important impairment of life quality occurred in patients under radiotherapy and after surgical treatment. There are significant differences from the health utilities recorded for other countries - for example, the state of health declines much more markedly in patients with metastatic disease among American women with breast carcinoma than among German women, in whom recurrent disease and a first diagnosis of metastasis were comparable. Overall, the VAS was able to distinguish more adequately than the EQ-5D questionnaire between the

  5. Health-state utilities in liver cirrhosis: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Peyman Adibi

    2012-01-01

    Conclusions: The results of the currents study suggested that the cirrhosis status has had the most negative effect on patients, and that patients had a lower utility rate than their family members and caretakers.

  6. Health Status and Psychological Distress in Patients with Non-compaction Cardiomyopathy

    DEFF Research Database (Denmark)

    Brouwers, Corline; Caliskan, Kadir; Bos, Sven

    2015-01-01

    patients and 42 DCM patients. Outcome measures were health status (Short Form Health Survey-12), anxiety (Generalized Anxiety Disorder 7-item scale) and depression (Patient Health Questionnaire 9-item scale). RESULTS: NCCM patients showed significantly worse health status (Physical Component Score F(1...... from DCM patients (Physical Component Score F(1,82) = 2,61, P = .11; Mental Component Score F(1,82) = .55, P = .46), anxiety (F(1,82) = 1.16, P = .28) and depression scores (F(1,82) = 1,95, P = .17). CONCLUSION: Cardiac symptoms are likely to play a role in the observed poor health status and elevated......BACKGROUND: Non-compaction cardiomyopathy (NCCM) is a cardiomyopathy characterized by left ventricular tribeculae and deep intertrabecular recesses. Because of its genetic underpinnings and physical disease burden, noncompaction cardiomyopathy is expected to be associated with a lower health status...

  7. Oral health and nutritional status in a group of geriatric rehabilitation patients.

    Science.gov (United States)

    Andersson, Pia; Westergren, Albert; Karlsson, Siv; Rahm Hallberg, Ingalill; Renvert, Stefan

    2002-09-01

    The aims of this study were to evaluate the oral health status and nutritional status in a group of geriatric rehabilitation patients, and to analyse the relationship between these two parameters. Nurses at the ward performed structured assessments of oral and nutritional status using the Revised Oral Assessment Guide and the Subjective Global Assessment form in 223 newly admitted patients. Most oral health problems were found among patients who stayed longer at the hospital and were more dependent on help as compared with the healthier patients. Thirty-four per cent of the patients were either severely undernourished, at risk or suspected to be undernourished (UN). Oral health problems were more common among UN patients (p oral health problem was found on teeth or dentures (48%). Problems related to the tongue and lips were also common among UN patients (56 and 44%, respectively). Oral health status was correlated (r = 0.32) to nutritional status. Problems with swallowing had the strongest association to the nutritional status (OR 6.05; 95% CI 2.41-15.18). This study demonstrated that poor oral health status was related to undernourishment.

  8. Health and nutritional status of children in Ethiopia: do maternal characteristics matter?

    Science.gov (United States)

    Seid, Abdu Kedir

    2013-03-01

    In Ethiopia, despite some recent improvements, the health and nutritional status of children is very poor. A better understanding of the main socioeconomic determinants of child health and nutrition is essential to address the problem and make appropriate interventions. In the present study, an attempt is made to explore the effect of maternal characteristics on the health and nutritional status of under-five children using the 2005 Ethiopian Demographic and Health Survey. The health and nutritional status of children are measured using the two widely used anthropometric indicators height-for-age (HAZ) and weight-for-height (WHZ). In the ordinary least squares (OLS) estimation, it is observed that maternal characteristics have a significant impact on child health and nutritional status. The magnitudes of the coefficients, however, are found to slightly increase when maternal education is instrumented in the 2SLS estimation. Moreover, in the quantile regression (QR) estimation, the impacts of maternal characteristics are observed to vary between long-term and current child health and nutritional status.

  9. Health Status and Measurement of Some Haematological ...

    African Journals Online (AJOL)

    Background: A good school health programme is necessary to optimize the educational opportunities and make appropriate adjustments for optimal development of the school child. This study was done to determine some haematological parameters as a correlate of health status of new entrants in two mission owned ...

  10. Perceived oral health status and treatment needs of dental auxiliaries

    African Journals Online (AJOL)

    Abstract. Objective: To determine the perceived oral health status and treatment needs of Nigerian dental therapists in students from Federal School of Dental Therapy and Technology Enugu, Nigeria was conducted using self-administered questionnaire to obtain information on demography, self-reported oral health status, ...

  11. Long-term effects of oral clefts on health care utilization

    DEFF Research Database (Denmark)

    Pedersen, Morten Saaby; Wehby, George L; Pedersen, Dorthe Almind

    2015-01-01

    clefts use more health services than their unaffected siblings. Additional results show that the effects are driven primarily by congenital malformation-related hospitalizations and intake of anti-infectives. Although the absolute differences in most health care utilization diminish over time, affected......Oral clefts are among the most common birth defects affecting thousands of newborns each year, but little is known about their potential long-term consequences. In this paper, we explore the impact of oral clefts on health care utilization over most of the lifespan. To account for time...... individuals have slightly higher utilization of some health care services in adulthood (particularly for diseases of the nervous and respiratory system). These results have important implications for affected individuals, their families, and their health professionals....

  12. The construct validity of the health utilities index mark 3 in assessing health status in lung transplantation

    Directory of Open Access Journals (Sweden)

    Zuk Dalyce

    2010-09-01

    Full Text Available Abstract Purpose To assess the cross-sectional construct validity of the Health Utilities Index Mark 3 (HUI3 in lung transplantation. Methods Two hundred and thirteen patients (103 pre-transplant and 110 post-transplant with mean age 53 years old (SD 13 were recruited during a randomized controlled clinical trial at the out-patient clinic in a tertiary institution. At baseline, patients self-completed measures that included the HUI3, EuroQol EQ-5D, Hospital Anxiety and Depression Scale (HADS and socio-demographic questionnaire. Six-minute walk test scores and forced expiratory volume in 1 second data were collected from patient's medical records. A priori hypotheses were formulated by members of the transplant team about the expected degree of association between the measures. Correlation coefficients of Results Of the ninety predictions made, forty three were correct but in 31 the correlation was slightly lower than predicted and in 7 the correlations were much higher than predicted. In 48% of the cases, predicted and observed associations were in agreement. Predictions of associations were off by one category in 42% of the cases; in 10% of the cases the predictions were off by two categories. Conclusions This is the first study providing evidence of cross-sectional construct validity of HUI3 in lung transplantation. Results indicate that the HUI3 was able to capture the burden of lung disease before transplantation and that post-transplant patients enjoyed higher health-related quality of life than pre-transplant patients.

  13. Occupational status and nutrition profile and health of public municipal employees

    Directory of Open Access Journals (Sweden)

    Patrícia Pinheiro de Freitas

    Full Text Available Abstract Background: Unhealthy lifestyles occur more often in low-socioeconomic status (SES groups. The assessment of isolated factors reduces the understanding of the problem instead of clarifying the dynamic interaction of these factors in influencing the health. Objective: To study the relationship between nutrition habits and health, and the coexistence of dietary risk factors, according to the occupational status of public municipal employees. Materials and Methods: An electronic epidemiological survey was conducted from September to December 2009. In total, 5,646 public municipal employees (temporary and permanent of the municipality (14.7% answered the questionnaire. Sociodemographic information, health, physical activity, nutritional profile, and working conditions related to eating were investigated. Occupational status was defined by the International Socio-Economic Index. The coexistence of dietary risk factors (low consumption of fruits and vegetables, high consumption of chicken skin and meat fat, and insufficient time to eat at work were evaluated using Venn diagrams. Results: Arterial hypertension, diabetes mellitus and overweight were more frequently reported in the low occupational status, and positive self-reported health was directly related to the occupational status of participants. Conclusion: Differences in health conditions and in the dietary habits of individuals according to occupational status indicate its relevance in the development of public and institutional policies that aim to promote health and reduce inequalities and the need for greater focus on those with lower occupational status.

  14. Predictors of burnout and health status in Samaritans' listening volunteers.

    Science.gov (United States)

    Roche, Adeline; Ogden, Jane

    2017-12-01

    Samaritan listening volunteers provide emotional support to people in distress or suicidal. Samaritans' has high volunteer turnover, which may be due to burnout. This study evaluated the role of demographic and psychosocial factors in predicting Samaritans listening volunteers' burnout and health status. Samaritans' listening volunteers (n = 216) from seven branches across UK completed an online survey to assess their levels of burnout (emotional exhaustion, depersonalisation, personal accomplishment), subjective health status, coping, empathy and social support. Overall, listeners showed low levels of burnout and good health. Regression analysis revealed that higher emotional exhaustion was predicted by younger age and avoidant coping style; higher depersonalisation was predicted by lower empathy fantasy and higher avoidant coping style; lower personal accomplishment scores were predicted by higher empathy personal distress and worse health status was predicted by more hours per week spent on listening duties, lower social support and higher avoidant coping style. Overall, different factors influenced different facets of burnout. However, higher use of avoidant coping style consistently predicted higher burnout and worse health status, suggesting avoidant coping is an important target for intervention.

  15. Health Data Recording, Reporting and Utilization Practices Among ...

    African Journals Online (AJOL)

    Health Data Recording, Reporting and Utilization Practices Among Primary Health Care Workers in Enugu State, South Eastern Nigeria. ... of PHC workers used notepads, 52.3% used notebooks while only 47.7% used health management information system (HMIS) forms to record data. ... AJOL African Journals Online.

  16. Oral Health Status of a Sample of Prisoners in Enugu: A ...

    African Journals Online (AJOL)

    Background: The aim of this study is to determine the oral health status of a sample of prisoners at the Federal Prison in Enugu. The health status of inmates in the prison system needs to be incorporated into data and reports that summarize the state of the nation's health; this will encourage the provision of health care to ...

  17. Factors associated with adolescent mental health service need and utilization

    NARCIS (Netherlands)

    Zwaanswijk, Marieke; Ende, J. van der; Verhaak, P.F.M.; Bensing, J.; Verhulst, F.C.

    2003-01-01

    Objective: To determine the association of parent, family, and adolescent variables with adolescent mental health service need and utilization. Method: Correlates of adolescent mental health service utilization, self-perceived need and unmet need were investigated in a general population sample of

  18. Marital Status, Marital Transitions, and Health: A Gendered Life Course Perspective*

    OpenAIRE

    Williams, Kristi; Umberson, Debra

    2004-01-01

    We work from a life course perspective to assess the impact of marital status and marital transitions on subsequent changes in the self-assessed physical health of men and women. Our results suggest three central conclusions regarding the association of marital status and marital transitions with self-assessed health. First, marital status differences in health appear to reflect the strains of marital dissolution more than they reflect any benefits of marriage. Second, the strains of marital ...

  19. Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE.

    Science.gov (United States)

    Atella, Vincenzo; Brunetti, Marianna; Maestas, Nicole

    2012-05-01

    Health risk is increasingly viewed as an important form of background risk that affects household portfolio decisions. However, its role might be mediated by the presence of a protective full-coverage national health service that could reduce households' probability of incurring current and future out-of-pocket medical expenditures. We use SHARE data to study the influence of current health status and future health risk on the decision to hold risky assets, across ten European countries with different health systems, each offering a different degree of protection against out-of-pocket medical expenditures. We find robust empirical evidence that perceived health status matters more than objective health status and, consistent with the theory of background risk, health risk affects portfolio choices only in countries with less protective health care systems. Furthermore, portfolio decisions consistent with background risk models are observed only with respect to middle-aged and highly-educated investors.

  20. Measuring general animal health status: Development of an animal health barometer.

    Science.gov (United States)

    Depoorter, Pieter; Van Huffel, Xavier; Diricks, Herman; Imberechts, Hein; Dewulf, Jeroen; Berkvens, Dirk; Uyttendaele, Mieke

    2015-03-01

    The development of an animal health barometer, an instrument to measure the general health of the Belgian livestock population on a yearly basis and to monitor its evolution over time, is described. The elaboration of a set of 13 animal health indicators (AHIs) as the basis for the animal health barometer is discussed. These indicators were weighted by experts - including scientists, policy makers and agro-industrial representatives - to determine their relative weight in the barometer. The result of the barometer is expressed as a comparison with a previous year. Based on the results of the 13 AHIs, it is concluded that general animal health in Belgium shows a positive evolution since 2008. The animal health barometer provides a composite view of the status of livestock health in Belgium and is a tool to communicate in an intelligible, comprehensible manner on aspects of animal health to consumers and professional stakeholders in the animal production and food chain. Together with the food safety barometer (Baert et al., 2011. Food Res. Int. 44, 940) and the plant health barometer (Wilmart et al., 2014. Eur. J. Plant Pathol. doi: 10.1007/s10658-014-0547-x), the animal health barometer is one of the three instruments to provide a holistic view on the overall status of the safety of the food chain in Belgium. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. A microeconometric analysis of health care utilization in Europe

    NARCIS (Netherlands)

    Majo, M.C.

    2010-01-01

    By analyzing the relationship between socio-economic status, health, and health care use for a variety of developed countries (with a main focus on Europe), this thesis attempts to address several questions: • What are the socio-economic factors driving the use of health care services: income,

  2. Does quality influence utilization of primary health care? Evidence from Haiti.

    Science.gov (United States)

    Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

    2018-06-20

    Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

  3. Socioeconomic Status, Health Behaviors, Obesity and Self-Rated Health among Older Arabs in Israel.

    Science.gov (United States)

    Khalaila, R N Rabia

    2017-03-01

    Socioeconomic inequalities in health are well documented. Recently, researchers have shown interest in exploring the mechanisms by which measures of SES operate through it to impact SRH, such as material, psychosocial and behavioral factors. To examine the relationships between SES indicators and self-rated health (SRH); and to determine whether health behaviors and obesity mediate the association between SES indicators and SRH. A secondary analysis of data previously collected through the third survey of socioeconomic and health status of the Arab population in Israel, in which the SRH of 878 Arab-Israelis age 50 or older were analyzed using logistic regression. The results showed that higher education level and current employment in old age are associated with better SRH. However, neither subjective economic status nor family income was associated with SRH. Greater physical activity was found to be related to good\\very good SRH, while obesity was associated with less than good SRH. Finally, health behaviors (physical activity) and obesity were revealed as mediators between SES indicators (education and employment status) and SRH. The results highlight the importance of high education level and employment status in old age to reduce health inequalities. The findings also show that the relationship between SES and SRH can operate through behavioral mechanisms (i.e., physical activity) and their consequences (i.e., obesity), that can, however, be changed in old age.

  4. Effect of health development assistance on health status in sub-Saharan Africa

    OpenAIRE

    Negeri, Gutema; Haile Mariam,Damen

    2016-01-01

    Keneni Gutema Negeri,1 Damen Halemariam,21School of Public and Environmental Health, Health Service Management Unit, College of Medicine and Health Sciences, Hawassa University, Hawassa, 2College of Medicine and Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Data on the effect of health aid on the health status in developing countries are inconclusive. Moreover, studies on this issue in sub-Saharan Africa are scarce. Therefore, this stud...

  5. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review.

    Science.gov (United States)

    Aidala, Angela A; Wilson, Michael G; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K; Caban, Maria; Rourke, Sean B

    2016-01-01

    consideration of material or social dimensions of housing adequacy, stability, and security of tenure. Two independent reviewers performed data extraction and quality appraisal. We used the Cochrane Risk of Bias Tool for randomized controlled trials and a modified version of the Newcastle Ottawa Quality Appraisal Tool for nonintervention studies. In our quality appraisal, we focused on issues of quality for observational studies: appropriate methods for determining exposure and measuring outcomes and methods to control confounding. Searches yielded 5528 references from which we included 152 studies, representing 139,757 HIV-positive participants. Most studies were conducted in the United States and Canada. Studies examined access and utilization of HIV medical care, adherence to antiretroviral medications, HIV clinical outcomes, other health outcomes, emergency department and inpatient utilization, and sex and drug risk behaviors. With rare exceptions, across studies in all domains, worse housing status was independently associated with worse outcomes, controlling for a range of individual patient and care system characteristics. Lack of stable, secure, adequate housing is a significant barrier to consistent and appropriate HIV medical care, access and adherence to antiretroviral medications, sustained viral suppression, and risk of forward transmission. Studies that examined the history of homelessness or problematic housing years before outcome assessment were least likely to find negative outcomes, homelessness being a potentially modifiable contextual factor. Randomized controlled trials and observational studies indicate an independent effect of housing assistance on improved outcomes for formerly homeless or inadequately housed people with HIV. Housing challenges result from complex interactions between individual vulnerabilities and broader economic, political, and legal structural determinants of health. The broad structural processes sustaining social exclusion and

  6. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review

    Science.gov (United States)

    Wilson, Michael G.; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K.; Caban, Maria; Rourke, Sean B.

    2016-01-01

    high-income countries. We defined housing status to include consideration of material or social dimensions of housing adequacy, stability, and security of tenure. Data collection and analysis. Two independent reviewers performed data extraction and quality appraisal. We used the Cochrane Risk of Bias Tool for randomized controlled trials and a modified version of the Newcastle Ottawa Quality Appraisal Tool for nonintervention studies. In our quality appraisal, we focused on issues of quality for observational studies: appropriate methods for determining exposure and measuring outcomes and methods to control confounding. Results. Searches yielded 5528 references from which we included 152 studies, representing 139 757 HIV-positive participants. Most studies were conducted in the United States and Canada. Studies examined access and utilization of HIV medical care, adherence to antiretroviral medications, HIV clinical outcomes, other health outcomes, emergency department and inpatient utilization, and sex and drug risk behaviors. With rare exceptions, across studies in all domains, worse housing status was independently associated with worse outcomes, controlling for a range of individual patient and care system characteristics. Conclusions. Lack of stable, secure, adequate housing is a significant barrier to consistent and appropriate HIV medical care, access and adherence to antiretroviral medications, sustained viral suppression, and risk of forward transmission. Studies that examined the history of homelessness or problematic housing years before outcome assessment were least likely to find negative outcomes, homelessness being a potentially modifiable contextual factor. Randomized controlled trials and observational studies indicate an independent effect of housing assistance on improved outcomes for formerly homeless or inadequately housed people with HIV. Housing challenges result from complex interactions between individual vulnerabilities and broader economic

  7. Oral health behavior of parents as a predictor of oral health status of their children.

    Science.gov (United States)

    Bozorgmehr, Elham; Hajizamani, Abolghasem; Malek Mohammadi, Tayebeh

    2013-01-01

    Introduction. It is widely acknowledged that the behavior of parents affects their children's health. This study aimed to evaluate the relationship between oral health behavior of parents and oral health status and behavior of their children in a sample of preschool children in Iran. Method and Material. A random sample of over-five-year-old preschool children and their parents were enrolled in the study. Selection of schools was by clustering method. Parents were asked to fill a piloted questionnaire which included demographic characteristics, socioeconomic status, oral health behaviors of children and their parents. Oral health status of children was examined. The parent and their children oral health relationship were tested using regression and correlation analysis. Results. About 222 parents and children participated in the study. There was a significant relationship between history of having dental problems in parents and dmft index in their children (P = 0.01). There was a significant relationship between parental frequency of tooth brushing and child frequency of tooth brushing (P = 0.05); however, there was no significant relationship between parental frequency of dental visits and those of their children (P = 0.1). Conclusion. The study concluded that some important health behaviors in parents, such as tooth brushing habits are important determinants of these behaviors in their young children. So promoting parent knowledge and attitude could affect their children oral health behavior and status.

  8. Infertile Individuals’ Marital Relationship Status, Happiness, and Mental Health: A Causal Model

    Science.gov (United States)

    Ahmadi Forooshany, Seyed Habiballah; Yazdkhasti, Fariba; Safari Hajataghaie, Saiede; Nasr Esfahani, Mohammad Hossein

    2014-01-01

    Background This study examined the causal model of relation between marital relation- ship status, happiness, and mental health in infertile individuals. Materials and Methods In this descriptive study, 155 subjects (men: 52 and women: 78), who had been visited in one of the infertility Centers, voluntarily participated in a self-evaluation. Golombok Rust Inventory of Marital Status, Oxford Happiness Ques- tionnaire, and General Health Questionnaire were used as instruments of the study. Data was analyzed by SPSS17 and Amos 5 software using descriptive statistics, independent sample t test, and path analysis. Results Disregarding the gender factor, marital relationship status was directly related to happiness (phappiness was directly related to mental health, (phappiness and mental health was significant (phappiness had a mediator role in relation between marital relationship status and mental health in infertile individu- als disregarding the gender factor. Also, considering the gender factor, only in infertile women, marital relationship status can directly and indirectly affect happiness and mental health. PMID:25379161

  9. Infertile individuals' marital relationship status, happiness, and mental health: a causal model.

    Science.gov (United States)

    Ahmadi Forooshany, Seyed Habiballah; Yazdkhasti, Fariba; Safari Hajataghaie, Saiede; Nasr Esfahani, Mohammad Hossein

    2014-10-01

    This study examined the causal model of relation between marital relation- ship status, happiness, and mental health in infertile individuals. In this descriptive study, 155 subjects (men: 52 and women: 78), who had been visited in one of the infertility Centers, voluntarily participated in a self-evaluation. Golombok Rust Inventory of Marital Status, Oxford Happiness Ques- tionnaire, and General Health Questionnaire were used as instruments of the study. Data was analyzed by SPSS17 and Amos 5 software using descriptive statistics, independent sample t test, and path analysis. Disregarding the gender factor, marital relationship status was directly related to happiness (phappiness was directly related to mental health, (phappiness and mental health was significant (phappiness had a mediator role in relation between marital relationship status and mental health in infertile individu- als disregarding the gender factor. Also, considering the gender factor, only in infertile women, marital relationship status can directly and indirectly affect happiness and mental health.

  10. Examining the Impact of Maternal Health, Race, and Socioeconomic Status on Daughter's Self-Rated Health Over Three Decades.

    Science.gov (United States)

    Shippee, Tetyana P; Rowan, Kathleen; Sivagnanam, Kamesh; Oakes, J Michael

    2015-09-01

    This study examines the role of mother's health and socioeconomic status on daughter's self-rated health using data spanning three decades from the National Longitudinal Surveys of Mature Women and Young Women (N = 1,848 matched mother-daughter pairs; 1,201 White and 647 African American). Using nested growth curve models, we investigated whether mother's self-rated health affected the daughter's self-rated health and whether socioeconomic status mediated this relationship. Mother's health significantly influenced daughters' self-rated health, but the findings were mediated by mother's socioeconomic status. African American daughters reported lower self-rated health and experienced more decline over time compared with White daughters, accounting for mother's and daughter's covariates. Our findings reveal maternal health and resources as a significant predictor of daughters' self-rated health and confirm the role of socioeconomic status and racial disparities over time. © The Author(s) 2015.

  11. Oral Health Status of Institutionalized Older Women from Different Socioeconomic Positions.

    Science.gov (United States)

    Heredia-Ponce, Erika; Irigoyen-Camacho, A Esther; Sánchez-García, Sergio

    2017-01-01

    To determine the association between oral health and socioeconomic position in institutionalized older women in Mexico City. A cross-sectional study was performed in two groups: high socioeconomic position (HSEP), living in a private retirement home, and low socioeconomic position (LSEP), living in a public assistance center. Oral health was determined by edentulism, oral hygiene, healthy teeth, experience of dental caries, missing and filled teeth, gingival bleeding, dental calculus, and periodontal disease. A latent class analysis (LCA) was used to classify oral health status in dentate. Included were 170 women (HSEP 54.1% and LSEP 45.8%), average age 77.3 (SD = 9.3) years. Oral health status was formed: Edentulous 32.4% HSEP and 67.6% LSEP; Class 1 Unfavorable 0% HSEP and 100% LSEP; Class2 Slightly favorable 41.2% HSEP and58.8% LSEP; and Class3 Favorable 84.6% HSEP and 15.4% LSEP. There was a statistically significant association between socioeconomic position (p < .001) and oral health status. The oral health of women studied was not optimal. Higher socioeconomic position was associated with better oral health status.

  12. The Subjective Well-Being Method of Valuation: An Application to General Health Status.

    Science.gov (United States)

    Brown, Timothy T

    2015-12-01

    To introduce the subjective well-being (SWB) method of valuation and provide an example by valuing health status. The SWB method allows monetary valuations to be performed in the absence of market relationships. Data are from the 1975-2010 General Social Survey. The value of health status is determined via the estimation of an implicit derivative based on a happiness equation. Two-stage least-squares was used to estimate happiness as a function of poor-to-fair health status, annual household income adjusted for household size, age, sex, race, marital status, education, year, and season. Poor-to-fair health status and annual household income are instrumented using a proxy for intelligence, a temporal version of the classic distance instrument, and the average health status of individuals who are demographically similar but geographically separated. Instrument validity is evaluated. Moving from good/excellent health to poor/fair health (1 year of lower health status) is equivalent to the loss of $41,654 of equivalized household income (2010 constant dollars) per annum, which is larger than median equivalized household income. The SWB method may be useful in making monetary valuations where fundamental market relationships are not present. © Health Research and Educational Trust.

  13. Health care resource utilization before and after perampanel initiation among patients with epilepsy in the United States.

    Science.gov (United States)

    Faught, Edward; Laliberté, François; Wang, Zhixiao; Barghout, Victoria; Haider, Batool; Lejeune, Dominique; Germain, Guillaume; Choi, Jiyoon; Wagh, Aneesha; Duh, Mei Sheng

    2017-10-01

    The purpose of this study was to evaluate changes in health care resource utilization following the initiation of perampanel for the treatment of epilepsy in the United States. Health care claims from Symphony Health's Integrated Dataverse database between December 2012 and November 2015 were analyzed. Patients newly initiated on perampanel, having ≥1 epilepsy (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 345.xx, ICD-10-CM code G40.xxx) or nonfebrile convulsion (ICD-9-CM code 780.39, ICD-10-CM code R56.9) diagnosis, and having ≥6 months of baseline and observation periods were included. Patients <12 years old at perampanel initiation were excluded. Of the 2,508 perampanel patients included in the study, the mean [median] (±standard deviation [SD]) age was 35.8 [34] (±16.0) years and 56.2% were female. The mean [median] (±SD) observation duration was 459.8 [462] (±146.3) days in the postperampanel period. The postperampanel period was associated with significantly lower rates of all health care resource utilization outcomes than the pre-period. For the post- versus pre-period, perampanel users had 42.3 versus 53.8 overall hospitalizations per 100 person-years (rate ratio [RR] = 0.80, p < 0.001) and 1,240.2 versus 1,343.8 outpatient visits per 100 person-years (RR = 0.91, p < 0.001). Epilepsy-related hospitalizations and outpatient visits were 25.2 versus 33.6 per 100 person-years (RR = 0.76, p < 0.001) and 327.0 versus 389.0 per 100 person-years (RR = 0.84, p < 0.001), respectively. Additionally, a significantly lower rate of status epilepticus in the post-period (1.8 events per 100 person-years) was observed compared to the pre-period (4.4 events per 100 person-years; RR = 0.43, p < 0.001). The monthly time trend of hospitalizations showed an increasing trend leading up to the initiation of perampanel, after which the hospitalizations decreased steadily. Use of perampanel for the treatment of epilepsy was

  14. Health-care utilization and associated factors in Gauteng province, South Africa.

    Science.gov (United States)

    Abera Abaerei, Admas; Ncayiyana, Jabulani; Levin, Jonathan

    2017-01-01

    More than a billion people, mainly in low- and middle-income countries, are unable to access needed health-care services for a variety of reasons. Possible factors influencing health-care utilization include socio-demographic and economic factors such as age, sex, education, employment and income. However, different studies have showed mixed results. Moreover, there are limited studies on health-care utilization. This study aimed to determine health-care utilization and associated factors among all residents aged 18 or over in Gauteng province, South Africa. A cross-sectional study was conducted from data collected for a Quality of Life survey which was carried out by Gauteng City-Region Observatory in 2013. Simple random sampling was used to select participants. A total of 27,490 participants have been interviewed. Data were collected via a digital data collection instrument using an open source system called Formhub. Coarsened Exact Matching (CEM) was used to improve estimation of causal effects. Stepwise multiple logistic regression was employed to identify factors associated with health-care utilization. Around 95.7% reported usually utilizing health-care services while the other 4.3% reported not having sought health-care services of any type. Around 75% of participants reported reduced quality of public health services as a major reason not to visit them. Higher odds of reported health-care utilization were associated with being female (OR = 2.18, 95% CI: 1.88-2.53; p immigrant (OR = 0.61, 95% CI: 0.53-0.70; p < 0.001). The results indicated that there is a need to improve the quality of public health-care services and perception towards them as improved health-care quality increases the choice of health-care providers.

  15. Oral Health Status and Behaviour of Mauritians Visiting Private Dental Clinics

    Science.gov (United States)

    Gunsam, P. Pugo; Banka, S.

    2011-01-01

    Purpose: This paper seeks to assess the oral health status and behaviour of a sample of the Mauritian population visiting private dental clinics. Design/methodology/approach: Oral health status was determined using the World Health Organization (Decayed, Missing, Filled Teeth (DMFT) index indicating the prevalence of caries, and factors associated…

  16. EQ-5D™-derived utility values for different levels of migraine severity from a UK sample of migraineurs

    Directory of Open Access Journals (Sweden)

    Stafford Megan R

    2012-06-01

    Full Text Available Abstract Background To estimate utility values for different levels of migraine pain severity from a United Kingdom (UK sample of migraineurs. Methods One hundred and six migraineurs completed the EQ-5D to evaluate their health status for mild, moderate and severe levels of migraine pain severity for a recent migraine attack, and for current health defined as health status within seven days post-migraine attack. Statistical tests were used to evaluate differences in mean utility scores by migraine severity. Results Utility scores for each health state were significantly different from 1.0 (no problems on any EQ-5D dimension (p  Conclusions Results indicate that all levels of migraine pain are associated with significantly reduced utility values. As severity worsened, utility decreased and severe migraine pain was considered a health state worse than death. Results can be used in cost-utility models examining the relative economic value of therapeutic strategies for migraine in the UK.

  17. Trajectories of Patient-Reported Health Status in Patients With an Implantable Cardioverter Defibrillator

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Denollet, Johan; Versteeg, Henneke

    2015-01-01

    , no use of ACE inhibitors, psychotropic medication, negative affectivity, and type D personality were identified as independent determinants of poorer mental health status. In conclusion, the population with an ICD seems to be heterogeneous in terms of patient-reported physical and mental health status......To date, no study has assessed the course of patient-reported health status in patients with an implantable cardioverter defibrillator (ICD). Studying health status trajectories and their baseline determinants would permit the identification of patients at risk for poor health outcomes after ICD...... implantation. A combined cohort of 1,222 patients with an ICD (79% men; age = 61.4 [11.2] years) completed the 12-Item Short-Form Health Survey at baseline and 2 to 3 months and 12 to 14 months after implantation. Latent class analyses were used to identify trajectories and predictors of health status over...

  18. Impact of depression on health care utilization and costs among multimorbid patients--from the MultiCare Cohort Study.

    Directory of Open Access Journals (Sweden)

    Jens-Oliver Bock

    Full Text Available OBJECTIVE: The objective of this study was to describe and analyze the effects of depression on health care utilization and costs in a sample of multimorbid elderly patients. METHOD: This cross-sectional analysis used data of a prospective cohort study, consisting of 1,050 randomly selected multimorbid primary care patients aged 65 to 85 years. Depression was defined as a score of six points or more on the Geriatric Depression Scale (GDS-15. Subjects passed a geriatric assessment, including a questionnaire for health care utilization. The impact of depression on health care costs was analyzed using multiple linear regression models. A societal perspective was adopted. RESULTS: Prevalence of depression was 10.7%. Mean total costs per six-month period were €8,144 (95% CI: €6,199-€10,090 in patients with depression as compared to €3,137 (95% CI: €2,735-€3,538; p<0.001 in patients without depression. The positive association between depression and total costs persisted after controlling for socio-economic variables, functional status and level of multimorbidity. In particular, multiple regression analyses showed a significant positive association between depression and pharmaceutical costs. CONCLUSION: Among multimorbid elderly patients, depression was associated with significantly higher health care utilization and costs. The effect of depression on costs was even greater than reported by previous studies conducted in less morbid patients.

  19. Routine health information system utilization and factors associated thereof among health workers at government health institutions in East Gojjam Zone, Northwest Ethiopia.

    Science.gov (United States)

    Shiferaw, Atsede Mazengia; Zegeye, Dessalegn Tegabu; Assefa, Solomon; Yenit, Melaku Kindie

    2017-08-07

    Using reliable information from routine health information systems over time is an important aid to improving health outcomes, tackling disparities, enhancing efficiency, and encouraging innovation. In Ethiopia, routine health information utilization for enhancing performance is poor among health workers, especially at the peripheral levels of health facilities. Therefore, this study aimed to assess routine health information system utilization and associated factors among health workers at government health institutions in East Gojjam Zone, Northwest Ethiopia. An institution based cross-sectional study was conducted at government health institutions of East Gojjam Zone, Northwest Ethiopia from April to May, 2013. A total of 668 health workers were selected from government health institutions, using the cluster sampling technique. Data collected using a standard structured and self-administered questionnaire and an observational checklist were cleaned, coded, and entered into Epi-info version 3.5.3, and transferred into SPSS version 20 for further statistical analysis. Variables with a p-value of less than 0.05 at multiple logistic regression analysis were considered statistically significant factors for the utilization of routine health information systems. The study revealed that 45.8% of the health workers had a good level of routine health information utilization. HMIS training [AOR = 2.72, 95% CI: 1.60, 4.62], good data analysis skills [AOR = 6.40, 95%CI: 3.93, 10.37], supervision [AOR = 2.60, 95% CI: 1.42, 4.75], regular feedback [AOR = 2.20, 95% CI: 1.38, 3.51], and favorable attitude towards health information utilization [AOR = 2.85, 95% CI: 1.78, 4.54] were found significantly associated with a good level of routine health information utilization. More than half of the health workers working at government health institutions of East Gojjam were poor health information users compared with the findings of others studies. HMIS training, data

  20. Analysis of Reproductive Parameters in Sows with Regard to Their Health Status

    Directory of Open Access Journals (Sweden)

    Pavel Nevrkla

    2016-01-01

    Full Text Available The aim of the study was to evaluate selected reproductive parameters in sows. Observed parameters were analysed in two herds with different health status. The experiment involved 160 hybrid sows from the 1st to the 5th litter (80 sows with health status A and 80 sows with health status B. Highly statistically significant differences (P ≤ 0.001 and significant differences (P ≤ 0.05 were found between the two groups in length of gravidity, total numbers of piglets, numbers of live-born piglets, numbers of stillborn piglets, numbers of reared piglets and losses of piglets per litter in favor of group B with declared health status. Evaluation of phenotypic correlation between the total number of piglets and the live-born piglets in the sows without declared health status revealed high positive correlation (P ≤ 0.01. Strong positive dependence was found also between the live-born and the reared piglets in this group. In the sows with declared health status, high positive correlation (P ≤ 0.01 was found also between the total number of piglets and the number of live-born piglets and between the number of live-born and reared piglets.

  1. Oral Health Status, Treatment Needs and Knowledge, Attitude and ...

    African Journals Online (AJOL)

    Background: Health care workers (HCWs) from an important component of the health care system of any nation. Adequate knowledge regarding oral health is also mandatory as it is directly related to general health. Aim: The present study was undertaken to assess oral health status and treatment needs of the health ...

  2. Infertile Individuals’ Marital Relationship Status, Happiness, and Mental Health: A Causal Model

    Directory of Open Access Journals (Sweden)

    Seyed Habiballah Ahmadi Forooshany

    2014-11-01

    Full Text Available Background: This study examined the causal model of relation between marital relationship status, happiness, and mental health in infertile individuals. Materials and Methods: In this descriptive study, 155 subjects (men: 52 and women: 78, who had been visited in one of the infertility Centers, voluntarily participated in a self-evaluation. Golombok Rust Inventory of Marital Status, Oxford Happiness Questionnaire, and General Health Questionnaire were used as instruments of the study. Data was analyzed by SPSS17 and Amos 5 software using descriptive statistics, independent sample t test, and path analysis. Results: Disregarding the gender factor, marital relationship status was directly related to happiness (p<0.05 and happiness was directly related to mental health, (p<0.05. Also, indirect relation between marital relationship status and mental health was significant (p<0.05. These results were confirmed in women participants but in men participants only the direct relation between happiness and mental health was significant (p<0.05. Conclusion: Based on goodness of model fit in fitness indexes, happiness had a mediator role in relation between marital relationship status and mental health in infertile individuals disregarding the gender factor. Also, considering the gender factor, only in infertile women, marital relationship status can directly and indirectly affect happiness and mental health.

  3. Socio-economic status and health in a marginalized group: the role of subjective social status among prison inmates.

    Science.gov (United States)

    Friestad, Christine

    2010-12-01

    One problem in studies of social inequality in health is that traditional socio-economic indicators are unsuitable for groups finding themselves on the outside of those societal arenas from which measures of education, income and occupation are generated. A measure of subjective social position has accordingly been proposed as an addition to the traditional objective socio-economic measures. The present study investigates this concepts' usefulness as an addition to objective SES markers in a sample of prison inmates, known for their marginalized position in society as well as their poor health. Analyses are based on the male part (n = 225) of a nationally representative sample of prison inmates in Norway. Outcome measures are self-rated health, long-standing illness or disability, mental health problems, perceived change in health status and drug use. Analyses of correlation as well as multivariate logistic regression analyses were performed. Subjective social status was bivariately related to all of the health outcomes, except long-standing illness. Multivariate analyses indicated that subjective social status influenced the odds of experiencing mental health problems, but not any of the other health outcomes when controlling for the other independent variables. Subjective social status may add important information to our understanding of the relationship between social disadvantage and mental health in a marginalized social group such as prison inmates.

  4. Subjective Social Status and Self-Reported Health Among US-born and Immigrant Latinos.

    Science.gov (United States)

    Garza, Jeremiah R; Glenn, Beth A; Mistry, Rashmita S; Ponce, Ninez A; Zimmerman, Frederick J

    2017-02-01

    Subjective social status is associated with a range of health outcomes. Few studies have tested the relevance of subjective social status among Latinos in the U.S.; those that have yielded mixed results. Data come from the Latino subsample of the 2003 National Latino and Asian American Study (N = 2554). Regression models adjusted for socioeconomic and demographic factors. Stratified analyses tested whether nativity status modifies the effect of subjective social status on health. Subjective social status was associated with better health. Income and education mattered more for health than subjective social status among U.S.-born Latinos. However, the picture was mixed among immigrant Latinos, with subjective social status more strongly predictive than income but less so than education. Subjective social status may tap into stressful immigrant experiences that affect one's perceived self-worth and capture psychosocial consequences and social disadvantage left out by conventional socioeconomic measures.

  5. Focus on vulnerable populations and promoting equity in health service utilization--an analysis of visitor characteristics and service utilization of the Chinese community health service.

    Science.gov (United States)

    Dong, Xiaoxin; Liu, Ling; Cao, Shiyi; Yang, Huajie; Song, Fujian; Yang, Chen; Gong, Yanhong; Wang, Yunxia; Yin, Xiaoxu; Xu, Xing; Xie, Jun; Sun, Yi; Lu, Zuxun

    2014-05-26

    Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents. Multistage sampling method was applied to select 35 cities in China. Four CHIs were randomly chosen in every district of the 35 cities. A total of 88,482 visitors to the selected CHIs were investigated by using intercept survey method at the exit of the CHIs in 2008, 2009, 2010, and 2011. Descriptive analyses were used to analyze the main characteristics (gender, age, and income) of the CHI visitors, and the results were compared with that from the National Health Services Survey (NHSS, including CHIs and higher levels of hospitals). We also analyzed the service utilization and the satisfactions of the CHI visitors. The proportions of the children (2.4%) and the elderly (about 22.7%) were lower in our survey than those in NHSS (9.8% and 38.8% respectively). The proportion of the low-income group (26.4%) was apparently higher than that in NHSS (12.5%). The children group had the lowest satisfaction with the CHIs than other age groups. The satisfaction of the low-income visitors was slightly higher than that of the higher-income visitors. The utilization rate of public health services was low in CHIs. The CHIs in China appears to fulfill the public health target of uptake by vulnerable populations, and may play an important role in promoting equity in health service utilization. However, services for children and the elderly should be strengthened.

  6. Effect of Human Placental Extract on Health Status in Elderly Koreans

    Directory of Open Access Journals (Sweden)

    Mihee Kong

    2012-01-01

    Full Text Available Objectives. Human placental extract (HPE has begun to be used in Korea in various ways to improve health, even though evidence-based data is insufficient. This study investigated the effects of HPE on health status in elderly Koreans. Design. Randomized, single-blind, and case-control study design. Setting and Participants. Thirty-nine community-dwelling healthy Koreans ≥65 years of age. Intervention. The participants were randomly categorized into a placebo group (=17 and HPE group (=22. The HPE group received abdominal subcutaneous injections of HPE for 8 weeks. The placebo group was injected with normal saline. Measurements. The degree of health status was surveyed by the Korean health status measure for the elderly (KoHSME V1.0 at baseline and the end of the study. Results. In the HPE group, the scores of physical function, sexual life, and general heath perception at the end of the study period were significantly improved from baseline (=.007, .020, and .005, resp., while the health status of the placebo group remained unchanged during the study period. There was a significant difference over the study period between the two groups in the mean change of the physical function score (=.036. Conclusion. A HPE injection regimen can improve the health status in elderly Koreans.

  7. Health Literacy Impact on National Healthcare Utilization and Expenditure.

    Science.gov (United States)

    Rasu, Rafia S; Bawa, Walter Agbor; Suminski, Richard; Snella, Kathleen; Warady, Bradley

    2015-08-17

    Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. We evaluated the impact of low health literacy (LHL) on healthcare utilization and healthcare expenditure. Database analysis used Medical Expenditure Panel Survey (MEPS) from 2005-2008 which provides nationally representative estimates of healthcare utilization and expenditure. Health literacy scores (HLSs) were calculated based on a validated, predictive model and were scored according to the National Assessment of Adult Literacy (NAAL). HLS ranged from 0-500. Health literacy level (HLL) and categorized in 2 groups: Below basic or basic (HLS Healthcare utilization expressed as a physician, nonphysician, or emergency room (ER) visits and healthcare spending. Expenditures were adjusted to 2010 rates using the Consumer Price Index (CPI). A P value of 0.05 or less was the criterion for statistical significance in all analyses. Multivariate regression models assessed the impact of the predicted HLLs on outpatient healthcare utilization and expenditures. All analyses were performed with SAS and STATA® 11.0 statistical software. The study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally from 2005-2008. The cohort had an average age of 49 years and included more females (57%). Caucasian were the predominant racial ethnic group (83%) and 37% of the cohort were from the South region of the United States of America. The proportion of the cohort with basic or below basic health literacy was 22.4%. Annual predicted values of physician visits, nonphysician visits, and ER visits were 6.6, 4.8, and 0.2, respectively, for basic or below basic compared to 4.4, 2.6, and 0.1 for above basic. Predicted values of office and ER visits expenditures were $1284 and $151, respectively, for basic or below basic and $719 and $100 for above basic (P healthcare utilization and expenditure. Individuals with below basic or basic HLL have greater healthcare

  8. Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh.

    Science.gov (United States)

    Haider, Mohammad Rifat; Rahman, Mohammad Masudur; Moinuddin, Md; Rahman, Ahmed Ehsanur; Ahmed, Shakil; Khan, M Mahmud

    2017-01-01

    Despite remarkable progress in maternal and child health, inequity persists in maternal care utilization in Bangladesh. Government of Bangladesh (GOB) with technical assistance from United Nation Population Fund (UNFPA), United Nation Children's Fund (UNICEF) and World Health Organization (WHO) started implementing Maternal and Neonatal Health Initiatives in selected districts of Bangladesh (MNHIB) in 2007 with an aim to reduce inequity in healthcare utilization. This study examines the effect of MNHIB on inequity in maternal care utilization. Two surveys were carried out in four districts in Bangladesh- baseline in 2008 and end-line in 2013. The baseline survey collected data from 13,206 women giving birth in the preceding year and in end-line 7,177 women were interviewed. Inequity in maternal healthcare utilization was calculated pre and post-MNHIB using rich-to-poor ratio and concentration index. Mean age of respondents were 23.9 and 24.6 years in 2008 and 2013 respectively. Utilization of pregnancy-related care increased for all socioeconomic strata between these two surveys. The concentration indices (CI) for various maternal health service utilization in 2013 were found to be lower than the indices in 2008. However, in comparison to contemporary BDHS data in nearby districts, MNHIB was successful in reducing inequity in receiving ANC from a trained provider (CI: 0.337 and 0.272), institutional delivery (CI: 0.435 in 2008 to 0.362 in 2013), and delivery by skilled personnel (CI: 0.396 and 0.370). Overall use of maternal health care services increased in post-MNHIB year compared to pre-MNHIB year and inequity in maternal service utilization declined for three indicators out of six considered in the paper. The reductions in CI values for select maternal care indicators imply that the program has been successful not only in improving utilization of maternal health services but also in lowering inequality of service utilization across socioeconomic groups

  9. [Mental health status in railway female workers and its occupational influencing factors].

    Science.gov (United States)

    Ji, F L; Liu, Z M; Liu, Z S; Zou, J F; Yu, W L; Li, H M; Li, J; Kong, L M; Jiang, Q

    2018-02-20

    Objective: To investigate the mental health status of railway female workers and related influencing factors, and to provide a scientific strategy for labor protection regulations in railway female workers. Methods: Cluster sampling was used to select 5033 female workers from Jinan, Nanning, Qinghai-Tibet, and Wuhan railway systems in China from January to August, 2016. A uniform reproductive health questionnaire, as well as the Symptom Checklist-90 (SCL-90) , was used to investigate their general information (age, marital status, education level, and family income) , work type (day shift, night shift, or work on shift) , work position, and the presence or absence of exposure to occupational hazardous factors. The score on each factor of SCL-90 and the positive rate of mental health status were calculated. Results: The positive rate of mental health status was 10.6% in railway female workers. The workers exposed to occupational hazardous factors had a significantly higher positive rate of mental health status than those not exposed to occupational hazardous factors (14.20% vs 8.02%, P mental health status between workers with different ages, marital status, education levels, histories of abortion, or annual family income levels ( P mental health problems ( OR =1.797, 95% CI : 1.393-2.318; OR =0.641, 95% CI : 0.498-0.827; OR =0.586, 95% CI : 0.439-0.783; OR =0.580, 95% CI : 0.378-0.890) . Conclusion: Railway female workers have lower levels of mental health than the general population and are under significant occupational stress. Exposure to occupational hazardous factors, night shift, overwork, and carrying heavy objects are associated with the development of mental health problems in railway female workers.

  10. Health Journalism: Health Reporting Status and Challenges.

    Science.gov (United States)

    Keshvari, Mahrokh; Yamani, Niko; Adibi, Peyman; Shahnazi, Hossein

    2018-01-01

    Media play crucial role in disseminating health information. Due to the importance of accurate health news reports, and the national need to professionalism in health journalism, this study aimed to investigate the characteristics of health journalists, and health reporting status and the challenges involved. Using consensus sampling, this descriptive cross-sectional study was conducted on all health news reporters in Isfahan (34 journalists) in 2015-2016. Data collection was done via a researcher-made questionnaire. Content validity of the questionnaire was determined by qualitative method and based on the opinions of six experts. The test-retest reliability coefficient was 98.0. Data analysis was done by Statistical Package for the Social Sciences, version 16 and descriptive statistics and content analysis were used for analyzing the responses to two open questions. Among 34 journalists, 56% were women and 44% men; the majority of journalists (65%) had no specialized training on health reporting, 35% of journalists were not able to understand the health issues, and the knowledge of medical terminology in 59% of them was moderate to low. The most important required skill for reporters was the ability to interpret medical research reports (88%), 97% were eager to participate in specialized health education. Our study showed that health journalists lacked knowledge and specialized training for dissemination of health news. This has brought about serious challenges. Thus, development and implementation of training courses in close collaboration with educational department of the Ministry of Health and news programs professionals at Islamic Republic of Iran Broadcasting is highly recommended.

  11. Investigating the Relationship between Perceived Discrimination, Social Status, and Mental Health.

    Science.gov (United States)

    Lee, Hedwig; Turney, Kristin

    2012-03-01

    A growing body of evidence suggests that experiences with discrimination have implications for mental health and that these associations may vary by social status. We use data from the Chicago Community Adult Health Study (CCAHS) to examine how two types of perceived discrimination, chronic everyday discrimination and major lifetime discrimination, are linked to mental health, and how this association varies by race/ethnicity, gender, and socioeconomic status. Results indicate that everyday discrimination is generally independently linked to greater depressive symptoms, loneliness, and hostility across all social status groups. Major discrimination is not associated with depressive symptoms or loneliness after adjusting for a host of covariates, but is associated with hostility, especially for certain groups. These findings highlight the need to examine multiple indicators of discrimination and mental health, and to pay attention to both differences and similarities in these associations by social status.

  12. Vitamin D Status of College Students: Implications for Health Leaders

    Science.gov (United States)

    Cress, Eileen McKenna

    2014-01-01

    Vitamin D deficiency is considered to be a pandemic with implications for compromised bone health and other chronic diseases. Few studies have examined vitamin D status in college-aged individuals where prevention of future health consequences is still possible. Serum vitamin D 25(OH)D status and vitamin D intake were examined in 98 college…

  13. Focus on vulnerable populations and promoting equity in health service utilization ––an analysis of visitor characteristics and service utilization of the Chinese community health service

    OpenAIRE

    Dong, Xiaoxin; liu, Ling; Cao, Shiyi; Yang, Huajie; Song, Fujian; Yang, Chen; Gong, Yanhong; Wang, Yunxia; Yin, Xiaoxu; Xie, Jun; Sun, Yi; Lu, Zuxun

    2014-01-01

    Background Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents. Methods Multistage sa...

  14. Utility-preserving anonymization for health data publishing.

    Science.gov (United States)

    Lee, Hyukki; Kim, Soohyung; Kim, Jong Wook; Chung, Yon Dohn

    2017-07-11

    Publishing raw electronic health records (EHRs) may be considered as a breach of the privacy of individuals because they usually contain sensitive information. A common practice for the privacy-preserving data publishing is to anonymize the data before publishing, and thus satisfy privacy models such as k-anonymity. Among various anonymization techniques, generalization is the most commonly used in medical/health data processing. Generalization inevitably causes information loss, and thus, various methods have been proposed to reduce information loss. However, existing generalization-based data anonymization methods cannot avoid excessive information loss and preserve data utility. We propose a utility-preserving anonymization for privacy preserving data publishing (PPDP). To preserve data utility, the proposed method comprises three parts: (1) utility-preserving model, (2) counterfeit record insertion, (3) catalog of the counterfeit records. We also propose an anonymization algorithm using the proposed method. Our anonymization algorithm applies full-domain generalization algorithm. We evaluate our method in comparison with existence method on two aspects, information loss measured through various quality metrics and error rate of analysis result. With all different types of quality metrics, our proposed method show the lower information loss than the existing method. In the real-world EHRs analysis, analysis results show small portion of error between the anonymized data through the proposed method and original data. We propose a new utility-preserving anonymization method and an anonymization algorithm using the proposed method. Through experiments on various datasets, we show that the utility of EHRs anonymized by the proposed method is significantly better than those anonymized by previous approaches.

  15. Predicting Health Care Utilization After Behavioral Health Referral Using Natural Language Processing and Machine Learning

    OpenAIRE

    Roysden, Nathaniel; Wright, Adam

    2015-01-01

    Mental health problems are an independent predictor of increased healthcare utilization. We created random forest classifiers for predicting two outcomes following a patient’s first behavioral health encounter: decreased utilization by any amount (AUROC 0.74) and ultra-high absolute utilization (AUROC 0.88). These models may be used for clinical decision support by referring providers, to automatically detect patients who may benefit from referral, for cost management, or for risk/protection ...

  16. Predicting Health Care Utilization After Behavioral Health Referral Using Natural Language Processing and Machine Learning.

    Science.gov (United States)

    Roysden, Nathaniel; Wright, Adam

    2015-01-01

    Mental health problems are an independent predictor of increased healthcare utilization. We created random forest classifiers for predicting two outcomes following a patient's first behavioral health encounter: decreased utilization by any amount (AUROC 0.74) and ultra-high absolute utilization (AUROC 0.88). These models may be used for clinical decision support by referring providers, to automatically detect patients who may benefit from referral, for cost management, or for risk/protection factor analysis.

  17. 75 FR 34537 - Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a...

    Science.gov (United States)

    2010-06-17

    ... 45 CFR Part 147 Group Health Plans and Health Insurance Coverage Relating to Status as a... for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan... and Insurance Oversight, Department of Health and Human Services. ACTION: Interim final rules with...

  18. Population health status of South Asian and African-Caribbean communities in the United Kingdom

    OpenAIRE

    Calvert, Melanie; Duffy, Helen; Freemantle, Nick; Davis, Russell; Lip, Gregory YH; Gill, Paramjit

    2012-01-01

    Abstract Background Population health status scores are routinely used to inform economic evaluation and evaluate the impact of disease and/or treatment on health. It is unclear whether the health status in black and minority ethnic groups are comparable to these population health status data. The aim of this study was to evaluate health-status in South Asian and African-Caribbean populations. Methods Cross-sectional study recruiting participants aged ≥ 45 years (September 2006 to July 2009) ...

  19. Evaluation on equality and efficiency of health resources allocation and health services utilization in China.

    Science.gov (United States)

    Sun, Jian; Luo, Hongye

    2017-07-14

    China is faced with a daunting challenge to equality and efficiency in health resources allocation and health services utilization in the context of rapid economic growth. This study sought to evaluate the equality and efficiency of health resources allocation and health services utilization in China. Demographic, economic, and geographic area data was sourced from China Statistical Yearbook 2012-2016. Data related to health resources and health services was obtained from China Health Statistics Yearbook 2012-2016. Furthermore, we evaluated the equality of health resources allocation based on Gini coefficient. Concentration index was used to measure the equality in utilization of health services. Data envelopment analysis (DEA) was employed to assess the efficiency of health resources allocation. From 2011 to 2015, the Gini coefficients for health resources by population ranged between 0.0644 and 0.1879, while the Gini coefficients for the resources by geographic area ranged from 0.6136 to 0.6568. Meanwhile, the concentration index values for health services utilization ranged from -0.0392 to 0.2110. Moreover, in 2015, 10 provinces (32.26%) were relatively efficient in terms of health resources allocation, while 7 provinces (22.58%) and 14 provinces (45.16%) were weakly efficient and inefficient, respectively. There exist distinct regional disparities in the distribution of health resources in China, which are mainly reflected in the geographic distribution of health resources. Furthermore, the people living in the eastern developed areas are more likely to use outpatient care, while the people living in western underdeveloped areas are more likely to use inpatient care. Moreover, the efficiency of health resources allocation in 21 provinces (67.74%) of China was low and needs to be improved. Thus, the government should pay more attention to the equality based on geographic area, guide patients to choose medical treatment rationally, and optimize the resource

  20. Oral Health Status and Normative Needs of College Students in Mangalore, Karnataka

    Directory of Open Access Journals (Sweden)

    Lalithambigai G

    2017-01-01

    Full Text Available Introduction: Community-oriented oral health promotion programmes can be efficiently targeted by assessing the oral health status comprehensively. Aim: To investigate oral health status and normative needs of college students in Mangalore, Karnataka. Materials and Methods: A descriptive study was done among 720, 18–20-year-old students attending degree colleges in Mangalore using multi-stage random sampling. Oral health status was recorded as per World Health Organization oral health assessment form. The data were coded and analysed using the Statistical Package for the Social Sciences (SPSS 11.5 version software. Results: Overall dental caries prevalence accounted to 68.1%, with a mean Decayed, Missed and Filled teeth (DMFT of 1.94 [males had higher DMFT score (2.06 than females (1.82], and majority of the students required one surface restoration. Periodontal status of the students as measured by Community Periodontal Index (CPI showed that majority of the study participants (34.9% had calculus necessitating the need for oral prophylaxis. Conclusion: Oral health status of the age groups not traditionally studied gives the complete picture of the oral disease burden, indicating the need of oral heath preventive measures among college students in India.

  1. Relationship of socioeconomic status with health behaviors and self-perceived health in the elderly: A community-based study, Turkey.

    Science.gov (United States)

    Simsek, Hatice; Doganay, Sinem; Budak, Refik; Ucku, Reyhan

    2014-10-01

    The purpose of the present study was to determine the effects of socioeconomic status on health behaviors and perceived health. The present cross-sectional study included 2947 community-dwelling older adults aged 65 years and older. Dependent variables were health behaviors and self-perceived health. The independent variable was socioeconomic status. In men, the risk of unhealthy diet was higher among the uneducated group (OR 4.48) and among those with poor/very poor economic status (OR 3.31). Additionally, in men, having poor/very poor self-perceived health was found to be 3.50-fold significantly higher among the uneducated group than the secondary school and higher-educated group. Lower education level and lower social class were found to be protective factors for smoking in women. In women, the risk of unhealthy diet was found to be 1.54- and 2.18-fold significantly higher, respectively, among those who graduated from primary school and uneducated. There was also a relationship between poor/very poor economic status and unhealthy diet among elderly women (OR 2.80). In women, the risk of physical inactivity was found to be 1.98-fold significantly higher in the uneducated group and 1.79-fold significantly higher in those with poor/very poor economic status, 0.33-fold significantly lower in skilled employees/white collar workers. With regard to self-perceived health status, education level and perceived economic status were significantly related to poor/very poor health status in women (OR 2.09 and OR 4.08, respectively). In older men and women, lower socioeconomic status increases the risk of unhealthy diet and poor health perception. In older women, lower socioeconomic status is a protective factor for smoking, but it also increases physical inactivity. © 2013 Japan Geriatrics Society.

  2. Low-socioeconomic status workers: their health risks and how to reach them.

    Science.gov (United States)

    Harris, Jeffrey R; Huang, Yi; Hannon, Peggy A; Williams, Barbara

    2011-02-01

    To help workplace health promotion practitioners reach low-socioeconomic status workers at high risk for chronic diseases. We describe low-socioeconomic status workers' diseases, health status, demographics, risk behaviors, and workplaces, using data from the Behavioral Risk Factor Surveillance System, Medical Expenditure Panel Survey, and Bureau of Labor Statistics. Workers with household annual incomes less than $35,000, or a high school education or less, report more chronic diseases and lower health status. They tend to be younger, nonwhite, and have much higher levels of smoking and missed cholesterol screening. They are concentrated in the smallest and largest workplaces and in three low-wage industries that employ one-quarter of the population. To decrease chronic diseases among low-socioeconomic status workers, we need to focus workplace health promotion programs on workers in low-wage industries and small workplaces.

  3. Behavioral lifestyle and mental health status of Japanese factory workers.

    Science.gov (United States)

    Ezoe, S; Morimoto, K

    1994-01-01

    Lifestyle factors, sometimes associated with physical health and mortality, have also been known to be associated with mental health status. This study seeks to correlate behavioral lifestyles with major components of mental health among Japanese factory workers. We administered the 28-item version of the General Health Questionnaire (GHQ-28) and a questionnaire concerning eight personal health practices to 2,132 male and 668 female factory workers at a camera-manufacturing company in Japan. There were strong negative relationships of a higher total number of favorable lifestyles as indicated by the Health Practice Index (HPI) to psychological distress and its components: somatic symptoms, anxiety-insomnia, and social dysfunction. After controlling for the effects of confounding factors that included age, marital status, and somatic condition, multiple logistic regression analysis indicated that five of the eight health factors among male workers--mental stress, nutritional balance, eating breakfast regularly, physical exercise, and working hours--were significantly related to the grade of psychological distress or its three components. Among female workers, five health practices, i.e., mental stress, physical exercise, sleeping hours, working hours, and cigarette smoking, were significantly associated with the grade of psychological distress or its three components. Good health practices might be individually and as a whole associated with better mental health status in factory workers.

  4. Perceived health status and daily activity participation of older Malaysians.

    Science.gov (United States)

    Ng, Sor Tho; Tengku-Aizan, Hamid; Tey, Nai Peng

    2011-07-01

    This article investigates the influence of perceived health status on the daily activity participation of older Malaysians. Data from the Survey on Perceptions of Needs and Problems of the Elderly, which was conducted in 1999, were used. The negative binomial regression results show that older persons with good perceived health status reported more varieties of daily activity participation, especially among the uneducated and those with below-average self-esteem. The multinomial logistic regression model suggests that older persons with good perceived health status tended to engage daily in paid work only or with leisure activities, whereas those perceived to have poor health were more likely to engage in leisure activities only or leisure and family role activities. Promotion of a healthy lifestyle at a younger age encourages every person to monitor and take responsibility for their own health, which is a necessary strategy to ensure active participation at an older age, and thus improve their well-being.

  5. Oral health status and treatment needs of elderly people in Ile-ife ...

    African Journals Online (AJOL)

    Background: Oral health is an important and often neglected component of an older person's general health and well- being. Objectives: To determine the oral health status of elderly persons in Ile-Ife, Nigeria. Methods: The oral health status of 95 elderly patients who presented at the General outpatient clinic of the Obafemi ...

  6. Health Status, Intention to Seek Health Examination, and Participation in Health Education Among Taxi Drivers in Jinan, China

    Science.gov (United States)

    Yang, Yan; Fan, Xiao-sheng; Tian, Cui-huan; Zhang, Wei; Li, Jie; Li, Shu-qing

    2014-01-01

    Background: Taxi drivers are exposed to various risk factors such as work overload, stress, an irregular diet, and a sedentary lifestyle, which make these individuals vulnerable to many diseases. This study was designed to assess the health status of this occupational group. Objectives: The objective was to explore the health status, the intention to seek health examination, and participation in health education among taxi drivers in Jinan, China. Patients and Methods: The sample-size was determined scientifically. The systematic sampling procedure was used for selecting the sample. Four hundred taxi drivers were randomly selected from several taxi companies in Jinan. In total, 396 valid questionnaires (from 370 males and 26 females) were returned. Health status, intention to seek health examination, and participation in health education were assessed by a self-designed questionnaire. Other personal information including sex, age, ethnicity, marital status, years of employment as a taxi driver, education level, and habits were also collected. Results: This survey revealed that 54.8% of taxi drivers reported illness in the last two weeks and 44.7% of participants reported chronic diseases. The prevalence rates of hypertension, diabetes mellitus, gastroenteritis, arthritis, and heart disease were 18.2%, 8.8%, 26%, 18.4%, and 4.8% of questioned taxi drivers, respectively. Significant self-reported symptoms included fatigue, waist and back pain, headache, dyspepsia, and dry throat affecting 49.7%, 26.2%, 23.5%, 26%, and 27% of participants, respectively. In total, 90.1% of subjects thought that it was necessary to receive a regular health examination. Only 17.9% of subjects had been given information about health education, and significantly, more than 87% of subjects who had been given information about health education reported that the information had been helpful. Conclusions: Taxi drivers’ health was poor in our survey. Thus, using health education interventions

  7. [Perceptions and experiences of access to health services and their utilization among the immigrant population].

    Science.gov (United States)

    Bas-Sarmiento, Pilar; Fernández-Gutiérrez, Martina; Albar-Marín, M A Jesús; García-Ramírez, Manuel

    2015-01-01

    To identify and describe the needs and problems of the immigrant population related to access and utilization of health services. A descriptive, qualitative, phenomenological study was conducted using focus groups. The study area was the county of Campo de Gibraltar (Spain), which represents the gateway to Europe for immigration from Africa. The final sample size (51 immigrants from 11 countries) was determined by theoretical saturation. A narrative analysis was conducted with QSR NVivo9 software. Immigrants' discourse showed four categories of analysis: response to a health problem, system access, knowledge of social and health resources, and health literacy needs. Responses to health problems and the route of access to the health care system differed according to some sociodemographic characteristics (nationality/culture of origin, length of residence, and economic status). In general, immigrants primarily used emergency services, hampering health promotion and prevention. The health literacy needs identified concerned language proficiency and the functioning of the health system. There is a need to promote interventions to enhance health literacy among immigrants. These interventions should take into account diversity and length of residence, and should be based on an action-participation methodology. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. Correlates of and Barriers to the Utilization of Health Services for Delivery in South Asia and Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Nai-Peng Tey

    2013-01-01

    Full Text Available The high maternal and neonatal mortality rates in South Asia and Sub-Saharan Africa can be attributed to the lack of access and utilization of health services for delivery. Data from the Demographic and Health Surveys conducted in Bangladesh, India, Pakistan, Kenya, Nigeria, and Tanzania show that more than half of the births in these countries were delivered outside a health facility. Institutional delivery was closely associated with educational level, family wealth, place of residence, and women’s media exposure status, but it was not influenced by women’s work status and their roles in decision-making (with the exception of Nigeria. Controlling for other variables, higher parity and younger women were less likely to use a health facility for delivery. Within each country, the poorer, less educated and rural women had higher unmet need for maternal care services. Service related factors (accessibility in terms of cost and distance and sociocultural factors (e.g., did not perceive the need for the services and objections from husband and family also posed as barriers to institutional delivery. The paper concludes with some suggestions to increase institutional delivery.

  9. Impact of middle-of-the-night awakenings on health status, activity impairment, and costs

    Directory of Open Access Journals (Sweden)

    Moline M

    2014-07-01

    reported significantly worse mental and physical health status and worse health utilities relative to insomnia-free matched controls (all P<0.05. Annual per-employee indirect costs were also significantly higher ($4,328 vs $3,000; P<0.05. Among only MOTN awakenings respondents, 74.6% were considered only symptomatic (ie, they did not report having insomnia or having been diagnosed with insomnia. Conclusion: These findings collectively highlight the prevalence and socioeconomic impact of specific types of insomnia symptoms, including MOTN awakenings, experienced by adults in the US. Keywords: insomnia, nocturnal awakenings, work productivity, health outcomes, sleep quality, sleep symptoms

  10. The relationship between seven health practices and oral health status in community-dwelling elderly Thai.

    Science.gov (United States)

    Samnieng, Patcharaphol; Ueno, Masayuki; Zaitsu, Takashi; Shinada, Kayoko; Wright, Fredrick A C; Kawaguchi, Yoko

    2013-12-01

    This study aims to analyse the relationship between seven health practices, oral health behaviors, and oral health status in community dwelling elderly Thai. The subjects were 612 elderly people (mean age = 68.8 ± 5.9 years). Questionnaires survey about sociodemographics, self-reported seven health practices and oral health behaviors were conducted by trained interviewers. Oral examinations investigated the number of teeth present, decayed teeth, periodontal status and functional tooth units (FTUs). Oral malodor was assessed by Organoleptic Test, and unstimulated saliva was collected for 5 min. Five health practices (smoking, drinking, physical activity, breakfast and weight maintenance) were significantly related with oral health behaviors. ancova analysis demonstrated the following significant associations: (i) smoking behavior with number of teeth present, number of FTUs, decayed teeth, periodontal disease, oral malodor and salivary flow rate, (ii) drinking alcohol behavior with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (iii) eating breakfast behavior with periodontal disease, oral malodor and salivary flow rate, (iv) eating between-meal snack with number of teeth present, number of FTUs, decayed teeth and periodontal disease, (v) maintaining weight with number of teeth present, number of FTUs, periodontal disease and oral malodor, (vi) sleeping with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (vii) physical activity with periodontal disease and salivary flow rate. Good health practices were related with good oral health behaviors. Moreover, general health practices were associated with the clinical oral health status such as number of teeth present, decayed teeth, FTUs, periodontal disease, oral malodor and salivary flow rate. The elderly with good general health practices were considered to have good oral health status. Improving general health

  11. Observation of influences of mental health promotion and mental intervention on mental health status of professionals

    OpenAIRE

    Jiang, Shu-Qiang; Zhang, Jian-Ling

    2015-01-01

    Objective: To observe the influences of mental health promotion and mental intervention on mental health status of professionals. Method: 2878 professionals for physical examination were selected and randomly divided into treatment group and control group, with 1443 professionals and 1435 professionals, respectively. Then, the difference of mental health status before and after mental intervention between two groups was compared. Results: In treatment group, the proportion of people with heal...

  12. Health Status, Health Problems and Practices Among Refugees from the Middle East, Eastern Europe and Southeast Asia.

    Science.gov (United States)

    Young, Rosalie F.; And Others

    1987-01-01

    Interviews were conducted with refugees from Poland, Rumania, Iraq, and Vietnam to assess their health care utilization and health service use barriers. The results showed good overall health. The areas of greatest need were dental health, prenatal care, and mental health. Language was a barrier to health service utilization. (VM)

  13. The Change in Mental Health Status of Indonesian Health Care Migrant Worker in Japan

    Directory of Open Access Journals (Sweden)

    Susiana Nugraha

    2017-11-01

    Full Text Available Under the Japan – Indonesia Economic Partnership Agreement, more than 1,000 of Indonesian health care workers have migrated to Japan. Social adjustment during the process of migration is linked to mental health changes. This study aimed to figure out the strongest predictor that influences the change in mental health status as a result of migration. Baseline data were collected in Jakarta in 2013 during pre-departure orientation. Follow-up study was conducted one year after the study participants migrated to Japan in 2014. Using longitudinal design, this study employed 92 participants consisting of nurse and certified care worker candidates. The multiple linear regression analysis was conducted to figure out the predictors that influence the change in mental health status. The prediction model expected to explain 39.9% of the change in mental health status, p value < 0.01, while sex (b = 0.201, p value < 0.05, economic conditions in pre-migration (b = -0.200, p value < 0.05, and the socio cultural adaptation competency (b = -0.238, p value < 0.05. This finding assumed that female candidates and those who have economic constraint in pre-migration stage, and those who have declining in socio-cultural adaptation competency tend to have lower mental health one year after the migration.

  14. Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006

    Directory of Open Access Journals (Sweden)

    Valencia-Mendoza Atanacio

    2011-10-01

    Full Text Available Abstract Background A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. Methods By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006, we modeled an individual's decision when experiencing an illness to use services provided by the (1 Ministry of Health (MoH, (2 social security, (3 private entities, or (4 to not use formal services (no healthcare service utilization. Results Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Conclusions Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the

  15. Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006.

    Science.gov (United States)

    Danese-Dlsantos, Laura G; Sosa-Rubí, Sandra G; Valencia-Mendoza, Atanacio

    2011-10-07

    A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization). Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the

  16. Job stress and mental health of permanent and fixed-term workers measured by effort-reward imbalance model, depressive complaints, and clinic utilization.

    Science.gov (United States)

    Inoue, Mariko; Tsurugano, Shinobu; Yano, Eiji

    2011-01-01

    The number of workers with precarious employment has increased globally; however, few studies have used validated measures to investigate the relationship of job status to stress and mental health. Thus, we conducted a study to compare differential job stress experienced by permanent and fixed-term workers using an effort-reward imbalance (ERI) model questionnaire, and by evaluating depressive complaints and clinic utilization. Subjects were permanent or fixed-term male workers at a Japanese research institute (n=756). Baseline data on job stress and depressive complaints were collected in 2007. We followed up with the same population over a 1-year period to assess their utilization of the company clinic for mental health concerns. The ERI ratio was higher among permanent workers than among fixed-term workers. More permanent workers presented with more than two depressive complaints, which is the standard used for the diagnosis of depression. ERI scores indicated that the effort component of permanent work was associated with distress, whereas distress in fixed-term work was related to job promotion and job insecurity. Moreover, over the one-year follow-up period, fixed-term workers visited the on-site clinic for mental concerns 4.04 times more often than permanent workers even after adjusting for age, lifestyle, ERI, and depressive complaints. These contrasting findings reflect the differential workloads and working conditions encountered by permanent and fixed-term workers. The occupational setting where employment status was intermingled, may have contributed to the high numbers of mental health-related issues experienced by workers with different employment status.

  17. Utilization of maternal health care services in post-conflict Nepal

    Directory of Open Access Journals (Sweden)

    Bhandari TR

    2015-08-01

    Full Text Available Tulsi Ram Bhandari, Prabhakaran Sankara Sarma, Vellappillil Raman Kutty Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India Background: Despite a decade-long armed conflict in Nepal, the country made progress in reducing maternal mortality and is on its way to achieve the Millennium Development Goal Five. This study aimed to assess the degree of the utilization of maternal health care services during and after the armed conflict in Nepal.Methods: This study is based on Nepal Demographic and Health Survey data 2006 and 2011. The units of analysis were women who had given birth to at least one child in the past 5 years preceding the survey. First, we compared the utilization of maternal health care services of 2006 with that of 2011. Second, we merged the two data sets and applied logistic regression to distinguish whether the utilization of maternal health care services had improved after the peace process 2006 was underway.Results: In 2011, 85% of the women sought antenatal care at least once. Skilled health workers for delivery care assisted 36.1% of the women, and 46% of the women attended postnatal care visit at least once. These figures were 70%, 18.7%, and 16%, respectively, in 2006. Similarly, women were more likely to utilize antenatal care at least once (odds ratio [OR] =2.18, confidence interval [CI] =1.95–2.43, skilled care at birth (OR =2.58, CI =2.36–2.81, and postnatal care at least once (OR =4.13, CI =3.75–4.50 in 2011.Conclusion: The utilization of maternal health care services tended to increase continuously during both the armed conflict and the post-conflict period in Nepal. However, the increasing proportion of the utilization was higher after the Comprehensive Peace Process Agreement 2006. Keywords: antenatal care, armed conflict, Nepal, post-conflict, postnatal care, skilled care at birth

  18. Perceptions of health status, medication side effects and depression after successful renal transplantation

    International Nuclear Information System (INIS)

    Kamran, F.; Masood, A.

    2017-01-01

    Objective: To investigate the perceptions of health status and depression among Renal Transplant Recipients (RTRs). Stydy Design: A longitudinal research design was used. Methods: Recipients’ perceived health status (PHS) was measured by a self-developed questionnaire that reflected the symptom severity and frequency of common immunosuppressant side effects. Depression levels were assessed using Beck Depression Inventory B.D.I II) .The sample population comprised of RTRs with a successful and healthy renal transplant recruited from private and government sector renal units in Lahore, Pakistan. Results: Recipients with poorer perceptions of health status tend to be more depressed as indicated by significant negative correlations between PHS and depression. However, further regression analysis found both constructs as significant predictors of each other, raising a question of causal direction. A cross lagged correlation analysis indicated that PHS appears to be a stronger predictor of depression comparatively. Most recipients tend to have positive perceptions of their health status (M = 30.84, S.D = 3.64) with minimum to moderate level of depression (M = 9.50, S.D = 4.00), It is found that a positive perception of health status is associated with lowered depression. Conclusion: Most recipients’ with a healthy kidney transplant tend to report a positive perception of their health status despite adverse medication side effects. However, the perceived health status is significantly associated with consequent feeling of depression. The study confirms the efficacy and positive health outcomes of renal transplantation in Pakistan. (author)

  19. COMPARATIVE STUDY OF HEALTH STATUS BETWEEN COUNTRIES ALONG THE NEW SILK ROAD

    Directory of Open Access Journals (Sweden)

    Ju’e Yan

    2016-04-01

    Full Text Available Using World Statistics Data from the year 2012, health status differences between countries along the “New Silk Road” were compared and analyzed. Life expectancy at birth, life expectancy at age 60, healthy life expectancy, neonatal mortality rate, infant mortality rate, under-five mortality rate, maternal mortality ratio, as well as certain disease incidence rates were used. The study indicated that the 12 countries along the New Silk Road had longer life expectancy at birth. Females had longer life expectancy at birth than males, but life expectancy at age 60 was shorter than the global average, and healthy life expectancy at birth was also shorter. Maternal health status was generally good in each country. China, Russia, and 4 other countries had better children’s health status than India, Tajikistan, Pakistan, and Afghanistan. Non-communicable diseases caused higher mortality than communicable diseases and accidental injuries. However, the age standardized mortality rates of communicable diseases in India, Tajikistan, Pakistan, and Afghanistan were still relatively high. Communicable diseases were also the leading cause of reduction in life expectancy. Tuberculosis had a more significant impact on health status. In conclusion, health status varies among the New Silk Road countries. Countries including China and Iran have relatively better health status, and non communicable diseases were the predominant risk factor impacting health. However, in countries such as India and Afghanistan, mortality caused by communicable diseases is still prominent. Under the current trend of globalization, New Silk Road countries are supposed to collaborate to expand their healthcare systems, and improve the health conditions for their people.

  20. Perceived oral health status and treatment needs of dental auxiliaries.

    Science.gov (United States)

    Azodo, Clement C; Ehizele, Adebola O; Umoh, Agnes; Ojehanon, Patrick I; Akhionbare, Osagie; Okechukwu, Robinson; Igbinosa, Lawrence

    2010-03-15

    To determine the perceived oral health status and treatment needs of Nigerian dental therapists in training and dental technology students. A descriptive cross-sectional study of students from Federal School of Dental Therapy and Technology Enugu, Nigeria was conducted using self-administered questionnaire to obtain information on demography, self-reported oral health status, knowledge of impact of oral health on daily life activity, dental attendance and perceived dental need. The perception of oral health status and treatment need of the two groups of dental auxiliaries was the same. Fewer respondents (27.3%) rated their oral health as excellent, while 50.4% rated their oral health as good. Majority (95.5%) agreed that oral health is a part of general health and 94.6% agreed that oral health has a role in daily life. Out of 81.4% that had previous dental treatment, scaling and polishing accounted for 66.1%. Presently, 48.8% think they need dental treatment ranging from scaling and polishing (33.9%), tooth restoration (10.3%), to extraction (1.2%). This survey revealed that most of the students are aware that oral health is a component of general health and that it has an impact on an individual's daily life. More than half of the students perceived their oral health as good, but only a few knew that there is a need for a preventive approach to oral health as evident by the percentage that perceived scaling and polishing as a treatment need.

  1. Assessment of perceived health status in hypertensive and diabetes mellitus patients at primary health centers in Oman

    Directory of Open Access Journals (Sweden)

    Ahmed Al-Mandhari

    2011-01-01

    Conclusions: The presence of both diseases was associated with lower physical scores of perceived health status. Health status was also affected by various demographic and clinical characteristics. However, the results should be interpreted in light of the study′s limitations.

  2. Health behaviours explain part of the differences in self reported health associated with partner/marital status in The Netherlands.

    Science.gov (United States)

    Joung, I M; Stronks, K; van de Mheen, H; Mackenbach, J P

    1995-10-01

    To describe the differences in health behaviours in disparate marital status groups and to estimate the extent to which these can explain differences in health associated with marital status. Baseline data of a prospective cohort study were used. Directly age standardised percentages of each marital group that engaged in each of the following behaviours--smoking, alcohol consumption, coffee consumption, breakfast, leisure exercise, and body mass index--were computed. Multiple logistic regression models were fitted to estimate the health differences associated with marital status with and without control for differences in health behaviours. The population of the city of Eindhoven and surrounding municipalities (mixed urban-rural area) in The Netherlands in March 1991. There were 16,311 men and women, aged 25-74 years, and of Dutch nationality. There were differences in relation to marital status for each health behaviour. Married people were more likely to practise positive health behaviours (such as exercise and eating breakfast) and less likely to engage in negative ones (such as smoking or drinking heavily) than the other groups. Control for all six health behaviours could explain an average of 20-36% of the differences in perceived and general health and subjective health complaints. Differences in health behaviours explained a considerable amount, but not all, of the health differences related to marital status. Longitudinal data are necessary to confirm these findings; to determine whether the differences in health behaviours related to marital status are caused by selection effects or social causation effects; and to learn how social control, social support, and stress inter-relate to reinforce negative or to maintain positive health behaviours.

  3. Type D personality and health status in cardiovascular disease populations

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Spek, Viola; Pedersen, Susanne S.

    2012-01-01

    Background: Knowledge of the factors associated with individual differences in patient-reported outcomes is essential to identify high-risk patients and improve secondary prevention. Design: In this meta-analysis, we examined the association between Type D personality and the individual differences...... in patient-reported physical and mental health status among cardiovascular patients. Methods: A computerized search of the literature through PUBMED and PsychINFO (from 1995 to May 2011) was performed and prospective studies were selected that analysed the association between Type D personality and health...... status in cardiovascular patients. Two separate meta-analyses were performed for the association of Type D personality with physical and mental health status, respectively. Results: Of all identified studies, ten studies met the selection criteria. The meta-analyses showed that Type D was associated...

  4. [Valuation of health-related quality of life and utilities in health economics].

    Science.gov (United States)

    Greiner, Wolfgang; Klose, Kristina

    2014-01-01

    Measuring health-related quality of life is an important aspect in economic evaluation of health programmes. The development of utility-based (preference-based) measures is advanced by the discipline of health economics. Different preference measures are applied for valuing health states to produce a weighted health state index. Those preference weights should be derived from a general population sample in case of resource allocation on a collective level (as in current valuation studies of the EuroQol group). Copyright © 2014. Published by Elsevier GmbH.

  5. Practice status of specialized agencies for occupational health management of small- to medium-size enterprises and the factors improving their performance: a cross-sectional survey study.

    Science.gov (United States)

    Lee, Saerom; Myong, Jun-Pyo; Kim, Eun-A; Eom, Huisu; Choi, Bowha; Kang, Young Joong

    2017-01-01

    We examined the current status of specialized agencies for occupational health management (SAs) and their workforce. Furthermore, we aimed to clarify the current practice status of SA healthcare professionals and factors that influence their performance. To examine the current SA workforce, we analyzed data from the 2014 Survey of Current Status of SA and their Workforce from the Ministry of Employment and Labor (MOEL). Furthermore, we mailed out an original questionnaire to SA professionals to determine their current health management status and factors that affect their performance. Data from the respondents ( N  = 384) were analyzed. In 2014, the workforce performing health management in SAs comprised 232 physicians, 507 nurses, and 312 occupational hygienists, with no significant regional differences in the distribution of physicians and nurses. According to the findings of the questionnaire, the average daily number of worker consultations by physicians and nurses was 22.8, while the average time taken for health management ranged from 74.3 to 104.3 min, depending on the size of the firm. Most of the respondents (41.5%) answered that they were following-up on more than 80% of individuals with illnesses. Among health management tasks, performance scores of "consultations for general diseases" and "consultations for lifestyle habits" were relatively high, whereas health promotion activities at workplaces were relatively low. There was a significant correlation between the utilization of general and special health examination results and task performance. Among health management tasks, follow-up management of individuals with illnesses and consultations for disease/lifestyle habits were relatively well performed, whereas health promotion activities at workplaces were not performed well. Among factors that positively influenced SA performance at workplaces, only the utilization of health examination results had significant effects. Therefore, to accomplish

  6. Applications of utility theory in the economic evaluation of health care

    NARCIS (Netherlands)

    H. Bleichrodt (Han)

    1996-01-01

    textabstractThis thesis studies the applicability of quality-adjusted life years (QALYs) and other utility based outcome measures in medical decision making and health economics. The main conclusion will be that utility based measures are more useful to model health related behaviour than has

  7. Incarceration and Women's Health: The Utility of Effective Health Education Programming--A Commentary

    Science.gov (United States)

    Robertson-James, Candace; Nunez, Ana

    2012-01-01

    The health and well-being of incarcerated women is a significant public health concern. Compared with non-incarcerated women, incarcerated women in the United States are more often from minority populations, younger (between the ages of 18 and 34 years), of low socioeconomic status, unemployed and mothers to children under 18 years of age. More…

  8. Socioeconomic inequality of diabetes patients' health care utilization in Denmark

    DEFF Research Database (Denmark)

    Sortsø, Camilla; Lauridsen, Jørgen; Emneus, Martha

    2017-01-01

    Understanding socioeconomic inequalities in health care is critical for achieving health equity. The aim of this paper is threefold: 1) to quantify inequality in diabetes health care service utilization; 2) to understand determinants of these inequalities in relation to socio-demographic and clin......Understanding socioeconomic inequalities in health care is critical for achieving health equity. The aim of this paper is threefold: 1) to quantify inequality in diabetes health care service utilization; 2) to understand determinants of these inequalities in relation to socio...... differences in inequality estimates. While income, alike other measures of labor market attachment, to a certain extent is explained by morbidity and thus endogenous, education is more decisive for patients' ability to take advantage of the more specialized services provided in a universal health care system....

  9. Seasonal agricultural youth workers' concerns on development - growth in adolescence period and utilization of health services

    Directory of Open Access Journals (Sweden)

    Zeynep simsek

    2015-06-01

    Full Text Available Aim: Physical, psychological and social changes occurring in adolescence period may be cause for concern. In this study, it was aimed to determine concerns on growth and development in adolescence period, related factors and utilization of health services. Methods: In this study, data related youths' concerns, utilization of health services and socio-demographic variables obtained from multi-purpose cross-sectional survey named Needs Assesment of Seasonal Agricultural Worker Families Survey-2011 were used. Survey framework was consisted of aged 15-24 young people of families who worked as a seasonal agricultural farmworker in the year of research conducted. Survey was completed in 1021 households total 915 youths selected by probability cluster sampling method of 1200 households by Turkish Statistical Institution (Response rates were 90,7% in women, and 77,2% in men. and lsquo;Woman and Men Questionnaires' were applied by face to face interview. University Research Ethics Committee approval was obtained. Data entry and analysis performed using SPSS 11.5 software, descriptive statistics, t-test, chi-square test and logistic regression analysis were conducted. Results: Of participants 63,6% of female and 46,6% of male adolescents reported at least one concern related to growth and development inadolescent period. While having any concern prevalence in women were changed working time in the fields and health perception, marital status and education level with adolescent's concerns were related in men significantly (P <0,05. 13,8% of females and 10,9% of males utilized the health services because of concerns. Conclusion: By Family Health Centers at this risky young group during their period of residence in their address, adolescent follow-up should be done, should be asked concerns and given early diagnosis and treatment. On the other hand, health education programs on adolescence period by Community Health Centers will be useful. [TAF Prev Med Bull

  10. The impact of SHS exposure on health status and exacerbations among patients with COPD

    Directory of Open Access Journals (Sweden)

    Mark D Eisner

    2009-05-01

    Full Text Available Mark D Eisner1,3, Carlos Iribarren3, Edward H Yelin2, Stephen Sidney3, Patricia P Katz2, Gabriela Sanchez3, Paul D Blanc11Division of Occupational and Environmental Medicine and Division of Pulmonary and Critical Care Medicine; 2Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco, CA, USA; 3Division of Research, Kaiser Permanente, Oakland, CA, USAAbstract: Secondhand smoke (SHS is a major contributor to indoor air pollution. Because it contains respiratory irritants, it may adversely influence the clinical course of persons with chronic obstructive pulmonary disease (COPD. We used data from nonsmoking members of the FLOW cohort of COPD (n = 809 to elucidate the impact of SHS exposure on health status and exacerbations (requiring emergency department visits or hospitalization. SHS exposure was measured by a validated survey instrument (hours of exposure during the past week. Physical health status was measured by the SF-12 Physical Component Summary Score and disease-specific health-related quality of life (HRQL by the Airways Questionnaire 20-R. Health care utilization for COPD was determined from Kaiser Permanente Northern California computerized databases. Compared to no SHS exposure, higher level SHS exposure was associated with poorer physical health status (mean score decrement −1.78 points; 95% confidence interval [CI] −3.48 to −0.074 points after controlling for potential confounders. Higher level SHS exposure was also related to poorer disease-specific HRQL (mean score increment 0.63; 95% CI 0.016 to 1.25 and less distance walked during the Six-Minute Walk test (mean decrement −50 feet; 95% CI −102 to 1.9. Both lower level and higher level SHS exposure was related to increased risk of emergency department (ED visits (hazard ratio [HR] 1.40; 95% CI 0.96 to 2.05 and HR 1.41; 95% CI 0.94 to 2.13. Lower level and higher level SHS exposure were associated with a greater risk of

  11. Socio-Demographic Determinants of Maternal Health-Care Service Utilization Among Rural Women in Anambra State, South East Nigeria

    Science.gov (United States)

    Emelumadu, OF; Ukegbu, AU; Ezeama, NN; Kanu, OO; Ifeadike, CO; Onyeonoro, UU

    2014-01-01

    Background: Although, antenatal care (ANC) attendance in sub Saharan Africa is high, however this does not always translate into quality ANC care service utilization. Aim: This study therefore is aimed at exploring pattern of maternal health (MH) services utilization and the socio-demographic factors influencing it in Anambra State, South East Nigeria. Subjects and Methods: A total of 310 women of reproductive age with a previous history of gestation attending ANC services between September, 2007 and August, 2008 in selected Primary Health Centers in Anambra State were studied. Responses were elicited from the study participants using a pre-tested, semi-structured interviewer-administered questionnaire. Data collected were analyzed using Statistical Package for Social Sciences (SPSS) version 17 (SPSS Inc, Chicago Illinois, USA). Association between socio-demographic characteristics and pattern of utilization of ANC and delivery services was measured using χ2-test, Regression analysis was done to identify factors associated with utilization of MH services. P < 0.05 was assumed to be significant. Results: Use of health facility was 293 (97.0%) and 277 (92,7%) out 302 women for ANC and delivery services respectively. Most women attended their first ANC consultation during the preceding pregnancy was after the first trimester and about 31% (94/298) of them had <4 ANC visits prior to delivery. Socio-demographic factors were found to be significantly associated with places where MH care services are accessed. Parity was found to be associated with timing of ANC booking and number of ANC attendance (χ2 = 9.49, P = 0.05). Odds of utilizing formal health facility for MH services were found to be significantly associated with increasing age (P < 0.01) and educational status of mothers (P < 0.001). Conclusions: The study revealed high maternal service utilization and 10% fetal loss, hence the need to address the gaps of late ANC booking and low ANC visits. PMID:24971212

  12. Life-Space Predicts Health Care Utilization in Community-Dwelling Older Adults.

    Science.gov (United States)

    Kennedy, Richard E; Williams, Courtney P; Sawyer, Patricia; Lo, Alexander X; Connelly, Kay; Nassel, Ariann; Brown, Cynthia J

    2017-09-01

    To determine whether decline in life-space mobility predicts increased health care utilization among community-dwelling older adults. Health care utilization (number of emergency department [ED] visits and hospitalizations) was self-reported during monthly interviews among 419 community-dwelling African American and non-Hispanic White adults aged 75 years and older in The University of Alabama at Birmingham (UAB) Study of Aging II. Life-space was measured using the UAB Life-Space Assessment. Generalized estimating equations were used to examine associations of life-space at the beginning of each interval with health care utilization over the 1-month interval. Overall, 400 participants were followed for 36 months. A 10-point decrease in life-space was associated with 14% increased odds of an ED visit and/or hospitalization over the next month, adjusting for demographics, transportation difficulty, comorbidity, and having a doctor visit in the last month. Life-space is a practical alternative in predicting future health care utilization to performance-based measures, which can be difficult to incorporate into clinical or public health practice.

  13. Adolescents Misperceive and Are Influenced By High Status Peers' Health Risk, Deviant, and Adaptive Behavior

    Science.gov (United States)

    Helms, Sarah W.; Choukas-Bradley, Sophia; Widman, Laura; Giletta, Matteo; Cohen, Geoffrey L.; Prinstein, Mitchell J.

    2015-01-01

    Most peer influence research examines socialization between adolescents and their best friends. Yet, adolescents also are influenced by popular peers, perhaps due to misperceptions of social norms. This research examined the extent to which out-group and in-group adolescents misperceive the frequencies of peers' deviant, health risk, and adaptive behaviors in different reputation-based peer crowds (Study 1) and the prospective associations between perceptions of high status peers' and adolescents' own substance use over 2.5 years (Study 2). Study 1 examined 235 adolescents' reported deviant (vandalism, theft), health risk (substance use, sexual risk), and adaptive (exercise, studying) behavior, and their perceptions of Jocks', Populars', Burnouts', and Brains' engagement in the same behaviors. Peer nominations identified adolescents in each peer crowd. Jocks and Populars were rated as higher status than Brains and Burnouts. Results indicated that peer crowd stereotypes are caricatures. Misperceptions of high status crowds were dramatic, but for many behaviors, no differences between Populars'/Jocks' and others' actual reported behaviors were revealed. Study 2 assessed 166 adolescents' substance use and their perceptions of popular peers' (i.e., peers high in peer perceived popularity) substance use. Parallel process latent growth analyses revealed that higher perceptions of popular peers' substance use in Grade 9 (intercept) significantly predicted steeper increases in adolescents' own substance use from Grade 9 to 11 (slope). Results from both studies, utilizing different methods, offer evidence to suggest that adolescents misperceive high status peers' risk behaviors, and these misperceptions may predict adolescents' own risk behavior engagement. PMID:25365121

  14. Adolescents misperceive and are influenced by high-status peers' health risk, deviant, and adaptive behavior.

    Science.gov (United States)

    Helms, Sarah W; Choukas-Bradley, Sophia; Widman, Laura; Giletta, Matteo; Cohen, Geoffrey L; Prinstein, Mitchell J

    2014-12-01

    Most peer influence research examines socialization between adolescents and their best friends. Yet, adolescents also are influenced by popular peers, perhaps due to misperceptions of social norms. This research examined the extent to which out-group and in-group adolescents misperceive the frequencies of peers' deviant, health risk, and adaptive behaviors in different reputation-based peer crowds (Study 1) and the prospective associations between perceptions of high-status peers' and adolescents' own substance use over 2.5 years (Study 2). Study 1 examined 235 adolescents' reported deviant (vandalism, theft), health risk (substance use, sexual risk), and adaptive (exercise, studying) behavior, and their perceptions of jocks', populars', burnouts', and brains' engagement in the same behaviors. Peer nominations identified adolescents in each peer crowd. Jocks and populars were rated as higher status than brains and burnouts. Results indicated that peer crowd stereotypes are caricatures. Misperceptions of high-status crowds were dramatic, but for many behaviors, no differences between populars'/jocks' and others' actual reported behaviors were revealed. Study 2 assessed 166 adolescents' substance use and their perceptions of popular peers' (i.e., peers high in peer perceived popularity) substance use. Parallel process latent growth analyses revealed that higher perceptions of popular peers' substance use in Grade 9 (intercept) significantly predicted steeper increases in adolescents' own substance use from Grade 9 to 11 (slope). Results from both studies, utilizing different methods, offer evidence to suggest that adolescents misperceive high-status peers' risk behaviors, and these misperceptions may predict adolescents' own risk behavior engagement. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  15. Utilisation of oral health services, oral health needs and oral health status in a peri-urban informal settlement.

    Science.gov (United States)

    Westaway, M S; Viljoen, E; Rudolph, M J

    1999-04-01

    Interviews were conducted with 294 black residents (155 females and 138 males) of a peri-urban informal settlement in Gauteng to ascertain utilisation of oral health services, oral health needs and oral health status. Only 37 per cent of the sample had consulted a dentist or medical practitioner, usually for extractions. Teenagers and employed persons were significantly less likely to utilise dentists than the older age groups and unemployed persons. Forty per cent were currently experiencing oral health problems such as a sore mouth, tooth decay and bleeding/painful gums. Two hundred and twelve (73 per cent) interviewees wanted dental treatment or advice. Residents who rated their oral health status as fair or poor appeared to have the greatest need for oral health services. The use of interviews appears to be a cost-effective method of determining oral morbidity.

  16. original article health services utilization and associated factors

    African Journals Online (AJOL)

    Abrham

    utilization of health services and associated factors in Jimma zone, south west Ethiopia. METHODS: A cross .... The sample size was calculated using Epi-Info 3.3.2 ... Before the start of data collection, the proposal was submitted to the ... Table 1. Health services access in Jimma zone, Southwest Ethiopia, February 2007.

  17. Disaster and primary health care utilization: a 4 year follow-up.

    NARCIS (Netherlands)

    Dorn, T.; Yzermans, J.; Kerssens, J.; Veen, P. ten

    2005-01-01

    Background: Although crucial for the management of the post-disaster phase, the impact of disasters on primary health care utilization is largely unknown. Often, pre-disaster base-line data is lacking. The current study quantified primary health care utilization after a major fire disaster in The

  18. Breastfeeding pattern, anthropometry and health status of infants ...

    African Journals Online (AJOL)

    Breastfeeding pattern, anthropometry and health status of infants attending child welfare clinics of a teaching hospital in Nigeria. ... Maternal older age, multiparity and delivery at a government health facility were positively associated with higher rates of EBF (p < 0.05). Only 110 (48.2%) babies were put to the breast ...

  19. Perceived oral health status and treatment needs of dental auxiliaries

    Directory of Open Access Journals (Sweden)

    Clement C. Azodo

    2010-03-01

    Full Text Available Objective: To determine the perceived oral health status and treatment needs of Nigerian dental therapists in training and dental technology students. Methods: A descriptive cross-sectional study of students from Federal School of Dental Therapy and Technology Enugu, Nigeria was conducted using self-administered questionnaire to obtain information on demography, self-reported oral health status, knowledge of impact of oral health on daily life activity, dental attendance and perceived dental need. Results: The perception of oral health status and treatment need of the two groups of dental auxiliaries was the same. Fewer respondents (27.3% rated their oral health as excellent, while 50.4% rated their oral health as good. Majority (95.5% agreed that oral health is a part of general health and 94.6% agreed that oral health has a role in daily life.Out of 81.4% that had previous dental treatment, scaling and polishing accounted for 66.1%. Presently, 48.8% think they need dental treatment ranging from scaling and polishing (33.9%, tooth restoration (10.3%, to extraction (1.2%. Conclusion: This survey revealed that most of the students are aware that oral health is a component of general health and that it has an impact on an individual's daily life. More than half of the students perceived their oral health as good, but only a few knew that there is a need for a preventive approach to oral health as evident by the percentage that perceived scaling and polishing as a treatment need.

  20. Work-Recreation Balance, Health-Promoting Lifestyles and Suboptimal Health Status in Southern China: A Cross-Sectional Study

    OpenAIRE

    Wu, Shengwei; Xuan, Zhengzheng; Li, Fei; Xiao, Wei; Fu, Xiuqiong; Jiang, Pingping; Chen, Jieyu; Xiang, Lei; Liu, Yanyan; Nie, Xiaoli; Luo, Ren; Sun, Xiaomin; Kwan, Hiuyee; Zhao, Xiaoshan

    2016-01-01

    Suboptimal health status (SHS)—an intermediate state between health and illness—refers to functional somatic symptoms that are medically undiagnosed. Although SHS has become a great challenge for global public health, very little about its etiology and mechanisms are known. Work-recreation balance is a part of work−life balance, and is related to stress which greatly influences health status. We therefore carried out a cross-sectional investigation between 2012 and 2013 within a clustered sam...

  1. Effect of lifestyle, education and socioeconomic status on periodontal health

    Science.gov (United States)

    Gundala, Rupasree; Chava, Vijay K.

    2010-01-01

    Background: The health model which forms the basis is knowledge, attitude, temporary, and permanent behaviors. Currently, more emphasis has been directed towards the combined influence of lifestyle, education, levels and socioeconomic factors, instead of regular risk factors in dealing with chronic illnesses. The present study is conducted to correlate the periodontal health of people with reference to lifestyle, education level, and socioeconomic status. Materials and Methods: A cross-sectional study was conducted in the Department of Periodontics, Narayana Dental College and Hospital, Nellore. A total of 1350 subjects were examined and 948 patients were randomly selected from out patient department. Information about their lifestyle, education level, and socioeconomic status were recorded using a questionnaire and correlated with the periodontal status. Results: The statistical analysis showed significant decrease in periodontitis when income and education levels increased. Also the prevalence of periodontitis associated with a healthy lifestyle is significantly lower when compared to an unhealthy lifestyle. Conclusions: There is a strong association of lifestyle, education level, and socioeconomic status with periodontal health. PMID:22114373

  2. Investigating the Relationship between Perceived Discrimination, Social Status, and Mental Health*

    OpenAIRE

    Lee, Hedwig; Turney, Kristin

    2012-01-01

    A growing body of evidence suggests that experiences with discrimination have implications for mental health and that these associations may vary by social status. We use data from the Chicago Community Adult Health Study (CCAHS) to examine how two types of perceived discrimination, chronic everyday discrimination and major lifetime discrimination, are linked to mental health, and how this association varies by race/ethnicity, gender, and socioeconomic status. Results indicate that everyday d...

  3. Older Adults’ Social Relationships and Health Care Utilization: A Systematic Review

    Science.gov (United States)

    Moore, Danielle Collingridge; Barron, Lynn; Stow, Daniel; Hanratty, Barbara

    2018-01-01

    findings. Main Results. The literature search retrieved 26 077 citations, 126 of which met inclusion criteria. Data were reported across 226 678 participants from 19 countries. We identified strong evidence of an association between weaker social relationships and increased rates of readmission to hospital (75% of high-quality studies reported evidence of an association in the same direction). In evidence of moderate strength, according to 2 high-quality and 3 medium-quality studies, smaller social networks were associated with longer hospital stays. When we considered received and perceived social support separately, they were not linked to health care use. Overall, the evidence did not indicate that older patients with weaker social relationships place greater demands on ambulatory care (including physician visits and community- or home-based services) than warranted by their needs. Authors’ Conclusions. Current evidence does not support the view that, independently of health status, older patients with lower levels of social support place greater demands on ambulatory care. Future research on social relationships would benefit from a consensus on clinically relevant concepts to measure. Public Health Implications. Our findings are important for public health because they challenge the notion that lonely older adults are a burden on all health and social care services. In high-income countries, interventions aimed at reducing social isolation and loneliness are promoted as a means of preventing inappropriate service use. Our review cautions against assuming that reductions in care utilization can be achieved by intervening to strengthen social relationships. PMID:29470115

  4. Older Adults' Social Relationships and Health Care Utilization: A Systematic Review.

    Science.gov (United States)

    Valtorta, Nicole K; Moore, Danielle Collingridge; Barron, Lynn; Stow, Daniel; Hanratty, Barbara

    2018-04-01

    . Data were reported across 226 678 participants from 19 countries. We identified strong evidence of an association between weaker social relationships and increased rates of readmission to hospital (75% of high-quality studies reported evidence of an association in the same direction). In evidence of moderate strength, according to 2 high-quality and 3 medium-quality studies, smaller social networks were associated with longer hospital stays. When we considered received and perceived social support separately, they were not linked to health care use. Overall, the evidence did not indicate that older patients with weaker social relationships place greater demands on ambulatory care (including physician visits and community- or home-based services) than warranted by their needs. Current evidence does not support the view that, independently of health status, older patients with lower levels of social support place greater demands on ambulatory care. Future research on social relationships would benefit from a consensus on clinically relevant concepts to measure. Public Health Implications. Our findings are important for public health because they challenge the notion that lonely older adults are a burden on all health and social care services. In high-income countries, interventions aimed at reducing social isolation and loneliness are promoted as a means of preventing inappropriate service use. Our review cautions against assuming that reductions in care utilization can be achieved by intervening to strengthen social relationships.

  5. Inequities in utilization of reproductive and maternal health services in Ethiopia.

    Science.gov (United States)

    Bobo, Firew Tekle; Yesuf, Elias Ali; Woldie, Mirkuzie

    2017-06-19

    Disparities in health services utilization within and between regional states of countries with diverse socio-cultural and economic conditions such as Ethiopia is a frequent encounter. Understanding and taking measures to address unnecessary and avoidable differences in the use of reproductive and maternal health services is a key concern in Ethiopia. The aim of the study was to examine degree of equity in reproductive and maternal health services utilization in Ethiopia. Data from Ethiopia demographic health survey 2014 was analyzed. We assessed inequities in utilization of modern contraceptive methods, antenatal care, facility based delivery and postnatal checkup. Four standard equity measurement methods were used; equity gaps, rate-ratios, concertation curve and concentration index. Inequities in service utilization were exhibited favoring women in developed regions, urban residents, most educated and the wealthy. Antenatal care by skilled provider was three times higher among women with post-secondary education than mothers with no education. Women in the highest wealth quantile had about 12 times higher skilled birth attendance than those in lowest wealth quantile. The rate of postnatal care use among urban resident was about 6 times that of women in rural area. Use of modern contraceptive methods was more equitably utilized service while, birth at health facility was less equitable across all economic levels, favoring the wealthy. Considerable inequity between and within regions of Ethiopia in the use of maternal health services was demonstrated. Strategically targeting social determinants of health with special emphasis to women education and economic empowerment will substantially contribute for altering the current situation favorably.

  6. Health Care Costs, Utilization and Patterns of Care following Lyme Disease

    Science.gov (United States)

    Adrion, Emily R.; Aucott, John; Lemke, Klaus W.; Weiner, Jonathan P.

    2015-01-01

    Background Lyme disease is the most frequently reported vector borne infection in the United States. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome – a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States. Objectives 1) to examine the impact of Lyme disease on health care costs and utilization, 2) to understand the relationship between Lyme disease and the probability of developing PTLDS, 3) to understand how PTLDS may impact health care costs and utilization. Methods This study utilizes retrospective data on medical claims and member enrollment for persons aged 0-64 years who were enrolled in commercial health insurance plans in the United States between 2006-2010. 52,795 individuals treated for Lyme disease were compared to 263,975 matched controls with no evidence of Lyme disease exposure. Results Lyme disease is associated with $2,968 higher total health care costs (95% CI: 2,807-3,128, pLyme disease, having one or more PTLDS-related diagnosis is associated with $3,798 higher total health care costs (95% CI: 3,542-4,055, pLyme disease is associated with increased costs above what would be expected for an easy to treat infection. The presence of PTLDS-related diagnoses after treatment is associated with significant health care costs and utilization. PMID:25650808

  7. [Self-perceived health status among immigrants in Italy].

    Science.gov (United States)

    Petrelli, Alessio; Di Napoli, Anteo; Rossi, Alessandra; Gargiulo, Lidia; Mirisola, Concetta; Costanzo, Gianfranco

    2017-01-01

    to evaluate self-perceived health status of immigrants in Italy. cross-sectional study based on the representative national samples of the multipurpose surveys "Health conditions and use of health services" conducted in 2005 and 2013 by the Italian National Institute of Statistics (Istat). the study was conducted on the age group of 18-64: No. 80,661 in 2005, among which 3.2% were immigrants, and No. 72,476 in 2013, among which 7.1% were immigrants. prevalence rate ratios (PRR) calculated through log-binomial regression models, stratified by survey edition and gender, by evaluating the association between the Physical Component Score (PCS), the Mental Component Score (MCS), and the overall health index and citizenship. Adjustment for the following confounding factors was performed: age, educational level, working condition, perceived economic resources, body mass index (BMI). in 2005, immigrants had a lower probability of poor-perceived physical health, both among men (PRR: 0.79; 95%CI 0.70-0.89) and women (PRR: 0.89; 95%CI 0.82- 0.97), compared to Italians. In 2013, the perceived health advantage of immigrants was reduced for both genders (PRR males: 0.87; 95%CI 0.80-0.95; PRR females: 0.94; 95%CI 0.88-0.99). In the considered period, the prevalence of people with worse mental health conditions increases, with lower PRR among immigrants, compared to Italians. Higher probability of «NOT good» overall perceived health was also observed among immigrants residing in Italy for at least 10 years (PRR men: 1.24; PRR women: 1.15) and among immigrants men from America (PRR: 1.35). from 2005 to 2013, immigrants seemed to maintain a better perception of health status than Italians. Nevertheless, study results show a decrease in self-perceived health, particularly mental health, in the considered period - apart from demographic, socioeconomic, and lifestyle factors - as well as a worse overall self-perceived health status among immigrants who stayed in Italy longer. Such

  8. A structured review of health utility measures and elicitation in advanced/metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    Hao Y

    2016-06-01

    Full Text Available Yanni Hao,1 Verena Wolfram,2 Jennifer Cook2 1Novartis Pharmaceuticals, East Hanover, NJ, USA; 2Adelphi Values, Bollington, UK Background: Health utilities are increasingly incorporated in health economic evaluations. Different elicitation methods, direct and indirect, have been established in the past. This study examined the evidence on health utility elicitation previously reported in advanced/metastatic breast cancer and aimed to link these results to requirements of reimbursement bodies. Methods: Searches were conducted using a detailed search strategy across several electronic databases (MEDLINE, EMBASE, Cochrane Library, and EconLit databases, online sources (Cost-effectiveness Analysis Registry and the Health Economics Research Center, and web sites of health technology assessment (HTA bodies. Publications were selected based on the search strategy and the overall study objectives. Results: A total of 768 publications were identified in the searches, and 26 publications, comprising 18 journal articles and eight submissions to HTA bodies, were included in the evidence review. Most journal articles derived utilities from the European Quality of Life Five-Dimensions questionnaire (EQ-5D. Other utility measures, such as the direct methods standard gamble (SG, time trade-off (TTO, and visual analog scale (VAS, were less frequently used. Several studies described mapping algorithms to generate utilities from disease-specific health-related quality of life (HRQOL instruments such as European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Core 30 (EORTC QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Breast Cancer 23 (EORTC QLQ-BR23, Functional Assessment of Cancer Therapy – General questionnaire (FACT-G, and Utility-Based Questionnaire-Cancer (UBQ-C; most used EQ-5D as the reference. Sociodemographic factors that affect health utilities, such as age, sex

  9. Diagnostic utility of fractional exhaled nitric oxide in prolonged and chronic cough according to atopic status

    Directory of Open Access Journals (Sweden)

    Takamitsu Asano

    2017-04-01

    Conclusions: Although high FeNO levels suggested the existence of AC, lower FeNO levels had limited diagnostic significance. Atopic status affects the utility of FeNO levels in the differential diagnosis of prolonged and chronic cough.

  10. Factors Associated With Perceived Health Status of Multiracial/Ethnic Midlife Women in the United States.

    Science.gov (United States)

    Ko, Young; Chee, Wonshik; Im, Eun-Ok

    2016-01-01

    To identify racial/ethnic differences in perceived health status and differences in the factors associated with perceived health status of midlife women in four broad racial/ethnic groups in the United States. A secondary analysis of Web-based survey data. Internet communities/groups among midlife women and Internet communities/groups of racial/ethnic minorities. Participants included 491 women 40 to 60 years of age who self-identified into four broad racial/ethnic categories (Hispanic, non-Hispanic [N-H] Asian American, N-H African American, or N-H White). Data related to participants' sociodemographic, behavioral, situational, and individual health factors and their coping resources were selected based on the Comprehensive Health Seeking and Coping Paradigm. Multiple logistic regression analyses were used to identify racial/ethnic differences in perceived health status and race/ethnicity-specific factors associated with perceived health status among midlife women. Perceived health status did not differ by race/ethnicity; however, factors that were associated with perceived health status did vary by race/ethnicity. Among N-H White women, educational level, level of family income, obesity, and menopausal symptoms were significantly associated with perceived not healthy status. In Hispanic women, perceived level of physical activity and obesity were significantly associated with not healthy status. Perceived level of physical activity was the only factor significantly associated with not healthy status in N-H Asian American women, and the level of family income was the only factor associated with not healthy status in N-H African American women. In future intervention development, researchers need to consider differences among racial/ethnic groups in the factors associated with women's perceived health status. Copyright © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  11. Mental Health Status of Double Minority Adolescents: Findings from National Cross-Sectional Health Surveys.

    Science.gov (United States)

    Chiang, Szu-Ying; Fleming, Theresa; Lucassen, Mathijs; Fenaughty, John; Clark, Terryann; Denny, Simon

    2017-06-01

    Little population-based work has been published about the mental health of adolescents with both sexual/gender (SG) and ethnic minority (i.e. double minority) status. This study aimed to provide an overview on their mental health. Analysis of data from a total of 17,607 high school students from New Zealand's 2007 and 2012 cross-sectional nationally representative Adolescent Health Surveys, including a total of 1306 (7.4%) SG minority participants, of whom 581 (3.3%) were also an ethnic minority. SG minority status, minority ethnicity, and female sex were associated with higher mental distress and poorer well-being. Generally speaking, double minority students reported poorer mental health than SG majority students of the same ethnicity, but reported better mental health than SG minority New Zealand European students. Explanations and future directions for research were suggested to further explore how double minority students negotiate mental health in the context of their communities/cultures in New Zealand.

  12. Impact of Predicting Health Care Utilization Via Web Search Behavior: A Data-Driven Analysis

    OpenAIRE

    Agarwal, Vibhu; Zhang, Liangliang; Zhu, Josh; Fang, Shiyuan; Cheng, Tim; Hong, Chloe; Shah, Nigam H

    2016-01-01

    Background By recent estimates, the steady rise in health care costs has deprived more than 45 million Americans of health care services and has encouraged health care providers to better understand the key drivers of health care utilization from a population health management perspective. Prior studies suggest the feasibility of mining population-level patterns of health care resource utilization from observational analysis of Internet search logs; however, the utility of the endeavor to the...

  13. Health status and measurement of some liver function parameters of ...

    African Journals Online (AJOL)

    Background: A good health program is necessary to optimize health care opportunities so as to make appropriate adjustments for optimal service delivery by our health workers in all health sectors. Aim: To determine some hepatic function parameters as a correlate of health status amongst staff of Niger Delta University ...

  14. Testing rank-dependent utility theory for health outcomes.

    Science.gov (United States)

    Oliver, Adam

    2003-10-01

    Systematic violations of expected utility theory (EU) have been reported in the context of both money and health outcomes. Rank-dependent utility theory (RDU) is currently the most popular and influential alternative theory of choice under circumstances of risk. This paper reports a test of the descriptive performance of RDU compared to EU in the context of health. When one of the options is certain, violations of EU that can be explained by RDU are found. When both options are risky, no evidence that RDU is a descriptive improvement over EU is found, though this finding may be due to the low power of the tests. Copyright 2002 John Wiley & Sons, Ltd.

  15. Forest health monitoring: national status, trends, and analysis 2016

    Science.gov (United States)

    Kevin M. Potter; Barbara L. Conkling

    2017-01-01

    The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introducesnew techniques for analyzing forest health data, and summarizes results of recently completed...

  16. Estimation of health state utilities in breast cancer

    Directory of Open Access Journals (Sweden)

    Kim SH

    2017-03-01

    Full Text Available Seon-Ha Kim,1 Min-Woo Jo,2 Minsu Ock,2 Hyeon-Jeong Lee,2 Jong-Won Lee3,4 1Department of Nursing, College of Nursing, Dankook University, Cheonan, 2Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, 3Department of Breast and Endocrine Surgery, Asan Medical Center, Seoul, 4Department of Surgery, University of Ulsan College of Medicine, Seoul, South Korea Purpose: The aim of this study is to determine the utility of breast cancer health states using the standard gamble (SG and visual analog scale (VAS methods in the Korean general population.Materials and methods: Eight hypothetical breast cancer health states were developed based on patient education material and previous publications. Data from 509 individuals from the Korean general population were used to evaluate breast cancer health states using the VAS and the SG methods, which were obtained via computer-assisted personal interviews. Mean utility values were calculated for each human papillomavirus (HPV-related health state.Results: The rank of health states was identical between two valuation methods. SG values were higher than VAS values in all health states. The utility values derived from SG were 0.801 (noninvasive breast cancer with mastectomy and followed by reconstruction, 0.790 (noninvasive breast cancer with mastectomy only, 0.779 (noninvasive breast cancer with breast-conserving surgery and radiation therapy, 0.731 (invasive breast cancer with surgery, radiation therapy, and/or chemotherapy, 0.610 (locally advanced breast cancer with radical mastectomy with radiation therapy, 0.587 (inoperable locally advanced breast cancer, 0.496 (loco-regional recurrent breast cancer, and 0.352 (metastatic breast cancer.Conclusion: Our findings might be useful for economic evaluation of breast cancer screening and interventions in general populations. Keywords: breast neoplasm, Korea, quality-adjusted life years, quality of life

  17. Factors affecting utilization of University health services in a tertiary ...

    African Journals Online (AJOL)

    2013-01-16

    Jan 16, 2013 ... Objective: To determine students' perception of health care services provided in a tertiary institution and ... evaluation of health services utilization among students in the .... African culture and health. ... Asian Am Pac Isl J.

  18. Filipino American grandparent caregivers' roles, acculturation, and perceived health status.

    Science.gov (United States)

    Kataoka-Yahiro, Merle R

    2010-01-01

    The purpose of this exploratory study was to describe the relationships between roles, acculturation, and perceived health status among 47 FA grandparent caregivers who were providing extensive caregiving to their grandchildren. Role satisfaction was significantly related to perceived health status. Role occupancy was significantly related to years lived in the U.S. and employment. Role integration and role stress were significantly related to gender and income. Acculturation was significantly related to role involvement, years lived in the U.S., language spoken, and education. The findings of this health disparities research study will lead to more contextual work in this area of study.

  19. Utility and justice in public health.

    Science.gov (United States)

    MacKay, Kathryn

    2017-12-11

    Many public health practitioners and organizations view themselves as engaged in the promotion or achievement of equity. However, discussions around public health frequently assume that practitioners and policy-makers take a utilitarian approach to this work. I argue that public health is better understood as a social justice endeavor. I begin by presenting the utility view of public health and then discuss the equity view. This is a theoretical argument, which should help public health to justify interventions for communicable and non-communicable diseases equally, and which contributes to breaking down the 'old/new' public health divide. This argument captures practitioners' views of the work they are engaged in and allows for the moral and policy justification of important interventions in communicable and non-communicable diseases. Systemic interventions are necessary to remedy high rates of disease among certain groups and, generally, to improve the health of entire populations. By viewing diseases as partly the result of failures of health protective systems in society, public health may justify interventions in communicable and non-communicable diseases equally. Public health holds a duty to improve the health of the worst-off in society; by prioritizing this group, the health of the whole community may improve. © The Author(s) 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  20. Health status and quality of life among older adults in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Mathew A. Mwanyangala

    2010-09-01

    Full Text Available Background: Increasingly, human populations throughout the world are living longer and this trend is developing in sub-Saharan Africa. In developing African countries such as Tanzania, this demographic phenomenon is taking place against a background of poverty and poor health conditions. There has been limited research on how this process of ageing impacts upon the health of older people within such low-income settings. Objective: The objective of this study is to describe the impacts of ageing on the health status, quality of life and well-being of older people in a rural population of Tanzania. Design: A short version of the WHO Survey on Adult Health and Global Ageing questionnaire was used to collect information on the health status, quality of life and well-being of older adults living in Ifakara Health and Demographic Surveillance System, Tanzania, during early 2007. Questionnaires were administered through this framework to 8,206 people aged 50 and over. Results: Among people aged 50 and over, having good quality of life and health status was significantly associated with being male, married and not being among the oldest old. Functional ability assessment was associated with age, with people reporting more difficulty in performing routine activities as age increased, particularly among women. Reports of good quality of life and well-being decreased with increasing age. Women were significantly more likely to report poor quality of life (odds ratio 1.31; p<0.001, 95% CI 1.15–1.50. Conclusions: Older people within this rural Tanzanian setting reported that the ageing process had significant impacts on their health status, quality of life and physical ability. Poor quality of life and well-being, and poor health status in older people were significantly associated with marital status, sex, age and level of education. The process of ageing in this setting is challenging and raises public health concerns.

  1. Status and review of health of Indian coral reefs

    Digital Repository Service at National Institute of Oceanography (India)

    Rajan, R.; Satyanarayan, C.; Raghunathan, C.; Koya, S.S.; Ravindran, J.; Manikandan, B.; Venkataraman, K.

    Status of reef health incorporating species-wise cover of scleractinians has been reported covering 61 stations in 29 reef locations of the four major reef regions in India as of March 2011, alongside a review of available reef health data since...

  2. Women’s Health Care Utilization among Harder-to-Reach HIV-Infected Women ever on Antiretroviral Therapy in British Columbia

    Directory of Open Access Journals (Sweden)

    Xuetao Wang

    2012-01-01

    Full Text Available Background. HIV-infected women are disproportionately burdened by gynaecological complications, psychological disorders, and certain sexually transmitted infections that may not be adequately addressed by HIV-specific care. We estimate the prevalence and covariates of women’s health care (WHC utilization among harder-to-reach, treatment-experienced HIV-infected women in British Columbia (BC, Canada. Methods. We used survey data from 231 HIV-infected, treatment-experienced women enrolled in the Longitudinal Investigations into Supportive and Ancillary Health Services (LISA study, which recruited harder-to-reach populations, including aboriginal people and individuals using injection drugs. Independent covariates of interest included sociodemographic, psychosocial, behavioural, individual health status, structural factors, and HIV clinical variables. Logistic regression was used to generate adjusted estimates of associations between use of WHC and covariates of interest. Results. Overall, 77% of women reported regularly utilizing WHC. WHC utilization varied significantly by region of residence (P value <0.01. In addition, women with lower annual income (AOR (95% CI = 0.14 (0.04–0.54, who used illicit drugs (AOR (95% CI = 0.42 (0.19–0.92 and who had lower provider trust (AOR (95% CI = 0.97 (0.95–0.99, were significantly less likely to report using WHC. Conclusion. A health service gap exists along geographical and social axes for harder-to-reach HIV-infected women in BC. Women-centered WHC and HIV-specific care should be streamlined and integrated to better address women’s holistic health.

  3. Forest Health Monitoring: national status, trends, and analysis 2014

    Science.gov (United States)

    Kevin M. Potter; Barbara L. Conkling

    2015-01-01

    The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

  4. Forest health monitoring: national status, trends, and analysis 2013

    Science.gov (United States)

    Kevin M. Potter; Barbara L. Conkling

    2015-01-01

    The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

  5. 77 FR 73646 - Notice of Effectiveness of Exempt Wholesale Generator or Foreign Utility Company Status

    Science.gov (United States)

    2012-12-11

    ... Renewable Energy Infrastructure FC12-10-000 Limited Partnership. Project AMBG2 LP FC12-11-000 SunBridge Wind... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket Nos. EG12-108-000, et al.] Notice of Effectiveness of Exempt Wholesale Generator or Foreign Utility Company Status [[Page 73647...

  6. Status of Utilizing Social Media Networks in the Teaching-Learning Process at Public Jordanian Universities

    Directory of Open Access Journals (Sweden)

    Muneera Abdalkareem Alshdefait

    2018-03-01

    Full Text Available This study aimed at finding out the status of utilizing social media networks in the teaching-learning process at public Jordanian Universities. To achieve the goal of the study, the descriptive developmental method was used and a questionnaire was developed, consisting of (35 statements. The questionnaire was checked for its validity and reliability. Then it was distributed to a sample of (382 male and female students from the undergraduate and graduate levels. The study results showed that the participants gave a low score to the status of utilizing social media networks in the teaching-learning process at public Jordanian universities. The results also showed that there were statistically significant differences between the participants of the study according to the academic rank attributed to the graduate students, and according to gender attributed to male students at the instrument macro level and on all dimensions of the two variables. In light of these results, the study recommended that public universities should utilize modern technology in the educational process, urge and encourage the teaching staff members to use the social media networks in the teaching-learning process and raise the students' awareness about the benefits of using social media networks. Keywords: Social media networks, Teaching-learning process, Public Jordanian Universities

  7. Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian Demographic and Health Survey

    OpenAIRE

    Tarekegn, Shegaw Mulu; Lieberman, Leslie Sue; Giedraitis, Vincentas

    2014-01-01

    Background Antenatal Care (ANC), use of skilled delivery attendants and postnatal care (PNC) services are key maternal health services that can significantly reduce maternal mortality. Understanding the factors that affect service utilization helps to design appropriate strategies and policies towards improvement of service utilization and thereby reduce maternal mortality. The objective of this study was to identify factors that affect utilization of maternal health services in Ethiopia. Met...

  8. Health insurance benefit design and healthcare utilization in northern rural China.

    Science.gov (United States)

    Wang, Hong; Liu, Yu; Zhu, Yan; Xue, Lei; Dale, Martha; Sipsma, Heather; Bradley, Elizabeth

    2012-01-01

    Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS) in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care) and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview. People who had both outpatient and inpatient coverage compared with inpatient coverage only had significantly more village-level outpatient visits, township-level outpatient visits, and total outpatient visits. Furthermore, the increased utilization of township and village-level outpatient care was experienced disproportionately by people who were poorer, whereas the increased inpatient utilization overall and at the county level was experienced disproportionately by people who were richer. The evidence from this study indicates that the design of health insurance benefits is an important policy tool that can affect the health services utilization and socioeconomic equity in service use at different levels. Without careful design, health insurance may not benefit those who are most in need

  9. Differences in health status and health behaviour among young Swiss adults between 1993 and 2003

    OpenAIRE

    Mohler-Kuo, Meichun; Wydler, Hans; Zellweger, Ueli; Gutzwiller, Felix

    2006-01-01

    OBJECTIVE: Very few studies specifically have examined the health status of 20-year-olds. The purpose of the present study is to examine the changes in health status and behaviour among young Swiss adults between 1993 and 2003. METHODS: The present study used data from the Swiss Federal Surveys of Adolescents, conducted in 1993 and 2003 among 20-year-olds in Switzerland. The study sample included military recruits and a representative community cohort. More than 20,000 subjects participate...

  10. Correlation between Food Intake and Health Status with the Nutritional Status of School Children Age 9-11 in Semarang City

    Directory of Open Access Journals (Sweden)

    Aiman Farag Mohammed Ali

    2016-12-01

    Full Text Available Malnutrition, a major risk factor for a number of infectious diseases, including acute upper respiratory tract infections (AURTI, is common in developing countries. Nutritional status is an important index of the quality of life. Objectives:To analyze the correlation between food intake and health status to nutritional status of 9-11 years old children in Semarang. The study was a correlation study carried among school children in Semarang aged 9-11 years old. Data are presented in the descriptive analyses and Spearman correlation. Overall, food intake (energy and protein of 9-11 years old children in Semarang is normal with ≥ 90% RDA, health status of them was satisfactory (very low AURTI incidence,and their nutritional status were mostly normal. There was a correlation between energy intake with nutritional status with indicators BMI, and z-score of W/A and H/A, but there was no correlation between protein intake and AURTI with nutritional status. Energy and food intake of the children correlate with all nutritional status being studied. It should be suggested to parents to implement balanced diet, to avoid the development of obesity among elementary school children through nutrition education to prevent malnutrition as well as obesity.How to CiteAli, A. F. M., Muis, S. F., & Suhartono, S. (2016. Correlation between Food Intake and Health Status with The Nutritional Status of School Children Age 9-11 in Semarang City. Biosaintifika: Journal of Biology & Biology Education, 8(3, 249-256. 

  11. Medicare home health utilization as a function of nursing home market factors.

    OpenAIRE

    Swan, J H; Benjamin, A E

    1990-01-01

    Rapid increases in the size and costs of the home health market, unknown impacts of Medicare's DRG hospital reimbursement on the posthospital market, and general lack of knowledge about factors that explain interstate variation in home health utilization all suggest the importance of developing and testing models of Medicare home health use. This article proposes and tests a model of state home health utilization as a function of the nursing home market. This model proposes that home health u...

  12. P-1139 - Increased utilization of health care services after psychotherapy

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Mortensen, Erik Lykke; Poulsen, Stig Bernt

    2012-01-01

    Background Psychotherapeutic treatment is associated with significant reduction of symptoms in patients, and it is generally assumed that treatment improves health and decreases the need for additional health care. The present study investigates the long-term changes in utilization of health care...... services for patients referred to psychotherapeutic treatment in 2004 and 2005. Method The study was a matched control study, which included 716 consecutive patients and 15,220 matched controls. Data from a comprehensive set of health care services were collected from central registries for an observation...... period of four years before intake and four years after ended treatment. Changes in utilization of health care services in eight health parameters were analyzed with t-test and with ANCOVA one and four year pre-post treatment. Results Of the 761 patients, 216 patients did not show up for treatment, while...

  13. Does childhood socioeconomic status influence adult health through behavioural factors?

    NARCIS (Netherlands)

    H. van de Mheen (Dike); K. Stronks (Karien); C.W.N. Looman (Caspar); J.P. Mackenbach (Johan)

    1998-01-01

    textabstractBACKGROUND: The purpose of this study is to assess to what extent the effect of childhood socioeconomic status on adult health could be explained by a higher prevalence of unhealthy behaviour among those with lower childhood socioeconomic status. METHODS:

  14. Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

    LENUS (Irish Health Repository)

    Moorhead, Anne

    2011-03-31

    Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices\\/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups\\' ability to identify body weight status in both adults and children. The health professional groups are: (a) community related public health nurses; (b) school public health nurses; (c) GPs and practice nurses (primary care); and (d) occupational health nurses (workplace) from both Northern Ireland and the Republic of Ireland. Methods\\/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based) - to determine the attitudes, current practices\\/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals\\' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices\\/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may

  15. Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

    Directory of Open Access Journals (Sweden)

    Murphy Kathy

    2011-03-01

    Full Text Available Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups' ability to identify body weight status in both adults and children. The health professional groups are: (a community related public health nurses; (b school public health nurses; (c GPs and practice nurses (primary care; and (d occupational health nurses (workplace from both Northern Ireland and the Republic of Ireland. Methods/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based - to determine the attitudes, current practices/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may

  16. Young Adults' Health Care Utilization and Expenditures Prior to the Affordable Care Act

    Science.gov (United States)

    Lau, Josephine S.; Adams, Sally H.; Boscardin, W. John; Irwin, Charles E.

    2014-01-01

    Purpose Examine young adults' health care utilization and expenditures prior to the ACA. Methods We used 2009 Medical Expenditure Panel Survey (MEPS) to 1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and 2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other socio-demographic factors, including race/ethnicity and income. Results Young adults had: 1) significantly lower rates of overall utilization (72%) than other age groups (83-88%, Pyoung adults had high out-of-pocket expenses. Compared to the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/ person, Pyoung adults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language and sex. Conclusions Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of ER visits. The ACA provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address non-insurance barriers and ensure equal access to health services. PMID:24702839

  17. Impact of Predicting Health Care Utilization Via Web Search Behavior: A Data-Driven Analysis.

    Science.gov (United States)

    Agarwal, Vibhu; Zhang, Liangliang; Zhu, Josh; Fang, Shiyuan; Cheng, Tim; Hong, Chloe; Shah, Nigam H

    2016-09-21

    By recent estimates, the steady rise in health care costs has deprived more than 45 million Americans of health care services and has encouraged health care providers to better understand the key drivers of health care utilization from a population health management perspective. Prior studies suggest the feasibility of mining population-level patterns of health care resource utilization from observational analysis of Internet search logs; however, the utility of the endeavor to the various stakeholders in a health ecosystem remains unclear. The aim was to carry out a closed-loop evaluation of the utility of health care use predictions using the conversion rates of advertisements that were displayed to the predicted future utilizers as a surrogate. The statistical models to predict the probability of user's future visit to a medical facility were built using effective predictors of health care resource utilization, extracted from a deidentified dataset of geotagged mobile Internet search logs representing searches made by users of the Baidu search engine between March 2015 and May 2015. We inferred presence within the geofence of a medical facility from location and duration information from users' search logs and putatively assigned medical facility visit labels to qualifying search logs. We constructed a matrix of general, semantic, and location-based features from search logs of users that had 42 or more search days preceding a medical facility visit as well as from search logs of users that had no medical visits and trained statistical learners for predicting future medical visits. We then carried out a closed-loop evaluation of the utility of health care use predictions using the show conversion rates of advertisements displayed to the predicted future utilizers. In the context of behaviorally targeted advertising, wherein health care providers are interested in minimizing their cost per conversion, the association between show conversion rate and predicted

  18. Effect of age, education and health status on community dwelling older men's health concerns.

    Science.gov (United States)

    Tannenbaum, Cara

    2012-06-01

    A significant gap in evidence characterizes the process of establishing patient-centered health priorities for older men. A cross-sectional postal survey of 2325 Canadian community dwelling men aged 55-97 years old was conducted in 2008 to gauge older men's level of concern for 24 different health items, to determine the impact of age, education and health status on these perceptions, and to ascertain whether men perceive that their health concerns are being attended to. Health issues of greatest concern to men were mobility impairment (64% of respondents), memory loss (64%), and medication side effects (63%). Respondents with lower educational attainment expressed greater concern about their health and were almost 2-fold times more likely to report being concerned about stroke, heart disease and prostate disorders in analyses that controlled for age and health status. Physical and mental health were independently associated with various concerns about health, but old age was not a reliable predictor, with only younger men (erectile dysfunction. Health items of greatest concern to men tended to be those with the lowest screening or counseling rates: these included incontinence, osteoporosis, mobility impairment, falls, anxiety issues, memory loss and depression. An improved consumer-guided agenda for addressing older men's health in the coming decade is urgently required.

  19. Distinct trajectories of disease-specific health status in heart failure patients undergoing cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H.; Pedersen, Susanne S.; Meine, Mathias

    2016-01-01

    of beta-blockers, use of psychotropic medication, anxiety, depression, and type D personality were found to be associated with poorer health status in unadjusted analyses. Interestingly, subgroups of patients (12-20 %) who experienced poor health status at baseline improved to stable good health status....... The timely identification of CRT-D patients who present with poor disease-specific health status (i.e., KCCQ score anxiety, depression, and/or type D personality) is paramount, as they may benefit from cardiac rehabilitation in combination...

  20. Change in health status and access to care in young adults with special health care needs: results from the 2007 national survey of adult transition and health.

    Science.gov (United States)

    Okumura, Megumi J; Hersh, Aimee O; Hilton, Joan F; Lotstein, Debra S

    2013-04-01

    Despite over 500,000 adolescents with special health care needs transitioning to adulthood each year, limited information is available on their health status or their access to care after transition. To describe the change in health status and access to care of a nationally sampled, longitudinal cohort of young adults with special health care needs (ASHCN). We analyzed follow-up data collected in the 2007 Survey of Adult Transition and Health on young adults who were 14-17 years of age when their parents participated in the 2001 National Survey of Children with Special Health Care Needs. We describe changes in access to care and health status over time, and used logistic regression to identify characteristics that were associated with declining health status in this cohort. 1,865 participants, aged 19-23 years, completed the Survey of Adult Transition and Health. Between 2001 and 2007, there was a 3.6 fold increase in the proportion experiencing delayed or forgone care; 10% reported a decline in health status. There was a 7.7-fold increase in the proportion reporting no insurance. In regression analysis, factors associated with declining health status between 2001 and 2007 included underlying disease severity and delayed or forgone care in young adulthood. We found significant deterioration in insurance coverage, usual source of care and receiving timely health care as ASHCN aged into adulthood, and that this was associated with decline in health status. Our findings suggest that further population-based analyses of health outcomes are needed to plan for interventions to assist this vulnerable population. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. [Associations between health-promoting lifestyle and suboptimal health status in Guangdong: a cross sectional study].

    Science.gov (United States)

    Chen, Jie-Yu; Yang, Le-Bin; Jiang, Ping-Ping; Sun, Xiao-Min; Yu, Ke-Qiang; Li, Fei; Wu, Sheng-Wei; Ji, Yan-Zhao; Zhao, Xiao-Shan; Luo, Ren

    2016-04-01

    To investigate associations between health-promoting lifestyle and suboptimal health status (SHS) in the population of Guangdong province. A cross-sectional survey was conducted in a clustered sample of 24 159 individuals aged 12-80 years from 2012 to 2013. Health-promoting lifestyle was assessed via the Health-Promoting Lifestyle Profile (HPLP-II), and SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Of the 24159 participants, subjects with SHS (46.0%) and disease status (35.2%) accounted for a much higher percentage than healthy subjects (18.8%). Regression analyses revealed a significant association between health status and healthy lifestyle (PUnhealthy lifestyle was an important risk factor for SHS and disease, especially the former. Compared with the participants with a healthy lifestyle (minimal exposure), after demographic adjustment, subjects with a 'poor' lifestyle (maximal exposure) were at a 43 times higher risk of developing SHS (OR: 42.825, 95% CI: 30.567-59.997), those with a general lifestyle were at a 21 times higher risk of SHS (OR: 21.072, 95%CI: 17.258-25.729), and those with a suboptimal lifestyle had a 4 times higher risk (OR: 4.085, 95%CI: 3.352-4.979). In the general population, the major risk factors for SHS included poor stress management, poor self-actualization, inactive exercise and poor interpersonal relationship. s Unhealthy lifestyles are significantly related to an increased risk of SHS. Intervention of unhealthy lifestyles, controlling the risk factors of SHS, and rigorous management of the time window of SHS are necessary to promote the heath status.

  2. Subjective social status, self-rated health and tobacco smoking: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Camelo, Lidyane do V; Giatti, Luana; Barreto, Sandhi M

    2014-11-01

    Using baseline data from ELSA-Brasil (N = 15,105), we investigated whether subjective social status, measured using three 10-rung "ladders," is associated with self-rated health and smoking, independently of objective indicators of social position and depression symptoms. Additionally, we explored whether the magnitude of these associations varies according to the reference group. Subjective social status was independently associated with poor self-rated health and weakly associated with former smoking. The references used for social comparison did not change these associations significantly. Subjective social status, education, and income represent distinct aspects of social inequities, and the impact of each of these indicators on health is different. © The Author(s) 2013.

  3. Women's health status in urban Ghana: dimensions and differentials using short form 36.

    Science.gov (United States)

    Frempong-Ainguah, Faustina; Bailey, Claire E; Hill, Allan G

    2018-04-24

    Global discourse on population, health and development have placed women's health issues at the top of development agenda. Women's reproductive health has received some attention in Ghana since the mid-1990s. However, studies on women's general health status, dimensions and the differentials in a rapidly growing urban setting is poorly understood and under-researched. This study sought to examine the various pathways in which individual socio-demographic factors, economic characteristics and endowment influence self-assessed health status among women living in the city of Accra, Ghana. The paper draws on a cross-sectional study carried out in 2008 and 2009 using a representative sample of urban women 20 years and older (n = 2814). Multivariate stepwise linear regression models were performed to investigate the influence of socio-demographic, economic and health indicators on health-related quality of life, measured by eight sub-scales of the Short Form-36 (SF-36). Interaction effects between some demographic and socio-economic variables were also performed. The analyses show diverse relationships between demographic, socio-economic and health indicators and health outcomes assessed using eight SF-36 sub-scales. Education, disease symptoms and age of the respondent were the most significant factors influencing good overall health status. Interestingly, age has no significant effect on mental health after controlling for all other explanatory variables. The findings show that health issues are multi-faceted requiring socio-cultural, health and economic policy interventions. Investing in women's education is important to improve health status. There is also the need for more effective collaboration across various sectors to improve the health and well-being of women in general. Ageing has increasing relationship with poor physical health status and the elderly should be given needed attention and support.

  4. Predicting Health Care Utilization After the First Behavioral Health Visit Using Natural Language Processing and Machine Learning

    OpenAIRE

    Roysden, Nathaniel

    2016-01-01

    Mental health problems are an independent predictor of increased healthcare utilization. We created random forest classifiers for predicting two outcomes following a patient’s first behavioral health encounter: decreased utilization by any amount (AUROC 0.74) and ultra-high absolute utilization (AUROC 0.88). These models may be used for clinical decision support by referring providers, to automatically detect patients who may benefit from referral, for cost management, or for risk/protection ...

  5. The chronic care model and relationships to patient health status and health-related quality of life.

    Science.gov (United States)

    Hung, Dorothy Y; Glasgow, Russell E; Dickinson, L Miriam; Froshaug, Desireé B; Fernald, Douglas H; Balasubramanian, Bijal A; Green, Larry A

    2008-11-01

    The chronic care model (CCM) is a system-level framework used to guide quality improvement efforts in health care. However, little is known about its relationship to patient-level health measures. This study describes the implementation of the CCM as adapted for prevention and health behavior counseling in primary care practices, and examines relationships between the CCM and patient health measures, including general health status and health-related quality of life (HRQOL). Baseline data from Round 2 of the Prescription for Health initiative (2005-2007) were used to assess CCM implementation in 57 practices located nationwide. Relationships between the CCM and three separate measures of health among 4735 patients were analyzed in 2007. A hierarchical generalized linear modeling approach to ordinal regression was used to estimate categories of general health status, unhealthy days, and activity-limiting days, adjusting for patient covariates and clustering effects. Outcome variances were significantly accounted for by differences in practice characteristics (pPractices that used individual or group planned visits were more likely to see patients in lower health categories across all measures (OR=0.74-0.81, pPractices that used patient registries, health promotion champions, evidence-based guidelines, publicly reported performance measures, and support for behavior change were associated with higher patient health levels (OR=1.28-1.98, ppractice's implementation of the CCM was significantly related to patient health status and HRQOL. Adapting the CCM for prevention may serve to reorient care delivery toward more proactive behavior change and improvements in patient health outcomes.

  6. What are the living conditions and health status of those who don’t report their migration status? a population-based study in Chile

    Directory of Open Access Journals (Sweden)

    Cabieses Baltica

    2012-11-01

    Full Text Available Abstract Background Undocumented immigrants are likely to be missing from population databases, making it impossible to identify an accurate sampling frame in migration research. No population-based data has been collected in Chile regarding the living conditions and health status of undocumented immigrants. However, the CASEN survey (Caracterizacion Socio- Economica Nacional asked about migration status in Chile for the first time in 2006 and provides an opportunity to set the base for future analysis of available migration data. We explored the living conditions and health of self-reported immigrants and respondents who preferred not to report their migration status in this survey. Methods Cross-sectional secondary analysis of CASEN survey in Chile in 2006. Outcomes: any disability, illness/accident, hospitalization/surgery, cancer/chronic condition (all binary variables; and the number of medical/emergency attentions received (count variables. Covariates: Demographics (age, sex, marital status, urban/rural, ethnicity, socioeconomic status (education level, employment status and household income, and material standard of living (overcrowding, sanitation, housing quality. Weighted regression models were estimated for each health outcome, crude and adjusted by sets of covariates, in STATA 10.0. Results About 1% of the total sample reported being immigrants and 0.7% preferred not to report their migration status (Migration Status - Missing Values; MS-MV. The MS-MV lived in more deprived conditions and reported a higher rate of health problems than immigrants. Some gender differences were observed by health status among immigrants and the MS-MV but they were not statistically significant. Regressions indicated that age, sex, SES and material factors consistently affected MS-MVs’ chance of presenting poor health and these patterns were different to those found among immigrants. Great heterogeneity in both the MS-MV and the immigrants, as

  7. What are the living conditions and health status of those who don't report their migration status? A population-based study in Chile.

    Science.gov (United States)

    Cabieses, Baltica; Pickett, Kate E; Tunstall, Helena

    2012-11-21

    Undocumented immigrants are likely to be missing from population databases, making it impossible to identify an accurate sampling frame in migration research. No population-based data has been collected in Chile regarding the living conditions and health status of undocumented immigrants. However, the CASEN survey (Caracterizacion Socio- Economica Nacional) asked about migration status in Chile for the first time in 2006 and provides an opportunity to set the base for future analysis of available migration data. We explored the living conditions and health of self-reported immigrants and respondents who preferred not to report their migration status in this survey. Cross-sectional secondary analysis of CASEN survey in Chile in 2006. any disability, illness/accident, hospitalization/surgery, cancer/chronic condition (all binary variables); and the number of medical/emergency attentions received (count variables). Covariates: Demographics (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (education level, employment status and household income), and material standard of living (overcrowding, sanitation, housing quality). Weighted regression models were estimated for each health outcome, crude and adjusted by sets of covariates, in STATA 10.0. About 1% of the total sample reported being immigrants and 0.7% preferred not to report their migration status (Migration Status - Missing Values; MS-MV). The MS-MV lived in more deprived conditions and reported a higher rate of health problems than immigrants. Some gender differences were observed by health status among immigrants and the MS-MV but they were not statistically significant. Regressions indicated that age, sex, SES and material factors consistently affected MS-MVs' chance of presenting poor health and these patterns were different to those found among immigrants. Great heterogeneity in both the MS-MV and the immigrants, as indicated by wide confidence intervals, prevented the identification

  8. What are the living conditions and health status of those who don’t report their migration status? a population-based study in Chile

    Science.gov (United States)

    2012-01-01

    Background Undocumented immigrants are likely to be missing from population databases, making it impossible to identify an accurate sampling frame in migration research. No population-based data has been collected in Chile regarding the living conditions and health status of undocumented immigrants. However, the CASEN survey (Caracterizacion Socio- Economica Nacional) asked about migration status in Chile for the first time in 2006 and provides an opportunity to set the base for future analysis of available migration data. We explored the living conditions and health of self-reported immigrants and respondents who preferred not to report their migration status in this survey. Methods Cross-sectional secondary analysis of CASEN survey in Chile in 2006. Outcomes: any disability, illness/accident, hospitalization/surgery, cancer/chronic condition (all binary variables); and the number of medical/emergency attentions received (count variables). Covariates: Demographics (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (education level, employment status and household income), and material standard of living (overcrowding, sanitation, housing quality). Weighted regression models were estimated for each health outcome, crude and adjusted by sets of covariates, in STATA 10.0. Results About 1% of the total sample reported being immigrants and 0.7% preferred not to report their migration status (Migration Status - Missing Values; MS-MV). The MS-MV lived in more deprived conditions and reported a higher rate of health problems than immigrants. Some gender differences were observed by health status among immigrants and the MS-MV but they were not statistically significant. Regressions indicated that age, sex, SES and material factors consistently affected MS-MVs’ chance of presenting poor health and these patterns were different to those found among immigrants. Great heterogeneity in both the MS-MV and the immigrants, as indicated by wide confidence

  9. Income inequality, social capital and self-rated health and dental status in older Japanese.

    Science.gov (United States)

    Aida, Jun; Kondo, Katsunori; Kondo, Naoki; Watt, Richard G; Sheiham, Aubrey; Tsakos, Georgios

    2011-11-01

    The erosion of social capital in more unequal societies is one mechanism for the association between income inequality and health. However, there are relatively few multi-level studies on the relation between income inequality, social capital and health outcomes. Existing studies have not used different types of health outcomes, such as dental status, a life-course measure of dental disease reflecting physical function in older adults, and self-rated health, which reflects current health status. The objective of this study was to assess whether individual and community social capital attenuated the associations between income inequality and two disparate health outcomes, self-rated health and dental status in Japan. Self-administered questionnaires were mailed to subjects in an ongoing Japanese prospective cohort study, the Aichi Gerontological Evaluation Study Project in 2003. Responses in Aichi, Japan, obtained from 5715 subjects and 3451 were included in the final analysis. The Gini coefficient was used as a measure of income inequality. Trust and volunteering were used as cognitive and structural individual-level social capital measures. Rates of subjects reporting mistrust and non-volunteering in each local district were used as cognitive and structural community-level social capital variables respectively. The covariates were sex, age, marital status, education, individual- and community-level equivalent income and smoking status. Dichotomized responses of self-rated health and number of remaining teeth were used as outcomes in multi-level logistic regression models. Income inequality was significantly associated with poor dental status and marginally significantly associated with poor self-rated health. Community-level structural social capital attenuated the covariate-adjusted odds ratio of income inequality for self-rated health by 16% whereas the association between income inequality and dental status was not substantially changed by any social capital

  10. Sexual orientation and health among U.S. adults: national health interview survey, 2013.

    Science.gov (United States)

    Ward, Brian W; Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S

    2014-07-15

    To provide national estimates for indicators of health-related behaviors, health status, health care service utilization, and health care access by sexual orientation using data from the 2013 National Health Interview Survey (NHIS). NHIS is an annual multipurpose health survey conducted continuously throughout the year. Analyses were based on data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Differences in health-related behaviors, health status, health care service utilization, and health care access by sexual orientation were examined for adults aged 18-64, and separately for men and women. Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay or lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to provide an answer. Significant differences were found in health-related behaviors, health status, health care service utilization, and health care access among U.S. adults aged 18-64 who identified as straight, gay or lesbian, or bisexual. NHIS sexual orientation data can be used to track progress toward meeting the Healthy People 2020 goals and objectives related to the health of lesbian, gay, and bisexual persons. In addition, the data can be used to examine a wide range of health disparities among adults identifying as straight, gay or lesbian, or bisexual. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  11. Working conditions of female part-time and full-time teachers in relation to health status.

    Science.gov (United States)

    Seibt, Reingard; Matz, Annerose; Hegewald, Janice; Spitzer, Silvia

    2012-08-01

    Teacher's volume of employment and health status are controversially discussed in the current literature. This study focused on female teachers with part-time versus full-time jobs in association with working conditions and health status depending on age. A sample of 263 part-time and 367 full-time female teachers (average age 46.7 ± 7.8 vs. 46.0 ± 6.3) participated in an occupational health screening. Specific work conditions, stressors (job history-questionnaire) and effort-reward-imbalance ratio (ERI-Q) were measured and their relationships to mental and physical health were analysed. Health status was quantified by complaints (BFB questionnaire), general mental health status (GHQ-12) and cardiovascular risk factors. On average, teachers in part-time positions reported 36 and in full-time positions 42 h per week. The effort-reward ratios were significantly associated with the volume of employment. Teachers in part-time jobs had only a slightly lower ERI-ratio. There were no differences between full-time and part-time teachers regarding health status. Eighteen percentage of both groups reported impaired mental health (GHQ ≥ 5), 48% of part-time teachers and 53% of full-time teachers suffered from high blood pressure. Low physical fitness was observed in 12% of part-time and 6% of full-time teachers. In this study, neither the volume of employment nor working conditions were found to be significantly correlated with health status. Part-time and full-time employment status did not appear to influence health in the teaching profession. Although there are differences in quantitative working demands, while the health status does not differ between both teacher groups.

  12. Assessment of utilization of maternal health care provisions in ...

    African Journals Online (AJOL)

    Assessment of utilization of maternal health care provisions in Orumba North Local Government Area of Anambra State, Nigeria. ... care facilities (52%). This study therefore, recommends equipping modern health care facilities with both human and material resources to enhance their performance. Also, periodic training of ...

  13. Health-state utilities in a prisoner population: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Levy Michael H

    2009-08-01

    Full Text Available Abstract Background Health-state utilities for prisoners have not been described. Methods We used data from a 1996 cross-sectional survey of Australian prisoners (n = 734. Respondent-level SF-36 data was transformed into utility scores by both the SF-6D and Nichol's method. Socio-demographic and clinical predictors of SF-6D utility were assessed in univariate analyses and a multivariate general linear model. Results The overall mean SF-6D utility was 0.725 (SD 0.119. When subdivided by various medical conditions, prisoner SF-6D utilities ranged from 0.620 for angina to 0.764 for those with none/mild depressive symptoms. Utilities derived by the Nichol's method were higher than SF-6D scores, often by more than 0.1. In multivariate analysis, significant independent predictors of worse utility included female gender, increasing age, increasing number of comorbidities and more severe depressive symptoms. Conclusion The utilities presented may prove useful for future economic and decision models evaluating prison-based health programs.

  14. Annual Report on Children's Health Care: Dental and Orthodontic Utilization and Expenditures for Children, 2010-2012.

    Science.gov (United States)

    Berdahl, Terceira; Hudson, Julie; Simpson, Lisa; McCormick, Marie C

    2016-01-01

    To examine general dental and orthodontic utilization and expenditures by health insurance status, public health insurance eligibility, and sociodemographic characteristics among children aged 0 to 17 years using data from 2010-2012. Nationally representative data from the Medical Expenditure Panel Survey (2010-2012) provided data on insurance status, public health insurance eligibility, and visits to dental providers for both general dental care and orthodontic care. Overall, 41.9% of US children reported an annual dental office-based visit for general (nonorthodontic) dental care. Fewer Hispanic (34.7%) and non-Latino black children (34.8%) received dental care compared to non-Hispanic whites (47.3%) and Asians (40.3%). Children living in families with the lowest income were also the least likely to have a visit (32.9%) compared to children in the highest-income families (54.7%). Among children eligible for public coverage, Medicaid-eligible children had the lowest percentage of preventive dental visits (29.2%). Socioeconomic and racial/ethnic disparities in use and expenditures for orthodontic care are much greater than those for general and preventive dental care. Average expenditures for orthodontic care were $1,823, of which 56% ($1,023) was paid out of pocket by families. Our findings provide a baseline assessment for examining trends in the future, especially as coverage patterns for children may change as the Affordable Care Act is implemented and the future of the State Child Health Insurance Program remains uncertain beyond 2017. Published by Elsevier Inc.

  15. The utility of salutogenesis for guiding health promotion: the case for young people's well-being.

    Science.gov (United States)

    García-Moya, Irene; Morgan, Antony

    2017-08-01

    Twenty years have passed since the publication of the seminal paper 'The salutogenic model as a theory to guide health promotion' (Health Promot Int 1996;11:11-18.), in which Antonovsky proposed salutogenesis and its central construct sense of coherence as a way of boosting the theoretical basis for health promotion activities. Since then there has been a notable amount of conceptual and empirical work carried out to further explore its significance. The aim of this paper is to critically assess the current theoretical status of salutogenesis and its utility to advance effective health promotion practice for young people. The assessment was carried out in the context of contemporary international policy agendas on well-being. An analytic framework was developed using the previous literature on the definition and function of theory. This organizing framework comprised four criteria: description, explanation, prediction and measurability. The paper concludes with a perspective on the status of salutogenesis as a theory and how it can be further developed. Specifically, the critical assessment highlighted that salutogenesis has been subjected to considerable empirical testing over the last few decades resulting in convincing evidence of the relevance and subsequent advancement of the idea. However, less emphasis seems to have been placed on a systematic process of testing and iteration to develop its theoretical basis. The paper identifies a number of aspects that should be developed to support the progression of salutogenesis to the next level. A research-practice cycle approach is proposed that can facilitate that important next step. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. 77 FR 42719 - Notice of Effectiveness of Exempt Wholesale Generator or Foreign Utility Company Status

    Science.gov (United States)

    2012-07-20

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [EG12-43-000, EG12-53-000, EG12-54-000, et al.] Notice of Effectiveness of Exempt Wholesale Generator or Foreign Utility Company Status Docket Nos. Sherbino I Wind Farm LLC EG12-43-000 Eagle Point Power Generation LLC....... EG12-53-000...

  17. Violence against women from different relationship contexts and health care utilization in Spain.

    Science.gov (United States)

    Montero, Isabel; Ruiz-Perez, Isabel; Martín-Baena, David; Talavera, Marta; Escribà-Agüir, Vicenta; Vives-Cases, Carmen

    2011-01-01

    Studies reported an excess of health services utilization among women with violence by an intimate partner (IPV). However, little is known about health utilization by women victims of other forms of interpersonal violence than IPV. This study aimed to determine the effect of violence from different relationship contexts on health care utilization. A cross-sectional study following a multistage cluster sampling scheme was conducted. Women aged 18 to 70 years were randomly selected according to their scheduled health care visit. The number of women invited to participate was 16,419 and 73% accepted. After exclusion, the final sample consisted of 10,815 women. The outcome variables were health care utilization (primary care, specialty services, emergency rooms, and hospital admissions) and the predictor variable was interpersonal violence from different relationship contexts. Multivariable adjusted logistic regression models were conducted to assess the independent effect of each violence relationship context on health care utilization. Compared with never abused women, use of health services was significantly higher for abused women, although the rates varied depending on the violence relationship context. The greatest probability of service use was among women whose abuse was perpetrated by both a partner and others. Comparing the magnitude of effect of each violence category by perpetrators other than a partner, this effect was stronger for violence in a social context in the case of emergency rooms only. Regardless of the perpetrator, lifetime violence increased health services utilization. Violence affects women's behavior in terms of how they use health services. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  18. The mental health status and associated factors affecting underprivileged Iranian women.

    Science.gov (United States)

    Maharlouei, Najmeh; Hoseinzadeh, Amin; Ghaedsharaf, Esmaeil; Zolfi, Hosein; Arab, Parisa; Farahmand, Zahra; Hallaj, Mahbanoo; Fazilat, Shiva; Heidari, Sayed Taghi; Joulaei, Hassan; Karbalaie, Fatemeh; Lankarani, Kamran B

    2014-12-01

    The prevalence of mental disorders in Iran approximates to that of other countries. This study evaluates mental health status and its related factors among underprivileged women in Shiraz, Iran. This research was conducted between June, 2010 and November, 2012, and comprised 2108 women who participated in the Shiraz Women's Health Cohort Study. The questionnaire used in the study was completed by trained general practitioner and included demographic information and the 28-item version of the General Health. The t-test, chi-square test and multivariate logistic regression model were used for statistical analysis. A P-value Health Questionnaire, the most prevalent mental disorder was social dysfunction observed in 1643 (77.9%) participants followed by somatic symptoms found in 1308 (62%) subjects. Mental disorders were most prevalent among married women (63.8%, P=0.004). Participants holding high school diploma or university degree (141; 52.4%) comprised the smallest proportion of subjects with mental disorders (P=0.01). Of a total 265 participants whose husband were in prison, 171 (64.5%) exhibited mental disorders, presenting the greatest proportion of women with mental disorders. Logistic regression analysis showed an association between mental health status and participants' level of education, number of children and marital status, based on the General Health Questionnaire total score. The results of this study showed a considerably higher prevalence of mental disorders among Iranian women in comparison with the general population. Therefore policymakers should pay greater attention to the mental health status of underprivileged Iranian women. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. The Relation Between Caregivers' Multiliterate Reading Habits and Their Children's Oral Health Status

    Science.gov (United States)

    2014-01-01

    Background Caregivers’ oral health literacy (OHL) assessment results have been found to be related to their children’s oral health status. A further aspect of this relationship may be the role of caregivers’ reading habits. Objective Our goal was to describe the relationship between caregivers’ multimodal (digital and print) and multilingual (English and Chinese) reading habits, their OHL, and their child’s oral health status in Hong Kong. Methods A random sample of 301 child-caregiver dyads was recruited from kindergartens in Hong Kong. Data included sociodemographic information and caregivers’ self-reported digital print and reading habits across two languages (Chinese and English). Caregivers’ OHL levels were assessed by two locally developed and validated oral health literacy assessment tasks: Hong Kong Rapid Estimate of Adult Literacy in Dentistry-30 (HKREALD-30) and the Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry (HKOHLAT-P). Children’s oral health status was assessed using two measures: dental caries experience (number of decayed, missing, and filled teeth) and oral hygiene status (Visible Plaque Index). Results Bivariate variations revealed significant differences in mean OHL scores between caregivers with different reading habits (Preading multimodal (print/digital) and multilingual (English/Chinese) texts, their literacy levels, and their children’s oral health status (Preading habits in the regression analysis, the caregivers' habit of reading digital and print texts was significantly retained in the final model. Regression analysis revealed significant associations between caregivers’ reading habits (digital Chinese) and their OHL word recognition scores: OR 5.00, 95% CI 1.10-3.65, P=.027. Significant associations were also evident for their OHL comprehension scores (digital Chinese: OR 2.30, 95% CI 1.30-4.20, P=.004; print Chinese: OR 2.50, 95% CI 1.40-4.30, P=.001). However, no significant associations

  20. Relationship of Nutritional Status with Oral Health Status in Visual Impairment

    Directory of Open Access Journals (Sweden)

    Patcharaphol Samnieng

    2015-04-01

    Full Text Available To analyze the relationship of nutritional status with oral health status among visual impairment. The subjects were 146 elderly people (70 males and 76 females aged 20-72 years (mean 48.8±6.2 years, Phitsanulok, Thailand. Mini Nutritional Assessment (MNA questionnaires were administered. Oral examinations investigated the number of present teeth, DMFT and Functional Tooth Units (FTUs. According to the MNA score, 44.5% of subjects were categorized as normal nutrition, 47.3% as questionable, and 8.2 % as malnutrition. The mean numbers of present teeth and FTUs were 17.8±6.9 and 6.9±3.2, respectively. Subjects with malnutrition had lower numbers of present teeth (10.7±1.4 and FTUs (4.3±1.7 than those with normal nutrition (20.2±0.7 and 12.3±0.5 (p≤0.05. Nutritional status of visual impaired Thai was associated with mean numbers of present teeth and FTUs. Keeping many natural teeth or having appropriate numbers of FTUs by replacing missing teeth with dentures would prevention malnutrition.

  1. The role of comorbid psychiatric conditions in health status in epilepsy.

    Science.gov (United States)

    Zeber, John E; Copeland, Laurel A; Amuan, Megan; Cramer, Joyce A; Pugh, Mary Jo V

    2007-06-01

    Comorbid psychiatric conditions are highly prevalent in patients with epilepsy, yet the long-term implications across multiple mental health conditions are poorly understood. We examined the association between psychiatric diagnoses and self-reported health status in veterans with epilepsy. ANCOVA models were used to derive adjusted SF-36V scores for individuals with epilepsy alone (N=7379) or with additional psychiatric conditions (N=6320): depression, schizophrenia, bipolar disorder, anxiety disorder, substance abuse, and posttraumatic stress disorder (PTSD). Compared with patients with epilepsy alone, scores of veterans with comorbid psychiatric diagnoses averaged 21% lower across all domains. Role Limitation scales exhibited the greatest decrement across domains. A PTSD diagnosis consistently corresponded to lower scores, followed by depression. Schizophrenia contributed the least detriment to perceived health status. Comorbid psychiatric conditions impart significant emotional and physical burdens, requiring timely recognition and treatment of these disorders. Patients with epilepsy are uniquely at risk for high physical-psychiatric comorbidity profiles, with concomitant losses in perceived health status.

  2. Predicting the changes in depressive symptomatology in later life: how much do changes in health status, marital and caregiving status, work and volunteering, and health-related behaviors contribute?

    Science.gov (United States)

    Choi, Namkee G; Bohman, Thomas M

    2007-02-01

    This study examined the unique effects of four variable groups on changes in older adults' depressive symptoms for a 2-year period: (1) baseline health and disability status, (2) changes in health and disability since baseline, (3) stability and changes in marital and caregiving status and in work and volunteering, and (4) stability and changes in health-related behaviors. With data from the 1998 and 2000 interview waves of the Health and Retirement Study, the authors used gender-separate multistep (hierarchical) residualized regression analyses in which the Center for Epidemiological Studies Depression scale (CES-D) score at follow-up is modeled as a function of the effect of each group of independent variables. As hypothesized, changes in health, disability, marital, and caregiving status explained a larger amount of variance than the existing and stable conditions, although each group of variables explained a relatively small amount (0.3-3.4%) of variance in the follow-up CES-D score.

  3. Availability and Utilization of Anganwadi Services in an Adopted Urban Area of Wardha

    Directory of Open Access Journals (Sweden)

    Bhagat VM

    2016-01-01

    Full Text Available Background - The ICDS is world’s largest community-based child nutrition and development programme aimed at holistic development of children (0-6 years, expectant and nursing mothers through the Anganwadi centers (AWC. Improvement in nutritional and health status of their beneficiaries to prevent morbidities and mortalities due to malnutrition is one of the important objectives of ICDS. Objectives: To determine the availability and extent of utilization of AWC services by the beneficiaries, and to study factors influencing utilization and reasons for non/under utilization. Methodology: A community based cross-sectional study conducted in three well defined adopted urban field practice areas of a rural tertiary health care facility in Wardha, Maharashtra. A cluster comprising of 40 households was identified in each area to provide 140 study participants. Epi-info-3.7.1 for univariate and SYSTAT-12 used for multivariate analysis. Results: Overall 89.29% of beneficiaries utilized one or more services of AWC. Working women and those with lower socio-economic status had significantly and independently lower/non utilization of AWC services. Conclusions: Most of the study participants were aware and utilized the services of AWC. Among the women not utilizing the services; the reasons for non-utilization need to be addressed for optimal utilization of AWCs.

  4. Does childhood socioeconomic status influence adult health through behavioural factors?

    NARCIS (Netherlands)

    van de Mheen, H.; Stronks, K.; Looman, C. W.; Mackenbach, J. P.

    1998-01-01

    The purpose of this study is to assess to what extent the effect of childhood socioeconomic status on adult health could be explained by a higher prevalence of unhealthy behaviour among those with lower childhood socioeconomic status. Data were obtained from the baseline of a prospective cohort

  5. Influence of self-perceived oral health and socioeconomic predictors on the utilization of dental care services by schoolchildren.

    Science.gov (United States)

    Piovesan, Chaiana; Antunes, José Leopoldo Ferreira; Guedes, Renata Saraiva; Ardenghi, Thiago Machado

    2011-01-01

    The influence of socioeconomic factors and self-rated oral health on children's dental health assistance was assessed. This study followed a cross-sectional design, with a multistage random sample of 792 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. A dental examination provided information on the prevalence of dental caries (DMFT index). Data about the use of dental service, socioeconomic status, and self-perceived oral health were collected by means of structured interviews. These associations were assessed using Poisson regression models (prevalence ratio; 95% confidence interval). The prevalence of regular use of dental service was 47.8%. Children from low socioeconomic backgrounds and those who rated their oral health as "poor" used the service less frequently. The distribution of the kind of oral healthcare assistance used (public/private) varied across socioeconomic groups. The better-off children were less likely to have used the public service. Clinical, socioeconomic, and psychosocial factors were strong predictors for the utilization of dental care services by schoolchildren.

  6. The physical and mental health of a large military cohort: baseline functional health status of the Millennium Cohort

    Directory of Open Access Journals (Sweden)

    Engel Charles C

    2007-11-01

    Full Text Available Abstract Background: The US military is currently involved in large, lengthy, and complex combat operations around the world. Effective military operations require optimal health of deployed service members, and both mental and physical health can be affected by military operations. Methods: Baseline data were collected from 77,047 US service members during 2001–2003 as part of a large, longitudinal, population-based military health study (the Millennium Cohort Study. The authors calculated unadjusted, adjusted, and weighted means for the Medical Outcomes Study Short Form 36-item Survey for Veterans physical (PCS and mental component summary (MCS scores over a variety of demographic and military characteristics at baseline. Results: The unadjusted mean PCS and MCS scores for this study were 53.4 (95% confidence interval: 53.3–53.4 and 52.8 (95% confidence interval: 52.7–52.9. Average PCS and MCS scores were slightly more favorable in this military sample compared to those of the US general population of the same age and sex. Factors independently associated with more favorable health status included male gender, being married, higher educational attainment, higher military rank, and Air Force service. Combat specialists had similar health status compared to other military occupations. Having been deployed to Southwest Asia, Bosnia, or Kosovo between 1998 and 2000 was not associated with diminished health status. Conclusion: The baseline health status of this large population-based military cohort is better than that of the US general population of the same age and sex distribution over the same time period, especially in older age groups. Deployment experiences during the period of 1998–2001 were not associated with decreased health status. These data will serve as a useful reference for other military health studies and for future longitudinal analyses.

  7. Disease-specific health status as a predictor of mortality in patients with heart failure

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Versteeg, Henneke; Zijlstra, Wobbe P

    2014-01-01

    AIMS: Some, but not all, studies have shown that patient-reported health status, including symptoms, functioning, and health-related quality of life, provides additional information to traditional clinical factors in predicting prognosis in heart failure patients. To evaluate the overall evidence......, the association of disease-specific health status on mortality in heart failure was examined through a systematic review and meta-analysis. METHODS AND RESULTS: Prospective cohort studies that assessed the independent association of disease-specific health status with mortality in heart failure were selected....... Searching PubMed (until March 2013) resulted in 17 articles in the systematic review and 17 studies in the meta-analysis. About half of the studies reported a significant relationship between disease-specific health status and mortality in heart failure, while the remainder found no association. A larger...

  8. Vietnamese Oral Health Beliefs and Practices: Impact on the Utilization of Western Preventive Oral Health Care.

    Science.gov (United States)

    Nguyen, Kim Yen T; Smallidge, Dianne L; Boyd, Linda D; Rainchuso, Lori

    2017-02-01

    Purpose: Infrequent use of the Western health care by the Vietnamese may be explained by deeply-rooted traditional oral health beliefs and practices unique to the Asian culture. This study investigated Vietnamese oral health beliefs and practices and their relationship to the utilization of Western preventive oral health care services among Vietnamese-Americans. Methods: An exploratory, cross-sectional survey design with a convenience sample of 140 par-ticipants (n = 140) was used for this study. Participants were recruited on site of a Vietnamese-owned business, with questionnaires consisting of 28 questions that were distributed in hard copy by the principal investigator (PI) on multiple occasions and at various times of the day. Results: Spearman Rank Correlations tests showed participants who agreed with the statement, "Regular dental visits will help prevent dental problems," were more likely to utilize medical health services (pissues. No statistical significance was found between age, gender, pri-mary language, years spent in the United States, education level, religion and the Vietnamese survey participants' individual oral beliefs and practices. Conclusion: The results suggest that Vietnamese Americans holding the belief that dental visits help prevent oral health problems, were more likely to utilize Western health care services. The study also supports existing literature that Vietnamese oral health beliefs and practices impact the use of Western health care services. Copyright © 2017 The American Dental Hygienists’ Association.

  9. The association between perceived social support, socio-economic status and mental health in young Malaysian adults.

    Science.gov (United States)

    Tam, C L; Foo, Y C; Lee, T H

    2011-06-01

    To examine gender differences in mental health and perceived social support, relationship between parents' income and mental health, and differences in mental health across education levels. A total of 303 students aged 16 to 26 years were recruited from Selangor, Malaysia. The Multidimensional Scale of Perceived Social Support and General Health Questionnaire were used to measure the level of perceived social support and the mental health status. Demographic data, including education level and parents' income, were also obtained. Females perceived significantly higher levels of overall social support than males (t = -2.7; p mental health status between males and females (t = -1.8; p > 0.05), as well as mental health status among different parental income groups (chi2 = 5.0; p > 0.05) and the education levels of the subjects (chi2 = 0.7; p > 0.05). A more favourable mental health status of the subjects was associated with higher parental incomes (r = -0.1; p mental health status in older adolescents and young adults. There was also a relationship between parental income and an individual's mental health status, but mental health was not related to their education level.

  10. Health Insurance Status as a Barrier to Ideal Cardiovascular Health for U.S. Adults: Data from the National Health and Nutrition Examination Survey (NHANES.

    Directory of Open Access Journals (Sweden)

    Michael A McClurkin

    Full Text Available Little is known about the association between cardiovascular (CV health and health insurance status. We hypothesized that U.S. adults without health insurance coverage would have a lower likelihood of ideal cardiovascular health.Using National Health and Nutrition Examination Survey (NHANES data from 2007-2010, we examined the relationship between health insurance status and ideal CV health in U.S. adults aged ≥19 years and <65 (N = 3304. Ideal CV health was defined by the American Heart Association (AHA as the absence of clinically manifested CV disease and the simultaneous presence of 6-7 "ideal" CV health factors and behaviors. Logistic regression modeling was used to determine the relationship between health insurance status and the odds of ideal CV health. Of the U.S. adult population, 5.4% attained ideal CV health, and 23.5% were without health insurance coverage. Those without health insurance coverage were more likely to be young (p<0.0001, male (p<0.0001, non-white (p<0.0001, with less than a high school degree (p<0.0001, have a poverty-to-income ratio less than 1 (p<0.0001 and unemployed (p<0.0001 compared to those with coverage. Lack of health insurance coverage was associated with a lower likelihood of ideal CV health; however, this relationship was attenuated by socioeconomic status.U.S. adults without health insurance coverage are less likely to have ideal CV health. Population-based strategies and interventions directed at the community-level may be one way to improve overall CV health and reach this at-risk group.

  11. How Multidimensional Health Locus of Control predicts utilization of emergency and inpatient hospital services.

    Science.gov (United States)

    Mautner, Dawn; Peterson, Bridget; Cunningham, Amy; Ku, Bon; Scott, Kevin; LaNoue, Marianna

    2017-03-01

    Health locus of control may be an important predictor of health care utilization. We analyzed associations between health locus of control and frequency of emergency department visits and hospital admissions, and investigated self-rated health as a potential mediator. Overall, 863 patients in an urban emergency department completed the Multidimensional Health Locus of Control instrument, and self-reported emergency department use and hospital admissions in the last year. We found small but significant associations between Multidimensional Health Locus of Control and utilization, all of which were mediated by self-rated health. We conclude that interventions to shift health locus of control may change patients' perceptions of their own health, thereby impacting utilization.

  12. Smoking status, knowledge of health effects and attitudes towards ...

    African Journals Online (AJOL)

    population's smoking status, their knowledge of the health ... the highest smoking rates are the Northern Cape (55%), ... expense of tobacco products and because of a medical ... tobacco excise tax if the money is used for health .... Although not shown in ... (35%) and cost of tobacco products (17%). ..... International tourist.

  13. Comparison of the Determinants of the Health Service System and the Health Status of the People in the Greater Mekong Subregion (GMS).

    Science.gov (United States)

    Phanphairoj, Kanjanee; Loa, Ritzmond

    2017-12-01

    Health is influenced by numerous factors that affect the health service system and health status of the people in every country. This article aims to compare the determinants of the health service system and the health status of the people in Thailand, the Lao PDR, Vietnam, and Cambodia; and to recommend policies that impact the population's health and the country's development. Methods: A comprehensive search of the literature from a variety of online search and academic databases, and synthesis of previous study was used in this paper. Data on country indicators were taken from published online databases of the Ministry of Public Health of Cambodia, Lao PDR, Thailand,and Vietnam; the World Health Organization, and the World Bank. In Thailand, the determinants of the health service system and health status of the people are medical information and technology because of the government initiatives to improve the quality of healthcare services through the use of modern technology. In Vietnam, the society and culture, and the strengths and weaknesses of the hospital significantly affect the health status and health service system there because of the religious beliefs of the people. However, in Cambodia, the strengths and weaknesses of the hospital are the primary determinant of the health service system and health status of the people due to the condition of the hospitals, the availability of new medical devices, and the number of healthcare professionals. In the Lao PDR, trade and investment, and medical information and technology, significantly influence the health service system and health status of the people because of the government efforts to outsource capital expenditures and medical technology. The strengths and weaknesses of the hospital are the key determinants of the health service system and health status of the people in all GMS countries. Understanding the determinants of health is essential in order to develop policies and programs that impact the

  14. A structured review of health utility measures and elicitation in advanced/metastatic breast cancer.

    Science.gov (United States)

    Hao, Yanni; Wolfram, Verena; Cook, Jennifer

    2016-01-01

    Health utilities are increasingly incorporated in health economic evaluations. Different elicitation methods, direct and indirect, have been established in the past. This study examined the evidence on health utility elicitation previously reported in advanced/metastatic breast cancer and aimed to link these results to requirements of reimbursement bodies. Searches were conducted using a detailed search strategy across several electronic databases (MEDLINE, EMBASE, Cochrane Library, and EconLit databases), online sources (Cost-effectiveness Analysis Registry and the Health Economics Research Center), and web sites of health technology assessment (HTA) bodies. Publications were selected based on the search strategy and the overall study objectives. A total of 768 publications were identified in the searches, and 26 publications, comprising 18 journal articles and eight submissions to HTA bodies, were included in the evidence review. Most journal articles derived utilities from the European Quality of Life Five-Dimensions questionnaire (EQ-5D). Other utility measures, such as the direct methods standard gamble (SG), time trade-off (TTO), and visual analog scale (VAS), were less frequently used. Several studies described mapping algorithms to generate utilities from disease-specific health-related quality of life (HRQOL) instruments such as European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Breast Cancer 23 (EORTC QLQ-BR23), Functional Assessment of Cancer Therapy - General questionnaire (FACT-G), and Utility-Based Questionnaire-Cancer (UBQ-C); most used EQ-5D as the reference. Sociodemographic factors that affect health utilities, such as age, sex, income, and education, as well as disease progression, choice of utility elicitation method, and country settings, were identified within the journal articles. Most

  15. 75 FR 70159 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-11-17

    ... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... contracts of insurance. The temporary regulations provide guidance to employers, group health plans, and health insurance issuers providing group health insurance coverage. The IRS is issuing the temporary...

  16. Oral Health Status Related to Social Behaviors among 6 - 11 Year Old Schoolchildren in Kosovo

    Directory of Open Access Journals (Sweden)

    Lulëjeta Ferizi

    2017-01-01

    Full Text Available The aim of the present study was to evaluate the current oral health status among schoolchildren in Kosovo aged 6-11 years. Material and methods: A study included 5679 schoolchildren aged 6 -11 years, from different towns of Kosovo. Dental health status was evaluated using the World Health Organization (WHO caries diagnostic criteria for decayed, missing and filled teeth (dmft/DMFT index, for deciduous and permanent dentition. The observed children have answered a number of questions about their oral hygiene, eating habits, and dental visits. The analysis included frequencies and means. The differences between means were tested using the student t-test (p<0.05. The factors associated with dental caries were tested using the Spearman’s rank. Results: The mean dmft/DMFT of schoolchildren aged 6-11 years was 4.36 ± 3.763 and 1.20 ± 1.488, respectively. Sealant placements were found among 90 schoolchildren, amounting to 1.58%. From 8 years of age, 50% of children brush their teeth twice a day. Confectionery consumption among the observed children has increased. Forty percent of them eat sweets at least once a day, and majority of them visit their dentists only when necessary. A significant correlation between consumption of confectionery, oral hygiene, dental visits and the prevalence of caries was confirmed. Conclusion: The results of the present study show that there is a high prevalence of caries among 6-11 year old schoolchildren, thus pointing to a need for an extensive program of primary oral health care as well as utilizing preventive measures and regular dental visits.

  17. Relationships among Work Life, Mental Health Status and Organisation-based Self-esteem

    Directory of Open Access Journals (Sweden)

    Devin Hassan Fahim

    2016-12-01

    Full Text Available Quality of Work Life (QWL is a multi-dimensional concept that covers employees’ feelings about various dimensions of work. The current study focused on QWL that can contribute to the mental health status and Organisation-Based Self-Esteem (OBSE of employees in context of sport organisation in Iran. In this descriptive–correlative study, data was collected using three standard questionnaires: Goldberg’s (1978 General Health Questionnaire (GHQ-12, Pierce, Gardner, Cummings and Dunham's (1989 OBSE scale, and Walton’s (1975 QWL questionnaire. The statistical sample of the study consisted of 67 (53 male, 14 female employees of sport and youth organisations of the Northern Khorasan Province of Iran. The alpha value for mental health, OBSE and QWL questionnaires were, respectively, 0.82, 0.80, 0.79. QWL was significantly correlated with mental health status and self-esteem of employees. Thus, it can be concluded that mental health and self-esteem of employees depend on how these employees perceive QWL in organisations. Among QWL subscales, fair and adequate pay along with growth opportunities were the strongest predictors of mental health; growth opportunities along with development of human capabilities were the strongest predictors of self-esteem of employees. Our study adds to the growing body of research on mental health status in relation to factors such as QWL. In view of our findings, we hope that improving work environment as a means of improving one’s mental health status will be more emphasized by organisation managers.

  18. Health literacy in elderly in Northern Norway- association with socioeconomic status and general health/oral health

    OpenAIRE

    Thoresen, Therese

    2013-01-01

    Objective: The aim of this study was to investigate whether oral health and health literacy are associated which diseases, medication, self- reported health/oral health and socioeconomic factors in a group of people ranging from 50 to 80 years of age. Materials and methods: The study consisted of 61 patients, 27 men (52-78 years; M=61.6 years) and 34 women (51-80 years; M=61.0 years). They had oral examination including dentition status by DMFT (decayed, missed, filled teeth), plaque index...

  19. Health insurance benefit design and healthcare utilization in northern rural China.

    Directory of Open Access Journals (Sweden)

    Hong Wang

    Full Text Available BACKGROUND: Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. METHODS AND FINDINGS: We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview. People who had both outpatient and inpatient coverage compared with inpatient coverage only had significantly more village-level outpatient visits, township-level outpatient visits, and total outpatient visits. Furthermore, the increased utilization of township and village-level outpatient care was experienced disproportionately by people who were poorer, whereas the increased inpatient utilization overall and at the county level was experienced disproportionately by people who were richer. CONCLUSION: The evidence from this study indicates that the design of health insurance benefits is an important policy tool that can affect the health services utilization and socioeconomic equity in service use at different levels. Without careful

  20. Psychological Perspectives on Pathways Linking Socioeconomic Status and Physical Health

    Science.gov (United States)

    Matthews, Karen A.; Gallo, Linda C.

    2011-01-01

    Low socioeconomic status (SES) is a reliable correlate of poor physical health. Rather than treat SES as a covariate, health psychology has increasingly focused on the psychobiological pathways that inform understanding why SES is related to physical health. This review assesses the status of research that has examined stress and its associated distress, and social and personal resources as pathways. It highlights work on biomarkers and biological pathways related to SES that can serve as intermediate outcomes in future studies. Recent emphasis on the accumulation of psychobiological risks across the life course is summarized and represents an important direction for future research. Studies that test pathways from SES to candidate psychosocial pathways to health outcomes are few in number but promising. Future research should test integrated models rather than taking piecemeal approaches to evidence. Much work remains to be done, but the questions are of great health significance. PMID:20636127

  1. Aging, Nutritional Status and Health

    Directory of Open Access Journals (Sweden)

    Wilma Leslie

    2015-07-01

    Full Text Available The older population is increasing worldwide and in many countries older people will outnumber younger people in the near future. This projected growth in the older population has the potential to place significant burdens on healthcare and support services. Meeting the diet and nutrition needs of older people is therefore crucial for the maintenance of health, functional independence and quality of life. While many older adults remain healthy and eat well those in poorer health may experience difficulties in meeting their nutritional needs. Malnutrition, encompassing both under and over nutrition increases health risks in the older population. More recently the increase in obesity, and in turn the incidence of chronic disease in older adults, now justifies weight management interventions in obese older adults. This growing population group is becoming increasingly diverse in their nutritional requirements. Micro-nutrient status may fluctuate and shortfalls in vitamin D, iron and a number of other nutrients are relatively common and can impact on well-being and quality of life. Aging presents a number of challenges for the maintenance of good nutritional health in older adults.

  2. SURVEY OF NUTRITIONAL STATUS AND HEALTH BEHAVIOR OF PREGNANT WOMEN IN BONTOMATE’NE HEALTH CENTER OF JENEPONTO DISTRICT, INDONESIA

    Directory of Open Access Journals (Sweden)

    Yusriani

    2016-05-01

    Full Text Available Background: Maternal mortality is a global health problem, and generally occurs mainly in developing countries. The main causes of maternal mortality still include bleeding, eclampsia and infections which contribute about 60% of total maternal deaths. Interventions to reduce the number of maternal deaths is pretty much done, especially in improving the nutritional status and health behavior of pregnant women, but have not yielded optimal results. Aim: This study aimed to determine the nutritional status and health behavior of pregnant women at health centers Bontomate'ne Jeneponto. Methods: This study uses survey design analytic descriptive approach. The population was all pregnant women in the working area Bontomate'ne health center with 189 people. All the population census or taken by total sampling. Data obtained through direct interviews and observations by using a questionnaire. Results: The results showed that normal nutritional status of pregnant women as much as 85.1% and maternal nutritional status category KEK as much as 14.9%. Knowledge of pregnant women about the risk factors of maternal death, danger signs of pregnancy, the importance of antenatal care (ANC, planning a pregnancy and a safe delivery and post natal care (PNC is categorized as less as much as 90.1%, and the mother's knowledge enough category only 9.9%. Pregnant women who have a positive attitude by 71.3% and amounted to 28.7% negative. Actions poor pregnant women as much as 34.7% and the capital measures both categories as much as 65.3%. Conclusion: Nutritional status and health behavior of pregnant mothers can provide chances for the occurrence of maternal deaths. Suggested the need to conduct needs to conduct education and training to build the knowledge and experience of pregnant women about the nutritional status and health behavior was good with involving the active participation of health workers, community, family, mother and husband.

  3. Impact of an Advanced Imaging Utilization Review Program on Downstream Health Care Utilization and Costs for Low Back Pain.

    Science.gov (United States)

    Graves, Janessa M; Fulton-Kehoe, Deborah; Jarvik, Jeffrey G; Franklin, Gary M

    2018-06-01

    Early magnetic resonance imaging (MRI) for acute low back pain (LBP) has been associated with increased costs, greater health care utilization, and longer disability duration in workers' compensation claimants. To assess the impact of a state policy implemented in June 2010 that required prospective utilization review (UR) for early MRI among workers' compensation claimants with LBP. Interrupted time series. In total, 76,119 Washington State workers' compensation claimants with LBP between 2006 and 2014. Proportion of workers receiving imaging per month (MRI, computed tomography, radiographs) and lumbosacral injections and surgery; mean total health care costs per worker; mean duration of disability per worker. Measures were aggregated monthly and attributed to injury month. After accounting for secular trends, decreases in early MRI [level change: -5.27 (95% confidence interval, -4.22 to -6.31); trend change: -0.06 (-0.01 to -0.12)], any MRI [-4.34 (-3.01 to -5.67); -0.10 (-0.04 to -0.17)], and injection [trend change: -0.12 (-0.06 to -0.18)] utilization were associated with the policy. Radiograph utilization increased in parallel [level change: 2.46 (1.24-3.67)]. In addition, the policy resulted in significant decreasing changes in mean costs per claim, mean disability duration, and proportion of workers who received disability benefits. The policy had no effect on computed tomography or surgery utilization. The UR policy had discernable effects on health care utilization, costs, and disability. Integrating evidence-based guidelines with UR can improve quality of care and patient outcomes, while reducing use of low-value health services.

  4. UTILIZATION OF HEALTH CARE SERVICES AMONG INTERNAL MIGRANTS IN HANOI AND ITS CORRELATION WITH HEALTH INSURANCE: A CROSS-SECTIONAL STUDY.

    Science.gov (United States)

    Le, Anh Thi Kim; Vu, Lan Hoang; Schelling, Esther

    2015-12-01

    Economic transition ( DoiMoi ) in the 1980s in Viet Nam has led to internal migration, particularly rural-to-urban migration. Many studies suggested that there is a difference between non-migrants and migrants in using health care services. Current studies have mostly focused on migrants working in industrial zones (IZs) but migrants working in private small enterprises (PSEs) and seasonal migrants seem to be ignored. However, these two groups of migrants are more vulnerable in health care access than others because they usually work without labor contracts and have no health insurance. The study aims to compare the utilization of health care services and explore its correlated factors among these three groups. This cross-sectional study included 1800 non-migrants and migrants aged 18-55 who were selected through stratified sampling in Long Bien and Ba Dinh districts, Hanoi. These study sites consist of large industrial zones and many slums where most seasonal migrants live in. A structured questionnaire was used to collect information on health service utilization in the last 6 months before the study. Utilization of heath care services was identified as "an ill person who goes to health care centers to seek any treatment (i.e. both private and public health care centers)". 644 of 1800 participants reported having a health problem in the last 6 months before the study. Among these 644 people, 335 people used health care services. The percentage of non-migrants using health care service was the highest (67.6%), followed by migrants working in IZ (53.7%), migrants working in PSE (44%), and seasonal migrants (42%). Multivariate logistic regression showed migrants, especially seasonal migrants and migrants working in PSE, were less likely to use health care services (OR=0.35, p=0.016 and 0.38, p= 0.004, respectively), compared to non-migrants. The study also found that having no health insurance was a risk factor of the utilization (OR=0.29, pincome were not related

  5. Current knowledge of US metal and nonmetal miner health: Current and potential data sources for analysis of miner health status

    Science.gov (United States)

    Yeoman, K. M.; Halldin, C. N.; Wood, J.; Storey, E.; Johns, D.; Laney, A. S.

    2016-01-01

    ABSTRACT Little is known about the current health status of US metal and nonmetal (MNM) miners, in part because no health surveillance systems exist for this population. The National Institute for Occupational Safety and Health (NIOSH) is developing a program to characterize burden of disease among MNM miners. This report discusses current knowledge and potential data sources of MNM miner health. Recent national surveys were analyzed, and literature specific to MNM miner health status was reviewed. No robust estimates of disease prevalence were identified, and national surveys did not provide information specific to MNM miners. Because substantial gaps exist in the understanding of MNM miners' current health status, NIOSH plans to develop a health surveillance program for this population to guide intervention efforts to reduce occupational and personal risks for chronic illness. PMID:25658684

  6. The role of parental health care utilization in children's unnecessary utilization in China: evidence from Shaanxi province.

    Science.gov (United States)

    Zhang, Yi; Zhou, Zhongliang; Si, Yafei

    2017-03-09

    China has a large population of children under 18 years of age, whose health is of great concern to the Chinese health care system. However, few studies have been conducted to analyze the factors associated with children's unnecessary health care utilization in China. The objective of this study is to provide some empirical evidence on this issue by investigating the role of parental health care utilization in children's unnecessary health care use. The data were obtained from the fifth Health Service Survey of Shaanxi province in 2013. We employed three dependent variables to measure children's health care utilization: the number of children's outpatient visits during the past 2 weeks, whether or not infusion was used if the child had any outpatient visits during the past 2 weeks, and the number of children's inpatient visits during last year. Based on specific characteristics of these outcome variables, negative binomial models were used for the non-negative numbers of outpatient and inpatient visits, while a probit model was used for the zero-one indicator variable showing whether infusion was used during outpatient visits. Based on a sample of 11,024 children, our results of multivariate analysis showed that children whose parents used outpatient care were estimated to have a larger number of outpatient visits than those whose parents did not have outpatient visits in the past 2 weeks (with a difference of 0.0393 visits). Among children having outpatient visits in the last 2 weeks, the probability of obtaining infusion was 57.01 percentage points higher for children whose parents used infusion in the past 2 weeks than the probability for those whose parents did not use infusion. The predicted number of inpatient visits was higher for children whose parents used inpatient services in the last year, compared with the group whose parents did not use (with a difference of 0.0567 visits). Moreover, we noted that the positive association between parental and

  7. Do predictors of volunteering in older age differ by health status?

    Science.gov (United States)

    Principi, Andrea; Galenkamp, Henrike; Papa, Roberta; Socci, Marco; Suanet, Bianca; Schmidt, Andrea; Schulmann, Katharine; Golinowska, Stella; Sowa, Agnieszka; Moreira, Amilcar; Deeg, Dorly J H

    2016-06-01

    It has been widely recognised that poor health is one of the main barriers to participation in volunteer activities in older age. Therefore, it is crucial to examine the participation of older people in volunteering, especially those in poor health. Based on the resource theory of volunteering, the aim of this study is to better understand the correlates of volunteering among older people with different health statuses, namely those without health problems (neither multimorbidity nor disability), those with mild health problems (multimorbidity or disability), and those with severe health problems (multimorbidity and disability). Data were drawn from the fourth wave (2011-2012, release 1.1.1) of the Survey of Health, Ageing and Retirement in Europe, which includes European people aged 50 years or older. The results showed that variables linked to volunteering were generally similar regardless of health status, but some differences were nevertheless identified. For older people with mild or severe health problems, for instance, depressive symptoms were negatively associated with their involvement in volunteer activities. We found a positive association of being widowed (rather than married) with volunteering in older people with particularly poor health, whereas high income was associated with volunteering in the case of mild health problems only. These results demonstrate that variables associated with volunteer participation partially differ between older people depending on their health status. These differences should be considered by policy makers in their attempts to promote volunteering in older people, as a means of preventing their social exclusion.

  8. Benchmarking dairy herd health status using routinely recorded herd summary data.

    Science.gov (United States)

    Parker Gaddis, K L; Cole, J B; Clay, J S; Maltecca, C

    2016-02-01

    Genetic improvement of dairy cattle health through the use of producer-recorded data has been determined to be feasible. Low estimated heritabilities indicate that genetic progress will be slow. Variation observed in lowly heritable traits can largely be attributed to nongenetic factors, such as the environment. More rapid improvement of dairy cattle health may be attainable if herd health programs incorporate environmental and managerial aspects. More than 1,100 herd characteristics are regularly recorded on farm test-days. We combined these data with producer-recorded health event data, and parametric and nonparametric models were used to benchmark herd and cow health status. Health events were grouped into 3 categories for analyses: mastitis, reproductive, and metabolic. Both herd incidence and individual incidence were used as dependent variables. Models implemented included stepwise logistic regression, support vector machines, and random forests. At both the herd and individual levels, random forest models attained the highest accuracy for predicting health status in all health event categories when evaluated with 10-fold cross-validation. Accuracy (SD) ranged from 0.61 (0.04) to 0.63 (0.04) when using random forest models at the herd level. Accuracy of prediction (SD) at the individual cow level ranged from 0.87 (0.06) to 0.93 (0.001) with random forest models. Highly significant variables and key words from logistic regression and random forest models were also investigated. All models identified several of the same key factors for each health event category, including movement out of the herd, size of the herd, and weather-related variables. We concluded that benchmarking health status using routinely collected herd data is feasible. Nonparametric models were better suited to handle this complex data with numerous variables. These data mining techniques were able to perform prediction of health status and could add evidence to personal experience in herd

  9. 75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-06-17

    ... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human Services... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

  10. The social income inequality, social integration and health status of internal migrants in China.

    Science.gov (United States)

    Lin, Yanwei; Zhang, Qi; Chen, Wen; Ling, Li

    2017-08-04

    To examine the interaction between social income inequality, social integration, and health status among internal migrants (IMs) who migrate between regions in China. We used the data from the 2014 Internal Migrant Dynamic Monitoring Survey in China, which sampled 15,999 IMs in eight cities in China. The Gini coefficient at the city level was calculated to measure social income inequality and was categorized into low (0.2 0.5). Health status was measured based upon self-reported health, subjective well-being, and perceptions of stress and mental health. Social integration was measured from four perspectives (acculturation and integration willingness, social insurance, economy, social communication). Linear mixed models were used to examine the interaction effects between health statuses, social integration, and the Gini coefficient. Factors of social integration, such as economic integration and acculturation and integration willingness, were significantly related to health. Social income inequality had a negative relationship with the health status of IMs. For example, IMs in one city, Qingdao, with a medium income inequality level (Gini = 0.329), had the best health statuses and better social integration. On the other hand, IMs in another city, Shenzhen, who had a large income inequality (Gini = 0.447) were worst in health statues and had worse social integration. Policies or programs targeting IMs should support integration willingness, promote a sense of belonging, and improve economic equality. In the meantime, social activities to facilitate employment and create social trust should also be promoted. At the societal level, structural and policy changes are necessary to promote income equity to promote IMs' general health status.

  11. Utilization of information technology in eastern North Carolina physician practices: determining the existence of a digital divide.

    Science.gov (United States)

    Rosenthal, David A; Layman, Elizabeth J

    2008-02-13

    The United States Department of Health and Human Services (DHHS) has emphasized the importance of utilizing health information technologies, thus making the availability of electronic resources critical for physicians across the country. However, few empirical assessments exist regarding the current status of computerization and utilization of electronic resources in physician offices and physicians' perceptions of the advantages and disadvantages of computerization. Through a survey of physicians' utilization and perceptions of health information technology, this study found that a "digital divide" existed for eastern North Carolina physicians in smaller physician practices. The physicians in smaller practices were less likely to utilize or be interested in utilizing electronic health records, word processing applications, and the Internet.

  12. Health behaviours explain part of the differences in self reported health associated with partner/marital status in The Netherlands

    NARCIS (Netherlands)

    Joung, I. M.; Stronks, K.; van de Mheen, H.; Mackenbach, J. P.

    1995-01-01

    To describe the differences in health behaviours in disparate marital status groups and to estimate the extent to which these can explain differences in health associated with marital status. Baseline data of a prospective cohort study were used. Directly age standardised percentages of each marital

  13. Mental health service utilization in sub-Saharan Africa: is public mental health literacy the problem? Setting the perspectives right.

    Science.gov (United States)

    Atilola, Olayinka

    2016-06-01

    The severely constrained resources for mental health service in less-developed regions like sub-Saharan Africa underscore the need for good public mental health literacy as a potential additional mental health resource. Several studies examining the level of public knowledge about the nature and dynamics of mental illness in sub-Saharan Africa in the last decade had concluded that such knowledge was poor and had called for further public enlightenment. What was thought to be mental health 'ignorance' has also been blamed for poor mainstream service utilization. These views however assume that non-alignment of the views of community dwellers in sub-Saharan Africa with the biomedical understanding of mental illness connotes 'ignorance', and that correcting such 'ignorance' will translate to improvements in service utilization. Within the framework of contemporary thinking in mental health literacy, this paper argues that such assumptions are not culturally nuanced and may have overrated the usefulness of de-contextualized public engagement in enhancing mental health service utilization in the region. The paper concludes with a discourse on how to contextualize public mental health enlightenment in the region and the wider policy initiatives that can improve mental health service utilization. © The Author(s) 2015.

  14. Association between employment status and self-rated health: Korean working conditions survey.

    Science.gov (United States)

    Kwon, Kimin; Park, Jae Bum; Lee, Kyung-Jong; Cho, Yoon-Sik

    2016-01-01

    This research was conducted with an aim of determining the association between employment status and self-rated health. Using the data from the Third Korean Working Conditions Survey conducted in 2011, We included data from 34,783 respondents, excluding employers, self-employed workers, unpaid family workers, others. Self-rated health was compared according to employment status and a logistic regression analysis was performed. Among the 34,783 workers, the number of permanent and non-permanent workers was 27,564 (79.2 %) and 7,219 (20.8 %). The risk that the self-rated health of non-permanent workers was poor was 1.20 times higher when both socio-demographic factors, work environment and work hazards were corrected. In this study, perceived health was found to be worse in the non-permanent workers than permanent workers. Additional research should investigate whether other factors mediate the relationship between employment status and perceived health.

  15. Lifetime Exposure to Family Violence: Implications for the Health Status of Older African American Women

    Science.gov (United States)

    Sprauve-Holmes, Nancy E; Gaughan, John; Kaslow, Nadine J.

    2009-01-01

    Abstract Background Family violence among older women encompasses intimate partner violence (IPV) and elder maltreatment, both linked to poor health status. Little is known about the association between family violence and the health status of older innercity African American women. Methods One hundred fifty-eight African American women, aged ≥50, were interviewed in the ambulatory clinics of a large public hospital. Lifetime family violence exposure as an adult was measured by the Family Violence against Older Women (FVOW) scale; physical and mental health status were measured by the physical and mental component summary scores of the Short Form 8® scale. Results Mean participant age was 61.5 years (SD 7.1). Participants with FVOW scores in the top quartile were considered to have high lifetime family violence exposure. Participants with higher family violence exposure and those younger, unemployed, or disabled reported worse physical and mental health status. Lower income and not having Medicare were associated with worse physical and mental health status, respectively. Using stepwise linear regression techniques, only employment status and high family violence exposure were associated with worse physical (F = 7.16, p = 0.0011) and mental health (f = 7.09, p = 0.0012) status. Women with high FVOW scores reported physical and mental component summary scores that were 4.18 and 4.6 points lower, respectively, than those of women with lower FVOW scores. Conclusions Among older, innercity, African American women, lack of employment and high levels of family violence exposure as an adult are associated with worse physical and mental health status. Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients' current health status. PMID:19183088

  16. Investigation of health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences: health-promoting hospitals.

    Science.gov (United States)

    Hamidi, Yadollah; Hazavehei, Seyed Mohammad Mahdi; Karimi-Shahanjarini, Akram; SeifRabiei, Mohamad Ali; Farhadian, Maryam; Alimohamadi, Shohreh; Kharghani Moghadam, Seyedeh Melika

    2017-12-01

    The prophecy of health promoting hospitals (HPH) is bringing about a change and transition from treatment-oriented to health-oriented attitudes. In Iran, hospitals usually play the traditional roles. The present study was aimed at the evaluation of the health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences (HUMS). This applied study was conducted in two Hamadan specialized hospitals in the Hamadan city. The health promotion status was evaluated using a self-assessment checklist designed by the World Health Organization's HPH. The evaluation was done in five standards including management policy, patient assessment, patient information and intervention, promotion of a healthy workplace and continuity and cooperation. The results showed that both the hospitals studied had a poor status in terms of promoting a healthy workplace (average = 31.24%) and management policy standards (average = 35.29%) in comparison with the other relevant standards: patient assessment (53.12%), patient information and intervention (62.5%), continuity and cooperation (65.78%)). The results of the standards and sub-standards status displayed better performance in the cardiovascular hospital (53.67%) compared to the women and parturition hospital (42.64%). The findings indicated that HPH standards are very low in the studied hospitals. The reason behind this wide gap might be due to the fact that hospitals in Iran are more treatment-oriented and patient-oriented and they do not play an active part in health promoting. It was found that management policy and promoting healthy workplace standards had the worst status and must be improved.

  17. A Dental Hygiene Professional Practice Index (DHPPI) and access to oral health status and service use in the United States.

    Science.gov (United States)

    Wing, Paul; Langelier, Margaret H; Continelli, Tracey A; Battrell, Ann

    2005-01-01

    The purpose of this article is to summarize a larger study that developed a statistical index that defines the professional practice environment of dental hygienists (DHs) in the United States, and to determine the extent to which the index scores are related to the number of DHs and dentists, the utilization of dental services, and selected oral health outcomes across the 50 states. A Dental Hygiene Professional Practice Index (DHPPI) defines the professional status, supervision requirements, tasks permitted, and reimbursement options for DHs in each of the 50 states and the District of Columbia, as of December 31, 2001. Spearman rank order correlations between the DHPPI and numbers of oral health professionals, utilization of oral health services, and oral health outcomes in the 50 states are also presented. The analyses revealed that: There are significant differences in the legal practice environments (as reflected in the DHPPI) across the 50 states and the District of Columbia. Between 1990 and 2001, the number of DHs per capita increased by 46% in the United States, while the number of dentists per 100,000 population increased by only 10%. The DHPPI was not significantly correlated with the number of DHs or dentists in the 50 states in 2001. The DHPPI was significantly positively correlated with the salaries of DHs in 2001. The DHPPI was also significantly and positively correlated with a number of indicators of utilization of oral health services and oral health outcomes. Both access to oral health services and oral health outcomes are positively correlated with the DHPPI. This suggests that states with low DHPPI scores would be logical candidates for revised DH practice statutes and regulations to accomplish these objectives.

  18. The comparison of health status between male and female medical radiation workers in China

    International Nuclear Information System (INIS)

    Wang, Hui; Liu, Guochao; Tian, Youjia; Zhang, Fengmei; Feng, Zhihui; Chen, Qianshu; Qu, Jianying; Lim, David

    2017-01-01

    To assess the health statue of chronically exposed Chinese medical radiation workers. A cross-sectional study of 530 medical radiation workers in a city of China was conducted to document the health status and the monitored annually absorbed doses. Long-term and low-dose radiation exposure can affect a number of health indicators in the individuals, which covered the cardiovascular system, hematologic system, ophthalmology, liver and kidney s functions, chromosome aberration and micronucleus. The differences in the health status between male and female individuals were associated with job types and exposed years of service. The monitored doses of individuals were lower than the limit value of the national standard. The health status in chronically exposed individuals demonstrated some gender difference associated with length of exposure and work type. This study provides some evidence to understand the health status of medical radiation workers in China and have the potentially to inform screening and clinical diagnosis. (authors)

  19. Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related?

    Science.gov (United States)

    Wang, Qing; Shen, Jay J

    2016-06-06

    Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons' early life, are expected to be effective and successful.

  20. Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related?

    Directory of Open Access Journals (Sweden)

    Qing Wang

    2016-06-01

    Full Text Available Cardiovascular diseases (CVDs are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS, a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons’ early life, are expected to be effective and successful.

  1. Construct validity of SF-6D health state utility values in an employed population.

    Science.gov (United States)

    Baxter, Siyan; Sanderson, Kristy; Venn, Alison; Otahal, Petr; Palmer, Andrew J

    2015-04-01

    Health utility values permit cost utility analysis in workplace health promotion; however, utility measures of working populations have not been validated. To investigate construct validity of SF-6D health utility in a public service workforce. SF-12v2 Health Survey was administered to 3,408 randomly selected public service employees in Australia in 2010. SF-12 scores were converted to SF-6D health utility values. Associations and correlates of SF-6D with health, socio-demographic and work characteristics [comorbidities, body mass index (BMI), Kessler-10 psychological distress (K10), education, salary, effort-reward imbalance (ERI), absenteeism] were explored. Ceiling effects were analysed. Nationally representative employee SF-6D values from the Household, Income and Labour Dynamics in Australia (HILDA) survey (n = 11,234) were compared. All analyses were stratified by sex. Mean (SE) age was 45.7 (0.35) males; 44.5 (0.22) females. Females represented 72 % of the sample. Mean (SE) health utility 0.792 (0.004); 0.771 (0.003) was higher in males. SF-6D demonstrated both a significant inverse association (p negative correlations (female; male) with K10 (r = -0.63; r = -0.66), comorbidity count (r = -0.40; r = -0.33), ERI (r = -0.37; r = -0.34) and absenteeism (p imbalance and absenteeism are negatively associated with employee health. SF-6D is a valid measure of perceived health states in working populations.

  2. Prevalence, care-seeking, and health service utilization for non-communicable diseases among Syrian refugees and host communities in Lebanon.

    Science.gov (United States)

    Doocy, Shannon; Lyles, Emily; Hanquart, Baptiste; Woodman, Michael

    2016-01-01

    Given the large burden of non-communicable diseases (NCDs) among both Syrian refugees and the host communities within which they are settled, humanitarian actors and the government of Lebanon face immense challenges in addressing health needs. This study assessed health status, unmet needs, and utilization of health services among Syrian refugees and host communities in Lebanon. A cross-sectional survey of Syrian refugees and host communities in Lebanon was conducted using a two-stage cluster survey design with probability proportional to size sampling. To obtain information on chronic NCDs, respondents were asked a series of questions about hypertension, cardiovascular disease, diabetes, chronic respiratory disease, and arthritis. Differences in household characteristics by care-seeking for these conditions were examined using chi-square, t-test, and adjusted logistic regression methods. Over half (50.4 %) of refugee and host community households (60.2 %) reported a member with one of the five NCDs. Host community prevalence rates were significantly higher than refugees for all conditions except chronic respiratory diseases ( p  = 0.08). Care-seeking for NCDs among refugees and host community households was high across all conditions with 82.9 and 97.8 %, respectively, having sought care in Lebanon for their condition. Refugees utilized primary health care centers (PHCC) (57.7 %) most often while host communities sought care most in private clinics (62.4 %). Overall, 69.7 % of refugees and 82.7 % of host community members reported an out-of-pocket consultation payment ( p  = 0.041) with an average payment of US$15 among refugees and US$42 for the host community ( p Syrian crisis and the burden on the Lebanese health system, implications for both individuals with NCDs and Lebanon's health system are immense. The burden of out of pocket expenses on persons with NCDs are also substantial, especially given the tenuous economic status of many refugees

  3. The Electronic Health Literacy and Utilization of Technology for Health in a Remote Hawaiian Community: Lana'i.

    Science.gov (United States)

    Witten, Nash Ak; Humphry, Joseph

    2018-03-01

    The Lana'i Community Health Center (LCHC) like other health care organizations, is striving to implement technology-enabled care (TEC) in the clinical setting. TEC includes such technological innovations as patient portals, mobile phone applications, wearable health sensors, and telehealth. This study examines the utilization of communication technology by members of the Lana'i community and LCHC staff and board members in the home and in their daily lives and evaluates the community's electronic health literacy. Quantitative surveys and qualitative focus groups were utilized. These revealed that members of the Lana'i community and LCHC staff and board members regularly utilize technology, in the form of smart cell phones, WiFi, and internet texting. This community has integrated technology into their daily lives, even though they live on an isolated island with 3,102 people; however, despite this integration, the electronic health literacy of this population appears insufficient for proper understanding and utilization of TEC, limiting the potential of patient portals or remote monitoring of patient generated data for chronic disease prevention and management without additional education and mentoring. It is therefore in the best interest of the LCHC and other health organizations wishing to implement TEC in a rural community such as Lana'i to include a strong educational component with use of TEC, and perhaps establish a mentor/partnership program for the highly-challenged patient.

  4. Impact of socioeconomic status on Brazilian elderly health Impacto do status socioeconômico na saúde de idosos brasileiros

    Directory of Open Access Journals (Sweden)

    Marília Ramos

    2007-08-01

    Full Text Available OBJECTIVE: To investigate the impact of socioeconomic status on elderly health. METHODS: The study was based on cross-sectional data from Survey on Health, Well-Being, and Aging in Latin America and the Caribbean. The sample comprised 2,143 non-institutionalized elderly aged 60 years and older living in the urban area of São Paulo, southeastern Brazil. Linear regression models estimated the effect of socioeconomic status indicators (years of schooling completed, occupation and purchasing power on each one of the following health indicators: depression, self-rated health, morbidity and memory capacity. A 5% significance level was set. RESULTS: There was a significant effect of years of education and purchasing power on self-rated health and memory capacity when controlled for the variables number of diseases during childhood, bed rest for at least a month due to health problems during childhood, self-rated health during childhood, living arrangements, sex, age, marital status, category of health insurance, intake of medicines. Only purchasing power had an effect on depression. Despite the bivariate association between socioeconomic status indicators and number of diseases (morbidity, this effect was no longer seen after including the controls in the model. CONCLUSIONS: The study results confirm the association between socioeconomic status indicators and health among Brazilian elderly, but only for some dimensions of socioeconomic status and certain health outcomes.OBJETIVO: Investigar o impacto do status socioeconômico na saúde de idosos. MÉTODOS: Utilizou-se a base de dados transversal Inquérito sobre a Saúde, o Bem estar o Envelhecimento na América Latina e Caribe. Analisaram-se 2.143 idosos (60 anos ou mais residentes em domicílios, na área urbana de São Paulo, no ano de 2000. Modelos de regressões lineares estimaram o efeito dos indicadores de status socioeconômico (anos de estudo completos, ocupação e poder de compra nos

  5. Does the health status of intimate partner violence victims warrant pharmacies as portals for public health promotion?

    Science.gov (United States)

    Cerulli, Catherine; Cerulli, Jennifer; Santos, Elizabeth J; Lu, Najii; He, Hua; Kaukeinen, Kimberly; White, Anne Marie; Tu, Xin

    To explore whether the health status of intimate partner violence (IPV) victims warrants pharmacies to be portals for public health promotion. Specific objectives included (1) identifying prevalence of IPV including domestic violence (DV) and sexual assault (SA) in a community sample, (2) describing characteristics and correlates of DV/SA between participants who reported and did not report DV/SA, and (3) exploring whether DV/SA status is related to mental health medication use. Cross sectional. Upstate New York during 2006. English- and Spanish-speaking respondents younger than 65 years of age answering four questions to assess DV/SA. Secondary analysis of a countywide random telephone survey, the 2006 Monroe County Adult Health Survey, which collects prevalence data on health behaviors and health status indicators. To determine whether those reporting DV/SA are at increased odds for mental health medication use, controlling for other sociodemographic- and health-related variables. The survey response rate was 30.3%, with 1,881 respondents meeting inclusion criteria. Those reporting DV/SA were almost twice as likely to use mental health medications. However, when controlling for other variables, only poor mental and physical health were significant in increasing the odds of mental health medication use. The analyses reported here suggest that DV/SA victims in a community sample use mental health medications. When controlling for other variables, survey respondents reported worse physical and mental health. If pharmacies are suitable portals for DV/SA outreach, curricula would need to provide the knowledge and skills needed to take an active role in this public health promotion.

  6. Impact of Home Health Care on Health Care Resource Utilization Following Hospital Discharge: A Cohort Study.

    Science.gov (United States)

    Xiao, Roy; Miller, Jacob A; Zafirau, William J; Gorodeski, Eiran Z; Young, James B

    2018-04-01

    As healthcare costs rise, home health care represents an opportunity to reduce preventable adverse events and costs following hospital discharge. No studies have investigated the utility of home health care within the context of a large and diverse patient population. A retrospective cohort study was conducted between 1/1/2013 and 6/30/2015 at a single tertiary care institution to assess healthcare utilization after discharge with home health care. Control patients discharged with "self-care" were matched by propensity score to home health care patients. The primary outcome was total healthcare costs in the 365-day post-discharge period. Secondary outcomes included follow-up readmission and death. Multivariable linear and Cox proportional hazards regression were used to adjust for covariates. Among 64,541 total patients, 11,266 controls were matched to 6,363 home health care patients across 11 disease-based Institutes. During the 365-day post-discharge period, home health care was associated with a mean unadjusted savings of $15,233 per patient, or $6,433 after adjusting for covariates (p Home health care independently decreased the hazard of follow-up readmission (HR 0.82, p home health care most benefited patients discharged from the Digestive Disease (death HR 0.72, p home health care was associated with significant reduction in healthcare utilization and decreased hazard of readmission and death. These data inform development of value-based care plans. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Launch of patient-centered website is associated with reduced health care utilization: a nationwide natural experiment.

    NARCIS (Netherlands)

    Spoelman, W.; Bonten, T.; Waal, M. de; Drenthen, T.; Smeele, I.; Nielen, M.; Chavannes, N.

    2016-01-01

    Background: Health care costs and utilization are rising. High quality patient-centered online information may reduce health care utilization, but evidence of the effect of online health information on health care utilization is scarce. We hypothesized that the release of a nationwide evidence-based

  8. Chronic fatigue syndrome and fibromyalgia in Canada: prevalence and associations with six health status indicators

    Directory of Open Access Journals (Sweden)

    C. Rusu

    2015-03-01

    Full Text Available Introduction: Few studies have considered the factors independently associated with chronic fatigue syndrome (CFS and/or fibromyalgia (FM or considered the impact of these conditions on health status using population-based data. Methods: We used data from the nationally representative 2010 Canadian Community Health Survey (n= 59 101 to describe self-reported health professional-diagnosed CFS and/or FM, and their associations with 6 health status indicators. Results: In 2010, diagnosed CFS and FM are reported by 1.4% (95% confidence interval [CI]: 1.3%–1.6% and 1.5% (1.4%–1.7%, respectively, of the Canadian household population aged 12 years and over, with comorbid CFS and FM affecting 0.3% (0.3%–0.4% of that population. Prevalent CFS and/or FM were more common among women, adults aged 40 years and over, those with lowest income, and those with certain risk factors for chronic disease (i.e. obesity, physical inactivity and smoking. After controlling for differences between the groups, people with CFS and/or FM reported poorer health status than those with neither condition on 5 indicators of health status, but not on the measure of fair/poor mental health. Having both CFS and FM and having multiple comorbid conditions was associated with poorer health status. Conclusion: Co-occurrence of CFS and FM and having other chronic conditions were strongly related to poorer health status and accounted for much of the differences in health status. Understanding factors contributing to improved quality of life in people with CFS and/or FM, particularly in those with both conditions and other comorbidities, may be an important area for future research.

  9. Women's health status and gender inequality in China.

    Science.gov (United States)

    Yu, M Y; Sarri, R

    1997-12-01

    This paper examines the health status of women in China by reviewing levels and trends of female mortality at several phases of a woman's life cycle focusing on infancy girlhood, childbearing and old age. The mortality rates of Chinese women and men are compared for the period 1950-1990 as are comparisons with women in selected countries. The cause-specific death rate, expressed as a percentage of all deaths, and the burden of disease, measured in terms of the disability-adjusted life years (DALYs), are used to reflect the changing patterns of female diseases and causes of deaths. Significant improvement in the health status of Chinese women since 1950 is widely acknowledged as a major achievement for a developing country with the largest population in the world, but the differentials in women's health by region and urban/rural areas are considerable. The Physical Quality of Life Index (PQLI) indicates that the overall level of physical well-being of Chinese women has increased in recent decades, but disparity in health between men and women still exists. The Gender-Related Development Index (GDI) further reveals that China has achieved significant progress in women's health during the past four decades, but far less has been achieved with respect to gender equality overall. The final sections of the paper focus on the discussion of some health problems faced by the female population during the process of economic reform since the 1980 s. In order to promote gender equality between women and men, concerns on women's health care needs are highlighted.

  10. Utilization of maternal health-care services by tribal women in Kerala.

    Science.gov (United States)

    Jose, Jinu Annie; Sarkar, Sonali; Kumar, S Ganesh; Kar, Sitanshu Sekhar

    2014-01-01

    The coverage of maternal care services among the tribal women in Kerala is better as compared to other states in India. This study was done to identify the factors contributing to better coverage of maternal care services among the tribal women in Kerala and to study the reasons for remaining differences that exists in utilization of services between tribal and non-tribal pregnant women. This was a descriptive cum qualitative study conducted in Thariode Gramapanchayat in the Wayanad district of Kerala. Among all women who had registered their pregnancies in the 5 sub-centres under CHC Thariode and had delivered between September 2009 and October 2010, equal numbers of tribal and non-tribal ante-natal women, 35 each were interviewed in-depth using a semi-structured questionnaire. Quantitative data was analysed using SPSS Version 16.0. Content analysis was done for qualitative data. The determinants of utilization in tribal women were general awareness, affordability, accessibility and quality of services along with motivation by health workers. Among tribal antenatal women, 85% utilized maternal health care facilities fully compared to 100% among non-tribal women. Lower levels of education and lack of transport facilities were prime factors contributing to under utilization by tribal women. Affordable, accessible and good quality of services in the public health system in Kerala and motivation by health workers were important contributing factors for better utilization of maternal care services.

  11. Effective Factors in Environmental Health Status of Grocery Stores

    Directory of Open Access Journals (Sweden)

    Mehdi Asadi

    2012-08-01

    Full Text Available Aims of the Study: This study was carried out to determine the effective factors in environmental health status of grocery stores in the city of Qom (located in the center of Iran. Materials & Methods: In this cross-sectional study, 283 grocery stores from 3 different regions were selected randomly using stratified sampling. Data were gathered through observation, interview, and questionnaire. The questionnaire consisted of two sections: section 1 dealt with some shop managers’ features including the age, educational level, job satisfaction, passing “food and occupational hygiene training courses”, store ownership, duration of employment, and features of stores including their location (Region and environmental health condition. And section 2 dealt with the important aspects of regulations of Article 13. The data analyzed using statistical procedures such as Spearman Rank Correlation and Multivariate Regression Analysis. P-values less than 0.05 were considered as statistically significant. Results: Among the investigated factors, the manager’s educational level had a greater impact on the environmental health conditions of grocery stores. The ownership status of grocery stores, Job satisfaction and passing “food and occupational hygiene training courses” were next in the ranking, respectively (p <0.001 for all measures, except for shop ownership, for which p-value was <0.02. Conclusions: Planning and implementation of effective operational and strategic programs addressing the above mentioned issues seems to be necessary. Such programs will improve the health status of the stores over time.

  12. Assessing the empirical validity of alternative multi-attribute utility measures in the maternity context

    Directory of Open Access Journals (Sweden)

    Morrell Jane

    2009-05-01

    Full Text Available Abstract Background Multi-attribute utility measures are preference-based health-related quality of life measures that have been developed to inform economic evaluations of health care interventions. The objective of this study was to compare the empirical validity of two multi-attribute utility measures (EQ-5D and SF-6D based on hypothetical preferences in a large maternity population in England. Methods Women who participated in a randomised controlled trial of additional postnatal support provided by trained community support workers represented the study population for this investigation. The women were asked to complete the EQ-5D descriptive system (which defines health-related quality of life in terms of five dimensions: mobility, self care, usual activities, pain/discomfort and anxiety/depression and the SF-36 (which defines health-related quality of life, using 36 items, across eight dimensions: physical functioning, role limitations (physical, social functioning, bodily pain, general health, mental health, vitality and role limitations (emotional at six months postpartum. Their responses were converted into utility scores using the York A1 tariff set and the SF-6D utility algorithm, respectively. One-way analysis of variance was used to test the hypothetically-constructed preference rule that each set of utility scores differs significantly by self-reported health status (categorised as excellent, very good, good, fair or poor. The degree to which EQ-5D and SF-6D utility scores reflected alternative dichotomous configurations of self-reported health status and the Edinburgh Postnatal Depression Scale score was tested using the relative efficiency statistic and receiver operating characteristic (ROC curves. Results The mean utility score for the EQ-5D was 0.861 (95% CI: 0.844, 0.877, whilst the mean utility score for the SF-6D was 0.809 (95% CI: 0.796, 0.822, representing a mean difference in utility score of 0.052 (95% CI: 0.040, 0

  13. The MRC dyspnoea scale by telephone interview to monitor health status in elderly COPD patients.

    Science.gov (United States)

    Paladini, Luciana; Hodder, Rick; Cecchini, Isabella; Bellia, Vincenzo; Incalzi, Raffaele Antonelli

    2010-07-01

    Dyspnoea is the most common symptom associated with poor quality of life in patients affected by Chronic Obstructive Pulmonary Disease (COPD). While COPD severity is commonly staged by lung function, the Medical Research Council (MRC) dyspnoea scale has been proposed as a more clinically meaningful method of quantifying disease severity in COPD. We wished to assess whether this scale might also be useful during telephone surveys as a simple surrogate marker of perceived health status in elderly patients with COPD. We conducted a comprehensive health status assessment by telephone survey of 200 elderly patients who had a physician diagnosis of COPD. The telephone survey contained 71 items and explored such domains as educational level, financial status, living arrangements and social contacts, co-morbid illness, and the severity and the impact of COPD on health status. Patients were categorized according to the reported MRC score: mild dyspnoea (MRC scale of 1), moderate dyspnoea (MRC scale of 2 and 3), or severe dyspnoea (MRC of 4 and 5). Deterioration in most of the recorded indicators of health status correlated with an increasingly severe MRC score. This was most evident for instrumental activities of daily living (IADL), perceived health and emotional status, pain-related limitations, limitations in social life, hospital admissions in preceding year and prevalence of most co-morbidities. The MRC dyspnoea scale is a reliable index of disease severity and health status in elderly COPD patients which should prove useful for remote monitoring of COPD and for rating health status for epidemiological purposes.

  14. The effects of Air Pollution on Health Status in Great Britain

    OpenAIRE

    Giovanis, Eleftherios; Ozdamar, Oznur

    2014-01-01

    This study explores the effects of air pollution on self-reported health status. Moreover, this study explores the willingness to pay for improving the air quality in UK. The estimates are based on data from the British Household Panel Survey (BHPS). The effects of air pollution on individuals’ health status are estimated and their monetary value is calculated. In particular, two main air pollutants are examined; ground-level ozone (O3) and carbon monoxide (CO). Moreover, various approaches ...

  15. A Checklist for Reporting Valuation Studies of Multi-Attribute Utility-Based Instruments (CREATE)

    NARCIS (Netherlands)

    Xie, Feng; Pickard, A. Simon; Krabbe, Paul F. M.; Revicki, Dennis; Viney, Rosalie; Devlin, Nancy; Feeny, David

    Multi-attribute utility-based instruments (MAUIs) assess health status and provide an index score on the full health-dead scale, and are widely used to support reimbursement decisions for new healthcare interventions worldwide. A valuation study is a key part of the development of MAUIs, with the

  16. Strategies Utilized by Professional Nurses in the Primary Health ...

    African Journals Online (AJOL)

    Strategies Utilized by Professional Nurses in the Primary Health Care Facilities Regarding Adherence of Patients to Anti-Retroviral Therapy (ART) in Capricorn District, Limpopo Province, South Africa.

  17. Perceived neighborhood quality, sleep quality, and health status: evidence from the Survey of the Health of Wisconsin.

    Science.gov (United States)

    Hale, Lauren; Hill, Terrence D; Friedman, Elliot; Nieto, F Javier; Galvao, Loren W; Engelman, Corinne D; Malecki, Kristen M C; Peppard, Paul E

    2013-02-01

    Why does living in a disadvantaged neighborhood predict poorer mental and physical health? Recent research focusing on the Southwestern United States suggests that disadvantaged neighborhoods favor poor health, in part, because they undermine sleep quality. Building on previous research, we test whether this process extends to the Midwestern United States. Specifically, we use cross-sectional data from the Survey of the Health of Wisconsin (SHOW), a statewide probability sample of Wisconsin adults, to examine whether associations among perceived neighborhood quality (e.g., perceptions of crime, litter, and pleasantness in the neighborhood) and health status (overall self-rated health and depression) are mediated by overall sleep quality (measured as self-rated sleep quality and physician diagnosis of sleep apnea). We find that perceptions of low neighborhood quality are associated with poorer self-rated sleep quality, poorer self-rated health, and more depressive symptoms. We also observe that poorer self-rated sleep quality is associated with poorer self-rated health and more depressive symptoms. Our mediation analyses indicate that self-rated sleep quality partially mediates the link between perceived neighborhood quality and health status. Specifically, self-rated sleep quality explains approximately 20% of the association between neighborhood quality and self-rated health and nearly 19% of the association between neighborhood quality and depression. Taken together, these results confirm previous research and extend the generalizability of the indirect effect of perceived neighborhood context on health status through sleep quality. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Perceptions of healthcare quality in Ghana: Does health insurance status matter?

    Science.gov (United States)

    Duku, Stephen Kwasi Opoku; Nketiah-Amponsah, Edward; Janssens, Wendy; Pradhan, Menno

    2018-01-01

    This study's objective is to provide an alternative explanation for the low enrolment in health insurance in Ghana by analysing differences in perceptions between the insured and uninsured of the non-technical quality of healthcare. It further explores the association between insurance status and perception of healthcare quality to ascertain whether insurance status matters in the perception of healthcare quality. Data from a survey of 1,903 households living in the catchment area of 64 health centres were used for the analysis. Two sample independent t-tests were employed to compare the average perceptions of the insured and uninsured on seven indicators of non-technical quality of healthcare. A generalised ordered logit regression, controlling for socio-economic characteristics and clustering at the health facility level, tested the association between insurance status and perceived quality of healthcare. The perceptions of the insured were found to be significantly more negative than the uninsured and those of the previously insured were significantly more negative than the never insured. Being insured was associated with a significantly lower perception of healthcare quality. Thus, once people are insured, they tend to perceive the quality of healthcare they receive as poor compared to those without insurance. This study demonstrated that health insurance status matters in the perceptions of healthcare quality. The findings also imply that perceptions of healthcare quality may be shaped by individual experiences at the health facilities, where the insured and uninsured may be treated differently. Health insurance then becomes less attractive due to the poor perception of the healthcare quality provided to individuals with insurance, resulting in low demand for health insurance in Ghana. Policy makers in Ghana should consider redesigning, reorganizing, and reengineering the National Healthcare Insurance Scheme to ensure the provision of better quality healthcare

  19. Effect of Pediatric Behavioral Health Screening and Colocated Services on Ambulatory and Inpatient Utilization.

    Science.gov (United States)

    Hacker, Karen A; Penfold, Robert B; Arsenault, Lisa N; Zhang, Fang; Soumerai, Stephen B; Wissow, Lawrence S

    2015-11-01

    The study sought to determine the impact of a pediatric behavioral health screening and colocation model on utilization of behavioral health care. In 2003, Cambridge Health Alliance, a Massachusetts public health system, introduced behavioral health screening and colocation of social workers sequentially within its pediatric practices. An interrupted time-series study was conducted to determine the impact on behavioral health care utilization in the 30 months after model implementation compared with the 18 months prior. Specifically, the change in trends of ambulatory, emergency, and inpatient behavioral health utilization was examined. Utilization data for 11,223 children ages ≥4 years 9 months to <18 years 3 months seen from 2003 to 2008 contributed to the study. In the 30 months after implementation of pediatric behavioral health screening and colocation, there was a 20.4% cumulative increase in specialty behavioral health visit rates (trend of .013% per month, p=.049) and a 67.7% cumulative increase in behavioral health primary care visit rates (trend of .019% per month, p<.001) compared with the expected rates predicted by the 18-month preintervention trend. In addition, behavioral health emergency department visit rates increased 245% compared with the expected rate (trend .01% per month, p=.002). After the implementation of a behavioral health screening and colocation model, more children received behavioral health treatment. Contrary to expectations, behavioral health emergency department visits also increased. Further study is needed to determine whether this is an effect of how care was organized for children newly engaged in behavioral health care or a reflection of secular trends in behavioral health utilization or both.

  20. Utilization of Mental Health Care, Treatment Patterns, and Course of Psychosocial Functioning in Northern German Coronary Artery Disease Patients with Depressive and/or Anxiety Disorders.

    Science.gov (United States)

    Westermair, Anna Lisa; Schaich, Anja; Willenborg, Bastian; Willenborg, Christina; Nitsche, Stefan; Schunkert, Heribert; Erdmann, Jeanette; Schweiger, Ulrich

    2018-01-01

    Comorbid mental disorders in patients with coronary artery disease (CAD) are common and associated with adverse somatic outcomes. However, data on utilization rates of mental health care and treatment efficiency are scarce and inconsistent, which we tried to remedy with the present preliminary study on Northern German CAD patients. A total of 514 German CAD patients, as diagnosed by cardiac catheterization, were assessed using the Mini International Neuropsychiatric Interview and the Global Assessment of Functioning (GAF) scale. Global utilization of mental health care since onset of CAD was 21.0%. Depressive disorders, younger age, and lower GAF at onset of CAD were associated with higher utilization rates, while anxiety disorders and gender were not. Lower GAF at onset of CAD, female gender, and psychotherapy was positively associated with higher gains in GAF, while younger age and anxiety disorders were negatively associated. The majority of CAD patients with comorbid depression reported to have received mental health treatment and seemed to have benefited from it. However, we found preliminary evidence of insufficiencies in the diagnosis and treatment of anxiety disorders in CAD patients. Further studies, preferably prospective and with representative samples, are needed to corroborate or falsify these findings and explore possible further mediators of health-care utilization by CAD patients such as race, ethnicity, and socioeconomic status.

  1. The current status of HANARO utilization

    International Nuclear Information System (INIS)

    Kim, Hark Rho; Lee, Choong Sung; Sohn, Jae Min; Park, Kyung Bae

    2003-01-01

    The HANARO (High-flux Advanced Neutron Application Research Reactor) is now operating at 24 MW to meet the user's demands in a variety of utilization fields. The most active field is the neutron scattering and diffraction using the currently available HRPD (High Resolution Powder Diffraction), FCD (Four Circle Diffraction), RSI (Residual Stress Instrument), and SANS (Small Angle Neutron Scattering). Using these instruments, we have been investigating such characteristics as materials' crystal structure and phase transition, residual stress, texture, and hard and soft matters. Through examination and inspection of the test specimens, NRF (Neutron Radiography Facility) is contributing to such fields as the nuclear industry, ordnance industry, aerospace industry, and archaeology. The second utilization field is the fuel and material irradiation test. KAERI (Korea Atomic Energy Research Institute) has developed atomized fuel powder and provided it to USA, France and Argentina. Under the RERTR program, KAERI has been contributing to the development of research reactor fuels of better quality. To test the reactor materials and fuels, instrumented and non-instrumented capsules are widely being used. To produce and supply RIs and pharmaceuticals for medical and industrial purposes, HANARO and its RIPF (Radioisotope Production Facility) has been fully complying with demands so that the national welfare might be enhanced by our efforts. NAA (Neutron Activation Analysis) is assisting the nuclear industry, environmental research and the promotion of the health area. To support all active utilizations, HANARO operators have been making every effort to not only improve the systems, if needed, but also to avoid the inadvertent reactor trip. Based upon this stable neutron supply, we have been developing and expanding the utilization fields and facilities. The PNS(Polarized Neutron Spectrometer) is under construction and the reflectometer is in preparation. The BNCT(Boron Neutron

  2. Physical and mental health status and health behaviors in male breast cancer survivors: a national, population-based, case-control study.

    Science.gov (United States)

    Andrykowski, Michael A

    2012-09-01

    Identify the current physical and mental health status and health behaviors of male breast cancer survivors. Using data from the national, population-based, 2009 Behavioral Risk Factor Surveillance System (BRFSS) survey, 66 cases of male breast cancer were identified (mean age = 66.2 years, mean time since diagnosis = 12.0 years). Male breast cancer cases were matched with 198 male BRFSS respondents with no history of cancer (control group) on age, education, and minority status. The male breast cancer and control groups were compared on physical and mental health status and health behaviors, using t-test and logistic regression analyses. The male breast cancer group reported poorer physical and mental health than controls. Male breast cancer survivors were significantly (p mental health (Effect Size = 0.49), and physical health (Effect Size = 0.29) were not good. In contrast, the male breast cancer and control groups were similar with regard to current health behaviors, including tobacco and alcohol use, diet, exercise, and health care. The diagnosis and treatment of male breast cancer may be associated with clinically important and long-term deficits in physical and mental health status, deficits which may exceed those evidenced by long-term female breast cancer survivors. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

  3. Influence of socioeconomic status on the relationship between locus of control and oral health.

    Science.gov (United States)

    Acharya, Shashidhar; Pentapati, Kalyana Chakravarthy; Singh, Sweta

    2011-01-01

    The objectives of this study were to assess the relationship between Locus of Control (LoC) and oral health among a group of rural adolescent school children and to examine the influence of socioeconomic status (SES) on the association between health, LoC and oral health status. A total of 318 children 15 years of age from a public and private school formed the study population. The children were administered following the Indian translation of the 18-item Multidimensional Health Locus of Control scale, and subsequently examined for caries and oral hygiene. T tests and correlation analyses showed a significant relationship between higher 'Internal' Locus of Control and dental caries. A hierarchical multiple regression analysis was performed to assess the effect of socioeconomic status on LoC and oral health using three interaction models which showed a statistically significant interaction between 'Internal' LoC and socioeconomic status on caries. Socioeconomic stratum-specific estimates of the relationship between the LoC and caries revealed a positive association between Internal LoC and caries in the middle socioeconomic group. The results demonstrated the relationship between Locus of Control and oral health, and the role of socioeconomic status having a strong bearing on this relationship.

  4. Enabling and Predisposing Factors for the Utilization of Preventive Dental Health Care in Migrants and Non-Migrants in Germany

    Directory of Open Access Journals (Sweden)

    Patrick Brzoska

    2017-08-01

    Full Text Available BackgroundIn many European countries including Germany, migrants utilize preventive services less frequently than the majority population. This is also true for the utilization of dental checkups. Little is known about which demographic, social, behavioral, and health-related factors influence the decision of migrants to seek preventive dental health care and how these factors differ from those in non-migrants. The aim of the present study was to examine the role of these factors among migrants and non-migrants residing in Germany.MethodsData from cross-sectional national health surveys are used, providing information on preventive dental health behavior from n = 41,220 individuals, of which 15.0% are migrants. Andersen’s Behavioral Model of Health Services Use is the conceptual framework of the investigation. Multiple logistic regression models were applied to examine the role of different predisposing and enabling factors. Interaction terms were included in order to examine whether determinants differ between migrants and non-migrants. Average marginal effects (AMEs are reported in addition to odds ratios (ORs as measures of effect size which are robust against bias arising from unobserved heterogeneity.ResultsMigrants are at an about 36% lower chance of utilizing regular dental checkups than non-migrants [OR = 0.64 (95% confidence interval, 95% CI: 0.61, 0.68; AME = −0.081 (95% CI = −0.093, −0.069]. Differences are partly explained by the influence of demographic, social, behavioral, and health-related factors [adjusted OR = 0.69 (95% CI: 0.64, 0.73; AME = −0.065 (95% CI = −0.076, −0.053]. Younger age, being male, lower socioeconomic status, a non-statutory health insurance, not living in a relationship, living in the Western part of Germany and in an urban setting, and poor limited social support were associated with a lower chance of utilizing regular dental checkups. Interaction effects could be

  5. Present status of nuclear energy development and utilization in Japan 1994

    International Nuclear Information System (INIS)

    1994-03-01

    Today, world energy demands continue to increase, and over the middle and long-term, access to petroleum supplies may become difficult. At the same time, such serious environmental problems as global warming and acid rain, which are caused by the burning of fossil fuels, have drawn great public attention, and the international community has urged that solutions to them should be found. Because nuclear power offers an economically efficient, stable supply of energy whose production has little adverse effect on the environment, the world has recognized the necessity of continuing to develop and use it. The changing international political situation, however, has complicated nuclear energy matters. In Japan, particularly the collapse of the former Soviet Union and North Korea's announcement of its intention to withdraw from the Nuclear Weapons Non-Proliferation Treaty have been cause for concern. Under these circumstances, it has become increasingly important for Japan to secure stable sources of energy, since Japan is dependent on imports for its energy supply. To that end, Japan has steadily promoted the development and utilization of nuclear energy. In fiscal 1992, nuclear power accounted for 28.2 % of the total power generated by Japanese electric utilities. Japan has also worked steadily to develop a nuclear fuel cycle, which is important to the long-term stability of the energy supply. This publication describes the present status of nuclear energy development and utilization in Japan. (J.P.N.)

  6. Community Health Status Indicators (CHSI) to Combat Obesity, Heart Disease and Cancer

    Data.gov (United States)

    U.S. Department of Health & Human Services — Community Health Status Indicators (CHSI) to combat obesity, heart disease, and cancer are major components of the Community Health Data Initiative. This dataset...

  7. Population health status of South Asian and African-Caribbean communities in the United Kingdom.

    Science.gov (United States)

    Calvert, Melanie; Duffy, Helen; Freemantle, Nick; Davis, Russell; Lip, Gregory Y H; Gill, Paramjit

    2012-04-25

    Population health status scores are routinely used to inform economic evaluation and evaluate the impact of disease and/or treatment on health. It is unclear whether the health status in black and minority ethnic groups are comparable to these population health status data. The aim of this study was to evaluate health-status in South Asian and African-Caribbean populations. Cross-sectional study recruiting participants aged ≥ 45 years (September 2006 to July 2009) from 20 primary care centres in Birmingham, United Kingdom.10,902 eligible subjects were invited, 5,408 participated (49.6%). 5,354 participants had complete data (49.1%) (3442 South Asian and 1912 African-Caribbean). Health status was assessed by interview using the EuroQoL EQ-5D. The mean EQ-5D score in South Asian participants was 0.91 (standard deviation (SD) 0.18), median score 1 (interquartile range (IQR) 0.848 to 1) and in African-Caribbean participants the mean score was 0.92 (SD 0.18), median 1 (IQR 1 to 1). Compared with normative data from the UK general population, substantially fewer African-Caribbean and South Asian participants reported problems with mobility, usual activities, pain and anxiety when stratified by age resulting in higher average health status estimates than those from the UK population. Multivariable modelling showed that decreased health-related quality of life (HRQL) was associated with increased age, female gender and increased body mass index. A medical history of depression, stroke/transient ischemic attack, heart failure and arthritis were associated with substantial reductions in HRQL. The reported HRQL of these minority ethnic groups was substantially higher than anticipated compared to UK normative data. Participants with chronic disease experienced significant reductions in HRQL and should be a target for health intervention.

  8. Population health status of South Asian and African-Caribbean communities in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Calvert Melanie

    2012-04-01

    Full Text Available Abstract Background Population health status scores are routinely used to inform economic evaluation and evaluate the impact of disease and/or treatment on health. It is unclear whether the health status in black and minority ethnic groups are comparable to these population health status data. The aim of this study was to evaluate health-status in South Asian and African-Caribbean populations. Methods Cross-sectional study recruiting participants aged ≥ 45 years (September 2006 to July 2009 from 20 primary care centres in Birmingham, United Kingdom.10,902 eligible subjects were invited, 5,408 participated (49.6%. 5,354 participants had complete data (49.1% (3442 South Asian and 1912 African-Caribbean. Health status was assessed by interview using the EuroQoL EQ-5D. Results The mean EQ-5D score in South Asian participants was 0.91 (standard deviation (SD 0.18, median score 1 (interquartile range (IQR 0.848 to 1 and in African-Caribbean participants the mean score was 0.92 (SD 0.18, median 1 (IQR 1 to 1. Compared with normative data from the UK general population, substantially fewer African-Caribbean and South Asian participants reported problems with mobility, usual activities, pain and anxiety when stratified by age resulting in higher average health status estimates than those from the UK population. Multivariable modelling showed that decreased health-related quality of life (HRQL was associated with increased age, female gender and increased body mass index. A medical history of depression, stroke/transient ischemic attack, heart failure and arthritis were associated with substantial reductions in HRQL. Conclusions The reported HRQL of these minority ethnic groups was substantially higher than anticipated compared to UK normative data. Participants with chronic disease experienced significant reductions in HRQL and should be a target for health intervention.

  9. Mental Health Services Utilization and Expenditures Among Children Enrolled in Employer-Sponsored Health Plans.

    Science.gov (United States)

    Walter, Angela Wangari; Yuan, Yiyang; Cabral, Howard J

    2017-05-01

    Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services. Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007-2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders. Multivariate Poisson regression and linear regression modeling techniques were used. Mental health services use for outpatient behavioral health therapy (BHT) was higher in the years after the implementation of the MHPAEA (2010-2013). Specifically, before the MHPAEA implementation, the annual total visits for BHT provided by mental health physicians were 17.1% lower and 2.5% lower for BHT by mental health professionals, compared to years when MHPAEA was in effect. Children covered by consumer-driven and high-deductible plans had significantly higher out-of-pocket expenditures for BHT compared to those enrolled PPOs. Our findings demonstrate increased mental health services use and higher out-of-pocket costs per outpatient visit after implementation of the MHPAEA. As consumer-driven and high-deductible health plans continue to grow, enrollees need to be cognizant of the impact of health insurance benefit designs on health services offered in these plans. Copyright © 2017 by the American Academy of Pediatrics.

  10. Systematic review of health state utility values for acute myeloid leukemia

    OpenAIRE

    Forsythe, Anna; Brandt, Patricia S; Dolph, Mike; Patel, Sachin; Rabe, Adrian Paul J; Tremblay, Gabriel

    2018-01-01

    Anna Forsythe,1 Patricia S Brandt,2 Mike Dolph,1 Sachin Patel,3 Adrian Paul J Rabe,1 Gabriel Tremblay1 1Purple Squirrel Economics, New York, NY, 2Novartis Pharmaceuticals, East Hanover, NJ, USA; 3Novartis Pharmaceuticals UK Limited, Frimley, Camberley, Surrey, UK Background: Cost-utility analyses for acute myeloid leukemia (AML) require health state utility values (HSUVs) in order to calculate quality-adjusted life-years (QALYs) for each health state. Aim: This study reviewed AML-related HSU...

  11. Dental Health Status and Treatment Needs of Police Personnel of a ...

    African Journals Online (AJOL)

    Background: Oral health is an integral part of general health. Police personnel form the backbone for safety and security of a community hence their health is of utmost importance. Aim: The present study was conducted to assess the oral health status and treatment needs of police personnel employed in police stations of ...

  12. Health care utilization in patients with gout: a prospective multicenter cohort study.

    Science.gov (United States)

    Singh, Jasvinder A; Bharat, Aseem; Khanna, Dinesh; Aquino-Beaton, Cleopatra; Persselin, Jay E; Duffy, Erin; Elashoff, David; Khanna, Puja P

    2017-05-31

    All published studies of health care utilization in gout have been cross-sectional to date, and most used a patient-reported diagnosis of gout. Our objective was to assess health care utilization and its predictors in patients with physician-confirmed gout in a prospective cohort study. In a multi-center prospective cohort study of U.S. veterans with rheumatologist-confirmed gout (N = 186; two centers), we assessed patient self-reported overall and gout-specific health care utilization with the Gout Assessment Questionnaire (GAQ) every 3-months for a 9-month period. Comparisons were made using the student's t test or the chi-square, Wilcoxon rank sum test or Fisher exact test, as appropriate. Mixed effects Poisson regression was used to assess potential correlates of gout-related health care utilization. Mean age was 64.6 years, 98% were men, 13% Hispanic or Latino, 32% were African-American, 6% did not graduate high school, mean serum urate was 8.3 and mean Deyo-Charlson score was 3.1. During the past year, mean gout-related visits were as follows: rheumatologist, 1.5; primary care physician, 2 visits; ≥1 inpatient visits, 7%; ≥1 ER visits, 26%; and urgent care/walk-in visit, 33%. In longitudinal analyses, African-American race and gout flares in the last 3 months were associated with significantly higher rate ratio of gout-related outpatient visits. African-American race and lack of college education were associated with significantly higher rate ratio for gout-related urgent visits and overnight stays. African-American race and recent gout flares were associated with higher outpatient utilization and African-American race and no college education with higher urgent or inpatient utilization. Future studies should examine whether modifiable predictors of utilization can be targeted to reduce healthcare utilization in patients with gout.

  13. [Association of job burnout with subjective well-being and health status among employees from 29 provinces in China].

    Science.gov (United States)

    Xu, C J; Xiao, Y; Pan, N; Ye, J; Lin, Q X; Jin, Y

    2017-10-20

    Objective: To investigate the influence of job burnout on subjective well-being and health status among employees in China. Methods: The data from the 2014 China Labor-force Dynamic Survey were used to analyze the association of job burnout with subjective well-being and health status among 7289 employees aged 18-64 years from 29 provinces in China.Some items from the Maslach Burnout Inventory-General Survey were used to investigate job burnout; subjective well-being assessment included life happiness and degree of satisfaction with living condition; the questions for self-evaluation of health status were used to analyze health status. Results: Of all employees,30.5% had low subjective well-being and 4.7% had poor health status based on self-evaluation. The logistic regression analysis showed that emotional exhaustion(two items), reduced sense of personal accomplishment,and cynicism were risk factors for low subjective well-being( OR =1.07,1.11,1.10,and 1.06, P factor for poor health status ( OR =1.10 and 1.07, P influence on health status( P >0.05). Conclusion: Emotional exhaustion is a major influencing factor for health status,and reducing job burnout may be an effective method for improving subjective well-being and health status.

  14. Influence of parental employment status on Dutch and Slovak adolescents' health

    NARCIS (Netherlands)

    Sleskova, M.; Tuinstra, J.; Geckova, A.M.; van Dijk, J.P.; Salonna, F.; Groothoff, J.W.; Reijneveld, S.A.

    2006-01-01

    Background: Recent research shows the possibility that the link between parental employment status and children's health can be affected by different cultural or societal settings. The aim of this study was to explore whether the effect of father's and mother's employment status on several aspects

  15. The effect of floorball training on health status, psychological health and social capital in older men

    DEFF Research Database (Denmark)

    Wikman, Johan Michael; Nistrup, Anne; Vorup Petersen, Jacob

    2017-01-01

    that the men in the floorball group improved in the SF-12 composite score for mental health, as well as the HADS subscales anxiety and depression, compared to the men in the petanque group. In addition, 21 interviews were conducted with a sample of the men engaged in floorball. According to the statements...... by many of the men as the main reason for their participation throughout the 12-week period. The statistical results and the interview findings suggest that participation in a ball game such as floorball has several benefits regarding health status, psychological health and social capital and in addition......This article presents the results of a multidisciplinary study which investigated the effects of a period with floorball training on health status, psychological health and social capital of older men. Thirty-nine untrained men aged 69.9 ± 0.6 (range: 65–76) were randomized into a group playing...

  16. Self-rated health and employment status in chronic haemodialysis patients

    DEFF Research Database (Denmark)

    Molsted, Stig; Aadahl, Mette; Schou, Lone

    2004-01-01

    OBJECTIVE: Along with survival and other types of clinical outcome, physical, mental and social well-being are important indicators of the effectiveness of the medical care that haemodialysis (HD) patients receive. The present cross-sectional study was designed to assess self-rated health in HD...... patients were included. They were asked to complete the Short Form 36 (SF-36) questionnaire and additional questions concerning education and employment status. The SF-36 consists of eight scales representing physical, social, mental and general health. Clinical, biochemical and dialysis adequacy data were...... patients from a large Danish HD centre compared to a Danish general population sample with similar sex and age distributions. Furthermore, employment status and associations between self-rated health and clinical, social and demographic factors were investigated. MATERIAL AND METHODS: A total of 150...

  17. Adults with Greater Weight Satisfaction Report More Positive Health Behaviors and Have Better Health Status Regardless of BMI

    Directory of Open Access Journals (Sweden)

    Christine E. Blake

    2013-01-01

    Full Text Available Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS. Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES adults with baseline examination between 1987 and 2002 (n=19,003. Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and multivariate logistic regression. Results. Compared to men, women were more likely to be dieting (32% women; 18% men and had higher weight dissatisfaction. Men and women with greater weight dissatisfaction reported more dieting, yo-yo dieting, and snacking and consuming fewer meals, being less active, and having to eat either more or less than desired to maintain weight regardless of weight status. Those who were overweight or obese and dissatisfied with their weight had the poorest health. Conclusion. Greater satisfaction with one’s weight was associated with positive health behaviors and health outcomes in both men and women and across weight status groups.

  18. [Health status and intimate partner violence].

    Science.gov (United States)

    Sanz-Barbero, Belén; Rey, Lourdes; Otero-García, Laura

    2014-01-01

    To describe the prevalence of intimate partner violence (IPV) in Spain in the last year and at some point during the lifetime, to determine health status in women according to whether they had experienced IPV or not, and to analyze the individual variables associated with IPV in Spain. A cross-sectional study was performed of the database, Macrosurvey on Gender Violence in Spain 2011. This database includes data on 7,898 women older than 18 years old. The dependent variables were IPV-last year, IPV-ever in life. Covariates consisted of sociodemographic characteristics, socioeconomic status, maternal experience of IPV, social support, and self-care. The measure of association used was the OR with its 95% confidence interval (95% CI). A total of 3.6% of women had experienced IPV-last year and 12.2% ever in life. Female victims of IPV had poorer health than women who had not experienced IPV. Immigrant women living in Spain for 6 years or more were more likely to experience IPV-ever in life than Spanish women [OR (95% CI): 1.95 (1.50, 2.53)]. An interaction was found between nationality and the existence of children under 18 years old. Among women with children under 18 years old, immigrant women were more likely to experience IPV-last year than Spanish women [OR (95% CI): 1.99 (1.25, 3.17)]. Other variables associated with IPV were age, low socioeconomic status, low social support and having a mother who had experienced IPV. In Spain, some women have a higher probability of experiencing IPV. The variables associated with greater vulnerability to IPV should be taken into account when implementing measures to prevent or alleviate IPV. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  19. The relationship between turbidity of mouth-rinsed water and oral health status.

    Science.gov (United States)

    Takeuchi, Susumu; Ueno, Masayuki; Takehara, Sachiko; Pham, Thuy Anh Vu; Hakuta, Chiyoko; Morishima, Seiji; Shinada, Kayoko; Kawaguchi, Yoko

    2013-01-01

    The purpose of this study was to examine the relationship between turbidity of mouth rinsed water and oral health status such as dental and periodontal conditions, oral hygiene status, flow rate of saliva and oral bacteria. Subjects were 165 patients who visited the Dental Hospital, Tokyo Medical and Dental University. Oral health status, including dental and periodontal conditions, oral hygiene status and flow rate of saliva, was clinically examined. The turbidity was measured with a turbidimeter. Quantification of Fusobacterium spp, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and total bacteria levels was performed using real-time PCR. The Pearson correlation and multiple regression analysis were used to explore the associations between the turbidity and oral health parameters. The turbidity showed significant correlations with the number of decayed teeth and deep pockets, the plaque index, extent of tongue coating and Fusobacterium spp, P. gingivalis, T. forsythia, T. denticola and total bacteria levels. In a multiple regression model, the turbidity was negatively associated with the flow rate of saliva and positively associated with the total number of bacteria (p turbidity of mouth rinsed water could be used as an indicator to evaluate oral health condition and the amount of bacteria in the oral cavity. In addition, the turbiditimeter appeared as a simple and objective device for screening abnormality of oral health condition at chair side as well as community-based research.

  20. Oral health-related quality-of-life scores differ by socioeconomic status and caries experience.

    Science.gov (United States)

    Chaffee, Benjamin W; Rodrigues, Priscila Humbert; Kramer, Paulo Floriani; Vítolo, Márcia Regina; Feldens, Carlos Alberto

    2017-06-01

    (i) Quantify the relative association between child dental caries experience and maternal-reported child oral health-related quality of life (OHRQoL); (ii) examine whether that association differed according to family socioeconomic status (SES); and (iii) explore whether absolute OHRQoL varied by family SES at similar levels of child caries experience. This study was a cross-sectional analysis of children in southern Brazil (n=456, mean age: 38 months) participating in an existing health centre-based intervention study. OHRQoL impact was quantified as mean score on the Brazilian Early Childhood Oral Health Impact Scale (ECOHIS) and compared over categories of caries experience (dmft: 0, dmft: 1-4, dmft: ≥5). Adjusted ECOHIS ratios between caries categories were calculated using regression modelling, overall and within socioeconomic strata defined by maternal education, social class and household income. Caries prevalence (dmft >0) was 39.7%, mean ECOHIS score was 2.0 (SD: 3.5), and 44.3% of mothers reported OHRQoL impact (ECOHIS score >0). Increasing child caries experience was associated with worsening child and family quality of life: ECOHIS scores were 3.0 times greater (95% CI: 2.0, 4.4) for children with dmft ≥5 vs dmft=0, a pattern that persisted regardless of family socioeconomic status (P for interaction: all >0.3). However, adjusted for dental status and sociodemographic characteristics, mean ECOHIS scores were lower when reported by mothers of less educational attainment (ratio: 0.7; 95% CI: 0.5, 1.0), lower social class (ratio: 0.7; 95% CI: 0.5, 1.0) or in lower income households (ratio: 0.8; 95% CI: 0.6, 1.3). Dental caries was associated with negative child and family experiences and lower OHRQoL across all social groups; yet, families facing greater disadvantage may report lesser quality-of-life impact at the same level of disease experience. Thus, subjective quality-of-life measures may differ under varying social contexts, with possible