scholarly journals Out-of-Pocket Costs of Asthma Follow-Up Care in Adults in a Sub-Saharan African Country

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Cajetan Chigozie Onyedum ◽  
Olufemi Olumuyiwa Desalu ◽  
Kingsley Nnanna Ukwaja ◽  
Chinwe Chukwuka ◽  
Nnamdi Ikechukwu Nwosu ◽  
...  
Keyword(s):  
Direct Cost ◽  
Cost Of Care ◽  
Medication Cost ◽  
Asthma Care ◽  
Health Seeking ◽  
Cross Sectional ◽  
Patient Costs ◽  
Follow Up Care ◽  
Asthma Patients

Asthma care imposes economic burden on affected patients. Patient costs for asthma care have not been documented in Africa. We aimed to determine the out-of-pocket cost of asthma follow-up care incurred by patients in Nigeria. We conducted a cross-sectional study in three tertiary hospitals in southeastern and northwestern Nigeria. Poorly controlled asthma patients attending a follow-up visit in the respiratory clinic of the hospitals were surveyed. Sociodemographic, health-seeking behavior, and cost data were collected using a structured questionnaire. Of the 110 patients who completed the study, 56 (51%) were females. Also, 72 (65%) of the patients had known about their asthma illness for more than four years. Mean annual direct cost of asthma care was US$368.4 (±228) per patient. Medication cost accounted for the majority (87%) of this cost. Patient costs of care incurred did not differ significantly across age (P = 0.15), education (P = 0.23), marital status (0.49), residence (P = 0.47), or gender (P = 0.65) categories. We conclude that direct cost of care was found to be substantial among poorly controlled asthma patients. Further studies to estimate the costs incurred by patients with exacerbation and differing severity of the disease should be conducted.

Effect of Covid-19 Pandemic on Non-Covid illness in the General population of Pakistan

2021 ◽  
Vol 15 (11) ◽  
pp. 2879-2881
Author(s):  
Zorain Mustafa Khalil ◽  
Jannat Sardar Sheikh ◽  
Bismah Riaz ◽  
Mohammad Salman Imtiaz ◽  
Anum Arif ◽  
...  
Keyword(s):  
Health Center ◽  
Medical Condition ◽  
Cross Sectional Study ◽  
Medical Attention ◽  
Health Seeking ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Middle Income ◽  
Long Term Impact

Aim: The goal of this study was to examine the influence of the Covid-19 pandemic 2020 on the health-seeking behavior of the general public in a lower-middle-income nation like Pakistan by looking at the availability, accessibility, and usage of health infrastructure. Methodology: In this cross-sectional study, 394 Pakistani patients completed an online questionnaire measuring their willingness to seek medical treatment, reporting for follow-up visits, and the ease of getting medical care about their medical condition, both before and after the pandemic. The information was then examined. Results: During the pandemic, 21.8 percent of patients visited a health center for follow-up. Fear of infection from the health institution kept 20.3 percent of patients from showing up for follow-up. 17.5 percent of patients had significant symptoms from their underlying sickness but delayed going to the doctor due to the fear of the virus. Patients' appointments were canceled or rescheduled in 20.1 percent of cases, while 54.1 percent did not feel the need to visit a health center. Conclusion: Fear of the virus, lockdowns, limitations, and other reasons have resulted in a substantial proportion of the population avoiding ER/health facility visits while suffering symptoms that necessitate medical attention. The long-term impact on a developing country's healthcare system, such as Pakistan, will be negative unless extraordinary steps are made to provide safe, accessible, and cheap health care during the epidemic. Keywords: Barrier, comorbidities, COVID-19, healthcare, pandemic

scholarly journals Long-term prognosis of new adult-onset asthma in obese patients

2020 ◽  
pp. 2001209
Author(s):  
Pinja Ilmarinen ◽  
Adrienn Pardo ◽  
Leena E. Tuomisto ◽  
Iida Vähätalo ◽  
Onni Niemelä ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Oral Corticosteroid ◽  
Normal Weight ◽  
Adult Onset ◽  
Cross Sectional ◽  
Asthma Patients ◽  
Long Term Prognosis ◽  
Poor Outcomes

BackgroundObesity has been associated with poor outcomes of asthma in cross-sectional studies but long-term effect of obesity on asthma remains unknown.AimsTo study the effects of obesity, found at the time of diagnosis of adult-onset asthma, on 12-year prognosis by focusing on oral corticosteroid (OCS) use and respiratory-related hospital admissions.MethodsPatients diagnosed with adult-onset asthma (n=203) were divided into three categories based on diagnostic BMI (<25, 25–29.9, ≥30 kg·m−2) and followed for 12-years as part of Seinäjoki Adult Asthma Study. Self-reported and dispensed OCS were assessed for the 12-year period. Data on hospital admissions were analysed based on medical records.Results12 years after diagnosis, of the patients obese (≥30 kg·m−2) at diagnosis, 86% remained obese. During the follow-up, no difference was found in the weight gain between the BMI categories. During the 12-year follow-up, patients obese at diagnosis reported more often use of OCS courses (46.9% versus 23.1%, p=0.028), were dispensed OCS more often (81.6% versus 56.9%, p=0.014) and at higher doses (median 1350 (IQR 280–3180)mg versus 600 (0–1650)mg prednisolone, p=0.010) compared to normal-weight patients. Furthermore, obese had more often ≥1 respiratory-related hospitalisation compared to normal-weight patients (38.8% versus 16.9%, p=0.033). In multivariate logistic regression analyses, obesity predicted oral corticosteroid use and hospital admissions.ConclusionsIn adult-onset asthma, patients obese at diagnosis mostly remained obese at long-term and had more exacerbations and respiratory-related hospital admissions compared to normal-weight patients during 12-year follow-up. Weight loss should be a priority in their treatment to prevent this outcome.

scholarly journals Opportunity costs of attending surgical clinic appointments and experiences with telemedicine for follow-up care

2021 ◽  
Vol 9 ◽  
pp. 205031212110452
Author(s):  
Mitchell D Thatcher ◽  
Michael W Thatcher ◽  
Mckinley C Smith ◽  
Michelle McCarron ◽  
Jeremy Reed
Keyword(s):  
Cross Sectional Study ◽  
Ease Of Use ◽  
Phone Call ◽  
Opportunity Costs ◽  
Diagnostic Ability ◽  
Cross Sectional ◽  
Follow Up Care ◽  
Yard Care ◽  
Surgical Clinic

Objectives: Telemedicine has been rapidly implemented in orthopedics during the coronavirus (COVID-19) pandemic. The purpose of this study was to quantify opportunity costs for patients attending typical in-person appointments and understand their perceptions of telemedicine for follow-up care. Methods: A cross-sectional study was performed by surveying patients who had elective orthopedic surgery and attended at least one in-person and one phone call appointment. The survey assessed opportunity costs associated with in-person appointments, experience with telemedicine, and preferred type of future appointment. Results: Of the 49 eligible patients, 41 (83.7%) completed the survey. The median travel distance to the clinic was 108 km, and the time spent in the clinic was 60 min. Participants responded “yes” to various forms of opportunity costs associated with attending in-person appointments, including missed work (46.3%), lost income (34.1%), recreational activities (26.8%), home or yard care (14.6%), socializing with friends or family (12.2%), school (2.4%), and childcare (2.4%). In addition, elements of the telemedicine appointment were rated from 1 (least favorable) to 10 (most favorable), and averages were calculated for ease of use (9.2), convenience (8.4), confidence in the doctor’s diagnostic ability (8.2), likelihood of using the service again (6.4), and overall satisfaction (8.2). Preferred future appointment types included having the first visit in-person and subsequent visits via telephone (61.0%), in-person only (36.6%), and unsure (2.4%). Conclusion: This study identifies various opportunity costs associated with in-person orthopedic appointments and a favorable view toward telemedicine for follow-up care.

scholarly journals Screening and follow-up care for cognitive and emotional problems after transient ischaemic attack and ischaemic stroke: a national, cross-sectional, online survey among neurologists in the Netherlands

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046316
Author(s):  
Jos Slenders ◽  
Renske Van den Berg-Vos ◽  
Johanna Visser-Meily ◽  
Caroline van Heugten ◽  
Vincent Kwa
Keyword(s):  
Clinical Practice ◽  
Ischaemic Stroke ◽  
Transient Ischaemic Attack ◽  
Online Survey ◽  
Emotional Problems ◽  
Information Provision ◽  
Cross Sectional ◽  
Follow Up Care ◽  
Ischaemic Attack

BackgroundAfter stroke, many patients experience cognitive and/or emotional problems. While national guidelines recommend screening for these problems, actual screening rates might be limited.ObjectiveThis study aimed to examine the clinical practice at neurology departments regarding screening, information provision and follow-up care for cognitive and emotional problems after transient ischaemic attack (TIA) and ischaemic stroke.MethodsA nationwide, cross-sectional, online survey was conducted between October 2018 and October 2019 among neurologists in all hospitals in the Netherlands.ResultsNeurologists in 78 hospitals were invited to join the survey, and 52 (67%) of them completed it. Thirty-one (59%) neurologists reported that screening for cognitive problems after TIA and ischaemic stroke was mostly or always performed. When cognitive screening was performed, 42 (84%) used validated screening instruments. Twenty-nine (56%) of the respondents reported that screening for emotional problems was mostly or always performed. When emotional screening was performed, 31 (63%) reported using validated screening instruments. Timing of screening and information provision was highly variable, and the majority reported that there was no protocol for follow-up care when cognitive or emotional problems were found.ConclusionsThis study demonstrates that clinical practice at neurology departments is highly variable regarding screening, information provision and follow-up care for cognitive and emotional problems in patients after TIA or ischaemic stroke. Approximately half of the participating neurologists reported that screening was performed only sometimes or never for cognitive and emotional problems after TIA and ischaemic stroke.

scholarly journals The Use of Telemedicine Access to Schools to Facilitate Expert Assessment of Children with Asthma

2008 ◽  
Vol 2008 ◽  
pp. 1-7 ◽  
Author(s):  
David A. Bergman ◽  
Paul J. Sharek ◽  
Kathryn Ekegren ◽  
Shannon Thyne ◽  
Michelle Mayer ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Physician ◽  
Expert Assessment ◽  
Asthma Care ◽  
School Based ◽  
Follow Up Care ◽  
Children With Asthma ◽  
Asthma Outcomes ◽  
Improve Access

Research has shown that access to an asthma specialist improves asthma outcomes. We hypothesized that we could improve access to expert asthma care through a telemedicine link between an asthma specialist and a school-based asthma program. We conducted a prospective cohort study in 3 urban schools to ascertain the feasibility of using an asthma-focused telemedicine solution. Each subject was seen by an asthma expert at 0, 8, and 32 weeks. The assessment and recommendations for care were sent to the primary care physician (PCP) and parents were told to contact their physician for follow-up care. Eighty three subjects participated in the study. Subjects experienced improvement (P<.05) in family social activities and the number of asthma attacks. Ninety four percent of subjects rated the program as good or excellent. This study demonstrates the feasibility and acceptance of a school-based asthma program using a telemedicine link to an asthma specialist.

scholarly journals Obstetric Danger Signs: Knowledge, Attitude, Health-Seeking Action, and Associated Factors among Postnatal Mothers in Nekemte Town, Oromia Region, Western Ethiopia—A Community-Based Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Misganu Teshoma Regasa ◽  
Jote Markos ◽  
Ashenafi Habte ◽  
Shivaleela P. Upashe
Keyword(s):  
Cross Sectional Study ◽  
Knowledge Level ◽  
Sectional Study ◽  
Danger Sign ◽  
Health Seeking ◽  
Community Based ◽  
Cross Sectional ◽  
Obstetric Danger Signs ◽  
Danger Signs

Background. Maternal mortality remains unacceptably high due to pregnancy complications and remains the major health problems in many developing countries such as Ethiopia. Having poor knowledge of obstetric danger signs contributes to delays in seeking and receiving skilled care which in turn increases maternal mortality. However, in Ethiopia, studies are lacking regarding the knowledge level of mothers about obstetric danger signs during pregnancy, child birth, and postnatal periods. In Ethiopia, the proportion of those who have full knowledge of these obstetric danger signs during pregnancy, child birth, and postnatal period is not known. Despite few studies are conducted at health facility level focusing on danger signs during pregnancy, the issue of health-seeking action after identifying danger signs and attitude of mothers towards obstetric danger sign was not addressed. Objectives. To determine knowledge, attitude, health-seeking action towards obstetric danger signs, and associated factors among postpartum women. Methods.A community-based cross-sectional study was conducted in Nekemte Town from October 1 to November 30, 2017. Multistage sampling technique was employed to select the total sample size of 621. Ethical clearance was obtained from Wollega University research and ethical committee. A pretested structured questionnaire was used to collect data from respondents. Data were entered to EpiData version 3.1 and exported to SPSS version 20 for analysis. To assess the associations between dependent and independent variables, binary and multivariate logistic regressions were employed, and the strength of association was presented using odds ratios with 95% confidence intervals. Result. Only 197 (32.3%) of respondents were able to spontaneously mention at least five key obstetric danger signs during antepartum, intrapartum, and postpartum (in the three phases) with at least one obstetric danger sign in each phase and thus were considered as having good knowledge of key obstetric danger signs. Government employee (AOR = 3.28, 95% CI: 1.98–5.42), able to read and write (AOR = 4.92, 95% CI: 2.14–11.3), primary school (AOR = 4.90, 95% CI: 2.11–11.4), ANC follow-up (AOR = 6.2, 95% CI: 1.82–21.21), and ANC visit (AOR = 4.07, 95% CI: 2.35–7.06) were significantly associated with knowledge of obstetric danger sign. From 150 (24.6%) participants who faced obstetric danger signs during their last pregnancy, the majority of them, 137 (91.3%), had a good practice which is seeking a health facility for care. Conclusion and Recommendation. Despite their low knowledge level and attitude, the practice of mothers in response to obstetric danger signs was encouraging. Occupation, educational status, ANC follow-up, and number of ANC visits were variables significantly associated with knowledge of obstetric danger signs. Health care providers should provide health education and counseling to increase awareness, and appropriate counseling during antenatal care at each visit is of paramount importance.

Virtual vs traditional care settings for low-acuity urgent conditions: An economic analysis of cost and utilization using claims data

2019 ◽  
pp. 1357633X1986123
Author(s):  
Tim Lovell ◽  
Jordan Albritton ◽  
Joe Dalto ◽  
Cheryl Ledward ◽  
William Daines
Keyword(s):  
Primary Care ◽  
Emergency Care ◽  
Antibiotic Use ◽  
Cost Of Care ◽  
Urgent Care ◽  
Cross Sectional ◽  
Care Programme ◽  
Virtual Care ◽  
Virtual Visits

Background On-demand, direct-to-consumer video (or virtual) visits represent one of the fastest growing telemedicine services. Due to the absence of an in-person physical examination, some question the effectiveness, efficiency and value of virtual care visits. To address these questions, we conducted a retrospective, cross-sectional review of Intermountain Healthcare’s virtual care programme. Method This study used SelectHealth claims for virtual, urgent, primary and emergency care delivered between 1 April 2016–31 March 2017. We included all claims with primary diagnosis from the nine most common categories for virtual care. A secondary data source included survey data indicating how virtual visits redirect care. Results We matched 1531 virtual visit claims with claims from urgent (4377), primary (4388) and emergency care (2285). There were no differences in follow-up rates between virtual and urgent care and no differences in antibiotic use between virtual and urgent or primary care. Virtual care was significantly lower than all other care settings in utilization of laboratory and imaging services, index visit cost and total costs over 21 days. Conclusions This study affirmed lower cost for virtual care without an associated increase in overall follow-up rates or antibiotic use when compared with urgent or primary care. This suggests that virtual visits are can be used to lower the total cost of care for applicable conditions. The implications are that virtual visits help lower operational costs of providing care, particularly in integrated systems with capitated reimbursement. Under the right circumstances, the increased adoption of virtual care should lead to greater savings.

Factors Influencing a Community Pharmacist's Interventions in Asthma Care

2009 ◽  
Vol 142 (5) ◽  
pp. 240-246 ◽  
Author(s):  
Natalie Nadaira ◽  
Catherine Ouellet ◽  
Nola René-Henri ◽  
Yvonne Khamla ◽  
Johanne Collin ◽  
...  
Keyword(s):  
Patient Education ◽  
Focus Group ◽  
Drug Monitoring ◽  
Community Pharmacists ◽  
Asthma Care ◽  
Support Materials ◽  
Factors Influencing ◽  
Asthma Patients ◽  
Definition Of

Background: Little is known about current pharmacists' interventions related to drug counselling and monitoring in asthma, along with the barriers and facilitators to these, in the province of Quebec. Objectives: To identify and explore organizational, relational and professional factors that influence community pharmacists' interventions in asthma care and propose solutions to overcome the barriers to these interventions. Methods: In 2006, a survey and an invitation to participate in a focus group were sent to community pharmacists in Quebec. Three focus groups were held to discuss the results of the survey about community pharmacists' interventions in asthma and the factors influencing these interventions, along with solutions to identified barriers. Each focus group lasted for approximately 120 minutes and was moderated by 2 investigators. Results: Seventeen community pharmacists participated in the study. One focus group was held with pharmacy owners, 1 with salaried pharmacists who graduated before 1990 and 1 with salaried pharmacists who graduated after 1996. Owners and salaried pharmacists of different years of graduation generally made the same comments. Most pharmacists reported intervening with asthma patients, especially when initial prescriptions were filled. Lack of time and unclear definition of tasks were reported as barriers. Solutions were proposed to resolve barriers, such as clearly defining tasks and ensuring quick access to support materials for patient education and drug monitoring. Conclusion: Community pharmacists report intervening in asthma care mostly when patients fill their initial prescription. Several barriers to follow-up interventions were identified.

scholarly journals FACTORS CONTRIBUTING FOR NONCOMPLIANCE OF FOLLOW-UP CARE AMONG POST CARDIAC PATIENTS

2019 ◽  
pp. 22-25
Author(s):  
THENMOZHI P. ◽  
PRIYA T.
Keyword(s):  
Physical Activity ◽  
Medication Adherence ◽  
Health Care Providers ◽  
Lifestyle Changes ◽  
Cardiac Patients ◽  
Care Providers ◽  
Cross Sectional ◽  
Activity Schedule ◽  
Follow Up Care

Objective: Compliance in following healthy diet, physical activity schedule, cessation of smoking and alcohol, medication adherence and regular follow up is very essential component in the management of patients with cardiovascular disease to prevent reoccurrence and reduce mortality. Hence the study was conducted with the aim to assess the factors contributing for noncompliance of follow-up care among post cardiac patients. Methods: Cross-sectional research design was employed with 50 samples who matched the inclusion criteria were selected by convenience sampling technique. Demographic variables data were collected by using structured questionnaire followed by assessed the factors contributing for noncompliance using checklist. Results: The findings of the current study revealed that all physical, psychological, economical, social and spiritual factors were highly influenced the noncompliance. Of these, the highest percentage 80% reported lack of accessibility as well financial support and around 70% percentage reported side effects of medication and low health literacy. Conclusion: Health care providers need to be focussed on interventional strategies especially health education in discharge plan to ensure that these patients adhere to follow up including medication adherence, following physical activity plan, dietary modification, lifestyle changes and regular follow up visit to prevent readmission and lead a successful life.

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