scholarly journals Western or Traditional Healers? Understanding Decision Making in the Hmong Population

2016 ◽  
Vol 39 (3) ◽  
pp. 400-415 ◽  
Author(s):  
Maichou Lor ◽  
Phia Xiong ◽  
Linda Park ◽  
Rebecca J. Schwei ◽  
Elizabeth A. Jacobs
Keyword(s):  
Health Care ◽  
Cultural Values ◽  
Treatment Options ◽  
The United States ◽  
Traditional Healers ◽  
Care Utilization ◽  
Structured Interviews ◽  
Host Countries ◽  
Traditional Health ◽  
Health Care Encounters

Research has documented the influence of cultural values, beliefs, and traditional health practices on immigrants’ health care utilization in their host countries. We describe our findings of how Hmong immigrants to the United States make decisions about whether and when to use traditional and/or Western health services. We conducted semi-structured interviews with 11 Hmong adults. We found their decisions depended on whether they classified the illness as spiritual or not and how they evaluated the effectiveness of different treatment options for their illness. Hmong participants’ expectations for effective treatment in traditional or Western health care encounters combined with physical evidence of an illness influenced their decisions and often led them to shift from one type of care to the other. Understanding cultural differences in perceptions of the causes of illnesses and the link between perceived cause and treatment is important to improving care for the Hmong population.

Health Outcomes and Health Care Utilization Among Obstetric Deliveries With Concurrent CKD in the United States

2020 ◽  
Vol 75 (1) ◽  
pp. 148-150 ◽  
Author(s):  
Andrea L. Oliverio ◽  
Lindsay K. Admon ◽  
Laura H. Mariani ◽  
Tyler N.A. Winkelman ◽  
Vanessa K. Dalton
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Utilization ◽  
Health Outcomes ◽  
The United States ◽  
Care Utilization

Real Men Do…Real Men Don’t: Young Latino and African American Men’s Discourses Regarding Sexual Health Care Utilization

2009 ◽  
Vol 4 (3) ◽  
pp. 218-230 ◽  
Author(s):  
Debra Kalmuss ◽  
Karen Austrian
Keyword(s):  
Health Care ◽  
African American ◽  
Sexual Health ◽  
African American Men ◽  
The United States ◽  
Care Utilization ◽  
Care Seeking ◽  
Sexual Health Care ◽  
New Directions ◽  
The Relationship

There is growing recognition that men as well as women need sexual health care (SHC) services. Despite this, male friendly sexual health services are not readily available in the United States, and men are underutilizing the services that are available. This situation needs to be rectified to improve sexual health outcomes for men and women. In this study we conducted 10 focus groups with young adult Latino and African American men to examine their perceptions of the factors influencing SHC utilization among the men they know, with an emphasis on how notions of what it means to be a man affects health care seeking. The findings both amplify and complicate the relationship between masculinity and SHC seeking. They suggest new directions for public health efforts to enhance men’s SHC utilization.

Ethnomedicines for Diarrhoea and Dysentery by the tribals of Visakhapatnam District, Andhra Pradesh

2019 ◽  
Vol 26 (1) ◽  
pp. 49-54
Author(s):  
P. Naidu ◽  
P. Yadav
Keyword(s):  
Health Care ◽  
Medicinal Plants ◽  
Andhra Pradesh ◽  
Low Cost ◽  
Traditional Healers ◽  
Eastern Ghats ◽  
Tribal Community ◽  
Traditional Health ◽  
Traditional Health Care ◽  
Visakhapatnam District

Traditional health care system is practiced by indigenous tribal community inhabiting Eastern Ghats of Visakhapatnam district in Andhra Pradesh. Diarrhoea and Dysentery are prevalent causing morbidity and mortality. This study documented 62 medicinal plants used locally for the treatment of diarrhoea and dysentery. The traditional healers provide safe and low cost remedies accumulated, enriched and passed on through generations without any written documentation.

scholarly journals Quantified Kinematics to Evaluate Patient Chemotherapy Risks in Clinic

2020 ◽  
pp. 583-601
Author(s):  
Zaki Hasnain ◽  
Tanachat Nilanon ◽  
Ming Li ◽  
Aaron Mejia ◽  
Anand Kolatkar ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Motion Capture ◽  
Performance Status ◽  
Area Under The Curve ◽  
The United States ◽  
Clinic Visit ◽  
Activity Levels ◽  
Health Care Encounters ◽  
The Right

PURPOSE Performance status (PS) is a key factor in oncologic decision making, but conventional scales used to measure PS vary among observers. Consumer-grade biometric sensors have previously been identified as objective alternatives to the assessment of PS. Here, we investigate how one such biometric sensor can be used during a clinic visit to identify patients who are at risk for complications, particularly unexpected hospitalizations that may delay treatment or result in low physical activity. We aim to provide a novel and objective means of predicting tolerability to chemotherapy. METHODS Thirty-eight patients across three centers in the United States who were diagnosed with a solid tumor with plans for treatment with two cycles of highly emetogenic chemotherapy were included in this single-arm, observational prospective study. A noninvasive motion-capture system quantified patient movement from chair to table and during the get-up-and-walk test. Activity levels were recorded using a wearable sensor over a 2-month period. Changes in kinematics from two motion-capture data points pre- and post-treatment were tested for correlation with unexpected hospitalizations and physical activity levels as measured by a wearable activity sensor. RESULTS Among 38 patients (mean age, 48.3 years; 53% female), kinematic features from chair to table were the best predictors for unexpected health care encounters (area under the curve, 0.775 ± 0.029) and physical activity (area under the curve, 0.830 ± 0.080). Chair-to-table acceleration of the nonpivoting knee ( t = 3.39; P = .002) was most correlated with unexpected health care encounters. Get-up-and-walk kinematics were most correlated with physical activity, particularly the right knee acceleration ( t = −2.95; P = .006) and left arm angular velocity ( t = −2.4; P = .025). CONCLUSION Chair-to-table kinematics are good predictors of unexpected hospitalizations, whereas the get-up-and-walk kinematics are good predictors of low physical activity.

scholarly journals Bundle Payment, Health Care Utilization, and Outcomes Following Surgery for Anterior, Middle, and Posterior Cranial Fossa Skull Base Meningioma: A Market Scan Analysis

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Mayur Sharma ◽  
Beatrice Ugiliweneza ◽  
Maxwell Boakye ◽  
Norberto O Andaluz ◽  
Brian J Williams
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Hospital Stay ◽  
Complication Rate ◽  
The United States ◽  
Posterior Cranial Fossa ◽  
Care Utilization ◽  
Outpatient Services ◽  
Significant Difference ◽  
Cranial Fossa

Abstract INTRODUCTION Meningioma is the most common benign intracranial brain tumor accounting for approximately one-third of all primary brain tumors. The aim of our study was to compare the bundle payment, health care utilization, and outcomes following surgery for anterior (AFM), middle (MFM), and posterior cranial fossa meningioma (PFM) across the United States. METHODS We queried the Market Scan database using ICD-9 and CPT-4, from 2000 to 2016. We included adult patients who had at least 24 mo of enrollment following the surgical procedure. The outcome of interest was length of hospital stay, disposition, complications, and reoperation following the procedure. RESULTS A cohort of 1,188 patients was identified from the database. In all 43.86% of tumors were AFM, 32.32% were MFM, and only 23.8% were PFM. Patients who underwent surgery for PFM had significant longer hospital stay (P = .0013), higher complication rate (P = .0009), and less likely to be discharged home (P = .0013) during index hospitalization. Patients with MFM and PFM incurred higher outpatient services with no differences in corresponding payments compared to those with AFM at 12 mo (P < .0001) and 24 mo follow-up (P < .0001). There were no differences in overall payments at 12 mo (AFM: $19,702; MFM: $20,671; PFM: $20,922) and 24 mos (AFM: $37,142; MFM: $44,133; PFM: $36,601) among the cohorts. There was no significant difference in 90-d median bundle payments among the groups, $66,173 (AFM) vs $65,602 (MFM), and $71,837 (PFM), P = .1955. CONCLUSION Ninety-day bundle payment and overall payments (at 12 mo and 24 mo) were not significantly different among the cohorts. Patients with PFM had longer hospital stay, higher complication rate, and less likely to be discharged home with higher utilization of outpatient services at 12 mo and 24 mo.

scholarly journals Predictors of High Health Care Utilization in Patients With Inflammatory Bowel Disease Within 1 Year of Establishing Specialist Care

2020 ◽  
Author(s):  
Kenechukwu Chudy-Onwugaje ◽  
Alexander P Mamunes ◽  
David A Schwartz ◽  
Sara Horst ◽  
Raymond K Cross
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Health Care Utilization ◽  
Bowel Disease ◽  
The United States ◽  
Care Utilization ◽  
Medical Assistance ◽  
High Utilizers ◽  
Inflammatory Bowel ◽  
Hospital Visits

Abstract Background A small proportion of patients with inflammatory bowel disease (IBD) consume a disproportionate amount of health care resources, with most of these spent on unplanned care in emergency room (ER) and hospital visits. Interventions in those at high risk in the outpatient setting could reduce the need for future inpatient care. We sought to describe the characteristics predictive of high health care utilization within 1 year after an initial IBD clinic encounter. Methods This was a retrospective study of new IBD patients seen at the outpatient clinics of 2 tertiary IBD centers in the United States. Baseline sociodemographic and clinical characteristics were collected, and the number of IBD-related ER and hospital visits were recorded over the 1-year period after the initial clinic encounter. Patients with ≥2 visits (high utilizers) were compared with those with no visits. Results Of the 735 patients included in the final analysis, 106 (14.4%) were high utilizers, and they had a mean of 2.9 visits (maximum = 10) in the 1 year after their initial encounter. In multivariate analysis, insurance coverage through medical assistance (odds ratio [OR] 3.57; 95% confidence interval [CI], 1.38–9.20), steroid use (OR 1.83; 95% CI, 1.11–3.04), short inflammatory bowel disease questionnaire score &lt;50 (OR 2.29; 95% CI, 1.23–4.27), and current ostomy (OR 4.82; 95% CI, 1.51–15.37) were independently associated with high utilization. Conclusions Multidisciplinary care and resources should be preferentially channeled towards new clinic patients with severe disease and on medical assistance, as this could reduce future inpatient visits and result in cost savings.

scholarly journals Health Care Utilization and Expenditures Attributable to Cigar Smoking Among US Adults, 2000-2015

2018 ◽  
Vol 133 (3) ◽  
pp. 329-337 ◽  
Author(s):  
Yingning Wang ◽  
Hai-Yen Sung ◽  
Tingting Yao ◽  
James Lightwood ◽  
Wendy Max
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Home Care ◽  
Smokeless Tobacco ◽  
Health Care Expenditures ◽  
The United States ◽  
Health Concern ◽  
Care Utilization ◽  
Ed Visits ◽  
Cigar Smoking

Objectives: Cigar use in the United States is a growing public health concern because of its increasing popularity. We estimated health care utilization and expenditures attributable to cigar smoking among US adults aged ≥35. Methods: We analyzed data on 84 178 adults using the 2000, 2005, 2010, and 2015 National Health Interview Surveys. We estimated zero-inflated Poisson (ZIP) regression models on hospital nights, emergency department (ED) visits, physician visits, and home-care visits as a function of tobacco use status—current sole cigar smokers (ie, smoke cigars only), current poly cigar smokers (smoke cigars and smoke cigarettes or use smokeless tobacco), former sole cigar smokers (used to smoke cigars only), former poly cigar smokers (used to smoke cigars and smoke cigarettes or use smokeless tobacco), other tobacco users (ever smoked cigarettes and used smokeless tobacco but not cigars), and never tobacco users (never smoked cigars, smoked cigarettes, or used smokeless tobacco)—and other covariates. We calculated health care utilization attributable to current and former sole cigar smoking based on the estimated ZIP models, and then we calculated total health care expenditures attributable to cigar smoking. Results: Current and former sole cigar smoking was associated with excess annual utilization of 72 137 hospital nights, 32 748 ED visits, and 420 118 home-care visits. Annual health care expenditures attributable to sole cigar smoking were $284 million ($625 per sole cigar smoker), and total annual health care expenditures attributable to sole and poly cigar smoking were $1.75 billion. Conclusions: Comprehensive tobacco control policies and interventions are needed to reduce cigar smoking and the associated health care burden.

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