scholarly journals The Evolution of Income-Related Inequalities in Health Care Utilization in Switzerland Over Time

2004 ◽  
Author(s):  
Robert E. Leu ◽  
Martin Schellhorn
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Inequalities In Health ◽  
Over Time

Results from year 1 of an embedded supportive oncology practice.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 40-40
Author(s):  
Bethann Scarborough ◽  
Emily Chai ◽  
Randall F. Holcombe ◽  
Eric Lee ◽  
Nathan Goldstein
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Utilization ◽  
Symptom Management ◽  
Care Utilization ◽  
First Year ◽  
Goals Of Care ◽  
Supportive Oncology ◽  
Oncology Practice ◽  
Over Time

40 Background: We present the findings from our first year of a Supportive Oncology practice embedded in a quaternary care center’s outpatient cancer practice. Methods: One palliative medicine physician saw patients 4 days per week. Oncologists made referrals for symptom management, psychosocial support, advance care planning, or by predetermined triggers for palliative care. Results: 239 patients were referred for a total of 821 visits. Palliative care referrals increased over time; 0.6% of the cancer center’s patients were referred in the first quarter and 1.5% were referred in the third quarter. Referral reasons included symptom management/support (90%), goals of care (5%), or triggers (6%). Six to 9 symptoms were addressed at 41% of visits. Sixteen percent of patients initially referred for symptoms were later seen for conversations regarding goals of care. Of these patients, 76% discussed goals of care with their oncologist, 61% were referred to hospice and 47% enrolled in hospice. Supportive oncology visits were associated with decreased health care utilization, with a downward trend in Emergency Department visits (0.82 vs. 0.72 per patient) and inpatient admissions (0.91 vs. 0.84 per patient) after the initial palliative care visit compared to use before the visit. Approximately 17% of all Supportive Oncology patients enrolled in hospice. Conclusions: Our first year of an embedded palliative care practice focused on building collaborative relationships. The steady referral growth over time indicates that oncologists increasingly accepted the program. While only a small proportion of patients were referred, the high visit complexity reflects this population’s acuity. Decreased health care utilization may be due to better symptom control or care aligned with patients’ values. Early referrals for symptom management facilitate goals of care discussions later on, and the importance of delivering a unified message on treatment options is seen in the hospice referral rate of 61% for the subset of patients who discussed goals of care with palliative care and oncology. Embedding palliative care in oncology fosters expert symptom management, seamless communication, and trusting relationships between oncologists, palliative care, and patients.

scholarly journals Burden of Active Tuberculosis in an Integrated Health Care System, 1997–2016: Incidence, Mortality, and Excess Health Care Utilization

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Paul Y Wada ◽  
Christian Lee-Rodriguez ◽  
Yun-Yi Hung ◽  
Jacek Skarbinski
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Active Tuberculosis ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
First Year ◽  
Potential Value ◽  
Outpatient Visits ◽  
Integrated Health Care System ◽  
Over Time

Abstract Active tuberculosis (TB) is preventable. To quantify the potential value of prevention, we assessed active TB burden in a large health system from 1997 to 2016. Compared with a matched non-TB cohort, patients with active TB had higher mortality (8.4% vs 1.3%), mean number of hospitalizations (0.55 vs 0.10), emergency department visits (0.78 vs 0.28), and outpatient visits (14.6 vs 5.9) in the first year. TB-associated hospital use (mean number of hospitalizations and total length of stay) increased from 1997–2000 compared with 2013–2016 despite decreasing active TB incidence. Active TB is associated with high mortality and health care utilization and has remained stable or increased over time.

scholarly journals Diagnosing Asthma: The Fit between Survey and Administrative Database

2002 ◽  
Vol 9 (6) ◽  
pp. 407-412 ◽  
Author(s):  
Lisa Huzel ◽  
Leslie L Roos ◽  
Nick R Anthonisen ◽  
Jure Manfreda
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Population Studies ◽  
Administrative Database ◽  
Care Utilization ◽  
Physician Visits ◽  
The Past ◽  
Asthma Symptoms ◽  
Trends Over Time ◽  
Over Time

BACKGROUND:Standard methods for population studies of asthma include surveying population samples using questionnaires and examining people in laboratories. These procedures are extremely expensive. It would be helpful if, at least for some purposes, they could be replaced by cheaper techniques with adequate validity. OBJECTIVES: To determine agreement between survey and database in regard to the prevalence of asthma.METHODS: Responses to survey questions about asthma symptoms in the past 12 months were linked to physician claims in the Manitoba Population Health Repository.RESULTS: The overall agreement was moderate (κ=0.45 to 0.50) and increased if two years of physician claims were studied (κ=0.55 to 0.59); studying additional years had no further effect on agreement. Sex and smoking did not significantly affect the kappa scores.CONCLUSIONS: There were several plausible reasons for discrepancies. Symptoms recorded on the survey were intrinsically different from those recorded for physician visits. Physicians also used other respiratory codes instead of asthma, and survey participants did not see a physician every year for asthma. The estimates of prevalence derived from the survey and the administrative database included two overlapping groups of people. In each, the diagnosis of asthma seems justifiable, although the agreement between the two groups was only moderate to substantial. Both methods are useful, although they are useful for different purposes. Health care utilization estimates may be particularly useful for studying trends over time.

scholarly journals Income-related inequalities in health care utilization in Mongolia, 2007/2008–2012

2015 ◽  
Vol 14 (1) ◽  
Author(s):  
Javkhlanbayar Dorjdagva ◽  
Enkhjargal Batbaatar ◽  
Bayarsaikhan Dorjsuren ◽  
Jussi Kauhanen
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Inequalities In Health

scholarly journals Health Service Use among Individuals with Depression and Psychological Distress: A Population-Based Cohort Study in Ontario, Canada: Utilisation des services de santé par les personnes souffrant de dépression et de détresse psychologique : une étude de cohorte dans la population de l’Ontario, Canada

2020 ◽  
Vol 65 (9) ◽  
pp. 641-651
Author(s):  
Maria Chiu ◽  
Farah E. Saxena ◽  
Paul Kurdyak ◽  
Andrew S. Wilton ◽  
Simone N. Vigod
Keyword(s):  
Health Care ◽  
Psychological Distress ◽  
Health Care Utilization ◽  
Acute Care ◽  
Care Utilization ◽  
Services De Santé ◽  
Unexposed Group ◽  
Utilisation Des Services ◽  
Over Time

Objectives: Relatively little is known about how health-care utilization differs among individuals with psychological distress compared to those with major depressive disorder (MDD). Methods: Ontario participants of the Canadian Community Health Survey Cycle 1.2 (2002) were linked to health administrative data to follow their health-care utilization patterns for up to 15 years. Based on their survey responses, we classified individuals hierarchically into Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria MDD, psychological distress (Kessler-6: 8 to 24), or an unexposed group with neither condition. We compared the rates of outpatient and acute care mental and nonmental health-related visits across the 3 groups over time using Poisson regression. Results: Among the 430 individuals with MDD, 668 with psychological distress, and 9,089 in the unexposed group, individuals with MDD and psychological distress had higher rates of health-care utilization than the unexposed overall and across time. The rates of psychiatrist visits for the MDD group were significantly higher than the other groups initially but declined over the follow-up. Conversely, the rates of psychiatrist visits among the psychological distress group increased over time and converged with that of the MDD group by the end of follow-up (rate ratioMDD vs. psychological distress at 1 year: 4.20 [1.97 to 11.40]; at 15 years: 1.53 [0.54 to 4.08]). Acute care visits were similar between the MDD and psychological distress groups at all time points. Conclusions: Individuals with psychological distress required mental health care rivalling that of individuals with MDD over time, suggesting that even a cross-sectional assessment of significant psychological distress is a serious clinical concern.

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