Health services utilization of people having and not having a regular doctor in Canada

Thanh, Nguyen Xuan; Rapoport, John

doi:10.1002/hpm.2338

Cited by 9 publications

(7 citation statements)

References 19 publications

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“…Multiple strategies may have a role in increasing the continuity of care and quality of care and improving patient outcomes, many of which may reduce hospitalization and ED visits of African American older adults with multiple CMCs. While the index condition (DM) is important, improving self-management of other comorbid conditions such as heart disease, hypertension, and asthma should not be discounted [59]. Such interventions may reduce health disparities among undeserved minority older adults with multiple comorbid conditions.…”

Section: Discussionmentioning

confidence: 99%

Poor Self-Rated Health Is Associated with Hospitalization and Emergency Department Visits in African American Older Adults with Diabetes

Assari

Smith

Bazargan

2020

J. Racial and Ethnic Health Disparities

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Objectives We investigated the associations between poor self-rated health (SRH), hospitalization, and emergency department (ED) visits among African American older adults with diabetes mellitus (DM). Methods This survey recruited 235 non-institutionalized African American older adults (age > = 55 years) with diabetes mellitus (DM). Participants were recruited using a convenience sample from economically disadvantaged urban areas of South Los Angeles, California. Poor SRH was the independent variable. Hospitalization and ED visits in the past 12 months were the outcomes. Demographic factors, health [comorbid medical conditions (CMCs) and polypharmacy], health behaviors (smoking and drinking), and access (difficulty accessing care, dissatisfaction with the medical care, routine source of care, and visiting the same doctor) were confounders. Binary logistic regressions were used for data analysis. Results Poor SRH was associated with higher odds of hospitalization and ED visit, while all covariates were controlled. Conclusions Poor SRH may be predictive of increased healthcare utilization among African American older adults with DM. Research should test whether close monitoring of African American older adults with DM and poor SRH helps reduce their frequency of hospitalization and ED visits or not.

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Section: Discussionmentioning

confidence: 99%

Poor Self-Rated Health Is Associated with Hospitalization and Emergency Department Visits in African American Older Adults with Diabetes

Assari

Smith

Bazargan

2020

J. Racial and Ethnic Health Disparities

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“…Some studies showed that living in areas covered by primary healthcare with FHS presented favorable results for use of health services 30,31 . Other countries with effective primary healthcare also achieved positive results for use of health services and for achieving UHC 7,32,33 . Primary healthcare is essential for bridging the gap to UHC 34 .…”

Section: Place Of Last Dental Visitmentioning

confidence: 97%

The relationship between private health plans and use of medical and dental health services in the Brazilian health system

Pilotto

Celeste

2019

Ciênc. saúde coletiva

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To describe the last place of medical and dental health service used in relation to private health plans, and examine the effect of being registered in the primary healthcare system through the Family Health Strategy (FHS). This was a cross-sectional study using data from Brazil’s 2008 National Household Survey. Multinomial logistic regression was performed to analyze how a private health plan and enrollment in the FHS influenced the use of health services. Results showed that individuals with a private health plan tend to use medical and dental services more than individuals without such a plan. However, many individuals with a private health plan used public services or paid out-of-pocket services, mainly for dental care. Among individuals without a private plan, being enrolled in the FHS reduced the use of out-of-pocket private services, regardless of age, income or educational level. Enrollment in the FHS increased the chances of using public services, and the effect of this enrollment is greater among those who have a private plan. Policies to strengthen public primary healthcare and to expand the FHS should be encouraged within the universal health system.

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“…Therefore, it is reasonable to assume that lack of continuity of care, a higher rate of frequent ED visits, combined with a longer waiting time at ED are significant factors contributing to health disparities among AA older adults. Current research shows that continuity of care improves quality of care, improves patient outcomes, reduces hospitalizations and decreases ED visits, particularly among older adults with CMCs that need self-management (e.g., heart disease, diabetes, hypertension, and asthma) [58]. Improving and maintaining continuity of care among older adults have the potential to reduce health disparities.…”

Section: Discussionmentioning

confidence: 99%

Emergency Department Utilization among Underserved African American Older Adults in South Los Angeles

Bazargan

Smith

Cobb

et al. 2019

IJERPH

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Objectives: Using the Andersen’s Behavioral Model of Health Services Use, we explored social, behavioral, and health factors that are associated with emergency department (ED) utilization among underserved African American (AA) older adults in one of the most economically disadvantaged urban areas in South Los Angeles, California. Methods: This cross-sectional study recruited a convenience sample of 609 non-institutionalized AA older adults (age ≥ 65 years) from South Los Angeles, California. Participants were interviewed for demographic factors, self-rated health, chronic medication conditions (CMCs), pain, depressive symptoms, access to care, and continuity of care. Outcomes included 1 or 2+ ED visits in the last 12 months. Polynomial regression was used for data analysis. Results: Almost 41% of participants were treated at an ED during the last 12 months. In all, 27% of participants attended an ED once and 14% two or more times. Half of those with 6+ chronic conditions reported being treated at an ED once; one quarter at least twice. Factors that predicted no ED visit were male gender (OR = 0.50, 95% CI = 0.29–0.85), higher continuity of medical care (OR = 1.55, 95% CI = 1.04–2.31), individuals with two CMCs or less (OR = 2.61 (1.03–6.59), second tertile of pain severity (OR = 2.80, 95% CI = 1.36–5.73). Factors that predicted only one ED visit were male gender (OR = 0.45, 95% CI = 0.25–0.82), higher continuity of medical care (OR = 1.39, 95% CI = 1.01–2.15) and second tertile of pain severity (OR = 2.42, 95% CI = 1.13–5.19). Conclusions: This study documented that a lack of continuity of care for individuals with multiple chronic conditions leads to a higher rate of ED presentations. The results are significant given that ED visits may contribute to health disparities among AA older adults. Future research should examine whether case management decreases ED utilization among underserved AA older adults with multiple chronic conditions and/or severe pain. To explore the generalizability of these findings, the study should be repeated in other settings.

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Health services utilization of people having and not having a regular doctor in Canada

Cited by 9 publications

References 19 publications

Poor Self-Rated Health Is Associated with Hospitalization and Emergency Department Visits in African American Older Adults with Diabetes

Poor Self-Rated Health Is Associated with Hospitalization and Emergency Department Visits in African American Older Adults with Diabetes

The relationship between private health plans and use of medical and dental health services in the Brazilian health system

Emergency Department Utilization among Underserved African American Older Adults in South Los Angeles

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