Access to routine care and risks for 30-day readmission in patients with cardiovascular disease

Dupre, Matthew E.; Xu, Hanzhang; Granger, Bradi B.; Lynch, Scott M.; Nelson, Alicia; Churchill, Erik; Willis, Janese M.; Curtis, Lesley H.; Peterson, Eric D.

doi:10.1016/j.ahj.2017.10.001

Cited by 27 publications

(31 citation statements)

References 50 publications

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“…Access to healthcare is a fundamental social determinant of health that has been targeted by the World Health Organization to improve the availability and timeliness of quality healthcare [1]. Numerous studies have shown that timely and/or adequate access to healthcare promotes better health and well-being [2,3] and that inadequate access to care has been associated with greater psychological distress [4], lower levels of physical health [5], higher rates of rehospitalization [6], and overall higher risks of morbidity and mortality [3,7]. Moreover, a large body of literature has demonstrated the correlates and consequences of access to healthcare in a variety of settings and populations [7,8].…”

Section: Introductionmentioning

confidence: 99%

Adequate access to healthcare and added life expectancy among older adults in China

Li-sha

Dupre

et al. 2020

BMC Geriatr

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Background: Adequate access to healthcare is associated with lower risks of mortality at older ages. However, it is largely unknown how many more years of life can be attributed to having adequate access to healthcare compared with having inadequate access to healthcare. Method: A nationwide longitudinal survey of 27,794 older adults aged 65+ in mainland China from 2002 to 2014 was used for analysis. Multivariate hazard models and life table techniques were used to estimate differences in life expectancy associated with self-reported access to healthcare (adequate vs. inadequate). The findings were assessed after adjusting for a wide range of demographic factors, socioeconomic status, family/social support, health practices, and health conditions. Results: At age 65, adequate access to healthcare increased life expectancy by approximately 2.0-2.5 years in men and women and across urban-rural areas compared with those who reported inadequate access to healthcare. At age 85, the corresponding increase in life expectancy was 1.0-1.2 years. After adjustment for multiple confounding factors, the increase in life expectancy was reduced to approximately 1.1-1.5 years at age 65 and 0.6-0.8 years at age 85. In women, the net increase in life expectancy attributable to adequate access to healthcare was 6 and 8% at ages 65 and 85, respectively. In men, the net increases in life expectancy were generally greater (10 and 14%) and consistent after covariate adjustments. In contrast, the increase in life expectancy was slightly lower in rural areas (2.0 years at age 65 and 1.0 years at age 85) than in urban areas (2.1 years at age 65 and 1.1 years age 85) when no confounding factors were taken into account. However, the increase in life expectancy was greater in rural areas (1.0 years at age 65 and 0.6 years at age 85) than in urban areas (0.4 years at age 65 and 0.2 years at age 85) after accounting for socioeconomic and other factors. Conclusions: Adequate access to healthcare was associated with longer life expectancy among older adults in China. These findings have important implications for efforts to improve access to healthcare among older populations in China.

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Section: Introductionmentioning

confidence: 99%

Adequate access to healthcare and added life expectancy among older adults in China

Li-sha

Dupre

et al. 2020

BMC Geriatr

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“…Numerous studies from many populations have shown that adequate access to medical care promotes better health [1–8] and that inadequate access to medical care is linked with greater psychological distress [9, 10], readmission of hospitalization [11], lower levels of self-rated health and life satisfaction [12], worse physical health [3, 4, 13, 14], and overall higher rates of morbidity and mortality [6, 14–16]. Adequate access to medical care is particularly critical to health conditions and well-being of older adults who generally have greater needs for care and treatment to manage diseases than their younger counterparts.…”

Section: Introductionmentioning

confidence: 99%

Age and sex differences in the association between access to medical care and health outcomes among older Chinese

Zhang

Dupre

Qiu³

et al. 2018

BMC Health Serv Res

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BackgroundWhether the association between access to medical care and health outcomes differs by age and gender among older adults in China is unclear. We aimed to investigate the associations between self-reported inadequate access to care and multiple health outcomes among older men and women in mainland China.MethodsBased on four latest waves available so far from a national longitudinal study in mainland China in 2005–2014, we used multilevel random-effect logistic models to estimate the contemporaneous relationships between inadequate access to care and disabilities in instrumental activities of daily living (IADL) and cognitive impairment in men and women at ages 65–74, 75–84, 85–94, and 95+, separately. We also used multilevel hazard models to investigate the relationships between reported access to care and mortality in 2005–2014. Nested models were used to adjust for survey design, sociodemographic background, enrollment in health insurance, and health behaviors.ResultsApproximately 6.5% of older adults in China reported inadequate access to care in the period of 2005–2014; and the percentages increased with age and were higher among women at older ages (≥75 years). Overall, older adults with self-reported inadequate access to care had greater odds of IADL and ADL disabilities and cognitive impairment than those with adequate access to healthcare. The elevated odds ratios (ORs) in men were higher in middle-old (75–84) and old-old (85–94) age groups compared to other age groups; whereas the elevated ORs in women were higher in young-old (65–74) and middle-old (75–84) age groups. The relationship between access to care and the health outcomes was generally weakest at the oldest-old ages (95+). Inadequate access to care was also linked with higher mortality risk, primarily in adults aged 75–84, and it was somewhat more pronounced in women than in men.ConclusionsIncreased odds of physical disability and cognitive impairment and increased risk of mortality are linked with inadequate access to care. The associations were generally stronger in women than in men and varied across age groups. The findings of the present study have important implications for further improving access to health care and improving health outcomes of older adults in China.

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“…We first examined the distribution of ADL and general health and assessed the bivariable relationships with acceptance. For simplicity, we dichotomized as follows: no difficulty versus having at least one ADL difficulty, average health or above/unhealthy (Dupre et al, 2017; Xu et al, 2019).…”

Section: Methodsmentioning

confidence: 99%

Acceptance of Love and Remarriage Among Older Adults in the Philippines

Kim

Cruz

et al. 2020

J Aging Health

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Objectives: Later-life re-partnership has been linked to healthy aging, but little is known about Philippine older adults’ perception of love and remarriage in older age. Methods: Using two nationally representative surveys on aging in the Philippines, we estimated the proportion of older adults reporting acceptance. Using weighted logistic regression, we assessed sociodemographic and health factors associated with acceptance as well as the relationship of this acceptance with social activity and health behaviors. Results: Only seventeen percent of respondents reported acceptance. Per multivariable analyses, unmarried men and married women reported acceptance, and acceptance was associated with increased social activity and smoking in men, less smoking in women, and more drinking in both genders. Discussion: Most older adults in the Philippines reported love and remarriage in old age as unacceptable. Through these results, we can understand how attitudes toward later-life relationship impact older adults’ health and well-being.

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Access to routine care and risks for 30-day readmission in patients with cardiovascular disease

Cited by 27 publications

References 50 publications

Adequate access to healthcare and added life expectancy among older adults in China

Adequate access to healthcare and added life expectancy among older adults in China

Age and sex differences in the association between access to medical care and health outcomes among older Chinese

Acceptance of Love and Remarriage Among Older Adults in the Philippines

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