Gender differences in health care use among the elderly population in areas of Norway and Finland. A cross-sectional analysis based on the HUNT study and the FINRISK Senior Survey

Suominen‐Taipale, Anna Liisa; Martelin, Tuija; Koskinen, Seppo; Holmen, Jostein; Johnsen, Roar

doi:10.1186/1472-6963-6-110

Cited by 53 publications

(42 citation statements)

References 38 publications

(28 reference statements)

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“…In this semi-rural setting with a significant coal mining legacy, the women probably enjoy a better state of physical health than the men. Whether this gender difference in the length of stay is similar in other areas in the UK remains to be seen, although gender differences in healthcare-seeking behaviour have been reported previously in other countries, 13,14 although which gender utilises healthcare systems more depends on where the studies were undertaken.…”

Section: Discussionmentioning

confidence: 73%

Selecting ambulatory emergency care (AEC) patients from the medical emergency in-take: the derivation and validation of the Amb score

et al. 2012

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-Accurate prediction of the likelihood of same-day discharge could make it possible to direct one-third of the medical in-take to an ambulatory care unit, thereby facilitating bed management. In Phase 1 of this study, we identified seven independent factors that contribute to an ambulatory care score (Amb score) that can potentially be used as a tool to select ambulatory emergency care (AEC) patients from the medical emergency in-take. A high score was associated with discharge within 12 hours of assessment and treatment in hospital. In Phase 2, we verified and internally validated the performance of the Amb score in a different cohort of patients, finding that it functioned well in identifying early discharges (ie AEC patients), with an area under the receiver operator curve (AUROC) of 0.91 (95% CI 0.88-0.94). An Amb score of у5 has a sensitivity of 96% (95% CI 90-98) and a specificity of 62% (95% CI 55-68) in identifying potential AEC patients.KEY WORDS: Amb score, ambulatory emergency care, admission, medical in-take BackgroundThe number of emergency hospital admissions and their costs continue to increase annually. 1 It is appropriate that all emergency referrals from primary care should be assessed in hospital, but admission is not always necessary. Acute medical units (AMU) help to reduce length of stay and prevent unnecessary admissions. 2 In addition, ambulatory care units contribute to admission-avoidance: many medical emergencies can be managed in the ambulatory care setting provided diagnostic services and assessment facilities are readily available. 3,4 Notwithstanding the diagnosis, some conditions do not warrant in-patient management; indeed, up to a third of referrals seen in AMU are discharged on the same day. 5,6 This constitutes a significant proportion of patients that could potentially be assessed within the ambulatory emergency care setting.The RCP Acute Medicine Task Force 7 defines ambulatory emergency care (AEC) as 'the clinical care which may include diagnosis, observation, treatment and rehabilitation, not provided within the traditional hospital bed base or within the traditional outpatient services that can be provided across the primary-secondary care interface. In the context of acute medicine, it is the care of a condition that is perceived either by the patient or by the referring practitioner as urgent, and that requires prompt clinical assessment undertaken by a competent clinical decision maker.' AEC patients tend to fall into one of four categories: a diagnostic exclusion group in which certain conditions, such as a possible deep venous thrombosis, must be ruled out; a low-risk group, such as those with communityacquired pneumonia with a low CURB65 score; a specific diagnostic group, who require a procedure such as pleural effusion; and finally, the group that requires a treatment that has traditionally been provided in an inpatient department, such as those with low-risk pulmonary embolism.In hospitals where AEC patients are managed in a geographically separate unit ...

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Section: Discussionmentioning

confidence: 73%

Selecting ambulatory emergency care (AEC) patients from the medical emergency in-take: the derivation and validation of the Amb score

et al. 2012

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“…Dentre os idosos urbanos, observou-se em alguns indicadores diferencial de gênero na utilização de serviços que tendeu a favorecer os homens. Há divergência na literatura sobre os fatores que explicam as variações de gênero no padrão de utilização de serviços de saúde, e alguns autores propõem que estes sofrem influência do contexto social e cultural 23 . O menor diferencial de gênero na utilização de serviços de saúde nos idosos urbanos fala em favor da tese que fatores sociais e culturais estariam na base das diferenças na percepção de morbidade e na decisão de procurar serviços de saúde dos idosos rurais, fatores estes que se alterariam com a urbanização.…”

Section: Metodologiaunclassified

“…Nas pessoas com mais de 65 anos, em particular, a percepção da gravidade do problema de saúde relaciona-se a maiores taxas de utilização de serviços de saúde 24 . Maiores taxas de internação hospitalar nos homens idosos já foram descritas em outros contextos e podem indicar diferença no perfil de morbidade de homens e mulheres idosas, com os homens idosos apresentando problemas de saúde mais graves 25,26 , mas podem também refletir a ocorrência de seleção de gênero na decisão médica, com os médicos sendo mais propensos a internar homens idosos do que mulheres idosas 23 .…”

Section: Metodologiaunclassified

Acesso e uso de serviços de saúde em idosos residentes em áreas rurais, Brasil, 1998 e 2003

Travassos

Viacava

2007

Cad. Saúde Pública

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“…Medicaid patients in this Midwest state are statistically more likely to be females due to eligibility requirements. As a result, the impact on such policies on men may not be fully represented in this study since male patients may not use health care at the same rate as female patients [27]. Second, because the study was limited to patients with diabetes mellitus, it is uncertain if results may be generalized to patients with other types of chronic diseases.…”

Section: Resultsmentioning

confidence: 90%

Is the Safety Net Leaking?: Measuring Changes in Quality of Care and Healthcare Utilization for Patients with Diabetes Mellitus before and after Implementation of Cost-Sharing at a Public Hospital

Willis¹,

Wang²,

Wu³

et al. 2016

Int J Community Fam Med

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Background: In 2003, a county hospital system in the Midwest implemented policies that increased patient cost sharing via increased co-payments for services. The purpose of this study was to measure the impact of those changes for vulnerable patients with diabetes mellitus in subsequent years.. Methods: A state-of-the art electronic medical record system recorded quality and utilization measures for two years before and two years after the operational changes. Data from 2,394 patients with both diabetes mellitus and reliable utilization and quality of care data were included in the study. The associations between the quality of care, health care costs, healthcare utilization, patients' third party pay or status, and the policy implementation were examined using Linear Mixed-Effects and Generalized Estimating Equations (GEE) models. Results: Compared to before the policy change, the quality of care measures significantly improved for patients with Medicare and indigent care pay or status. Healthcare costs, emergency department visits, and hospitalizations significantly increased after the policy change for patients with Medicare and indigent care insurance. Visits to primary care clinics decreased after the policy change for patients with Medicaid, Medicare, and self pay where as patients on the indigent care program had higher primary care visits. Conclusion:The policy implementation impacted patients in the Indigent Care program, as intended, but also impacted Medicare patients more negatively, in financial and utilization aspects, than expected by the policy. More costly utilization patterns, after increasing cost-sharing policy changes in public hospitals, may lead to higher medical costs for the system in the long-term.

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Gender differences in health care use among the elderly population in areas of Norway and Finland. A cross-sectional analysis based on the HUNT study and the FINRISK Senior Survey

Abstract: Background: The aim of the study was to examine gender differences in the self-reported use of health care services by the elderly in rural and metropolitan areas of two Nordic countries with slightly different health care systems: Finland and Norway.

Cited by 53 publications

References 38 publications

Selecting ambulatory emergency care (AEC) patients from the medical emergency in-take: the derivation and validation of the Amb score

Selecting ambulatory emergency care (AEC) patients from the medical emergency in-take: the derivation and validation of the Amb score

Acesso e uso de serviços de saúde em idosos residentes em áreas rurais, Brasil, 1998 e 2003

Is the Safety Net Leaking?: Measuring Changes in Quality of Care and Healthcare Utilization for Patients with Diabetes Mellitus before and after Implementation of Cost-Sharing at a Public Hospital

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