Type of Multimorbidity and Patient-Centered Care Among Elderly Medicare Beneficiaries

Abstract

A447and optimise the reporting of such evaluations. To our knowledge, there are no such published guidelines in Spain. Methods: This guidance was designed with the main aim of providing authors with recommendations, in the form of a checklist, to optimise design and reporting of EE and BIA to be submitted to the Catalan Health System (CatSalut) within its harmonization program for pharmaceutical innovation. Results: For a given evaluation, two separate guidelines with corresponding checklists assess its methodology, quality, and reporting based on several dimensions. ConClusions: The steps outlined in this first guidance in Spain, although not compulsory, will provide useful practical tips for how to go about designing and reporting of an EE or a BIA for pharmaceuticals in Catalonia (Spain).

Help-Seeking Behaviors Among Older Adults: A Scoping Review

“…In regards to accessibility and awareness of formal services, older adults expressed related issues such as costs, long wait times, short consultation times or having busy schedules as help-seeking barriers (Djukanović et al, 2015;Dollard et al, 2014;Frost et al, 2020;Garg et al, 2017;Garrido et al, 2011;Hannaford et al, 2019;Kagan et al, 2018;Lawrence et al, 2006;Lee et al, 2012Lee et al, , 2020Murata et al, 2010;Polacsek et al, 2019;Schneider et al, 2014;Waterworth et al, 2018). Location and lack of available transportation also made it more difficult for older adults to seek help, especially among those living in rural areas or those with physical constraints (Chen, 2020;Chung et al, 2018;Frost et al, 2020;Garg et al, 2017;Garrido et al, 2011;Gur-Yaish et al, 2016;Mukherjee, 2019;Murata et al, 2010;Polacsek et al, 2019;Waterworth et al, 2018).…”

“…Within formal support, several articles described how mistrust, perceptions of a physician’s role, and past interactions with formal healthcare providers can negatively influence older adults’ help-seeking behaviors. Here, the notion that physicians could either not help at all or any more than they already were helping was prevalent (Dollard et al, 2014; Elias & Lowton, 2014; Garg et al, 2017). This perspective was reinforced by past experiences of help-seeking, when misdiagnosis or non-diagnosis occurred (Clarke et al, 2014; Polacsek et al, 2019).…”

“…When confronted with a symptom, older adults would commonly self-assess their health first to determine whether seeking help was necessary (Hurst et al, 2013; Hwang & Jeong, 2012; Tsai & Tsai, 2007; Waterworth et al, 2018). As such, there was often a delay in help-seeking as many underestimated the seriousness of their conditions (Garg et al, 2017; Murata et al, 2010) and would subsequently wait to see if the problems went away or attempt to self-manage their conditions, with informal support being a common first choice of help (Altizer et al, 2014; Begum et al, 2012; Canvin et al, 2018; Djukanović et al, 2015; Frost et al, 2020; Garrido et al, 2011; Hurst et al, 2013; Hwang & Jeong, 2012; Johnston et al, 2010; Lee et al, 2020; McCabe et al, 2017; Tsai & Tsai, 2007). For example, Kelly et al (2011) found that despite acknowledgment of hearing impairment, those in the non-consulting group did not experience communication breakdowns or experienced them in predictable ways, resulting in lower levels of anxiety and a lack of help-seeking.…”

Equity in healthcare access and service coverage for older people: a scoping review of the conceptual literature

“…Suurmond, 2016 30 Barriers to perceived need: limited expectations regarding availability of or eligibility for the service Travers, 2020 68 Content/amount; sources and accessibility of information about services Willging, 2018 46 Provision of information about insurance options Bradley, 2002 22 Psychosocial factors: self-determination Capacity to make decisions Demand: Patients' ability to understand their needs and the services required (health literacy), and their ability to make decisions and to act Supply: Providers' ability to understand the needs and the services required by older people, and their ability to make decisions and to act, for example, relevant education and resources Open access two or more chronic conditions 54 is certainly known to be both more prevalent in elderly populations than other age groups, [54][55][56][57] and also to be increasing. 58 The combination of mental and physical comorbidities is also known to reduce the likelihood of accessing relevant healthcare, 57 which therefore has yet further equity implications for this group. Multimorbidity is therefore an element in a number of our factors such as awareness, capacity to make decisions, need, personal economic, social and cultural circumstances influencing access, and physical accessibility.…”

How to measure barriers in accessing mental healthcare? Psychometric evaluation of a screening tool in parents of children with intellectual and developmental disabilities

“…Participants' general physical health was assessed to calculate convergent validity of the PHBS by the PROMIS Global Physical Health Scale (PROMIS GPH-4; [42]). This was conducted in line with the current evidence on the association between physical health problems and diminished help-seeking behavior [43,44]. It consists of 4 items asking about the overall physical health, physical function, pain, and fatigue.…”