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Tao X, Zeng Y, Jiao W. The impact of medical insurance and old-age security on the utilization of medical services by the older population with disabilities. BMC Health Serv Res 2024; 24:892. [PMID: 39103801 DOI: 10.1186/s12913-024-11323-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/17/2024] [Indexed: 08/07/2024] Open
Abstract
OBJECTIVE In this study, the impact of medical insurance and old-age security on the use of medical services by the older population with disabilities is analyzed. A reference for decision makers is provided to improve medical and old-age security policies and enhance the use of medical services by the older population. METHODS Data were drawn from 3,737 older people with disabilities aged 65 years or above from the 2018 China Longitudinal Healthy Longevity Survey. A two-part model based on social ecological theory was used for both analysis and group prediction. RESULTS In terms of the use of outpatient medical services, old-age pension significantly increased the probability of outpatient visits for this population group (P < 0.05). Urban employee/resident medical insurance, the new rural cooperative medical insurance, and retirement pension significantly affected medical expenses. In terms of the use of inpatient medical services, the new rural cooperative medical insurance and retirement pension significantly influenced the choice of inpatient medical services; retirement pension increased inpatient medical expenditure (p < 0.01). The expected average probability of hospitalization, unconditional expected cost, and conditional expected cost for the older population with disabilities were 49.5%, RMB 6629.31, and RMB 3281.51, respectively. Both conditional and unconditional expected costs were significantly higher for older people with disabilities with the following attributes: male, married, no less than three chronic conditions, and unassisted daily care; costs were lower for older people with disabilities who are female, not married, had less than three chronic conditions, and had a spouse, child, or other caregiver. CONCLUSION Medical insurance and old-age security can significantly promote the utilization of medical services by the older population with disabilities. It is therefore recommended to focus on strengthening the support and health management of these people who are unattended to improve the effective use of health services and better meet their needs.
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Affiliation(s)
- Xiaomeng Tao
- School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Yanbing Zeng
- School of Public Health, Capital Medical University, Beijing, 100069, China.
| | - Weiping Jiao
- Xuan Wu Hospital, Capital Medical University, Beijing, China
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Kress AC, Vashist A, Zhang QC, Dragicevic A, Njie GJ. Tobacco use among adults with disabilities in nine countries-Demographic and Health Survey, 2016-2021. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003232. [PMID: 38885251 PMCID: PMC11182554 DOI: 10.1371/journal.pgph.0003232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024]
Abstract
Few studies have investigated tobacco use among people with disabilities living in low- and middle-income countries (LMICs). We aimed to examine current tobacco use among men and women with disabilities using Demographic and Health Survey (DHS) data from 9 LMICs. We considered a respondent currently use tobacco products if they reported current use of any combustible/smoked tobacco products or smokeless tobacco products. We performed secondary analyses of DHS data from 2016-2021 collected in Haiti, Mali, Mauritania, Nigeria, Pakistan, Rwanda, South Africa, Timor-Leste, and Uganda. We examined marginal effects in logistic regression to calculate the adjusted prevalence and adjusted prevalence differences of tobacco use by disability status, controlling for selected sociodemographic characteristics. The adjusted prevalence of current use of tobacco products among women with a moderate/severe disability, mild disability, and no disability varied across countries, with medians of 1.9% (range = 0.1% [Mali] to 11.3% [Pakistan]), 3.2% (range = 0.9% [Nigeria] to 13.3% [South Africa]), and 2.3% (range = 0.5% [Nigeria] to 8.9% [South Africa]), respectively. For men with moderate/severe disability, the median adjusted prevalence for current use of tobacco products was 18.8% (range = 8.9% [Rwanda] to 55.0% [Timor-Leste]). The median prevalences of current use of tobacco products for men with mild disability and no disability were similar to those with moderate/severe disability, at 16.5% and 15.9%, respectively. Current tobacco product use among people with disabilities varied for countries included in our study; however, with few exceptions, current tobacco product use was similar across disability status groups. Additional research is warranted to determine whether our findings extend beyond the nine countries assessed here. It is important to consider the needs of people with disabilities in tobacco prevention, control, and cessation efforts so that this substantial population can benefit equitably from such programs, interventions, or policies.
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Affiliation(s)
- Alissa C. Kress
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Aastha Vashist
- Noninfectious Disease Programs, CDC Foundation, assigned to the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Qing C. Zhang
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia, United States of America
| | - Adriana Dragicevic
- Noninfectious Disease Programs, CDC Foundation, assigned to the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Gibril J. Njie
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
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Silva R, Pizato N, da Mata F, Figueiredo A, Ito M, Pereira MG. Mediterranean Diet and Musculoskeletal-Functional Outcomes in Community-Dwelling Older People: A Systematic Review and Meta-Analysis. J Nutr Health Aging 2018; 22:655-663. [PMID: 29806854 DOI: 10.1007/s12603-017-0993-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Population aging is increasing and this process together with its characteristics influence the prevalence and incidence of chronic conditions and musculoskeletal-functional outcomes such as frailty, functional disability and sarcopenia. Nutritional strategies focused on dietary patterns, such as a Mediterranean diet, can be protective from these outcomes. PURPOSE To investigate the association between adherence to a Mediterranean diet and frailty, functional disability and sarcopenia in community-dwelling older people. METHODS We systematically reviewed electronic databases (MEDLINE, EMBASE, and others) and grey literature for articles investigating the relationship between adherence to a Mediterranean diet and frailty, functional disability and sarcopenia in community-dwelling people aged 60 and over. Study selection, quality of study assessment and data extraction were conducted independently by two authors. Random effects meta-analyses were performed, and pooled Odds Ratios (OR) were obtained. RESULTS After the literature search, screening and eligibility investigation, we included 12studies, with a total of 20,518 subjects. A higher adherence to a Mediterranean diet was found to be inversely associated with frailty (OR 0.42, 95% CI: 0.28-0.65, I2=24.9%, p=0.262) and functional disability (OR 0.75, 95% CI: 0.61-0.93, I2=0.0%, p=0.78). Highly different study characteristics prevented us from performing a meta-analysis for sarcopenia. Cohort data indicated no association between adherence to a Mediterranean diet and sarcopenia; however, cross-sectional results showed a positive relationship. CONCLUSION A Mediterranean diet is protective of frailty and functional disability, but not of sarcopenia. More longitudinal studies are needed to understand the relationship between a Mediterranean diet and sarcopenia.
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Affiliation(s)
- R Silva
- Roberta Silva, Universidade de Brasilia, Brazil, ;
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Linardakis M, Papadaki A, Smpokos E, Micheli K, Vozikaki M, Philalithis A. Relationship of behavioral risk factors for chronic diseases and preventive health services utilization among adults, aged 50+, from eleven European countries. J Public Health (Oxf) 2015. [DOI: 10.1007/s10389-015-0683-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Bardach SH, Schoenberg NE, Howell BM. What Motivates Older Adults to Improve Diet and Exercise Patterns? J Community Health 2015; 41:22-9. [DOI: 10.1007/s10900-015-0058-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Pitt-Catsouphes M, James JB, Matz-Costa C. Workplace-based health and wellness programs: the intersection of aging, work, and health. THE GERONTOLOGIST 2015; 55:262-70. [PMID: 26035602 DOI: 10.1093/geront/gnu114] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 10/14/2014] [Indexed: 12/22/2022] Open
Abstract
Workplace-based health and wellness programs (HWPs) may be an obvious yet under-utilized strategy for promoting positive health-related behaviors among older workers and for increasing their ability to continue to work. Given the unprecedented number of older adults who extend their labor force attachment beyond traditional retirement ages, a new vision of older adults' economic security and overall quality-of-life should take into account the intersections of aging, work, and health. The purpose of this article is to: (a) discuss the workplace as an increasingly important setting that can expand the reach and effectiveness of health promotion efforts; (b) examine current knowledge of barriers and facilitators that can affect older workers' participation in workplace-based HWPs; and (c) suggest new incentive structures that may increase older workers' engagement in these programs. We develop a rationale for our proposition that sustained participation in HWPs may improve the health status of older workers and reduce health care costs. It is our conclusion that there is significant potential for workplace-based HWPs to support older adults who want to or need to work.
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Affiliation(s)
- Marcie Pitt-Catsouphes
- Boston College Graduate School of Social Work, Sloan Center on Aging & Work at Boston College, Chestnut Hill, MA.
| | - Jacquelyn Boone James
- Boston College Graduate School of Social Work, Sloan Center on Aging & Work at Boston College, Chestnut Hill, MA
| | - Christina Matz-Costa
- Boston College Graduate School of Social Work, Sloan Center on Aging & Work at Boston College, Chestnut Hill, MA
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An AR, Shin DW, Kim S, Lee CH, Park JH, Park JH, Oh MK, Hwang SH, Kim Y, Cho B. Health behaviors of people with retinitis pigmentosa in the republic of Korea. Ophthalmic Epidemiol 2014; 21:279-86. [PMID: 24968102 DOI: 10.3109/09286586.2014.926939] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate the health behaviors of people with retinitis pigmentosa (RP) in the Republic of Korea. METHODS An online questionnaire was used to survey members of the Korean Retinitis Pigmentosa Society (KRPS), over 3 months from December 2010 to February 2011. Controls were selected from participants of the 4th Korean National Health and Nutrition Examination Survey and were matched with people with RP using the propensity score method to optimize comparative analysis. A semi-structured interview was also conducted with five members of the KRPS to identify potential reasons for physical inactivity and unhealthy diet and to develop effective interventions. RESULTS A total of 194 eligible people with RP responded to the online survey, and 187 individuals were matched with the control population by propensity score matching. RP subjects reported a lower rate of current smoking and greater use of preventive healthcare services. However, people with RP were more physically inactive (50.8% vs 27.3%, p < 0.001) and consumed more fast food (69.5% vs 58.3%, p = 0.024) than the control population. CONCLUSION Physical inactivity and fast food consumption were more frequently reported in people with RP than the general population. Efforts to understand the possible reasons and develop interventions to improve these health behaviors are warranted.
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Affiliation(s)
- Ah Reum An
- Department of Family Medicine, Seoul National University Hospital , Seoul , Republic of Korea
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Estudillo-Valderrama MA, Roa LM, Reina-Tosina J, Roman-Martinez I. Ambient assisted living: a methodological approach. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2011; 2010:2155-8. [PMID: 21096154 DOI: 10.1109/iembs.2010.5626628] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this paper, the most important challenges and trends related to the application of Ambient Assisted Living (AAL) methods and techniques to the social/healthcare context are discussed. In order to find out technical solutions to these challenges, the main methodological issues concerning the design of open and distributed architectures are analyzed. The objective is to improve the efficiency/cost ratio in the provision of social and healthcare services to citizens with special needs, through the application of new paradigms in the context of AAL environments. Finally, some results and conclusions regarding the proposed open architecture are illustrated for the case of a distributed biomedical sensor network designed by the authors following this methodology.
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Affiliation(s)
- Miguel A Estudillo-Valderrama
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) and the Biomedical Engineering Group, University of Seville, Spain.
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Plow M, Cho C, Finlayson M. Utilization of health promotion and wellness services among middle-aged and older adults with multiple sclerosis in the mid-west US. Health Promot Int 2010; 25:318-30. [PMID: 20427373 DOI: 10.1093/heapro/daq023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Routine engagement in healthy behaviors may improve quality of life in older adults with chronic disabling conditions, such as multiple sclerosis (MS). However, older adults with chronic conditions may face many barriers to engaging in healthy behaviors. Health promotion and wellness services may help older adults with chronic conditions engage in healthy behaviors. Thus, the purpose of this study was to identify factors associated with the use of and unmet needs for heath promotion services among middle-aged and older adults with MS. Data from a cross-sectional telephone survey of individuals aging with MS in the mid-west USA were used for this study (n = 1282). A multinomial regression model was used to identify variables associated with the utilization of health promotion services. A logistic regression model was used to identify variables associated with unmet needs for these services. Females (OR = 1.51; CI: 1.13, 2.00), high school graduates (OR = 1.77; CI: 1.34, 2.34) and people who reported no problems with mobility or balance (OR = 1.68; CI: 1.12, 2.51) were more likely to utilize health promotion and wellness services. Factors that increased the likelihood of reporting an unmet need for these services were being female (OR = 2.34; CI: 1.56, 3.51), greater than a high school education (OR = 1.58; CI: 1.14, 2.20), not being married (OR = 1.79; CI: 1.31, 2.43), having inadequate income (OR = 1.83; CI: 1.31, 2.56), experiencing pain (OR = 1.96; CI: 1.34, 2.87) and reporting less ability to do everyday activities now compared with 1 year ago (OR = 2.13; CI: 1.16, 3.92). To avoid widening the health-disparities gap, future research needs to explore strategies that promote utilization of health promotion services among all middle-aged and older adults with MS.
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Affiliation(s)
- Matthew Plow
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL 60612, USA.
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