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Lu H, Wang H, Zhu L, Xu J, Su Z, Dong W, Ye F. The impact of WeChat online education and care on the mental distress of caregivers and satisfaction of elderly postoperative colorectal cancer patients. Clin Res Hepatol Gastroenterol 2024; 48:102372. [PMID: 38719145 DOI: 10.1016/j.clinre.2024.102372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/02/2024] [Accepted: 05/05/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE WeChat-based nursing interventions alleviate mental distress. This study intended to investigate the effect of WeChat online education and care (WOEC) on the mental health of caregivers and the satisfaction of elderly postoperative colorectal cancer (CRC) patients. METHODS In total, 92 elderly postoperative CRC patients and 92 caregivers were randomly separated into the WOEC group (46 patients and 46 caregivers) and the control care group (46 patients and 46 caregivers). Caregivers received corresponding intervention for 8 weeks. Beck depression inventory (BDI) and beck anxiety inventory (BAI) of caregivers, and self-report satisfaction (SRS) of patients were assessed. RESULTS In caregivers, BDI scores at 8 weeks after enrollment (W8) (P = 0.024) and BAI score at W8 (P = 0.009), depression severity at W8 (P = 0.036), as well as anxiety severity at 4 weeks after enrollment (W4) (P = 0.028) and W8 (P = 0.047) were declined in the WOEC group versus the control care group. Regarding patients, SRS scores at W4 (P = 0.044) and W8 (P = 0.025), the satisfaction degree at W4 (P = 0.033) and W8 (P = 0.034), as well as the satisfied and very satisfied rates at W4 (P = 0.031) and W8 (P = 0.029) were elevated in the WOEC group versus the control care group. By subgroup analyses, WOEC exhibited favorable effects on reducing mental stress in caregivers of patients with eastern cooperative oncology group performance status at enrollment <3, and in caregivers with an education level of high school & university and above. CONCLUSION WOEC effectively relieves mental stress in caregivers of elderly postoperative CRC patients, and also elevates satisfaction in these patients.
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Affiliation(s)
- Hui Lu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu, China
| | - Huihong Wang
- Department of Nursing, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu, China
| | - Lingyun Zhu
- Department of Internal Medicine, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu, China.
| | - Jiahui Xu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu, China
| | - Zhenzhen Su
- Department of Gastroenterology, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu, China
| | - Wenxia Dong
- Department of Nephrology, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu, China.
| | - Fen Ye
- Department of Neurology, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu, China
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Hu Y, Wang Z, Wu L. Multidimensional health heterogeneity of Chinese older adults and its determinants. SSM Popul Health 2023; 24:101547. [PMID: 38021459 PMCID: PMC10661850 DOI: 10.1016/j.ssmph.2023.101547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Nowadays, the "Healthy China" and "Actively Addressing Population Aging" are two important national strategies in China. Promoting high-quality development of demand-driven older adults health services is an important way to achieve these strategies. From the perspective of active ageing, assessing the health status of older adults from multiple dimensions becomes crucial as it helps identify their specific health service needs, intervention measures, and health policies tailored to this population. Methods Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) wave 4 (2018). A total of 4190 older adults (aged ≥60 years) were included as the analysis sample. Latent class analysis was performed to categorize older adults based on 6 health indicators, including Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), doctor diagnosed chronic diseases, depressive symptoms, cognitive function, and social participation. Multinomial logistic model was used to explore determinants associated with the various patterns of multidimensional health of older adults. Results The multidimensional health of older people was classified into three latent classes: Relatively Healthy (Class 1, n = 2806, 66.97%), Highly Depressed and Relatively Health Risk (Class 2, n = 1189, 28.38%), and Functional Impairment (Class 3, n = 195, 4.65%). Gender, age, education, marital status, number of children, alcohol consumption, physical activity, savings, residence, air quality satisfaction, and medical service satisfaction had significant effects on the attribution of all multidimensional health latent classes. Conclusion Heterogeneous and multidimensional health classes exist in China's older population, and these classes are influenced by a variety of factors and to varying degrees. Policymakers and healthcare providers can use these evidence to further address the diverse needs of older adults and improve older-care health services, ultimately achieving the goal of Active Ageing and Healthy China.
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Affiliation(s)
- Yi Hu
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, 518028, China
| | - Zhenyu Wang
- School of Government, Sun Yat-sen University, Guangzhou, Guangdong, 510006, China
| | - Liqun Wu
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, 518028, China
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Wong ELY, Wang K, Cheung AWL, Graham C, Yeoh EK. Thinking beyond the virus: perspective of patients on the quality of hospital care before and during the COVID-19 pandemic. Front Public Health 2023; 11:1152054. [PMID: 37744522 PMCID: PMC10515219 DOI: 10.3389/fpubh.2023.1152054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/16/2023] [Indexed: 09/26/2023] Open
Abstract
Objectives The COVID-19 pandemic has a huge impact on the healthcare system and affects the normal delivery of routine healthcare services to hospitalized patients. This study aimed to examine the differences in patient experience of hospital service before and during COVID-19 among the discharged adult population. Methods A territory-wide patient experience survey was conducted before and during COVID-19 (between October 2019 and April 2020) among patients discharged from the main acute and rehabilitation public hospitals in Hong Kong. A hierarchical ordinal logistic model was employed to examine the difference in multiple dimensions of patient experience, with adjustments of covariates. Results In total, 9,800 participants were recruited. During the pandemic, there was a marginally significant increase in overall care rating (AOR: 1.12, 95% CI: 0.99-1.27), and an improvement in the timeliness of admission. However, significant reductions in patients' confidence in nurses were observed. Communication of information regarding medication side effects reduced significantly (AOR: 0.72, 95% CI: 0.64-0.82). Conclusion The patients hospitalized during the pandemic reported worse responsiveness in communication in their patient journey than those admitted before the pandemic. These findings will help develop appropriate strategies to address patients' concerns in the new normal.
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Affiliation(s)
- Eliza Lai-yi Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
| | - Kailu Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
| | - Annie Wai-ling Cheung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
| | | | - Eng-kiong Yeoh
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
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Shaaban AN, Martins MRO, Peleteiro B. Factors associated with self-perceived health status in Portugal: Results from the National Health Survey 2014. Front Public Health 2022; 10:879432. [PMID: 36148345 PMCID: PMC9485892 DOI: 10.3389/fpubh.2022.879432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 08/04/2022] [Indexed: 01/21/2023] Open
Abstract
Background Self-perceived health is an important indicator of illness and mortality. This study aims at identifying a wide range of factors that can influence self-perceived health status among a representative sample in Portugal. Methods We used the 2014 National Health Survey (n = 17,057), whereby participants were required to assess their health status from "Very good," "Good," "Fair," "Poor" to "Very poor." We grouped the answers "Very good" and "Good," and "Poor" and "Very poor," respectively. Multinomial logistic regression was used to compare participants' characteristics across groups by computing odds ratio and corresponding 95% confidence intervals. Models included Socioeconomic/demographic characteristics, objective health status, healthcare use, functional disability, barriers to healthcare services utilization, lifestyle variables, mental health status, social support, and satisfaction with life as potential factors that can affect self-perceived health. Models were adjusted for sex, age, educational level, degree of urbanization, and presence of chronic diseases. Results About 45% of participants reported good/very good, 39% reported fair, while ~16% reported poor/very poor health perception. Poor/very poor health was more reported by women when compared to men (19.1 vs. 11.4%, respectively, p < 0.001). A higher prevalence of poor/very poor health status was reported by participants living in thinly populated areas or among older populations. Lower educational levels, lower income, as well as unemployment, were found to increase the risk of reporting poor/very poor health status. Utilizing healthcare services more frequently, experiencing barriers to access healthcare services, having depressive symptoms or activity limitations, or lacking social support were found to be significantly associated with poor/very poor self-perceived health. Conclusion Subjects living in Portugal tend to report less good/very good health status and more poor/very poor health when compared to the rest of Europe. This study stresses the importance of socioeconomic factors, chronic illness, barriers to access healthcare services, social isolation, and mental health status in influencing self-perceived health and highlights the urgent need for social-informed policies, strategies, and interventions to reduce health inequalities in Portugal.
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Affiliation(s)
- Ahmed Nabil Shaaban
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden,Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Lisbon, Portugal,Epidemiology Research Unit (EPIUnit) – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Maria Rosario O. Martins
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Lisbon, Portugal
| | - Bárbara Peleteiro
- Epidemiology Research Unit (EPIUnit) – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica Faculdade de Medicina da Universidade do Porto, Porto, Portugal,*Correspondence: Bárbara Peleteiro
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Gavurova B, Megyesiova S. Sustainable Health and Wellbeing in the European Union. Front Public Health 2022; 10:851061. [PMID: 35372223 PMCID: PMC8966080 DOI: 10.3389/fpubh.2022.851061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Altogether, 17 Sustainable Development Goals (SDGs) are an urgent call for action to end poverty, protect the planet, and ensure prosperity for all. Goal 3 is crucial in terms of good health and wellbeing. The main aim of this study is to analyze and evaluate differences among indicators of SDG 3: Sustainable health and wellbeing in the EU countries. Methods The status and development of the EU Member States regarding their successes or failures in terms of Goal 3 were subjected to analysis. Altogether, 11 indicators were used to rank the EU countries using the TOPSIS and ranking methods. The ranks were assigned to the countries in two periods. The first period is related to the time from 2010 till 2014, and the second period from 2015 till 2019. Results The EU countries achieved a positive development in 10 of 11 indicators that monitor the achievement of the EU in terms of Goal 3. The only variable that changed negatively was the obesity rate. Positivity was observed in the decline of the standardized preventable and treatable mortality, which declined from 317.3 in the first period to 295 in the second period; the drop of the population weighted annual mean concentration of fine particulate PM2.5, from 16.4 to 13.6 μg/m3, and also in the increase of the share of people with good or very good perceived health, which was combined with a decrease of the self-reported unmet need for medical examination and care. The best-rated country in terms of SDG 3 was, in both periods, Sweden, while the worst-rated was Latvia. Conclusions Governments and institutions in the EU can intervene to increase the accessibility and quality of the health care system, but every citizen should try to do their best to reduce some of the risk factors, such as smoking or obesity, to try living healthier and to help to achieve higher ambitions in terms of sustainable health and wellbeing.
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Affiliation(s)
- Beata Gavurova
- Faculty of Mining, Ecology, Process Control and Geotechnologies, Institute of Earth Resources, Technical University of Košice, Košice, Slovakia
| | - Silvia Megyesiova
- Faculty of Business Economy, University of Economics, Bratislava, Slovakia
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Ramos-Vera C, Saintila J, Calizaya-Milla YE, Acosta Enríquez ME, Serpa Barrientos A. Relationship Between Satisfaction With Medical Care, Physical Health, and Emotional Well-Being in Adult Men: Mediating Role of Communication. J Prim Care Community Health 2022; 13:21501319221114850. [PMID: 35880499 PMCID: PMC9340312 DOI: 10.1177/21501319221114850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Non-communicable diseases and psychiatric pathologies are the health problems that most affect the population in the United States. OBJECTIVE This study aimed to examine the mediating role of patient-centered communication (PCC) in the relationship between satisfaction with medical care, physical health, and emotional well-being in American men. METHODS A cross-sectional - predictive study was carried out. The variables analyzed were satisfaction with medical care, physical health, and emotional well-being. Information from the Health Information National Trends Survey Data (HINTS) was used; HINTS 5, cycle 3 (collected between January and June 2019) and 4 (2020). Data from 3338 men were considered (mean age: M = 55.40, SD = 19.53). Data analyses were carried out using structural equation modeling (SEM) to represent the statistical mediation model with latent and observable variables. RESULTS Analyses showed that the variables were significantly related (P < .01). In the mediation model, there is evidence that satisfaction predicts communication (β = .764, P < .001) and this, in turn, is related to physical health (β = .079, P = .007) and emotional well-being (β = .145, P < .001). In addition, the standardized estimates of the structural multiple mediation model presented acceptable goodness-of-fit indices: χ2/gl = 2.24, CFI = 0.999, TLI = 0.999, RMSEA = 0.019 [90% CI: 0.013-0.022], SRMR = 0.018. CONCLUSION Patient-centered communication plays a significant dual mediating role in the relationship between satisfaction with medical care, physical health, and emotional well-being, respectively. Therefore, PCC is essential in healthcare for American men.
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Hung CH, Lee YH, Lee DC, Chang YP, Chow CC. The mediating and moderating effects of shared decision making and medical autonomy on improving medical service satisfaction in emergency observation units. Int Emerg Nurs 2021; 60:101101. [PMID: 34864441 DOI: 10.1016/j.ienj.2021.101101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 09/15/2021] [Accepted: 09/29/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Distinct from other medical settings, the emergency setting is unique and requires flexible and adaptive decision making to provide quality medical services. This study was designed to investigate the mediating and moderating effects of shared decision making (SDM) and patient attitude toward medical autonomy (AMA) on improving medical service satisfaction (MSS) in emergency observation units. METHODS In this cross-sectional study, we collected data via a verified structured questionnaire. A total of 165 participants met the inclusion criteria, and 100% of the questionnaires recovered were valid. RESULTS The results show that SDM had a partial mediating effect (p < 0.01) and that it significantly improved MSS. AMA had a moderating effect on some domains (p < 0.01). Meeting patient needs and increasing their participation in decision making can effectively improve MSS. However, excessive patient participation might not be productive, which is an important finding of this study. CONCLUSION In emergency observation units, SDM-based doctor-patient interactions and cooperation, effective patient-centered communication, and respect for patients' medical autonomy improve the doctor-patient relationship and patients' health literacy. Patients can thus participate in selecting the best treatment plan to achieve expected health outcomes, and ultimately improve MSS.
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Affiliation(s)
- Chun-Hua Hung
- Emergency Department, Changhua Christian Medical Foundation, Erlin Christian Hospital, 558, Sec. 1, Da-Chen Rd., Erlin, Changhua 52665, Taiwan ROC
| | - Yi-Hua Lee
- Department of Administration, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County 35053, Taiwan ROC
| | - De-Chi Lee
- Department of Information Management, Da-Yeh University, 168 University Road, Dacun, Changhua 51591, Taiwan ROC
| | - Yuan-Ping Chang
- Department of Nursing, Fooyin University, 151 Jinxue Rd., Daliao Dist., Kaohsiung City 83102, Taiwan ROC.
| | - Chih-Chung Chow
- Office of the Deputy Superintendent, Changhua Christian Hospital, 135 Nan-Hsiao Street, Changhua 500, Taiwan ROC
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Odiase O, Akinyi B, Kinyua J, Afulani P. Community Perceptions of Person-Centered Maternity Care in Migori County, Kenya. Front Glob Womens Health 2021; 2:668405. [PMID: 34816219 PMCID: PMC8593945 DOI: 10.3389/fgwh.2021.668405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 09/02/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Community perceptions of quality of maternal healthcare services-including Person-centered maternity care (PCMC)-influences the health-seeking behavior of women. Yet few studies have examined this quantitatively. This study aims to examine community perceptions of PCMC and its associated factors. Materials and Methods: We used data from a survey on community perceptions of PCMC in Migori County, Kenya conducted in August 2016. Community members were relatives or friends of women aged 15 to 49 years who gave birth in the 9 wk preceding the survey (N = 198). PCMC was measured using a 30-item scale with three sub-scales for dignity and respect, communication and autonomy, and supportive care. PCMC scores were standardized to range from 0 to 100, with higher scores indicative of higher PCMC. Descriptive, bivariate, and multivariate analyses were performed in STATA (version 14). Results: The average total PCMC score was 62 (SD = 15.7), with scores of 74, 63, and 53 for dignity and respect, supportive care, and communication and autonomy, respectively. Controlling for other factors, respondents who were employed and literate had higher PCMC perception scores than those who were less literate and unemployed. Respondents who rated their health as very good had higher PCMC perception scores than those who rated their health as poor. Female respondents who previously gave birth at a health facility had lower perceptions of dignity and respect than those with no prior facility birth. Conclusion: The findings imply that community perceptions of PCMC, particularly related to communication and autonomy, are poor. Given the effects of these perceptions on use of maternal health services, there is a need to improve PCMC.
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Affiliation(s)
- Osamuedeme Odiase
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Beryl Akinyi
- Global Programs for Research and Training, Nairobi, Kenya
| | | | - Patience Afulani
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
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The Impact of New Technologies on Individuals’ Health Perceptions in the European Union. SUSTAINABILITY 2020. [DOI: 10.3390/su122410349] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The healthcare systems of European countries currently face challenges regarding the sustainability of healthcare provision. The growing sophistication of new technologies is transforming the accessibility and management of health services and information, while also challenging society’s ability to offer fair access to health services for all people. The aim of this paper is to identify and analyze some of the determinants of the self-perceived health status across the EU28 area and to determine how the digitalization of health is impacting the self-rated health of the European populations, given the fact that a healthier population is one of the 17 goals of sustainable development on the 2030 Agenda. The research method used is panel-data regression using secondary data from international databases. The results indicate that there is a direct relationship between the way people are assessing personal health, the ability to use the Internet for seeking health-related information, and the use of various apps to purchase health-related items online. Our findings are useful for academics, industry specialists, and public authorities in designing sustainable health products and policies by focusing on the development of suitable mHealth programs for generating more patient-centered services where the idea of self-care is encouraged.
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Saez M, Vidiella-Martin J, Casasnovas GL. Impact of the great recession on self-perceived health in Spain: a longitudinal study with individual data. BMJ Open 2019; 9:e023258. [PMID: 30782700 PMCID: PMC6361339 DOI: 10.1136/bmjopen-2018-023258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 08/10/2018] [Accepted: 09/27/2018] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Our objective in this study is to evaluate the impact the Great Recession (2008-2014) had on self-perceived health in Spain. DESIGN We use a longitudinal database (four waves of the Bank of Spain's Survey of Household Finances (2005, 2008, 2011 and 2014)) with repeated observations of the same individuals before and after the Great Recession. INTERVENTIONS We consider the Great Recession in a natural experiment and we introduce it as an explanatory variable in a mixed logistic regression model in which we explain the probability of a subject declaring poor health (fair, bad and very bad). In the model we control for both observed and unobserved confounders at both individual and family level. RESULTS We find an average downward trend in self-perceived health during the most severe period of the Great Recession (2009-2011). However, the fact that the adjusted measures are less volatile than the crude ones shows that variation in health status can be captured by either demographic or socioeconomic controls. In fact, there are significant differences in the impact the economic crisis had on health in terms of gender and age group. In particular, the (adjusted) risk of declaring poor health increases after the crisis began but only in those families in which the reference person is a woman younger than 45 years of age or a man aged 75 years or older. CONCLUSIONS Given our results, we discuss the link between financial wealth and self-rated health and how policy-makers could address the health inequalities that arise from adverse economic and financial shocks.
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Affiliation(s)
- Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain
| | - Joaquim Vidiella-Martin
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Tinbergen Institute, Amsterdam, The Netherlands
| | - Guillem López Casasnovas
- Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain
- Department of Economics and Business, Department of Economics and Business, Barcelona, Spain
- Barcelona Graduate School (BGSE), Universitat Pompeu Fabra, Barcelona, Spain
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Chen LJ, Chang YJ, Shieh CF, Yu JH, Yang MC. Accessibility of ophthalmic healthcare for residents of an offshore island-an example of integrated delivery system. BMC Health Serv Res 2016; 16:261. [PMID: 27412399 PMCID: PMC4944472 DOI: 10.1186/s12913-016-1501-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 07/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To assess the utilization of and satisfaction with ophthalmic healthcare provided by integrated delivery system (IDS) since 2000 and vision-related quality of life (VRQoL) for residents of an offshore island of Taiwan. METHODS Facilitators interviewed residents (age ≥ 50 years) with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) for VRQoL and a questionnaire on clinical information, ophthalmic care utilization and satisfaction. RESULTS A total of 841 participants (response rate 93.4 %, 841/900) completed the questionnaire survey. Mean age was 63.7 (±10. 7) years. The common eye diseases were cataract (44.7 %), dry eye (15.5 %), and glaucoma (8.7 %). Among the participants, 61.0 % sought ophthalmic care under the IDS in the past year and 17.6 % experienced unmet ophthalmic needs in the past 6 months. Satisfaction with ophthalmic care under the IDS was 88.1 %. Determinants of dissatisfaction under the IDS were distance to healthcare facility and VRQoL. Predictors of VRQoL included age, residential area, marital status, occupation, comorbid condition, commercial insurance, household income, cataracts and glaucoma. CONCLUSIONS The implementation of IDS improves accessibility of ophthalmic care for residents of an offshore island. Geographic proximity to avail healthcare facility and VRQoL affect satisfaction with the IDS.
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Affiliation(s)
- Li-Ju Chen
- />Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 637, No 17, Hsu-Chow Road, Taipei, 10055 Taiwan
- />Department of Ophthalmology, Heping Branch, Taipei City Hospital, Taipei, Taiwan
| | - Yun-Jau Chang
- />Department of General Surgery, National Taiwan University Hospital, Taipei, Taiwan
- />Department of General Surgery, Zhongxing branch, Taipei City Hospital, Taipei, Taiwan
| | - Chun-Fu Shieh
- />Public Health Bureau, Lienchiang County, Matsu Taiwan
| | - Jy-Haw Yu
- />Department of Ophthalmology, Heping Branch, Taipei City Hospital, Taipei, Taiwan
| | - Ming-Chin Yang
- />Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 637, No 17, Hsu-Chow Road, Taipei, 10055 Taiwan
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