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Enyeji A, Ibrahimou B, Barengo NC, Ramirez G, Arrieta A. Racial Disparities in Cardiovascular Health Among the Acute Coronary Syndrome Population. Popul Health Manag 2023; 26:378-386. [PMID: 37930632 DOI: 10.1089/pop.2023.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
The relative distribution of proportions of cardiovascular health (CVH) categories within racial groups has been examined. However, little scientific evidence exists on the gap trend in racial/ethnic disparities in mean CVH score among non-Hispanic (NH) Whites and Blacks. This study examined the trend(s) in the gap(s) in predicted CVH scores between NH Whites and Blacks over 10 years. In a cross-sectional analytical study, 10 years of Medical Expenditure Panel Survey data from 2008 to 2018 were pooled, utilizing multivariate Poisson's regression of CVH metrics on race, while controlling for relevant covariates. The interactions of acute coronary syndrome (ACS) with CVH metrics, and other key variables such as trends and grouped Charlson Comorbidity Index allowed for variations in the effect of these variables on the subgroups. The mean gap in CVH scores was on average 0.15 [95% confidence interval (CI) 0.137 to 0.170], with Blacks consistently having reduced odds of having ideal CVH until 2014. The overall impact of having an ACS decreased acquired CVH scores by 24.1% [95% CI -0.275 to 0.207], and was equal for both racial subgroups (P < 0.05). The Affordable Care Act (ACA)-trend was positive, increasing the likelihood of improved CVH in the sample (P < 0.05), deflecting a downward trend in acquired CVH scores for both races, as the gap narrowed into more recent years. The CVH gap was stabilized by the ACA, but never really converged, suggesting that efforts to reduce existing disparities between Blacks and NH Whites in the United States would require government policies to look beyond mere "access" and/or "affordability" to health care.
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Affiliation(s)
- Abraham Enyeji
- Department of Global Health, and Robert Stempel College of Public Health and Social Works, Florida International University, Miami, Florida, USA
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health and Social Works, Florida International University, Miami, Florida, USA
| | - Noël C Barengo
- Department of Global Health, and Robert Stempel College of Public Health and Social Works, Florida International University, Miami, Florida, USA
- Department of Medical and Population Health Sciences, Education, and Research, Translational Medicine, Florida International University, Miami, Florida, USA
- Department of Medicine, Riga Stradins University, Riga, Latvia
| | - Gilbert Ramirez
- Department of Global Health, and Robert Stempel College of Public Health and Social Works, Florida International University, Miami, Florida, USA
| | - Alejandro Arrieta
- Department of Global Health, and Robert Stempel College of Public Health and Social Works, Florida International University, Miami, Florida, USA
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Enyeji AM, Barengo NC, Ramirez G, Ibrahimou B, Arrieta A. Regional Variation in Health Care Utilization Among Adults With Inadequate Cardiovascular Health in the USA. Cureus 2023; 15:e44121. [PMID: 37750128 PMCID: PMC10518208 DOI: 10.7759/cureus.44121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/27/2023] Open
Abstract
Background Prior evidence of region-level differences in health outcomes and specialized healthcare services in the US poses questions of whether there are differences in utilization of healthcare that may account for regional differences in healthcare outcomes. This study aimed to examine regional differences in healthcare utilization for individuals with poor cardiovascular health (CVH) compared to those with ideal/intermediate CVH. Methods In this cross-sectional analytical study, two 3-year periods (2008-2010 and 2018-2020) were pooled and analyzed using multivariate Poisson's regression of region on counts of healthcare utilization, while controlling for relevant covariates. The interaction of the non-southern regions with recent years was to reveal how the regional dispersion in healthcare usage was changing over time for the non-southern regions compared to the south. Results The results showed significant regional variation in healthcare usage for individuals with poor CVH, with lower health utilization rates observed primarily in southern states, consistent with higher rates of coronary heart disease in those regions. The impact of a unit improvement on CVH score was to reduce the level of healthcare utilization by 15.7% ([95% CI, 15 - 17%; p < 0.001]) for individuals with poor CVH and 19.1% ([95% CI, 19 - 20%; p < 0.001]) for the intermediate and ideal subgroups, with the Northeast exhibiting the highest level of healthcare usage. Conclusion Our results suggest that there is a need for public health interventions to reduce regional disparities in access to healthcare for the people at greatest risk of cardiovascular events by considering individual factors as well as the broader regional and policy contexts where these people live.
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Affiliation(s)
- Abraham M Enyeji
- Department of Global Health, Robert Stempel College of Public Health & Social Works, Florida International University, Miami, USA
| | - Noel C Barengo
- Faculty of Medicine, Riga Stradiņš University, Riga, LVA
- Department of Global Health, Robert Stempel College of Public Health & Social Works, Florida International University, Miami, USA
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Miami, USA
| | - Gilbert Ramirez
- Department of Global Health, Robert Stempel College of Public Health & Social Works, Florida International University, Miami, USA
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health & Social Works, Florida International University, Miami, USA
| | - Alejandro Arrieta
- Department of Global Health, Robert Stempel College of Public Health & Social Works, Florida International University, Miami, USA
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Tucker CM, Bell N, Corbett CF, Lyndon A, Felder TM. Using medical expenditure panel survey data to explore the relationship between patient-centered medical homes and racial disparities in severe maternal morbidity outcomes. Womens Health (Lond) 2023; 19:17455057221147380. [PMID: 36660909 PMCID: PMC9887166 DOI: 10.1177/17455057221147380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND There are persistent racial/ethnic disparities in the occurrence of severe maternal morbidity. Patient-centered medical home care has the potential to address disparities in maternal outcomes. OBJECTIVES To examine (1) the association between receiving patient-centered medical home care and severe maternal morbidity outcomes and (2) the interaction of race/ethnicity on patient-centered medical home status and severe maternal morbidity. DESIGN/METHODS Using 2007 to 2016 data from the Medical Expenditures Panel Survey, we conducted a cross-sectional study to estimate the association between receipt of care from a patient-centered medical home and the occurrence of severe maternal morbidity, and racial-specific (White, Black, Asian, Other) relative risks of severe maternal morbidity. Our study used race as a proxy measure for exposure racism. We identified mothers (⩾15 years) who gave birth during the study period. We identified patient-centered medical home qualities using 11 Medical Expenditures Panel Survey questions and severe maternal morbidities using medical claims, and calculated generalized estimating equation models to estimate odds ratios of severe maternal morbidity and 95% confidence intervals. RESULTS Among all mothers who gave birth (N = 2801; representing 5,362,782 US lives), only 25% received some exposure patient-centered medical home care. Two percent experienced severe maternal morbidity, and this did not differ statistically (p = 0.11) by patient-centered medical home status. However, our findings suggest a 85% decrease in the risk of severe maternal morbidity among mothers who were defined as always attending a patient-centered medical home (odds ratios: 0.15; 95% confidence interval:0.01-1.87; p = 0.14) and no difference in the risk of severe maternal morbidity among mothers who were defined as sometimes attending a patient-centered medical home (odds ratios: 1.00; 95% confidence interval:0.16-6.42; p = 1.00). There was no overall interaction effect in the model between race and patient-centered medical home groups (p = 0.82), or ethnicity and patient-centered medical home groups (p = 0.62) on the severe maternal morbidity outcome. CONCLUSION While the rate of severe maternal morbidity was similar to US rates, few mothers received care from a patient-centered medical home which may be due to underreporting. Future research should further investigate the potential for patient-centered medical home-based care to reduce odds of severe maternal morbidity across racial/ethnic groups.
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Affiliation(s)
- Curisa M Tucker
- Department of Pediatrics, Stanford
University School of Medicine, Palo Alto, CA, USA,Curisa M Tucker, Department of Pediatrics,
Stanford University School of Medicine, 3145 Porter Drive, Palo Alto, CA 94304,
USA.
| | - Nathaniel Bell
- College of Nursing, University of South
Carolina, Columbia, SC, USA
| | | | - Audrey Lyndon
- Rory Meyers College of Nursing, New
York University, New York, NY, USA
| | - Tisha M Felder
- College of Nursing, University of South
Carolina, Columbia, SC, USA
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Almalki ZS, Alahmari AK, Alshehri AM, Altowaijri A, Alluhidan M, Ahmed N, AlAbdulsalam AS, Alsaiari KH, Alrashidi MA, Alghusn AG, Alqahtani AS, Alzarea AI, Alanazi MA, Alqahtani AM. Investigating households' out-of-pocket healthcare expenditures based on number of chronic conditions in Riyadh, Saudi Arabia: a cross-sectional study using quantile regression approach. BMJ Open 2022; 12:e066145. [PMID: 36171033 PMCID: PMC9528624 DOI: 10.1136/bmjopen-2022-066145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This study investigated the level and associated factors, focusing on the number of individuals with chronic conditions, of out-of-pocket healthcare expenditures (OOPHE). DESIGN A cross-sectional study was conducted from January 2021 to June 2021. SETTING Riyadh Province, Saudi Arabia. PARTICIPANTS A total of 1176 households that used any healthcare services at least once in the past 3 months. OUTCOME MEASURES The OOPHE incurred in the previous 3-month period when a household member is receiving health services. The effects of predisposing, enabling and need factors on the level of OOPHE. The association between the number of individuals with chronic conditions in a household and OOPHE along with the OOPHE distribution. RESULTS The average household OOPHE among all the surveyed households (n=1176) was SAR1775.30. For households affected by one chronic condition, OOPHE was SAR1806, and for households affected by more than one chronic condition, OOPHE was SAR2704. If the head of the household was older, better educated and employed, they were more vulnerable to a higher OOPHE (p<0.0001). At the household level, the increased number of family members with chronic conditions, the presence of a member less than 14 years old, higher socioeconomic status, coverage from health insurance plans, residence in an urban area and the presence of a member with a disability in the household were correlated with a considerably greater level of OOPHE (p<0.0001). The result of quantile regression analysis indicates that an increase in the number of members with chronic conditions in a household was significantly associated with greater overall OOPHE at higher health expenditure quantiles. CONCLUSIONS The burden of OOPHE on households with chronic conditions remains heavy, and some disparities still exist. The number of individuals with chronic conditions in a household plays a substantial and prominent role in increasing the risk of incurring OOPHE.
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Affiliation(s)
- Ziyad S Almalki
- Clinical Pharmacy, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Abdullah K Alahmari
- Clinical Pharmacy, Prince Sattam Bin Abdulaziz University College of Pharmacy, Al-Kharj, Saudi Arabia
| | - Ahmed M Alshehri
- Clinical Pharmacy, Prince Sattam Bin Abdulaziz University College of Pharmacy, Al-Kharj, Saudi Arabia
| | - Abdulaziz Altowaijri
- Clinical Leadership Department, Center of National Health Insurance, Riyadh, Saudi Arabia
| | - Mohammed Alluhidan
- General Directorate for National Health Economics and Policy, Saudi Health Council, Riyadh, Saudi Arabia
| | - Nehad Ahmed
- Clinical Pharmacy, Prince Sattam Bin Abdulaziz University College of Pharmacy, Al-Kharj, Saudi Arabia
| | - Abdulhakim S AlAbdulsalam
- Clinical Pharmacy, Prince Sattam Bin Abdulaziz University College of Pharmacy, Al-Kharj, Saudi Arabia
| | - Khalid H Alsaiari
- Clinical Pharmacy, Prince Sattam Bin Abdulaziz University College of Pharmacy, Al-Kharj, Saudi Arabia
| | - Meshari A Alrashidi
- Clinical Pharmacy, Prince Sattam Bin Abdulaziz University College of Pharmacy, Al-Kharj, Saudi Arabia
| | - Abdulrahman G Alghusn
- Clinical Pharmacy, Prince Sattam Bin Abdulaziz University College of Pharmacy, Al-Kharj, Saudi Arabia
| | - Ali S Alqahtani
- Clinical Pharmacy, Prince Sattam Bin Abdulaziz University College of Pharmacy, Al-Kharj, Saudi Arabia
| | - Abdulaziz I Alzarea
- Clinical Pharmacy, Al-Jouf University College of Pharmacy, Sakaka, Saudi Arabia
| | - Mona A Alanazi
- Medical Research Administration, Prince Mohammed Bin Abdul Aziz Hospital, Riyadh, Saudi Arabia
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Almalki ZS, Alahmari AK, Alqahtani N, Alzarea AI, Alshehri AM, Alruwaybiah AM, Alanazi BA, Alqahtani AM, Ahmed NJ. Households' Direct Economic Burden Associated with Chronic Non-Communicable Diseases in Saudi Arabia. Int J Environ Res Public Health 2022; 19:9736. [PMID: 35955092 PMCID: PMC9368111 DOI: 10.3390/ijerph19159736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Households' economic burden associated with chronic non-communicable diseases (NCDs) is a deterrent to healthcare access, adversely impacting patients' health. Therefore, we investigated the extent of out-of-pocket (OOP) spending among individuals diagnosed with chronic NCDs among household members in Riyadh, Saudi Arabia. Face-to-face interviews were conducted among households in Riyadh Province from the beginning of January 2021 to the end of June 2021. The respondents were asked to record OOP spending throughout the past three months in their health. A generalized linear regression model was used to determine the effects of several factors on the level of OOP spending. A total of 39.6% of the households studied had at least one member with a chronic NCD. Diabetes patients spent an average of SAR 932 (USD 248), hypertension patients SAR 606 (USD 162), and hypothyroid patients SAR 402 (USD 107). It was shown that households with older and more educated members had greater OOP spending. Households with an employed head of household, more family members, higher SES status, health insurance coverage, and urban residency had significantly higher OOP expenditure. The burden of OOP spending for chronic NCD households remains high, with some disparities. The research offers important information for decision making to lower OOP cost among NCD households.
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Affiliation(s)
- Ziyad S. Almalki
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Riyadh 16278, Saudi Arabia
| | - Abdullah K. Alahmari
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Riyadh 16278, Saudi Arabia
| | - Nasser Alqahtani
- Drug & Pharmaceutical Affairs, Riyadh First Health Cluster (C1) at Ministry of Health, Riyadh 12233, Saudi Arabia
| | | | - Ahmed M. Alshehri
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Riyadh 16278, Saudi Arabia
| | - Abdulrahman M. Alruwaybiah
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Riyadh 16278, Saudi Arabia
| | - Bader A. Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Riyadh 16278, Saudi Arabia
| | - Abdulhadi M. Alqahtani
- Research Center, King Fahad Medical City, Clinical Research Department, Riyadh 12231, Saudi Arabia
| | - Nehad J. Ahmed
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Riyadh 16278, Saudi Arabia
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Gholamzadeh M, Abtahi H, Ghazisaeeidi M. Applied techniques for putting pre-visit planning in clinical practice to empower patient-centered care in the pandemic era: a systematic review and framework suggestion. BMC Health Serv Res 2021; 21:458. [PMID: 33985502 PMCID: PMC8116646 DOI: 10.1186/s12913-021-06456-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/27/2021] [Indexed: 11/28/2022] Open
Abstract
Background One of the main elements of patient-centered care is an enhancement of patient preparedness. Thus, pre-visit planning assessment tools was emerged to prepare and involve patients in their treatment process. Objective The main objective of this article was to review the applied tools and techniques for consideration of putting pre-visit planning into practice. Methods Web of Science, Scopus, IEEE, and PubMed databases were searched using keywords from January 2001 to November 2020. The review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Then, qualitative analysis was done to suggest an appropriate framework by mapping the main concepts. Results Out of 385 citations were retrieved in initial database searches, 49 studies from ten countries were included. Applied pre-visit techniques can be classified into eight categories. Our results showed that almost 81% of studies were related to procedures that were done between each visit, while 42% of articles were related to before visits. Accordingly, the main approach of included articles was patient preparedness. While 38 studies reported this approach is effective, three studies reported the effectiveness of such tools as moderate, only two articles believed it had a low effect on improving patient-centered care. Conclusion This survey summarized the characteristics of published studies on pre-visit planning in the proposed framework. This approach could enhance the quality of patient care alongside enhancement patient-provider communication. However, such an approach can also be helpful to control pandemic diseases by reducing unnecessary referrals. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06456-7.
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Affiliation(s)
- Marsa Gholamzadeh
- Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, 5th Floor, Fardanesh Alley, Qods Ave, Tehran, Iran
| | - Hamidreza Abtahi
- Pulmonary and Critical care Medicine Department, Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghazisaeeidi
- Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, 5th Floor, Fardanesh Alley, Qods Ave, Tehran, Iran.
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Hand BN, Coury DL, White S, Darragh AR, Moffatt-Bruce S, Harris L, Longo A, Garvin JH. Specialized primary care medical home: A positive impact on continuity of care among autistic adults. Autism 2021; 25:258-265. [PMID: 32907353 PMCID: PMC7854931 DOI: 10.1177/1362361320953967] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
LAY ABSTRACT There is a nationally recognized need for innovative healthcare delivery models to improve care continuity for autistic adults as they age out of pediatric and into adult healthcare systems. One possible model of care delivery is called the "medical home". The medical home is not a residential home, but a system where a patient's healthcare is coordinated through a primary care physician to ensure necessary care is received when and where the patient needs it. We compared the continuity of care among autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the CAST, to matched national samples of autistic adults with private insurance or Medicare. Continuity of primary care among CAST patients was significantly better than that of matched national samples of autistic adult Medicare beneficiaries and similar to that of privately insured autistic adults. Our findings suggest that medical homes, like CAST, are a promising solution to improve healthcare delivery for the growing population of autistic adults.
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Affiliation(s)
| | | | - Susan White
- The Ohio State University Wexner Medical Center
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Jayathilaka R, Joachim S, Mallikarachchi V, Perera N, Ranawaka D. Chronic diseases: An added burden to income and expenses of chronically-ill people in Sri Lanka. PLoS One 2020; 15:e0239576. [PMID: 33113548 PMCID: PMC7592793 DOI: 10.1371/journal.pone.0239576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 09/10/2020] [Indexed: 01/16/2023] Open
Abstract
In the global context, health and the quality of life of people are adversely affected by either one or more types of chronic diseases. This paper investigates the differences in the level of income and expenditure between chronically-ill people and non-chronic population. Data were gathered from a national level survey conducted namely, the Household Income and Expenditure Survey (HIES) by the Department of Census and Statistics (DCS) of Sri Lanka. These data were statistically analysed with one-way and two-way ANOVA, to identify the factors that cause the differences among different groups. For the first time, this study makes an attempt using survey data, to examine the differences in the level of income and expenditure among chronically-ill people in Sri Lanka. Accordingly, the study discovered that married females who do not engage in any type of economic activity (being unemployed due to the disability associated with the respective chronic illness), in the age category of 40-65, having an educational level of tertiary education or below and living in the urban sector have a higher likelihood of suffering from chronic diseases. If workforce population is compelled to lose jobs, it can lead to income insecurity and impair their quality of lives. Under above findings, it is reasonable to assume that most health care expenses are out of pocket. Furthermore, the study infers that chronic illnesses have a statistically proven significant differences towards the income and expenditure level. This has caused due to the interaction of demographic and socio-economic characteristics associated with chronic illnesses. Considering private-public sector partnerships that enable affordable access to health care services for all as well as implementation of commercial insurance and community-based mutual services that help ease burden to the public, are vital when formulating effective policies and strategies related to the healthcare sector. Sri Lanka is making strong efforts to support its healthcare sector and public, which was affected by the coronavirus (COVID-19) in early 2020. Therefore, findings of this paper will be useful to gain insights on the differences of chronic illnesses towards the income and expenditure of chronically-ill patients in Sri Lanka.
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Affiliation(s)
- Ruwan Jayathilaka
- Department of Business Management, SLIIT Business School, Sri Lanka Institute of Information Technology, Malabe, Sri Lanka
| | - Sheron Joachim
- Department of Business Management, SLIIT Business School, Sri Lanka Institute of Information Technology, Malabe, Sri Lanka
| | - Venuri Mallikarachchi
- Department of Business Management, SLIIT Business School, Sri Lanka Institute of Information Technology, Malabe, Sri Lanka
| | - Nishali Perera
- Department of Business Management, SLIIT Business School, Sri Lanka Institute of Information Technology, Malabe, Sri Lanka
| | - Dhanushika Ranawaka
- Department of Business Management, SLIIT Business School, Sri Lanka Institute of Information Technology, Malabe, Sri Lanka
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Abstract
In the global context, the health and quality of life of people are adversely affected by either one or more types of chronic diseases. The chronic pain associated with diagnosed patients may include heavy medical expenditure along with the physical and mental suffering they undergo. Usually, unbearable amounts of medical expenses are incurred, to improve or sustain the health condition of the patient. Consequently, the heavy financial burden tends to push households from a comfortable or secure life, or even from bad to worse, towards the probability of becoming poor. Hence, this study is conducted to identify the impact chronic illnesses have on poverty using data from a national survey referred as the Household Income and Expenditure Survey (HIES), with data gathered by the Department of Census and Statistics (DCS) of Sri Lanka in 2016. As such, this study is the first of its kind in Sri Lanka, declaring the originality of the study based on data collected from the local arena. Accordingly, the study discovered that married females who do not engage in any type of economic activity, in the age category of 40-65, having an educational level of tertiary level or below and living in the urban sector have a higher likelihood of suffering from chronic diseases. Moreover, it was inferred that, if a person is deprived from access to basic education in the level of education, lives in the rural or estate sector, or suffers from a brain disease, cancer, heart disease or kidney disease, he is highly likely to be poor. Some insights concluded from this Sri Lankan case study can also be applied in the context of other developing countries, to minimise chronic illnesses and thereby the probability of falling into poverty.
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Affiliation(s)
- Ruwan Jayathilaka
- Department of Business Management, SLIIT Business School, Sri Lanka Institute of Information Technology, Malabe, Sri Lanka
| | - Sheron Joachim
- Department of Business Management, SLIIT Business School, Sri Lanka Institute of Information Technology, Malabe, Sri Lanka
| | - Venuri Mallikarachchi
- Department of Business Management, SLIIT Business School, Sri Lanka Institute of Information Technology, Malabe, Sri Lanka
| | - Nishali Perera
- Department of Business Management, SLIIT Business School, Sri Lanka Institute of Information Technology, Malabe, Sri Lanka
| | - Dhanushika Ranawaka
- Department of Business Management, SLIIT Business School, Sri Lanka Institute of Information Technology, Malabe, Sri Lanka
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Squires A, Ridge L, Miner S, McDonald MV, Greenberg SA, Cortes T. Provider Perspectives of Medication Complexity in Home Health Care: A Qualitative Secondary Data Analysis. Med Care Res Rev 2019; 77:609-619. [DOI: 10.1177/1077558719828942] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A primary service provided by home care is medication management. Issues with medication management at home place older adults at high risk for hospital admission, readmission, and adverse events. This study sought to understand medication management challenges from the home care provider perspective. A qualitative secondary data analysis approach was used to analyze program evaluation interview data from an interprofessional educational intervention study designed to decrease medication complexity in older urban adults receiving home care. Directed and summative content analysis approaches were used to analyze data from 90 clinician and student participants. Medication safety issues along with provider–provider communication problems were central themes with medication complexity. Fragmented care coordination contributed to medication management complexity. Patient-, provider-, and system-level factors influencing medication complexity and management were identified as contributing to both communication and coordination challenges.
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