Health Services Utilisation (health + services_utilisation)

Distribution by Scientific Domains

Selected Abstracts

Oral health conditions of community-dwelling cognitively intact elderly persons with disabilities

Ralph Saunders
Objectives:, To present descriptive information on oral health and health care of community-dwelling elderly persons with disabilities who are living at home. Background:, Most previous studies have focused on specific subpopulations, namely, persons who are essentially healthy and independent, are homebound, or are nursing home residents. Little information appears to be available on community-residing elderly persons with disabilities. Materials and methods:, A total of 641 participants aged 65 years and over in a Medicare Demonstration who were cognitively intact, completed an oral health questionnaire within 1 year of Demonstration entry. Demonstration participants were required to be living in the community, need or receive help with 2+ activities of daily living (ADLs) or 3+ instrumental ADLs (IADLs), and have recently experienced significant health services utilisation. Results:, Subject mean age was 79.1 years, 73.8% were female, and 4% were minority. They were dependent in a mean of 1.8 ADLs and 2.9 IADLs. 43.1% reported that they had no natural teeth, 77.4% had dentures, 58.8% frequently felt their mouth was dry, 5.2% had jaw pain now and 6.1% had at some time experienced burning sensations in their mouth or tongue. 40.4% reported that they were currently in need of dental treatment, although 56.2% indicated they now had a dentist, and 42.1% identified having a dental visit within the past 12 months. 19.7% indicated some dental insurance coverage. Conclusion:, This is one of the first studies to focus on community-dwelling elderly people with disabilities. Substantial oral health morbidity was reported. [source]

Drug-related problems in elderly general practice patients receiving pharmaceutical care

Elaine Lau Research fellow
Objective To describe the types of drug-related problems identified by pharmacists providing pharmaceutical care to elderly patients in the primary care or general medicine setting, and the impact of their recommendations on drug-related outcomes. Methods Searches of the MEDLINE, EMBASE, CINAHL, HealthSTAR, and International Pharmaceutical Abstracts electronic databases from 1990 to 2002 were conducted and a manual search of references from retrieved articles and references on file was performed. Large (n> 100) randomised, controlled studies comparing the provision of pharmaceutical care to usual care in seniors in primary care or general medicine settings were included. Two reviewers evaluated articles based on inclusion criteria and extracted data from the intervention arm of each study, resolving discrepancies by consensus. Nine original articles were included for analysis. Key findings The mean number of drug-related problems (DRPs) identified per patient was 3.2 and the mean number of recommendations made per patient was 3.3. The most common DRP identified was not taking/receiving a prescribed drug appropriately (35.2%, range 4.7,49.3%). The most common recommendations made involved patient education (37.2%, range 4.6,48.2%). Implementation rates were generally high for all types of recommendations, with the highest being for provision of patient education (81.6%). The small number of studies available examining measures of drug utilisation and costs, health services utilisation, and patient outcomes produced inconsistent results, making it difficult to draw conclusions. Conclusions Substantial numbers and a wide range of DRPs were identified by pharmacists who provided pharmaceutical care to seniors in the primary care and general medicine setting. Pharmacists' drug-therapy recommendations were well accepted; however, further study is needed to determine the impact of these recommendations on health-related outcomes. [source]

The comparison of health status and health services utilisation between Indigenous and non-Indigenous infants in Australia

Lixin Ou
Abstract Objective: To examine the differences in health services utilisation and the associated risk factors between Indigenous and non-Indigenous infants at a national level in Australia. Methods: We analysed data from a national representative longitudinal study, the Longitudinal Study for Australian Children (LSAC) starting in 2004. We used survey logistic regression and survey multiple linear regression to examine the factors associated with health services utilisation. Results: Health status of Indigenous infants was poorer than that of non-Indigenous. In comparison to non-Indigenous infants, in the previous 12-month period, the Indigenous infants were significantly less likely to use the following health services: maternal and child health centre or help lines (OR=0.35, 95%CI: 0.24-0.49); maternal and child health nurse visits (OR=0.45, 95%CI: 0.32-0.63); general practitioners (GPs) (OR=0.45, 95%CI: 0.31-0.64); and paediatrician (OR=0.52, 95%CI: 0.35-0.77). In contrast, they were more likely to visit a hospital outpatient clinic (OR=1.82, 95%CI: 1.16-2.85). Mothers' age, education and marital status were associated with certain health services use. Financial status and residential location were the important predictors of the use of health services. Conclusion: The rates of health services utilisation by Indigenous infants were lower and were associated with mothers' characteristics and socio-economic status. Implications: The gaps in health services utilisation between Indigenous and non-Indigenous infant requires immediate policy initiatives. Further research is needed to explore the causal pathways between health status, health services utilisation and multiple risk factors at different levels. [source]