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Posttraumatic growth in coronary artery disease outpatients: relationship to degree of trauma and health service use.

https://arctichealth.org/en/permalink/ahliterature126272
Source
J Psychosom Res. 2012 Apr;72(4):293-9
Publication Type
Article
Date
Apr-2012
Author
Yvonne W Leung
David A Alter
Peter L Prior
Donna E Stewart
Jane Irvine
Sherry L Grace
Author Affiliation
York University, Canada. yvonnewleung@gmail.com
Source
J Psychosom Res. 2012 Apr;72(4):293-9
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Aged
Ambulatory Care
Cohort Studies
Continuity of Patient Care
Coronary Artery Disease - prevention & control - psychology - rehabilitation
Female
Health Services - utilization
Humans
Male
Middle Aged
Ontario
Personality Development
Prospective Studies
Recurrence - prevention & control
Sick Role
Stress Disorders, Post-Traumatic - diagnosis - psychology
Utilization Review
Abstract
Posttraumatic growth (PTG) is frequently reported after the strike of a serious medical illness. The current study sought to: 1) assess the relationship between degree of cardiac "threat" and PTG one-year post-hospitalization; and 2) to explore the association between PTG and healthcare utilization.
In a cohort study, 2636 cardiac inpatients from 11 Ontario hospitals completed a sociodemographic survey; clinical data were extracted from charts. One year later, 1717 of these outpatients completed a postal survey, which assessed PTG and healthcare utilization. Morbidity data were obtained retrospectively through probabilistic linkage to administrative data. The predicted risk of recurrent events for each participant was calculated using a logistic regression model, based on participants' sociodemographic and clinical characteristics. The relationship among PTG, trauma and health service use was examined with multiple regression models.
Greater PTG was significantly related to greater predicted risk of recurrent events (p
PubMed ID
22405224 View in PubMed
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A prospective examination of disease management program use by complex cardiac outpatients.

https://arctichealth.org/en/permalink/ahliterature126092
Source
Can J Cardiol. 2012 Jul-Aug;28(4):490-6
Publication Type
Article
Author
Shannon Gravely
Robert D Reid
Paul Oh
Heather Ross
Donna E Stewart
Sherry L Grace
Author Affiliation
York University, Toronto, Ontario, Canada.
Source
Can J Cardiol. 2012 Jul-Aug;28(4):490-6
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - rehabilitation
Aged
Ambulatory Care - utilization
Angioplasty, Balloon, Coronary - rehabilitation
Cardiac Valve Annuloplasty - rehabilitation
Cohort Studies
Comorbidity
Coronary Artery Bypass - rehabilitation
Coronary Disease - epidemiology - rehabilitation
Disease Management
Female
Follow-Up Studies
Heart Failure - epidemiology - rehabilitation
Heart Valve Prosthesis Implantation - rehabilitation
Humans
Male
Middle Aged
Ontario
Prospective Studies
Referral and Consultation - statistics & numerical data
Treatment Outcome
Abstract
The use of disease management programs (DMPs) by patients with cardiovascular disease (CVD) is associated with improved outcomes. Although rates of cardiac rehabilitation (CR) use are well established, less is known about other DMPs. The objectives of this study were to describe the degree of DMP utilization by CVD outpatients, and examine factors related to use.
This study represents a secondary analysis of a larger prospective cohort study. In hospital, 2635 CVD inpatients from 11 hospitals in Ontario Canada completed a survey that assessed factors affecting DMP utilization. One year later, 1803 participants completed a mailed survey that assessed DMP utilization.
One thousand seventy-three (59.5%) participants reported using at least 1 DMP. Overall, 951 (52.7%) reported participating in cardiac rehabilitation, and among participants with a comorbid indication, 212 (41.2%) reported attending a diabetes education centre, 28 (25.9%) attended stroke rehabilitation, 35 (12.9%) used a heart failure clinic, and 13 (11.7%) attended a smoking cessation program. A multinomial logistic regression analysis showed that compared with no DMP use, participants that attended 1 or multiple programs were younger, married, diagnosed with a myocardial infarction, less likely to have had a percutaneous coronary intervention and had higher perceptions of personal control over their heart condition. There were few differences between participants that used 1 vs multiple DMPs, however, having diabetes or comorbid stroke significantly increased the likelihood of multiple DMP use.
Approximately 40% of CVD outpatients do not access DMPs. An integrated approach to vascular disease management appears warranted.
PubMed ID
22424663 View in PubMed
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Referral and use of heart failure clinics: what factors are related to use?

https://arctichealth.org/en/permalink/ahliterature126685
Source
Can J Cardiol. 2012 Jul-Aug;28(4):483-9
Publication Type
Article
Author
Shannon Gravely
Liane Ginsburg
Donna E Stewart
Susanna Mak
Sherry L Grace
Author Affiliation
York University, Faculty of Health, Toronto, Ontario, Canada.
Source
Can J Cardiol. 2012 Jul-Aug;28(4):483-9
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Female
Health Services Needs and Demand - utilization
Heart Failure - epidemiology - rehabilitation
Humans
Male
Middle Aged
Odds Ratio
Ontario
Prospective Studies
Referral and Consultation - statistics & numerical data
Rehabilitation Centers - utilization
Risk factors
Utilization Review - statistics & numerical data
Abstract
Heart failure (HF) clinics have been shown to reduce hospital readmissions and generally have favourable effects on quality of life, survival, and care costs. This study investigated the rates of referral and use of HF clinics and examined factors related to program use.
This study represents a secondary analysis of a larger prospective cohort study conducted in Ontario. In hospital, 474 HF inpatients from 11 hospitals across Ontario completed a survey that examined predisposing, enabling, and need factors affecting HF clinic use. Then 1 year later, 271 HF patients completed a mailed survey that assessed referral to and use of HF clinics.
Forty-one patients (15.2%) self-reported referral, and 35 (13%) self-reported attending an HF clinic. Generalized estimating equations showed that factors related to greater program use were having an HF clinic at the site of hospital recruitment (odds ratio [OR] = 8.40; P = 0.04), referral to other disease management programs (OR = 4.87; P = 0.04), higher education (OR = 4.61; P = 0.02), lower stress (OR = 0.93; P = 0.03), and lower functional status (OR = 0.97; P = 0.03).
Similar to previous research, only one-seventh of HF patients were referred to and used an HF clinic. Both patient-level and health-system factors were related to HF clinic use. Given the benefits of HF clinics, more research examining how equitable access can be increased is needed. Also, the appropriateness and cost repercussions of use of multiple disease management programs should be investigated.
PubMed ID
22366509 View in PubMed
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