Skip header and navigation

Refine By

26 records – page 1 of 3.

Access and coverage of needle and syringe programmes (NSP) in Central and Eastern Europe and Central Asia.

https://arctichealth.org/en/permalink/ahliterature84779
Source
Addiction. 2007 Aug;102(8):1244-50
Publication Type
Article
Date
Aug-2007
Author
Aceijas Carmen
Hickman Matthew
Donoghoe Martin C
Burrows Dave
Stuikyte Raminta
Author Affiliation
Centre for Research on Drugs and Health Behaviour (CRDHB), London School of Hygiene and Tropical Medicine (LSHTM), Department of Public Health and Policy, London, UK.
Source
Addiction. 2007 Aug;102(8):1244-50
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Asia, Central - epidemiology
Demography
Europe, Eastern - epidemiology
Female
HIV Infections - prevention & control
Health Services Accessibility - standards - statistics & numerical data
Hepatitis C - prevention & control
Humans
Male
Needle-Exchange Programs - economics - organization & administration - supply & distribution
Abstract
OBJECTIVE: To estimate access, activity and coverage of needle and syringe programmes (NSP) in Central and Eastern Europe and Central Asia. METHODS: Two data sets ('regional' and 'high-coverage sites') were used to estimate NSP provision (availability/number of sites), NSP utilization (syringes distributed/year), needle and syringe distribution (needles/syringes distributed/IDU/year), IDU reached (number/percentage of IDU contacted/year), regular reach (five or more contacts/month) and syringe coverage (percentage of injections/IDU/year administrable with new injecting equipment). RESULTS: Regional data set: results from 213 sites in 25 countries suggested that Czech Republic, Poland, Russia and Ukraine had > 10 NSP during 2001/2. Czech Republic, Kazakhstan, Latvia, Russia, Slovakia and Ukraine had >or= 10,000 IDU in contact with NSP. Ten countries reached >or= 10% of the estimated IDU population. The 25 countries distributed approximately 17 million syringes/needles. Eight countries distributed > 0.5 million syringes/year. Syringe coverage (assuming 400 injections/IDU/year) was 15% in Macedonia. Overall syringe coverage was 1.2% and when assuming 700 injections/IDU/year it decreased to 0.7%. Syringe coverage for the IDU population in contact with NSP was 60% in Croatia, Macedonia, Moldova and Tajikistan. Overall syringe coverage for the population in contact with NSP was 9.8%. High-coverage data set: Soligorsk, Pskov and Sumy's NSP reached 92.3%, 92.2% and 73.3% of their estimated IDU population, respectively (regular reach: 0.2%, 1.8% and 22.7%). The distribution levels were 47.2, 51.7 and 94.2 syringes/IDU/year, respectively. CONCLUSION: The evidence suggests suboptimal levels of NSP implementation, programme activity and coverage. This paper provides a baseline for development of indicators that could be used to monitor NSP. Strategies to increase coverage that may go beyond NSP are urgently required, as is research into understanding how NSP can contribute to better syringe coverage among IDU.
Notes
Comment In: Addiction. 2007 Aug;102(8):1179-8017624968
PubMed ID
17565564 View in PubMed
Less detail

Accessibility of tertiary hospitals in Finland: A comparison of administrative and normative catchment areas.

https://arctichealth.org/en/permalink/ahliterature291196
Source
Soc Sci Med. 2017 06; 182:60-67
Publication Type
Journal Article
Date
06-2017
Author
Tiina Huotari
Harri Antikainen
Timo Keistinen
Jarmo Rusanen
Author Affiliation
Geography Research Unit, University of Oulu, PO Box 3000, FI-90014, Finland. Electronic address: tiina.huotari@oulu.fi.
Source
Soc Sci Med. 2017 06; 182:60-67
Date
06-2017
Language
English
Publication Type
Journal Article
Keywords
Catchment Area (Health) - statistics & numerical data
Finland
Geographic Mapping
Health Services Accessibility - standards - statistics & numerical data
Humans
Tertiary Care Centers - organization & administration - statistics & numerical data - supply & distribution
Abstract
The determination of an appropriate catchment area for a hospital providing highly specialized (i.e. tertiary) health care is typically a trade-off between ensuring adequate client volumes and maintaining reasonable accessibility for all potential clients. This may pose considerable challenges, especially in sparsely inhabited regions. In Finland, tertiary health care is concentrated in five university hospitals, which provide services in their dedicated catchment areas. This study utilizes Geographic Information Systems (GIS), together with grid-based population data and travel-time estimates, to assess the spatial accessibility of these hospitals. The current geographical configuration of the hospitals is compared to a normative assignment, with and without capacity constraints. The aim is to define optimal catchment areas for tertiary hospitals so that their spatial accessibility is as equal as possible. The results indicate that relatively modest improvements can be achieved in accessibility by using normative assignment to determine catchment areas.
PubMed ID
28414937 View in PubMed
Less detail

[Access to general practitioners in a county in Troms]

https://arctichealth.org/en/permalink/ahliterature70574
Source
Tidsskr Nor Laegeforen. 2005 Aug 25;125(16):2210-2
Publication Type
Article
Date
Aug-25-2005
Author
Anne Helen Hansen
Ivar J Aaraas
Jorun Støvne Pettersen
Gerd Ersdal
Author Affiliation
Tromsø kommune, Rådhuset, 9299 Tromsø. anne.helen.hansen@tromso.kommune.no
Source
Tidsskr Nor Laegeforen. 2005 Aug 25;125(16):2210-2
Date
Aug-25-2005
Language
Norwegian
Publication Type
Article
Keywords
Comparative Study
Emergency Medical Services - standards - statistics & numerical data
English Abstract
Family Practice - standards - statistics & numerical data
Female
Health Services Accessibility - standards - statistics & numerical data
Humans
Interviews
Male
Norway
Physicians, Family
Physicians, Women
Referral and Consultation - standards - statistics & numerical data
Rural Health Services - standards - statistics & numerical data
Telephone
Urban Health Services - standards - statistics & numerical data
Abstract
BACKGROUND: In 2002 the Norwegian Board of Health made a survey of the accessibility of general practitioners in Troms county in North Norway. MATERIAL AND METHODS: In a telephone interview one secretary in each surgery informed about telephone response time, planned time for telephone consultations, recorded numbers of urgent consultations, and waiting time to obtain a routine consultation. RESULTS: On average, the planned telephone time was two hours per week. Telephone time was in inverse proportion to the number of patients on the doctor's list. Rural doctors spent twice as much time as urban colleagues on the telephone with their patients. Doctors with lists between 500 and 1500 patients had a higher proportion of urgent consultations compared with doctors with shorter or longer lists. INTERPRETATION: Telephone response time below two minutes and waiting times for routine consultations below 20 days appear to be within acceptable norms. When patient lists are above 1500, doctors' capacity to offer telephone contact and emergency services to their patients seems reduced.
PubMed ID
16138139 View in PubMed
Less detail

Access to health care and geographic mobility of HIV/AIDS patients.

https://arctichealth.org/en/permalink/ahliterature213684
Source
AIDS Patient Care. 1995 Dec;9(6):297-302
Publication Type
Article
Date
Dec-1995
Author
R S Hogg
M T Schechter
A. Schilder
R. Le
S A Strathdee
I L Goldstone
M V O'Shaughnessy
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital/University of British Columbia, Vancouver, Canada.
Source
AIDS Patient Care. 1995 Dec;9(6):297-302
Date
Dec-1995
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Catchment Area (Health) - statistics & numerical data
Cross-Sectional Studies
Data Collection
Delivery of Health Care - standards - trends
Female
HIV Infections - diagnosis - therapy
Health Services Accessibility - standards - statistics & numerical data - trends
Humans
Logistic Models
Male
Middle Aged
Questionnaires
Socioeconomic Factors
Abstract
To determine the patterns and determinants of mobility in persons with HIV infection or AIDS on a population basis.
Descriptive cross-sectional population health study.
650 full members (i.e., HIV-positive) of the Vancouver Persons with AIDS Society who were residents of British Columbia and who allow the society to include unsolicited material with their monthly newsletter.
Migration history, access to HIV-related care at diagnosis, current and pre-HIV sociodemographic characteristics, and current health status.
Two hundred and fifty-two persons living with HIV/AIDS participated in the study. At the time of the survey, the majority of subjects were male (94 percent), aged between 30 and 54 years (87 percent), and able to carry out daily activities without assistance (84 percent). The median time since the known date of HIV infection was 6 years. Access to care at diagnosis was associated in this population with being diagnosed in the largest metropolitan area in the province (OR = 2.14; 95 percent CI: 1.18, 3.87), a pre-HIV income of $30,000 or more per annum (OR = 0.49; 95 percent CI: 0.27, 0.89), a known date of diagnosis prior to 1990 (78 percent versus 64 percent; p = 0.019), and living in the same residence from the date of known HIV diagnosis to the date of the survey (63 percent versus 51 percent; p = 0.024).
Although no definitive causal association can be provided by this cross-sectional analysis, our results clearly highlight several ways in which the need for treatment and care potentially affect where persons with HIV/AIDS choose to live.
PubMed ID
11361439 View in PubMed
Less detail

[Albin--a primary health care patient]

https://arctichealth.org/en/permalink/ahliterature97724
Source
Lakartidningen. 2010 Jan 20-26;107(3):122-3
Publication Type
Article

[Barriers to treatment access reported by people with anxiety disorders].

https://arctichealth.org/en/permalink/ahliterature113187
Source
Can J Psychiatry. 2013 May;58(5):300-5
Publication Type
Article
Date
May-2013
Author
Michel Perreault
David Lafortune
Anick Laverdure
Mariko Chartier-Otis
Claude Bélanger
André Marchand
Stéphane Bouchard
Diana Milton
Author Affiliation
Université McGill, Montréal, Québec. michel.perreault@douglas.mcgill.ca
Source
Can J Psychiatry. 2013 May;58(5):300-5
Date
May-2013
Language
French
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anxiety Disorders - diagnosis - epidemiology - psychology - therapy
Chi-Square Distribution
Communication Barriers
Community Mental Health Services - standards
Female
Health Services Accessibility - standards - statistics & numerical data
Humans
Male
Needs Assessment
Patient Acceptance of Health Care - psychology - statistics & numerical data
Patient Preference - statistics & numerical data
Quebec - epidemiology
Questionnaires
Abstract
Our study examined the barriers to treatment experienced by people with anxiety disorders (ADs) who had not received services for their problems. Recommendations to improve treatment access made by participants are reported.
A web-based questionnaire on treatment accessibility for anxiety disorders was completed by 610 people living in Quebec reporting an anxiety problem. Chi-square tests were used to compare answers from people who received services (n = 151) with answers from people who had not (n = 434 ).
Treatment wait times that were too long (X2 = 29.66, df = 1, P
PubMed ID
23756290 View in PubMed
Less detail

Cardiac rehabilitation barriers by rurality and socioeconomic status: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature107685
Source
Int J Equity Health. 2013;12:72
Publication Type
Article
Date
2013
Author
Shamila Shanmugasegaram
Paul Oh
Robert D Reid
Treva McCumber
Sherry L Grace
Author Affiliation
York University and University Health Network, Toronto, Canada. sgrace@yorku.ca.
Source
Int J Equity Health. 2013;12:72
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cross-Sectional Studies
Female
Health Services Accessibility - standards - statistics & numerical data
Heart Diseases - rehabilitation
Humans
Male
Middle Aged
Ontario
Rural Population - statistics & numerical data
Socioeconomic Factors
Abstract
Despite greater need, rural inhabitants and individuals of low socioeconomic status (SES) are less likely to undertake cardiac rehabilitation (CR). This study examined barriers to enrollment and participation in CR among these under-represented groups.
Cardiac inpatients from 11 hospitals across Ontario were approached to participate in a larger study. Rurality was assessed by asking participants whether they lived within a 30-minute drive-time from the nearest hospital, with those >30 minutes considered "rural." Participants completed a sociodemographic survey, which included the MacArthur Scale of Subjective Social Status. One year later, they were mailed a survey which assessed CR utilization and included the Cardiac Rehabilitation Barriers Scale. In this cross-sectional study, CR utilization and barriers were compared by rurality and SES.
Of the 1809 (80.4%) retained, there were 215 (11.9%) rural participants, and the mean subjective SES was 6.37 ± 1.76. The mean CRBS score was 2.03 ± 0.73. Rural inhabitants reported attending significantly fewer CR sessions (p
Notes
Cites: J Cardiovasc Nurs. 2011 Jul-Aug;26(4 Suppl):S1-221659807
Cites: Ital Heart J. 2003 Aug;4(8):551-814564982
Cites: Cochrane Database Syst Rev. 2011;(7):CD00180021735386
Cites: J Cardiopulm Rehabil Prev. 2011 Jul-Aug;31(4):203-1021705915
Cites: Am Heart J. 2011 Oct;162(4):571-584.e221982647
Cites: J Cardiopulm Rehabil Prev. 2012 Jan-Feb;32(1):41-722193933
Cites: Clin Rehabil. 2012 Feb;26(2):152-6421937522
Cites: Scand J Public Health. 2012 May;40(3):286-9322637368
Cites: JAMA. 2004 Mar 3;291(9):1100-714996779
Cites: Ann Epidemiol. 2004 Feb;14(2):143-5015018888
Cites: Health Technol Assess. 2004 Oct;8(41):iii-iv, ix-x, 1-15215461879
Cites: Med Care. 1976 Jul;14(7):616-24940405
Cites: Arch Intern Med. 1992 May;152(5):1033-51580707
Cites: BMJ. 1997 Feb 22;314(7080):547-529055712
Cites: J Adv Nurs. 2005 Mar;49(5):538-5515713186
Cites: J Cardiopulm Rehabil. 2005 Mar-Apr;25(2):80-415818195
Cites: Public Health. 2005 Nov;119(11):1016-2216085152
Cites: J Rural Health. 2006 Spring;22(2):140-616606425
Cites: Arch Intern Med. 2007 May 28;167(10):1019-2517533204
Cites: Circulation. 2007 Oct 9;116(15):1653-6217893274
Cites: Med J Aust. 2008 Jun 16;188(12):712-418558894
Cites: Can J Cardiol. 2009 Apr;25(4):e96-919340365
Cites: Pediatrics. 2009 May;123(5):e815-919403474
Cites: Heart. 2009 Dec;95(23):1897-90019815940
Cites: Cochrane Database Syst Rev. 2010;(7):CD00713120614453
Cites: Int J Health Geogr. 2010;9:2720525345
Cites: Arch Intern Med. 2011 Feb 14;171(3):235-4121325114
Cites: Circulation. 2000 Apr 25;101(16):1913-810779456
Cites: Rehabil Nurs. 2001 Jul-Aug;26(4):141-712035581
Cites: J Rural Health. 2002 Summer;18(3):382-312186311
Cites: Rehabil Nurs. 2003 Mar-Apr;28(2):57-6312673978
Cites: J Cardiovasc Nurs. 2011 Jul-Aug;26(4 Suppl):S5-1421659814
PubMed ID
23985017 View in PubMed
Less detail

Housing status and the health of people living with HIV/AIDS.

https://arctichealth.org/en/permalink/ahliterature120784
Source
Curr HIV/AIDS Rep. 2012 Dec;9(4):364-74
Publication Type
Article
Date
Dec-2012
Author
M-J Milloy
Brandon D L Marshall
Julio Montaner
Evan Wood
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, B.C., V6Z 1Y6, Canada. mjmilloy@cfenet.ubc.ca
Source
Curr HIV/AIDS Rep. 2012 Dec;9(4):364-74
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - drug therapy - epidemiology
Antiretroviral Therapy, Highly Active
Attitude to Health
Canada - epidemiology
Disease Progression
Female
HIV Seropositivity - drug therapy - epidemiology
Health Services Accessibility - standards - statistics & numerical data
Homeless Persons - statistics & numerical data
Housing - statistics & numerical data
Humans
Male
Medication Adherence - statistics & numerical data
Socioeconomic Factors
Substance-Related Disorders - epidemiology
Viral Load
Abstract
Individuals who are homeless or living in marginal conditions have an elevated burden of infection with HIV. Existing research suggests the HIV/AIDS pandemic in resource-rich settings is increasingly concentrated among members of vulnerable and marginalized populations, including homeless/marginally-housed individuals, who have yet to benefit fully from recent advances in highly-active antiretroviral therapy (HAART). We reviewed the scientific evidence investigating the relationships between inferior housing and the health status, HAART access and adherence and HIV treatment outcomes of people living with HIV/AIDS (PLWHA.) Studies indicate being homeless/marginally-housed is common among PLWHA and associated with poorer levels of HAART access and sub-optimal treatment outcomes. Among homeless/marginally-housed PLWHA, determinants of poorer HAART access/adherence or treatment outcomes include depression, illicit drug use, and medication insurance status. Future research should consider possible social- and structural-level determinants of HAART access and HV treatment outcomes that have been shown to increase vulnerability to HIV infection among homeless/marginally-housed individuals. As evidence indicates homeless/marginally-housed PLWHA with adequate levels of adherence can benefit from HAART at similar rates to housed PLWHA, and given the individual and community benefits of expanding HAART use, interventions to identify HIV-seropositive homeless/marginally-housed individuals, and engage them in HIV care including comprehensive support for HAART adherence are urgently needed.
Notes
Cites: PLoS One. 2011;6(7):e2269821799935
Cites: N Engl J Med. 2011 Aug 11;365(6):493-50521767103
Cites: AIDS Patient Care STDS. 2011 Sep;25(9):525-3221774689
Cites: Am J Epidemiol. 2011 Sep 1;174(5):515-2221749972
Cites: AIDS Behav. 2011 Nov;15(8):1612-2221850442
Cites: J Pain Symptom Manage. 2011 Dec;42(6):893-90221802896
Cites: AIDS Patient Care STDS. 2012 Jan;26(1):60-722107040
Cites: J Acquir Immune Defic Syndr. 2012 Apr 1;59(4):393-922134149
Cites: Am J Mens Health. 2009 Mar;3(1):25-3519430589
Cites: Health Soc Care Community. 2009 Jul;17(4):388-9519187420
Cites: BMC Public Health. 2009;9:22019583862
Cites: PLoS One. 2009;4(9):e725519787070
Cites: AIDS Behav. 2009 Oct;13(5):841-819644748
Cites: AIDS Care. 2009 Jun;21(6):692-70019806485
Cites: J Acquir Immune Defic Syndr. 2009 Nov 1;52(3):342-919675463
Cites: Am J Public Health. 2009 Nov;99 Suppl 3:S675-8019372524
Cites: Int J Epidemiol. 2009 Dec;38(6):1624-3319820106
Cites: AIDS Care. 2012;24(4):434-4321999644
Cites: AIDS Care. 2012;24(5):577-8222103666
Cites: PLoS One. 2012;7(4):e3520722558128
Cites: AIDS. 2012 Jun 1;26(9):1049-6322333747
Cites: AIDS Educ Prev. 2012 Jun;24(3):270-922676465
Cites: Curr Opin HIV AIDS. 2012 Jul;7(4):332-822576468
Cites: AIDS. 2012 Jun 19;26(10):1231-4122706009
Cites: Public Health Rep. 2012 Jul-Aug;127(4):407-2122753984
Cites: AIDS Patient Care STDS. 2012 Aug;26(8):463-7022775237
Cites: AIDS Res Hum Retroviruses. 2012 Sep;28(9):1007-1422214200
Cites: Am J Public Health. 2013 Feb;103(2):308-1522720766
Cites: AIDS Behav. 2013 Oct;17(8):2654-6622065234
Cites: Int J Drug Policy. 2010 Jan;21(1):4-919747811
Cites: PLoS One. 2010;5(1):e885120107514
Cites: Subst Abus. 2010 Jan;31(1):24-3420391267
Cites: AIDS Behav. 2010 Jun;14(3):493-50319949848
Cites: AIDS Patient Care STDS. 2010 Jul;24(7):421-820578910
Cites: AIDS. 2000 Mar 10;14(4):357-6610770537
Cites: JAMA. 2000 Apr 26;283(16):2152-710791509
Cites: JAMA. 2001 Jan 10;285(2):200-611176814
Cites: CMAJ. 2001 Jan 23;164(2):229-3311332321
Cites: J Epidemiol Community Health. 2001 Jul;55(7):515-2011413184
Cites: J Health Care Poor Underserved. 2002 Feb;13(1):49-6511836913
Cites: Am J Public Health. 2002 May;92(5):778-8411988447
Cites: J Acquir Immune Defic Syndr. 2002 Jul 1;30(3):351-812131573
Cites: AIDS Patient Care STDS. 2003 Aug;17(8):401-613678541
Cites: AIDS Care. 2004 Jul;16(5):594-60415223529
Cites: Am J Public Health. 2004 Jul;94(7):1207-1715226145
Cites: Clin Infect Dis. 2004 Oct 15;39(8):1190-815486844
Cites: JAMA. 1989 Sep 8;262(10):1352-72761036
Cites: Am Psychol. 1991 Nov;46(11):1115-281772149
Cites: JAMA. 1994 Aug 10;272(6):455-618040981
Cites: JAMA. 1997 Jul 2;278(1):63-59207341
Cites: J Gen Intern Med. 2004 Nov;19(11):1111-715566440
Cites: J Acquir Immune Defic Syndr. 2005 Feb 1;38(2):191-515671804
Cites: Am J Public Health. 2005 Oct;95(10):1747-5216186453
Cites: AIDS Patient Care STDS. 2005 Oct;19(10):690-516232053
Cites: AIDS Behav. 2005 Sep;9(3):251-6516088369
Cites: J Gen Intern Med. 2006 Jan;21(1):61-416423125
Cites: J Acquir Immune Defic Syndr. 2006 Apr 1;41(4):486-9216652058
Cites: Clin Infect Dis. 2006 Jul 15;43(2):234-4216779752
Cites: AIDS Care. 2006 Nov;18(8):911-717012080
Cites: AIDS Behav. 2007 Jul;11(4):603-1017028996
Cites: AIDS Behav. 2007 Nov;11(6 Suppl):149-6117546496
Cites: AIDS Behav. 2007 Nov;11(6 Suppl):101-1517768674
Cites: Am J Public Health. 2007 Dec;97(12):2238-4517971562
Cites: AIDS. 2008 Jan 30;22(3):415-2018195568
Cites: AIDS Behav. 2008 Sep;12(5):815-2117682939
Cites: CMAJ. 2008 Oct 7;179(8):779-8418838453
Cites: J Community Health. 2008 Dec;33(6):434-4318581214
Cites: AIDS Behav. 2009 Feb;13(1):1-918483850
Cites: J Gen Intern Med. 2009 Jan;24(1):14-2018953617
Cites: J Acquir Immune Defic Syndr. 2008 Dec 1;49(4):451-519186357
Cites: BMJ. 2009;338:b164919406887
Cites: Lancet. 2010 Jul 31;376(9738):367-8720650518
Cites: AIDS. 2010 Nov 27;24(18):2835-4021045636
Cites: Arch Gen Psychiatry. 2010 Dec;67(12):1282-9021135328
Cites: Women Health. 2010 Dec;50(8):719-3621170815
Cites: Am J Public Health. 2011 Mar;101(3):546-5321233439
Cites: J Infect Dis. 2011 May 1;203(9):1215-2121459814
Cites: Am J Epidemiol. 2011 May 1;173(9):1049-5821362739
Cites: Lancet. 2011 Jun 25;377(9784):2156-721676455
Cites: AIDS Care. 2011 Jul;23(7):822-3021400308
Cites: J Urban Health. 2011 Jun;88(3):545-5521409604
PubMed ID
22968432 View in PubMed
Less detail

The impact of travel distance, travel time and waiting time on health-related quality of life of diabetes patients: An investigation in six European countries.

https://arctichealth.org/en/permalink/ahliterature282936
Source
Diabetes Res Clin Pract. 2017 Apr;126:16-24
Publication Type
Article
Date
Apr-2017
Author
Uwe Konerding
Tom Bowen
Sylvia G Elkhuizen
Raquel Faubel
Paul Forte
Eleftheria Karampli
Mahdi Mahdavi
Tomi Malmström
Elpida Pavi
Paulus Torkki
Source
Diabetes Res Clin Pract. 2017 Apr;126:16-24
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Diabetes Mellitus, Type 2 - epidemiology - therapy
England - epidemiology
Europe - epidemiology
Female
Finland - epidemiology
Germany - epidemiology
Greece - epidemiology
Health Services Accessibility - standards - statistics & numerical data
Health status
Humans
Male
Middle Aged
Netherlands - epidemiology
Quality of Life
Spain - epidemiology
Surveys and Questionnaires
Time Factors
Travel
Waiting Lists
Abstract
The effects of travel distance and travel time to the primary diabetes care provider and waiting time in the practice on health-related quality of life (HRQoL) of patients with type 2 diabetes are investigated.
Survey data of 1313 persons with type 2 diabetes from six regions in England (274), Finland (163), Germany (254), Greece (165), the Netherlands (354), and Spain (103) were analyzed. Various multiple linear regression analyses with four different EQ-5D-3L indices (English, German, Dutch and Spanish index) as target variables, with travel distance, travel time, and waiting time in the practice as focal predictors and with control for study region, patient's gender, patient's age, patient's education, time since diagnosis, thoroughness of provider-patient communication were computed. Interactions of regions with the remaining five control variables and the three focal predictors were also tested.
There are no interactions of regions with control variables or focal predictors. The indices decrease with increasing travel time to the provider and increasing waiting time in the provider's practice.
HRQoL of patients with type 2 diabetes might be improved by decreasing travel time to the provider and waiting time in the provider's practice.
PubMed ID
28189950 View in PubMed
Less detail

Individual and Area-level Factors Contributing to the Geographic Variation in Ambulatory Care Sensitive Conditions in Finland: A Register-based Study.

https://arctichealth.org/en/permalink/ahliterature310786
Source
Med Care. 2021 02 01; 59(2):123-130
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
02-01-2021
Author
Markku Satokangas
Martti Arffman
Harri Antikainen
Alastair H Leyland
Ilmo Keskimäki
Author Affiliation
Department of General Practice and Primary Health Care, Network of Academic Health Centres, University of Helsinki.
Source
Med Care. 2021 02 01; 59(2):123-130
Date
02-01-2021
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Aged, 80 and over
Ambulatory Care - methods - statistics & numerical data
Cross-Sectional Studies
Female
Finland
Geographic Mapping
Health Services Accessibility - standards - statistics & numerical data
Humans
Male
Middle Aged
Registries - statistics & numerical data
Abstract
Measuring primary health care (PHC) performance through hospitalizations for ambulatory care sensitive conditions (ACSCs) remains controversial-recent cross-sectional research claims that its geographic variation associates more with individual socioeconomic position (SEP) and health status than PHC supply.
To clarify the usage of ACSCs as a PHC performance indicator by quantifying how disease burden, both PHC and hospital supply and spatial access contribute over time to geographic variation in Finland when individual SEP and comorbidities were adjusted for.
The Finnish Care Register for Health Care provided hospitalizations for ACSCs (divided further into subgroups of acute, chronic, and vaccine-preventable causes) in 2011-2017. With 3-level nested multilevel Poisson models-individuals, PHC authorities, and hospital authorities-we estimated the proportion of the variance in ACSCs explained by selected factors at 3 time periods.
In age-adjusted and sex-adjusted analysis of total ACSCs the variances between hospital authorities was nearly twice that between PHC authorities. Individual SEP and comorbidities explained 19%-30% of the variance between PHC authorities and 25%-36% between hospital authorities; and area-level disease burden and arrangement and usage of hospital care a further 14%-16% and 32%-33%-evening out the unexplained variances between PHC and hospital authorities.
Alongside individual factors, areas' disease burden and factors related to hospital care explained the excess variances in ACSCs captured by hospital authorities. Our consistent findings over time suggest that the local strain on health care and the regional arrangement of hospital services affect ACSCs-necessitating caution when comparing areas' PHC performance through ACSCs.
PubMed ID
33201086 View in PubMed
Less detail

26 records – page 1 of 3.