Use Of Outpatient Healthcare Services Research Articles

Use of outpatient healthcare services before and after the onset of unemployment

Abstract Background The onset of unemployment may entail adverse health effects and, thus, increase the need for healthcare services. On the other hand, the onset of unemployment may weaken access to the healthcare services, which may as such decrease the overall use of healthcare services. The aim was to examine the use of outpatient healthcare services in different sectors of healthcare before and after the onset of unemployment and to study whether job loss affected the use of these services. Methods Longitudinal individual-level register-based data was utilized on all individuals living in the City of Oulu, Finland, who became unemployed in 2017 (N = 1,999), their propensity matched controls (N = 1,999), and unmatched controls (N = 58,459) in a quasi-experimental design. Use of outpatient healthcare services was examined in one-month periods from 12 months before to 12 months after the onset of unemployment. Several socio-demographic factors, along with sickness and employment histories, were used for propensity score matching. Difference-in-differences analysis was used to measure the differences in the use of outpatient healthcare services between the unemployed and their matched controls. Results The use of healthcare services decreased significantly after the onset of unemployment. This was due to a decrease in the use of occupational healthcare services. No change related to job loss was observed in the use of public or private healthcare services. The number of healthcare visits increased again after the unemployment ended. Difference-in-differences analyses showed that compared to propensity score matched controls, becoming unemployed reduced the use of healthcare services. Conclusions When access to occupational healthcare services ceases, other healthcare services do not appear to fill the gap among those who become unemployed. Adequate healthcare services should be guaranteed to all population groups equally based on need, irrespective of the labour market status. Key messages • The overall use of outpatient healthcare services decreases significantly after job loss in Finland because of a decrease in the use of occupational healthcare services. • Adequate and easily accessible healthcare services should be guaranteed to all population groups equally based on need, irrespective of the labour market status or other socio-demographic factors.

Use of outpatient healthcare services before and after the onset of unemployment: A register-based propensity score matched study from Finland.

The aim was to examine the use of outpatient healthcare services in different sectors of healthcare before and after the onset of unemployment and to study whether job loss affected the use of these services. Longitudinal individual-level register-based data was utilized on all individuals living in the City of Oulu, Finland, who became unemployed in 2017 (N = 1,999), their propensity matched controls (N = 1,999), and unmatched controls (N = 58,459) in a quasi-experimental design. Use of outpatient healthcare services was examined in one-month periods from 12 months before to 12 months after the onset of unemployment. Several socio-demographic factors, along with sickness and employment histories, were used for matching. Difference-in-differences analysis was used to measure the differences in the use of outpatient healthcare services between the unemployed and their matched controls. The use of health services decreased significantly after the onset of unemployment. This was due to a decrease in the use of occupational health services. No change related to job loss was observed in the use of public or private healthcare services. The number of healthcare visits increased again after the unemployment ended. Difference-in-differences analyses showed that compared to propensity score matched controls, becoming unemployed reduced the use of health services. When access to occupational healthcare services ceases, other health services do not appear to fill the gap among those who become unemployed. Adequate healthcare services should be guaranteed to all population groups equally based on need, irrespective of the labour market status.

Determinants of concurrent use of Biomedicine and Korean Medicine on the hypertension patients: A cross-sectional study

BackgroundThis study assessed the utilization of biomedicine and Korean Medicine (KM) among hypertension patients. MethodsThe study was a cross-sectional analysis conducted using the Korean National Health and Nutrition Examination Survey (KNHANES), which is a nationwide survey conducted every year for a representative Korean population. The use of outpatient healthcare services for hypertension patients was analyzed, and the usage determinants adjusted by the demographic and health status variables were identified. A chi-square test and logistic regression analysis were used for statistical analysis using R (version 3.6.0). ResultsAmong 3320 hypertension patients, 208 patients (6.27%, Weighted%: 5.99%) used the biomedicine and KM concurrently. Multivariable regression analyses revealed hypertension patients who were obese (OR: 1.417, CI: 1.007–1.995) and had an experience of sickness (OR: 2.323, CI: 1.561–3.457) to be more likely to use biomedicine and KM concurrently. ConclusionThe utilization rate and determinants of the concurrent use of biomedicine and KM were identified in patients with hypertension. Although the overall usage rate was not high, the health care patterns of healthcare consumers need to be understood. Therefore, further studies on its effectiveness and safety are recommended.

Research commentary: Continuing utilisation of specialised health services in extremely preterm infants

This study compared healthcare use of 2 groups of preterm infants comparing 23e25 wks vs 26e28 wks from discharge to 18 months of age. 254 infants from 3 hospital centres in Quebec were followed looking at rehospitalisation rates, use of outpatient healthcare services, the use of prescribed medication and medical assistive technology (bronchodilators, O2). Further information was obtained from a comprehensive assessment at 18 months corrected age and a standardised questionnaire including socio demographic characteristics during follow up clinic appointments. Routine care appointments were excluded from the study and information was checked against medical charts/records. They demonstrate a higher use of all services in the 23e25 wks age group (57% compared to 49% in the 26e28 wks) with rehospitalisation mainly for respiratory illness bronchopulmonary dysplasia

Changes over Fourteen Years in Adult Obesity in Estonia: Socioeconomic Status and Use of Outpatient Health Services

It has been noted that great socioeconomic and lifestyle changes have triggered an epidemic of obesity among Eastern Europeans. The objective of this study was to assess the change of adult obesity in Estonia by socioeconomic status and the use of outpatient healthcare services among obese individuals over time. It can be maintained that obesity distribution in Estonia in 1990-2004 developed similarly to an average Western country and, regardless of an increasing level of male obesity, obesity prevalence for 16-64 year-olds was on the average level in Europe in 2004 - 14.0% for men and 14.9% for women. Change in obesity prevalence correlates quite well with changes in the economy in Estonia. From studied socioeconomic variables only age and education (among women) strongly affect the change in obesity level. Obese individuals used outpatient medical care slightly differently compared to individuals with a normal BMI.