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Biomedical subjects

Ronald M Andersen

Publications and source records attributed to Ronald M Andersen.

25 records · Page 2Linked to original sources
PubMed2003

The impact of HIV on oral health and subsequent use of dental services.

OBJECTIVE: This study examined differences in health and access to dental services among a nationally representative sample of patients with HIV using Andersen's Behavioral Model of Health Services Use. METHODS: This investigation is a longitudinal study that used structural equation modeling to analyze data from the HIV Cost and Services Utilization Study, a probability sample of 2,864 adults under treatment for HIV infection. Key predisposing variables included sex, drug use, race/ethnicity, education, and age. Enabling factors included income, insurance, and regular source of care. Need factors included mental, physical, and oral health. Dependent variables included whether a respondent utilized dental services and number of visits. RESULTS: More education, dental insurance, usual source of dental care, and poor oral health predicted a higher probability of having a dental visit. African Americans, Hispanics, those exposed to HIV through drug use or heterosexual contact, and those in poor physical health were less likely to have a dental visit. Of those who visited dental professionals, older persons, those with dental insurance, and those in worse oral health had more visits. African Americans and persons in poor mental health had fewer visits. CONCLUSIONS: Persons with more HIV-related symptoms and a diagnosis of AIDS have a greater need for dental care than those with fewer symptoms and without AIDS, but more pressing needs for physical and mental health services limit their access to dental services. Providers should better attend to the oral health needs of persons with HIV who are in poor physical and mental health.

Adolescent↗
PubMed2003

Case management and access to services for homeless women.

Previous research on case management for homeless persons has not sufficiently addressed access to services for women of reproductive age. This cross-sectional study estimates the proportion of homeless women with case managers and the associations of case management with access to shelter; food stamps; Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and general medical care. Nine hundred seventy-four homeless women were sampled in Los Angeles County in 1997 and asked about their use of services and whether they had case managers. Approximately 56 percent of respondents had case managers. Having a case manager was associated with greater odds of using food stamps and of finding shelter without difficulty in the previous 30 days, but not with use of WIC or with unmet needs for medical care. More assertive forms of outreach may be necessary to link this population to case managers and a broader range of services.

Adolescent↗
PubMed2002

Use of the Behavioral Model of Health Care Use to identify correlates of use of treatment for panic attacks in the community.

BACKGROUND: The aim of this study was to identify predisposing, enabling, and need factors associated with health service use for panic attacks among adults in the United States using the Behavioral Model of Health Care Use. METHOD: Data were drawn from the National Comorbidity Survey (n = 8098), a community-based household sample representative of the United States adult (age 15-54) population. Stepwise logistic regression models were used to compute odds ratios (with 95 % confidence intervals) measuring the association between predisposing, enabling, and need factors and the self-reported health service use for treatment of panic attacks. RESULT: In addition to perceived (perception of poor mental health) and evaluated need (severity of panic attacks, psychiatric morbidity), predisposing (being older, married, more educated, white) factors were independently associated with use of treatment for panic attacks. Distinct correlates for use of primary care, specialized mental health treatment, and use of psychotropic medication were found. In addition to need factors, predisposing factors are independently associated with the use of services for panic attacks in the community. CONCLUSIONS: These results suggest that factors other than severity of panic and degree of psychiatric morbidity may influence use of services for panic. Future studies that examine whether these factors reflect barriers to care for those in need of mental health treatment may help to inform programs aimed at targeting those with unmet need in the community.

Adolescent↗
PubMed2002

Access to medical care for low-income persons: how do communities make a difference?

This paper considers the impact of community-level variables over and above the effects of individual characteristics on healthcare access of low-income children and adults residing in large metropolitan statistical areas (MSAs). Further, we rank MSAs' performance in promoting healthcare access for their low-income populations. The individual-level data come from the 1995 and 1996 National Health Interview Survey (NHIS). The community-level variables are derived from multiple public-use data sources. The outcome variable is whether low-income individuals received a physician visit in the past twelve months. The proportion receiving a visit by MSA varied from 63% to 99% for children and from 62% to 83% for adults. Access was better for individuals with health insurance and a regular source of care and for those living in communities with more federally-funded health centers. Children residing in MSA.

Adolescent↗
PubMed2002

Response to symptoms among a U.S. national probability sample of adults infected with human immunodeficiency virus.

Previous studies concerning disparities in Human Immunodeficiency Virus (HIV) services use among vulnerable groups did not control for specific clinical need for care such as symptom events. Using the Andersen Behavioral Model of Health Services Use, the authors determined whether minorities, women, and the less educated (vulnerable groups) were less likely to receive care for HIV symptoms. Persons enrolled in the HIV Cost and Services Utilization Study were asked whether they received care for their most bothersome symptom. Surprisingly, minorities and women were no more likely to go without care than other groups. Those with Medicaid, Medicare, private health maintenance organization (HMO) insurance, or no insurance were less likely to receive care for symptoms than those with private-non-HMO insurance. Vulnerable groups were no less likely to use services for HIV-related symptoms when need for care was considered. However, disparities may exist for symptom-specific care among HIV infected persons covered by public or HMO insurance.

Adolescent↗
PubMed2002

Psychiatric symptoms, health services, and HIV risk factors among homeless women.

The authors determined whether psychiatric symptoms and lack of health and/or social services contacts were associated with HIV risk behaviors among a probability sample of homeless women. Women were interviewed regarding socioeconomic indicators, psychiatric symptoms, health and/or social services contacts, and past-year HIV risk behaviors. Overall, 8 percent of the women injected drugs, 64 percent engaged in unprotected sex, and 22 percent traded sex. Multiple logistic regression results revealed that substance abuse was positively associated with injection drug use and trading sex. Homeless women with case managers were less likely to inject drugs. Although barriers to obtaining drug treatment were associated with trading sex, women attending self-help meetings for substance abuse were also more likely to trade sex. Homeless women who are substance abusers are vulnerable to HIV risk behaviors. Risk reduction interventions for homeless women should be implemented through substance abuse and intensive case management programs.

Adolescent↗