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At least 127 records · Page 7Linked to original sources
PubMed1994

The relationship of chronic diseases and health status to the health services utilization of older Americans.

OBJECTIVE: To study simultaneously the relationships among chronic diseases and physical health status as they affect health services utilization of older adults. DESIGN: Secondary analysis of a large, cross-sectional health interview survey, the Supplement on Aging of the 1984 National Health Interview Survey, using multiple equation methods to evaluate disease-specific impacts on physical health status, the direct impact of specific diseases on utilization of physician services and hospital care, and the indirect impact of specific diseases on utilization, mediated through physical health status. PARTICIPANTS: A total of 11,497 people aged 65 and older, representing a complex, multistage sample of the noninstitutionalized, older adult population of the United States. MEASUREMENTS: Predictor variables included specific chronic diseases (hypertension, arthritis, diabetes, cancer, and atherosclerotic heart disease), self-rated health status, and total number of disabilities. Control variables included age, gender, race, education, social integration. Outcome variables were physician visits and hospital stays. MAIN RESULTS: It was shown that different diseases have different relative impacts on physical health status, probability of utilization, and amount of utilization, if any, and different chronic diseases have a different mix of direct and indirect effects on utilization. CONCLUSION: The impact of chronic disease on health services utilization in a community-dwelling population is not a simple or direct relationship. Diseases vary according to their impact on different types of utilization, their impact on the probability of any health services use versus the amount of use, and on how much their effect on utilization is mediated through health status.

Aged↗
PubMed1996

Self-perceived health status and health-related quality of life of extremely low-birth-weight infants at adolescence.

OBJECTIVES: To estimate and to compare the self-assessed health status and health-related quality of life of extremely low-birth-weight (ELBW) and control infants during adolescence. DESIGN: Prospective, observational study of an inception cohort with a concurrent control group. SETTING: Geographically defined region in central-west Ontario. PARTICIPANTS: We interviewed 141 (83 percent) of 169 ELBW survivors born between 1977 and 1982 and 124 (86 percent) of 145 controls aged between 12 and 16 years. In addition, proxy responses obtained from parents were used for 9 severely impaired teenagers. MAIN OUTCOME MEASURES: Assessments of health status (6 attributes), measured with the Health Utilities Index Mark 2 classification system, and health-related quality of life (utilities), quantified with 2 preference measurement techniques, were used to quantify each participants self-reported, subjectively defined health state and 4 preselected hypothetical health states. RESULTS: Adolescents who were ELBW infants reported a higher number of attributes affected, as well as more complex and severe limitations in cognition, sensation, self-care, and pain, compared with controls. Statistically significant differences for the teenagers' health-related quality of life were noted between ELBW and control teenagers in the mean utility scores (0.87 +/- 0.26 vs 0.93 +/- 0.11; P=.02 on a conventional scale where O=dead and 1.00=perfect health). However, a similar percentage of ELBW and control teenagers (71 percent vs 73 percent) gave utility ratings of more than 0.95 for their health status. CONCLUSIONS: Direct measures of self-reported health status and utility scores indicated that, as a cohort, adolescents who were ELBW infants suffer from a greater burden of morbidity and rate their health-related quality of life as significantly lower than control teenagers. Nevertheless, the vast majority of ELBW respondents view their health-related quality of life as quite satisfactory and are difficult to distinguish from controls.

Adolescent↗
PubMed1999

Assessment of health status and health-related quality of life in survivors of Hodgkin's disease in childhood.

Although the great majority of children with Hodgkin's disease survive with modern treatment strategies, the list of late sequelae is long, yet there is no published information on the comprehensive health status and health-related quality of life (HRQL) in this population. In the experience of a single institution, survivors of Hodgkin's disease in childhood were invited to self-report on their health status using a 15-item questionnaire connected to the Health Utilities Index, a series of multi-attribute health status classification systems that, in turn, are linked to preference functions which provide single-attribute and global utility scores for HRQL. The mean global utility score was 0.85 (on a 0 = dead to 1. 0 = perfect health scale), a figure less than that in survivors of acute lymphoblastic leukemia (ALL) but comparable to that in survivors of brain tumors (0.84) or extremely low birthweight (ELBW 0.82). The burden of morbidity is emphasized by the ratio of the numbers of health states per patient:0.67 for survivors of Hodgkin's disease, 0.66 for survivors of brain tumors, 0.39 for survivors of ELBW, 0.47 for survivors of high-risk ALL and 0.28 for survivors of standard-risk ALL. In Hodgkin's disease survivors, the attributes affected most commonly and severely were pain, cognition and emotion. This experience demands exploration of the health status and HRQL in a much larger cohort of such survivors, perhaps in the context of co-operative group studies.

Child↗
PubMed1980

Health status and health care use by type of private health coverage.

There is considerable speculation on the causes of the frequently observed lower rates of hospital use by group practice--or HMO--members than by persons covered by other health care arrangements. It is often asserted that HMO enrollees are a self-selected healthier population, or that their use of hospitals is not fully recorded. A major study in California of the actual health and use of hospitals by a representative sample of persons under age 65 showed these assertions to be unfounded.

Adolescent↗
PubMed2002

Does the label "fibromyalgia" alter health status, function, and health service utilization? A prospective, within-group comparison in a community cohort of adults with chronic widespread pain.

OBJECTIVE: To determine if assigning the label of fibromyalgia (FM) to individuals with chronic widespread pain has a significant effect on long-term health status, function, and health service utilization. METHODS: In the London Fibromyalgia Epidemiology Study, 100 individuals with FM were identified by screening 3,395 non-institutionalized adults. Only 28 of the 100 had been previously diagnosed with FM; for 72, the diagnostic label was new. All 28 with prediagnosed FM were female compared with 58 of the 72 newly diagnosed cases. In a prospective, within-group comparison, we compared previously non-labeled FM cases at study entry (prelabeling) and at 18 and 36 months followup (postlabeling) with respect to general health status, fibromyalgia-related symptoms, and all items from the Fibromyalgia Impact Questionnaire (FIQ) (including total FIQ score, and several measures of health service utilization) to see if health status, function, and health services utilization had changed, using paired t-tests. We also compared percentage reporting work disability at baseline and 18 months using Pearson's chi(2). RESULTS: Fifty-six (78%) of the original 72 newly diagnosed FM cases were available for reassessment at 18 months, and 43 (60%) at 36 months. Although physical functioning decreased slightly over time, there also was a statistically significant improvement in satisfaction with health, and newly diagnosed FM cases reported fewer symptoms and major symptoms over the long term. No other differences in clinical status or health service use occurred over time. CONCLUSION: The FM label does not have a meaningful adverse affect on clinical outcome over the long term. Further research is necessary to document the short- and long-term effect of labeling in the chronic pain patient.

Activities of Daily Living↗
PubMed1992

The oral health status and health behaviour of 12 and 15 year-old adolescents in Jakarta, Indonesia.

Indonesia is a developing country with few dental services and a population at risk to deteriorating oral health. Five hundred and ninety-one 12 and 15 year-old children drawn from a low fluoride (F- less than 0.1 ppm) urban area of Jakarta, Indonesia were examined for dental caries, fluorosis, and periodontal diseases. In addition, a questionnaire was administered investigating socio-demographic background, use of dental services, and preventive oral care. Although the severity of dental caries experience was moderate, untreated caries on the occlusal surface formed the highest proportion of the dental caries experience. CPITN examination revealed a large proportion of the subjects had calculus as their highest score, combined with a substantial number of sites which exhibited bleeding on probing. Questionnaire data revealed a high home use of fluoridated toothpaste by the subjects but a predominant use of dental services for pain relief. Findings from this study suggest a need for primary preventive programmes focusing on occlusal sealants and plaque control.

Adolescent↗
PubMed1998

['Public health status and perspectives' 1997. IV. Health status and life expectancy weighted].

The construction of composite measures of population health status meets the need to combine data on mortality and morbidity into one single population health index. Such indices can serve in principle to monitor population health status over time, or as support for the allocation of resources. In the framework of the 'Dutch public health status and forecasts report' for 1997 several calculations, new for the Netherlands, are made along the lines of both the 'health expectancy and the 'disability-adjusted life years' (DALY) concepts.

Forecasting↗
PubMed2004

Correlates of sexual behaviors with health status and health perception in Chinese adolescents: a cross-sectional survey in schools.

Sexual intercourse remains taboo among adolescents in a Chinese society such as Hong Kong. It is not openly discussed and little research has been done on its impact on health, although it carries serious risks of contracting sexually transmitted diseases (STDs)/HIV. In 1999, a cross-sectional, self-report survey on youth risk behaviors was carried out on 8382 students 15-18 years of age from 48 schools in Hong Kong. Three hundred seventy-seven (4.69%) reported that they had had sexual intercourse. Among them, forced sex (16.94%) was common, most often happening to boys (52.38%). They were more likely to have consulted doctors in the last month (odds ration [OR] 1.41 in boys 95% confidence interval [CI] 1.03, 1.94; OR 2.46 in girls 95% CI 1.81, 3.30) and 6 months (OR 1.33 in boys 95% CI 0.98, 1.78; OR 2.66 in girls 95% CI 1.80, 3.91). They also perceived poorer and deteriorating health. The sexually active female students were 6.70 times (95% CI 4.65, 9.66) more likely to attempt suicide than the other group and were more likely to take sick leaves (OR 3.56 in girls 95% CI 2.35, 5.41). Parental education and occupation, place of birth, and type of housing did not correlate in the initiation of sexual intercourse. The sexually experienced group reported worse physical and psychological health as well as health perception. Some of the characteristics and patterns identified in our study were quite different from the findings in the West but further studies are required to determine the reason for this.

Adolescent↗
PubMedDate not supplied

Posttraumatic stress disorder and health status: the veterans health study.

This article examines the association between self-reported prevalence of posttraumatic stress disorder (PTSD) and health status in a sample of 2425 male Department of Veterans Affairs (VA) ambulatory care patients who participated in the Veterans Health Study. Participants were recruited at 1 of 4 VA outpatient clinics in the Boston area. They completed self-report measures of PTSD (using the PTSD Checklist and measures of exposure to traumatic events), depression (using the Center for Epidemiologic Studies--Depression scale), and health status (using the Short-Form-36) and a medical history interview assessing 22 conditions and a history of psychiatric treatment. The screening prevalence of PTSD was 20.2% among all patients (24.3% among those exposed to traumatic events); another 15.5% met the criteria for depression but not PTSD. The health status of patients with either PTSD or depression was significantly worse than that of patients with neither disorder, even after controlling for age, education, and number of comorbid medical conditions. Patients with PTSD reported more medical conditions than did other patients. Patients with PTSD currently in mental health treatment had worse health status than did those who reported no treatment; the health status of patients who reported past mental health treatment was generally comparable to that of those with no treatment. The prevalence and comorbidity of PTSD among this sample of VA ambulatory care patients were higher than previously reported among samples of community-residing adults. The association of PTSD with health status was substantial, suggesting that the burden of PTSD is at least comparable to, and may be worse than, that of depression. Mental health treatment alleviated some of this burden. The potential impact of PTSD on health status should be more widely recognized.

Boston↗
PubMed2002

Can a Back Pain E-mail Discussion Group improve health status and lower health care costs?: A randomized study.

BACKGROUND: Given the high health care utilization, limited evidence for the effectiveness of back pain interventions, and the proliferation of e-mail health discussion groups, this study seeks to determine if the Internet can be used to improve health status and health care utilization for people with chronic back pain. METHODS: Randomized controlled trial. Participants included 580 people from 49 states with chronic back pain having at least 1 outpatient visit in the past year, no "red-flag" symptoms, and access to e-mail. Major exclusion criteria included continuous back pain for more than 90 days causing major activity intolerance and/or receiving disability payments. INTERVENTION: Closed, moderated, e-mail discussion group. Participants also received a book and videotape about back pain. Controls received a subscription to a non-health-related magazine of their choice. MAIN OUTCOME MEASURES: Pain, disability, role function, health distress, and health care utilization. RESULTS: At 1-year treatment, subjects compared with controls demonstrated improvements in pain (P =.045), disability (P =.02), role function (P =.007), and health distress (P =.001). Physician visits for the past 6 months declined by 1.5 visits for the treatment group and by 0.65 visits for the control group (P =.07). Mean hospital days declined nearly 0.20 days for the treated group vs and increased 0.04 days for the control group (P =.24). CONCLUSIONS: An e-mail discussion group can positively affect health status and possibly health care utilization. It may have a place in the treatment of chronic recurrent back pain.

Back Pain↗