Dataset Information

Age, gender, and current living status were associated with perceived access to treatment among Canadians using a cross sectional survey.

ABSTRACT:

Background

Access, particularly timely access, to care is the Canadian public's most important healthcare concern. The drivers of perceived appropriateness of access to care among patients with at least one chronic health condition (CHC) are not, however, well defined. This study evaluated whether personal characteristics, self-reported health status and care received were associated with patients' perception of effective access in managing a chronic illness.

Methods

The study population (n?=?619) was drawn from a representative sample of the adult Canadian population who reported having ?1 CHC in the 2013-2014 Health Care in Canada survey. Ordinal regression, with the continuation ratio model, was used to evaluate association of perceived level of access to treatment with socio-demographic factors, perceived health status and care utilization experience.

Results

Factors most closely associated with patients' satisfaction with care access were: age, sex, current cohabitation, care affordability, and availability of support and information to help manage their CHCs. Individuals, particularly females, ConclusionsIndividuals living alone, who are younger, and women may be especially susceptible to lower perceived access to care of CHCs and a sense of pessimism about things not getting better. Further evaluation of the reasons behind these findings may help develop effective strategies to assist these populations to access the care they need.

SUBMITTER: Chan CWT

PROVIDER: S-EPMC6006735 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Publications

Age, gender, and current living status were associated with perceived access to treatment among Canadians using a cross sectional survey.

Chan Catherine W T CWT Gogovor Amédé A Valois Marie-France MF Ahmed Sara S

BMC health services research 20180619 1

<h4>Background</h4>Access, particularly timely access, to care is the Canadian public's most important healthcare concern. The drivers of perceived appropriateness of access to care among patients with at least one chronic health condition (CHC) are not, however, well defined. This study evaluated whether personal characteristics, self-reported health status and care received were associated with patients' perception of effective access in managing a chronic illness.<h4>Methods</h4>The study pop ...[more]

PMID: 29921265

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Project description:BackgroundThe discipline of anaesthesiology in China has undergone historical changes and development during the past century. However, nationwide comprehensive data on the current status of each hospital department providing anaesthesia care has been lacking since the discipline was first established in China. This information is essential for effective regulation of healthcare policies by both the professional associations and the government health ministry. Therefore, a nationwide survey was set up in 2018 to investigate the current status of Chinese anaesthesiology. This paper reports the findings of the survey.MethodsWe performed a cross-sectional nationwide census survey of the current status of each hospital department providing anaesthesia care in 31 provinces across the Chinese mainland. The content of the survey included general information of the department, the hospital level and scale, the volume of the anaesthesiology department, the characteristics of anaesthesiologists, and the caseload of the anaesthesiology departments. Face-to-face interviews were performed by trained interviewers. The Chinese Anaesthesiology Department Tracking Database (CADTD) was established during the survey. Data quality control was undertaken by the investigation committee throughout the survey process.FindingsThe nationwide census survey was completed by 11,432 hospital departments providing anaesthesia care throughout mainland China from June 1, 2018 to June 30, 2019. Among the 11,432 departments, 4591 (40•16%) belonged to specialised hospitals, while 6841 (59•84%) were affiliated to general hospitals. The proportion of independent anaesthesiology departments was 45•15% in mainland China. There was a total of 92,726 anaesthesiologists, or 6•7 per 100,000 of the population. Regions with better economic conditions had more anaesthesiologists per 100,000 of the population. From 2015 to 2017, the workload of anaesthesiologists has increased by 10%.InterpretationThe discipline of anaesthesiology in China has entered a rapid development phase. However, the current status of anaesthesiology is not well defined, which makes it difficult to meet the needs of the increasing Chinese healthcare demand. The evidence from this survey offers valuable information for policy makers and anaesthesiology associations to monitor the development of the discipline and regulate healthcare policies effectively.FundingNational Key Research and Development Program of China (Grant No. 2018YFC2001900).

Project description:BackgroundWith conflicting information about COVID-19, the general public may be uncertain about how to proceed in terms of precautionary behavior and decisions about whether to return to activity.ObjectiveThe aim of this study is to determine the factors associated with COVID-19-related concerns, precautionary behaviors, and willingness to return to activity.MethodsNational survey data were obtained from the Democracy Fund + UCLA Nationscape Project, an ongoing cross-sectional weekly survey. The sample was provided by Lucid, a web-based market research platform. Three outcomes were evaluated: (1) COVID-19-related concerns, (2) precautionary behaviors, and (3) willingness to return to activity. Key independent variables included age, gender, race or ethnicity, education, household income, political party support, religion, news consumption, number of medication prescriptions, perceived COVID-19 status, and timing of peak COVID-19 infections by state.ResultsThe data included 125,508 responses from web-based surveys conducted over 20 consecutive weeks during the COVID-19 pandemic (comprising approximately 6250 adults per week), between March 19 and August 5, 2020, approved by the University of California, Los Angeles (UCLA) Institutional Review Board for analysis. A substantial number of participants were not willing to return to activity even after the restrictions were lifted. Weighted multivariate logistic regressions indicated the following groups had different outcomes (all P<.001): individuals aged ≥65 years (COVID-19-related concerns: OR 2.05, 95% CI 1.93-2.18; precautionary behaviors: OR 2.38, 95% CI 2.02-2.80; return to activity: OR 0.41, 95% CI 0.37-0.46 vs 18-40 years); men (COVID-19-related concerns: OR 0.73, 95% CI 0.70-0.75; precautionary behaviors: OR 0.74, 95% CI 0.67-0.81; return to activity: OR 2.00, 95% CI 1.88-2.12 vs women); taking ≥4 medications (COVID-19-related concerns: OR 1.47, 95% CI 1.40-1.54; precautionary behaviors: OR 1.36, 95% CI 1.20-1.555; return to activity: OR 0.75, 95% CI 0.69-0.81 vs <3 medications); Republicans (COVID-19-related concerns: OR 0.40, 95% CI 0.38-0.42; precautionary behaviors: OR 0.45, 95% CI 0.40-0.50; return to activity: OR 2.22, 95% CI 2.09-2.36 vs Democrats); and adults who reported having COVID-19 (COVID-19-related concerns: OR 1.24, 95% CI 1.12-1.39; precautionary behaviors: OR 0.65, 95% CI 0.52-0.81; return to activity: OR 3.99, 95% CI 3.48-4.58 vs those who did not).ConclusionsParticipants' age, party affiliation, and perceived COVID-19 status were strongly associated with their COVID-19-related concerns, precautionary behaviors, and willingness to return to activity. Future studies need to develop and test targeted messaging approaches and consider political partisanship to encourage preventative behaviors and willingness to return to activities.

Project description:BackgroundThe aim of this work was to study potential gender differences in perceived food healthiness and food avoidance in a population-representative sample of the Swedish adult population.MethodsA questionnaire regarding diet and health was posted to 2000 randomly selected residents in Sweden, aged 20-65 years. Questions were posed regarding which foods or food components the participants avoided due to perceived unhealthiness and how healthy they believed the food items to be. The pre-specified food components included sugar, carbohydrate, gluten, lactose, dairy, fat, saturated fat, red meat, white flour, salt, alcohol and food additives (specifically glutamate, sweetening, preservative and coloring agents). Chi square tests were used to study differences in perceived food healthiness and food avoidance depending on gender.ResultsAround 50% reported avoidance of sugar (51.6%) and sweeting agents (45.2%), whereas fewer reported avoidance of saturated fat (16.8%) and salt (10.6%). Women were more likely than men to avoid gluten (AOR [95% CI] 2.84 [1.33-6.05]), red meat (3.29 [1.86-5.80]), white flour (2.64 [1.65-4.21]), preservatives (1.7 [1.07-2.70]) and coloring agents (2.10 [1.29-3.41]) due to perceived unhealthiness. Gender differences were also apparent in perceived healthiness of sugar, gluten, dairy, red meat, white flour, alcohol and food additives, where women tended to be more negative than men in their attitudes. Women more often said to read new findings in media about diet (16% vs 9%, p = 0.029) and prioritize a healthy lifestyle (35% vs 25%, p = 0.015). More than a third of both women and men reported worrying over the healthiness of their diet, and a higher proportion of women than men (18% vs 11%, p = 0.015) agreed with the statement that they were often anxious over having an unhealthy diet.ConclusionsWomen in this population-based study of residents in Sweden were more likely than men to avoid eating gluten, red meat, white flour and food additives due to perceived unhealthiness, and reported more diet and health related anxiety. Future research to identify effective ways of promoting healthy eating for both women and men, while minimizing diet-health related anxiety, is highly warranted.

Project description:BackgroundConflict between physicians and patients is an increasingly serious problem, leading to the disrepute attached to Chinese physicians' social image and position. This study assesses the status of physicians' self-perceived professional reputation damage and explains it's the adverse outcomes including withdrawal behavior and workplace well-being. Moreover, potential causes of Chinese physicians' disrepute have been outlined.MethodsPrimary data were collected through a cross-sectional online survey of physicians from 10 provinces in China, who were invited to complete an anonymous survey from December 2018 to January 2019. A total of 842 physicians (effective response rate: 92.22%) were recruited as participants.ResultsAbout 83% of the participants self-perceived professional reputation damage from the sense of the public opinion concept. Approach half of participants exhibited the idea of turnover intention (47.3%) and one or more symptoms of burnout (46.4%). About 74.9% of the participants experienced a degree of stress. Additionally, three out of five participants reported low-level subjective well-being. More than 70% of the participants disapproved of their offspring becoming a physician. Four factors leading to physicians' damaged professional reputations are those addressed: conflict transfer, cognitive bias, improper management, and individual deviance. Stigmatised physicians are more likely to practice high-frequent defensive medicine (β = 0.172, P <0.001), intend to leave the profession (β = 0.240, P <0.001), disapprove of their children becoming physicians (β = 0.332, P<0.001) and yield worse levels of workplace well-being, including high levels of perceived stress (β = 0.214, P <0.001), increasing burnout (β = 0.209, P <0.001), and declining sense of well-being (β = - 0.311, P<0.001).ConclusionChinese physicians were aware of damaged professional reputations from the sense of the public opinion concept, which contributes to increasing withdrawal behaviors and decreasing workplace well-being-a worsening trend threatening the entire health system. This novel evidence argues a proposal that Chinese health policy-makers and hospital administrators should promote the destigmatization of physicians immediately.

Project description:BackgroundThere is a heavy and disproportionate burden of human immunodeficiency virus (HIV) infection among migrant communities living in Europe. Despite this, the published evidence related to HIV testing, prevention, and treatment needs for migrants is sparse.ObjectiveThe aim of this study was to identify the factors associated with access to primary care and HIV testing among migrant groups living in Europe.MethodsA Web-based survey (available in 14 languages) was open to all people aged 18 years and older, living outside their country of birth in the World Health Organization (WHO) European area. Community organizations in 9 countries promoted the survey to migrant groups, focusing on those at a higher risk of HIV (sub-Saharan Africans, Latin Americans, gay or bisexual men, and people who inject drugs). Multivariable analysis examined factors associated with access to primary care and previous history of an HIV test.ResultsIn total, 559 women, 395 heterosexual men, and 674 gay or bisexual men were included in the analysis, and 68.1% (359/527) of women, 59.5% (220/371) of heterosexual men, and 89.6% (596/664) of gay or bisexual men had tested for HIV. Low perceived risk was the reason given for not testing by 62.3% (43/69) of gay or bisexual men and 83.3% (140/168) of women and heterosexual men who reported never having tested for HIV. Access to primary care was >60% in all groups. Access to primary care was strongly positively associated with living in Northern Europe compared with Southern Europe (women: adjusted odds ratio, aOR 34.56 [95% CI 11.58-101]; heterosexual men: aOR 6.93 [95% CI 2.49-19.35], and gay or bisexual men: aOR 2.53 [95% CI 1.23-5.19]), whereas those with temporary residency permits were less likely to have access to primary care (women: aOR 0.41 [95% CI 0.21-0.80] and heterosexual men: aOR 0.24 [95% CI 0.10-0.54] only). Women who had experience of forced sex (aOR 3.53 [95% CI 1.39-9.00]) or postmigration antenatal care (aOR 3.07 [95% CI 1.55-6.07]) were more likely to have tested for HIV as were heterosexual men who had access to primary care (aOR 3.13 [95% CI 1.58-6.13]) or reported "Good" health status (aOR 2.94 [95% CI 1.41-5.88]).ConclusionsAccess to primary care is limited by structural determinants such as immigration and health care policy, which varies across Europe. For those migrants who can access primary care and other health services, missed opportunities for HIV testing remain a barrier to earlier testing and diagnosis for migrants in Europe. Clinicians should be aware of these potential structural barriers to HIV testing as well as low perception of HIV risk in migrant groups.

Project description:ObjectivesTo determine whether access to rapid access chest pain clinics of people with recent onset symptoms is equitable by age, socioeconomic status, ethnicity and gender, according to need.DesignRetrospective cohort study with ecological analysis.SettingPatients referred from primary care to five rapid access chest pain clinics in secondary care, across England.ParticipantsOf 8647 patients aged ≥35 years referred to chest pain clinics with new-onset stable chest pain but no known cardiac history, 7570 with documented census ward codes, age, gender and ethnicity comprised the study group. Patients excluded were those with missing date of birth, gender or ethnicity (n=782) and those with missing census ward codes (n=295).Outcome measuresEffects of age, gender, ethnicity and socioeconomic status on clinic attendance were calculated as attendance rate ratios, with number of attendances as the outcome and resident population-years as the exposure in each stratum, using Poisson regression. Attendance rate ratios were then compared with coronary heart disease (CHD) mortality ratios to determine whether attendance was equitable according to need.ResultsAdjusted attendance rate ratios for patients aged >65 years were similar to younger patients (1.1, 95% CI 1.05 to 1.16), despite population CHD mortality rate ratios nearly 15 times higher in the older age group. Women had lower attendance rate ratios (0.81, 95% CI 0.77 to 0.84) and also lower population CHD mortality rate ratios compared with men. South Asians had higher attendance rates (1.67, 95% CI 1.57 to 1.77) compared with whites and had a higher standardised CHD mortality ratio of 1.46 (95% CI 1.41 to 1.51). Although univariable analysis showed that the most deprived patients (quintile 5) had an attendance rate twice that of less deprived quintiles, the adjusted analysis showed their attendance to be 13% lower (0.87, 95% CI 0.81 to 0.94) despite a higher population CHD mortality rate.ConclusionThere is evidence of underutilisation of chest pain clinics by older people and those from lower socioeconomic status. More robust and patient focused administrative pathways need to be developed to detect inequity, correction of which has the potential to substantially reduce coronary mortality.

Dataset Information

Age, gender, and current living status were associated with perceived access to treatment among Canadians using a cross sectional survey.

Background

Methods

Results

Publications

Age, gender, and current living status were associated with perceived access to treatment among Canadians using a cross sectional survey.

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