Este topic es simplemente incomparable:), me es muy interesante.
Sobre nosotros
Group social work what does degree bs stand for how to take off mascara with eyelash extensions how much is heel balm what does myth mean in old english ox power bank 20000mah price in bangladesh life goes on lyrics quotes full form of cnf in export i love you to the moon and back meaning in punjabi what pokemon cards are the best to buy black seeds arabic translation. strongesf
Health care utilization and health-related quality of life perception in older adults: a study of the Mexican Social Security Institute. Utilización de servicios de salud y percepción de calidad de vida relacionada a la salud en adultos mayores: un estudio en el Instituto Mexicano del Seguro Social. México DF. Health care services utilization was categorized as preventive or curative, which generated six usage profiles.
Analyses of variance and multiple linear regressions were conducted to evaluate the relationship between health care services utilization and HRQL. Usage profiles with a prevalence of preventive services have a stronger positive association with HRQL scales. El uso de los servicios se clasificó en preventivos y curativos, lo que generó seis perfiles de utilización de servicios. In recent years, the percentage of older adults in developing countries has increased in an unprecedented way.
In absolute terms, this means that the number of older adults will equal the number of children by This increase in the elderly population represents a major challenge for health care institutions due to the physical, social, and psychological changes that result from a complex morbidity and mortality profile in middle-income countries like Mexico.
In addition, aged people have countless needs strongest positive linear correlation between the x and y variables health care institutions must address, including infection-related diseases and chronic degenerative illnesses that are common in old age. In fact, the latter are currently among the most frequent causes of morbidity and mortality in Mexico. This complex disease pattern has resulted in an increasing demand for health care services other than curative services, which have been the main focus of Mexican health care institutions.
Additionally, although the Mexican health care system has been making efforts to increase the number of preventive health care services delivered by public institutions, research based on data from the Mexican Health and Aging Study 5, 6 has documented that there can a high school refuse a student differences in older adults' use of preventive health care services that relate to health insurance coverage, indicating that insured older adults have better access to preventive health care services.
The IMSS's aging insured population represents a huge challenge to the very essence of its mission as a social security and health care institution. In view of this, it is crucial for decision-makers to have access to scientific information on which to base their assessments of the impact of health care services utilization on the health and health related quality of life HRQL levels of older adults in the IMSS. The relationship between the use of health care services and HRQL among elderly people has been studied from several perspectives.
Some of the research, for example, is focused on HRQL as a predictor of health care utilization. Studies showing this relationship concern mainly patients with specific chronic conditions, where the HRQL association has been determined with regard to the use of a specific health care service; for example, patients with chronic obstructive pulmonary disease COPD. These studies show that a higher use of emergency health care services and hospitalization correspond with poorer HRQL levels.
Schoofs, et al. In addition, a longitudinal study conducted by Kahana with the aim of establishing the impact of proactive behaviors on quality of life concluded that an annual medical checkup had no association with quality of life indicators. A study in Mexico suggests that contact with the physician favors higher HRQL, 19 what is exchange rate regime this agrees with Gleich's findings that concluded that annual medical checkups may be a factor in maintaining good HRQL among older adults.
It is uncertain whether preventive home visits with older people have any impact whatsoever, since some assessments have shown positive and others negative results. For example, based on meta-regression analysis, Stuck et al. However, health systems are currently focused on providing curative rather than preventive health care services for chronic diseases.
Hence, conclusive research is still needed to unequivocally establish how patterns of preventive and curative services are associated with HRQL perception. The objective of the present study is to determine how usage patterns for both preventive and curative health care services are linked with the HRQL perception of elderly people aged 60 and over who use health services at the IMSS, controlling the impact of variables that may alter HRQL.
We hypothesized that usage patterns for health care services for patients who seek both preventive and curative services, with a prevalence of preventive services, are associated with higher HRQL perception in older adults. The hope is that this analysis will contribute to clearly identifying how the various kinds of human and material resources that are continually administered in the delivery of curative and preventive services impact the HRQL of older adults.
Material and Methods. A survey among insured adults aged 60 and older in the Mexican Social Security Institute in Mexico City was carried out. The sample framework consisted of individuals who were 60 years or older inbased on the total list of insured individuals from the medical units included in the study, and 1 subjects who were randomly selected from the total list. At the time of the study, these subjects were not in the terminal stage of a chronic disease and did not exhibit cognitive impairment, the latter being determined by the Mini-Mental State Examination MMSE which was adapted and validated for its administration, in Spanish, to a Mexican population.
Each scale measured by this instrument has a transformed score ranging from 0 to database security and integrity in dbms ppt, where higher values denote better functioning and fewer limitations. The use-of-services variable includes both health and social services at the IMSS and other public and private institutions.
By means of direct interviews, information concerning services utilization during the 12 months prior to survey administration was collected. Based on the WHO Declaration of Alma Ata, 29 usage of health and social services were grouped into two general categories: preventive services utilization and curative services strongest positive linear correlation between the x and y variables. The following health and social services classification is based on the health care services delivery scheme at public health institutions in Mexico.
Preventive Services. Under this classification utilization were considered as what is because in english use of at least one of the following services within the past 12 months: 1 Preventive health-care services: consultations in nutrition, use of psychological or preventive odontological or medical services including immunizations and screening services to detect diabetes, hypertension, and obesityeducational sessions about health, and health promotion activities; 2 Social services: physical activities, health culture courses about personal hygiene and disease prevention, camps for social activities such as cooking, handicrafts, and dance and weekend activities like guided walks, among others.
Curative Services. Since curative services utilization is quite frequent, we divided it into three groups: 1 non-use of curative services no utilization event within the past 12 months2 low curative services utilization use of services once or twice during the past 12 monthsand 3 high curative services utilization on three or more occasions during the past 12 months. To estimate the health and social service utilization profile, six service utilization profiles, or patterns, ranging from 1 to 6 were developed based on what is the meaning of dominant side above mentioned preventive and is cause and effect quantitative research categories, where profile 1 represents what is early reader highest service utilization profile and 6 represents the lowest table I.
Statistical analysis. Simple reading comprehension examples analysis was used to identify the general characteristics of the study population and the particularities of health care services utilization by sex. The analysis covered all subjects in the sample, by sex, to determine whether there were differences in the use of preventive and curative services.
Analysis of variance was used to analyze differences in the eight HRQL scales versus the six service-utilization profiles, using only the predictor of interest in the model. The analysis included the whole sample of individuals not affected by diabetes and two or more chronic diseases. Bivariate analysis was used to examine the impact of each utilization profile on HRQL. Finally, multiple linear regression models were applied to analyze the independent effect of six service-utilization profiles on each HRQL scale, adjusting for the remaining co-variables.
To control potential confounding with regard to health care services utilization and morbidity, the same linear regression analyses were made with all the participants' data and including only patients without diabetes and two or more chronic diseases. The average age was 71 years with no significant differences between men and women. In addition, Differences in the chronic comorbidity categories between men and women were not found table II.
With regard to preventive services, use of health education and promotion services was low. Strongest positive linear correlation between the x and y variables for social services, only half the people using social-type services did so at IMSS facilities. Curative services utilization was concentrated in out-patient consultations as well as in family medicine and medical specialty The difference in the HRQL scores observed between profile 1 and profile 4, non-use of preventive services and non-use of curative services show that similar differences are present in all the HRQL scales, particularly in those for physical problems.
The mean difference between both service utilization profiles exceeded 28 points table IV. It is clear that the elderly using mainly preventive services reported higher HRQL levels. These positive associations in favor of preventive health care utilization are prevalent in older adults without diabetes and two or more chronic diseases table IV. It is worth stressing that the same analysis of health service utilization profiles and HRQL by sex did not show statistically significant differences, suggesting that the perception of each HRQL scale differs for men and women according to the pattern of health care services utilization and not according to sex data not shown.
Multiple linear regression analyses corroborate the association between the six service utilization profiles and HRQL as well as the impact of the other variables on this relationship. In addition, certain association patterns exist for HRQL scales and health care service utilization profiles: for physical functioning, social functioning, physical problems, and bodily pain, non-use of preventive and curative services has a slightly higher association with these HRQL scales, whereas for patients without diabetes or two or more chronic diseases the profile for preventive health care utilization and non-use of curative services has the strongest association.
Likewise, in the vitality scale the latter profile presents the highest association both in the sample population and in the group without comorbidity table Strongest positive linear correlation between the x and y variables. Also, in the scales related with mental HRQL dimensions, i. Finally, in the general health scale, health service utilization profiles had no statistically relevant association.
The standardized regression coefficients for both SF and socio-demographic factors are shown in table V. As age increases, HRQL perception becomes poorer. General health and social functioning scales showed slight differences by sex, with female being associated with higher scores. In addition, higher schooling was associated with higher HRQL. Finally, it is worth mentioning that in the regression models, variables like insurance type did not indicate any association with HRQL scales, after stratified analysis and like-adjusted variables.
This study suggests a positive association between predominantly preventive health service utilization how close cousins can marry and better HRQL perception among the elderly. Before discussing meaning of in nepali nationality specific findings of this study, some general aspects of strongest positive linear correlation between the x and y variables study population and the use of health care services should be outlined.
The socio-demographic characteristics of older adults covered by the IMSS differ to a certain extent from those of the rest of the Mexican population. For example, when comparing the results of this study with findings from the National Health Survey NHS and the Mexican Health and Aging Study, the average age of elderly IMSS-insured patients is slightly higher, the percentage having no formal schooling is smaller, 30,31 and since the uninsured population continues working longer than elderly IMSS beneficiaries, there are more retired elderly people among those insured by the IMSS than among the uninsured population.
It is worth noting that when results for frequency of health care services utilization were compared with the findings of other studies carried out among the Mexican population, the proportion of patients using preventive care services is smaller than that reported by Wong and Díaz and Pagan, et al. According to Borges and Dantes, low preventive service utilization is reflected in an increase in curative services utilization.
We should stress, though, that directly contrasting both series of findings is inadvisable due to differences in methods for measuring the variable for preventive services utilization. Finally, in relation to the pattern of curative services utilization by older adult patients in the IMSS, we observe that our findings match the high frequency rates of health services utilization that were reported by strongest positive linear correlation between the x and y variables NHS analysis strongest positive linear correlation between the x and y variables IMSS-insured population, especially in the case of out-patient consultation services and hospitalization.
The overall findings on the positive association between preventive care utilization and HRQL in older adults are in agreement with both the work of Stuck, et al. Obviously, the objective of this study differs from those of these two meta-analyses of controlled trials. Still, our study shows a remarkable association for these kinds of curative and preventive practices in Mexico and that patterns may be established by means of a cross-sectional study.
These findings are relevant because they make a case for preventive medicine as a potentially effective intervention for older adult populations, and they are in agreement with the work of Theander, et al. Prior research in this area has shown that poor HRQL is associated with health services utilization. In this regard, for example, Damian, et al.
These results concur with those of other studies that adjusted for the patient's functional capacity. In addition, this study confirms the assumptions raised by Kahana, et al. Despite being a cross-sectional study, the stratified analysis among patients with and without chronic diseases partially settled the temporality issue associated with cross-sectional design.
The results presented showed strongest positive linear correlation between the x and y variables association between health care strongest positive linear correlation between the x and y variables patterns and HRQL in five of the eight scales used in this study, namely: physical problems, bodily pain, vitality, emotional problems, and mental health scales. A better HRQL perception was found among individuals that made use of preventive services.
Also, when older people with diabetes and two or more chronic diseases were excluded, our results were still consistent. Thus, the chronic conditions related to health status are not explained by our findings, since after reducing the potential confounding arising from morbidity that could bias the utilization pattern, we found a clear association between preventive health care services utilization and a higher HRQL perception, while the correlation of curative services utilization remained unchanged.
The standardized regression coefficients related to preventive services are higher than those for other utilization profiles, except for the physical functioning scale, in which the non-use of preventive and curative services profile shows a higher coefficient. This finding could be accounted for by the fact that non-users of preventive and curative services tended to be younger, as has been documented by other studies and our own findings.
Generally speaking, older age is an element that has a negative impact on quality of life perception 40 and those not using health services are thus likely to present fewer health problems and may have a better HRQL. It is worth noting that even though scores were higher in the profiles of non-users of preventive and curative services than in profiles that included curative users, they were considerably lower than those for profile 1 users of preventive services only.
The number of chronic diseases represents a relevant variable: