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PubMed2002

The impact of attendance patterns on oral health in a general dental practice.

OBJECTIVE: The aim of this study was to examine the impact of attendance patterns on oral health in the context of government policy on dental care and registration in the UK. METHOD: The data involved 643 consecutive patient responses to a questionnaire on dental health taken from a survey that was conducted during 1998 in an urban area of Swansea. The survey continued for a period of six months and covered patients of 18 years of age and over, responding to a questionnaire on the subjective oral health status indicators including the pattern of their attendance to dental practices. RESULTS: Regular dental care attendance has a significant positive impact on dental health while its impact on the number of teeth present is insignificant. Regular attendees also suffer significantly less from the severity, prevalence, social and psychological impacts of dental health problems. CONCLUSION: Regular dental attendance is associated with better oral health when regularity of care is defined as a visit within a two-year period. The rationality of a 15 month registration period is therefore debatable in the context of developing equitable services.

Adolescent↗
PubMedDate not supplied

Health needs of the elderly.

Elderly residents in two high-rise apartments in Erie, Pennsylvania, were surveyed to identify health needs in this type of congregate dwelling. Responses to a 20-item structured questionnaire were analyzed in relation to health condition, physical functioning, and access to medical care. When the elderly surveyed were divided into subsamples of males living alone, females living alone, and pairs, some differences were found. For example, females living alone had most difficulty in ambulatory activities (physical functioning) and 24.3 percent of the total elderly surveyed were not well in health condition. Recommendations included: A nurse practitioner could assess their health status at a specified health center or in their own apartments. Community groups or a home health aide could provide assistance for the 32 percent of the elderly surveyed who indicated difficulty with physical functioning activities. For the 11.7 percent who reported no access to medical care, a counseling or referral service monitored by a health professional could be provided.

Activities of Daily Living↗
PubMed1986

Perinatal mortality standards: construction and use of a health care performance indicator.

Perinatal mortality rates are an important index of the performance of perinatal health care services, but comparisons are confounded by variations in the prior risk status of the clienteles of different districts and different maternity units. A method of allowing for these differences has been devised. It is based jointly upon the exclusion of certain classes of birth, and on indirect standardisation for birthweight and a number of modifying factors. The method is described, tested, demonstrated, and proposed for more general use.

Birth Weight↗
PubMed1991

Priorities for provision of health care services for children in the Cape Province.

Geographical areas in the Cape Province are ranked by their need for resources for child health care as determined by several proxy indicators of child health. Low birthweight and perinatal mortality rates for 1989, infant and age-specific childhood death rates, as well as death rates for tuberculosis, gastroenteritis and measles for 1985 are used as indicators of need. The ten magisterial districts having the highest priority for resources are, in decreasing order of need: De Aar, Colesberg, Uitenhage, Sterkstroom, Gordonia, Prince Albert, Philipstown, Victoria West, Kirkwood and Richmond. Limitations in the data are: wide, unquantifiable confidence limits, non-independence of different indicators, lack of timeliness, and incomplete statistics. Despite these problems with the data there are several reasons for employing them. Firstly, the quality of the data is only likely to be improved if they are actually used, and, secondly, there is no alternative. Areas identified as high priority need investigation in situ because corrective action is required for either the data collection system, or child health. Recommendations for improvements in resource management in child health care are: regionalisation of a unitary health care service, more timely data collection in geographically standardised regions, introduction of management objectives, and resource allocation guided by health status indicators.

Age Factors↗
PubMed1975

Accuracy of a health interview survey in measuring chronic illness prevalence.

The accuracy of a household health interview survey in measuring the prevalence of chronic illness was tested by comparing survey responses with the same respondents' medical records. Results indicate that the survey is far from a perfect discriminator of recorded medical status. The false-positive rate was 25 percent, and the rate of false negatives was nearly 40 percent. False positives were greater for Mexican-Americans and other nonwhites than for white respondents. The household health interview survey is nonetheless an important planning tool since it reflects respondents' perceived health levels, which may be used to predict utilization of primary medical services.

Adolescent↗
PubMedDate not supplied

[Social inequality in health and the utilization of health services among the elderly in Latin America].

OBJECTIVE: To learn if there is social inequality in health and in the utilization of health services among the elderly in six cities of Latin America: Buenos Aires, Argentina; São Paulo, Brazil; Santiago, Chile; Havana, Cuba; Mexico City, Mexico; and Montevideo, Uruguay. METHODS: This study used data from a project called Health, Well-being, and Aging in Latin America and the Caribbean (known as the "SABE project"). To investigate the presence of social inequality in health an ordinal probit model was used, with health status indicated by the following dependent variables: activities of daily living, instrumental activities of daily living, physical mobility, and self-rated health. To measure social inequality in the utilization of health services two characteristics were assessed: one for outpatient medical services (whether or not individuals received outpatient care, and how many times), and one for hospital admissions (whether or not individuals were hospitalized). For outpatient services, we estimated a negative binomial hurdle model, and for hospital admissions, a logit model was constructed. RESULTS: Our main results suggest the presence of social inequality in health in all the cities, with better-off socioeconomic groups having better health. The difference in health was less marked in Havana, Buenos Aires, and Montevideo, and it was more pronounced in São Paulo and Mexico City. With respect to the utilization of health services we found inequalities in the use of outpatient services in Santiago, Mexico City, and São Paulo. In Santiago and Mexico City, more schooling was associated with a higher number of expected outpatient medical visits; however, the opposite was found in São Paulo. For hospital admissions, inequality was found only in São Paulo, with individuals with more years of schooling being much more likely to be hospitalized. CONCLUSION: To a certain extent, our results reflect the socioeconomic and demographic characteristics of the countries in which each of the six cities is located. The cities in the countries with the worst social indicators (high income inequality and low human development index) tended to have the greatest inequalities in health and in the utilization of health services.

Age Factors↗
PubMed1989

Psychosocial distress and perceived health status among elderly users of a health maintenance organization.

A variety of measures was used to assess the relationship of psychosocial distress and perceived health status among 1,034 older (65+) members of an HMO. Distress was measured by recent life events, four types of social strain, and the CES-D, a measure of depression/demoralization. The distributions of these measures and perceived health status indicate that this sample was relatively healthy and undistressed. The strength of the associations within each group of variables is significant but generally modest. Using hierarchical multiple regression analysis with demographic variables, social support, and religiosity as controls, the strongest associations are between health status and the CES-D, life events, financial strain, and the strain of being single (unmarried respondents only).

Aged↗
PubMed1983

Monitoring simultaneously two or more indices of health care. Multivariate quality control procedures.

Often the data collected in a health care evaluation program consist of a number of indices, each of which represents a different component of a health care process. The question, "Is the health care process in control," to be answered effectively, must be answered in terms of the effect of the several indices considered jointly rather than in terms of each variable considered separately. This article describes the nature of the problem of monitoring jointly several indices of health care and presents two quality control methods, the control ellipse and Hotelling's T2, which are applicable to the multivariable setting. The discussion focuses on the case of monitoring simultaneously two related indices of health care, and extension of the two techniques to more than two indices is discussed briefly.

Factor Analysis, Statistical↗
PubMed1995

Infants of Mexican immigrants. Health status of an emerging population.

Previous studies suggest that infants of Mexican immigrants have favorable birth outcomes despite their high socioeconomic risks. These favorable outcomes have been associated with a protective sociocultural orientation among immigrants. A sample of 708 infants of Mexican origin was assessed to determine whether such health advantages at birth are sustained at 8 to 16 months of age, or alternatively, whether their health deteriorates because of adverse socioeconomic conditions. A a cross-sectional survey was conducted in San Diego County to determine whether the child was healthy or ill (the latter indicating a history of serious infectious disease) and the factors associated with this outcome. Among infants born without serious medical problems, 74% remained healthy. For 26% of the infants, their health status was eroded by social conditions. Factors associated with illness were large households, barriers to care, and maternal characteristics including smoking, pregnancy complications, and employment. Women born in Mexico who were newcomers to the United States and spoke Spanish exclusively were more likely than non-newcomers to have ill children. In this population, one fourth of Latino infants of immigrants were at high risk for serious infectious disease despite using preventive care.

Adolescent↗