Socioeconomic and Geographic Disparities in Accessing Nursing Homes With High Star Ratings

Yuan, Yasheng; Louis, Christopher J.; Cabral, Howard; Schneider, Jeffrey C.; Ryan, Colleen M.; Kazis, Lewis E.

doi:10.1016/j.jamda.2018.05.017

Cited by 40 publications

(28 citation statements)

References 34 publications

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“…Likewise for the use of outpatient services, some references found a correlation between the level of socioeconomics and healthy lifestyle. Economic limitations make people trapped in unhealthy situations and behavior, such as unhealthy housing and unbalanced eating patterns (Yuan et al, 2018;Telleen et al, 2012;Dhruve, Badgaiyan and Pandey, 2016;Kusumawardani et al, 2018). Table 2 shows that insurance ownership also influences the use of outpatient and inpatient services in puskesmas.…”

Section: Resultsmentioning

confidence: 99%

Urban-Rural Disparities in The Utilization of Primary Health Care Center Among Elderly in East Java, Indonesia

Wulandari¹,

Laksono²

2019

Preprint

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Introduction: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output. Aim: This study was intended to analyze urban-rural disparity in the utilization of primary health care or puskesmas use by the elderly.Methods: This study was used the 2013 Riskesdas (Indonesian Basic Health Survey) raw data. The 2013 Riskesdas was designed a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province were obtained. Data were analyzed using Multinomial Logistic Regression tests.Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). The elderly who have a primary school and under education have the possibility of 1.558 times more utilizing outpatients in the puskesmas than the elderly who have college education levels (OR 1.558; 95% CI 1.001-2.424). Conclusions: There was a disparity between urban and rural areas in the utilization of outpatient puskesmas in East Java by the elderly. Policy makers in East Java are recommended to improve facilities and infrastructure of the puskesmas in rural areas by paying attention to the results of this study.

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Section: Resultsmentioning

confidence: 99%

Urban-Rural Disparities in The Utilization of Primary Health Care Center Among Elderly in East Java, Indonesia

Wulandari¹,

Laksono²

2019

Preprint

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“…Also, the situation of nursing homes in Spain includes both public and private institutions, and so, regardless of the level of deprivation of a person's CT, it is possible to move to them. In this regard, various studies in countries such as the United States have associated low socioeconomic status with access to poorer quality nursing homes [41,42].…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic inequalities in the place of death in urban small areas of three Mediterranean cities

Nolasco

Fernández‐Alcántara

Pereyra-Zamora

et al. 2020

Int J Equity Health

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Background Dying at home is the most frequent preference of patients with advanced chronic conditions, their caregivers, and the general population. However, most deaths continue to occur in hospitals. The objective of this study was to analyse the socioeconomic inequalities in the place of death in urban areas of Mediterranean cities during the period 2010–2015, and to assess if such inequalities are related to palliative or non-palliative conditions. Methods This is a cross-sectional study of the population aged 15 years or over. The response variable was the place of death (home, hospital, residential care). The explanatory variables were: sex, age, marital status, country of birth, basic cause of death coded according to the International Classification of Diseases, 10th revision, and the deprivation level for each census tract based on a deprivation index calculated using 5 socioeconomic indicators. Multinomial logistic regression models were adjusted in order to analyse the association between the place of death and the explanatory variables. Results We analysed a total of 60,748 deaths, 58.5% occurred in hospitals, 32.4% at home, and 9.1% in residential care. Death in hospital was 80% more frequent than at home while death in a nursing home was more than 70% lower than at home. All the variables considered were significantly associated with the place of death, except country of birth, which was not significantly associated with death in residential care. In hospital, the deprivation level of the census tract presented a significant association (p < 0.05) so that the probability of death in hospital vs. home increased as the deprivation level increased. The deprivation level was also significantly associated with death in residential care, but there was no clear trend, showing a more complex association pattern. No significant interaction for deprivation level with cause of death (palliative, not palliative) was detected. Conclusions The probability of dying in hospital, as compared to dying at home, increases as the socioeconomic deprivation of the urban area of residence rises, both for palliative and non-palliative causes. Further qualitative research is required to explore the needs and preferences of low-income families who have a terminally-ill family member and, in particular, their attitudes towards home-based and hospital-based death.

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“…A study conducted by Yuan et al found that nursing homes located in communities with lower socioeconomic statuses were associated with overall lower star ratings, staff ratings, and quality ratings. 21 As a result, residents in disadvantaged areas experience disparities in accessing highly rated nursing home care. Similarly, socioeconomically disadvantaged counties may lack sufficient resources to adequately staff rehabilitation care facilities and provide the quality of care that meets industry standards.…”

Section: Discussionmentioning

confidence: 99%

Gunshot wounds to the head: racial disparities in inpatient management and outcomes

Chiu¹,

Fuentes²,

Mehta³

2019

Neurosurgical Focus

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OBJECTIVESeveral studies have indicated that racial disparities may exist in the management and outcomes of acute trauma care. One segment of trauma care that has not been as extensively investigated, however, is that of cranial trauma care. The goal of this study was to determine whether significant differences exist among racial and ethnic groups in various measures of inpatient management and outcomes after gunshot wounds to the head (GWH).METHODSIn this study, the authors used the Nationwide (National) Inpatient Sample (NIS) to investigate all-cause mortality, receipt of surgery, days from admission to initial intervention, discharge disposition, length of hospital stay, and total hospital charges of those with GWH from 2012 to 2016. A 1:1 propensity score–matched analysis was conducted to evaluate the effect of race on these endpoints, while controlling for baseline demographics and comorbidities.RESULTSA total of 333 patients met the inclusion and exclusion criteria: 148 (44.44%) white/Caucasian, 123 (36.94%) black/African American, 54 (16.22%) Hispanic/Latinx, and 8 (2.40%) Asian. African American patients were sent to immediate care and rehabilitation significantly less often than Caucasian patients (RR 0.17 [95% CI 0.04–0.71]). There were no significant differences in mortality, length of stay, rates of surgical intervention, or total hospital charges among any of the racial groups.CONCLUSIONSThe authors’ findings suggest that racial disparities in inpatient cranial trauma care and outcomes may not be as prevalent as previously thought. In fact, the disparities seen were only in disposition. More research is needed to further elucidate and address disparities within this population, particularly those that may exist prior to, and after, hospitalization.

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Socioeconomic and Geographic Disparities in Accessing Nursing Homes With High Star Ratings

Cited by 40 publications

References 34 publications

Urban-Rural Disparities in The Utilization of Primary Health Care Center Among Elderly in East Java, Indonesia

Urban-Rural Disparities in The Utilization of Primary Health Care Center Among Elderly in East Java, Indonesia

Socioeconomic inequalities in the place of death in urban small areas of three Mediterranean cities

Gunshot wounds to the head: racial disparities in inpatient management and outcomes

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