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A meta-analysis of 16 randomized controlled trials to evaluate computer-based clinical reminder systems for preventive care in the ambulatory setting.

Shea, S; DuMouchel, W; Bahamonde, L
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //1996 Português
Relevância na Pesquisa
46.32%
OBJECTIVE: Computer-based reminder systems have the potential to change physician and patient behaviors and to improve patient outcomes. We performed a meta-analysis of published randomized controlled trials to assess the overall effectiveness of computer-based reminder systems in ambulatory settings directed at preventive care. DESIGN: Meta-analysis. SEARCH STRATEGY: Searches of the Medline (1966-1994), Nursing and Allied Health (1982-1994), and Health Planning and Administration (1975-1994) databases identified 16 randomized, controlled trials of computer-based reminder systems in ambulatory settings. STATISTICAL METHODS: A weighted mixed effects model regression analysis was used to estimate intervention effects for computer and manual reminder systems for six classes of preventive practices. MAIN OUTCOME MEASURE: Adjusted odds ratio for preventive practices. RESULTS: Computer reminders improved preventive practices compared with the control condition for vaccinations (adjusted odds ratio [OR] 3.09; 95% confidence interval [CI] 2.39-4.00), breast cancer screening (OR 1.88; 95% CI 1.44-2.45), colorectal cancer screening (OR 2.25; 95% CI 1.74-2.91), and cardiovascular risk reduction (OR 2.01; 95% CI 1.55-2.61) but not cervical cancer screening (OR 1.15; 95% CI 0.89-1.49) or other preventive care (OR 1.02; 95% CI 0.79-1.32). For all six classes of preventive practices combined the adjusted OR was 1.77 (95% CI 1.38-2.27). CONCLUSION: Evidence from randomized controlled studies supports the effectiveness of data-driven computer-based reminder systems to improve prevention services in the ambulatory care setting.

Do our patients receive maximum benefit from preventive care? A North American perspective.

Rosser, W W; Lamberts, H
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1990 Português
Relevância na Pesquisa
46.39%
Politicians, their constituents and family physicians believe that preventive medicine is essential if health care is to be improved. Family physicians believe that the majority of their patients are well cared for with preventive health care services but in reality preventive services are provided to less than half the population and some to fewer than 10%. Barriers to providing preventive care include the selection of procedures of unproven effectiveness, public unawareness of the benefits of the procedure and practical obstacles for physicians providing the services. Assessment of each of these barriers indicates how preventive care can be improved. Narrowing the gap between what we believe about preventive care and the level of preventive services we are providing could improve the health of our nations. However, the concept of primum non nocere must dominate the assessment of currently advocated preventive procedures and the consideration of new procedures.

Preventive care: do we practice what we preach?

Lurie, N; Manning, W G; Peterson, C; Goldberg, G A; Phelps, C A; Lillard, L
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /07/1987 Português
Relevância na Pesquisa
46.42%
We used insurance claims from enrollees in the Rand Health Insurance Experiment to determine the amount of selected components of preventive care received by a representative sample of the non-aged population in the United States and to determine whether insurance coverage was an important determinant of that amount. Only 45 percent of infants received timely immunization for DPT and polio; 93 per cent received some well child care by 18 months of age. In the three-year experimental period, only 4 per cent of adults had a tetanus shot, 66 per cent of women aged 17-44 and 57 per cent aged 45-65 received a Pap smear, and 2 per cent of women aged 45-65 had a mammogram. Cost sharing was associated with even less preventive care: 60 per cent of children on the free plan and 49 per cent on cost sharing plans received preventive care of any type. For adults, women on the free plan received more preventive care of several kinds, and those aged 45-65 received more Pap smears than those on cost-sharing plans. Even with free care, most enrollees did not receive adequate preventive care. Thus, free care alone, while significant, is not a sufficient incentive to providing recommended levels of preventive care. The average per person insurance charge for increasing the amount of preventive care to a level consistent with that recommended would be $22 for a complete set of immunizations by age 18 months...

Preventive care and barriers to effective prevention. How do family physicians see it?

Hutchison, B. G.; Abelson, J.; Woodward, C. A.; Norman, G.
Fonte: College of Family Physicians of Canada Publicador: College of Family Physicians of Canada
Tipo: Artigo de Revista Científica
Publicado em /09/1996 Português
Relevância na Pesquisa
46.44%
OBJECTIVES: To assess how adequately family physicians think they are delivering preventive care and to examine barriers to providing preventive care. DESIGN: Cross-sectional survey. SETTING: Primary care medical practices in south-central Ontario. PARTICIPANTS: Four hundred eighty family physicians and general practitioners who graduated from medical school between 1972 and 1988. MAIN OUTCOME MEASURES: Satisfactory preventive care delivery versus self-assessed coverage of patients for 15 preventive maneuvers. Perceived reasons for lack of success in providing recommended preventive care. RESULTS: For 10 of the 15 maneuvers, the proportion of physicians who regarded 90% or higher as satisfactory coverage was twice as great as the proportion who thought they provided that level of coverage. For 11 of the 15 maneuvers, most respondents reported coverage lower than the level they regarded as satisfactory. For six maneuvers, more than two thirds thought they provided less than satisfactory coverage. More than two thirds of respondents suggested these barriers to providing recommended preventive care: patient is healthy and does not visit; patient refuses, is not interested, or does not comply; no effective systems to remind patients to come in for preventive care; and priority given to presenting problem. CONCLUSION: Many family physicians and general practitioners in south-central Ontario provide preventive care to their patients at lower levels than they consider satisfactory. They identified barriers to providing preventive services successfully; these barriers suggest approaches for improving care.

Prompting Clinicians about Preventive Care Measures: A Systematic Review of Randomized Controlled Trials

Dexheimer, Judith W.; Talbot, Thomas R.; Sanders, David L.; Rosenbloom, S. Trent; Aronsky, Dominik
Fonte: American Medical Informatics Association Publicador: American Medical Informatics Association
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
Relevância na Pesquisa
46.38%
Preventive care measures remain underutilized despite recommendations to increase their use. The objective of this review was to examine the characteristics, types, and effects of paper- and computer-based interventions for preventive care measures. The study provides an update to a previous systematic review. We included randomized controlled trials that implemented a physician reminder and measured the effects on the frequency of providing preventive care. Of the 1,535 articles identified, 28 met inclusion criteria and were combined with the 33 studies from the previous review. The studies involved 264 preventive care interventions, 4,638 clinicians and 144,605 patients. Implementation strategies included combined paper-based with computer generated reminders in 34 studies (56%), paper-based reminders in 19 studies (31%), and fully computerized reminders in 8 studies (13%). The average increase for the three strategies in delivering preventive care measures ranged between 12% and 14%. Cardiac care and smoking cessation reminders were most effective. Computer-generated prompts were the most commonly implemented reminders. Clinician reminders are a successful approach for increasing the rates of delivering preventive care; however...

Maternal determinants of pediatric preventive care utilization among blacks and whites.

Alio, Amina P.; Salihu, Hamisu M.
Fonte: National Medical Association Publicador: National Medical Association
Tipo: Artigo de Revista Científica
Publicado em /06/2005 Português
Relevância na Pesquisa
46.42%
OBJECTIVE: We assessed maternal characteristics that were predictive of preventive care utilization among children 0-5 years and compared black-white differences in preventive care usage. METHOD: We used the 1996-2000 series of public use files from the Medical Expenditure Panel Survey (MEPS). Receipt of preventive care was defined as up-to-date immunization coverage of the child and at least one dental visit during the year. RESULTS: A total of 10,525 children were analyzed consisting of 2,090 blacks (19.9%) and 8,435 whites (80.1%). Black mothers were in general older and less educated. Black households were larger in size and contained a greater number of children. Black mothers earned, on average, much less than their white counterparts even though they tended to be more frequently employed than whites. Despite similar levels of insurance coverage for both racial groups, the overwhelming majority of white mothers were privately insured (73.2%), in contrast to only about half of blacks with private insurance coverage [54.3% (p < 0.0001)]. Overall, the level of pediatric preventive services utilization was a paltry 15.4%. Children of black mothers were significantly less likely to receive preventive care than whites (OR = 0.78; 95% CI = 0.64-0.94). Other determinants of preventive care use were maternal age...

A computer-generated reminder system improves physician compliance with diabetes preventive care guidelines.

Nilasena, D. S.; Lincoln, M. J.
Fonte: American Medical Informatics Association Publicador: American Medical Informatics Association
Tipo: Artigo de Revista Científica
Publicado em //1995 Português
Relevância na Pesquisa
46.33%
Computerized reminder systems have been shown to be effective in improving physician compliance with preventive services guidelines. Very little has been published about the use of computerized reminders for preventive care in diabetes. We implemented a computer-generated reminder system for diabetes care guidelines in a randomized controlled study in the outpatient clinics of 35 internal medicine residents at the University of Utah and Salt Lake Veterans Affairs Hospitals. After a six month study period, compliance with the recommended care significantly improved in both the intervention group that received patient-specific reminders about the guidelines (38.0% at baseline, 54.9% at follow-up) and the control group that received a nonspecific report (34.6% at baseline, 51.0% at follow-up). There was no significant difference between the two groups. Both clinic sites showed similar improvement over baseline levels of compliance. Residents who completed encounter forms used by the system showed a significantly greater improvement in compliance than those who did not complete encounter forms (19.7% vs. 7.6%, p = 0.006). The improvements in guideline compliance were seen in all areas of diabetes preventive care studied, and significant improvements were seen with recommended items from the medical history...

Interrelation of preventive care benefits and shared costs under the Affordable Care Act (ACA)

Dixon, Robert Brent; Hertelendy, Attila J.
Fonte: Kerman University of Medical Sciences Publicador: Kerman University of Medical Sciences
Tipo: Artigo de Revista Científica
Publicado em 23/08/2014 Português
Relevância na Pesquisa
46.41%
With the implementation of the Affordable Care Act (ACA), access to insurance and coverage of preventive care services has been expanded. By removing the barrier of shared costs for preventive care, it is expected that an increase in utilization of preventive care services will reduce the cost of chronic diseases. Early detection and treatment is anticipated to be less costly than treatment at full onset of chronic conditions. One concern of early detection of disease is the cost to treat. In reality, the confluence of early detection may result in greater overall expenditures. Even with improved access to preventive care benefits, cost-sharing of other health services remains a major component of insurance plans. In order to treat identified conditions or diseases, cost-sharing comes into play. With the greater adoption of cost-sharing insurance plans, expenditures on the part of enrollee are anticipated to rise. Once the healthcare recipients realize the implication of early identification and resultant treatment costs, enrollment in preventive care may decline. Healthcare legislation and regulation should consider the full spectrum of care and the microeconomic costs associated with preventive treatment. Although the system at large may not realize the immediate impact...

Use of Preventive Care Services, Beneficiary Characteristics, and Medicare HMO Performance

Greene, Jessica; Blustein, Jan; Laflamme, Kelly A.
Fonte: CENTERS for MEDICARE & MEDICAID SERVICES Publicador: CENTERS for MEDICARE & MEDICAID SERVICES
Tipo: Artigo de Revista Científica
Publicado em //2001 Português
Relevância na Pesquisa
46.42%
Medicare health maintenance organization (HMO) enrollees use more preventive care services than their fee-for-service (FFS) counterparts. This may be because those who enroll in HMOs have characteristics that make them more disposed to use preventive care. To investigate this possibility, we examined the use of four preventive care services by respondents to the 1996 Medicare Current Beneficiary Survey (MCBS). Unadjusted preventive care use rates for HMO enrollees were slightly higher than rates for non-HMO enrollees with private supplemental insurance. However, after adjusting for enrollee characteristics (sociodemographics, health behaviors, health status, and functioning) we found that preventive care use rates for HMO enrollees were substantially higher—consistent with HMO enrollees being less disposed to use preventive care. In comparing preventive care service rates across groups, managers and policymakers may want to consider taking into account beneficiary characteristics that are correlated with the disposition to use preventive care.

Rural Urban Disparity in the Use of Preventive Care: What can we learn from Colorectal Cancer Screening?

Fan, Lin (1979 - ); Noyes, Katia
Fonte: University of Rochester Publicador: University of Rochester
Tipo: Tese de Doutorado
Português
Relevância na Pesquisa
66.3%
Thesis (Ph.D.)--University of Rochester. School of Medicine & Dentistry. Dept. of Community and Preventive Medicine, 2012.; There is evidence of rural urban disparity in the use of preventive care including colorectal cancer (CRC) screening. In this study, we try to understand the reasons behind the rural urban disparity in CRC screenin, and the trend for the screening and rural-urban disparity in the screening before and after Medicare expansion of colonoscopy coverage in 2001. We use Medicare Current Beneficiary Survey (MCBS), Area Resource File (ARF), Rural –Urban Commuting Area Codes (RUCAs) and American Hospital Association Annual Survey Database. We use weighted logistic regression to explore the explanations of rural urban disparity in CRC screening. We use bivariate probit model and propensity score to control for sample selection. Logistic regression analysis is used to explore the screening and disparity trend over time. We found that people with higher education, greater income, better supplemental insurance coverage, shorter distance, and living in an area with greater provider supply are more likely to receive CRC screening. Education, income, supplemental insurance coverage explains disparities between urban and large...

Opportunistic electronic reminders : improving performance of preventive care in general practice

Frank, O.; Litt, J.; Beilby, J.
Fonte: Royal Australian College of General Practitioners Publicador: Royal Australian College of General Practitioners
Tipo: Artigo de Revista Científica
Publicado em //2004 Português
Relevância na Pesquisa
56.31%
BACKGROUND: Preventive care is an important role for general practitioners, yet opportunities for prevention are often missed. METHOD: We provided an automatic electronic record preventive care reminder system for 12 preventive care activities for one 10 doctor practice. All patients who attended were randomised by the terminal digit of their record number. RESULTS: The control uptake of opportunistic prevention was low; ranging from 1.5% (tetanus immunisation) to 27% (influenza immunisation). The reminders increased this by significant but small amounts for four out of 12 activities (immunisation for tetanus and pneumococcus and recording of allergies and weight), insignificant increases for four (mumps, measles and rubella immunisation, recording of smoking, and taking of cervical smears and of blood pressure), and insignificantly decreased influenza immunisation, and screening for diabetes and hyperlipidaemia. DISCUSSION: Opportunistic electronic reminders have the potential to increase preventive care in general practice.; Oliver Frank, John Litt and Justin Beilby; Copyright © 2004 Royal Australian College of General Practitioners Copyright to Australian Family Physician. Reproduced with permission. Permission to reproduce must be sought from the publisher...

Opportunistic reminders and other influences on the performance of preventive activities in consultations in general practice

Frank, Oliver Ralph
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado Formato: 1628202 bytes; 98541 bytes; application/pdf; application/pdf
Publicado em //2006 Português
Relevância na Pesquisa
46.45%
Introduction - Eighty five per cent of Australians visit a GP each year, but do not receive all of the preventive care which is indicated for them. There have been no controlled trials of the effects of on-screen preventive care reminders in Australian general practice, and there is little published research examining characteristics of patients, doctors and consultations associated with the performance of preventive services in general practice. This study aimed to measure the effects of opportunistic reminders and to explore previously unexamined patient, GP and consultation factors associated with performance of preventive activities. The hypotheses were : a ) that general practitioners who were using a computer medical record system would take at least fifteen per cent more of opportunities to perform preventive care activities if they were reminded ; b ) that this would occur without any significant increase in the number of consultations or in patient billings ; and c ) that every characteristic of patients, GPs, consultations and preventive opportunities would be significantly associated with the performance of the preventive activities. Method - All patients who attended a ten GP fully computerised practice during one year were enrolled and randomised either to an intervention group...

Paying Primary Health Care Centers for Performance in Rwanda

Basinga, Paulin; Gertler, Paul J.; Soucat, Agnes L.B.; Binagwaho, Agnes; Soucat, Agnes L.B.; Sturdy, Jennifer R.; Vermeersch, Christel M.J.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
Português
Relevância na Pesquisa
46.35%
Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities' input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children...

Health Care in Sri Lanka : What Can the Private Health Sector Offer?

Govindaraj, Ramesh; Navaratne, Kumari; Cavagnero, Eleonora; Seshadri, Shreelata Rao
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
Português
Relevância na Pesquisa
46.31%
This review represents an attempt to bridge the significant knowledge gaps on the private health sector in Sri Lanka, and foster a dialogue on opportunities for collaboration between the government and the private sector. It accomplishes this through a systematic collection and analysis of primary and secondary data on the provision, financing, and regulation of health care services. On health service delivery, the review finds that the private sector: includes a range of providers; focuses primarily on curative and outpatient services rather than preventive services; is heavily dependent on the public sector for its supply of human resources; and is concentrated in urban areas. The quality of health care services in Sri Lanka in both the private and public sectors, while better than in most developing countries, still lags behind those in more advanced countries. There is also little systematic dialogue and collaboration between the public and private sectors. On financing, the review finds that private health expenditure is more than half of total health expenditure...

Provision of preventive care to unannounced standardized patients

Hutchison, B; Woodward, C A; Norman, G R; Abelson, J; Brown, J A
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 27/01/1998 Português
Relevância na Pesquisa
46.4%
OBJECTIVE: To examine the relation between physician, training and practice characteristics and the provision of preventive care as described in the guidelines of the Canadian Task Force on the Periodic Health Examination. DESIGN: Cross-sectional study. SETTING: Family practices open to new patients within 1 hour's drive of Hamilton, Ont. PARTICIPANTS: A total of 125 family physicians were randomly selected from respondents to an earlier preventive care survey. Of the 125, 44 (35.2%) declined to participate, and an additional 19 (15.2%) initially consented but later withdrew when they closed their practices to new patients. Sixty-two physicians thus participated in the study. INTERVENTION: Unannounced standardized patients posing as new patients to the practice visited study physicians' practices between September 1994 and August 1995, portraying 4 scenarios: 48-year-old man, 70-year-old man, 28-year-old woman and 52-year-old woman. OUTCOME MEASURES: Proportion of preventive care manoeuvres carrying grade A, B, C, D and E recommendations from the Canadian Task Force on the Periodic Health Examination that were performed, offered or advised. A standard score was computed based on the performance of grade A and B manoeuvres (good or fair evidence for inclusion in the periodic health examination) and the non-performance of grade D and E manoeuvres (fair or good evidence for exclusion from the periodic health examination). RESULTS: Study physicians performed or offered 65.6% of applicable grade A manoeuvres...

Do female primary care physicians practise preventive care differently from their male colleagues?

Woodward, C. A.; Hutchison, B. G.; Abelson, J.; Norman, G.
Fonte: College of Family Physicians of Canada Publicador: College of Family Physicians of Canada
Tipo: Artigo de Revista Científica
Publicado em /12/1996 Português
Relevância na Pesquisa
46.42%
OBJECTIVE: To assess whether female primary care physicians' reported coverage of patients eligible for certain preventive care strategies differs from male physicians' reported coverage. DESIGN: A mailed survey. SETTING: Primary care practices in southern Ontario. PARTICIPANTS: All primary care physicians who graduated between 1972 and 1988 and practised in a defined geographic area of Ontario were selected from the Canadian Medical Association's physician resource database. Response rate was 50%. MAIN OUTCOME MEASURES: Answers to questions on sociodemographic and practice characteristics, attitudes toward preventive care, and perceptions about preventive care behaviour and practices. RESULTS: In general, reported coverage for Canadian Task Force on the Periodic Health Examination's (CTFPHE) A and B class recommendations was low. However, more female than male physicians reported high coverage of women patients for female-specific preventive care measures (i.e., Pap smears, breast examinations, and mammography) and for blood pressure measurement. Female physicians appeared to question more patients about a greater number of health risks. Often, sex of physician was the most salient factor affecting whether preventive care services thought effective by the CTFPHE were offered. However...

Prevention of pressure ulcers in bedridden patients - nursing preventive care

de Paula, Franciny Paravidini; Flumimense Federal University; Cruz, Isabel CF da; Professional Nursing Master
Fonte: Universidade Federal Fluminense Publicador: Universidade Federal Fluminense
Tipo: Peer-reviewed Article; systematic review Formato: text/html
Publicado em 03/07/2010 Português
Relevância na Pesquisa
66.15%
This study obtained through a literature review, whose main goal was to obtain data for use by nursing staff for preventive care, systematic and individualized in hospitalized patients at risk for developing pressure ulcers, identifying risk factors to this, and often these are presented in bedridden patients in an institution providing health services.

Nurses: the "front gate" to provide effective pediatric preventive care

Pérez-Cuevas,Ricardo; Muñoz Hernández,Onofre; Gutiérrez Trujillo,Gonzalo
Fonte: Instituto Nacional de Salud, Hospital Infantil de México Federico Gómez Publicador: Instituto Nacional de Salud, Hospital Infantil de México Federico Gómez
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2010 Português
Relevância na Pesquisa
66.35%
The objective of this paper is to analyze the importance of nurses as key providers of preventive services for Mexican children and adolescents. Nurses represent a long-standing tradition as public health providers and are very close to the individual, the family and the community. Their contribution to the preventive care of patients of these age groups is explicit and tangible. Health needs for this segment of the population and the current conditions of the Mexican health care system call for further actions. Preventive care should be accessible, high quality and comprehensive. To accomplish these goals it is necessary to invest in the public health workforce. Also, the need to increase its efficiency and effectiveness of preventive services should prompt the Mexican health care system to support the skill mix and promote the presence of nurse practitioners in primary care facilities.

Health care utilization and health-related quality of life perception in older adults: a study of the Mexican Social Security Institute

Gallegos-Carrillo,Katia; García-Peña,Carmen; Durán-Muñoz,Carlos; Mudgal,Jyoti; Durán-Arenas,Luis; Salmerón-Castro,Jorge
Fonte: Instituto Nacional de Salud Pública Publicador: Instituto Nacional de Salud Pública
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2008 Português
Relevância na Pesquisa
46.31%
OBJECTIVE: To establish how health care service utilization patterns are associated with health-related quality of life (HRQL) perception in older adults. MATERIAL AND METHODS: A cross-sectional study in adults aged 60 years or more was conducted in a random sample of 1150 beneficiaries of the Mexican Social Security Institute (IMSS) in Mexico City during 2003. Health care services utilization was categorized as preventive or curative, which generated six usage profiles. HRQL was measured by means of the SF-36 questionnaire. Analyses of variance and multiple linear regressions were conducted to evaluate the relationship between health care services utilization and HRQL. RESULTS: The use of preventive and curative services has a positive association with HRQL levels. Usage profiles with a prevalence of preventive services have a stronger positive association with HRQL scales. CONCLUSIONS: This study suggests a positive association between use patterns for primarily preventive health care services and a better HRQL perception among older adults.

Health care utilization and health-related quality of life perception in older adults: a study of the Mexican Social Security Institute

Gallegos-Carrillo,Katia; García-Peña,Carmen; Durán-Muñoz,Carlos; Mudgal,Jyoti; Durán-Arenas,Luis; Salmerón-Castro,Jorge
Fonte: Instituto Nacional de Salud Pública Publicador: Instituto Nacional de Salud Pública
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2008 Português
Relevância na Pesquisa
46.31%
OBJECTIVE: To establish how health care service utilization patterns are associated with health-related quality of life (HRQL) perception in older adults. MATERIAL AND METHODS: A cross-sectional study in adults aged 60 years or more was conducted in a random sample of 1150 beneficiaries of the Mexican Social Security Institute (IMSS) in Mexico City during 2003. Health care services utilization was categorized as preventive or curative, which generated six usage profiles. HRQL was measured by means of the SF-36 questionnaire. Analyses of variance and multiple linear regressions were conducted to evaluate the relationship between health care services utilization and HRQL. RESULTS: The use of preventive and curative services has a positive association with HRQL levels. Usage profiles with a prevalence of preventive services have a stronger positive association with HRQL scales. CONCLUSIONS: This study suggests a positive association between use patterns for primarily preventive health care services and a better HRQL perception among older adults.