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Effect of the economic crisis on the use of health and home care services among Spanish COPD patients

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death worldwide. Consequently, COPD patients are frequent users of health and social resources. Therefore, they are highly vulnerable to decreases in investment in healthcare services. We aimed to describe th...

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Autores principales: de Miguel-Diez, Javier, Lopez-de-Andres, Ana, Herandez-Barrera, Valentin, Jimenez-Trujillo, Isabel, Puente-Maestu, Luis, Cerezo-Lajas, Alicia, Jimenez-Garcia, Rodrigo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836665/
https://www.ncbi.nlm.nih.gov/pubmed/29535513
http://dx.doi.org/10.2147/COPD.S150308
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author de Miguel-Diez, Javier
Lopez-de-Andres, Ana
Herandez-Barrera, Valentin
Jimenez-Trujillo, Isabel
Puente-Maestu, Luis
Cerezo-Lajas, Alicia
Jimenez-Garcia, Rodrigo
author_facet de Miguel-Diez, Javier
Lopez-de-Andres, Ana
Herandez-Barrera, Valentin
Jimenez-Trujillo, Isabel
Puente-Maestu, Luis
Cerezo-Lajas, Alicia
Jimenez-Garcia, Rodrigo
author_sort de Miguel-Diez, Javier
collection PubMed
description BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death worldwide. Consequently, COPD patients are frequent users of health and social resources. Therefore, they are highly vulnerable to decreases in investment in healthcare services. We aimed to describe the utilization of health and home care services among Spanish COPD patients during the economic crisis to identify factors independently associated with changes in the utilization of these services and to study the time trends from 2009 to 2014. METHODS: We used data from the European Health Interview Surveys for Spain (EHSS) conducted between 2009/2010 (n=22,188) and 2014 (n=22,842). We included responses from adults with COPD aged 40 years or over. Dependent variables included self-reported hospitalizations during the previous year, general practitioner (GP) visits during the last 4 weeks, other health care services used during the previous year (nursing, rehabilitation, and psychological services), and home care services use during the previous year. Independent variables included demographic and socioeconomic characteristics, health status variables, and lifestyles. RESULTS: We identified 1,328 and 1,008 COPD patients from EHSS 2009 and EHSS 2014, respectively. We observed a significant increase in non-GP services use (30.6% in 2009 vs 39.11% in 2014; p<0.001). No changes were found for hospitalizations, GP visits, and home care services use over time. Multivariable models showed that associated factors with a higher use included any chronic comorbidity and worse self-rated health. Physical activity was a strong predictor of fewer hospitalizations and less home care service use. Female sex was associated with significantly fewer hospitalizations (OR 0.72; 95% CI 0.58–0.89). CONCLUSION: We found an increase in the use of non-GP services (nursing, rehabilitation, and psychological) but not in other health and home care services. The only differences in hospitalizations were observed according to sex. Therefore, the effect of the economic crisis, if any, seems to have been of small magnitude.
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spelling pubmed-58366652018-03-13 Effect of the economic crisis on the use of health and home care services among Spanish COPD patients de Miguel-Diez, Javier Lopez-de-Andres, Ana Herandez-Barrera, Valentin Jimenez-Trujillo, Isabel Puente-Maestu, Luis Cerezo-Lajas, Alicia Jimenez-Garcia, Rodrigo Int J Chron Obstruct Pulmon Dis Original Research BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death worldwide. Consequently, COPD patients are frequent users of health and social resources. Therefore, they are highly vulnerable to decreases in investment in healthcare services. We aimed to describe the utilization of health and home care services among Spanish COPD patients during the economic crisis to identify factors independently associated with changes in the utilization of these services and to study the time trends from 2009 to 2014. METHODS: We used data from the European Health Interview Surveys for Spain (EHSS) conducted between 2009/2010 (n=22,188) and 2014 (n=22,842). We included responses from adults with COPD aged 40 years or over. Dependent variables included self-reported hospitalizations during the previous year, general practitioner (GP) visits during the last 4 weeks, other health care services used during the previous year (nursing, rehabilitation, and psychological services), and home care services use during the previous year. Independent variables included demographic and socioeconomic characteristics, health status variables, and lifestyles. RESULTS: We identified 1,328 and 1,008 COPD patients from EHSS 2009 and EHSS 2014, respectively. We observed a significant increase in non-GP services use (30.6% in 2009 vs 39.11% in 2014; p<0.001). No changes were found for hospitalizations, GP visits, and home care services use over time. Multivariable models showed that associated factors with a higher use included any chronic comorbidity and worse self-rated health. Physical activity was a strong predictor of fewer hospitalizations and less home care service use. Female sex was associated with significantly fewer hospitalizations (OR 0.72; 95% CI 0.58–0.89). CONCLUSION: We found an increase in the use of non-GP services (nursing, rehabilitation, and psychological) but not in other health and home care services. The only differences in hospitalizations were observed according to sex. Therefore, the effect of the economic crisis, if any, seems to have been of small magnitude. Dove Medical Press 2018-02-28 /pmc/articles/PMC5836665/ /pubmed/29535513 http://dx.doi.org/10.2147/COPD.S150308 Text en © 2018 de Miguel-Diez et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
de Miguel-Diez, Javier
Lopez-de-Andres, Ana
Herandez-Barrera, Valentin
Jimenez-Trujillo, Isabel
Puente-Maestu, Luis
Cerezo-Lajas, Alicia
Jimenez-Garcia, Rodrigo
Effect of the economic crisis on the use of health and home care services among Spanish COPD patients
title Effect of the economic crisis on the use of health and home care services among Spanish COPD patients
title_full Effect of the economic crisis on the use of health and home care services among Spanish COPD patients
title_fullStr Effect of the economic crisis on the use of health and home care services among Spanish COPD patients
title_full_unstemmed Effect of the economic crisis on the use of health and home care services among Spanish COPD patients
title_short Effect of the economic crisis on the use of health and home care services among Spanish COPD patients
title_sort effect of the economic crisis on the use of health and home care services among spanish copd patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836665/
https://www.ncbi.nlm.nih.gov/pubmed/29535513
http://dx.doi.org/10.2147/COPD.S150308
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