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Advances in Population-Based Healthcare Research: From Measures to Evidence

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (15 September 2021) | Viewed by 26409

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Special Issue Editors

Dr. Pietro Ferrara

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Guest Editor

Center for Public Health Research, University of Milan-Bicocca, Via Pergolesi 33, 20900 Monza, Italy
Interests: epidemiology; public health; population-based healthcare; health policy; preventive medicine
Special Issues, Collections and Topics in MDPI journals

Dr. Luciana Albano

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Guest Editor

Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 5, Via Luciano Armanni, 80138 Naples, Italy
Interests: public health; epidemiology; health systems; health policy; preventive medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are arranging a Special Issue on “Advances in Population-Based Healthcare Research: From Measures to Evidence” in the International Journal of Environmental Research and Public Health (IF 2.849).

Although a universal consensus on the definition of “Population Health” is far from being reached, it is commonly designated as the distribution health outcomes among groups of individuals. On a broader point of view, this definition focuses on measurement, highlighting the importance of measures of health outcomes as actionable metrics that lead to community health improvement. Indeed, research on population health includes specific topics that concern health and health outcomes, which may serve as relevant health policy intervention.

By focusing more on groups rather than on individual patients, population health aims to promote improvements to the quality of healthcare supply through evidence-based decisions, the correction of social and economic determinants of health, and health expenditure revision.

Thus, we would like to invite you to contribute to this Special Issue with qualitative or quantitative research that explores particular topics of population health, aiming to promote a discussion on:

Health determinants;
Health factors;
Health outcomes;
Health measures and data;
Health service research;
Healthcare management;
Policies and programs;
Value-based healthcare.

Dr. Pietro Ferrara
Dr. Luciana Albano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Health outcomes
Health policies
Health service research
Healthcare management
Population health
Public health
Determinants of health

Published Papers (11 papers)

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Editorial

Jump to: Research

4 pages, 554 KiB

Open AccessEditorial

Advances in Population-Based Healthcare Research: From Measures to Evidence

by Pietro Ferrara and Luciana Albano

Int. J. Environ. Res. Public Health 2022, 19(20), 13122; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192013122 - 12 Oct 2022

Viewed by 942

Abstract

Whether “population health” encompasses a concept of health or a field of study of health determinants is not yet defined, though the term is widely used in healthcare and research worldwide [...] Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

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Research

Jump to: Editorial

9 pages, 294 KiB

Open AccessArticle

Exploratory Analysis of Related Factors with Absenteeism and Presenteeism on Workers: Using the Fourth Korea Working Condition Survey

by Young-Hyeon Bae

Int. J. Environ. Res. Public Health 2021, 18(21), 11214; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111214 - 26 Oct 2021

Cited by 5 | Viewed by 1920

Abstract

Purpose: This study aimed to identify the factors related to absenteeism and presenteeism in workers and to provide basic evidence to help improve their quality of life and work productivity. Methods: Data from the Fourth Korea working condition survey were analyzed. A stepwise regression model was developed to identify the related factors for exploratory analysis. Results: Absenteeism and subjective risk perception related to work and health conditions were the strongest predictive factors, followed by presenteeism. Fatigue was the strongest predictive factor for presenteeism, followed by a high temperature at the workplace, lower back pain, and other health conditions, in that order. Conclusion: The quality of life and the productivity of workers could be improved by focusing on the factors affecting absenteeism and presenteeism, such as the working environment and health status. Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

11 pages, 340 KiB

Open AccessArticle

Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population

by Neeru Gupta, Dan Lawson Crouse, Ismael Foroughi and Thalia Nikolaidou

Int. J. Environ. Res. Public Health 2021, 18(21), 11197; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111197 - 25 Oct 2021

Cited by 2 | Viewed by 2102

Abstract

Background: Little is known about the extent to which socioenvironmental characteristics may influence mental health outcomes in smaller population centres or differently among women and men. This study used a gender-based analysis approach to explore individual- and neighbourhood-level sex differences in mental health service use in a context of uniquely smaller urban and rural settlements. Methods: This cross-sectional analysis leveraged multiple person-based administrative health datasets linked with geospatial datasets among the population aged 1 and over in the province of New Brunswick, Canada. We used multinomial logistic regression to examine associations between neighbourhood characteristics with risk of service contacts for mood and anxiety disorders in 2015/2016, characterizing the areal measures among all residents (gender neutral) and by males and females separately (gender specific), and controlling for age group. Results: Among the province’s 707,575 eligible residents, 10.7% (females: 14.0%; males: 7.3%) used mental health services in the year of observation. In models adjusted for gender-neutral neighbourhood characteristics, service contacts were significantly more likely among persons residing in the most materially deprived areas compared with the least (OR = 1.09 [95% CI: 1.05–1.12]); when stratified by individuals’ sex, the risk pattern held for females (OR = 1.13 [95% CI: 1.09–1.17]) but not males (OR = 1.00 [95% CI: 0.96–1.05]). Residence in the most female-specific materially deprived neighbourhoods was independently associated with higher risk of mental health service use among individual females (OR = 1.08 [95% CI: 1.02–1.14]) but not among males (OR = 1.02 [95% CI: 0.95–1.10]). Conclusion: These findings emphasize that research needs to better integrate sex and gender in contextual measures aiming to inform community interventions and neighbourhood designs, notably in small urban and rural settings, to reduce socioeconomic inequalities in the burden of mental disorders. Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

16 pages, 391 KiB

Open AccessArticle

Organizational Factors Moderating Changes in Tobacco Use Dependence Care Delivery Following a Comprehensive Tobacco-Free Workplace Intervention in Non-Profit Substance Use Treatment Centers

by Kathy Le, Tzuan A. Chen, Isabel Martinez Leal, Virmarie Correa-Fernández, Ezemenari M. Obasi, Bryce Kyburz, Teresa Williams, Kathleen Casey, Matthew Taing, Daniel P. O’Connor and Lorraine R. Reitzel

Int. J. Environ. Res. Public Health 2021, 18(19), 10485; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910485 - 06 Oct 2021

Cited by 11 | Viewed by 2155

Abstract

Although tobacco use is the leading preventable cause of death and is elevated among patients with substance use disorders, many substance use treatment centers (SUTCs) do not offer tobacco use interventions (i.e., screening and treatment). This study examined a key outcome of the implementation of a tobacco-free workplace program that provided education and specialized training to employees; namely, changes in clinician provision of the five As (Asking about tobacco use; Advising to quit; Assessing willingness to quit; Assisting with quitting; Arranging follow-up) from before to after the larger program implementation. The five As are a brief tobacco screening and treatment protocol that was taught as part of the program and that formed the basis for further intervention (e.g., provision of nicotine replacement therapies, Motivational Interviewing to enhance desire and willingness to make a quit attempt). Moreover, we also examined organizational moderators that may have impacted changes in the delivery of the five As over time among clinicians from 15 participating SUTCs. The number of the centers’ total and unique annual patient visits; full-time employees; and organizational readiness for implementing change were assessed as potential moderators of change in clinicians’ behaviors over time. Clinicians completed pre- and post-program implementation surveys assessing their provision of the five As. Results demonstrated significant increases in Asking (p = 0.0036), Advising (p = 0.0176), Assisting (p < 0.0001), and Arranging (p < 0.0001). SUTCs with higher Change Efficacy (p = 0.025) and lower Resource Availability (p = 0.019) had greater increases in Asking. SUTCs with lower Resource Availability had greater increases in Assessing (p = 0.010). These results help guide tobacco control program implementation to increase the provision of tobacco use interventions (i.e., the five As) to SUTC patients and elucidate Change Efficacy and Resource Availability as organizational factors promoting this clinician behavior change. Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

10 pages, 652 KiB

Open AccessArticle

Association between Statin Use and Meniere’s Disease: Results from a National Health Screening Cohort

by So Young Kim, Dae Myoung Yoo, Chanyang Min and Hyo Geun Choi

Int. J. Environ. Res. Public Health 2021, 18(16), 8692; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168692 - 17 Aug 2021

Cited by 1 | Viewed by 2307

Abstract

The protective effects of statins against inner ear diseases have been suggested. This study investigated the relationship between previous statin use and the occurrence of Meniere’s disease (MD). Participants ≥40 years old in the Korean National Health Insurance Service-Health Screening Cohort 2002–2015 were enrolled. A total of 7734 MD participants were matched with 38,670 comparison participants. The dates of statin prescriptions for the 2 years before the onset of MD were examined. A conditional logistic regression analysis was performed to estimate the odds ratios (ORs) of statin use for MD. Regarding the different types of statins, lipophilic statins, but not hydrophilic statins, were associated with lower odds of MD in the <65 year-old group (adjusted OR = 0.81, 95% CI = 0.68–0.97, p = 0.023). Prior statin use did not show association with MD in the adult population. Regarding the different types of statins, lipophilic statin use was related to a lower rate of MD in a middle-aged population. Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

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9 pages, 545 KiB

Open AccessArticle

Association between Osteoporosis and Low Hemoglobin Levels: A Nested Case–Control Study Using a National Health Screening Cohort

by So-Young Kim, Dae-Myoung Yoo, Chanyang Min and Hyo-Geun Choi

Int. J. Environ. Res. Public Health 2021, 18(16), 8598; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168598 - 14 Aug 2021

Cited by 15 | Viewed by 2396

Abstract

An association between anemia and an increased risk of osteoporosis has been suggested. The goal of this study was to estimate the association of hemoglobin (Hb) level with osteoporosis. A total of 69,760 osteoporosis patients aged ≥ 40 years old from the Korean National Health Insurance Service Health Screening Cohort were enrolled. From an identical cohort database, 69,760 comparison participants were randomly selected. Hb levels before the onset of osteoporosis were evaluated. The association of Hb level with osteoporosis was analyzed using a conditional logistic regression model adjusted for obesity, smoking status, alcohol consumption, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, and the Charlson comorbidity index score. Fifteen percent of the osteoporosis group and 14.17% of the comparison group had anemia. The Hb level was associated with 0.98-fold lower odds for osteoporosis (95% confidence intervals = 0.97–0.99, p < 0.001). A low Hb level was associated with a high risk of osteoporosis in the adult population. There was a consistent association between a low Hb level and osteoporosis in patients with comorbidities. Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

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15 pages, 661 KiB

Open AccessArticle

Access to Healthcare Following Serious Injury: Perspectives of Allied Health Professionals in Urban and Regional Settings

by Jemma Keeves, Sandra C. Braaf, Christina L. Ekegren, Ben Beck and Belinda J. Gabbe

Int. J. Environ. Res. Public Health 2021, 18(3), 1230; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031230 - 29 Jan 2021

Cited by 13 | Viewed by 3641

Abstract

Barriers to accessing healthcare exist following serious injury. These issues are not well understood and may have dire consequences for healthcare utilisation and patients’ long-term recovery. The aim of this qualitative study was to explore factors perceived by allied health professionals to affect access to healthcare beyond hospital discharge for people with serious injuries in urban and regional Victoria, Australia. Twenty-five semi-structured interviews were conducted with community-based allied health professionals involved in post-discharge care for people following serious injury across different urban and regional areas. Interview transcripts were analysed using thematic analysis. Many allied health professionals perceived that complex funding systems and health services restrict access in both urban and regional areas. Limited availability of necessary health professionals was consistently reported, which particularly restricted access to mental healthcare. Access to healthcare was also felt to be hindered by a reliance on others for transportation, costs, emotional stress and often lengthy time of travel. Across urban and regional areas, a number of factors limit access to healthcare. Better understanding of health service delivery models and areas for change, including the use of technology and telehealth, may improve equitable access to healthcare. Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

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13 pages, 1533 KiB

Open AccessArticle

LACE Score-Based Risk Management Tool for Long-Term Home Care Patients: A Proof-of-Concept Study in Taiwan

by Mei-Chin Su, Yu-Chun Chen, Mei-Shu Huang, Yen-Hsi Lin, Li-Hwa Lin, Hsiao-Ting Chang and Tzeng-Ji Chen

Int. J. Environ. Res. Public Health 2021, 18(3), 1135; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031135 - 28 Jan 2021

Cited by 6 | Viewed by 2651

Abstract

Background: Effectively predicting and reducing readmission in long-term home care (LTHC) is challenging. We proposed, validated, and evaluated a risk management tool that stratifies LTHC patients by LACE predictive score for readmission risk, which can further help home care providers intervene with individualized preventive plans. Method: A before-and-after study was conducted by a LTHC unit in Taiwan. Patients with acute hospitalization within 30 days after discharge in the unit were enrolled as two cohorts (Pre-Implement cohort in 2017 and Post-Implement cohort in 2019). LACE score performance was evaluated by calibration and discrimination (AUC, area under receiver operator characteristic (ROC) curve). The clinical utility was evaluated by negative predictive value (NPV). Results: There were 48 patients with 87 acute hospitalizations in Pre-Implement cohort, and 132 patients with 179 hospitalizations in Post-Implement cohort. These LTHC patients were of older age, mostly intubated, and had more comorbidities. There was a significant reduction in readmission rate by 44.7% (readmission rate 25.3% vs. 14.0% in both cohorts). Although LACE score predictive model still has room for improvement (AUC = 0.598), it showed the potential as a useful screening tool (NPV, 87.9%; 95% C.I., 74.2–94.8). The reduction effect is more pronounced in infection-related readmission. Conclusion: As real-world evidence, LACE score-based risk management tool significantly reduced readmission by 44.7% in this LTHC unit. Larger scale studies involving multiple homecare units are needed to assess the generalizability of this study. Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

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24 pages, 1606 KiB

Open AccessArticle

A Bi-Objective Home Health Care Routing and Scheduling Model with Considering Nurse Downgrading Costs

by Pouria Khodabandeh, Vahid Kayvanfar, Majid Rafiee and Frank Werner

Int. J. Environ. Res. Public Health 2021, 18(3), 900; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18030900 - 21 Jan 2021

Cited by 16 | Viewed by 3144

Abstract

In recent years, the management of health systems is a main concern of governments and decision-makers. Home health care is one of the newest methods of providing services to patients in developed societies that can respond to the individual lifestyle of the modern age and the increase of life expectancy. The home health care routing and scheduling problem is a generalized version of the vehicle routing problem, which is extended to a complex problem by adding special features and constraints of health care problems. In this problem, there are multiple stakeholders, such as nurses, for which an increase in their satisfaction level is very important. In this study, a mathematical model is developed to expand traditional home health care routing and scheduling models to downgrading cost aspects by adding the objective of minimizing the difference between the actual and potential skills of the nurses. Downgrading can lead to nurse dissatisfaction. In addition, skillful nurses have higher salaries, and high-level services increase equipment costs and need more expensive training and nursing certificates. Therefore, downgrading can enforce huge hidden costs to the managers of a company. To solve the bi-objective model, an ε-constraint-based approach is suggested, and the model applicability and its ability to solve the problem in various sizes are discussed. A sensitivity analysis on the Epsilon parameter is conducted to analyze the effect of this parameter on the problem. Finally, some managerial insights are presented to help the managers in this field, and some directions for future studies are mentioned as well. Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

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11 pages, 330 KiB

Open AccessArticle

The Association of Post-Materialism with Health Care Use. Findings of a General Population Survey in Germany

by André Hajek and Hans-Helmut König

Int. J. Environ. Res. Public Health 2020, 17(23), 8869; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17238869 - 28 Nov 2020

Cited by 3 | Viewed by 1681

Abstract

(1) The aim of this study was to identify the association between post-materialism and health care use (in terms of the frequency of doctor visits and the reason for doctor visits). (2) Data were taken from the German General Social Survey (a representative sample of individuals aged 18 years and over, n = 3338). The Inglehart’s post-materialist index was used to quantify post-materialism. The doctor visits (self-reported) in the past three months served as an outcome measure. The reasons for seeing a doctor served as an additional outcome measure (acute illness; chronic illness; feeling unwell; requesting advice; visit to the doctor’s office without consulting the doctor (e.g., need to get a prescription); preventive medical check-up/vaccination). (3) After adjusting for several covariates, negative binomial regressions revealed that compared with materialism, post-materialism was associated with decreased doctor visits (total sample; women). Moreover, the likelihood of visiting the doctor for reasons of chronic illnesses was lower in post-materialistic women, whereas the likelihood of visiting the doctor for reasons of preventive medical check-up/vaccination was higher in post-materialistic women. (4) Study findings identify an unexplored link between post-materialism and doctor visits in women. One may conclude that in the long-term, the increased likelihood of preventive medical check-ups in post-materialistic women will be beneficial in decreasing the need for doctor visits for reasons of chronic illnesses. However, future research is required to elucidate the underlying mechanisms. Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

10 pages, 1273 KiB

Open AccessArticle

Estimates of Cancer Mortality Attributable to Carcinogenic Infections in Italy

by Pietro Ferrara, Sara Conti, Fernando Agüero, Luciana Albano, Cristina Masuet-Aumatell, Josep Maria Ramon-Torrell and Lorenzo Giovanni Mantovani

Int. J. Environ. Res. Public Health 2020, 17(23), 8723; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17238723 - 24 Nov 2020

Cited by 4 | Viewed by 2439

Abstract

Several infectious agents are ascertained causes of cancer, but the burden of cancer mortality attributable to carcinogenic infections in Italy is still unknown. To tackle this issue, we calculated the rate and regional distribution of cancer deaths due to infections sustained by seven pathogens ranked as group 1 carcinogenic agents in humans by the International Agency for Research on Cancer. Population attributable fractions related to these agents were applied to annual statistics of cancer deaths coded according to the 10th International Classification of Diseases. The estimated burden of cancer mortality attributable to carcinogenic infections in Italy during the period 2011–2015 was 8.7% of all cancer deaths registered yearly, on average. Approximately 60% of deaths occurred in men, and almost the whole burden was due to four infectious agents (Helicobacter pylori, hepatitis C virus, high-risk human papillomavirus, and hepatitis B virus). The analysis of regional distribution showed a higher number of infection-related cancer deaths in the northern regions, where the estimates reached 30 (Liguria) and 28 (Friuli Venezia Giulia) deaths per 100,000 inhabitants in 2015. Since one-twelfth of cancer deaths were attributable to these modifiable risk factors, the implementation of appropriate prevention and treatment interventions may help to reduce the impact of these infections on cancer mortality. Full article

(This article belongs to the Special Issue Advances in Population-Based Healthcare Research: From Measures to Evidence)

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