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Smoking-Related Disparities in Health Care Access and Utilization Among Adults- [electronic resource]
Smoking-Related Disparities in Health Care Access and Utilization Among Adults- [electronic resource]
상세정보
- 자료유형
- 학위논문파일 국외
- 최종처리일시
- 20240214101935
- ISBN
- 9798380183130
- DDC
- 614.4
- 서명/저자
- Smoking-Related Disparities in Health Care Access and Utilization Among Adults - [electronic resource]
- 발행사항
- [S.l.]: : The Ohio State University., 2022
- 발행사항
- Ann Arbor : : ProQuest Dissertations & Theses,, 2022
- 형태사항
- 1 online resource(250 p.)
- 주기사항
- Source: Dissertations Abstracts International, Volume: 85-03, Section: B.
- 주기사항
- Advisor: Ferketich, Amy K.
- 학위논문주기
- Thesis (Ph.D.)--The Ohio State University, 2022.
- 사용제한주기
- This item must not be sold to any third party vendors.
- 초록/해제
- 요약Background. Cigarette smoking continues to be a major cause of illness, disability, and death and a significant burden in the health care system of the United States. Yet, gaps remain in our understanding of health care access and use related to smoking. Guided by comprehensive health services frameworks and recent data, this research explored smoking-related disparities in health care access and utilization among adults. We used large statewide surveys conducted in Ohio to (1) assess trends in health care access measures among low-income adults by smoking status following Ohio's Medicaid expansion and (2) describe factors associated with overuse of emergency departments (EDs) and underuse of preventive care among adult smokers. Using a related follow-up panel survey, we (3) examined the relationship between smoking and COVID19-related health care use and testing during the early months of the COVID-19 pandemic in Ohio.Methods. We assessed trends in five health care access measures by smoking status covering the pre- (i.e., 2012) and post-Medicaid expansion (i.e., 2015 to 2019) periods in Ohio using survey-weighted multivariable logistic regression. We carried out the analysis in ten multiply imputed datasets to handle missing data. We built multivariable descriptive models for factors associated with ED overuse and preventive care underuse in ten multiply imputed datasets accounting for potential contextual determinants of care. We examined the association between smoking and COVID-19-related health care use and COVID-19 testing using survey-weighted multivariable logistic regression models.Results. Compared to the pre-expansion period, we found improvements in unmet dental care needs, unmet medical exam or supply needs, and the ability to pay medical bills among smokers. However, we did not find an improvement in having a usual source of care (USC) or unmet mental care needs. We also found that progress in access measures among smokers is not as notable as that of non-smokers. ED overuse was related to poorer self-rated health, low income, Medicaid insurance or uninsurance, mental distress, and chronic health conditions. Underuse of preventive care was associated with lack of a USC, uninsurance, low income, and being unmarried or male. We found that current smokers, compared to never smokers, were more likely to seek both virtual and in-person care for COVID-19-related concerns during the early months of the pandemic, although differences in COVID-19 testing were short-lived.Conclusion. This research improved the existing knowledge of health care disparities by characterizing access measures and determinants of use among smokers. The study's findings could be leveraged to support policies and interventions to further reduce unmet care needs, improve preventive care use, and lower avoidable health care spending attributed to smoking. The research will also serve as an input for future research examining the long-term impact of the COVID-19 pandemic on health care access and use among smokers.
- 일반주제명
- Epidemiology.
- 일반주제명
- Public health.
- 일반주제명
- Health care management.
- 키워드
- Smoking
- 키워드
- Adults
- 기타저자
- The Ohio State University Public Health
- 기본자료저록
- Dissertations Abstracts International. 85-03B.
- 기본자료저록
- Dissertation Abstract International
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■00520240214101935
■006m o d
■007cr#unu||||||||
■020 ▼a9798380183130
■035 ▼a(MiAaPQ)AAI30723758
■035 ▼a(MiAaPQ)OhioLINKosu165833773396668
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a614.4
■1001 ▼aTeferra, Andreas Admassu.
■24510▼aSmoking-Related Disparities in Health Care Access and Utilization Among Adults▼h[electronic resource]
■260 ▼a[S.l.]:▼bThe Ohio State University. ▼c2022
■260 1▼aAnn Arbor :▼bProQuest Dissertations & Theses, ▼c2022
■300 ▼a1 online resource(250 p.)
■500 ▼aSource: Dissertations Abstracts International, Volume: 85-03, Section: B.
■500 ▼aAdvisor: Ferketich, Amy K.
■5021 ▼aThesis (Ph.D.)--The Ohio State University, 2022.
■506 ▼aThis item must not be sold to any third party vendors.
■520 ▼aBackground. Cigarette smoking continues to be a major cause of illness, disability, and death and a significant burden in the health care system of the United States. Yet, gaps remain in our understanding of health care access and use related to smoking. Guided by comprehensive health services frameworks and recent data, this research explored smoking-related disparities in health care access and utilization among adults. We used large statewide surveys conducted in Ohio to (1) assess trends in health care access measures among low-income adults by smoking status following Ohio's Medicaid expansion and (2) describe factors associated with overuse of emergency departments (EDs) and underuse of preventive care among adult smokers. Using a related follow-up panel survey, we (3) examined the relationship between smoking and COVID19-related health care use and testing during the early months of the COVID-19 pandemic in Ohio.Methods. We assessed trends in five health care access measures by smoking status covering the pre- (i.e., 2012) and post-Medicaid expansion (i.e., 2015 to 2019) periods in Ohio using survey-weighted multivariable logistic regression. We carried out the analysis in ten multiply imputed datasets to handle missing data. We built multivariable descriptive models for factors associated with ED overuse and preventive care underuse in ten multiply imputed datasets accounting for potential contextual determinants of care. We examined the association between smoking and COVID-19-related health care use and COVID-19 testing using survey-weighted multivariable logistic regression models.Results. Compared to the pre-expansion period, we found improvements in unmet dental care needs, unmet medical exam or supply needs, and the ability to pay medical bills among smokers. However, we did not find an improvement in having a usual source of care (USC) or unmet mental care needs. We also found that progress in access measures among smokers is not as notable as that of non-smokers. ED overuse was related to poorer self-rated health, low income, Medicaid insurance or uninsurance, mental distress, and chronic health conditions. Underuse of preventive care was associated with lack of a USC, uninsurance, low income, and being unmarried or male. We found that current smokers, compared to never smokers, were more likely to seek both virtual and in-person care for COVID-19-related concerns during the early months of the pandemic, although differences in COVID-19 testing were short-lived.Conclusion. This research improved the existing knowledge of health care disparities by characterizing access measures and determinants of use among smokers. The study's findings could be leveraged to support policies and interventions to further reduce unmet care needs, improve preventive care use, and lower avoidable health care spending attributed to smoking. The research will also serve as an input for future research examining the long-term impact of the COVID-19 pandemic on health care access and use among smokers.
■590 ▼aSchool code: 0168.
■650 4▼aEpidemiology.
■650 4▼aPublic health.
■650 4▼aHealth care management.
■653 ▼aSmoking
■653 ▼aHealth care access
■653 ▼aCOVID-19 pandemic
■653 ▼aAdults
■653 ▼aHealth care disparities
■690 ▼a0766
■690 ▼a0769
■690 ▼a0573
■71020▼aThe Ohio State University▼bPublic Health.
■7730 ▼tDissertations Abstracts International▼g85-03B.
■773 ▼tDissertation Abstract International
■790 ▼a0168
■791 ▼aPh.D.
■792 ▼a2022
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T16935457▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
■980 ▼a202402▼f2024
