Mobility of patients within Healthcare
Institutions
Inês Videira, Inês Jorge, Iolanda Ferreira, Ivete Afonso, Jennifer
Pires, Joana Ribeiro, Joana Vaz, Joana Fernandes, Joana Costa,
Joana Magalhães
Faculdade de Medicina da Universidade do
Porto
Introdução à Medicina
Turma 10
2005/2006
Mobility of patients within Healthcare Institutions
Presentation Summary
Introduction
Objective
Methods
Results/Discussion
Discussion Synthesis
Limitations - Bias
Mobility of patients within Healthcare Institutions
Objective
To study patients’ mobility within
healthcare institutions.
Mobility of patients within Healthcare Institutions
Study Classification
Analytic: relates the variables in study
Observational: studies the characteristics of the
target population
Transversal: data is collected in a single moment
Retrospective: information refers to the previous
year Analysis Unit: all the individuals over 65
years old per household
Methods
Mobility of patients within Healthcare Institutions
Sample design
Random sample of 83 adult individuals out of the available population
Methods
Target population: individuals over 65 years old of Oporto region (Espinho, Gondomar, Matosinhos, Maia, Oporto, Paredes, Stª Maria da Feira, Trofa, Valongo, Vila do Conde, Vila Nova de Gaia) Available population: individuals over 65 years old of Oporto region with household phone number starting with 22.
Mobility of patients within Healthcare Institutions
Methods Data collection
Random Digit Dialling – revision of the method by Mitofsky and Waksberg
Questionnaire design The questionnaire included sociodemographic characteristics (age, sex, city)
Questions related to the subject in study.
Scale pilot - interview with six subjects, in which the five questions were developed
Mobility of patients within Healthcare Institutions
Methods
Statistic Issues
Simple frequency distribution - to show the characteristics of the subjects and their answers
Variance was calculated for every variable. Relations between variables were defined using cross tabs and multiple response tables
Analyses performed with SPSS for Windows 13.0
Mobility of patients within Healthcare Institutions
Results/Discussion
Sample Results: 56 women and 26 men
Mean number of age 72.6 years old
Ages between 65 and 89 years old
Results/Discussion
The mean number of different healthcare institutions visited in 2005 was 4.8
People go to different types of institutions or to different institutions within the same type?
Mobility of patients within Healthcare Institutions
Table 1 – Mean numbers of attended healthcare institutions, within the same type, by men and women separately and both genders together.
Results/Discussion
The median of healthcare institutions attended to within the same type is one.
People usually go to one medical institution per type.
Hospitals
Health Centres
Private Laboratories
Private Physicians
Pharmacies
Men 0,81 0,69 0,92 0,96 1,15
Women 1,13 0,86 0,96 0,68 1,34
Both Genders
1,04 0,80 0,94 0,76 1,27
Mobility of patients within Healthcare Institutions
Results/Discussion
Hospitals: 25% went to more than one hospital vs 51%
that only went to one hospital Health Centres:
Low variability – only 5% attended more than one institution
Pharmacies: 28% went to more than one pharmacy vs 57%
that went to one
Mobility of patients within Healthcare Institutions
Number of distinct types of institutions
1 2 3 4 5
Number of people 2 (2%) 8 (10%) 22 (27%) 30 (36%) 21 (25%)
Table 2 – Number of types of institutions visited and the corresponding amount of people who visited them.
Results/Discussion
61% of the individuals go to more than three distinct types of healthcare institutions – existence of certain mobility.
Mobility of patients within Healthcare Institutions
Table 3 – H: Hospitals; PL: Private laboratories; HC: Health Centres; PP: Private Physicians; P: Pharmacies; Y/Y: Went to both institutions; N/N: Attended none of the institutions; Y/N; Attended only one of the institutions. The results presented in the table regard the 83 questionnaires obtained.
Crossing of 2 different healthcare
institutionsY/Y N/N Y/N
P + PL 56 (67%) 3 (4%) 24 (29%)
HC + P 54 (66%) 6 (7%) 23 (27%)
H + P 52 (63%) 2 (2%) 29 (35%)
HC + PL 51 (61%) 7 (8%) 25 (31%)
H + PL 50 (60%) 4 (5%) 29 (35%)
H + HC 50 (60%) 9 (11%) 24 (29%)
P + PP 40 (48%) 4 (5%) 39 (47%)
PL + PP 40 (48%) 8 (10%) 35 (42%)
H + PP 37 (45%) 8 (10%) 38 (45%)
HC + PP 34 (41%) 7 (8%) 42 (51%)
Doctors
Private Labs
Pharmacies
Results/Discussion
Mobility of patients within Healthcare Institutions
Based on the statistics there should be an exchange of medical information between pharmacies and private labs, provided by information systems.
The previous institutions are intrinsically linked to physicians, therefore with the public places where they work.
Hospitals, health centres, private labs and pharmacies, should be informatically linked, because more than 60% of the individuals attended each association of two institutions.
Results/Discussion
Mobility of patients within Healthcare Institutions
Results/Discussion
Lapa
Trindade
Carmo
Terço
Vila_Real
Vale_Sousa
Guimarães
Vila_Conde
Valongo
Póvoa
Matosinhos
Pedro_Hispano
VNG
CHVNG
Prelada
Joaquim_Urbano
IPO
HSA
HSJ
Of the 83 inquired individuals:
20 (24%)didn’t go to any hospital;
63 (76%) went to at least one.
HSJ: 30%
VNG: 24%
HSA: 21%
Mobility of patients within Healthcare Institutions
Results/Discussion
Of the 19 inquiries that went to HSJ:
4 (21%) also attended HSA;
2 (10%) went to IPO as well;
2 attended Hospital de Valongo.
Mobility of patients within Healthcare Institutions
Results/Discussion
Men and Women – are there any differences? Women often go, in average, to more
health institutions than men. This difference is not significant – our
sample is too small. Statement supported by values of
median (equals one, in both men and women separately).
Mobility of patients within Healthcare Institutions
Discussion Synthesis
Patients’ mobility has been registered: More pronounced between different types
of healthcare institutions Less distinct among the same type of
medical institutions
Patients would indeed benefit from an information linkage between different types of healthcare institutions
Mobility of patients within Healthcare Institutions
Discussion Synthesis If there is to exist information systems
that link different medical institutions, those should preferably be: Pharmacies and Private Laboratories: 67% Health Centres and Pharmacies: 66% Hospitals and Pharmacies: 63% Health Centres and Private Laboratories:
61% Hospitals and Private Laboratories: 60% Hospitals and Health Centres: 60%
Mobility of patients within Healthcare Institutions
Not every individual in target population owns a
household phone number
Restricted time period of interviews
Limitations - Bias
Some of the phone numbers starting with 22
include places out of the Oporto region
Data collected in one moment may not also reflect
the reality due to people’s memory lapses
Individuals that refuse to participate