Bayer-Oglesby, Lucy

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Bayer-Oglesby
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Lucy
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Bayer-Oglesby, Lucy

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Enddatum: 2022 × Typ: 01A - Beitrag in wissenschaftlicher Zeitschrift ×

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  • Vorschaubild
    Publikation
    Social disparities in unplanned 30-day readmission rates after hospital discharge in patients with chronic health conditions: A retrospective cohort study using patient level hospital administrative data linked to the population census in Switzerland
    (Public Library of Science, 22.09.2022) Zumbrunn, Andrea; Bachmann, Nicole; Bayer-Oglesby, Lucy; Joerg, Reto [in: PLOS ONE]
    Unplanned readmissions shortly after discharge from hospital are common in chronic diseases. The risk of readmission has been shown to be related both to hospital care, e.g., medical complications, and to patients’ resources and abilities to manage the chronic disease at home and to make appropriate use of outpatient medical care. Despite a growing body of evidence on social determinants of health and health behaviour, little is known about the impact of social and contextual factors on readmission rates. The objective of this study was to analyse possible effects of educational, financial and social resources of patients with different chronic health conditions on unplanned 30 day-readmission risks. The study made use of nationwide inpatient hospital data that was linked with Swiss census data. The sample included n = 62,109 patients aged 25 and older, hospitalized between 2012 and 2016 for one of 12 selected chronic conditions. Multivariate logistic regressions analysis was performed. Our results point to a significant association between social factors and readmission rates for patients with chronic conditions. Patients with upper secondary education (OR = 1.26, 95% CI: 1.11, 1.44) and compulsory education (OR = 1.51, 95% CI: 1.31, 1.74) had higher readmission rates than those with tertiary education when taking into account demographic, social and health status factors. Having private or semi-private hospital insurance was associated with a lower risk for 30-day readmission compared to patients with mandatory insurance (OR = 0.81, 95% CI: 0.73, 0.90). We did not find a general effect of social resources, measured by living with others in a household, on readmission rates. The risk of readmission for patients with chronic conditions was also strongly predicted by type of chronic condition and by factors related to health status, such as previous hospitalizations before the index hospitalization (+77%), number of comorbidities (+15% higher probability per additional comorbidity) as well as particularly long hospitalizations (+64%). Stratified analysis by type of chronic condition revealed differential effects of social factors on readmissions risks. Compulsory education was most strongly associated with higher odds for readmission among patients with lung cancer (+142%), congestive heart failure (+63%) and back problems (+53%). We assume that low socioeconomic status among patients with chronic conditions increases the risk of unplanned 30-day readmission after hospitalisation due to factors related to their social situation (e.g., low health literacy, material deprivation, high social burden), which may negatively affect cooperation with care providers and adherence to recommended therapies as well as hamper active participation in the medical process and the development of a shared understanding of the disease and its cure. Higher levels of comorbidity in socially disadvantaged patients can also make appropriate self-management and use of outpatient care more difficult. Our findings suggest a need for increased preventive measures for disadvantaged populations groups to promote early detection of diseases and to remove financial or knowledge-based barriers to medical care. Socially disadvantaged patients should also be strengthened more in their individual and social resources for coping with illness.
    01A - Beitrag in wissenschaftlicher Zeitschrift
  • Vorschaubild
    Publikation
    Social inequalities, length of hospital stay for chronic conditions and the mediating role of comorbidity and discharge destination: A multilevel analysis of hospital administrative data linked to the population census in Switzerland
    (Public Library of Science, 24.08.2022) Bayer-Oglesby, Lucy; Zumbrunn, Andrea; Bachmann, Nicole [in: PLOS ONE]
    Social factors are recognized determinants of morbidity and mortality and also have an impact on use of medical services. The objective of this study was to assess the associations of educational attainment, social and financial resources, and migration factors with length of hospital stays for chronic conditions. In addition, the study investigated the role of comorbidity and discharge destination in mediating these associations. The study made use of nationwide inpatient data that was linked with Swiss census data. The study sample included n = 141,307 records of n = 92,623 inpatients aged 25 to 84 years, hospitalized between 2010 and 2016 for a chronic condition. Cross-classified multilevel models and mediation analysis were performed. Patients with upper secondary and compulsory education stayed longer in hospital compared to those with tertiary education (β 0.24 days, 95% CI 0.14–0.33; β 0.37, 95% CI 0.27–0.47, respectively) when taking into account demographic factors, main diagnosis and clustering on patient and hospital level. However, these effects were almost fully mediated by burden of comorbidity. The effect of living alone on length of stay (β 0.60 days, 95% CI 0.50–0.70) was partially mediated by both burden of comorbidities (33%) and discharge destination (30.4%). (Semi-) private insurance was associated with prolonged stays, but an inverse effect was observed for colon and breast cancer. Allophone patients had also prolonged hospital stays (β 0.34, 95% CI 0.13–0.55). Hospital stays could be a window of opportunity to discern patients who need additional time and support to better cope with everyday life after discharge, reducing the risks of future hospital stays. However, inpatient care in Switzerland seems to take into account rather obvious individual needs due to lack of immediate support at home, but not necessarily more hidden needs of patients with low health literacy and less resources to assert their interests within the health system.
    01A - Beitrag in wissenschaftlicher Zeitschrift
  • Vorschaubild
    Publikation
    Social and regional factors predict the likelihood of admission to a nursing home after acute hospital stay in older people with chronic health conditions. A multilevel analysis using routinely collected hospital and census data in Switzerland
    (Frontiers, 2022) Bachmann, Nicole; Zumbrunn, Andrea; Bayer-Oglesby, Lucy [in: Frontiers in Public Health]
    If hospitalization becomes inevitable in the course of a chronic disease, discharge from acute hospital care in older persons is often associated with temporary or persistent frailty, functional limitations and the need for help with daily activities. Thus, acute hospitalization represents a particularly vulnerable phase of transient dependency on social support and health care. This study examines how social and regional inequality affect the decision for an institutionalization after acute hospital discharge in Switzerland. The current analysis uses routinely collected inpatient data from all Swiss acute hospitals that was linked on the individual level with Swiss census data. The study sample included 60,209 patients 75 years old and older living still at a private home and being hospitalized due to a chronic health condition in 199 hospitals between 2010 and 2016. Random intercept multilevel logistic regression was used to assess the impact of social and regional factors on the odds of a nursing home admission after hospital discharge. Results show that 7.8% of all patients were admitted directly to a nursing home after hospital discharge. We found significant effects of education level (compulsory vs. tertiary education OR = 1.16 (95% CI: 1.03–1.30), insurance class (compulsory vs. private insurance OR = 1.24 (95% CI: 1.09–1.41), living alone vs. living with others (OR = 1.64; 95% CI: 1.53–1.76) and language regions (French vs. German speaking part: OR = 0.54; 95% CI: 0.37–0.80) on the odds of nursing home admission in a model adjusted for age, gender, nationality, health status, year of hospitalization and hospital-level variance. The language regions moderated the effect of education and insurance class but not of living alone. This study shows that acute hospital discharge in older age is a critical moment of transient dependency especially for socially disadvantaged patients. Social and health care should work coordinated together to avoid unnecessary institutionalizations.
    01A - Beitrag in wissenschaftlicher Zeitschrift
  • Vorschaubild
    Publikation
    Innovative Methoden zur Wirkungsforschung in der stationären Suchttherapie – Messung von Veränderungen der Lebensqualität
    (Hochschule für Soziale Arbeit FHNW, 01/2015) Bayer-Oglesby, Lucy; Schmid, Holger [in: Soziale Innovation]
    01A - Beitrag in wissenschaftlicher Zeitschrift
  • Vorschaubild nicht verfügbar
    Publikation
    Text messaging to support smoking cessation in young people: A cluster randomised controlled trial
    (Taylor & Francis, 01.07.2013) Haug, Severin; Schmid, Holger; Bayer-Oglesby, Lucy [in: Psychology and Health]
    01A - Beitrag in wissenschaftlicher Zeitschrift
  • Vorschaubild nicht verfügbar
    Publikation
    Long-term exposure models for traffic related NO2 across geographically diverse areas over separate years
    (Elsevier, 2012) Sally Liu, L.-J.; Tsai, Ming-Yi; Keidel, Dirk; Gemperli, Armin; Ineichen, Alex; Hazenkamp-von Arx, Marianne; Bayer-Oglesby, Lucy; Rochat, Thierry; Künzli, Nino; Ackermann-Liebrich, Ursula; Straehl, Peter; Schwartz, Joel; Schindler, Christian [in: Atmospheric Environment]
    Although recent air pollution epidemiologic studies have embraced land-use regression models for estimating outdoor traffic exposure, few have examined the spatio-temporal variability of traffic related pollution over a long term period and the optimal methods to take these factors into account for exposure estimates. We used home outdoor NO2 measurements taken from eight geographically diverse areas to examine spatio-temporal variations, construct, and evaluate models that could best predict the within-city contrasts in observations. Passive NO2 measurements were taken outside of up to 100 residences per area over three seasons in 1993 and 2003 as part of the Swiss cohort study on air pollution and lung and heart disease in adults (SAPALDIA). The spatio-temporal variation of NO2 differed by area and year. Regression models constructed using the annual NO2 means from central monitoring stations and geographic parameters predicted home outdoor NO2 levels better than a dispersion model. However, both the regression and dispersion models underestimated the within-city contrasts of NO2 levels. Our results indicated that the best models should be constructed for individual areas and years, and would use the dispersion estimates as the urban background, geographic information system (GIS) parameters to enhance local characteristics, and temporal and meteorological variables to capture changing local dynamics. Such models would be powerful tools for assessing health effects from long-term exposure to air pollution in a large cohort
    01A - Beitrag in wissenschaftlicher Zeitschrift
  • Vorschaubild nicht verfügbar
    Publikation
    Validity of Ambient Levels of Fine Particles as Surrogate for Personal Exposure to Outdoor Air Pollution—Results of the European EXPOLIS-EAS Study (Swiss Center Basel)
    (Taylor & Francis, 27.12.2011) Bayer-Oglesby, Lucy; Künzli, Nino; Röösli, Martin; Braun-Fahrländer, Charlotte; Mathys, Patrick; Stern, Willem; Jantunen, Matti; Kousa, Anu [in: Journal of the Air & Waste Management Association]
    To evaluate the validity of fixed-site fine particle levels as exposure surrogates in air pollution epidemiology, we considered four indicator groups: (1) PM2.5 total mass concentrations, (2) sulfur and potassium for regional air pollution, (3) lead and bromine for traffic-related particles, and (4) calcium for crustal particles. Using data from the European EXPOLIS (Air Pollution Exposure Distribution within Adult Urban Populations in Europe) study, we assessed the associations between 48-hr personal exposures and home outdoor levels of the indicators. Furthermore, within-city variability of fine particle levels was evaluated. Personal exposures to PM2.5 mass were not correlated to corresponding home outdoor levels (n = 44, rSpearman (Sp) = 0.07). In the group reporting neither relevant indoor sources nor relevant activities, personal exposures and home outdoor levels of sulfur were highly correlated (n = 40, rSp = 0.85). In contrast, the associations were weaker for traffic (Pb: n = 44, rSp = 0.53; Br: n = 44, rSp = 0.21) and crustal (Ca: n = 44, rSp = 0.12) indicators. This contrast is consistent with spatially homogeneous regional pollution and higher spatial variability of traffic and crustal indicators observed in Basel, Switzerland. We conclude that for regional air pollution, fixed-site fine particle levels are valid exposure surrogates. For source-specific exposures, however, fixed-site data are probably not the optimal measure. Still, in air pollution epidemiology, ambient PM2.5 levels may be more appropriate exposure estimates than total personal PM2.5 exposure, since the latter reflects a mixture of indoor and outdoor sources.
    01A - Beitrag in wissenschaftlicher Zeitschrift
  • Vorschaubild nicht verfügbar
    Publikation
    Improvements in PM10 Exposure and Reduced Rates of Respiratory Symptoms in a Cohort of Swiss Adults (SAPALDIA)
    (American Thoracic Society, 2009) Schindler, Christian; Keidel, Dirk; Gerbase, Margaret W.; Zemp, Elisabeth; Bettschart, Robert; Brändli, Otto; Brutsche, Martin H.; Burdet, Luc; Karrer, Werner; Knöpfli, Bruno; Pons, Marco; Rapp, Regula; Bayer-Oglesby, Lucy; Künzli, Nino; Schwartz, Joel; Liu, Lee-Jane S.; Ackermann-Liebrich, Ursula; Rochat, Thierry [in: American Journal of Respiratory and Critical Care Medicine]
    Rationale: Reductions in mortality following improvements in air quality were documented by several studies, and our group found, in an earlier analysis, that decreasing particulate levels attenuate lung function decline in adults. Objectives: We investigated whether decreases in particulates with an aerodynamic diameter of less than 10 microm (PM10) were associated with lower rates of reporting respiratory symptoms (i.e., decreased morbidity) on follow-up. Methods: The present analysis includes 7,019 subjects who underwent detailed baseline examinations in 1991 and a follow-up interview in 2002. Each subject was assigned model-based estimates of average PM10 during the 12 months preceding each health assessment and the difference was used as the exposure variable of interest (DeltaPM10). Analyses were stratified by symptom status at baseline and associations between DeltaPM10 and change in symptom status during follow-up were adjusted for important baseline characteristics, smoking status at follow-up, and season. We then estimated adjusted odds ratios for symptoms at follow-up and numbers of symptomatic cases prevented due to the observed reductions in PM10. Measurements and main results: Residential exposure to PM10 was lower in 2002 than in 1991 (mean decline 6.2 microg/m3; SD = 3.9 microg/m3). Estimated benefits (per 10,000 persons) attributable to the observed changes in PM10-levels were: 259 (95% confidence interval [CI]: 102-416) fewer subjects with regular cough, 179 (95% CI, 30-328) fewer subjects with chronic cough or phlegm and 137 (95% CI, 9-266) fewer subjects with wheezing and breathlessness. Conclusions: Reductions in particle levels in Switzerland over the 11-year follow-up period had a beneficial effect on respiratory symptoms among adults.
    01A - Beitrag in wissenschaftlicher Zeitschrift
  • Vorschaubild
    Publikation
    Characterization of source-specific air pollution exposure for a large population-based Swiss cohort (SAPALDIA)
    (National Institute of Environmental Health Sciences, 2007) Liu, L.-J. Sally; Curjuric, Ivan; Keidel, Dirk; Heldstab, Jürg; Künzli, Nino; Bayer-Oglesby, Lucy; Ackermann-Liebrich, Ursula; Schindler, Christian [in: Environmental Health Perspectives]
    Background: Although the dispersion model approach has been used in some epidemiologic studies to examine health effects of traffic-specific air pollution, no study has evaluated the model predictions vigorously. Methods: We evaluated total and traffic-specific particulate matter < 10 and < 2.5 microm in aero-dynamic diameter (PM(10), PM(2.5)), nitrogren dioxide, and nitrogen oxide concentrations predicted by Gaussian dispersion models against fixed-site measurements at different locations, including traffic-impacted, urban-background, and alpine settings between and across cities. The model predictions were then used to estimate individual subjects' historical and cumulative exposures with a temporal trend model. Results: Modeled PM(10) and NO(2) predicted at least 55% and 72% of the variability of the measured PM(10) and NO(2), respectively. Traffic-specific pollution estimates correlated with the NO(x) measurements (R(2) >or=0.77) for background sites but not for traffic sites. Regional background PM(10) accounted for most PM(10) mass in all cities. Whereas traffic PM(10) accounted for < 20% of the total PM(10), it varied significantly within cities. The modeling error for PM(10) was similar within and between cities. Traffic NO(x) accounted for the majority of NO(x) mass in urban areas, whereas background NO(x) accounted for the majority of NO(x) in rural areas. The within-city NO(2) modeling error was larger than that between cities. Conclusions: The dispersion model predicted well the total PM(10), NO(x), and NO(2) and traffic-specific pollution at background sites. However, the model underpredicted traffic NO(x) and NO(2) at traffic sites and needs refinement to reflect local conditions. The dispersion model predictions for PM(10) are suitable for examining individual exposures and health effects within and between cities.
    01A - Beitrag in wissenschaftlicher Zeitschrift
  • Vorschaubild nicht verfügbar
    Publikation
    Annoyance due to air pollution in Europe
    (Oxford University Press, 2007) Jacquemin, Bénédicte; Sunyer, Jordi; Forsberg, Bertil; Götschi, Thomas; Bayer-Oglesby, Lucy; Ackermann-Liebrich, Ursula; de Marco, Roberto; Heinrich, Joachim; Jarvis, Deborah; Torén, Kjell; Künzli, Nino [in: International Journal of Epidemiology]
    Background Annoyance due to air pollution is a subjective score of air quality, which has been incorporated into the National Environmental monitoring of some countries. The objectives of this study are to describe the variations in annoyance due to air pollution in Europe and its individual and environmental determinants. Methods This study took place in the context of the European Community Respiratory Health Survey II (ECRHS II) that was conducted during 1999–2001. It included 25 centres in 12 countries and 7867 randomly selected adults from the general population. Annoyance due to air pollution was self-reported on an 11-point scale. Annual mean mass concentration of fine particles (PM2.5) and its sulphur (S) content were measured in 21 centres as a surrogate of urban air pollution. Results Forty-three per cent of participants reported moderate annoyance (1–5 on the scale) and 14% high annoyance (≥6) with large differences across centres (2–40% of high annoyance). Participants in the Northern European countries reported less annoyance. Female gender, nocturnal dyspnoea, phlegm and rhinitis, self-reported car and heavy vehicle traffic in front of the home, high education, non-smoking and exposure to environmental tobacco smoke were associated with higher annoyance levels. At the centre level, adjusted means of annoyance scores were moderately associated with sulphur urban levels (slope 1.43 μg m−3, standard error 0.40, r = 0.61). Conclusions Annoyance due to air pollution is frequent in Europe. Individuals’ annoyance may be a useful measure of perceived ambient quality and could be considered a complementary tool for health surveillance.
    01A - Beitrag in wissenschaftlicher Zeitschrift