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INTRODUCTION: COVID-19 has become a burden to all nations across the globe, and vaccination currently remains the most effective means of fighting the SARS-COV-2 pandemic. From the time of approval and subsequent distribution of the various COVID-19 vaccines, nearly 72.3% (5.5 billion) of the globe's population have been vaccinated, leaving slightly more than a quarter of the globe's population at risk. With the approval and availability of booster vaccine dosages to individuals with chronic conditions, including coronary heart disease (CHD), it is vital to comprehend the factors underlying the uptake of COVID-19 vaccination in such subgroups. Further, the American Heart Association recommends vaccination against COVID-19 in populations with coronary heart disease (CHD). This is because they are more likely to experience severe outcomes due to COVID-19 infection. This study assesses the uptake of COVID-19 vaccines as well as predictors of its uptake. METHODS: Using the 2022 survey data from the National Health Interview Survey (NHIS), 1,708 adults ≥ 40 years with CHD who responded yes/no to whether they had received the vaccine were identified. A Pearson's chi-square test was used to ascertain differences among those who had received the vaccine and those who had not. A logistic regression (multivariate regression) was used to evaluate predictors of COVID-19 vaccination. RESULTS: About 1,491/1,708 (86.8%) adults ≥ 40 years reported being vaccinated against COVID-19. Among them, 1,065/1,491 (68.4%) had received more than two vaccination doses. The predictors of COVID-19 vaccination were older age (odds ratio (OR): 2.01 (95% confidence interval (CI): 1.40-2.89), p < 0.001), ratio of family income to poverty threshold of 1 and above (OR: 2.40 (95% CI: 1.58-3.64), p < 0.001), having a college degree (OR: 3.09 (95% CI: 1.85-5.14), p < 0.001), and being insured (OR: 3.26 (95% CI: 1.03-10.26), p = 0.044). CONCLUSION: The findings of the study have indicated that 68.4% of adults 40 years and above with CHD have been vaccinated against COVID-19 and have received more than two doses of vaccines. More than half have followed recommendations and have received booster doses of the vaccine. Old age (above 40 years) and a higher socioeconomic class are associated with being more likely to follow COVID-19 vaccination guidelines. Despite the higher vaccination rate of 68.4% in the adults with heart diseases group, strategies for improving booster vaccine awareness alongside accessibility are needed to enhance additional dosage uptake, protect them against novel COVID-19 variants, and ensure the development of sustained immunity.
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In healthcare, continuity of care is a crucial element, especially for patients in the field of psychiatry who have recently been discharged from a hospital. The shift from inpatient to outpatient care poses challenges for patients and healthcare providers, including openness to treatment, competing priorities, financial insecurity, concerns and dilemmas faced by patients regarding their post-hospitalization life after improvements in symptoms, lack of social support, poor patient-doctor relationships, lack of insight, and stigma associated with mental illness. Therefore, it is vital to employ effective strategies to ensure patients receive the required care and support during this transition. This review delves into the significance of continuity of care for psychiatric patients post-hospitalization, effective strategies for the transition, and the challenges and barriers to implementation from the perspective of a family medicine practice. To analyze physicians' role in managing psychiatric patients post-hospitalization, we developed a comprehensive search strategy. This involved extracting relevant data, updates, guidelines, and recommendations. Our search spanned various online repositories, such as PubMed and Google Scholar, specifically focusing on US-based guidelines aligned with our objectives. The search was conducted using medical subject headings (MeSH) and combinations of "OR," "AND," and "WITH." We crafted keywords to optimize our search strategy, including psychiatric illness, post-hospitalization, follow-up, follow-up care, primary care follow-up, and guidelines. Exploring online repositories yielded 132 articles, and we identified some guidelines that addressed our objectives. We established inclusion and exclusion criteria for our review and reviewed 21 papers. Post-hospitalization follow-up is a critical facet of psychiatric care, aligning with guidelines from the American Psychiatric Association and other relevant sources. Emphasizing continuity of care ensures a smooth transition from inpatient to outpatient settings, sustaining therapeutic momentum and minimizing the risk of relapse. This comprehensive approach involves careful medication management, regular mental health assessments, education on condition-specific coping strategies, and coordinated care between healthcare providers. It includes conducting risk assessments, safety planning, building social support and community integration, prompt post-hospitalization follow-up, and tailored treatment plans. Together, these measures enhance overall wellness for recently discharged patients. This holistic strategy tackles pressing short-term needs while facilitating long-term stability, promoting resilience and successful community reintegration, reducing readmission likelihood, and ultimately supporting sustained recovery.
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BACKGROUND: Oral health is an essential aspect of overall well-being, with regular dental care being fundamental to its maintenance. This study focuses on understanding dental care utilization among adults aged 18 and above who have visited a dentist or dental clinic in the past year, aiming to uncover patterns, disparities, and determinants of oral health practices within this demographic. METHODS: Data from the U.S. Centers for Disease Control and Prevention (CDC) Oral Health dataset were utilized to conduct this analysis. The dataset encompasses a diverse and nationally representative sample of adults aged 18 and above. The study explored the proportion of adults who sought dental care between 2008 and 2020, further stratified by demographic variables including age, gender, income, education, and race. The analysis provides insights into the prevalence of dental care utilization and the role of demographic factors in shaping oral health behaviors. RESULTS: The study found that 64.8% (n =397,291; 95% CI: 64.4 - 65.2) of adults aged 18 and above visited a dentist or dental clinic in 2020. Subgroup analysis revealed variations in dental care use by age, gender, income, education, and race. Among genders, 67.4% (n = 150,510; 95% CI: 66.9 - 67.9) of females sought care in 2020, compared to 61.9% (n = 116,535; 95% CI: 61.4 - 62.4) of males. Those earning >$50,000 had the highest proportion, 75.3% (n = 13,363; 95% CI: 74.8 - 75.8), seeking care. Among racial groups, White adults had the highest proportion, 68.4% (n = 204,486; 95% CI: 68.0 - 68.8) in 2020. In education groups, college graduates or professionals had the highest, 77.3% (n = 121,800; 95% CI: 76.8 - 77.8) in 2020. Among ages, adults aged 65+ had the highest proportion, 67.1% (n = 96,012; 95% CI: 66.4 - 67.8) in 2020. However, as age decreased, dental visit proportion generally remained within the same range. CONCLUSION: This study enhances our understanding of dental care utilization patterns within the studied population, shedding light on disparities in oral health practices. Moreover, it provides insight into how demographic factors shape dental/oral healthcare-seeking behaviors. Ultimately, these insights guide efforts to improve oral health outcomes and well-being within this population.