Academic journal article Central European Journal of Public Health

The Implications of Nutrition Services within the Health Care System on the Quality of Life and Longevity, in Developed Countries: A Re-Analysis of 38 Studies

Academic journal article Central European Journal of Public Health

The Implications of Nutrition Services within the Health Care System on the Quality of Life and Longevity, in Developed Countries: A Re-Analysis of 38 Studies

Article excerpt

SUMMARY

Background: The United Nations' Global Population Pyramid is undertaking a shift from pyramid to cube. The concomitant decline in fertility and mortality rates produces a higher portion of older people, and, thus, an increased number of deaths due to cancer and cardiovascular disease (CVD). Limited studies have investigated the effect of health care services on longevity. In this work, findings from studies throughout the world are presented and re-analysed in order to evaluate the effect of health care services on population's health status.

Methods: Studies that have assessed the associations of nutritional and other health care services (i.e., physicians supply, technical support, intercollaboration) on longevity and health status were retrieved (searches in PubMed, EMBASE, Scopus, up to January 2010), and summarized here.

Results: Few studies, mostly located in the US and the UK, have evaluated the role of health care services on population's health status. The majority of the studies reported a beneficial association between the frequency of physicians and mortality, while some other studies reported weak or no associations between physician's supply and longevity. Also nutritional services (screening) seem to promote better clinical outcome.

Conclusion: Although very few data are available, it seems that there is a positive correlation between the quality and quantity of health care services and longevity. Strong primary health care seems to be effective on the population's health outcome. Active health policy and enhancement of health and nutritional services within the health care system may contribute to improved population's health and their overall quality of life.

Key words: health care systems; health care services; nutritional services; physicians; mortality; longevity

INTRODUCTION

Health care is produced by system inputs (i.e., physicians, medicines, facilities) that interact within the population through various processes, like medical consultations, surgeries, deliveries, and result in health outcomes (1). Public Health, as an organized effort of society, espouses several principles, namely: a) emphasis on collective responsibility and role of the state; b) focus on whole populations; c) emphasis on prevention; d) concern for the underlying socio-economic determinants of health and disease; e) multi-disciplinary approach (both quantitatively and qualitatively); and f) partnerships with populations served (2, 3). It is known that health care services are categorized in three different groups: primary, secondary and tertiary care providing a variety of effective basic and completed services (4, 5). Furthermore, nutritional care compromise a basic part of heath care services. The nutritional support contains four distinct steps: a) nutrition assessment, b) nutrition diagnosis, c) nutrition intervention and d) nutrition monitoring and evaluation (6). Through nutritional care, dieticians and nutrition practitioners could promote therapeutic lifestyle changes and better quality oflife at individual and community level through counselling and education (7).

Public health focuses on population's health. There are many determinants which are commonly classified as either proximal or distal (8). These health determinants have deep effect on life expectancy. The health care system, which operates at proximal level, shares an interface with other sectors of organized societies such as the social, political and economic systems. Health care system inputs such as physicians and medical technology may be the result of inter-sectoral dynamics and social choices. It is expected that public health care systems can influence many of the proximal non-medical determinants and avert or minimize the need for expensive medical care. This is also why the new public health plan hopes to address major risk factors implicated in the global burden of disease (9).

Developed populations currently enjoy unprecedented wealth and longevity (10). …

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