Dissertations / Theses on the topic 'Health service utilisation'
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Xu, Fang, and 徐方. "Self-rated health, chronic diseases and health service utilisation in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2015. http://hdl.handle.net/10722/212607.
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Master of Philosophy
Williams, Jonathan Mark. "Energy utilisation and combined heat & power sizing in the health service." Thesis, Cardiff University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273836.
Full textRoberts, Nicola. "Using attachment theory within mental health community services to improve patient outcomes and reduce service utilisation costs." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/using-attachment-theory-within-mental-health-community-services-to-improve-patient-outcomes-and-reduce-service-utilisation-costs(78a9832e-0e8f-4d2b-a6a4-8d7ffdf5aa6d).html.
Full textMacey, Steven Michael. "Assessing the excess health service utilisation and direct medical costs of injuries." Thesis, Swansea University, 2010. https://cronfa.swan.ac.uk/Record/cronfa42913.
Full textNoor, Abdisalan Mohamed. "Developing spatial models of health service access and utilisation to define health equity in Kenya." Thesis, Open University, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.417576.
Full textBhatti, J. V. "Acculturation, shame, & self-compassion : an examination of mental health service utilisation." Thesis, University of Liverpool, 2018. http://livrepository.liverpool.ac.uk/3027481/.
Full textMacRae, Jayden. "Using a natural experiment to assess the effect of spatial barriers on health service utilization." Thesis, University of Canterbury. Geography, 2014. http://hdl.handle.net/10092/9346.
Full textSchlecht, Nicolas F. "Physiological and psychosocial determinants of health-care service utilisation in chronic obstructive pulmonary disease patients." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0024/MQ50872.pdf.
Full textNguyen, Mai Phuong. "Contribution of private healthcare to universal health coverage: an investigation of private over public health service utilisation in Vietnam." Thesis, Queensland University of Technology, 2021. https://eprints.qut.edu.au/225903/1/Mai%20Phuong_Nguyen_Thesis.pdf.
Full textAnskär, Eva. "Time flies in primary care : a study on time utilisation and perceived psychosocial work environment." Licentiate thesis, Linköpings universitet, Institutionen för medicin och hälsa, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-156119.
Full textBakgrund: Under de senaste decennierna har det i svensk primärvård varit omfattande omorganisationer, vilket har påverkat arbetstidens innehåll. Arbetssituationen är komplex och omfattningen av administration har ökat. Det övergripande syftet med föreliggande studie var att beskriva arbetstidens innehåll bland personal i svensk primärvård och att undersöka samband mellan upplevd psykosocial arbetsmiljö och arbetsuppgifternas legitimitet. Metod: Studien har genomförts som en deskriptiv multicenterstudie med tvärsnittsdesign och inkluderade sjuksköterskor, läkare, vårdadministratörer, undersköterskor och övriga professioner (fysioterapeuter, arbetsterapeuter, psykologer, kuratorer, dietister och fotvårdsspecialister) vid elva vårdcentraler i sydöstra Sverige. Studien inleddes med att deltagarna ombads att besvara ett frågeformulär vars första del bestod av en skattning av hur arbetsuppgifterna var fördelade. Frågeformuläret innehöll också frågor om illegitima arbetsuppgifter; Bern Illegitimate Tasks Scale (BITS) och psykosocial arbetsmiljö; Copenhagen Psychosocial Questionnaire (COPSOQ). Därefter gjordes en tidsstudie där deltagarna fick registrera tidsåtgången för olika arbetsuppgifter, varje dag under två separata veckor. Arbetsuppgifterna delades upp i tre huvudkategorier; direkt patientarbete, indirekt patientarbete och övrigt arbete. Varje huvudkategori hade flera underkategorier. Svarsfrekvensen var 75% för frågeformuläret och 79% för tidsstudien. Resultat: Resultatet från delarbete I visar att personal i primärvård ägnade 37% av arbetstiden direkt med patienter. Alla professioner skattade den direkta patienttiden till större andel än vad tidsstudien visade. Läkare upplevde sämst psykosocial arbetsmiljö avseende kvantitativa krav, stress och rollkonflikter. Det förelåg ett samband mellan andelen administrativa arbetsuppgifter och rollkonflikter, ju mer administration desto mer rollkonflikter. I delstudie II visade resultatet att mer än en fjärdedel av läkarna upplevde en hög nivå av illegitima arbetsuppgifter avseende onödiga arbetsuppgifter, vilket var signifikant mer jämfört med andra professioner. För personalgruppen som helhet framträdde ett samband mellan upplevelsen av att ha mycket illegitima arbetsuppgifter och upplevelse av negativ psykosocial arbetsmiljö samt med hög andel administrationsrelaterade arbetsuppgifter. Konklusion: Personal i primärvård ägnar en begränsad andel av arbetstiden åt direkt patientarbete och läkare upplever sämre psykosocial arbetsmiljö än övriga professioner. Arbetstidens fördelning mellan olika arbetsuppgifter påverkar den psykosociala arbetsmiljön. Upplevelsen av att utföra en stor andel illegitima arbetsuppgifter påverkar den psykosociala arbetsmiljön negativt, vilket kan ha inverkan på hur personalen uppfattar sin professionella roll. Upplevelsen av att ha mycket oskäliga arbetsuppgifter har samband med hög andel icke patientrelaterad administration. Avhandlingen belyser vikten av att beslutsfattare noga överväger fördelningen av icke patientrelaterade arbetsuppgifter bland personal i primärvård, för att möjliggöra effektiv användning av personalresurserna och för att främja goda arbetsförhållanden. Förhoppningen är också att studiens resultat ska bidra till fortsatt utveckling av primärvården så att den medicinska kompetensen kommer patienterna till nytta i så stor omfattning som möjligt.
Koopu, Pauline Irihaere, and n/a. "Kia pakari mai nga niho : oral health outcomes, self-report oral health measures and oral health service utilisation among Maori and non-Maori." University of Otago. School of Dentistry, 2005. http://adt.otago.ac.nz./public/adt-NZDU20070502.152634.
Full textMaddams, Jacob. "Cancer prevalence in the United Kingdom : current estimates, future projections and health service utilisation among cancer survivors." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/cancer-prevalence-in-the-united-kingdom(774b2620-4501-4ea4-bcf9-fc2309986c7f).html.
Full textMatondolo, Siyamthanda Luthando. "Utilisation of ICT in healthcare centre to support HIV/AIDS flow of information and service delivery In Khayelitsha." Thesis, Cape Peninsula University of Technology, 2012. http://hdl.handle.net/20.500.11838/2477.
Full textThis research is an attempt to investigate the utilisation of Information Communication Technology (ICT) in Healthcare to support the flow of HIV/AIDS patient’s general information in public and private sector. Furthermore, the research examines the detail flow of database information for healthcare service delivery to patients, in particular HIV/AIDS patients, in Khayelitsha Township. Finally, the research will detail the types of technologies currently being utilised to transfer this information, technology utilised for capturing or data collection profile of the patient. The research study data collecting was done in 2009 in mostly private and public healthcare centre in Khayelitsha township. First, the study will concentrate on general utilisation of ICT in healthcare service delivery and flow of information for public and private sector healthcare centres. Additionally, the research also looks at NGOs such as HIV/AIDS Unit in Cape Peninsula University of Technology (CPUT) and Treament Action Campaign (TAC) to find out what ICT equipment is being utilised to transfer this information to adult people to inform and make them to be aware of HIV/AIDS and improve healthcare service delivery to patients and particularly to HIV/AIDS patients. Taking NGO’s such as TAC and CPUT HIV/AIDS Unit that are well informed about HIV/AIDS, nationally and internationally will make our research results to be more precise. The research will also look at the utilisation of ICT in flow of information at healthcare centre such as communication between healthcare providers such as receptionist/clerk, nurses, doctors and medical researchers since they are the first people who deal with HIV/AIDS patient cases when they come for healthcare provision.
Peters, Fatima. "Exploring parental and occupational therapists' perceptions of the utilisation of the occupational therapy service at three paediatric outpatient units in the Western Cape Province, South Africa." University of the Western Cape, 2011. http://hdl.handle.net/11394/5386.
Full textBackground: The Western Cape's Comprehensive Service Plan (CSP) is committed to "treating the right patient at the right level right, with the right skills and at the right cost" (Page 1, Tygerberg Hospital Annual Report, 2007). Occupational therapy (OT) Managers in the Metro District, Western Cape Province are in the process of aligning the OT services to the new CSP document. A major problem is the high default rate (non attendance) and irregular attendance (patient attends but skips sessions) amongst paediatric out-patients. In order to properly improve the OT paediatric services, it is vital for the OT managers to know the reasons for the poor utilisation of the OT services at the paediatric out-patient units. Purpose of study: The irregular attendance and high default rates (where patients stop attending the OT sessions completely) among children are a major problem at three OT out-patient units in Cape Town, Western Cape Province. The occupational therapists who work at these units are adamant that this impacts negatively on the child's progress. This study sought to explore the factors influencing the utilisation of the OT service in these three OT paediatric out-patient units in the hope of providing relevant information to the OT managers of these units in order to rethink the current service and make appropriate changes to improve adherence and treatment progress. Study design: This was an exploratory study using qualitative research methods. In-depth interviews were conducted with ten parents of children who have to attend the OT out-patient services. One group discussion was conducted with the occupational therapists that provide the services at the out-patient units. Sampling: Purposive sampling methods were employed to select four occupational therapists (at least one from each unit) and ten parents (at least three from each unit, with at least two who attended poorly and one that attended regularly). Analysis: Thematic analysis was used to interpret the data. The data was coded and categorised according to themes that emerged during data analysis. Results: The results of this study revealed that the factors that impact the utilisation of the OT service at the three OT units is complex. Factors that influenced the utilisation of the OT services in this study were related to the OT service such as staff attitude, relationship between the occupational therapist and the mothers as well as their child, communication between the mother and the occupational therapist, treatment progress, parent involvement in the OT programme and access to the OT service. Other factors such as the mothers' perception of the severity of the child's health condition, family support, work factors and family support were important factors related to the mother. The findings also revealed that environmental factors namely stigma, discrimination and travelling to the OT units impacted utilisation of the OT service. The participants made recommendations on how to improve the service. Conclusion: This study describes the complexity of what impacted the utilisation of the OT services and how closely interlinked these different factors are. It is evident from the findings of this study that a comprehensive, client centred approach is required to properly deal with the factors that negatively impact the utilisation of this service. Recommendations: A multi-faceted approach is required. Important issues to address are the shortage of occupational therapists across the levels of health care in the Western Cape Province; improving on the client centred approach in OT intervention programmes; advancing advocacy against stigma and discrimination against children with disabilities; and making public transport more accessible to children and their mothers.
Rentsch, C. T. "Point-of-contact interactive record linkage between demographic surveillance and health facilities to measure patterns of HIV service utilisation in Tanzania." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2018. http://researchonline.lshtm.ac.uk/4650292/.
Full textAdams, Claire E. "Help-seeking for mental health problems among older adults with chronic diseases: An evaluation and intervention." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2022. https://ro.ecu.edu.au/theses/2516.
Full textLauwers, Marion. "A three essay dissertation on IS use during the post-adoption stage : a focus on the long-term health care sector." Thesis, Lille, 2018. http://www.theses.fr/2018LIL1A016.
Full textDeveloping Health Information Systems (HIS) effective use becomes an imperative for the long-term health care sector, which is facing quality and productivity concerns, in a context under pressure, linked to European population ageing. Despite growing interest for the Information Systems’ (IS) post-adoption stage, this one stills largely unexplored compared to the implementation and adoption stages. Tackling this issue, this dissertation focuses on IS exploitative and exploratory uses in the healthcare sector, two kind of uses considered as key to reach benefits from IS and increase performance in the post-adoption stage. A first essay defines and conceptualizes our understanding of exploitative and exploratory uses, their antecedents and outcomes on users’ performance. Following essays analyze the dynamics behind these two use behaviors in the long term health care sector, as well as the role of the environment, and of the stress related to the technology, on these former. Results highlight the importance of studying exploitative and exploratory uses together. Thus, our findings show the way in which users switch between these two use behaviors as well as the way in which constraints related to the environment tend to lock users in exploitative use. Nevertheless, these findings also unveil solutions to get out of this exploitation trap. Finally, they highlight the ambivalent role of the system itself, and more specifically of the stress related to the technology on HIS exploitative and exploratory uses
Mpanya, Kabeya Alain. "Facteurs socioculturels et contrôle de la trypanosomiase humaine africaine en République démocratique du Congo." Doctoral thesis, Universite Libre de Bruxelles, 2015. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209041.
Full textLa Trypanosomiase Humaine Africaine (THA) appelée également « maladie du sommeil» est une maladie parasitaire provoquée par un protozoaire du genre Trypanosoma dont deux sous-espèces (T. brucei gambiense et T. brucei rhodesiense) sont pathogènes à l’homme. La stratégie de lutte contre cette maladie est essentiellement basée sur le dépistage précoce et le traitement des malades, complété avec le contrôle du vecteur. Cependant, l’utilisation du service de dépistage de la THA par les communautés exposées représente un défi majeur. L’adhésion aux campagnes de dépistage actif avec des équipes mobiles spécialisées était en-dessous de 50% dans certains villages endémiques fin des années nonante. De surcroît, l’utilisation des services de santé fixes en RDC est si faible que ceci compromet le dépistage passif dans les formations sanitaires fixes. Notre hypothèse est que cette faible utilisation des services de santé pourrait elle-même être due à un problème d’acceptabilité du dépistage et traitement de la THA par les communautés vivant dans les zones de transmission de la THA. Tout ceci compromet l’élimination de la THA comme problème de santé publique, un but que s’est fixé la communauté internationale d’ici 2020.
Ce travail a comme objectif d’explorer cette dimension socioculturelle de la maladie qui est souvent négligée dans le contrôle de la THA et générer une meilleure connaissance de ces aspects.
Nous avons réalisé cinq études en total pour adresser la question de la sous-utilisation des services de dépistage et traitement de la THA par les communautés et sa relation avec l’acceptabilité des services. Nous avons d’abord développé une première étude qui évalue les résultats du traitement de la THA en analysant rétrospectivement les données de routine du programme de contrôle de la THA pour l’année 2006 à 2008. Ensuite, nous avons réalisé trois études qualitatives par focus group (groupe focalisé) et entretiens individuels pour documenter la dimension socioculturelle de la lutte contre la THA. D’abord une étude qui a exploré les perceptions sur la THA dans la communauté, suivi par une étude qui explore les perceptions sur le traitement de la THA et une autre qui se concentre sur les pratiques diagnostics des professionnels de santé face à un syndrome neurologique en contexte de ressources limitées.
Une cinquième étude combine une enquête-ménage avec des focus groups et des entretiens individuels pour explorer les perceptions de la communauté sur la santé en général et les services de santé.
Nous avons comparé les obstacles à l’utilisation des services de dépistage et traitement de la THA identifiés dans ce travail avec les messages de sensibilisation sur la THA utilisés au programme de contrôle de la THA en RDC et nous avons développé des recommandations stratégiques.
L’évaluation des indicateurs de performances sur l’issue de traitement montre que le taux de suivi post-thérapeutique est faible dans son ensemble :25 % pour le premier suivi de six mois et moins d’un pourcent des patients revient pour la dernière visite de contrôle au mois 24. Nous avons aussi observé dans cette étude un taux d’échec au mélarsoprol et à la pentamidine respectivement de 30% et de 22 % au Kasaï Oriental qui sont cependant difficilement interprétables, car le dénominateur est incomplet. Comme très peu de patients reviennent au contrôle post-thérapeutique, cette proportion est probablement biaisée vers ceux qui sont en échec de traitement.
L’étude de perception de la THA montre que la maladie est bien connue dans les communautés vivant dans les zones à risque. Par contre, plusieurs obstacles au dépistage et traitement de la THA ont été identifiés. Les plus importants sont :la toxicité des médicaments de la THA, les obstacles financiers, l’inadéquation entre le programme de dépistage des équipes mobiles et les occupations des communautés, les interdits qui accompagnent le traitement de la THA, le manque de confidentialité et la peur de la ponction lombaire.
L’étude sur la perception du traitement de la THA a montré que le mélarsoprol est perçu comme un médicament toxique et est surnommé « médicament des interdits ». Par contre, le régime NECT est perçu comme un nouveau médicament moins toxique qui a rendu les interdits liés au mélarsoprol obsolètes sauf un seul, celui de ne pas avoir de rapport sexuel pendant la période de traitement et de suivi post thérapeutique qui est de 6 mois. Les interdits ont été instaurés de manière empirique par les professionnels de santé et les communautés pour mitiger les effets indésirables du mélarsoprol. Leur violation pourrait entrainer des conséquences graves et mortelles. Ces interdits sont fortement ancrés dans les croyances de la communauté et constituent aujourd’hui un obstacle au dépistage et traitement.
L’étude sur les pratiques diagnostiques des professionnels de santé en matière de syndrome neurologique en contexte de ressources limitées a montré qu’en zone rurale le diagnostic est principalement clinique. Les obstacles perçus au diagnostic de confirmation sont essentiellement d’ordre financier puisque le patient doit tout financer de sa poche. Autres obstacles évoqués sont le manque d’outils de diagnostic et la perception de la communauté qui voit le clinicien comme un devin (petit dieu) ou oracle capable de « deviner » directement la maladie sans passer par un processus diagnostique de laboratoire.
L’étude sur les perceptions de la santé et des services de santé a montré que les capacités de travailler (82%) et les capacités de se mouvoir (66%) sont les signes de bonne santé les plus perçus. 90% des responsables des ménages perçoivent positivement la santé de leur ménage. Les opinions sur le service de santé sont partagées.
Les études présentées dans ce travail ont généré des nouvelles connaissances sur la dimension socioculturelle de la THA. L’analyse des messages de sensibilisation sur la THA utilisés par le programme de contrôle de la THA en RDC en termes de comparaison avec les obstacles au dépistage et traitement de la THA identifiés dans ce travail montre que ces aspects socioculturels bien qu’étant des véritables goulots d’étranglements dans la dynamique de la lutte contre la THA ne sont pas bien ciblés par la communication sur la THA.
Les perspectives des communautés exposées au risque de la THA doivent être adressées par un dialogue continu entre professionnels de santé et communautés adapté aux réalités locales. Ainsi il sera possible d’améliorer de manière opérationnelle les stratégies d’information, éducation et communication, et de façon plus large, le dépistage et traitement de la THA en intégrant la dimension socioculturelle de la THA dans la politique de lutte contre la THA.
SUMMARY
Human African Trypanosomiasis (HAT), also known as “sleeping sickness” is a parasitic disease caused by protozoa of the species Trypanosoma. There are two types that infect humans, Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense. The strategy used to control sleeping sickness consists of early case detection and treatment of patients, together with vector control. Meanwhile, utilization/access to HAT screening by the affected communities remains a major challenge. Adherence to active screening programs with mobile units was below 50% in certain endemic villages end of the 90’s. Moreover, utilization of fixed health facilities in DRC is so low that it compromises passive case finding. Our hypothesis is that this low utilization of health services is caused by a problem of acceptance of case detection and treatment of HAT by the communities living in the HAT transmission zones. This compromises the target of the international community to eliminate HAT as a public health problem by 2020. This thesis wants to explore and tries to generate more knowledge on the socio-cultural aspect that is often neglected in the control of HAT.
We conducted five studies to address the lack of community participation in HAT screening and treatment activities and the relation with acceptance of these services.
The first study evaluated the results of HAT treatment by retrospectively analyzing data of the routine HAT control program for the period 2006-2008.
Afterwards we performed three qualitative studies consisting of focus group discussions and individual interviews to document the socio-cultural dimension of the fight against HAT. The first study explored the community perceptions regarding sleeping sickness. The second study explored the perceptions regarding HAT treatment and a third study focused on diagnostic practices of health professionals in low-resource settings facing a neurological syndrome.
The fifth study consists of a household survey, focus group discussions and individual interviews to explore community perception regarding health in general and health services. We compared the identified barriers to screening and treatment of HAT with awareness messages on sleeping sickness used by the HAT control program in DRC and we developed strategic recommendations. The evaluation of performance indicators for treatment showed that compliance with post-treatment follow-up is very poor: 25% for the first post-treatment follow-up examination at six months and less than 1% of the patients returns for the final examination at 24 months. In this study we also observed a treatment failure rate of respectively 30% and 22% for melarsoprol and pentamidine in Kasai-Oriental. However, these date are difficult to interpret because of an incomplete denominator. As only few patients return for follow-up visits, this proportion is probably biased towards those in treatment failure.
The study on the perception of sleeping sickness shows that the disease is well known amongst the communities living in the endemic areas. However, several screening and treatment barriers were identified. The most important are: drug toxicity, financial barriers, the incompatibility between the itineraries of the mobile screening teams and the local communities’ activities, the prohibitions related to HAT treatment, lack of confidentiality and fear of lumbar punctures. The study on the perceptions regarding HAT treatment show that melarsoprol is perceived as a toxic drug and is nicknamed the ‘taboo drug’. On the other hand the NECT regime is perceived as the new drug that is less toxic and that has abolished all the taboos of melarsoprol with the important exception of sexual intercourse during the treatment period and the post-treatment follow-up period of six months.
The prohibitions have been established empirically by healthcare providers and communities to mitigate the side effects of the melarsoprol regimen. Violating these restrictions is believed to cause severe and sometimes mortal complications. Communities adhere strictly to these prohibitions and this constitutes a barrier for HAT screening and treatment.
The study focusing on diagnostic work-up of neurological syndromes in low-resource settings by health care providers has shown that in rural areas diagnosis is usually clinical. Barriers to confirmation of diagnosis are mainly related to the purchasing power of the patient. Other reported barriers are a lack of diagnostic tools and the communities’ perceptions associated with the care provider. Clinicians are perceived as diviners being able to directly identify the cause of the illness without using laboratory tests. The study regarding the perceptions on health and health services has shown that ability to work (82%) and ability to move (66%) are the most perceived signs of good health. 90% of the household responsibles positively perceive the health of their family. The opinions on the health services are divided.
The studies presented in this thesis have generated new insights on the socio-cultural dimension of HAT. The analysis of the awareness messages on HAT in DRC compared with the reported HAT screening and treatment barriers have shown that
although these sociocultural aspects are real bottlenecks in the dynamic of the fight against HAT, they are not targeted by the communication on HAT.
The prospects for communities at risk of HAT should be addressed through continuous dialogue between health professionals and communities adapted to local realities.
It will thus be possible to operationally improve the information strategies, education and communication, and more broadly, screening and treatment of HAT by integrating the socio-cultural dimension in the fighting policy against sleeping sickness.
Doctorat en Sciences
info:eu-repo/semantics/nonPublished
Treanor, Charlene Jennifer. "The health status and utilisation of health services by cancer survivors with late effects." Thesis, Queen's University Belfast, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.603428.
Full textManthalu, Gerald Herbert. "The impact of user fee exemption on maternal health care utilisation and health outcomes at mission health care facilities in Malawi." Thesis, University of Aberdeen, 2014. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=214843.
Full textJohansson, Birgitta. "Intensified primary health care for cancer patients : Utilisation of medical services." Doctoral thesis, Uppsala University, Department of Public Health and Caring Sciences, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-512.
Full textThe aim of the present thesis is to evaluate the effects of an Intensified Primary Health Care (IPHC) intervention on GPs' and home care nurses' possibilities to monitor and support cancer patients, and on cancer patients utilisation of medical services. A further aim is to identify determinants of cancer patients' utilisation of such services. A total of 485 patients newly diagnosed with breast, colorectal, gastric or prostate cancer were randomised to the intervention or to a control group. The follow-up period was 24 months for all patients.
Patients randomised to the IPHC were referred to the home care nurse. The home care nurse and the GP received copies of the medical record each time the patient was discharged from hospital after a period of in-patient care, or had visited a specialist out-patient clinic. In addition to this, recurrent education and supervision in cancer care were arranged.
The IPHC resulted in a marked increase of home care nurse follow-up contacts. The majority of control patients (74%) reported no such contacts, while 89% of IPHC patients reported this. High age (=80 yr) was the strongest predictor within the IPHC group for reporting a continuing home care nurse contact. Furthermore, the IPHC increased GPs' knowledge about patients' disease and treatments, and appeared to facilitate their possibilities to support the patients. The IPHC reduced the utilisation of specialist care among elderly cancer patients. The number of days of hospitalisation for older patients (=70 yr) randomised to the IPHC were 393 less than for older control patients during the 3 first months after inclusion. Regression analyses defined diagnosis, extensive treatment, comorbidity, low functional status, pain and socio-economic factors as predictors of a high utilisation of medical services.
Bayer, Jordana. "Critical factors contributing to under-utilisation of professional mental health services /." Title page, table of contents and abstract only, 1990. http://web4.library.adelaide.edu.au/theses/09ARPS/09arpsb357.pdf.
Full textIbrahim, Ghada. "The role of the health system in women's utilisation of maternal health services in Sudan." Thesis, City, University of London, 2015. http://openaccess.city.ac.uk/17079/.
Full textRahman, Syed Azizur. "Utilisation of primary health care services in rural Bangladesh : the population and provider perspectives." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2001. http://researchonline.lshtm.ac.uk/682288/.
Full textIdris, Deeni Rudita. "Health help seeking behaviour and health care services utilisation of Bruneian men : a grounded theory study." Thesis, Durham University, 2017. http://etheses.dur.ac.uk/12438/.
Full textToan, Ngo Van. "Utilisation of health services in a transitional society : studies in Vietnam 1991-1999 /." Stockholm, 2001. http://diss.kib.ki.se/2001/91-628-4812-7/.
Full textMatizirofa, Lyness. "Perceived quality and utilisation of maternal health services in peri-urban, commercial farming, and rural areas in South Africa." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&.
Full textBeale, Norman. "Unemployment and family morbidity : a study of a factory closure in British general practice." Thesis, University of Cambridge, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387595.
Full textSaleh, Doha Mahmoud Ismail. "The utilisation of ambulatory health care services in Saudi Arabia : a quantitative analysis." Thesis, London School of Economics and Political Science (University of London), 2004. http://etheses.lse.ac.uk/1862/.
Full textArchary, Paverson. "Trends of utilisation of reproductive health services by lesbian women in Cape Town." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/13150.
Full textBackground: The Lesbian, Gay, Bisexual and Transgender (LGBT) community has historically been marginalised. Increased international awareness of the LGBT profile has led to the recognition that the medical profession has overlooked the health needs of lesbian women, with a resultant paucity of data regarding lesbian women’s health risks. International literature has shown that lesbians remain at risk of sexually transmitted infections and HIV; are at significant risk of mental health disorders; exhibit a high-risk profile for cardiovascular disease, diabetes, as well as cancer, and underutilise health care services due to experiences of homophobia. South African data is almost non-existent. Objective: To explore Cape Town wsw’s (women who have sex with women) experiences with, and trends of utilisation of Reproductive Healthcare Services. Study Design: Cross Sectional Survey. Methods: A sample of self-identified wsw was recruited using a snowball sampling method to complete an anonymous, self-administered online questionnaire during February 2013. Outcome Measures: Predominantly descriptive, with an aim to validate the study questionnaire for the South African context. Results: A total of 116 responses were analysed. The mean age of the population was 37 years of age, with the majority identifying as lesbian. The population comprised predominantly of Caucasian, middle class suburban residents, with most having medical aid, and accessing private health care. A significant proportion of respondents reported previous intercourse with a male sexual partner. Barrier contraception was not always used during intercourse with men and almost never during sex with women. There were a significant number of sexually transmitted infections in women with no previous male sexual partners. Most respondents considered themselves to be at low risk of contracting HIV, and at intermediate risk of cervical and breast cancer, and showed higher than average utilization of cervical screening practices for 4 this population, despite a general perception that screening is unnecessary in lesbian women. A general trend towards disclosure of sexual orientation was noted; however users of private healthcare were significantly more likely to have disclosed their orientation to their physician than users of public and NGO services. Respondents held a preference for practitioners that were themselves gay/lesbian.The study tool was validated for use in the South African context; however redundancy could not be formally excluded from the questionnaire. Conclusions: Wsw from Cape Town experience internationally comparable exposures and risks of gynaecological problems. Further research is required to fully understand the healthcare needs of lesbian women living in lower socio-economic conditions.
Salem, Salem F. "The geography of health in Libya : accessibility to, utilisation of, and satisfaction with public polyclinics in Benghazi." Thesis, Durham University, 1995. http://etheses.dur.ac.uk/1709/.
Full textMbugua, Jason Karanja. "Impact of user charges on health care utilisation patterns in rural Kenya : the case of Kibwezi Division." Thesis, University of Sussex, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335506.
Full textFritsche, Ntombikayise. "Utilisation of university health care services by employees of the University of Fort Hare." Thesis, University of Fort Hare, 2016. http://hdl.handle.net/10353/5950.
Full textZhang, Jianzhen (Jenny). "Socioeconomic position and utilisation of preventive health services among adults in the general population." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16532/1/Jianzhen_Zhang_Thesis.pdf.
Full textZhang, Jianzhen (Jenny). "Socioeconomic position and utilisation of preventive health services among adults in the general population." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16532/.
Full textDiop, Kine Bibi. "Factors associated with diabetes prevalence and utilisation of diabetes care services in Mauritius." Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/10383.
Full textDiabetes is a growing problem worldwide. It is estimated that at least 171 million people have diabetes worldwide and this figure is projected to more than double by 2030. Mauritius has not been spared from diabetes. Indeed, it has one of the highest diabetes prevalence in the world. It is creating tremendous pressure not only on households but on the health care system.
Evans, Stuart Wyn. "Investigation and evaluation of the utilisation of advice offered to the public by community pharmacists." Thesis, Cardiff University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337199.
Full textGreenaway, John Richard. "The utilisation of endoscopy services : strategies for patient management at the primary/secondary care interface." Thesis, University of Newcastle Upon Tyne, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391398.
Full textKachimanga, Chiyembekezo. "Improving utilisation of maternal health related services: the impact of a community health worker pilot programme in Neno Malawi." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29196.
Full textMensah, Daniel Kweku Adabo. "An investigation of the knowledge and attitudes of Adolescents towards the sexual and reproductive Health services in the Omaruru district, Namibia." University of the Western Cape, 2020. http://hdl.handle.net/11394/7625.
Full textBackground- Sexual and Reproductive Health (SRH) problems continue to affect adolescents’ health and well-being even into their adulthood. Globally and especially within sub-Saharan Africa with a heavy burden of adolescent SRH problems, increased attention is being paid to these issues. This study looks at adolescents’ awareness, utilisation of and experiences of the available SRH services in Omaruru District, Namibia. Methodology- This analytical cross-sectional study used a two-stage cluster sampling method. Data from students aged 15-19 years in secondary schools were collected and analysed using a structured self-administered questionnaire and STATA statistical software respectively. Ethical approval was obtained from the Biomedical Research and Ethics Committee (University of the Western Cape) and the Namibian Health Ministry. Written parental/caregiver informed consent and written participant assent, as per the Namibian law were obtained. Results- While 87% of respondents had heard of SRH, 46% had ever used SRH services. Of these 44% were contraceptive services. Fifty-one percent had ever had sex (of which 17% had given birth to or fathered their first child), 56% of their first sexual experiences were between ages 15-17 years. Twelve percent had used illegal drugs three months prior to the survey. In multivariate analyses female sex, urban residence and reported sexual debut had significant independent relationships with contraception use. Use of SRH services was independently significantly associated with having had sexual debut. Among SRH services users: 71% would recommend these services to their friends, 51% and 56% found health providers welcoming, with good attitudes, and guaranteeing their privacy and confidentiality. Conclusion Greater effort is needed to curb teenage pregnancy in school-going adolescents by promoting the use of all SRH services especially contraception among sexually active adolescents. It is encouraging that respondents who had used SRH service reported that their privacy and, confidentiality were respected and that healthcare providers’ attitudes generally satisfactory. Lower SRH knowledge, service use and use of contraception and condoms needs further investigation in rural youth and then programmatic and service changes tailored to their needs. Gender norms that underpin adolescent females disadvantage in a number of SRH areas needs to be addressed
Ghimire, Laxmi. "Health services utilisation for sexually transmitted infections including HIV by female sex workers in Nepal." Thesis, University of Aberdeen, 2010. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=158823.
Full textMeer, Ayishah Z. "An investigation into the reasons for the under utilisation of mental health services amongst farmers." Thesis, University of Leicester, 2004. http://hdl.handle.net/2381/31194.
Full textAlfaqeeh, Ghadah Ahmad. "Access and utilisation of primary health care services in Riyadh Province, Kingdom of Saudi Arabia." Thesis, University of Bedfordshire, 2015. http://hdl.handle.net/10547/603523.
Full textDunlop, Sheryl Lynn. "Socio-economic status and the utilisation of physicians' services, results from the national population health survey." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0001/MQ34024.pdf.
Full textRukundo, Emmanuel Nshakira [Verfasser]. "Effects of community-based health insurance on child health outcomes and utilisation of preventive health services : Evidence from rural south-western Uganda / Emmanuel Nshakira Rukundo." Bonn : Universitäts- und Landesbibliothek Bonn, 2018. http://d-nb.info/1173898611/34.
Full textGolo, Kossi Thomas. "Three essays on the impact of financial incentives, waiting times and home care on patients' health and utilization of health care services in Quebec." Doctoral thesis, Université Laval, 2020. http://hdl.handle.net/20.500.11794/66863.
Full textThis doctoral thesis is composed of three separate and independent chapters that aim to analyze certain health policies in Quebec, including financial incentives, waiting times and home care on patients’ health and the use of hospital services. The first chapter focuses on the impact of financial incentives on the health of patients in Quebec, especially the case of specialized care. It should be noted, first of all, that the demand for health care has increased significantly in Quebec in recent years for certain types of surgery. This increase, which has many causes, including demographic changes, resulted in higher waiting times than the medically required times for these surgeries. To solve this problem, the Quebec government implemented in 2004 the Access to Surgery Program (ASP) to financially encourage hospitals to perform more surgeries for which waiting times were longer. This program allowed to reduce the average waiting time for these surgeries, but has also led to an increase in expenses related to these surgeries. These increased expenditures were also due to some weaknesses in the program. A major reform, which consisted mainly of modifying the financial incentives, took place in April 2011, so that the funding would support good practice and the choice of the most appropriate technical platform. Our study, which is a first evaluation of this reform, aims to analyze the impact of this reform on the health of patients, including the length of stay in hospital after surgery and readmissions post-discharge. The results show a significant decrease in length of stay after the introduction of the reform and a non-significant impact on urgent readmissions post-discharge within 30 days. In the first chapter, the various policies were initially motivated by excessive waiting times. Yet, few studies have analyzed the impact of wait times on patient health in Quebec. This vi is the purpose of the second chapter, to analyze whether a high waiting time is associated with a risk of deterioration of the patients’ health. We use empirical models to analyze this problem. We introduce the differential distance from the patients’ home to the nearest hospital relative to the nearest hospital among hospitals with low wait times as an instrumental variable to account for the potential endogeneity of the waiting time. In this chapter, we analyze health variables in terms of the probability of urgent readmission post-discharge within 30 days and excess length of stay (additional length of stay after the maximum recommended length of stay). The results show that long waiting times increase the likelihood of emergency readmissions for patients who had a knee surgery, a thoracic or cardiovascular surgery, a neurosurgery or a surgery for a tumor of the uterus. There is no significant effect of waiting times on the probability of readmission for hip and prostate surgeries. Long waiting times also increase the hospital length of stay and costs of hospitalization for knee and hip surgeries. The aging of the Quebec population is leading to many crucial issues for health care services, particularly home care for the elderly (OIIQ, 2017). Home care is composed of all health care that public or private institutions provide to individuals in their homes. These services are desirable for anyone who needs care for chronic illnesses, palliative care, rehabilitation care, end-of-life care, or care for loss of autonomy linked to aging. Home care could be a safe, low-cost alternative to health care in hospital. Home care, thus contributes to people to stay at home and receive paramedical services from nurses and care assistants, coordinated with those received from other home care providers such as physiotherapists, housekeepers and carers. In the third chapter, we analyze the extent to which hospital services and home care for the elderly are substitutes. We also analyze the impact of home care on admission to long-term care facilities (LTCFs). Our analysis shows that increased home care for the elderly reduces the probability of admission and the length of stay in emergency. The effect of home care is greater for seniors with less disabilities. The results also show that an increase in home care reduces the probability of being admitted to LTCFs.
Stone, Nicole Clare. "The provision, and utilisation, of sexual health services and contraception by heterosexual young people in the UK." Thesis, University of Southampton, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440970.
Full textAlizadeh, khoei Mahtab. "Assessing factors in utilisation of health services and community aged care services by the Iranian elderly living in the Sydney metropolitan area." University of Sydney, 2008. http://hdl.handle.net/2123/3986.
Full textAbstract As one of the most culturally diverse countries in the world, Australia has a high proportion of minority communities. However, its ageing population, particularly within these ethnic minorities, faces a range of barriers or difficulties in gaining access to and using health and aged care services. This study aims to identify the acculturation factors that affect the health status of Iranian-born elderly immigrants to Australia and their utilisation of health and community aged care services. The results of this study will be of value to Iranian elders, their families, and Australian aged health care service providers. The findings could also contribute towards enriched multicultural policy and improved social fairness, access to services, and equity for the aged from different ethnic backgrounds. 302 Iranian migrants aged 65 years who had lived in the Sydney Metropolitan area for at least six months were surveyed via a written questionnaire, face-to-face interviews, and telephone interviews. The results were analysed using SPSS and then compared to the findings from a 1999 survey of NSW elderly. The results indicate that Iranian migrants suffer higher levels of psychological distress and are more limited in their physical functioning than the general population of older Australians. They are in greater need of assistance with activities of daily living, have a lower sense of wellbeing, and are far less likely to utilise aged care services. Iranian migrant who do not speak English at home experience these disadvantages to an even greater extent English language proficiency was the only acculturation factor found to affect whether Iranian elderly utilised health and community aged care services, while ability to engage in activities of daily living (ADL) was the only health variable associated with their utilisation of community supportive aged care services. This variable did not predict the use of community aged care services in the broader sample of NSW respondents. Since limited proficiency in English placed elderly Iranian migrants at greater health risk and impeded their access to necessary assistance, the findings suggest that they would clearly benefit from English classes and from access to health and community care services and information regarding these services in the Farsi language.
Harris, Patricia Amanda. "Promoting research utilisation and evidence-based decision making amongst healthcare managers : utilising nonrecursive structural equation modelling to develop the theory of planned behaviour." n.p, 2005. http://ethos.bl.uk/.
Full textStoddart, Helen. "The health determinants of social networks, social support and the utilisation of home care services in the elderly." Thesis, University of London, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246738.
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