Journal articles on the topic 'Service utilisation'
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B. Neethi, B. Neethi, and A. Sailaja A. Sailaja. "Development of Extension Service Utilisation Index." International Journal of Scientific Research 2, no. 11 (June 1, 2012): 25–27. http://dx.doi.org/10.15373/22778179/nov2013/9.
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Pan, Zijing, Wanchun Xu, Zhong Li, Chengzhong Xu, Fangfang Lu, Pei Zhang, Liang Zhang, and Ting Ye. "Trajectories of Outpatient Service Utilisation of Hypertensive Patients in Tertiary Hospitals in China." International Journal of Environmental Research and Public Health 17, no. 3 (January 29, 2020): 852. http://dx.doi.org/10.3390/ijerph17030852.
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This study aims to identify the characteristics and trajectories of outpatient service utilisation for hypertensive patients in tertiary hospitals. This study also attempts to investigate the determinants of the trajectories of outpatient service utilisation. A total of 9822 patients with hypertension and hypertension-related medical utilisation were recruited in Yichang, China from January 1 to December 31 in 2016. The latent trajectories of outpatient service utilisation were identified through latent class growth analysis. Differences in the demographic characteristics and medical utilisation among patients in different trajectories were tested by one-way ANOVA and chi-square analysis. The predictors of the trajectory groups of outpatient service utilisation were identified through multinomial logistic regression. Four trajectory groups were determined as stable-low (34.7%), low-fluctuating (13.4%), high-fluctuating (22.5%), and stable-high (29.4%). Significant differences were observed in all demographic characteristics (p < 0.001) and medical service utilisation variables (p < 0.001) among the four trajectories except for inpatient cost (p = 0.072). Determinants for outpatient service utilisation patterns include the place of residence, education level, outpatient visit times, inpatient service utilisation, and outpatient cost. Overall, hypertensive patients visiting outpatient units in the tertiary hospital were middle-aged, elderly, and well-educated, and they received poor follow-up services. The four identified latent trajectories have different characteristics and medical utilisation patterns. Trajectory group-based measurements are necessary for hypertension management and economic burden reduction.
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Simpson, Grahame K., Mark Sabaz, Maysaa Daher, Robert Gordon, and Barbara Strettles. "Challenging Behaviours, Co-morbidities, Service Utilisation and Service Access among Community-dwelling Adults with Severe Traumatic Brain Injury: A Multicentre Study." Brain Impairment 15, no. 1 (May 2014): 28–42. http://dx.doi.org/10.1017/brimp.2014.7.
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Objective: To examine patterns, predictors and unmet needs of service utilisation and access to mental health and/or drug and alcohol services among community-dwelling adults with severe traumatic brain injury, and compare those who displayed challenging behaviours with those not displaying challenging behaviour.Design: Retrospective multicentre study.Subjects: All active clients (n= 507) of the New South Wales (NSW) Brain Injury Rehabilitation Program (BIRP) community rehabilitation teams.Methods: Clinician-rated data were collected on client challenging behaviours, mental health and functional status, service utilisation and unmet needs. Between-groups analyses (challenging behaviour versus no challenging behaviours) were conducted to examine patterns of service utilisation and unmet needs. Predictors for service utilisation were tested by multiple linear regression.Results: Challenging behaviours were associated with higher use of BIRP and non-BIRP services and greater levels of unmet needs. Challenging behaviour was an independent predictor of higher levels of service utilisation, in conjunction with pre- and post-injury mental health and drug and alcohol co-morbidities and geographic location. Only 15.3% of the 111 clients with challenging behaviours and co-morbid drug and alcohol problems accessed a drug and alcohol service, while another 32.4% had unmet needs for such services.Conclusion: Challenging behaviours make an independent contribution to increased levels of service utilisation after severe traumatic brain injury.
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Darma, Azri, Hidayati Hidayati, and Fadil Oenzil. "Differences between dental health service quality and utilization of Community Health Centres in the City of Padang based on indicators of utilisation effectiveness." Padjadjaran Journal of Dentistry 30, no. 2 (July 31, 2018): 140. http://dx.doi.org/10.24198/pjd.vol30no2.18330.
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Introduction: The high prevalence of oral disease have not been followed by the availability of oral healthcare, especially at the community-based level. This study was aimed to determine the differences between dental health service quality and utilisation of community health centres in the city of Padang based on indicators of utilisation effectiveness. Methods: A cross-sectional survey was conducted towards two Community Health Services (Puskesmas) as the samples selected using random sampling technique. One Community Health Service was representing a rarely visited Community Health Service with ≤ 9 patients visit per day, and another Community Health Service was representing oppositely. As much as 131 respondents were included in this study, selected using the purposive sampling method. Dimensional satisfaction of service quality including tangibility, reliability, responsiveness, assurance, and empathy, were collected by interviewing the respondents based on a self-reported questionnaire. All data were analysed using the chi-square test. Results: The majority of respondents agreed that dimensional satisfaction such as tangibility, reliability, responsiveness, assurance, and empathy at both Community Health Services were at a good level. There was a significant relationship (p < 0.05) between several dimensional satisfaction of service quality variables (the wide and clean parking area; intense involvement of dentists on every oral examination; friendly service by the front-office; and empathetic affection of dentists towards the patient’s complain) and the utilisation of oral health services. Conclusion: No service differences found from relationship analysis between dental health service quality and utilisation of community health centres in the city of Padang based on indicators of utilisation effectiveness.Keywords: Service quality, dimensional satisfaction, oral health service, service utilisation, Community Health Centre.
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Dotse-Gborgbortsi, Winfred, Andrew J. Tatem, Zoe Matthews, Victor A. Alegana, Anthony Ofosu, and Jim A. Wright. "Quality of maternal healthcare and travel time influence birthing service utilisation in Ghanaian health facilities: a geographical analysis of routine health data." BMJ Open 13, no. 1 (January 2023): e066792. http://dx.doi.org/10.1136/bmjopen-2022-066792.
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ObjectivesTo investigate how the quality of maternal health services and travel times to health facilities affect birthing service utilisation in Eastern Region, Ghana.DesignThe study is a cross-sectional spatial interaction analysis of birth service utilisation patterns. Routine birth data were spatially linked to quality care, service demand and travel time data.Setting131 Health facilities (public, private and faith-based) in 33 districts in Eastern Region, Ghana.ParticipantsWomen who gave birth in health facilities in the Eastern Region, Ghana in 2017.Outcome measuresThe count of women giving birth, the quality of birthing care services and the geographic coverage of birthing care services.ResultsAs travel time from women’s place of residence to the health facility increased up to two2 hours, the utilisation rate markedly decreased. Higher quality of maternal health services haves a larger, positive effect on utilisation rates than service proximity. The quality of maternal health services was higher in hospitals than in primary care facilities. Most women (88.6%) travelling via mechanised transport were within two2 hours of any birthing service. The majority (56.2%) of women were beyond the two2 -hour threshold of critical comprehensive emergency obstetric and newborn care (CEmONC) services. Few CEmONC services were in urban centres, disadvantaging rural populations.ConclusionsTo increase birthing service utilisation in Ghana, higher quality health facilities should be located closer to women, particularly in rural areas. Beyond Ghana, routinely collected birth records could be used to understand the interaction of service proximity and quality.
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Areru, Hiwot Abera, Mesay Hailu Dangisso, and Bernt Lindtjørn. "Large local variations in the use of health services in rural southern Ethiopia: An ecological study." PLOS Global Public Health 2, no. 5 (May 25, 2022): e0000087. http://dx.doi.org/10.1371/journal.pgph.0000087.
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Ethiopia is behind schedule in assuring accessible, equitable and quality health services. Understanding the geographical variability of the health services and adjusting small-area level factors can help the decision-makers to prioritize interventions and allocate scarce resources. There is lack of information on the degree of variation of health service utilisation at micro-geographic area scale using robust statistical tools in Ethiopia. Therefore, the objective of this study was to assess the health service utilisation and identify factors that account for the variation in health service utilisation at kebele (the smallest administrative unit) level in the Dale and Wonsho districts of the Sidama region. An exploratory ecological study design was employed on the secondary patient data collected from 1 July 2017 to 30 June 2018 from 65 primary health care units of the fifty-four kebeles in Dale and Wonsho districts, in the Sidama region. ArcGIS software was used to visualise the distribution of health service utilisation. SaTScan analysis was performed to explore the unadjusted and covariate-adjusted spatial distribution of health service utilisation. Linear regression was applied to adjust the explanatory variables and control for confounding. A total of 67,678 patients in 54 kebeles were considered for spatial analysis. The distribution of the health service utilisation varied across the kebeles with a mean of 0.17 visits per person per year (Range: 0.01–1.19). Five kebeles with health centres had a higher utilisation rate than other rural kebeles without health centres. More than half (57.4%) of the kebeles were within a 10 km distance from health centres. The study found that distance to the health centre was associated with the low health care utilisation. Improving the accessibility of health services by upgrading the primary health care units could increase the service use.
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Kamil, Wisam, Estie Kruger, and Marc Tennant. "Utilisation of Dental Services of Older People in Australia: An Economic Explanatory Model Based on Cost and Geographic Location." Geriatrics 6, no. 4 (October 20, 2021): 102. http://dx.doi.org/10.3390/geriatrics6040102.
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The increased percentage of older people retaining their natural dentition was associated with a burden of poor oral health and increased service demands. This study analyses the dental service utilisation of the ageing population in Australia and develops a modelled cost design that estimates the dental expenditure required to cover dental services for the aged population. Using the Australian Census of Population and Housing, ageing population and socioeconomic data were mapped to geographic boundaries and integrated with dental service provision data to estimate a model for the utilisation of dental services. The estimated financial cost of dental services was calculated based on the mean fees as per the Australian Dental Association’s Dental Fees Survey. The utilisation of the services varied considerably across the states and also by type of service, with limited numbers using periodontic services. However, there was an increase in cost for replacement and restorative services (5020 million AUD), most evident in the socioeconomic deprivation areas. In addition, the average dental services utilisation cost increased noticeably in the lower socioeconomic deciles of all regions outside major cities. The geographic maldistribution of older people significantly affects the utilisation of dental services, especially among disadvantaged communities. A predicted cost model of 6385 million AUD would cover the oral health needs of older Australians.
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Zeng, Yanbing, Weiqian Xu, and Xiaomeng Tao. "What factors are associated with utilisation of health services for the poor elderly? Evidence from a nationally representative longitudinal survey in China." BMJ Open 12, no. 6 (June 2022): e059758. http://dx.doi.org/10.1136/bmjopen-2021-059758.
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ObjectivesTo investigate the status and factors of healthcare service utilisation among the poor elderly in China.MethodsWe selected the poor elderly from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. The main outcome measures include utilisation indicators for the probability and costs of outpatient/inpatient services. Based on modified Andersen behaviour model, a two-part model is designed to analyse the factors of the health service utilisation of the poor elderly.ResultsThe visit rate of outpatient services increased from 15.05% in 2011 to 21.26% in 2015, and the hospitalisation rate increased from 7.26% to 14.32%. The median cost of outpatient and inpatient services in 2015 for the poor elderly were 350 RMB and 10 000 RMB, respectively, and the out-of-pocket ratios were 85.2% and 53.3%, respectively. 78.44% of the people who actually needed healthcare did not use health services, and the main reason was financial difficulties (42.32%). The poor elderly who are higher educated, have children, live in central regions and have social security and a poor health status and who do not smoke or drink are more likely to use health services. The need factor plays a crucial role in determining health service utilisation.ConclusionsThe poor elderly tends to have a worse health status and a heavier medical burden but had a lower utilisation of health services. Predisposing, enabling, need and health behaviour variables should be considered to improve the health service utilisation and the health of the poor elderly.
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Ruggeri, Mirella. "Service utilisation: a pivotal measure in assessing service needs and service outcome." Epidemiologia e psichiatria sociale. Monograph Supplement 6, S1 (April 1997): 105–12. http://dx.doi.org/10.1017/s1827433100000873.
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In past years the study of service utilization has given a great contribution to the evaluation of mental health services. Nowadays, the challenge that must be faced is to obtain from service utilization research useful knowledge for clinical practice and service planning.Psychiatric care organization should be based on coherent and comprehensive assessments of the population's morbidity and needs for care, and take into account costs and benefits of different forms of treatments in relieving mental disorders and meeting mental health needs. While the former issue has been widely studied, the last two are mostly unexplored. Specifically, there is limited amount of information available on the significance that certain patterns of service utilization, or changes in service utilization, may have for the patient, his/her relatives and the community, and on the correlation between certain characteristics of service utilization and the overall quality of care.In this perspective, service utilization must not be considered an isolated step in the patient's career; the causal link between needs, use, and outcome of services should be identified. A full understanding of the role of service utilization in psychiatry thus necessitates taking into consideration events occurring at various steps of a person's history:step 1: a person develops a mental disorder;step 2: in certain cases this will determine a mental health service need;step 3: in certain cases the service need will determine mental health service utilization;step 4: use of mental health services will have a certain outcome.
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Hendrickx, David, Ingrid Amgarth-Duff, Asha C Bowen, Jonathan R Carapetis, Robby Chibawe, Margaret Samson, and Roz Walker. "Barriers and Enablers of Health Service Utilisation for Childhood Skin Infections in Remote Aboriginal Communities of Western Australia." International Journal of Environmental Research and Public Health 17, no. 3 (January 28, 2020): 808. http://dx.doi.org/10.3390/ijerph17030808.
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In Australia, children living in remote Aboriginal communities experience high rates of skin infections and associated complications. Prompt presentation to primary care health services is crucial for early diagnosis and treatment. We performed a qualitative study in four remote Aboriginal communities in the Pilbara region of Western Australia to explore factors that affected health service utilisation for childhood skin infections in this setting. The study consisted of semistructured interviews and focus group discussions with parents and carers (n = 16), healthcare practitioners (n = 15) and other community service providers (n = 25). We used Andersen’s health service utilisation model as an analytical framework. Our analysis captured a wide range of barriers that may undermine timely use of health services for childhood skin infections. These included general factors that illustrate the importance of cultural competency amongst healthcare providers, patient-centred care and community engagement. Relating specifically to health service utilisation for childhood skin infections, we identified their apparent normalisation and the common use of painful benzathine penicillin G injections for their treatment as important barriers. Health service utilisation in this setting may be enhanced by improving general awareness of the significance of childhood skin infections, actively engaging parents and carers in consultation and treatment processes and strengthening community involvement in health service activities.
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Harvey, Sarah, Joanna Bromley, Miles Edwards, Megan Hooper, Hannah McAndrew, and Joanne Timms. "Audit of the impact of the integrated psychological medicine service (IPMS) on service utilisation." BJPsych Open 7, S1 (June 2021): S80—S81. http://dx.doi.org/10.1192/bjo.2021.252.
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AimsAn audit to assess the impact of an Integrated Psychological Medicine Service (IPMS) on healthcare utilization pre & post intervention. We hypothesized that an IPMS approach would reduce healthcare utilization.BackgroundThe IPMS focusses on integrating biopsychosocial assessments into physical healthcare pathways. It has developed in stages as opportunities presented in different specialities leading to a heterogeneous non-standardised service. The key aim is involvement of mental health practitioners, psychologists & psychiatrists in complex patients with comorbidity or functional presentations in combination with the specialty MDT. This audit is the first attempt to gather data across all involved specialities and complete a randomised deep dive into cases.MethodReferrals into IMPS from July 2019 to June 2020 pulled 129 referrals, of which a 10% randomised sample of 13 patients was selected to analyse. 5 patients had one year of data either side of the duration of the IPMS intervention (excluding 8 patients with incomplete data sets).We analysed; the duration & nature of the IPMS intervention, the number, duration & speciality of inpatient admissions & short stays, outpatient attendances, non-attendances & patient cancellations. Psychosocial information was also gathered. One non-randomised patient was analysed as a comparative case illustration.ResultRandomised patients; patient 78's utilisation remained static, patient 71 post-referral engaged with health psychology & reduced healthcare utilisation. Patient 7 increased healthcare utilisation post-referral secondary to health complications. Patient 54 did not attend & increased healthcare utilisation post-referral. Patient 106 had increased healthcare utilisation post-referral from a new health condition. The randomised sample identified limitations of using healthcare utilisation as an outcome measure when contrasted to the non-randomised case (which significantly reduced healthcare utilisation post-referral).ConclusionCorrelation only can be inferred from the data due to sample size, limitations & confounding factors e.g. psycho-social life events, acquired illness. Alternative outcome measurements documented (e.g PHQ9/GAD7) were not reliably recorded across pathways.The results evidenced that single cases can demonstrate highly desirable effects of a biopsychosocial approach but they can also skew data sets if results are pooled due to the small sample size & heterogeneous interventions. With some patients an increase in healthcare utilisation was appropriate for an improved clinical outcome. This audit identified that utilising healthcare utilisation as an outcome measure is a crude tool with significant limitations & the need to agree tailored outcome measures based on the type of intervention to assess the impact of IPMS.
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Andrews, Gavin, Scott Henderson, and Wayne Hall. "Prevalence, comorbidity, disability and service utilisation." British Journal of Psychiatry 178, no. 2 (February 2001): 145–53. http://dx.doi.org/10.1192/bjp.178.2.145.
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BackgroundHealth planning should be based on data about prevalence, disability and services used.AimsTo determine the prevalence of ICD–10 disorders and associated comorbidity, disability and service utilisation.MethodWe surveyed a national probability sample of Australian households using the Composite International Diagnostic Interview and other measures.ResultsThe sample size was 10 641 adults, response rate 78%. Close to 23% reported at least one disorder in the past 12 months and 14% a current disorder. Comorbidity was associated with disability and service use. Only 35% of people with a mental disorder in the 12 months prior to the survey had consulted for a mental problem during that year, and most had seen a general practitioner. Only half of those who were disabled or had multiple comorbidity had consulted and of those who had not, more than half said they did not need treatment.ConclusionsThe high rate of not consulting among those with disability and comorbidity is an important public health problem. As Australia has a universal health insurance scheme, the barriers to effective care must be patient knowledge and physician competence.
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Banke-Thomas, Aduragbemi, Aline Semaan, Dinah Amongin, Ochuwa Babah, Nafissatou Dioubate, Amani Kikula, Sarah Nakubulwa, et al. "A mixed-methods study of maternal health care utilisation in six referral hospitals in four sub-Saharan African countries before and during the COVID-19 pandemic." BMJ Global Health 7, no. 2 (February 2022): e008064. http://dx.doi.org/10.1136/bmjgh-2021-008064.
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IntroductionIn sub-Saharan Africa, referral hospitals are important sources of key maternal health services, especially during a crisis such as the COVID-19 pandemic. This study prospectively assessed the effect of the COVID-19 pandemic on maternal health service utilisation in six large referral hospitals in Guinea, Nigeria, Tanzania and Uganda during the first year of the pandemic.MethodsMixed-methods design combining three data sources: (1) quantitative data based on routine antenatal, childbirth and postnatal care data collected March 2019–February 2021, (2) qualitative data from recurring rounds of semi-structured interviews conducted July 2020–February 2021 with 22 maternity skilled heath personnel exploring their perceptions of service utilisation and (3) timeline data of COVID-19 epidemiology, global, national and hospital-level events. Qualitative and quantitative data were analysed separately, framed based on the timeline analysis and triangulated when reporting.ResultsThree periods including a first wave, slow period and second wave were identified. Maternal health service utilisation was lower during the pandemic compared with the prepandemic year in all but one selected referral hospital. During the pandemic, service utilisation was particularly lower during the waves and higher or stable during the slow period. Fear of being infected in hospitals, lack of transportation, and even when available, high cost of transportation and service closures were key reasons affecting utilisation during the waves. However, community perception that the pandemic was over or insinuation by Government of the same appeared to stabilise use of referral hospitals for childbirth.ConclusionUtilisation of maternal health services across the continuum of care varied through the different periods and across countries. In crisis situations such as COVID-19, restrictions and service closures need to be implemented with consideration given to alternative options for women to access and use services. Information on measures put in place for safe hospital use should be communicated to women.
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Gibson, David A. J., Rachael E. Moorin, David B. Preen, Jon D. Emery, and C. D'Arcy J. Holman. "Effects of the Medicare enhanced primary care program on primary care physician contact in the population of older Western Australians with chronic diseases." Australian Health Review 35, no. 3 (2011): 334. http://dx.doi.org/10.1071/ah09852.
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Objective. Assess uptake of Medicare’s enhanced primary care (EPC) services in Western Australia (WA) in 2001 to 2006, evaluating effect of EPC services on the regularity of contact with general practitioners (GPs) in patients aged 65+ years. Method. Whole-population cohort study using linked routinely collected health service data from State and Federal health databases. Analyses include age-standardised rate of EPC services, odds of EPC utilisation relative to other GP services using logistic regression, and total GP service regularity pre- and post-implementation of the EPC program. Results. EPC services provided to WA seniors increased 345% 2001 to 2006, comprising an increasing proportion of the total GP services (1.1 to 3.6%). Uptake of EPC services accelerated abruptly after 2004 due to greater use of ‘care plans’. EPC services were associated with a history of chronic disease, especially type 2 diabetes (OR = 1.74, 95% CI 1.66–1.82). Regularity of total GP services was improved with any EPC service exposure, with greater improvement occurring in the presence of annual EPC service exposure. Conclusions. EPC item uptake responded favourably to item changes from Medicare Australia. Prior exposure to EPC items increased the regularity of GP services, an outcome inversely associated with chronic disease progression. What is known about the topic? The Australian Federal government has invested substantial funds (over $200 million in 2007–08 alone) in the enhanced primary care (EPC) program with the intention of improving patient outcomes, specifically aged patients and those suffering from chronic disease. The EPC program uses high value Medicare items to incentivise GPs to engage in long-term planned care. However, limited research has examined the effect of this program on patient service utilisation and outcomes. What does this paper add? This paper provides a whole-population perspective on the EPC utilisation trends from 2001 to 2006 for Western Australian residents over 65 years of age. The paper then examines the likelihood of using the EPC program on the basis of calendar year, sex, age and chronic disease history. A comparison of the regularity of GP service utilisation for those exposed to the EPC program is also made. What are the implications for practitioners? The adjustments made to the EPC program in 2004, after feedback from GPs, appears to have substantially increased the utilisation of the program. Additionally, patients suffering from several different chronic diseases are more likely to be exposed to the EPC program. Exposure to the EPC program also appears to provide an improvement in regularity of service utilisation which has been associated with improved outcomes in the literature.
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Tufa, Yohanis, Abeza Mitiku, Shuayib Shemsu, and Kebebe Bidira. "Utilisation of growth monitoring service by mothers of infants in Mettu town, Southwest Ethiopia." BMJ Paediatrics Open 6, no. 1 (September 2022): e001588. http://dx.doi.org/10.1136/bmjpo-2022-001588.
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BackgroundGrowth monitoring (GM) is a preventive activity that serves as the core function in an integrated child health and nutrition programme. In most developing nations, including Ethiopia, however, the use of GM service is insufficient. Hence, the purpose of this study was to evaluate the use of GM services and associated characteristics among mothers of infants in Mettu town, Southwest Ethiopia.ObjectiveTo assess the utilisation of GM service by mothers of infants in Mettu town, Southwest Ethiopia, 2021.MethodA community-based cross-sectional study was conducted among 354 randomly selected mothers with children aged 0–23 months old from 25 June to 27 July 2021 in Mettu town. EpiData V.4.6.0 was used to enter data, which were then exported to SPSS V.25 for analysis. Simple binary and multivariable logistic regression analyses were performed to identify factors associated with GM service utilisation.ResultsA total of 354 study participants were included in the study, yielding a response rate of 95.2%. The proportion of GM service utilisation was 25.2% (95% CI: 20.24% to 29.33%). In multivariable regression analysis, age of index child 0–11 months (AOR (adjusted OR)=1.58; 95% CI: 1.052 to 3.713), early postnatal care (PNC) (AOR=1.72; 95% CI: 1.657 to 6.467), middle tertile wealth status (AOR=0.108; 95% CI: 0.047 to 0.319) and lower tertile wealth status (AOR=0.073; 95% CI: 0.013 to 0.874), utilisation of family health cards (AOR=2.09; 95% CI: 1.384 to 5.343) and taking ≤30 min to reach the nearest health facility (AOR=2.23; 95% CI: 2.061 to 7.350) were significantly associated with GM service utilisation.Conclusion and recommendationIn this study, only one-fourth of mothers with children aged 0–23 months old were using GM services. GM service utilisation was found to be significantly associated with child age, early PNC visit, wealth status, utilisation of family health cards and time taking ≤30 min to reach the nearest health facility. Hence, appropriate strategies that promote and encourage GM service utilisation should be designed.
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Hodgson, Sam, Jeffrey Morgan-Harrisskitt, Hilda Hounkpatin, Beth Stuart, and Hajira Dambha-Miller. "Primary care service utilisation and outcomes in type 2 diabetes: a longitudinal cohort analysis." BMJ Open 12, no. 1 (January 2022): e054654. http://dx.doi.org/10.1136/bmjopen-2021-054654.
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ObjectivesTo describe primary care utilisation patterns among adults with type 2 diabetes and to quantify the association between utilisation and long-term health outcomes.DesignRetrospective cohort study.Setting168 primary care practices in Southern England within the Electronic Care and Health Information Analytics database between 2013 and 2020.Participants110 240 adults with Quality and Outcomes Framework read code of type 2 diabetes diagnosis; age greater than 18 years; linked and continuous records available from April 2013 until April 2020 (or death).Primary and secondary outcome measures(1) Rates of service utilisation (total number of primary care contacts per quarter) across the study period; (2) participant characteristics associated with higher and lower rates of service utilisation; and (3) associations between service utilisation and (A) cardiovascular disease (CVD events) and (B) all-cause mortality.ResultsMean (SD) number of primary care attendances per quarter in the cohort of 110 240 went from 2.49 (2.01) in 2013 to 2.78 (2.06) in 2020. Patients in the highest usage tertile were more likely to be female, older, more frail, white, from the least deprived quintile and to have five or more comorbidities. In adjusted models, higher rates of service utilisation (per consultation) were associated with higher rates of CVD events (OR 1.0058; 95% CI 1.0053 to 1.0062; p<0.001) and mortality (OR 1.0057; 95% CI 1.0051 to 1.0064; p<0.001).ConclusionsPeople with type 2 diabetes are using primary care services more frequently, but increased volume of clinical care does not correlate with better outcomes, although this finding may be driven by more unwell patients contacting services more frequently. Further research on the nature and content of contacts is required to understand how to tailor services to deliver effective care to those at greatest risk of complications.
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Kapoor, Neena R., Amit Aryal, Suresh Mehata, Mahesh Dulal, Margaret E. Kruk, Sebastian Bauhoff, and Catherine Arsenault. "Effect of lifting COVID-19 restrictions on utilisation of primary care services in Nepal: a difference-in-differences analysis." BMJ Open 12, no. 11 (November 2022): e061849. http://dx.doi.org/10.1136/bmjopen-2022-061849.
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IntroductionAn increasing number of studies have reported disruptions in health service utilisation due to the COVID-19 pandemic and its associated restrictions. However, little is known about the effect of lifting COVID-19 restrictions on health service utilisation. The objective of this study was to estimate the effect of lifting COVID-19 restrictions on primary care service utilisation in Nepal.MethodsData on utilisation of 10 primary care services were extracted from the Health Management Information System across all health facilities in Nepal. We used a difference-in-differences design and linear fixed effects regressions to estimate the effect of lifting COVID-19 restrictions. The treatment group included palikas that had lifted restrictions in place from 17 August 2020 to 16 September 2020 (Bhadra 2077) and the control group included palikas that had maintained restrictions during that period. The pre-period included the 4 months of national lockdown from 24 March 2020 to 22 July 2020 (Chaitra 2076 to Ashar 2077). Models included month and palika fixed effects and controlled for COVID-19 incidence.ResultsWe found that lifting COVID-19 restrictions was associated with an average increase per palika of 57.5 contraceptive users (95% CI 14.6 to 100.5), 15.6 antenatal care visits (95% CI 5.3 to 25.9) and 1.6 child pneumonia visits (95% CI 0.2 to 2.9). This corresponded to a 9.4% increase in contraceptive users, 34.2% increase in antenatal care visits and 15.6% increase in child pneumonia visits. Utilisation of most other primary care services also increased after lifting restrictions, but coefficients were not statistically significant.ConclusionsDespite the ongoing pandemic, lifting restrictions can lead to an increase in some primary care services. Our results point to a causal link between restrictions and health service utilisation and call for policy makers in low- and middle-income countries to carefully consider the trade-offs of strict lockdowns during future COVID-19 waves or future pandemics.
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Neethi, B., and A. Sailaja. "Development of Extension Service Utilisation Index." International Journal of Current Microbiology and Applied Sciences 7, no. 05 (May 10, 2018): 2685–91. http://dx.doi.org/10.20546/ijcmas.2018.705.311.
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Andrews, Gavin, Cathy Issakidis, and Greg Carter. "Shortfall in mental health service utilisation." British Journal of Psychiatry 179, no. 5 (November 2001): 417–25. http://dx.doi.org/10.1192/bjp.179.5.417.
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BackgroundTreatment coverage for mental disorders is poor in most developed countries.AimsTo explore some reasons for the poor treatment coverage for mental disorders in developed countries.MethodData were taken from Australian national surveys and from the World Health Report.ResultsOnly one-third of people with a mental disorder consulted. Probability of consulting varied by diagnosis: 90% for schizophrenia, which is accounted for by external factors; 60% for depression; and 15% for substance use and personality disorders. The probability of consulting varied by gender, age, marital status and disability, from 73% among women aged 25–54 years, disabled and once married to 9% among males without these risk factors. Those who did not consult but were disabled or comorbid said that they “preferred to manage themselves”. Data from five countries showed no evidence that overall health expenditure, out-of-pocket cost or responsiveness of the health system affected the overall consulting rates.ConclusionsSocietal, attitudinal and diagnostic variables account for the variation. Funding does not. Public education about the recognition and treatment of mental disorders and the provision of effective treatment by providers might remedy the shortfall.
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McCrone, Paul, Graham Thornicroft, Michael Phelan, Frank Holloway, Til Wykes, and Sonia Johnson. "Utilisation and costs of community mental health services." British Journal of Psychiatry 173, no. 5 (November 1998): 391–98. http://dx.doi.org/10.1192/bjp.173.5.391.
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BackgroundThe costs and the effectiveness of mental health services need to be evaluated if provision is to be efficient. Service use and costs are described for two geographical areas in south London.MethodService use was measured comprehensively for clients in both sectors for two six-month time periods using the Client Service Receipt Interview This information was combined with unit costs to calculate service costs. The ‘hidden’ costs of informal care and unsupported accommodation were also calculated.ResultsAt baseline significantly more intensive sector clients had in-patient stays but by the follow-up this difference had disappeared. There was significantly more use of supported accommodation in the intensive sector during both time periods. Baseline and follow-up total service costs were significantly higher for the intensive sector. Costs were spread disproportionately and a small number of services accounted for a large proportion of cost.ConclusionsWhile the cost at Time 2 was significantly greater in the intensive sector, this was largely due to the high use of supported accommodation. There was some convergence in cost between the sectors over time.
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Falkenstein, Lina, Nathalie Eckel, Simone B. Kadel, Jochem Koenig, David Litaker, and Michael Eichinger. "Service provision and utilisation in German paediatric primary care practices during public health crises: Protocol of the mixed-methods COVID-19 PedCare Study." BMJ Open 12, no. 10 (October 2022): e054054. http://dx.doi.org/10.1136/bmjopen-2021-054054.
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IntroductionPublic health crises such as pandemics can cause serious disruptions to the utilisation and provision of healthcare services with negative effects on morbidity and mortality. Despite the important role of paediatric primary care in maintaining high-quality healthcare services during crises, evidence about service utilisation and provision remains limited especially in Germany. This study, therefore, explores the utilisation and provision of paediatric primary care services during the ongoing COVID-19 pandemic and their barriers and facilitators.Methods and analysisThe study uses a convergent mixed-methods design and comprises online surveys to parents, adolescents and primary care paediatricians (PCPs) and semistructured interviews with parents and PCPs. We recruit parents and adolescents from paediatric primary care practices and PCPs via email using mailing lists of the German Professional Association of Paediatricians and the German Society of Ambulatory Primary Care Paediatrics. The parent and adolescent surveys assess, inter alia, the utilisation of paediatric primary care services and its correlates, aspects of parental and child health as well as socioeconomic characteristics. The PCP survey investigates the provision of paediatric primary care services and its correlates, aspects of PCP health as well as sociodemographic and practice characteristics. The semistructured interviews with parents and PCPs explore several aspects of the online surveys in more detail. We use descriptive statistics and generalised linear mixed models to assess service utilisation and provision and specific correlates covered in the online surveys and apply qualitative content analysis to explore barriers and facilitators of service utilisation and provision more broadly in the semistructured interviews. We will integrate findings from the quantitative and qualitative analyses at the interpretation stage.Ethics and disseminationThe study was approved by the Medical Ethics Review Board of the Medical Faculty Mannheim at Heidelberg University (2020–650N). Study results will be published in journals with external peer-review.
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Xu, Jianqiang, Juan Zheng, Lingzhong Xu, and Hongtao Wu. "Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage." International Journal of Environmental Research and Public Health 18, no. 2 (January 12, 2021): 593. http://dx.doi.org/10.3390/ijerph18020593.
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Worldwide countries are recognising the need for and significance of universal health coverage (UHC); however, health inequality continues to persist. This study evaluates the status and equity of residents’ demand for and utilisation of health services and expenditure by considering the three components of universal health coverage, urban-rural differences, and different income groups. Sample data from China’s Fifth Health Service Survey were analysed and the ‘five levels of income classification’ were used to classify people into income groups. This study used descriptive analysis and concentration index and concentration curve for equity evaluation. Statistically significant differences were found in the demand and utilisation of health services between urban and rural residents. Rural residents’ demand and utilisation of health services decreased with an increase in income and their health expenditure was higher than that of urban residents. Compared with middle- and high-income rural residents, middle- and lower-income rural residents faced higher hospitalisation expenses; and, compared with urban residents, equity in rural residents’ demand and utilisation of health services, and annual health and hospitalisation expenditures, were poorer. Thus, equity of health service utilisation and expenditure for urban and rural residents with different incomes remain problematic, requiring improved access and health policies.
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Abood, Julianne, Julie Green, Michael J. Polonsky, Kerry Woodward, Zulfan Tadjoeddin, and Andre M. N. Renzaho. "The importance of information acquisition to settlement services literacy for humanitarian migrants in Australia." PLOS ONE 18, no. 1 (January 6, 2023): e0280041. http://dx.doi.org/10.1371/journal.pone.0280041.
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Background Due to the diversity and range of services provided to humanitarian migrants during the settlement phase of migration, acquiring information across multiple service domains is intrinsic to the effective utilisation of settlement services. There are research gaps investigating how humanitarian migrants experience and navigate unfamiliar, multiple, and often complex information and service systems of host countries. This study seeks to understand the impediments to humanitarian migrants’ effective utilisation of information about settlement services and to identify strategies that can be implemented to overcome these barriers. Methods Service providers were purposively recruited from organisations funded by the Australian Government to deliver settlement programs. The study applied an inductive thematic analysis approach to identify key themes that emerged from the data. Results From the perspective of service providers, the themed findings identified how humanitarian migrants gain knowledge about services, their information needs, information seeking practices and skills, and information specific to service domains. The findings illustrate the importance of acquiring information, knowledge, and skills across multiple information platforms and service domains as being integral to the effective utilisation of settlement services for humanitarian migrants. The study identifies systemic barriers to information and service access and suggests different strategies and approaches to improve access to context specific key information. The study identifies factors that inhibit the effectiveness of the Australian settlement service provision model and emphasises the need for targeted training of mainstream referral services. The study highlights the important role that settlement service providers play as mediators of information, adept at tailoring information to humanitarian migrants’ individual and community information needs. Conclusion The findings provide important insights that highlight the different roles that policymakers, researchers, and service providers can play to inform new approaches that improve the effectiveness of information and settlement service provision, as part of contributing to optimum settlement outcomes for humanitarian migrants.
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Mekonnen, Tensae, Tinashe Dune, Janette Perz, and Felix Akpojene Ogbo. "Trends and Determinants of Antenatal Care Service Use in Ethiopia between 2000 and 2016." International Journal of Environmental Research and Public Health 16, no. 5 (March 1, 2019): 748. http://dx.doi.org/10.3390/ijerph16050748.
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: Antenatal care (ANC) services are an essential intervention for improving maternal and child health worldwide. In Ethiopia, however, ANC service use has been suboptimal, and examining the trends and factors associated with ANC service use is needed to inform targeted maternal health care interventions. This study aimed to investigate the trends and determinants of ANC service utilisation in Ethiopia for the period ranging from 2000 to 2016. This study draws on the Ethiopia Demographic and Health Survey data for the years 2000 (n = 7928), 2005 (n = 7276), 2011 (n = 7881) and 2016 (n = 7558) to estimate the trends in ANC service utilisation. Multivariate logistic regression models with adjustment for clustering and sampling weights were used to investigate the association between the study factors and ANC service utilisation. Over the sixteen-year period, the proportion of Ethiopian women who received the recommended four or more ANC visits increased from 10.0% (95% confidence interval (95% CI: 8.7–12.5%) in 2000 to 32.0% (95% CI: 29.4–34.3%) in 2016. Similarly, the proportion of women who received one to three ANC visits increased from 27.0% (95% CI: 23.6–30.7%) in 2000 to 62.0% in 2016 (95% CI: 60.4–67.3%). Multivariate analyses showed that higher maternal and paternal education, higher household wealth status, urban residency and previous use of a contraceptive were associated with ANC service use (1–3 and 4+ ANC visits). The study suggests that while Ethiopian pregnant women’s engagement with ANC services improved during the millennium development goal era (2000–2015), recommended ANC use remains suboptimal. Improving the utilisation of ANC services among pregnant women is essential in Ethiopia, and efforts should focus on vulnerable women.
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Yan, Chiu-Lan, Li-Ting Kao, Ming-kung Yeh, Wu-Chien Chien, and Chin-Bin Yeh. "Healthcare utilisation for eating disorders among patients with depression: a cross-sectional study in Taiwan." BMJ Open 9, no. 12 (December 2019): e032108. http://dx.doi.org/10.1136/bmjopen-2019-032108.
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ObjectivesAlthough depressed patients may have a comorbid eating disorder (ED), to date, no study has focused on healthcare utilisation among this population. This study was designed to investigate the characteristics of healthcare service utilisation among depressed patients with ED.DesignA cross-sectional study.SettingThis population-based study used claims data from Taiwan’s National Health Insurance Research database between 2001 and 2012.ParticipantsThe study involved 1270 participants. These included 254 depressed individuals with ED and 1016 propensity score-matched depressed individuals without ED.Outcome measuresWe tracked each patient for a 1 year period to evaluate their healthcare service utilisation, including outpatient visits, inpatient days, and costs for psychiatry and non-psychiatry services. We performed a Mann-Whitney U test to compare outcome variables in healthcare service utilisation between the two groups.ResultsPatients with both depression and ED had significantly more outpatient visits (32.2 vs 28.9, p=0.023), outpatient costs (US$1089 vs US$877, p<0.001) and total costs (US$1356 vs US$1296, p<0.001) than comparison patients. For psychiatric services, patients with depression and ED had more outpatient visits (11.0 vs 6.8, p<0.001), outpatient costs (US$584 vs US$320, p<0.001) and total costs (US$657 vs US$568, p<0.001) than those without ED. For non-psychiatric services, there was no significant difference for all utilisation. This indicates that the total costs were about 1.0-fold greater for depression patient with ED than those without ED.ConclusionDepression patients with ED had more outpatient visits, outpatient costs and total costs of healthcare services than those without ED.
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Chen, Jiaqi, Song Xu, and Jing Gao. "The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach." International Journal of Environmental Research and Public Health 17, no. 5 (March 9, 2020): 1782. http://dx.doi.org/10.3390/ijerph17051782.
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In 2009, China launched a new health care reform as it endeavoured to develop a tiered system of disease diagnosis and treatment to promote the integration of medical resources. This was important for improving service capacity and building medical alliances that would eventually lead to improved health service utilisation efficiency. However, while the 2009 reform aimed to provide universal health insurance coverage to all citizens, its overall effect on health service utilisation efficiency remains unclear. We aimed to examine the new health care reform’s mixed effect by applying a longitudinal study using China Health and Nutrition Survey (CHNS) data and the difference-in-difference (DID) method to estimate the health reform’s impact on health insurance coverage rate. Then, we studied whether the increase in health insurance coverage rate affected health service utilisation efficiency in China. Our results showed that the increase in insurance coverage rate has indeed made expensive medical services available to low-income individuals. However, it also increased the likelihood of use of hospitals rather than primary care facilities, since there is more insurance cover for outpatient visits, which has led to an increased demand for quality services. This effect has generated a negative impact on health care utilisation which directly pertains to systemic inefficiency. This study thus indicates that China’s latest health reform requires further policies to improve its overall efficiency.
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Signorelli, R. G., N. S. Gluckman, N. Hassan, M. Coello, and S. Momartin. "Relationship Building, Collaboration and Flexible Service Delivery: The Path to Engagement of Refugee Families and Communities in Early Childhood Trauma Recovery Services." Children Australia 42, no. 3 (September 2017): 142–58. http://dx.doi.org/10.1017/cha.2017.30.
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Service utilisation by refugee families may be affected by the mismatch between Western individualistic service delivery approaches and the target communities’ more collectivist cultural patterns and practices. In addition to access barriers, utilisation of early childhood services by refugees can also be impacted upon by distrust of services, health and settlement issues, stigma, unfamiliarity with early childhood programmes, and fear of child protection and other legal systems. This low service utilisation sits in conflict with the need for early interventions for very young children, who are in the peak period of brain development. This article explores the implementation of a model to address these issues in early childhood work with refugee families and communities, with the intent to increase service uptake. Some strategies to address potential barriers will be described in the context of a community engagement model that includes consultation, relationship building, collaborative flexible service design and delivery, partnerships in community capacity building and cross-referral. Flexible, culturally appropriate interventions can enhance strengths based, non-pathologising and development-focused approach. A community engagement approach will, nevertheless, present challenges for service providers who must be willing to adapt their practices. Services and funding bodies need to recognise that this process is lengthy and resource intensive, but will ultimately lead to better service delivery and uptake, potentially leading to improvements in health, development and relational outcomes, for children and families from refugee backgrounds.
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Seers, Kara, Lynley Cook, Gillian Abel, Philip Schluter, and Paul Bridgford. "Is it time to talk? Interpreter services use in general practice within Canterbury." Journal of Primary Health Care 5, no. 2 (2013): 129. http://dx.doi.org/10.1071/hc13129.
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INTRODUCTION: Effective communication is fundamental to successful health care service delivery, and has a positive impact on access, quality of care, health outcomes, and patient satisfaction. Although there are a growing number of New Zealanders who do not speak English proficiently, underutilisation of trained interpreter services appears to be common in primary health care settings. AIMS: To describe the pattern of interpreter service need and utilisation by general practice services, and to identify key barriers and enabling factors to the use of trained interpreters. METHODS: A mixed methods study was employed. Census and Partnership Health Canterbury Te Kei o Te Waka (PHC) databases were combined, and quantitative analysis used to derive interpreter service need and utilisation patterns. Transcripts of focus groups and interviews from general practitioners, practice nurses and practice administration staff within the PHC were analysed, using qualitative methods to identify barriers and enablers to interpreter service use. RESULTS: For the years 20082010, approximately 10 742 consultations per year involved a non-English-speaking patient, yet in only approximately 74.8 (0.7%) consultations per year were interpreter services utilised. Analysis of focus groups and interviews identified four global themes that represented barriers for interpreter service utilisation; namely, practicalities, expectations, knowledge of service, and systems. DISCUSSION: The current use of interpreter services in PHC general practice appears to be significantly less than the need. In order to maximise health outcomes and reduce risk, strategies must be initiated to counter the barriers currently inhibiting interpreter service use, including adopting best practice policies. KEYWORDS: Communication; communication barriers; general practice; primary health care
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Mugisha, E., G. H. van Rensburg, and E. Potgieter. "Strategic Framework for Increasing Accessibility and Utilization of Voluntary Counseling and Testing Services in Uganda." AIDS Research and Treatment 2011 (2011): 1–9. http://dx.doi.org/10.1155/2011/912650.
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Despite the usefulness of VCT service as an entry point to prevention for the HIV-uninfected people and care, treatment and support for those who test HIV positive, VCT service remains poorly utilized among the fishing communities. The aim of the study was to identify factors influencing VCT service delivery and utilisation among fishing communities in Uganda and consequently, formulated a strategic framework for improving VCT service delivery and utilisation in the fishing communities. The study followed a 3-phased approach, collecting and analyzing quantitative data from Kasenyi fishing community under phase I, collecting and analyzing qualitative data from hospital managers and VCT counselors in phases II and III, respectively. Results indicate that VCT services delivery and utilisation is affected by factors at government (macro) level, the institution (meso) level, and at the individual (micro) level. Based on this, a strategic framework was designed, expected to increase VCT service availability, accessibility, and acceptability if applied. The researcher recommends the use of this useful tool in the design of VCT programs.
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Gibbs, Lisa, and Daniel Reidpath. "What about the men? General differences in utilisation of arthritis self-management services." Australian Journal of Primary Health 11, no. 1 (2005): 63. http://dx.doi.org/10.1071/py05009.
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As self-management programs for chronic illness increasingly become the domain of primary health care providers, it is important to consider gender inequities in access to these services and gender differences in patterns of use to inform the development and delivery of services. This study explores gender differences in levels and patterns of access to arthritis self-management services by analyzing data collected from the Telephone Information Service of Arthritis Victoria. Contingency tables were analyzed and odds-ratios calculated to confirm gender differences in levels and patterns of service utilisation. Men were found to be significantly under-represented as users of the service, even after taking into account gender differences in prevalence of arthritis in the population. Women were more likely than men to contact the service on their own behalf. Men were more likely to have a family member or friend contact the service for them. Women showed more interest in learning about their condition while men focused more on symptom management. These gender differences in rates and patterns of service use indicate that service providers of self-management services for conditions such as arthritis need to take into account the interaction between gender and service utilisation.
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Williams, Sarah E., Margaret D. Hartstone, and Linley A. Denson. "Dialectical Behavioural Therapy and Borderline Personality Disorder: Effects on Service Utilisation and Self-Reported Symptoms." Behaviour Change 27, no. 4 (December 1, 2010): 251–64. http://dx.doi.org/10.1375/bech.27.4.251.
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AbstractIn a pilot evaluation study, effectiveness of a 20-week dialectical behavioural therapy (DBT) skills training group program was explored for adult clients with borderline personality disorder (BPD;N= 140). Subjective ratings of depression, anxiety and BPD symptomatology were obtained pre and post group therapy. Objective measures of service utilisation levels were obtained for the 6 months prior to group therapy, the duration of therapy, and the 6 months following therapy. Group completers (n= 68) showed reductions in depression, anxiety and BPD symptomatology, as well as in the number of emergency department attendances. Completers with previous high service utilisation had decreases in telephone counselling calls and inpatient days during therapy, and fewer emergency department attendances post therapy. Completers had larger decreases in service utilisation than noncompleters (n= 72). Simultaneous engagement in individual DBT was related to higher group completion than was individual therapy as usual, but it did not impact on level of service utilisation or psychological functioning. This quasi-experimental pilot study suggests that DBT groups may improve psychological functioning and decrease service utilisation for BPD clients, particularly those with high service utilisation. The treatment warrants systematic evaluation.
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Walker, Tania, Mulu Woldegiorgis, and Jahar Bhowmik. "Utilisation of Skilled Birth Attendant in Low- and Middle-Income Countries: Trajectories and Key Sociodemographic Factors." International Journal of Environmental Research and Public Health 18, no. 20 (October 13, 2021): 10722. http://dx.doi.org/10.3390/ijerph182010722.
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Reducing the maternal mortality ratio (MMR) in low- and middle-income countries (LMICs) remains a huge challenge. Maternal mortality is mostly attributed to low coverage of maternal health services. This study investigated the trajectories and predictors of skilled birth attendant (SBA) service utilisation in LMIC over the past two decades. The data was sourced from standard demographic and health surveys which included four surveys on women with livebirth/s from selected countries from two regions with a pooled sample of 56,606 Indonesian and 63,924 Nigerian respondents. Generalised linear models with quasibinomial family of distributions were fitted to investigate the association between SBA utilisation and sociodemographic factors. Despite a significant improvement in the last two decades in both countries, the change was slower than hope for, and inconsistent. Women who received antenatal care were more likely to use an SBA service. SBA service utilisation was significantly more prevalent amongst literate women in Indonesia (AOR = 1.39, 95% CI: 1.24–1.54) and Nigeria (AOR = 1.41, 95% CI: 1.31–1.53) than their counterparts. The disparity based on geographic region and social factors remained significant over time. Given the significant disparities in SBA utilisation, there is a strong need to focus on community- and district-level interventions that aim at increasing SBA utilisation.
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Walker, Tania, Mulu Woldegiorgis, and Jahar Bhowmik. "Utilisation of Skilled Birth Attendant in Low- and Middle-Income Countries: Trajectories and Key Sociodemographic Factors." International Journal of Environmental Research and Public Health 18, no. 20 (October 13, 2021): 10722. http://dx.doi.org/10.3390/ijerph182010722.
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Reducing the maternal mortality ratio (MMR) in low- and middle-income countries (LMICs) remains a huge challenge. Maternal mortality is mostly attributed to low coverage of maternal health services. This study investigated the trajectories and predictors of skilled birth attendant (SBA) service utilisation in LMIC over the past two decades. The data was sourced from standard demographic and health surveys which included four surveys on women with livebirth/s from selected countries from two regions with a pooled sample of 56,606 Indonesian and 63,924 Nigerian respondents. Generalised linear models with quasibinomial family of distributions were fitted to investigate the association between SBA utilisation and sociodemographic factors. Despite a significant improvement in the last two decades in both countries, the change was slower than hope for, and inconsistent. Women who received antenatal care were more likely to use an SBA service. SBA service utilisation was significantly more prevalent amongst literate women in Indonesia (AOR = 1.39, 95% CI: 1.24–1.54) and Nigeria (AOR = 1.41, 95% CI: 1.31–1.53) than their counterparts. The disparity based on geographic region and social factors remained significant over time. Given the significant disparities in SBA utilisation, there is a strong need to focus on community- and district-level interventions that aim at increasing SBA utilisation.
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Galvão, Maria Helena Rodrigues, Arthur de Almeida Medeiros, and Angelo Giuseppe Roncalli. "Contextual and individual factors associated with public dental services utilisation in Brazil: A multilevel analysis." PLOS ONE 16, no. 7 (July 9, 2021): e0254310. http://dx.doi.org/10.1371/journal.pone.0254310.
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Background This study verified the association between contextual and individual factors and public dental services utilisation in Brazil. Methods The study was conducted based on a cross-sectional population-based household survey performed in Brazil (National Health Survey– 2019)). Data was collected between August 2019 and March 2020. Total sample included 43,167 individuals aged ≥15 years who had at least one dental appointment in the last 12 months before interview. Study outcome was ‘public dental service utilisation’, and Andersen’s behavioral model was adopted for selecting independent variables. A multilevel analysis was performed using individual factors as first level and federation units as second level. Results The highest prevalence of public dental service utilisation on an individual level was observed among unable to read or write people (PR: 3.31; p<0.001), indigenous (PR: 1.40; p<0.001), black or brown (PR: 1.16; p<0.001), with per capita household income of up to U$124 (PR: 2.40; p<0.001), living in the rural area (PR: 1.28; p<0.001), and who self-rated oral health as regular (PR: 1.15; p<0.001) or very bad/bad (PR: 1.26; p<0.001). On the contextual level, highest PR of public dental service utilisation was observed among those living in federal units with increased oral health coverage in primary health care. Conclusions Public dental service utilisation is associated with individual and contextual factors. These results can guide decision-making based on evidence from policymakers, demonstrating the potential for mitigating oral health inequalities and increasing service coverage in a public and universal health system.
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Preston, Neil Joseph, and Sam Fazio. "Establishing the Efficacy and Cost Effectiveness of Community Intensive Case Management of Long-Term Mentally Ill: A Matched Control Group Study." Australian & New Zealand Journal of Psychiatry 34, no. 1 (February 2000): 114–21. http://dx.doi.org/10.1046/j.1440-1614.2000.00696.x.
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Objective: The study attempted to identify whether chronic mentally ill persons after receiving intensive case management (ICM) could demonstrate improved inpatient service utilisation compared with a matched control group cohort. Costings were measured to observe whether the increase in providing intensive outpatient contacts would be offset by savings in reduced inpatient service utilisation. Method: Eighty ICM patients were matched on ICD-9 diagnosis, age, gender, length of illness, age at first inpatient and outpatient contact, marital status, educational level, employment status, country of birth, year of arrival to Australia and religion. Inpatient bed-days and outpatient contacts were recorded and compared 12 months prior to ICM treatment, 12 and 24 months after ICM using within/between group repeated measures analysis of variance. Results: The ICM group demonstrate significant reductions in inpatient service utilisation both within the 12- and 24-month period after receiving ICM treatment. The cost differential by 24 months of treatment was $801 475 in favour of the ICM model. The increase in costs of outpatient contacts were offset by a significant reduction in inpatient service utilisation. Conclusion: When outpatient contacts averaged one contact a week for the duration of the study period no significant reductions in inpatient service utilisation was recorded, as demonstrated by comparison with the matched control group. By increasing outpatient contacts by 3–4 contacts a week, inpatient contacts reduced by 36.8%. ICM is an efficacious and cost effective way to implement community-based services to the chronically long-term mentally ill.
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Coid, Donald R. "Measurement for Management: Report of a Pilot Project to Quantify Ambulance Misuse for Managers of a Fife Hospital." Health Services Management Research 2, no. 3 (November 1989): 213–16. http://dx.doi.org/10.1177/095148488900200305.
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Ambulance services appear to be under increasing pressure to provide a full range of services to the Community. It is important, therefore, that the service is appropriately utilised by patients. Health Service Managers, however, have little readily available information which identifies ‘appropriate’ utilisation. A simple technique is suggested to measure ‘appropriateness’ of utilisation of ambulances and a pilot survey of ambulance use by patients attending Dunfermline and West Fife Hospital Out-Patient clinics is described. In each case of ambulance use a panel of health professionals evaluated the ‘appropriateness’ of the patient having utilised this service. In the clinics surveyed, 91% of the sample of 328 patients did not use an ambulance to travel to clinics; in only two cases was use of the ambulance considered to be ‘probably inappropriate’. Misuse of the ambulance service was minimal during this study. Health Service Managers have been provided with some evidence to refute suggestions of substantial, inappropriate use of the ambulance service.
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Brandstetter, Susanne, David Rothfuß, Birgit Seelbach-Göbel, Michael Melter, Michael Kabesch, and Christian Apfelbacher. "Information on, knowledge and utilisation of support services during pregnancy and after childbirth: cross-sectional analyses of predictors using data from the KUNO-Kids health study." BMJ Open 10, no. 10 (October 2020): e037745. http://dx.doi.org/10.1136/bmjopen-2020-037745.
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ObjectivesTo investigate mothers’ knowledge and utilisation of antenatal and perinatal support services as well as predictors of knowledge and service utilisation.DesignCross-sectional study.SettingProspective birth cohort in Regensburg, Eastern Bavaria, Germany.Participants2455 mothers after delivery.Outcome measuresParticipants’ knowledge of distinct antenatal and perinatal support services (poor vs good, defined by median split). Participants’ use of antenatal services provided by midwife (yes, no) and of any other antenatal support services (yes, no).ResultsThe vast majority of mothers knew at least some support services. Two-thirds of women (68.4%) reported to have used the services provided by midwives. 23.6% of women reported to have used at least one of the other antenatal services. Good knowledge of services was associated with higher education (OR 1.37, 95% CI 1.13 to 1.67), no migration background (OR 2.26, 95% CI 1.76 to 2.90), better health literacy (OR 1.04, 95% CI 1.03 to 1.06), while being primiparous (OR 0.72, 95% CI 0.60 to 0.86) and being unmarried/living with a partner (OR 0.71, 95% CI 0.57 to 0.89) reduced the chance. Predictors of service utilisation differed with regard to the services considered.ConclusionsOverall, mothers had a good level of knowledge of antenatal and perinatal support services. However, we found that some groups of women were less well informed. This inequality in social predictors of knowledge of services was also partly reflected in differences in service utilisation during pregnancy.
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Becker, T., P. McCrone, G. Thornicroft, L. Loftus, M. Leese, S. Johnson, and D. Turner. "Social networks, service utilisation and service costs in South London." European Psychiatry 11 (January 1996): 263s. http://dx.doi.org/10.1016/0924-9338(96)88787-6.
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Haddison, Eposi C., Chia E. Julius, and Benjamin M. Kagina. "Health Services Utilisation before and during an Armed Conflict; Experiences from the Southwest Region of Cameroon." Open Public Health Journal 13, no. 1 (October 26, 2020): 547–54. http://dx.doi.org/10.2174/1874944502013010547.
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Introduction: Armed conflicts are a threat to the health of populations in affected areas. The threat can have several forms, such as direct injury or disruption of health service delivery and utilisation. There has been an armed conflict (Anglophone crisis) in the English-speaking regions of Cameroon since 2017. We assessed the utilisation of health services before and during the armed conflict s in the Southwest region of Cameroon. Methods: A retrospective study of surveillance data was carried out between 2016 and 2018. Regional data for selected routine immunisation, reproductive health, disease surveillance and HIV/AIDS indicators were retrieved. The data were presented as frequencies and described narratively. Results: In general, there was a difference in the utilisation of health services before and during the armed conflict. Specifically, there was an improvement in health service utilisation indicators from 2016 to 2017, followed by a decline in 2018. The DPT3 vaccination coverage dropped from 90% in 2017 to 55% in 2018; deliveries attended by qualified personnel dropped from 46% in 2017 to 26% in 2018; the absolute number of people tested for HIV dropped from 20,3987 in 2017 to 18,3654 in 2018. Conclusion: The utilisation of health services by the population of the Southwest region declined during the armed conflict. This decline could have a significant impact on the population’s health and potentially affect the set global health targets such as improved vaccination coverage in all districts. Due to the armed conflict, there were challenges with regard to accessing health services. Local, national, regional and global authorities must work together to develop risk mitigating interventions in settings with armed conflicts to preserve the delivery and utilisation of health services.
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Howarth, Ana, Morag Munro, Alf Theodorou, and Peter R. Mills. "Trends in healthcare utilisation during COVID-19: a longitudinal study from the UK." BMJ Open 11, no. 7 (July 2021): e048151. http://dx.doi.org/10.1136/bmjopen-2020-048151.
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ObjectiveThe first wave of the COVID-19 pandemic had a major impact on healthcare utilisation. The aim of this retrospective review was to quantify how utilisation of non-COVID care changed during this time so as to gain insight and inform planning of future services during potential second and subsequent waves.Methods and analysisA longitudinal design was used to analyse anonymous private UK health insurer datasets covering the period of January 2018 to August 2020. Taken as a measure of healthcare utilisation in the UK, incidence rates of claims broken down by service area and condition were calculated alongside overall monthly totals and costs. Pre-COVID-19 years were compared with the current year.ResultsHealthcare utilisation during the first wave of COVID-19 decreased by as much as 70% immediately after lockdown measures were implemented. After 2 months, the trend reversed and claims steadily began to increase, but did not reach rates seen from previous years by the end of August 2020. Assessment by service and diagnostic category showed that most areas, especially those highly reliant on in-person treatment, reflected the same pattern (ie, rapid drop followed by a steady recovery). The provision of mental health services differed from this observed trend, where utilisation increased by 20% during the first wave of COVID-19, in comparison to pre-COVID-19 years. The utilisation of maternity services and the treatment of existing cancers also stayed stable, or increased slightly, during this time.ConclusionsHealthcare utilisation in a UK-based privately insured population decreased dramatically during the first wave of the COVID-19 pandemic, being over 70% lower at its height. However, mental health services remained resilient during this time, possibly due to greater virtualisation of diagnostics and care.
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Tariku, Amare, Yemane Berhane, Alemayehu Worku, Gashaw Andargie Biks, Lars Åke Persson, and Yemisrach Behailu Okwaraji. "Health postservice readiness and use of preventive and curative services for suspected childhood pneumonia in Ethiopia: a cross-sectional study." BMJ Open 12, no. 4 (April 2022): e058055. http://dx.doi.org/10.1136/bmjopen-2021-058055.
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ObjectivePneumonia is the single-leading cause of infectious disease deaths in children under-5. Despite this challenge, the utilisation of preventive and curative child health services remains low in Ethiopia. We investigated the association between health post service readiness and caregivers’ awareness of pneumonia services, care-seeking and utilisation of pneumonia-relevant immunisation in four Ethiopian regions.Design and settingThis cross-sectional study was conducted in 52 districts of four regions of Ethiopia from December 2018 to February 2019. The health posts preparedness for sick child care was assessed using the WHO Health Service Availability and Readiness Assessment tool. Multilevel analyses were employed to examine the associations between health post readiness and household-level awareness and utilisation of services.ParticipantsWe included 165 health posts, 274 health extension workers (community health workers) and 4729 caregivers with 5787 children 2–59 months.Outcome measuresAwareness of pneumonia treatment, care-seeking behaviour and coverage of pentavalent-3 immunisation.ResultsOnly 62.8% of health posts were ready to provide sick child care services. One-quarter of caregivers were aware of pneumonia services, and 56.8% sought an appropriate care provider for suspected pneumonia. Nearly half (49.3%) of children (12–23 months) had received pentavalent-3 immunisation. General health post readiness was not associated with caregivers’ awareness of pneumonia treatment (adjusted OR, AOR 0.9, 95% CI 0.7 to 1.1) and utilisation of pentavalent-3 immunisation (AOR=1.2, 95% CI 0.8 to 1.6), but negatively associated with care-seeking for childhood illnesses (AOR=0.6, 95% CI 0.4 to 0.8).ConclusionWe found no association between facility readiness and awareness or utilisation of child health services. There were significant deficiencies in health post preparedness for services. Caregivers had low awareness and utilisation of pneumonia-related services. The results underline the importance of enhancing facility preparedness, providing high-quality care and intensifying demand generation efforts to prevent and treat pneumonia.
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Kavanagh, Shane, and Martin Knapp. "Cognitive disability and direct care costs for elderly people." British Journal of Psychiatry 174, no. 6 (June 1999): 539–46. http://dx.doi.org/10.1192/bjp.174.6.539.
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BackgroundPopulation ageing and the high costs of care support for elderly people have concentrated attention on economic issues. Is there an association between costs and cognitive disability?AimsTo compare service utilisation and direct costs for elderly people with different degrees of cognitive disability, and between people living in households and in communal establishments.MethodSecondary analysis of Office of Population Censuses and Surveys (OPCS) Disability Surveys data compared service utilisation and costs for 8736 elderly people with cognitive disability. Cost estimates were constructed for all health and social care services.ResultsA much greater proportion of people at higher levels of cognitive disability lived in communal establishments, where their (direct) costs were much higher than when supported in households. Service utilisation patterns and costs varied with cognitive disability.ConclusionsIt is important to look at the full range of living arrangements and support services when examining costs. The potential cost implications of pharmacotherapies, other treatments or new care arrangements cannot be appreciated without such a broad perspective.
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Yadav, Akhilesh, T. B. Singh, and Shikha Sachan. "Prevalence of Disrespect and Abuse and its Determinants during Antenatal Care Services in Rural Uttar Pradesh India." International Journal of Health Sciences and Research 12, no. 2 (February 16, 2022): 115–24. http://dx.doi.org/10.52403/ijhsr.20220216.
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Background: Respectful maternity care is essential to increase safe motherhood, linked with increased maternal health services utilization, such as ANC (Antenatal Care). However, disrespect and abuse during maternal health care service utilisation remain a potential barrier to improve service utilisation and the quality of services. Objective: This study aims to estimate the prevalence of disrespect and abuse (D&VA) during the utilisation of ANC services and identifies the associated factors. Methodology: A community based cross-sectional survey was conducted in the Balarampur district of Uttar Pradesh, India. The study included 364 women who underwent facility-based childbirth before six months of the survey. A multistage cluster sampling was used to select the potential participants of the study. Results: the findings of the study show that nearly 60% of women experienced disrespect and abuse during ANC services utilisation. About 18% of women reported that the health providers were rude to them. Also, 1.5% of women reported that health providers used abusive language during the ANC services utilisation. Women aged 25-34 years and 35 and above years were 54 % and 69 % less likely to experience disrespect and abuse respectively than women aged 15-24 Years. Low odds of disrespect and abuse was observed with other backward, and General caste than the women belong to Scheduled tribe/caste. Women who experience disrespect and abuse during ANC services were less likely to receive all four types of ANC services. Conclusions: Every woman has the right to receive kind and respectful maternity care, and mistreatment during maternal care services remains hindrances to achieving safe motherhood and child care. Key words: Disrespect and Abuse, Maternity Care, Antenatal Care Services, India.
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Mac-Seing, Muriel, Kate Zinszer, Charity Oga Omenka, Pierre de Beaudrap, Fereshteh Mehrabi, and Christina Zarowsky. "Pro-equity legislation, health policy and utilisation of sexual and reproductive health services by vulnerable populations in sub-Saharan Africa: a systematic review." Global Health Promotion 27, no. 4 (August 4, 2020): 97–106. http://dx.doi.org/10.1177/1757975920941435.
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Twenty-five years ago, the International Conference on Population and Development highlighted the need to address sexual and reproductive health (SRH) rights on a global scale. The sub-Saharan Africa region continues to have the highest levels of maternal mortality and HIV, primarily affecting the most vulnerable populations. Recognising the critical role of policy in understanding population health, we conducted a systematic review of original primary research which examined the relationships between equity-focused legislation and policy and the utilisation of SRH services by vulnerable populations in sub-Saharan Africa. We searched nine bibliographic databases for relevant articles published between 1994 and 2019. Thirty-two studies, conducted in 14 sub-Saharan African countries, met the inclusion criteria. They focused on maternal health service utilisation, either through specific fee reduction/removal policies, or through healthcare reforms and insurance schemes to increase SRH service utilisation. Findings across most of the studies showed that health-related legislation and policy promoted an increase in service utilisation, over time, especially for antenatal care, skilled birth attendance and facility-based delivery. However, social health inequalities persisted among subgroups of women. Neither the reviewed studies nor the policies specifically addressed youth, people living with HIV and people with disabilities. In the era of the sustainable development goals, addressing health inequities in the context of social determinants of health becomes unavoidable. Systematic and rigorous quantitative and qualitative research, including longitudinal policy evaluation, is required to understand the complex relationships between policy addressing upstream social determinants of health and health service utilisation.
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Vostanis, Panos, Howard Meltzer, Robert Goodman, and Tasmin Ford. "Service utilisation by children with conduct disorders." European Child & Adolescent Psychiatry 12, no. 5 (October 1, 2003): 231–38. http://dx.doi.org/10.1007/s00787-003-0330-6.
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Beaney, Thomas, Jonathan Clarke, Thomas Woodcock, Rachel McCarthy, Kavitha Saravanakumar, Mauricio Barahona, Mitch Blair, and Dougal S. Hargreaves. "Patterns of healthcare utilisation in children and young people: a retrospective cohort study using routinely collected healthcare data in Northwest London." BMJ Open 11, no. 12 (December 2021): e050847. http://dx.doi.org/10.1136/bmjopen-2021-050847.
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ObjectivesWith a growing role for health services in managing population health, there is a need for early identification of populations with high need. Segmentation approaches partition the population based on demographics, long-term conditions (LTCs) or healthcare utilisation but have mostly been applied to adults. Our study uses segmentation methods to distinguish patterns of healthcare utilisation in children and young people (CYP) and to explore predictors of segment membership.DesignA retrospective cohort study.SettingRoutinely collected primary and secondary healthcare data in Northwest London from the Discover database.Participants378 309 CYP aged 0–15 years registered to a general practice in Northwest London with 1 full year of follow-up.Primary and secondary outcome measuresAssignment of each participant to a segment defined by seven healthcare variables representing primary and secondary care attendances, and description of utilisation patterns by segment. Predictors of segment membership described by age, sex, ethnicity, deprivation and LTCs.ResultsParticipants were grouped into six segments based on healthcare utilisation. Three segments predominantly used primary care, two moderate utilisation segments differed in use of emergency or elective care, and a high utilisation segment, representing 16 632 (4.4%) children accounted for the highest mean presentations across all service types. The two smallest segments, representing 13.3% of the population, accounted for 62.5% of total costs. Younger age, residence in areas of higher deprivation and the presence of one or more LTCs were associated with membership of higher utilisation segments, but 75.0% of those in the highest utilisation segment had no LTC.ConclusionsThis article identifies six segments of healthcare utilisation in CYP and predictors of segment membership. Demographics and LTCs may not explain utilisation patterns as strongly as in adults, which may limit the use of routine data in predicting utilisation and suggest children have less well-defined trajectories of service use than adults.
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Pershouse, Kiley, Pim Kuipers, Delena Amsters, and Glenda Price. "Responding to the Health and Disability Service Needs of People Ageing with Spinal Cord Injury: Implications from an Australian Study." Australian Journal of Primary Health 12, no. 1 (2006): 65. http://dx.doi.org/10.1071/py06010.
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In the course of a large retrospective research study exploring implications of ageing with a spinal cord injury (SCI), 84 participants were asked to provide responses to a brief telephone questionnaire regarding the nature and quality of their utilisation of various health and disability services. The aim of this study was to explore service utilisation, level of satisfaction with the services utilised, and the nature of the support received from these services for a sample of people ageing with spinal cord injury (SCI). Findings highlighted that people ageing with SCI have need of a range of health and disability services predominantly focusing on achieving instrumental assistance. Satisfaction with service was generally high and demonstrated the importance of interpersonal communication skills, technical competence and responsiveness in the delivery of outcomes.
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Mahmood, M. Afzal, Anna E. Bauze, Justin T. Lokhorst, Peng Bi, and Arthur Saniotis. "Influence of living arrangements on health services utilisation in Australia." Australian Health Review 36, no. 1 (2012): 34. http://dx.doi.org/10.1071/ah10920.
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Background. The number of people living alone is increasing markedly. Others live as couples only, couples with child(ren) and single adult with child(ren). Health service utilisation could differ for people in different living arrangements as a result of varying levels of risk factors, health status, access to informal care and decision-making for accessing care. Objective. To identify the association between living arrangements and health service use. Methods. The Australian Bureau of Statistics’ National Health Survey 2001 data for people 18–65 years old were analysed for household composition and service use. Results. People in various household types differ in terms of their overall use of health services and their use of services by general practitioners. Sex, rurality, socioeconomic status and status of heart condition significantly influenced the use of health services. Conclusion. There are implications for health services provision and planning within the context of rapid changes in living arrangements. Additional research is required to explore the reasons to such differences, level of access to informal care, healthcare decision-making processes and consequences of under- or over-utilisation of services. What is known about the topic? Health service use is influenced by the disease burden and pattern, demography, economic factors, access to social support, quality of care and satisfaction with standards of care. These factors may influence access to and use of care. What does this paper add? This research points to the potential role of living arrangements on health services use. Many people now live alone and may not have access to informal care, and access to health information and education. People in different living arrangements appear to have different health service use. What are the implications for practitioners? Practitioners, in both primary care and acute care sectors, need to consider that patients, including younger people, may not have access to informal care, may present with delays and may not have the needed adequate support during convalescence. Health education needs to consider that people in different living arrangements may be exposed to different levels of risk factors in terms of their healthcare use.
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Singh, Neha S., Sarindi Aryasinghe, James Smith, Rajat Khosla, Lale Say, and Karl Blanchet. "A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises." BMJ Global Health 3, no. 2 (May 2018): e000682. http://dx.doi.org/10.1136/bmjgh-2017-000682.
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IntroductionWomen and girls are affected significantly in both sudden and slow-onset emergencies, and face multiple sexual and reproductive health (SRH) challenges in humanitarian crises contexts. There are an estimated 26 million women and girls of reproductive age living in humanitarian crises settings, all of whom need access to SRH information and services. This systematic review aimed to assess the utilisation of services of SRH interventions from the onset of emergencies in low- and middle-income countries.MethodsWe searched for both quantitative and qualitative studies in peer-reviewed journals across the following four databases: EMBASE, Global Health, MEDLINE and PsychINFO from 1 January 1980 to 10 April 2017. Primary outcomes of interest included self-reported use and/or confirmed use of the Minimum Initial Service Package services and abortion services. Two authors independently extracted and analysed data from published papers on the effect of SRH interventions on a range of SRH care utilisation outcomes from the onset of emergencies, and used a narrative synthesis approach.ResultsOf the 2404 identified citations, 23 studies met the inclusion criteria. 52.1% of the studies (n=12) used quasi-experimental study designs, which provided some statistical measure of difference between intervention and outcome. 39.1% of the studies (n=9) selected were graded as high quality, 39.1% moderate quality (n=9) and 17.4% low quality (n=4). Evidence of effectiveness in increasing service utilisation was available for the following interventions: peer-led and interpersonal education and mass media campaigns, community-based programming and three-tiered network of community-based reproductive and maternal health providers.ConclusionsDespite increased attention to SRH service provision in humanitarian crises settings, the evidence base is still very limited. More implementation research is required to identify interventions to increase utilisation of SRH services in diverse humanitarian crises settings and populations.
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Lee, Ye-Seul, In-Seon Lee, Song-Yi Kim, Hyangsook Lee, Hi-Joon Park, Hyejung Lee, Sung-Hoon Kim, and Younbyoung Chae. "Identification of Determinants of the Utilisation of Acupuncture Treatment Using Andersen's Behavioural Model." Acupuncture in Medicine 33, no. 2 (April 2015): 129–35. http://dx.doi.org/10.1136/acupmed-2014-010661.
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Objectives The utilisation of healthcare services is the result of a complex decision-making process with different determinants. This study aims to identify the determinants of the utilisation of acupuncture treatment using Andersen's behavioural model and quality of life. Methods In this study we reviewed Korean Health Panel data, a nationally representative set of data, and analysed the utilisation of outpatient acupuncture services during 2011. A two-part model, which included predisposing, enabling and need factors of Andersen's behavioural model in model 1 and the additional factor of health-related quality of life (HRQOL, EQ-5D Korean index) in model 2, was analysed by logistic analysis to identify determinants of acupuncture service usage among subjects who visited traditional Korean medical clinics. Results The higher frequency of acupuncture service usage among patients who visited traditional Korean medical clinics was associated with gender, age, number of chronic diseases, physical disabilities and HRQOL of the subjects. Conclusions This study shows that the important determinants of the frequency of acupuncture treatment utilisation are gender, age, number of chronic diseases and the presence of physical disabilities. Our findings contribute to understanding the characteristics of patients who use acupuncture treatment and may be used as a basic resource for related policy making by government officials and medical professionals.