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Letteratura scientifica selezionata sul tema "Health services utilisation"

Autore: Grafiati

Pubblicato: 4 giugno 2021

Ultima modifica: 1 febbraio 2022

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Articoli di riviste sul tema "Health services utilisation"

Xu, Jianqiang, Juan Zheng, Lingzhong Xu e 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, n. 2 (12 gennaio 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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McCrone, Paul, Graham Thornicroft, Michael Phelan, Frank Holloway, Til Wykes e Sonia Johnson. "Utilisation and costs of community mental health services". British Journal of Psychiatry 173, n. 5 (novembre 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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Darma, Azri, Hidayati Hidayati e 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, n. 2 (31 luglio 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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Nolan, Brian. "Economic incentives, health status and health services utilisation". Journal of Health Economics 12, n. 2 (luglio 1993): 151–69. http://dx.doi.org/10.1016/0167-6296(93)90025-a.

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Alkhawaldeh, Abdullah. "Factors associated with utilisation of university health centre services by students". International Journal Of Community Medicine And Public Health 4, n. 6 (22 maggio 2017): 1858. http://dx.doi.org/10.18203/2394-6040.ijcmph20172145.

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Background: Little is known about the factors that are associated with students’ utilisation of university health centre services. The current study examines factors associated with utilisation of university health centre services by students.Methods: Data were collected from 440 university students using a cross-sectional study design and self-reported questionnaire.Results: University health centre services were utilised by 147 (39.5%) of the students in the past 6 months. Utilisation of university health centre services was associated with gender, faculty, tobacco use and chronic illnesses. The main predictor of university health centre services utilisation at 6 months was chronic illnesses (OR=4.205).Conclusions: Although several factors were associated with university health centre services utilisation, chronic illness was the most important predictor.

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Skinner, Elizabeth H., Michele Foster, Geoffrey Mitchell, Michele Haynes, Martin O'Flaherty e Terry P. Haines. "Effect of health insurance on the utilisation of allied health services by people with chronic disease: a systematic review and meta-analysis". Australian Journal of Primary Health 20, n. 1 (2014): 9. http://dx.doi.org/10.1071/py13092.

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Allied health services benefit the management of many chronic diseases. The effects of health insurance on the utilisation of allied health services has not yet been established despite health insurance frequently being identified as a factor promoting utilisation of medical and hospital services among people with chronic disease. The objective of this systematic review and meta-analysis was to establish the effects of health insurance on the utilisation of allied health services by people with chronic disease. Medline (Ovid Medline 1948 to Present with Daily Update), EMBASE (1980 to 1 April 2011), CINAHL, PsychINFO and the Cochrane Central Register of Controlled Trials were searched to 12 April 2011 inclusive. Studies were eligible for inclusion if they were published in English, randomised controlled trials, quasi-experimental trials, quantitative observational studies and included people with one or more chronic diseases using allied health services and health insurance. A full-text review was performed independently by two reviewers. Meta-analyses were conducted. One hundred and fifty-eight citations were retrieved and seven articles were included in the meta-analyses. The pooled odds ratio (95% CI) of having insurance (versus no insurance) on the utilisation of allied health services among people with chronic disease was 1.33 (1.16−1.52; P < 0.001). There was a significant effect of insurance on the utilisation of non-physiotherapy services, pooled odds ratio (95% CI) 4.80 (1.46−15.79; P = 0.01) but having insurance compared with insurance of a lesser coverage was not significantly associated with an increase in physiotherapy utilisation, pooled odds ratio (95% CI) 1.53 (0.81−2.91; P = 0.19). The presence of co-morbidity or functional limitation and higher levels of education increased utilisation whereas gender, race, marital status and income had a limited and variable effect, according to the study population. The review was limited by the considerable heterogeneity in the research questions being asked, sample sizes, study methodology (including allied health service), insurance type and dependent variables analysed. The presence of health insurance was generally associated with increased utilisation of allied health services; however, this varied depending on the population, provider type and insurance product.

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Haddison, Eposi C., Chia E. Julius e Benjamin M. Kagina. "Health Services Utilisation before and during an Armed Conflict; Experiences from the Southwest Region of Cameroon". Open Public Health Journal 13, n. 1 (26 ottobre 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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Chen, Jiaqi, Song Xu e 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, n. 5 (9 marzo 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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Mahmood, M. Afzal, Anna E. Bauze, Justin T. Lokhorst, Peng Bi e Arthur Saniotis. "Influence of living arrangements on health services utilisation in Australia". Australian Health Review 36, n. 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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Buckley, Dermot, e Tony Lower. "Factors influencing the utilisation of health services by rural men". Australian Health Review 25, n. 2 (2002): 11. http://dx.doi.org/10.1071/ah020011.

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This research identified the barriers and enablers that influence the utilisation of health services by rural men in the Midwest region of Western Australia. The methodology was based on participatory action research, including qualitative assessments to determine the issues for a larger quantitative study. Four variables were identified as predictors for the use of health services: those who attended for preventive reasons; those not affected by seasonal work;men who thought a medical telephone line was not important; and those who did not consider privacy an important issue. Modification of health service delivery to men could potentially enhance appropriate utilisation of health services in rural areas.

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Più fonti

Tesi sul tema "Health services utilisation"

Treanor, Charlene Jennifer. "The health status and utilisation of health services by cancer survivors with late effects". Thesis, Queen's University Belfast, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.603428.

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The number of cancer survivors is increasing. Knowledge gaps exist regarding the health of survivors and their use of services, particularly survivors with long-term effects of the disease and treatment, including late effects. This PhD study comprised (i) a systematic review of health service utilisation by cancer survivors; (ii) a population-based comparative survey of the health status and service utilisation of cancer survivors and a matched General Practice population; (iii) an overview of reviews of late effects; (iv) a comparative analysis of cancer survivors with self-reported late effects and survivors without late effects in terms of their health status and services utilisation patterns and; (v) a qualitative study of the narrative of cancer survivors with late • effects. The health service utilisation review identified that increasing age was associated with less care and increased hospitalisations. Improved care receipt was dependent on type and frequency of physician contact which facilitated health service use. Survivors were generally higher service users and received more care than the general population- this finding concurs with results of the survey. Survivors also had significantly poorer health than the general population. The presence of co-morbidities was associated with less service receipt, though the survey found that survivors with late effects were high users of care and experienced poorer health than their counterparts without late effects. There was general I SUMMARY 2 - PAGE 3 - agreement that physical late effects tend to emerge some time post-treatment, but there was -- less agreement regarding the onset of psychological late effects. Late effects impacted on many aspects of survivors' lives and were managed in many ways. The main emergent themes from the qualitative analysis were: sense-making, social comparisons and psychology of the individual. Care recommendations and implementation of preventive care plans would facilitate receipt of appropriate care and improve health for survivors including those with late effects.

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Johansson, Birgitta. "Intensified primary health care for cancer patients : Utilisation of medical services". Doctoral thesis, Uppsala University, Department of Public Health and Caring Sciences, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-512.

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The aim of the present thesis is to evaluate the effects of an Intensified Primary Health Care (IPHC) intervention on GPs' and home care nurses' possibilities to monitor and support cancer patients, and on cancer patients utilisation of medical services. A further aim is to identify determinants of cancer patients' utilisation of such services. A total of 485 patients newly diagnosed with breast, colorectal, gastric or prostate cancer were randomised to the intervention or to a control group. The follow-up period was 24 months for all patients.

Patients randomised to the IPHC were referred to the home care nurse. The home care nurse and the GP received copies of the medical record each time the patient was discharged from hospital after a period of in-patient care, or had visited a specialist out-patient clinic. In addition to this, recurrent education and supervision in cancer care were arranged.

The IPHC resulted in a marked increase of home care nurse follow-up contacts. The majority of control patients (74%) reported no such contacts, while 89% of IPHC patients reported this. High age (=80 yr) was the strongest predictor within the IPHC group for reporting a continuing home care nurse contact. Furthermore, the IPHC increased GPs' knowledge about patients' disease and treatments, and appeared to facilitate their possibilities to support the patients. The IPHC reduced the utilisation of specialist care among elderly cancer patients. The number of days of hospitalisation for older patients (=70 yr) randomised to the IPHC were 393 less than for older control patients during the 3 first months after inclusion. Regression analyses defined diagnosis, extensive treatment, comorbidity, low functional status, pain and socio-economic factors as predictors of a high utilisation of medical services.

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Bayer, Jordana. "Critical factors contributing to under-utilisation of professional mental health services /". Title page, table of contents and abstract only, 1990. http://web4.library.adelaide.edu.au/theses/09ARPS/09arpsb357.pdf.

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Roberts, Nicola. "Using attachment theory within mental health community services to improve patient outcomes and reduce service utilisation costs". Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/using-attachment-theory-within-mental-health-community-services-to-improve-patient-outcomes-and-reduce-service-utilisation-costs(78a9832e-0e8f-4d2b-a6a4-8d7ffdf5aa6d).html.

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This thesis follows the paper-based format and papers one and two have been prepared for submission to Attachment and Human Development and the British Journal of Clinical Psychology, respectively. The relevant submission guidelines are included in the appendices (Appendix A and B).Attachment theory (Bowlby, 1977a) has prompted a wealth of empirical research in its contribution to adult attachment patterns and subsequent psychopathology in mental health (Holmes, 2001; Wallin, 2007). More recently, attachment theory has been proposed as a suitable framework by which to inform the organisation, design and delivery of mental health services (Goodwin, 2003; Seager et al., 2007) but it is unclear what this would look like in practice. Adopting an attachment-informed service model has key implications for individual and service outcomes and the two papers presented in this thesis aim to contribute to research in this area, followed by a critical review of the research, its relevance and future implications. Paper one is a narrative overview of the literature discussing the practice implications of services adopting an attachment-informed framework, and describes how this might be conceptualised in front-line service delivery. Articles reviewed described the influence of attachment theory in predominantly inpatient, secure forensic and/or psychiatric rehabilitation services, and its application within more generic community mental health services was explored. Paper two aimed to investigate the importance of individual attachment and service attachment to client psychopathology, quality of life, service utilisation and service costs in community-based mental health services. The final section, the Critical Review, critiqued the literature review and aimed to place the research within a wider context. This section considers the findings from the research and the limitations of the study, while also highlighting important issues for services, with implications for clinical practice and future research.

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Rahman, Syed Azizur. "Utilisation of primary health care services in rural Bangladesh : the population and provider perspectives". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2001. http://researchonline.lshtm.ac.uk/682288/.

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This thesis is about the Utilisation of Maternal and Child Health Care Services (MCH) in Rural Bangladesh. Investigations have been made to identify the underlying causes of low use of the MCH services provided through the public sector health care facilities, which is a major concern for the government of Bangladesh. This thesis focuses on the factors that are affecting the use of MCH services both from population and provider perspectives. Socio-economic condition of people, their knowledge and attitudes towards the public sector health care services are considered as population factors, while different aspects of quality of public health services, access to the service facilities and provider's behaviour are explored as the providers' factors. Aims: The aim of this research was to provide policy recommendations for improving utilisation of the public health services at the primary health care level by redesigning more accessible, acceptable and quality health care services, especially for rural women and children. Scope: Maternal health services: antenatal care; tetanus vaccination; place of child delivery; and postnatal care are considered in this study. While two major killer diseases: diarrhoea and acute respiratory infections, and immunisation of children under five years of age are included as child health care services. Methods: A combination of qualitative and quantitative methods are used to collect data /information from 360 mothers, 28 formal and informal community leaders, 44 various types of health care providers and 22 public sector facilities in a rural area of Bangladesh. The World Health Organisation (WHO) recommended 30 cluster sampling method was used in sample design. Household survey, in-depth interview, informal and formal discussion, participant observation and document analysis have been carried out to obtain necessary information/data. Data analyses: The quantitative data have been analysed by using STATA and SPSS statistical computer programme, performing descriptive, bivariate and logistic regression analysis. The qualitative information has been analysed in a descriptive way. Results: The results show that the use of government health facilities: THC, FWC and VHCP is generally very low with an exception of the use of VHCP for TT vaccination to women and child immunisation. The use of VHCP is encouraging for the government policy makers and planners. THC is partially meeting the health care need of rural people and mainly serving the interest of people of relatively high socio-economic condition. FWC is the most unused health care facility at the rural areas of Bangladesh. The majority of people (86%) received health care from non - qualified health care providers. Among the socio-economic factors - family education and income were found to be significant both individually and jointly with the variations of use of MCH services. The majority of the sample population does not have knowledge about the MCH service availability and possessed negative attitudes towards the public sector MCH services. These are attributable to the under utilisation problem. Nine gaps have been identified between peoples' `reasonable expectation' and the `existing' MCH service delivery system. Peoples' involvement in the health service organisation at the thana and union level was found almost nil. However their involvement in the operation of VHCP was encouraging. Low (2-3 minutes) consultation time, lack of privacy in treatment, unregulated involvement of public sector provider in private practice, lack of accountability, supervision and improper behaviour of providers deteriorating the quality of services hence decreases the use of public sector facilities. Unavailability of drug was found to be the single most important reason that deters people from using public facilities. Difficulties in access to quality services were found to be a major problem than access to the service facilities. Conclusions: This thesis suggests that giving priority to improving the service qualities of the existing facilities rather than construction/development of additional facilities at PHC level. It also suggests the initiation of behaviour change programmes for public sector health care providers. Secondly an effective mechanism needs to be developed to ensure peoples' involvement in the management and operation of public health care facilities to enhance accountability of public sector provider to the population and reduce the gap between them. Initiatives could be taken to improve the quality of non-qualified health care providers, as they are the main source of health care for the majority of population. Finally, increasing the education level of rural population particularly for women could increase the use of health services.

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Manthalu, Gerald Herbert. "The impact of user fee exemption on maternal health care utilisation and health outcomes at mission health care facilities in Malawi". Thesis, University of Aberdeen, 2014. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=214843.

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The Government of Malawi has entered into agreements with Christian health association of Malawi (CHAM) health care facilities in order to exempt their catchment populations from paying user fees. These agreements are called service level agreements (SLAs). Government in turn reimburses the CHAM health care facilities for the health services that they provide. The agreements started in 2006 with 28 out of 166 CHAM health care facilities and increased to 68 in 2010. The aim of the exemption policy is to guarantee universal access to a basic package of health care services. Although the agreements were designed to cover every health service in the basic health care package, only maternal and neonatal health services are included due to limited resources. The main objective of this thesis was to evaluate the impact of the health care financing change on health care utilisation and health. The specific objectives were as follows: first, to examine whether health care facility visits for maternal health care changed due to user fee exemption; second, to evaluate whether user fee exemption affected the choice of the health care provider where women living in the catchment areas of CHAM health care facilities with user fee exemption sought maternal health care; third, to analyse the effect of user fee exemption on birth weight and; fourth, to explore and apply novel methods in the evaluation of user fee exemption. The gradual uptake of service level agreements by CHAM health care facilities provided a natural experiment with treated and control health care facilities. An additional control group comprised of other demographic groups apart from pregnant women and neonates at CHAM health care facilities with service level agreements. In household survey data, individuals were assigned to treatment and control groups based on their proximity to either a CHAM health care facility with SLA or a CHAM health care facility without SLA. This proffered the unique opportunity to estimate the effect of a single treatment on multiple outcomes. The difference-in-differences (DiD) approach was used to obtain causal effects of user fee exemption. It was implemented in the context of fixed effects, switching regression and multinomial logit models across different chapters. Health care facility level panel data for utmost 146 health care facilities for a maximum of 8 years, 2003-2010, were used. The data were obtained from the Malawi health management xiii information system (HMIS). Linked survey data were also used. Malawi demographic and survey data for 2004 and 2010 were linked to health care facility data and then merged. Analyses that utilised health care facility data showed that user fee exemption had led to increases in first antenatal care visits in the first trimester, first antenatal care visits in any trimester, average antenatal care visits and deliveries at CHAM health care facilities with SLAs. Results from survey data showed that the probability of using a CHAM health care facility with user fee exemption for antenatal care increased, the probability of using home antenatal care declined and the probability of not using antenatal care also declined due to user fee exemption. The probability of delivering at a CHAM health care facility with SLA also increased while the probability of delivering at home declined. User fee exemption did not affect the choice of where to go for postpartum care. Results of the effect of user fee exemption on birth weight were not reported because of potential endogeneity bias arising from lack of instrumental variables for antenatal care. The key policy messages from this thesis are that the user fee exemption policy is an important intervention for increasing the utilisation of maternal health care and needs to be extended to as many CHAM health care facilities as necessary. User fee exemption is not enough, however. Other factors such as education of the woman and her husband/partner, wealth status and cultural factors are also important. This thesis has contributed to the body of knowledge in the following ways. First, it has generated evidence on the impact of user fee exemption on maternal health care utilisation and birth weight in Malawi. Second, with respect to maternal health care utilisation, the thesis has looked at variables that capture the whole maternal health care process from early pregnancy to postpartum care and in a policy relevant way. Third, the thesis has evaluated the effect of user fee exemption on a variable that have not been looked at before, first antenatal care visits in the first trimester. Fourth, the thesis has examined the effect of a single treatment on multiple outcomes in a methodologically unique way. Treatment effects, which were the changes in the probabilities of using different alternatives summed up to zero, thus showing where any increase in the probability of using the outcome of interest came from. Fifth, this thesis is first to use disequilibrium theory of demand and supply in health economics. Application of this theory entailed using switching regression models with unknown sample separation, a seldom used estimation method in health economics. This was an important contribution to the methods xiv of analysing aggregate health care utilisation. Sixth, the STATA program that was written for the estimation of the disequilibrium models was itself a very important contribution to the methods for estimating aggregate supply and demand.

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Ibrahim, Ghada. "The role of the health system in women's utilisation of maternal health services in Sudan". Thesis, City, University of London, 2015. http://openaccess.city.ac.uk/17079/.

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Background: Maternal mortality and morbidity still pose a significant challenge in Sudan, where no significant improvements in maternal health have been achieved despite the focus on the Millennium Development Goals. Under-utilisation is a major public health concern even though Sudan is among the African countries that have registered poor maternal and child health. Health services in Sudan are generally limited and with poor quality and disparate access. Therefore, there is a need for better understanding of the barriers to the provision and utilisation of maternal health services in order to improve the health and survival of Sudanese mothers. Objectives: This study sought to assess the maternal health system functions and influences on utilisation as well as the social, cultural, and women’s characteristics that may constitute barriers to utilisation. Methodology: The study used an explanatory sequential mixed-methods design. A comprehensive analysis was conducted using several quantitative and qualitative data sets, guided by a new framework, the Maternal Health System Performance framework (MHSP) developed as part of this work in order to assess both the three objectives and four functions of the health system on both macro and micro levels. Findings: The study findings provide clear evidence that the Sudan health system is not currently capable of achieving an adequate level of attainment of the health goals or equitable distribution, due to dysfunction of the four health system functions. In addition, the findings draw attention to the important role of the stewardship function in health system performance. This function can play a key role in health system reform, as it influences management of the health system and should work across all elements of the system to ensure a well-functioning health system and efficient use of resources. The findings also underline the important role of health system related factors rather than simply population factors (such as individual, household, and community factors) in the low service utilisation among women in poor settings. While it shows that certain population characteristics such as household income and education do have a significant impact on the utilisation, the health system functions, and in particular the stewardship function, are also demonstrated to be of considerable importance. Implication: These findings have implications for policy and practice, indicating that simply blaming women for not using maternal health services is unhelpful and inappropriate and indicate that decision makers should focus more fully on improving the performance of the health system. According to the comprehensive assessment of the health system performance, the study proposes several recommendations for each health system function to enhance the performance in the context of limited resources, ultimately to improve women’s and community health in Sudan.

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Matizirofa, Lyness. "Perceived quality and utilisation of maternal health services in peri-urban, commercial farming, and rural areas in South Africa". Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&amp.

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This investigation aimed to determine factors that influence women's utilisation of maternal health services, with specific focus on the quality of care and services available to disadvantaged communities in South Africa. It used the women's perspectives to assess the quality of maternal healthcare services in peri-urban commercial farming and rural areas with the purpose of understanding why women utilise maternal services the way they do.

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Idris, Deeni Rudita. "Health help seeking behaviour and health care services utilisation of Bruneian men : a grounded theory study". Thesis, Durham University, 2017. http://etheses.dur.ac.uk/12438/.

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Despite the growth in research on masculinities and health help seeking behaviour we have little idea of how gender and ethnicity intersect to inform health help seeking behaviour among men in multi-ethnic cultures. This paper presents findings from a PhD research project investigating how being a man in Brunei Darussalam, a country with a strong religious and diverse cultural society; influences men’s perceptions of and attitudes towards their health and health help seeking behaviour. Using Grounded Theory, this thesis reports a study that utilised semi structured interviews and focus group discussions with a total of 47 men and women from diverse ethnic backgrounds in Brunei Darussalam. Three key themes emerged from the analysis of interviews with men: 1) The physicality of health and its importance to masculinity; 2) “Ikhtiar” as a way of ‘doing masculinity’ in the context of experiences of ill-health; and 3) masculinity and legitimation of health help seeking. A core concept found in this study relates to the process by which men operate and re-negotiate their masculinity in relation to their engagement with health care services, particularly when their ability to perform masculine responsibilities are potentially jeopardised by ill-health. Themes emerging from interviews with women focused on the relationship between wives and husbands, and daughters and fathers, and the way caring responsibilities reinforced bonds within the family. Women saw men’s reluctance to use healthcare as ‘normal for men’, while men acknowledged that pressure from wives was a factor in their decision to seek help. This study contributes to the development of knowledge about masculinities and health in a geographical region where to date there has been no empirical research, despite the existence of epidemiological evidence indicating that men’s health needs are serious and appear to be unmet.

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Toan, Ngo Van. "Utilisation of health services in a transitional society : studies in Vietnam 1991-1999 /". Stockholm, 2001. http://diss.kib.ki.se/2001/91-628-4812-7/.

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Libri sul tema "Health services utilisation"

Health services utilisation in urban India: A study. Delhi, India: Mittal Publications, 1988.

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Nolan, Brian. The utilisation and financing of health services in Ireland. Dublin: Economic and Social Research Institute, 1991.

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Durkan, Joe. Health services utilisation in Britain: An empirical analysis using microdata. Dublin: University College Dublin. Centre for Economic Research, 1996.

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Durkan, Joe. Health services utilisation in the UK: An empirical analysis using microdata. Maynooth, Co Kildare: Maynooth College, Economics Department, 1996.

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Inganji, Francis. Health information system for effective utilisation of primary health care services and facilities in Botswana. [Gaborone]: Republic of Botswana, Ministry of Health, 1986.

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Shariff, Abusaleh. Determinants of maternal health care utilisation in India: Evidence from a recent household survey. New Delhi: National Council of Applied Economic Research, 2002.

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Enquête mortalité, morbidité et utilisation des services EMMUS-III, Haïti 2000. Pétionville, Haïti: Institut haïtien de l'enfance ; Calverton, Maryland, USA, 2001.

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Saili, Charmina. Strengthening the utilisation of quality reproductive health services in Samoa: Country brief. Samoa]: United Nations Population Fund (UNFPA), 2001.

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Imasiku, H. L. A study of factors contributing to the low utilisation of institutional based delivery services in Kalabo District. Kalabo [Zambia]: Kalabo District Health Board, 1999.

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Mutemwa, Susan. Research report on the study of factors contributing to low utilisation of safe motherhood programmes in Chadiza District. Lusaka?: s.n., 1999.

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Capitoli di libri sul tema "Health services utilisation"

Acheampong, George, e Solomon Yaw Agyeman-Boaten. "Utilisation and Pricing of Healthcare Services". In Health Service Marketing Management in Africa, 81–93. New York : Routledge, 2020.: Productivity Press, 2019. http://dx.doi.org/10.4324/9780429400858-8.

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Palmer, George R., e Maria Theresa Ho. "The Macroeconomics of Health Services: Health Expenditure, Financing and Utilisation". In Health Economics, 74–93. London: Macmillan Education UK, 2008. http://dx.doi.org/10.1007/978-1-137-06725-8_6.

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Bamisaiye, A. "Utilisation of child health services in developing countries". In Child Health in the Tropics, 309–19. Dordrecht: Springer Netherlands, 1985. http://dx.doi.org/10.1007/978-94-009-5012-2_31.

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Alam, Moneer. "Utilisation of Public Health Facilities: A Situational Assessment". In Paying Out-of-Pocket for Drugs, Diagnostics and Medical Services, 121–40. New Delhi: Springer India, 2013. http://dx.doi.org/10.1007/978-81-322-1281-2_7.

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Rai, Bina. "Pattern and Utilisation of Maternal and Child Health Services in Nepal". In Population Dynamics in Contemporary South Asia, 87–110. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-15-1668-9_4.

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Alam, Moneer. "Self-Reported Ailments and Hospitalisation: Differentials in Utilisation of Health Care". In Paying Out-of-Pocket for Drugs, Diagnostics and Medical Services, 79–83. New Delhi: Springer India, 2013. http://dx.doi.org/10.1007/978-81-322-1281-2_4.

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Madianos, M. G., C. N. Stefanis e D. Madianou. "Prevalence of Mental Disorders and Utilisation of Mental Health Services in Two Areas of Greater Athens". In Psychiatric Epidemiology, 372–86. London: Routledge, 2021. http://dx.doi.org/10.1201/9781003134831-33.

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Sidze, Estelle M., Martin K. Mutua e Hermann P. Donfouet. "Towards Achieving Equity in Utilisation of Maternal Health Services in Selected Sub-Saharan African Countries: Progress and Remaining Challenges in Priority Countries". In Women and Sustainable Human Development, 111–24. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-14935-2_7.

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Lovett, Raymond, e Katherine A. Thurber. "Health Conditions and Health Service Utilisation among Children in LSIC". In Indigenous Children Growing Up Strong, 209–31. London: Palgrave Macmillan UK, 2017. http://dx.doi.org/10.1057/978-1-137-53435-4_10.

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Andersen, Kristian Gjerrestad, Gbanaibolou Jombo, Sikiru Oluwarotimi Ismail, Yong Kang Chen, Hom Nath Dhakal e Yu Zhang. "Damage Characterisation in Composite Laminates Using Vibro-Acoustic Technique". In Springer Proceedings in Energy, 275–82. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63916-7_34.

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AbstractThe need to characterise in-service damage in composite structures is increasingly becoming important as composites find higher utilisation in wind turbines, aerospace, automotive, marine, among others. This paper investigates the feasibility of simplifying the conventional acousto-ultrasonic technique set-up for quick and economic one-sided in-service inspection of composite structures. Acousto-ultrasonic technique refers to the approach of using ultrasonic transducer for local excitation while sensing the material response with an acoustic emission sensor. However, this involves transducers with several auxiliaries. The approach proposed herewith, referred to as vibro-acoustic testing, involves a low level of vibration impact excitation and acoustic emission sensing for damage characterisation. To test the robustness of this approach, first, a quasi-static test was carried out to impute low-velocity impact damage on three groups of test samples with different ply stacking sequences. Next, the vibro-acoustic testing was performed on all test samples with the acoustic emission response for the samples acquired. Using the acoustic emission test sample response for all groups, the stress wave factor was determined using the peak voltage stress wave factor method. The stress wave factor results showed an inverse correlation between the level of impact damage and stress wave factor across all the test sample groups. This corresponds with what has been reported in literature for acousto-ultrasonic technique; thus demonstrating the robustness of the proposed vibro-acoustic set-up. Structural health monitoring, impact damage, acousto-ultrasonic testing, non-destructive testing.

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Atti di convegni sul tema "Health services utilisation"

Samuel, Liji. "TRANSFORMING THE HEALTHCARE SYSTEM: THE PUBLIC-PRIVATE HEALTHCARE DICHOTOMY IN INDIA IN THE ERA OF DIGITAL HEALTH". In International Conference on Public Health. The International Institute of Knowledge Management, 2021. http://dx.doi.org/10.17501/24246735.2020.6103.

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Digital health initiatives have become popular in all jurisdictions across the globe. The digital health move, though it is envisioned as a cost-effective way to ensure the availability of health care services especially for the people who live in rural areas, its success depends on the response of the health care system and the state control and regulation. India lacks a comprehensive statesponsored or state-regulated health care system and more than 70 percent of people utilise the private sector medical services. In this backdrop, the implementation of the National Digital Health Mission (NDHM), announced by the Government of India very recently, will be critical. Thus, this research paper strives to bring out the public-private disjunction in the availability and utilisation of public and private health care facilities, issues of health care financing and legal regulation of clinical establishments in the public and private sector. This study uses the doctrinal method and analyses the Five-Year Plans, National Sample Survey Reports, National Health Profile, National Health Accounts Estimates for India and other Government Reports and independent studies to detail the public-private dichotomy. However, this study finds limitations in presenting the current position of private health care service providers due to the unavailability of updated authoritative government reports/ studies/ surveys. On reviewing the currents trends in the public and private health care sector, the study finds that the private sector has surpassed the public sector in all means, including health provisioning, utilisation, and financing. The NDHM is a laudable initiative to ensure affordable health care to millions of people in India. However, any move to implement it, leaving the fundamental issue of deep-rooted public-private dichotomy existing in the healthcare sector will be detrimental. It will result in a digital divide in the public and private healthcare sector and gross violation of patients’ rights and mismanagement of health information. Keywords: digital health, National Digital Health Mission, private healthcare sector, utilisation of healthcare service

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Mills, Mark, Elizabeth Johnson, Hamza Zafar, Andrew Horwood, Nicola Lax, Sarah Charlesworth, Anna Gregory et al. "31 Utilisation of an existing exercise-based cardiac rehabilitation programme for patients with atrial fibrillation in the national health service: putting current services to good use". In British Cardiovascular Society Annual Conference ‘Digital Health Revolution’ 3–5 June 2019. BMJ Publishing Group Ltd and British Cardiovascular Society, 2019. http://dx.doi.org/10.1136/heartjnl-2019-bcs.30.

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Mahapatro, Meerambika. "Barriers to Utilisation of Maternal HealthUtilisation of Maternal HealthUtilisation of Maternal HealthUtilisation of Maternal HealthUtilisation of Maternal HealthUtilisation of Maternal HealthUtilisation of Maternal Health Services among Rural Women in Orissa A Qualitative assessment". In 2nd Annual Global Healthcare Conference (GHC 2013). Global Science and Technology Forum Pte Ltd, 2013. http://dx.doi.org/10.5176/2251-3833_ghc13.55.

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He, Weijing, Liwu Wei e Simon Smith. "Intensive Validation of Computer Prediction of Welding Residual Stresses in a Multi-Pass Butt Weld". In ASME 2010 29th International Conference on Ocean, Offshore and Arctic Engineering. ASMEDC, 2010. http://dx.doi.org/10.1115/omae2010-20490.

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Welding and joining technology is fundamental to offshore engineering. The construction of engineering facilities and pipelines requires the extensive use of welding and associated structural integrity assessments of safety critical or heavily loaded sections. Proof of integrity is based upon the externally applied loads and in service stresses as well as the welding residual stresses. The level and distribution of residual stresses arises from the complex thermo-mechanical history of heat flow and thermal expansion at very high temperatures during welding, so it has not been possible to make very accurate assessments of these in the same way that service stresses can be defined. Conservative assumptions are therefore made and this often means that the as-welded stresses are assumed to be of yield magnitude. The peak values of stress may well be very high, but the shrinkage of the latter passes of multi-pass welds may compress earlier passes giving rise to much lower levels of stress. There is considerable engineering interest in the utilisation of lower levels of residual stress where they exist or of the design of welds with lower residual stresses in sensitive areas such as the weld root. Currently there is no single technique that can claim to provide cost effective, accurate distributions of residual stresses in welds. The current paper provides an important contribution to the understanding of measurement and prediction techniques. It describes an extensive set of measurements taken on a girth butt weld. The weld was made using submerged arc and was made in 18 passes. The pipe was X52 with a 32mm wall thickness and 910mm outside diameter. Temperature, strain and displacement values were measured throughout the production of the weld. The intermediate values between each pass were recorded as well as the time varying history during the production of individual passes. The final through thickness residual stress distribution was measured. Finite Element Analysis (FEA) modelling was undertaken to determine whether modelling could provide a satisfactory prediction of the final residual stresses. Intermediate results were also used to understand the behaviour of the weld and the model more clearly. The modelling used material properties measured on material from a separate specimen. The weld cross section was identified for each pass so that the heat input method could be developed to represent the actual melt pool conditions of the weld. The measured values of hoop residual stress were up to the yield stress magnitude just below the cap, but were 20% of yield in the root of the weld. The axial residual stresses were less than 50% of yield. Linear kinematic hardening provided the most accurate prediction of residual stress. The hoop stresses were predicted to an accuracy of 10% with this material model. Other hardening models were less accurate, but all models were conservative. The results provide a basis for the adoption of more accurate distributions of residual stresses in Engineering Critical Assessments (ECAs) and assessments of weld performance under fatigue and corrosive conditions.

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Rapporti di organizzazioni sul tema "Health services utilisation"

Brick, Aoife, Conor Keegan e Maev-Ann Wren. Utilisation of specialist mental health services in Ireland - Baseline analysis for the Hippocrates model. ESRI, giugno 2020. http://dx.doi.org/10.26504/sustat90.

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Leahy, Siobhan, Anne Nolan, Jean O'Connell e Rose Anne Kenny. Obesity in an Ageing Society: Implications for health, physical function and health service utilisation. The Irish Longitudinal Study on Ageing, luglio 2014. http://dx.doi.org/10.38018/tildare.2014-01.

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Roe, Lorna, Christine McGarrigle, Belinda Hernández, Aisling O'Halloran, Siobhan Scarlett, Mark Ward, Charles Normand e Rose Anne Kenny. Patterns in health service utilisation: Results from Wave 5 of The Irish Longitudinal Study on Ageing. The Irish Longitudinal Study on Ageing, aprile 2020. http://dx.doi.org/10.38018/tildare.2020-04.

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Roe, Lorna, Aisling O'Halloran, Charles Normand e Catriona Murphy. THE IMPACT OF FRAILTY ON PUBLIC HEALTH NURSE SERVICE UTILISATION: Findings from The Irish Longitudinal Study on Ageing (TILDA). The Irish Longitudinal Study on Ageing, settembre 2016. http://dx.doi.org/10.38018/tildare.2016-01.

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