Artykuły w czasopismach na temat „Health service utilisation”
Kliknij ten link, aby zobaczyć inne rodzaje publikacji na ten temat: Health service utilisation.
Utwórz poprawne odniesienie w stylach APA, MLA, Chicago, Harvard i wielu innych
Sprawdź 50 najlepszych artykułów w czasopismach naukowych na temat „Health service utilisation”.
Przycisk „Dodaj do bibliografii” jest dostępny obok każdej pracy w bibliografii. Użyj go – a my automatycznie utworzymy odniesienie bibliograficzne do wybranej pracy w stylu cytowania, którego potrzebujesz: APA, MLA, Harvard, Chicago, Vancouver itp.
Możesz również pobrać pełny tekst publikacji naukowej w formacie „.pdf” i przeczytać adnotację do pracy online, jeśli odpowiednie parametry są dostępne w metadanych.
Przeglądaj artykuły w czasopismach z różnych dziedzin i twórz odpowiednie bibliografie.
1
Dotse-Gborgbortsi, Winfred, Andrew J. Tatem, Zoe Matthews, Victor A. Alegana, Anthony Ofosu i 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, nr 1 (styczeń 2023): e066792. http://dx.doi.org/10.1136/bmjopen-2022-066792.
Pełny tekst źródłaStreszczenie:
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.
2
Darma, Azri, Hidayati Hidayati i 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, nr 2 (31.07.2018): 140. http://dx.doi.org/10.24198/pjd.vol30no2.18330.
Pełny tekst źródłaStreszczenie:
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.
3
Areru, Hiwot Abera, Mesay Hailu Dangisso i Bernt Lindtjørn. "Large local variations in the use of health services in rural southern Ethiopia: An ecological study". PLOS Global Public Health 2, nr 5 (25.05.2022): e0000087. http://dx.doi.org/10.1371/journal.pgph.0000087.
Pełny tekst źródłaStreszczenie:
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.
4
Andrews, Gavin, Cathy Issakidis i Greg Carter. "Shortfall in mental health service utilisation". British Journal of Psychiatry 179, nr 5 (listopad 2001): 417–25. http://dx.doi.org/10.1192/bjp.179.5.417.
Pełny tekst źródłaStreszczenie:
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.
5
Chen, Jiaqi, Song Xu i 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, nr 5 (9.03.2020): 1782. http://dx.doi.org/10.3390/ijerph17051782.
Pełny tekst źródłaStreszczenie:
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.
6
Xu, Jianqiang, Juan Zheng, Lingzhong Xu i 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, nr 2 (12.01.2021): 593. http://dx.doi.org/10.3390/ijerph18020593.
Pełny tekst źródłaStreszczenie:
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.
7
Banke-Thomas, Aduragbemi, Aline Semaan, Dinah Amongin, Ochuwa Babah, Nafissatou Dioubate, Amani Kikula, Sarah Nakubulwa i in. "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, nr 2 (luty 2022): e008064. http://dx.doi.org/10.1136/bmjgh-2021-008064.
Pełny tekst źródłaStreszczenie:
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.
8
Simpson, Grahame K., Mark Sabaz, Maysaa Daher, Robert Gordon i 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, nr 1 (maj 2014): 28–42. http://dx.doi.org/10.1017/brimp.2014.7.
Pełny tekst źródłaStreszczenie:
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.
9
McCrone, Paul, Graham Thornicroft, Michael Phelan, Frank Holloway, Til Wykes i Sonia Johnson. "Utilisation and costs of community mental health services". British Journal of Psychiatry 173, nr 5 (listopad 1998): 391–98. http://dx.doi.org/10.1192/bjp.173.5.391.
Pełny tekst źródłaStreszczenie:
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.
10
Zeng, Yanbing, Weiqian Xu i 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, nr 6 (czerwiec 2022): e059758. http://dx.doi.org/10.1136/bmjopen-2021-059758.
Pełny tekst źródłaStreszczenie:
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.
11
Hendrickx, David, Ingrid Amgarth-Duff, Asha C Bowen, Jonathan R Carapetis, Robby Chibawe, Margaret Samson i 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, nr 3 (28.01.2020): 808. http://dx.doi.org/10.3390/ijerph17030808.
Pełny tekst źródłaStreszczenie:
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.
12
Kamil, Wisam, Estie Kruger i Marc Tennant. "Utilisation of Dental Services of Older People in Australia: An Economic Explanatory Model Based on Cost and Geographic Location". Geriatrics 6, nr 4 (20.10.2021): 102. http://dx.doi.org/10.3390/geriatrics6040102.
Pełny tekst źródłaStreszczenie:
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.
13
Ruggeri, Mirella. "Service utilisation: a pivotal measure in assessing service needs and service outcome". Epidemiologia e psichiatria sociale. Monograph Supplement 6, S1 (kwiecień 1997): 105–12. http://dx.doi.org/10.1017/s1827433100000873.
Pełny tekst źródłaStreszczenie:
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.
14
Sunderland, Matthew, Jill M. Newby i Gavin Andrews. "Health anxiety in Australia: prevalence, comorbidity, disability and service use". British Journal of Psychiatry 202, nr 1 (styczeń 2013): 56–61. http://dx.doi.org/10.1192/bjp.bp.111.103960.
Pełny tekst źródłaStreszczenie:
BackgroundHealth anxiety is associated with high distress, disability and increased health service utilisation. However, there are relatively few epidemiological studies examining the extent of health anxiety or the associated sociodemographic and health risk factors in the general population.AimsTo provide epidemiological data on health anxiety in the Australian population.MethodLifetime and current prevalence estimates, associations between comorbid disorders, psychological distress, impairment, disability and mental health service utilisation were generated using the Australian 2007 National Survey of Mental Hearth and Wellbeing.ResultsHealth anxiety affects approximately 5.7% of the Australian population across the lifespan and 3.4% met criteria for health anxiety at the time of the interview. Age, employment status, smoking status and comorbid physical conditions were significantly related to health anxiety symptoms. Health anxiety was associated with significantly more distress, impairment, disability and health service utilisation than that found in respondents without health anxiety.ConclusionsHearth anxiety is non-trivial; it affects a significant proportion of the population and further research and clinical investigation of health anxiety is required.
15
Harvey, Sarah, Joanna Bromley, Miles Edwards, Megan Hooper, Hannah McAndrew i Joanne Timms. "Audit of the impact of the integrated psychological medicine service (IPMS) on service utilisation". BJPsych Open 7, S1 (czerwiec 2021): S80—S81. http://dx.doi.org/10.1192/bjo.2021.252.
Pełny tekst źródłaStreszczenie:
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.
16
Mac-Seing, Muriel, Kate Zinszer, Charity Oga Omenka, Pierre de Beaudrap, Fereshteh Mehrabi i 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, nr 4 (4.08.2020): 97–106. http://dx.doi.org/10.1177/1757975920941435.
Pełny tekst źródłaStreszczenie:
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.
17
Tufa, Yohanis, Abeza Mitiku, Shuayib Shemsu i Kebebe Bidira. "Utilisation of growth monitoring service by mothers of infants in Mettu town, Southwest Ethiopia". BMJ Paediatrics Open 6, nr 1 (wrzesień 2022): e001588. http://dx.doi.org/10.1136/bmjpo-2022-001588.
Pełny tekst źródłaStreszczenie:
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.
18
Haddison, Eposi C., Chia E. Julius i Benjamin M. Kagina. "Health Services Utilisation before and during an Armed Conflict; Experiences from the Southwest Region of Cameroon". Open Public Health Journal 13, nr 1 (26.10.2020): 547–54. http://dx.doi.org/10.2174/1874944502013010547.
Pełny tekst źródłaStreszczenie:
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.
19
Mahmood, M. Afzal, Anna E. Bauze, Justin T. Lokhorst, Peng Bi i Arthur Saniotis. "Influence of living arrangements on health services utilisation in Australia". Australian Health Review 36, nr 1 (2012): 34. http://dx.doi.org/10.1071/ah10920.
Pełny tekst źródłaStreszczenie:
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.
20
Gibson, David A. J., Rachael E. Moorin, David B. Preen, Jon D. Emery i 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, nr 3 (2011): 334. http://dx.doi.org/10.1071/ah09852.
Pełny tekst źródłaStreszczenie:
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.
21
Seers, Kara, Lynley Cook, Gillian Abel, Philip Schluter i Paul Bridgford. "Is it time to talk? Interpreter services use in general practice within Canterbury". Journal of Primary Health Care 5, nr 2 (2013): 129. http://dx.doi.org/10.1071/hc13129.
Pełny tekst źródłaStreszczenie:
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
22
Kapoor, Neena R., Amit Aryal, Suresh Mehata, Mahesh Dulal, Margaret E. Kruk, Sebastian Bauhoff i Catherine Arsenault. "Effect of lifting COVID-19 restrictions on utilisation of primary care services in Nepal: a difference-in-differences analysis". BMJ Open 12, nr 11 (listopad 2022): e061849. http://dx.doi.org/10.1136/bmjopen-2022-061849.
Pełny tekst źródłaStreszczenie:
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.
23
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, nr 3 (listopad 1989): 213–16. http://dx.doi.org/10.1177/095148488900200305.
Pełny tekst źródłaStreszczenie:
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.
24
Tariku, Amare, Yemane Berhane, Alemayehu Worku, Gashaw Andargie Biks, Lars Åke Persson i 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, nr 4 (kwiecień 2022): e058055. http://dx.doi.org/10.1136/bmjopen-2021-058055.
Pełny tekst źródłaStreszczenie:
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.
25
Zhang, Yaoguang, Di Dong, Ling Xu, Zhiwen Miao, Wenhui Mao, Frank Sloan i Shenglan Tang. "Ten-year impacts of China’s rural health scheme: lessons for universal health coverage". BMJ Global Health 6, nr 4 (kwiecień 2021): e003714. http://dx.doi.org/10.1136/bmjgh-2020-003714.
Pełny tekst źródłaStreszczenie:
China has made profound progress in advancing universal health coverage (UHC) over the past two decades. New Cooperative Medical Scheme (NCMS) was initiated in 2003 to provide health insurance coverage to rural population. Its benefit packages and cost-sharing mechanism have changed significantly over time. This study aims to assess the impact of changing NCMS policies on NCMS enrollees’ service utilisation, medical financial burden and equity between 2003 and 2013. Data are from China National Health Services Survey (NHSS) which is conducted every 5 years. We used the subsample of NHSS that were enrolled in NCMS in 2003, 2008 and 2013. From 2003 to 2013, we found increased service utilisation and an elimination of inequity in service utilisation with respect to income. Contradicting prior findings of increasing financial burden after the NCMS implementation, we identified significant protective effect of NCMS against financial risks, and a reduction in percentage of households with high medical expenditure in the middle-income and high-income quintiles. The rural residents from the low-income groups have high financial risk, therefore, should be the priority target for future reforms. In pursuit of UHC globally, many countries struggle to provide good coverage to the disadvantaged rural population and balance between the competing priorities of various UHC dimensions. Our trend analysis revealed China’s two-stage approach with NCMS reform that first focused on expanding population coverage, then on service coverage and financial risk protection. This path could potentially be replicated in other middle-income and low-income countries to pave the way for UHC.
26
Pettigrew, Simone, Robert Donovan, Melanie Pescud, Duncan Boldy i Robert Newton. "Mature adults' attitudes to mental health service utilisation". Australian Psychologist 45, nr 2 (czerwiec 2010): 141–50. http://dx.doi.org/10.1080/00050060903428228.
Pełny tekst źródła
27
McNair, Ruth, Amy Pennay, Tonda L. Hughes, Scarlet Love, Jodie Valpied i Dan I. Lubman. "Health service use by same-sex attracted Australian women for alcohol and mental health issues: a cross-sectional study". BJGP Open 2, nr 2 (15.05.2018): bjgpopen18X101565. http://dx.doi.org/10.3399/bjgpopen18x101565.
Pełny tekst źródłaStreszczenie:
BackgroundSame-sex attracted women (SSAW) have higher rates of alcohol and mental health problems than heterosexual women, but utilisation of and satisfaction with treatment is limited.AimThis study investigated the influences on health service use for alcohol and mental health problems among SSAW.Design & settingThe Gelberg-Andersen behavioural model of health service utilisation was used to generate outcome variables.MethodA convenience sample of 521 community-connected Australian SSAW completed an online survey. Health service use according to sexual identity was compared using χ2 analysis. Binary logistic regression examined associations between the independent variables with treatment utilisation.ResultsReports of alcohol treatment were very low. Only 41.1% of participants with service need had utilised mental health and alcohol treatment. Bisexual women (adjusted odds ratio [AOR] = 2.76) and those with ‘other’ identities (AOR = 2.38) were more likely to use services than lesbian women. Enablers to service use were having a regular GP (AOR = 3.02); disclosure of sexuality to the GP (AOR = 2.42); lesbian, gay, bisexual and transgender (LGBT) community-connectedness (AOR = 1.11); and intimate partner violence ([IPV] AOR = 2.51). Social support was associated with a reduction in treatment use (AOR = 0.97). Significant access barriers included not feeling ready for help, and previous negative experiences related to sexual identity.ConclusionDisclosing sexual identity to a regular, trusted GP correlated with improved utilisation of alcohol and mental health treatment for SSAW. The benefits of seeking help for alcohol use, and of accessing LGBT-inclusive GPs to do so, should be promoted to SSAW.
28
Andrews, Gavin, Scott Henderson i Wayne Hall. "Prevalence, comorbidity, disability and service utilisation". British Journal of Psychiatry 178, nr 2 (luty 2001): 145–53. http://dx.doi.org/10.1192/bjp.178.2.145.
Pełny tekst źródłaStreszczenie:
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.
29
Whitley, Rob, JiaWei Wang, Marie-Josee Fleury, Aihua Liu i Jean Caron. "Mental Health Status, Health Care Utilisation, and Service Satisfaction among Immigrants in Montreal: An Epidemiological Comparison". Canadian Journal of Psychiatry 62, nr 8 (12.11.2016): 570–79. http://dx.doi.org/10.1177/0706743716677724.
Pełny tekst źródłaStreszczenie:
Objective: To examine variations between immigrants and nonimmigrants in 1) prevalence of common mental disorders and other mental health variables; 2) health service utilisation for emotional problems, mental disorders, and addictions, and 3) health service satisfaction. Methods: This article is based on a longitudinal cohort study conducted from May 2007 to the present: the Epidemiological Catchment Area Study of Montreal South-West (ZEPSOM). Participants were followed up at 4 time points (T1, n = 2433; T4, n = 1095). Core exposure variables include immigrant status (immigrant vs. nonimmigrant), duration of residence, and region of origin. Key outcome variables included mental health status, health service utilisation, and health service satisfaction. Data were analysed both cross-sectionally and longitudinally. Results: Immigrants had been in Canada for 20 years on average. Immigrants had significantly lower rates of high psychological distress (32.6% vs. 39.1%, P = 0.016), alcohol dependence (1.4% vs. 3.9%, P =0.010), depression (5.2% vs. 9.2%, P = 0.008), and various other mental disorders. They had significantly higher scores of mental well-being (48.9 vs. 47.1 score, P = 0.014) and satisfaction with social (34.0 vs. 33.4 score, P = 0.021) and personal relationships (16.7 vs. 15.6 score, P < 0.001). Immigrants had significantly lower rates of health service utilisation for emotional problems, mental disorders, and addictions and significantly higher rates of health service satisfaction at all time points. Asian and African immigrants had particularly low rates of utilisation and high rates of satisfaction. Conclusions: Immigrants had better overall mental health than nonimmigrants.
30
Falkenstein, Lina, Nathalie Eckel, Simone B. Kadel, Jochem Koenig, David Litaker i 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, nr 10 (październik 2022): e054054. http://dx.doi.org/10.1136/bmjopen-2021-054054.
Pełny tekst źródłaStreszczenie:
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.
31
Gibbs, Lisa, i Daniel Reidpath. "What about the men? General differences in utilisation of arthritis self-management services". Australian Journal of Primary Health 11, nr 1 (2005): 63. http://dx.doi.org/10.1071/py05009.
Pełny tekst źródłaStreszczenie:
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.
32
Khoo, Joanna, Helen Hasan i Kathy Eagar. "Utilisation patterns of privately funded mental health services in Australia". Journal of Health Organization and Management 33, nr 1 (18.03.2019): 5–17. http://dx.doi.org/10.1108/jhom-02-2018-0062.
Pełny tekst źródłaStreszczenie:
Purpose The purpose of this paper is twofold: first, to present patient-level utilisation patterns of hospital-based mental health services funded by private health insurers; and second, to examine the implications of the findings for planning and delivering private mental health services in Australia. Design/methodology/approach Analysing private health insurance claims data, this study compares differences in demographic and hospital utilisation characteristics of 3,209 patients from 13 private health insurance funds with claims for mental health-related hospitalisations and 233,701 patients with claims for other types of hospitalisations for the period May 2014 to April 2016. Average number of overnight admissions, length of stay and per patient insurer costs are presented for each group, along with overnight admissions vs same-day visits and repeat services within a 28-day period following hospitalisation. Challenges in analysing and interpreting insurance claims data to better understand private mental health service utilisation are discussed. Findings Patients with claims for mental health-related hospitalisations are more likely to be female (62.0 per cent compared to 55.8 per cent), and are significantly younger than patients with claims for other types of hospitalisations (32.6 per cent of patients aged 55 years and over compared to 57.1 per cent). Patients with claims for mental health-related hospitalisations have significantly higher levels of service utilisation than the group with claims for other types of hospitalisations with a mean length of stay per overnight admission of 15.0 days (SD=14.1), a mean of 1.3 overnight admissions annually (SD=1.2) and mean hospital costs paid by the insurer of $13,192 per patient (SD=13,457) compared to 4.6 days (SD=7.3), 0.8 admissions (SD=0.6) and $2,065 per patient (SD=4,346), respectively, for patients with claims for other types of hospitalisations. More than half of patients with claims for mental health-related hospitalisations only claim for overnight admissions. However, the findings are difficult to interpret due to the limited information collected in insurance claims data. Practical implications This study shows the challenges of understanding utilisation patterns with one data source. Analysing insurance claims reveals information on mental health-related hospitalisations but information on community-based care is lacking due to the regulated role of the private health insurance sector in Australia. For mental health conditions, and other chronic health conditions, multiple data sources need to be integrated to build a comprehensive picture of health service use as care tends to be provided in multiple settings by different medical and allied health professionals. Originality/value This study contributes in two areas: patient-level trends in hospital-based mental health service utilisation claimed on private health insurance in Australia have not been previously reported. Additionally, as the amount of data routinely collected in health care settings increases, the study findings demonstrate that it is important to assess the quality of these data sources for understanding service utilisation.
33
Galvão, Maria Helena Rodrigues, Arthur de Almeida Medeiros i Angelo Giuseppe Roncalli. "Contextual and individual factors associated with public dental services utilisation in Brazil: A multilevel analysis". PLOS ONE 16, nr 7 (9.07.2021): e0254310. http://dx.doi.org/10.1371/journal.pone.0254310.
Pełny tekst źródłaStreszczenie:
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.
34
Walker, Tania, Mulu Woldegiorgis i 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, nr 20 (13.10.2021): 10722. http://dx.doi.org/10.3390/ijerph182010722.
Pełny tekst źródłaStreszczenie:
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.
35
Walker, Tania, Mulu Woldegiorgis i 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, nr 20 (13.10.2021): 10722. http://dx.doi.org/10.3390/ijerph182010722.
Pełny tekst źródłaStreszczenie:
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.
36
COOPER, HELEN, CHRIS SMAJE i SARA ARBER. "Equity in Health Service Use by Children: Examining the Ethnic Paradox". Journal of Social Policy 28, nr 3 (czerwiec 1999): 457–78. http://dx.doi.org/10.1017/s0047279499005656.
Pełny tekst źródłaStreszczenie:
This article investigates whether equity is achieved in health service utilisation by children and young people aged 0–19 years. Data from the British General Household Survey 1991–4 is used to examine the influence of ethnicity, along with social class, housing tenure, family structure and employment of parents on the use of general practitioner, outpatient and inpatient services. Health status is the most powerful predictor of use for each health service and there is no evidence of socioeconomic inequalities. However, a clear ‘ethnic paradox’ persists after controlling for socioeconomic and demographic factors. South Asian children have a higher utilisation of GP services than any other ethnic group, but the use of hospital services is lower for children in all minority ethnic groups relative to the white population. Possible explanations for this paradox are examined in relation to indirect indicators of service quality. There is no evidence to suggest that South Asian children visit the doctor more frequently for a given illness episode than white children, but having a non-UK- born mother is associated with increased consultation and reduced use of outpatient services relative to UK-born South Asian parents.
37
Dolan, Carrie B. "Health aid projects have both expanded and constrained the capacity of health facilities to deliver malaria services to under-five children in Malawi". BMJ Global Health 3, nr 6 (grudzień 2018): e001051. http://dx.doi.org/10.1136/bmjgh-2018-001051.
Pełny tekst źródłaStreszczenie:
ObjectiveThis article examines the potential pathways health aid may use to influence the availability of malaria services at a facility level and the utilisation of malaria services for children under five in Malawi.MethodsThis work is grounded in a health services research theoretical model and combines a subnational census of health services available at Malawi health facilities with individual-level data on health service utilisation and the Government of Malawi’s official source of data about health aid allocation at a child-level (n=2171). Logistic and multinomial logistic models were used to assess the relationship between health aid, malaria service readiness and malaria service utilisation. Models were adjusted for predisposing, enabling and need factors and accounted for the complex relationship using a mediation approach.ResultsThe evidence presented suggests that health aid translates into increased diagnostic capacity, but not overall or training readiness. Results indicate that increasing aid projects in a region boost its facilities’ diagnostic readiness, increasing each facility’s relative likelihood of having a medium level of diagnostic readiness by 12% (relative risk (RR)=1.118; 95% CI 1.060 to 1.179) and its likelihood of having a high level of readiness by 23% (RR=1.230; 95% CI 1.161 to 1.303), but decreasing its readiness to provide training by 8% (RR=0.925; 95% CI 0.879 to 0.974).ConclusionThe results of this research highlight the fact that health aid is working to increase malaria diagnostic capacity at a facility level, but that increasing facility readiness to implement the diagnostic tests has been neglected.
38
Pershouse, Kiley, Pim Kuipers, Delena Amsters i 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, nr 1 (2006): 65. http://dx.doi.org/10.1071/py06010.
Pełny tekst źródłaStreszczenie:
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.
39
Buckley, Dermot, i Tony Lower. "Factors influencing the utilisation of health services by rural men". Australian Health Review 25, nr 2 (2002): 11. http://dx.doi.org/10.1071/ah020011.
Pełny tekst źródłaStreszczenie:
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.
40
Edu, Betta, Thomas U. Agan, Emmanuel Monjok i Krystyna Makoweicka. "Effect of Free Maternal Health Care Program on Health-seeking Behavior of Women during Pregnancy, Intra-partum and Postpartum Periods in Cross River State of Nigeria: A Mixed Method Study". Open Access Macedonian Journal of Medical Sciences 5, nr 3 (11.06.2017): 370–82. http://dx.doi.org/10.3889/oamjms.2017.075.
Pełny tekst źródłaStreszczenie:
BACKGROUND: Increasing the percentage of maternal health service utilization in health facilities, through cost-removal policy is important in reducing maternal deaths. The Cross River State Government of Nigeria introduced a cost-removal policy in 2009, under the umbrella of “PROJECT HOPE†where free maternal health services are provided. Since its inception, there has been no formal evaluation of its effectiveness. AIM: This study aims to evaluate the effect of the free maternal health care program on the health care-seeking behaviours of pregnant women in Cross River State, Nigeria.METHOD: A mixed method approach (quantitative and qualitative methods) was used to describe the effect of free maternal health care intervention. The quantitative component uses data on maternal health service utilisation obtained from PROJECT HOPE and Nigeria Demographic Health Survey. The qualitative part uses Focus Group Discussions to examine women's perception of the program.RESULTS: Results suggest weak evidence of change in maternal health care service utilization, as 95% Confidence Intervals overlap even though point estimate suggest increase in utilization. Results of quantitative data show increase in the percentage of women accessing maternal health services. This increase is greater than the population growth rate of Cross River State which is 2.9%, from 2010 to 2013. This increase is likely to be a genuine increase in maternal health care utilisation. Qualitative results showed that women perceived that there have been increases in the number of women who utilize Antenatal care, delivery and Post Partum Care at health facilities, following the removal of direct cost of maternal health services. There is urban and rural differences as well as between communities closer to health facility and those further off. Perceived barriers to utilization are indirect cost of service utilization, poor information dissemination especially in rural areas, perceived poor quality of care at facilities including drug and consumables stock-outs, geographical barriers, inadequate health work force, and poor attitude of skilled health workers and lack of trust in the health system.CONCLUSION: Reasons for Maternal health care utilisation even under a cost-removal policy is multi-factorial. Therefore, in addition to fee-removal, the government must be committed to addressing other deterrents so as to significantly increase maternal health care service utilisation.
41
Seilo, Noora, Susanna Paldanius, Reija Autio, Tuomas Koskela, Kristina Kunttu i Minna Kaila. "Association between university students’ two-staged health screening and student health care utilisation: register based observational study". BMJ Open 12, nr 7 (lipiec 2022): e052824. http://dx.doi.org/10.1136/bmjopen-2021-052824.
Pełny tekst źródłaStreszczenie:
ObjectivesThe aim of this study was to explore how university students’ participation in a two-staged health screening at the beginning of university studies associates with student health care utilisation in a 6-year follow-up.DesignNationwide, observational, register-based cohort study with a 6-year follow-up.SettingStudent health care in Finland. Finnish Student Health Service (FSHS) provides statutory student health services to university students in Finland. The two-staged health screening of FSHS includes the electronic health questionnaire (eHQ) provided annually to university entrants and a subsequent health check, when necessary, based on students eHQ response.ParticipantsA national cohort of university entrants from the 2011–2012 academic year (N=15 723) was assessed. After exclusions the study population consisted of 12 972 students, n (female)=7368, n (male)=5604.Outcome measuresThe primary outcome measures were students’ health service utilisation pattern obtained by clustering analyses method and the students’ participation in different stages of the health examination process.ResultsFour distinguishable health care utilisation patterns were identified: (1) constant low use, (2) constant high use, (3) increasing use and (4) decreasing use. The students’ OR for belonging to the constant high use group was significantly higher among females (OR 4.0, 95% CI 3.5 to 4.6) and students who attended the health check (OR 4.7, 95% CI 3.9 to 5.6).ConclusionsParticipating in the two-staged health screening was associated with increase in health care utilisation. The process detects students with health problems.
42
Mekonnen, Tensae, Tinashe Dune, Janette Perz i 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, nr 5 (1.03.2019): 748. http://dx.doi.org/10.3390/ijerph16050748.
Pełny tekst źródłaStreszczenie:
: 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.
43
Parajuli, Jamuna, i Dell Horey. "Barriers to and facilitators of health services utilisation by refugees in resettlement countries: an overview of systematic reviews". Australian Health Review 44, nr 1 (2020): 132. http://dx.doi.org/10.1071/ah18108.
Pełny tekst źródłaStreszczenie:
Objective The aim of this study was to provide an overview of the previously reviewed research literature to identify barriers and facilitators to health service utilisation by refugees in resettlement countries. Methods An overview of systematic reviews was conducted. Seven electronic databases (Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, ProQuest Central, Scopus, EBSCO and Google Scholar) were searched for systematic reviews of barriers and facilitators to health-seeking behaviour and utilisation of health services by refugees following resettlement. The two authors independently undertook data selection, data extraction and quality assessment using a validated tool. Results Nine systematic reviews covered a range of study areas and refugee populations. Barriers to health service utilisation fell into three broad areas: (1) issues related to refugees, including refugee characteristics, sociocultural factors and the effects of previous experiences; (2) issues related to health services, including practice issues and the knowledge and skills of health professionals; and (3) issues related to the resettlement context, including policies and practical issues. Few facilitators were identified or evaluated, but these included approaches to care, health service responses and behaviours of health professionals. Conclusions Barriers to accessing health care include refugee characteristics, practice issues in health services, including the knowledge and skills of health professionals, and the resettlement context. Health services need to identify barriers to culturally sensitive care. Improvements in service delivery are needed that meet the needs of refugees. More research is needed to evaluate facilitators to improving health care accessibility for these vulnerable groups. What is known about the topic? Refugee health after resettlement is poor, yet health service use is low. What does this paper add? Barriers to accessing health services in resettlement countries are related not only to refugees, but also to issues regarding health service practices and health professionals’ knowledge and skill, as well as the context of resettlement. Few facilitators to improving refugee access to health services have been identified. What are the implications for practitioners? The barriers associated with health professionals and health services have been linked to trust building, and these need to be addressed to improve accessibility of care for refugees.
44
Stuart, Geoffrey W., I. Harry Minas, Steven Klimidis i Siobhan O'connell. "English Language Ability and Mental Health Service Utilisation: A Census". Australian & New Zealand Journal of Psychiatry 30, nr 2 (kwiecień 1996): 270–77. http://dx.doi.org/10.3109/00048679609076105.
Pełny tekst źródłaStreszczenie:
Objective: To explore the relationship between English language proficiency and mental health service utilisation. Methods: In September 1993, a sample census was conducted of all mental health services in the State of Victoria, including public and private hospital wards, outpatient consultations provided by psychiatrists and clinical psychologists, and primary mental health care provided by general practitioners. Response rates ranged from 37% for monolingual general practitioners (GPs) to 96% for inpatient units. Particular emphasis was placed on patients' English language proficiency and the role played by bilingual clinicians. Results: Over 80% of inpatients received a diagnosis of either dementia or psychosis. This proportion was even greater in the case of patients with English language difficulties. The latter group of patients underutilised specialist outpatient services, and those using these services were less likely to receive psychotherapy than fluent English speakers. They utilised GPs for mental disorder at at least the same rate as other patients. There was a marked preference for bilingual GPs, with 80% of patients with poor English language skills consulting GPs who spoke their native language. Conclusion: There appears to be considerable underutilisation of specialist mental health services by patients who are not fluent in English. The liaison-consultation model of psychiatric care may be an effective way of addressing this problem, given the important role already played by bilingual GPs in the psychiatric care of those whose native language is not English.
45
Dolja-Gore, Xenia, Deborah Loxton, Catherine D'Este i Julie E. Byles. "Transitions in health service use among women with poor mental health: a 7-year follow-up". Family Medicine and Community Health 10, nr 2 (czerwiec 2022): e001481. http://dx.doi.org/10.1136/fmch-2021-001481.
Pełny tekst źródłaStreszczenie:
ObjectiveWomen suffering from mental health problems require varied needs of mental health service utilisation. Transition between general practitioner and mental health services use are available through the Better Access Scheme initiative, for those in need of treatment. The study’s aim was to identify trajectories of mental health service utilisation by Australian women.DesignThe Australian Longitudinal Study on Women’s Health data linked to the administrative medical claims dataset were used to identify subgroups of women profiled by their mental health service use from 2006 to 2013. Latent growth mixture model is a statistical method to profile subgroups of individuals based on their responses to a set of observed variables allowing for changes over time. Latent class groups were identified, and used to examine predisposing factors associated with patterns of mental health service use change over time.SettingThis study was conducted in Australia.ParticipantsNational representative sample of women of born in 1973–1978, who were aged between 28 and 33 years at the start of our study period.ResultsSix latent class trajectories of women’s mental health service use were identified over the period 2006–2013. Approximately, one-quarter of the sample were classified as the most recent users, while approximate equal proportions were identified as either early users, late/low user or late-high users. Additional, subgroups were defined as the consistent-reduced user and the late-high users, over time. Only 7.2% of the sample was classified as consistent high users who potentially used the services each year.ConclusionThese findings suggest that use of the Better Access Scheme mental health services through primary care was varied over time and may be tailored to each individual’s needs for the treatment of depressive symptoms.
46
Poudel-Tandukar, Kalpana, Krishina C. Poudel i Conlin Macdougall. "Factors influencing women's use of health services for Sexually Transmitted Infections in eastern Nepal". Australian Health Review 26, nr 1 (2003): 116. http://dx.doi.org/10.1071/ah030116.
Pełny tekst źródłaStreszczenie:
This paper explores low levels of women's health service utilization for Sexually Transmitted Infections (STIs)in Nepal. We interviewed 120 women individually and 53 in focus groups. Predictors of lower utilisation were self-medication, consultation with faith healers, inadequate knowledge of STIs, beliefs about causes, fear, social taboos and stigmatisation, women's secondary status, and presence of male health professionals. Results indicate the importance of people's beliefs in their decisions about health care. Strategies to improve access to health services in Nepal should systematically investigate the role of all these factors to improve access to and utilisation of health services for STIs.
47
Skinner, Elizabeth H., Michele Foster, Geoffrey Mitchell, Michele Haynes, Martin O'Flaherty i 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, nr 1 (2014): 9. http://dx.doi.org/10.1071/py13092.
Pełny tekst źródłaStreszczenie:
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.
48
Phaiyarom, Mathudara, Nareerut Pudpong, Rapeepong Suphanchaimat, Watinee Kunpeuk, Sataporn Julchoo i Pigunkaew Sinam. "Outcomes of the Health Insurance Card Scheme on Migrants’ Use of Health Services in Ranong Province, Thailand". International Journal of Environmental Research and Public Health 17, nr 12 (19.06.2020): 4431. http://dx.doi.org/10.3390/ijerph17124431.
Pełny tekst źródłaStreszczenie:
In 2002, Thailand achieved Universal Health Coverage for all citizens; however, it remains the case that undocumented migrants are not fully covered. The Health Insurance Card Scheme (HICS) of the Ministry of Public Health is the key policy aiming to cover undocumented migrants. This study examined the impact of this policy on the utilisation rate of public health facilities among HICS beneficiaries including undocumented migrants. Facility-based individual records between 2011 and 2015 were purposively retrieved from one provincial hospital, one district hospital, and two health centres in one of the most densely migrant-populated provinces in Thailand. Poisson regression was conducted on inpatient (IP) utilisation, while negative binomial regression was conducted on outpatient (OP) utilisation. Of 74,722 admissions, 19.0% were insured by HICS. About 14.0% of the outpatient records were for HICS beneficiaries. Overall, the HICS utilisation rate in migrants was lower than in Thai patients. Being insured with the HICS significantly increased OP utilisation by 1.7%, and IP utilisation by 11.1% (relative to uninsured). Disease status was the most important factor that positively influenced the utilisation rate. Further studies that explore the differences in health service utilisation among HICS beneficiaries with diverse economic backgrounds are recommended
49
Hodgson, Sam, Jeffrey Morgan-Harrisskitt, Hilda Hounkpatin, Beth Stuart i Hajira Dambha-Miller. "Primary care service utilisation and outcomes in type 2 diabetes: a longitudinal cohort analysis". BMJ Open 12, nr 1 (styczeń 2022): e054654. http://dx.doi.org/10.1136/bmjopen-2021-054654.
Pełny tekst źródłaStreszczenie:
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.
50
Millar, Elinor, James Stanley, Jason Gurney, Jeannine Stairmand, Cheryl Davies, Kelly Semper, Anthony Dowell, Ross Lawrenson, Dee Mangin i Diana Sarfati. "Effect of multimorbidity on health service utilisation and health care experiences". Journal of Primary Health Care 10, nr 1 (2018): 44. http://dx.doi.org/10.1071/hc17074.
Pełny tekst źródłaStreszczenie:
ABSTRACT INTRODUCTION Multimorbidity, the co-existence of two or more long-term conditions, is associated with poor quality of life, high health care costs and contributes to ethnic health inequality in New Zealand (NZ). Health care delivery remains largely focused on management of single diseases, creating major challenges for patients and clinicians. AIM To understand the experiences of people with multimorbidity in the NZ health care system. METHODS A questionnaire was sent to 758 people with multimorbidity from two primary health care organisations (PHOs). Outcomes were compared to general population estimates from the NZ Health Survey. RESULTS Participants (n = 234, 31% response rate) reported that their general practitioners (GPs) respected their opinions, involved them in decision-making and knew their medical history well. The main barriers to effective care were short GP appointments, availability and affordability of primary and secondary health care, and poor communication between clinicians. Access issues were higher than for the general population. DISCUSSION Participants generally had very positive opinions of primary care and their GP, but encountered structural issues with the health system that created barriers to effective care. These results support the value of ongoing changes to primary care models, with a focus on patient-centred care to address access and care coordination.