scholarly journals Can a Multitiered Copayment System Affect People’s Healthcare-seeking Behavior? A Case Study of Wenzhou, China

2021 ◽  
Author(s):  
Lizheng Ge ◽  
Yunyun Huang ◽  
Tingke Xu ◽  
Qianru Zhao ◽  
Chun Chen ◽  
...  
Keyword(s):  
Medical Care ◽  
Healthcare System ◽  
Tertiary Care ◽  
Care Facility ◽  
Healthcare Services ◽  
Health Seeking ◽  
Medical Care System ◽  
Healthcare Seeking ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior

Abstract Background. Facilitating the primary health care (PHC) system and maintaining people’s reasonable health-seeking behavior are key to establishing a sustainable healthcare system. China has employed a multitiered copayment system to incentivize the public to utilize PHC services through its hierarchical medical care system; however, most people still prefer visiting tertiary care hospitals. Methods. This preliminary study was conducted in 2016 on 1831 individuals from four regions of Wenzhou in Zhejiang Province to explore the effect and influencing factors of the multitiered copayment system that drives their primary healthcare-seeking behavior. We question whether a quality gap in healthcare services influences the minimal effect of the multitiered copayment system, which existing literature has considered as an important factor in the lack of reform in the Chinese healthcare system. We discuss the effect of the policy following the current situation in which there exists a large gap and further consider the hypothetical situation of a reduced gap in the future. Result. The results indicate that the initial effects of the multitiered copayment system was limited. However, they become more pronounced after the equalization of the quality of healthcare services. Moreover, the main determinants in people’s selection of PHC institutions changed from age and needs variables (self-rated health status) to age and enabling variables (distance to a medical care facility). Conclusion. This study confirms that changes in the quality gap in healthcare services influence the multitiered copayment system. Hence, reducing this gap can help to achieve the intended outcome of the tiered healthcare insurance schedule.

scholarly journals Analysis of Healthcare Seeking Behavior

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Chrissy Dangel ◽  
Steven Allgeier ◽  
Adam Haas ◽  
Amanda Johnson
Keyword(s):  
Emergency Department ◽  
Water Contamination ◽  
Poison Control ◽  
Poison Control Center ◽  
Health Seeking ◽  
Control Center ◽  
Healthcare Seeking ◽  
Health Seeking Behaviors ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior

This paper describes analyses of health seeking behaviors from two surveillance datastreams: Poison Control Center (PCC) calls and Emergency Department (ED) visit records. These analyses were conducted in order to quantify behaviors following the development of symptoms after water contamination exposure and to understand  the motivation, decision-making and timing behind healthcare seeking behaviors.

scholarly journals Health care seeking behavior for common childhood morbidities in Ethiopia: The effects of maternal behavior and access to key health services

2020 ◽  
Author(s):  
Cindy Xin Feng ◽  
Nigatu R Geda ◽  
Susan J Whiting ◽  
Rein Lepnurm ◽  
Carol J Henry ◽  
...  
Keyword(s):  
Working Mothers ◽  
Survey Design ◽  
Medical Attention ◽  
Demographic And Health Surveys ◽  
High Morbidity ◽  
Care Seeking ◽  
Health Seeking ◽  
Healthcare Seeking ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior

Abstract Background: Childhood morbidities such as diarrhea and pneumonia are the leading causes of death in Ethiopia. Appropriate healthcare-seeking behavior of mothers for common childhood illnesses could prevent a significant number of these early deaths; however, little nation-wide research has been conducted in Ethiopia to assess mothers’ healthcare-seeking behavior for their children.Method: The study used the Ethiopian Demographic and Health Surveys (EDHS) conducted in 2016 on a nationally representative sample of 10641 children under the age of five. The main determinants of care-seeking during diarrhea and Acute Respiratory Infection (ARI) episodes were assessed using multiple logistic regression analyses while adjusting for complex survey design.Results: Only 43% and 35% of households sought medical attention for their children in episodes of diarrhea and ARI, respectively, during a reference period of two weeks before the survey. The odds of seeking care for diarrhea are lower for non-working mothers versus working mothers. The likelihood of seeking care for diarrhea or ARI is higher for fathers who had education versus no education. The place of delivery for the child, receiving postnatal checkup and getting at least one immunization in the past determined the likelihood of seeking care for ARI, but not for diarrhea. The odds of seeking care are higher for both diarrhea and ARI among households that are headed by females and where mothers experienced domestic violence. Religion and types of family structure are also significant factors of seeking care for diarrhea episodes, but not for ARI.Conclusion: Given the high morbidity and mortality rates for children in Ethiopia, a deeper understanding of the health-seeking behaviour of mothers may provide insights for identifying the potential gaps and developing improvement of mothers’ awareness and perception towards childhood problems

scholarly journals SOCIAL SUPPORT AND HEALTHCARE-SEEKING BEHAVIOR OF OLDER PERSONS IN NIGERIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S143-S144
Author(s):  
Funmi Togonu-Bickersteth ◽  
Joshua O Aransiola ◽  
Catherine O Oyetunji-Alemede ◽  
Opeyemi Ekundayo ◽  
Oluwasegun Oluwaleimu
Keyword(s):  
Social Support ◽  
Older Persons ◽  
Healthcare Facility ◽  
Care Utilization ◽  
Binary Logistic Regression Analysis ◽  
Health Seeking ◽  
Healthcare Facilities ◽  
Healthcare Seeking ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior

Abstract Abstract The choice of healthcare facility by older persons is an important factor in their healthcare seeking behavior, and this can be associated with a number of factors. This study investigated the relationship between social support and healthcare facility choice of older persons in Nigeria. Other factors associated with the choice of healthcare facilities by older persons were also identified. Quantitative data were collected from a sample of 3,696 elderly aged 60 years above (55.6% male; 44.4% females; mean age = 69.2, SD = 8.60) who were selected through multi-stage systematic random sampling. Binary logistic regression analysis revealed that older persons who received social support were more likely to seek treatment in formal healthcare facilities, while older persons who did not receive any form of social support were more likely to seek treatment in informal healthcare facilities. Membership of social or religious groups was found to be a predictor of health seeking behavior among the older adults. Sex, age, level of education, and ability to handle activities of daily living (ADL), and ease of access to the nearest health facility, were found to be significantly associated with choice of healthcare facilities. The article concludes that there is need for conscious planning to provide formal supports to ease access of older persons to available health facilities. Such facilitation should include financial support and removal of existing physical and cultural barriers to health care utilization by older persons.

scholarly journals How Can One Strengthen a Tiered Healthcare System through Health System Reform? Lessons Learnt from Beijing, China

2020 ◽  
Vol 17 (21) ◽  
pp. 8040
Author(s):  
Shuduo Zhou ◽  
Jin Xu ◽  
Xiaochen Ma ◽  
Beibei Yuan ◽  
Xiaoyun Liu ◽  
...  
Keyword(s):  
Primary Care ◽  
Ambulatory Care ◽  
Healthcare System ◽  
Primary Healthcare ◽  
Healthcare Facilities ◽  
Healthcare Seeking ◽  
Seeking Behavior ◽  
Tertiary Hospitals ◽  
Healthcare Seeking Behavior ◽  
The Impact

How one can reshape the current healthcare sector into a tiered healthcare system with clarified division of functions between primary care facilities and hospitals, and improve the utilization of primary care, is a worldwide problem, especially for the low and middle-income countries (LMICs). This paper aimed to evaluate the impact of the Beijing Reform on healthcare-seeking behavior and tried to explain the mechanism of the change of patient flow. In this before and after study, we evaluated the changes of outpatient visits and inpatient visits among different levels of health facilities. Using the monitored and statistical data of 373 healthcare institutions 1-year before and 1-year after the Beijing Reform, interrupted time series analysis was applied to evaluate the impact of the reform on healthcare-seeking behavior. Semi-structured interviews were used to further explore the mechanisms of the changes. One year after the reform, the flow of outpatients changed from tertiary hospitals to community health centers with an 11.90% decrease of outpatients in tertiary hospitals compared to a 15.01% increase in primary healthcare facilities. The number of ambulatory care visits in primary healthcare (PHC) showed a significant upward trend (P < 0.10), and the reform had a significant impact on the average number of ambulatory care visits per institution in Beijing’s tertiary hospitals (p < 0.10). We concluded that the Beijing Reform has attracted a substantial number of ambulatory care visits from hospitals to primary healthcare facilities in the short-term. Comprehensive reform policies were necessary to align incentives among relative stakeholders, which was a critical lesson for other provinces in China and other LMICs.

scholarly journals Child Caregiver’s healthcare seeking behavior and its determinants for common childhood illnesses in Addis Ababa, Ethiopia: a community-based study

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Martha Bellete ◽  
Moges Muluneh Boke ◽  
Melaku Kindie Yenit
Keyword(s):  
Health Care ◽  
Addis Ababa ◽  
Care Facility ◽  
Childhood Illness ◽  
Community Based ◽  
Perceived Severity ◽  
Healthcare Seeking ◽  
Childhood Illnesses ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior

Abstract Background Appropriate healthcare-seeking behavior and access to the health care facility is key to improving health service utilization. Although the accessibility of comprehensive childhood disease intervention services in Ethiopia has been modified at the community level, the use of such health care services has remained limited. Therefore, this study aimed to assess the healthcare-seeking behavior of common childhood illness and its determinants. Methods A community-based cross-sectional study design was used. A multi-stage sampling method was used to recruit eight hundred and thirty-four study participants. A pre-tested and standardized questionnaire was used to collect data. The collected data were visually checked for incompleteness and entered into the statistical software Epi-info version 7 and exported to SPSS version 20 software for descriptive and bi-variable analysis. To identify variables associated with the healthcare-seeking behavior. Logistic regression analysis was performed. Adjusted odds ratios with a 95% confidence interval were used to see the strength of association, and variables with P-values of < 0.05 were considered statistically significant. Results The proportion of health care seeking behavior of care-givers for childhood illness was 69.5% (95% CI, 66.4, 72.4%). The education level of caregiver (AOR: 1.61, 95% CI: 1.01–2.60), knowledge of childhood illness (AOR: 2.02, 95% CI: 1.46–2.79), cough (AOR: 1.94, 95% CI: 1.39–2.71) and diarrhea (AOR: 2.09, 95% CI: 1.46–2.99) as main symptoms of illness and perceived severity of illness (AOR:3.12, 95% CI: 2.22–4.40) were significantly associated with healthcare-seeking behaviors of caregivers. Conclusion Low healthcare-seeking behavior was observed for childhood illnesses. Educational level, knowledge of childhood illness, cough, and diarrhea as primary symptoms of illness, and perceived severity of caregiver illness were significant associated with healthcare-seeking behavior. Therefore, interventions that strengthen the caregiver’s awareness of childhood illness and danger signs need to be considered. Besides, addressing the identified associated variables to healthcare-seeking behavior is critically important to curb the problem.

scholarly journals Determinants of Delay in Healthcare Seeking for Common Childhood Illnesses among Caregivers with Under-Five Children in Touboro Health District, Near Cameroon’ s Northeastern Border with Chad

2021 ◽  
pp. 1-14
Author(s):  
H. Ngouakam ◽  
E. Nekehforba ◽  
B. Tientche
Keyword(s):  
Health District ◽  
Health Seeking ◽  
Children Under Five ◽  
Healthcare Seeking ◽  
Under Five ◽  
Under Five Children ◽  
Childhood Illnesses ◽  
Female Children ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior

Aims: The study sought to determine the determinants of delay in health-seeking among caregivers with under-five children. Study Design: This was a mixed-method, cross-sectional study. Place and Duration of Study: The study took place in Touboro Health District involving 386 caregivers of under-five children from May to July 30, 2020. Methodology: A structured questionnaire and two focused group discussions were used to gather information on caregiver knowledge of healthcare-seeking behavior. Data were analyzed using SPSS version 25.0. Bivariable logistic regression was employed to identify factors associated with of healthcare seeking behavior. Results: Results of the 386 sick children, fever 39.9% (154/386), diarrhea 30.3% (117/386) and cough 24.9% (96/386) were the common symptoms. The majority of the caregivers of the under-five children had poor knowledge of 63% (243/386) about common infant illnesses. Caregivers of female children under-five(OR= 2.26, 95% CI: 1.29-3.96, P = 0.004), caregivers aged between 21 and 30 years (OR=5.53, 95% CI: 1.32-23.11, P = 0.019), caregivers whose occupation is housewife (OR=2.64 95% CI 1.23-5.68, P =10.013),) ,caregivers who host > 6children in a household (OR= 3.56 95% CI  1.42-8.92 , P =0.007) were key determinants of delay in health-seeking. Conclusion: Caregivers of female children under-five, caregivers aged between 21 and 30 years, caregivers whose occupation is housewife, caregivers under-five children residing in a rural area, caregivers who host more than 6 children in a household, households with an average monthly income of  <10.000 FRS Cfa were predictors of delay appropriate health-seeking. There is a need to intensify health education focusing on childhood illnesses, and timely care-seeking to effectively respond to caregiver's expectations among others.

scholarly journals KNOWLEDGE, ATTITUDE, AND HEALTHCARE-SEEKING BEHAVIOR AMONG FAMILIES OF CHILDREN WITH TUBERCULOSIS

2020 ◽  
Vol 6 (4) ◽  
pp. 127-135
Author(s):  
Muhammad Reza Saputra ◽  
Windy Rakhmawati ◽  
Sri Hendrawati ◽  
Fanny Adistie
Keyword(s):  
Care Facility ◽  
Signs And Symptoms ◽  
World Health ◽  
Good Knowledge ◽  
Early Screening ◽  
Healthcare Seeking ◽  
Attitude And Practice ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior ◽  
Knowledge Attitude And Practice

Background: Poor family healthcare-seeking behavior may cause delays in pediatric tuberculosis management. Knowledge and attitude are among the basic factors that influence in the family healthcare-seeking behavior.Objective: This study aimed to explore the knowledge, attitude, and healthcare-seeking behavior among families of children with tuberculosis.Methods: This was a cross-sectional descriptive quantitative study using accidental sampling method. Eighty-three families of children with tuberculosis were recruited. World Health Organization's Knowledge, Attitude and Practice Survey guideline was used to develop the questionnaires used in this study. Data were analyzed using descriptive statistics.Results: Results showed that 51.8% of the families had good knowledge and 53% had a positive attitude while 74.7% of the families did not do early screening, 67.5% preferred hospital for examinations, and 51.8% directly visited a health care facility when the child showed signs and symptoms of tuberculosis. In these families, 77.1% delayed taking the child for treatment for < 1 month, and the reason for the delay in 100% of these families was because they did not know that their children had signs and symptoms of tuberculosis.Conclusion: In conclusion, more than half of the families in this study already had good knowledge, attitude, and practice in accessing healthcare services although poor screening practice was still seen in most families. Thus, nurses have opportunities to provide appropriate health-related education to achieve the desired behavioral change.

scholarly journals Exploring the Healthcare Seeking Behavior of Medical Aid Beneficiaries Who Overutilize Healthcare Services: A Qualitative Descriptive Study

2019 ◽  
Vol 16 (14) ◽  
pp. 2485
Author(s):  
Jeonghyun Cho ◽  
Kyungin Jeong ◽  
Samsook Kim ◽  
Hyejin Kim
Keyword(s):  
Descriptive Study ◽  
Healthcare Services ◽  
Community Dwelling ◽  
Healthcare Seeking ◽  
Medical Aid ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Seeking Behavior ◽  
Qualitative Descriptive ◽  
Healthcare Seeking Behavior

We explored the healthcare seeking behavior of Medical Aid (MA) beneficiaries who over-utilize healthcare services in South Korea. We employed a qualitative descriptive study using semi-structured interviews with fifteen community-dwelling MA beneficiaries—who were categorized as over-utilizing healthcare services—and conventional content analysis. Four categories emerged: having unmet healthcare needs, wandering in search of effective healthcare services, routinizing their use of healthcare services, and being concerned about benefit restrictions due to their healthcare overutilization. Overall, these categories indicate participants’ behaviors used to fill the gap between their high healthcare needs and restricted MA benefits. The findings provide a foundation for healthcare providers, policymakers, researchers, and MA beneficiaries to discuss how to better address beneficiaries’ healthcare needs while preventing healthcare overutilization patterns. Effective and innovative interventions that target MA beneficiaries and their case managers are necessary to improve beneficiaries’ quality of life.

scholarly journals Healthcare-Seeking Behavior among Chinese Older Adults: Patterns and Predictive Factors

2021 ◽  
Vol 18 (6) ◽  
pp. 2969
Author(s):  
Yanbing Zeng ◽  
Yuanyuan Wan ◽  
Zhipeng Yuan ◽  
Ya Fang
Keyword(s):  
Older Adults ◽  
Predictive Factors ◽  
Medical Insurance ◽  
Utilization Rate ◽  
Heckman Selection Model ◽  
Healthcare Seeking ◽  
Inpatient Services ◽  
Medical Institutions ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior

This study aimed to investigate the patterns and predictive factors of healthcare-seeking behavior among older Chinese adults. A sample of 10,914 participants aged ≥60 years from the 2011, 2013 and 2015 China Health and Retirement Longitudinal Study (CHARLS) was included. The bivariate analyses and Heckman selection model was used to identify predictors of healthcare-seeking behavior. Results shows that the utilization rate of outpatient services increased from 21.61% in 2011 to 32.41% in 2015, and that of inpatient services increased from 12.44% to 17.68%. In 2015, 71.93% and 92.18% chose public medical institutions for outpatient and inpatient services, 57.63% and 17.00% chose primary medical institutions. The individuals who were female, were younger, lived in urban, central or western regions, had medical insurance, had poor self-rated health and exhibited activity of daily living (ADL) impairment were more inclined to outpatient and inpatient services. Transportation, medical expenses, the out-of-pocket ratio and the urgency of the disease were associated with provider selection. The universal medical insurance schemes improved health service utilization for the elderly population but had little impact on the choice of medical institutions. The older adults preferred public institutions to private institutions, preferred primary institutions for outpatient care, and higher-level hospitals for hospitalization.

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