Factors affecting the choice of health care utilisation between private and public services among the elderly population in India

Author(s):  
Chandrima Chatterjee ◽  
Narayan Chandra Nayak ◽  
Jitendra Mahakud ◽  
Suhita Chopra Chatterjee
2021 ◽  
Author(s):  
Xinlan Chen ◽  
Dai Su ◽  
Xinlin Chen ◽  
Yingchun Chen

Abstract BackgroundReceiving informal care from family members is the mainstream way of care for the elderly in China because of the influence of the culture of filial piety. However, the relationship between informal care and health care use in urban and rural areas needs to be further explored. This study aimed to understand the effect of informal care on health care utilisation for the elderly and explore how this effect differ between urban and rural China.MethodA total of 5704 residents aged 65 years and above were selected from the wave 3 (2015) and wave 4 (2018) of the China Health and Retirement Longitudinal Study, which is a nationally representative survey. A negative binomial regression model for panel data was used to explore the relationship between informal care and health care utilisation. Besides, a fixed-effect binary choice model for panel data was used for sensitivity test.ResultThe elderly who received informal care had an increase in outpatient and inpatient visits compared with those who did not receive. The inpatient visits of the elderly who received 15–29 days of informal care was higher (incidence rate ratio [IRR] = 2.082, P < 0.05). In addition, the elderly who received informal care for more than 30 days had 39.6% more inpatient visits (IRR = 1.396, P < 0.01) and 37.4% more outpatient visits than the elderly who did not receive informal care (IRR = 1.374, P < 0.05). For urban respondents, receiving informal care can facilitate outpatient use of the elderly, but for rural respondents, receiving informal care can predict an increase in outpatient and inpatient visits.ConclusionThe impact of informal care on health care utilisation varies between rural and urban residents. Relevant departments should pay attention to the differences in the medical service utilisation amongst different elderly groups and gradually reduce the medical inequality of the elderly.


Author(s):  
Josephine Storch ◽  
Carolin Fleischmann-Struzek ◽  
Norman Rose ◽  
Thomas Lehmann ◽  
Anna Mikolajetz ◽  
...  

Abstract Background To date, cost-effectiveness of influenza and pneumococcal vaccinations was assumed in several health economic modelling studies, but confirmation by real-world data is sparse. The aim of this study is to assess the effects on health care utilisation and costs in the elderly using real-world data on both, outpatient and inpatient care. Methods Retrospective community-based cohort study with 138,877 individuals aged ≥ 60 years, insured in a large health insurance fund in Thuringia (Germany). We assessed health care utilisation and costs due to influenza- or pneumococcal-associated diseases, respiratory infections, and sepsis in 2015 and 2016. Individuals were classified into four groups according to their vaccination status from 2008 to 2016 (none, both, or either only influenza or pneumococcal vaccination). Inverse probability weighting based on 236 pre-treatment covariates was used to adjust for potential indication and healthy vaccinee bias. Results Influenza vaccination appeared as cost-saving in 2016, with lower disease-related health care costs of − €178.87 [95% CI − €240.03;− €117.17] per individual (2015: − €50.02 [95% CI − €115.48;€15.44]). Cost-savings mainly resulted from hospital inpatient care, whereas higher costs occurred for outpatient care. Overall cost savings of pneumococcal vaccination were not statistically significant in both years, but disease-related outpatient care costs were lower in pneumococci-vaccinated individuals in 2015 [− €9.43; 95% CI − €17.56;− €1.30] and 2016 [− €12.93; 95% CI − €25.37;− €0.48]. Although we used complex adjustment, residual bias cannot be completely ruled out. Conclusion Influenza and pneumococcal vaccination in the elderly can be cost-saving in selective seasons and health care divisions. As cost effects vary, interpretation of findings is partly challenging.


2021 ◽  
Vol 3 ◽  
Author(s):  
Katinka Linnamäki

The purpose of this paper is to examine the Hungarian Fidesz-KDNP government´s discursive practices of control and care during the first wave of the COVID-19 pandemic. The paper researches the Hungarian government’s communication on the official Hungarian COVID-19 Facebook page during the first wave of the pandemic. Its aim is to answer the question how the Hungarian government articulated control and care to reinforce sedimented gendered division of care work and institutions of control to tackle the potential disruption of the system of care before the widespread vaccination of the elderly population was available in the country. The paper argues that the pandemic has allowed the government to exert control in areas, such as the crisis in the workforce market and health care system, as well as in the destabilized system of care work. The main finding is that in the material the government performs control over care work, whose intensified discussion during the pandemic could lead to a potential disruption within the illiberal logic on two different levels. First, physical care work related to immediate physical needs, like hunger, clothing, pain enacted by female shoppers, female health care workers and female social workers, is newly defined during the pandemic as local, family-bound and a naturally female task. Second, the government articulates care work, either as potentially harmful (for the elderly population and thus indirectly to the government’s familialist politics), or as vulnerable and in need of protection from outside influences (portrayed through the interaction of health care workers and “hospital commanders”). This enables the government to perform full state control over care workers through the mobilization of police and military masculinity and to strengthen and re-naturalize the already existing hierarchies between traditional gender roles from a new perspective during the pandemic. This state of affairs highlights the vulnerability both of the elderly population, on whom its familialism builds, and of the system of informal care work, which builds on the unpaid care work of female citizens, who paradoxically are also articulated as potential harm for the elderly and for the system.


2000 ◽  
Vol 118 (4) ◽  
pp. A678
Author(s):  
Paul Moayyedi ◽  
Richard Feltbower ◽  
Sara Duffett ◽  
Will Crocombe ◽  
David Forman ◽  
...  

2009 ◽  
Vol 13 (4) ◽  
pp. 453-460 ◽  
Author(s):  
Gisela Hostenkamp ◽  
Jan Sørensen

AbstractObjectiveRegular dietary intake of fish is associated with reduced risk of developing cardiovascular and other chronic diseases, and may improve general well-being. If fish eaters are healthier, they may use fewer health-care resources. The present study aimed to describe the reported intake of fish and fish products in a Danish general population, and to investigate whether fish consumption is associated with generic measures of self-reported health and consumption of health-care resources.DesignData on eating patterns and health status for 3422 Danish adults were obtained by telephone interview in the Funen County Health Survey. These data were merged with individual-level register data on health-care utilisation. Survey respondents were categorised into those consuming fish at least once weekly (fish eaters) and those consuming fish less frequently (non-fish eaters).ResultsPeople who reported eating fish twice monthly or once weekly had significantly better overall self-reported health than those who rarely eat fish, even after adjustment for age, gender, social characteristics and lifestyle factors. Fish eaters did not have significantly lower aggregated health-care costs, although their hospital utilisation was significantly lower than that for non-fish eaters.ConclusionsModerate fish consumption was associated with better self-reported general health even after controlling for possible confounding variables. Overall, fish eaters appeared to use the same amount of health-care resources as non-eaters, although fish eaters used more medicine but were less likely to be admitted to a hospital.


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