Healthcare Utilization Pattern in Sri Lanka; Evidence from Household Survey

2020 ◽  
pp. 235-252
Author(s):  
G. L. D. C. Perera
Keyword(s):  
Sri Lanka ◽  
Healthcare Utilization ◽  
Household Survey ◽  
Utilization Pattern

scholarly journals 1632. Different Healthcare Utilization Pattern in Vaccine Hesitant Children

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S595-S596
Author(s):  
Sangho Sohn ◽  
Kwan Hong ◽  
Hari Hwang ◽  
Byung Chul Chun
Keyword(s):  
Healthcare Utilization ◽  
Total Duration ◽  
Population Data ◽  
Medical Attention ◽  
Utilization Rate ◽  
Utilization Pattern ◽  
Pneumococcal Infections ◽  
Opt Out ◽  
History Of ◽  
Type Of Institution

Abstract Background National Immunization Program (NIP) in Korea provides 17 types of mandatory vaccines for all children free of charge. However, vaccine-hesitant group refusing the NIP are being a major threat to public health. We analyzed the healthcare utilization pattern observed in NIP eligible children and sought to identify those who remain unvaccinated using national population data. Methods History of receiving protein conjugate pneumococcal vaccine (PCV) was reviewed to determine the vaccination status of children born between 2013 and 2015. Children who had 3-doses or more out of 3 + 1 schedule were defined vaccinated, while those with no record of vaccination were defined unvaccinated. Their healthcare utilization records, including a number of visits, total duration, type of institution (hospitals, complementary and alternative medicine [CAM]), and purpose of visits (outpatient care, hospitalization), were retrieved from the National Health Insurance (NHI) Review and Assessment Service. Annual healthcare utilization rate and incidence of pneumococcal infections were estimated with Poisson regression and compared between study arm. The proportion of CAM out of total healthcare utilization was also compared. Results Among 1,272,685 children, 51% were boys and median age was 29.4-months. Two-percent of the cohort remained unvaccinated until study end. Annual hospital visiting rates were 26.9 times (95% confidence interval [CI] 26.9–27.0) for vaccinated and 3.4 (95% CI 3.4–3.5) for unvaccinated. Average NHI benefit period per year was 28.8 days (95% CI 28.8–29.0) for vaccinated and 3.9 (95% CI 3.8–3.9) for unvaccinated. The discrepancy resulted in under-detection of pneumococcal incidence in unvaccinated with 10.1 cases (95% CI 9.9–10.4) per 1,000 child-months whereas that of vaccinated was 42.5 (95% CI 42.4–42.6). Vaccine hesitant children preferred CAM at least 3-times more than vaccinated children (CAM proportion 3.5% in hesitant group vs. 1.07% in vaccinated group, P < 0.001). Conclusion Vaccine hesitant group not only refuses vaccination but also tends to opt-out from the entire medical attention and prefer CAM. Active detection considering this different pattern should be implemented in order to ensure the public benefits from the vaccination program. Disclosures All authors: No reported disclosures.

scholarly journals Patient experiences of access to NCD medicines in Sri Lanka: Evidence of the success story towards universal coverage

2019 ◽  
Vol 3 ◽  
pp. 239920261987322
Author(s):  
BMR Fernandopulle ◽  
Nalika Gunawardena ◽  
SHP de Silva ◽  
Chinta Abayawardana ◽  
LK Hirimuthugoda
Keyword(s):  
Sri Lanka ◽  
Communicable Disease ◽  
Household Survey ◽  
Universal Coverage ◽  
Patient Experiences ◽  
Community Based ◽  
State Sector ◽  
Government Hospitals ◽  
Almost All ◽  
Non Communicable Disease

Introduction: In Sri Lanka in 2013, 16 medicines were identified as priority to manage non-communicable disease (NCD), and in 2017, 48 NCD medicines were price-regulated. Objective: The aim of the present study was to describe the experiences on availability of drugs and out-of-pocket expenditure (OOPE) for drugs among patients with NCDs in Sri Lanka. Methods: This community-based, household survey was conducted in nine districts of the country. The survey included 1100 adults (aged 50 years and above) with a diagnosis of NCD for 5 years. They were interviewed by trained pharmacy students. Results: Approximately 66%, 49% and 21.6% suffering from hypertension, diabetes and ischaemic heart disease, respectively, with a majority having more than one NCD. The evidence showed that prescribers align to drugs that have been recognized to be made more available and more affordable. Of all, 14% had prescriptions with all NCD medicines classified in the list, while 40% had only one or two of the drugs prescribed which are not in the list. Most of the prescribed drugs were also included in the price regulation – with 29% having all medicines included, while 31.6% having only one or two drugs prescribed out of the list. Approximately, two-thirds (64.2%) had exclusively used government hospitals for NCD care during the past 5 years. A majority (58.3%) had all prescribed drugs available at the last visit to the state sector clinic, while almost all of the others (35.7%) had some of the drugs available. Conclusion: The study concluded that patient experiences in Sri Lanka showed good availability and access to NCD medicines in Sri Lanka.

Health insurance ownership and its impact on healthcare utilization

2019 ◽  
Vol 47 (2) ◽  
pp. 244-267
Author(s):  
Ajantha Sisira Kumara ◽  
Ramanie Samaratunge
Keyword(s):  
Health Insurance ◽  
Sri Lanka ◽  
Peer Review ◽  
Healthcare Utilization ◽  
National Survey ◽  
Determinants Of Health ◽  
Risk Propensity ◽  
Formal Sector ◽  
Content Type ◽  
Reported Health

Purpose The purpose of this paper is to explore the determinants of health insurance ownership of individuals in the Sri Lankan labor force and to examine how insurance ownership impacts healthcare utilization. Design/methodology/approach The authors first used logit model to explore determinants of health insurance ownership. The authors then employed propensity score matching method to estimate impact of insurance ownership on healthcare utilization. Data were obtained from national survey of self-reported health in Sri Lanka – 2014 (n=59,276). National survey of self-reported health in Sri Lanka – 2014 was conducted by the Department of Census and Statistics from January to December 2014. Findings Results showed that individuals with higher educational attainments, headed by literate-heads, based in urban sector, employed in formal sector, and with health adversities and higher degree of risk propensity are more inclined to have a health cover. Health insurance ownership reduces the likelihood of utilizing public facilities while increasing the likelihood of utilizing private facilities for non-communicable diseases (NCDs) and acute illnesses. Welfare consequences of expanding insurance ownership are doubtful due to oligopolistic private healthcare market and adverse selection issue faced by insurers in Sri Lanka. Originality/value This is the first study examining health insurance–healthcare utilization nexus based on Sri Lanka-wide microdata. Also, the study applies bias-corrected matching methods to establish causal links between two constructs. Without being so generalized, healthcare utilization is examined in terms of NCD care and Acute illnesses care, which improves robustness of results and leads to evidence-based healthcare policies. Peer review The peer review history for this paper is available at: https//publons.com/publon/10.1108/IJSE-05-2019-0333.

scholarly journals Healthcare Utilization of Below Poverty Line Population under Government-Funded Health Protection Scheme in one sub-district in Bangladesh: A Cross-Sectional Study

2021 ◽  
Author(s):  
Md. Zahid Hasan ◽  
Mohammad Wahid Ahmed ◽  
Gazi Golam Mehdi ◽  
Jahangir AM Khan ◽  
Ziaul Islam ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Inpatient Care ◽  
Household Survey ◽  
Poverty Line ◽  
Cross Sectional Study ◽  
Hospital Inpatient ◽  
Cross Sectional ◽  
Protection Scheme ◽  
The Government ◽  
Hospital Inpatient Care

Abstract BackgroundThe below poverty line (BPL) population in rural Bangladesh have low access to hospital inpatient-care (IPC) services. The Government of Bangladesh (GoB) launched pilot Shasthyo Suroksha Karmasuchi (SSK) at Kalihati Upazila of Tangail district in 2016 aiming to improve IPC access of the BPL population and financial protection for healthcare. The GoB funded scheme provides IPC for 78 diseases and outpatient consultation through an existing health facility. In this study, we aimed to assess the level of healthcare utilization among the scheme beneficiaries and identify the associated factors with utilization.MethodsThis was an exploratory study with a cross-sectional household survey conducted from July to September 2018 among 806 sampled households using a structured questionnaire. Data on illness and healthcare utilization was collected from the selected households for the last 90 days of the interview date. A logistic regression model was applied to determine the factors associated with healthcare utilization from SSK facility.ResultsOverall, 8% of the ill patients in the last 90 days prior to survey sought healthcare from SSK facilities (n=639; total patients who sought care), 28% from medically trained providers (MTPs), and 64% from non-MTPs. Of the 23 (3.6%) patients who sought inpatient care (IPC), less than half (10 patients) of them utilized IPC under SSK. Individuals with accident/injury, unemployed, having knowledge about SSK, non-BPL status, were more likely to utilize healthcare from SSK facility. Individuals reside more than 15 km away from facility, had 4-5 family members, and above secondary level education were less likely to utilize care from SSK facility.Conclusions It is evident that healthcare utilization of beneficiaries from the SSK scheme was very low. Effective strategies for enhancing knowledge on SSK benefits and precise BPL households targeting can be instrumental in increasing utilization of the scheme. The scheme also has a potential to bring the individuals under its coverage who utilize healthcare from other MTP and non-MTP.

scholarly journals Special Health Care Utilization Pattern with Elevated Costs and High Risk of Premature Death Among Adults Living in Segregated Roma Settlements

2018 ◽  
Author(s):  
János Sándor ◽  
Anita Pálinkás ◽  
Ferenc Vincze ◽  
Nóra Kovács ◽  
Sipos Valéria ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Personal Data ◽  
Health Indicators ◽  
Premature Mortality ◽  
Premature Death ◽  
Care Utilization ◽  
Insurance Fund ◽  
Utilization Pattern ◽  
Special Health Care ◽  
Increased Risk

Roma is the largest ethnic minority of Europe with poor health status, which is poorly explored due to legal constrains of ethnicity assessment. We aimed to elaborate health-indicators for adults living in segregated Roma settlements (SRS) representing the most vulnerable Roma subpopulation. SRSs were mapped in a study area populated by 54682 adults. Records of all adults living in the study area were processed in the National Institute of Health Insurance Fund Management. Aggregated, age-sex standardized SRS-specific and non-SRS-specific indicators on healthcare utilization and premature death along with the ratio of them (RR) were computed with 95% confidence intervals. The rate of GP appointments was significantly higher among SRS inhabitants (RR=1.152, 95%CI: 1.136&ndash;1.167). The proportion of subjects hospitalized (RR=1.286, 1.177&ndash;1.405), and the reimbursement for inpatient care (RR=1.060, 1.057&ndash;1.064) were elevated for SRS. Premature mortality was significantly higher in SRSs (RR=1.711, 1.085-2.696). Our study demonstrated that it is possible to compute the SRS-specific version of the routine healthcare indicators without violating the protection of personal data by converting a sensitive ethical issue to a non-sensitive small area geographical analysis; there is an SRS-specific healthcare utilization pattern, which is associated with elevated costs and increased risk of premature death.

The utilization pattern of surgical lung biopsies (SLB) for the diagnosis of interstitial lung diseases (ILD) in Sri Lanka

2019 ◽  
Author(s):  
Amila Rathnapala ◽  
S Wickramasinghe ◽  
D Tilakaratne ◽  
H Chreif ◽  
S Palihawadana ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
Utilization Pattern ◽  
Lung Biopsies

scholarly journals Timing of mortality among internally displaced persons due to the tsunami in Sri Lanka: cross sectional household survey

BMJ ◽  
2006 ◽  
Vol 332 (7537) ◽  
pp. 334-335 ◽  
Author(s):  
Nobuyuki Nishikiori ◽  
Tomoko Abe ◽  
Dehiwala G M Costa ◽  
Samath D Dharmaratne ◽  
Osamu Kunii ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Household Survey ◽  
Internally Displaced Persons ◽  
Displaced Persons ◽  
Cross Sectional ◽  
Internally Displaced

scholarly journals Healthcare Utilization of Below Poverty Line Population under Government-Funded Health Protection Scheme in One Sub-district in Bangladesh: A Cross-Sectional Study

2021 ◽  
Author(s):  
Md. Zahid Hasan ◽  
Mohammed Wahid Ahmed ◽  
Gazi Golam Mehdi ◽  
Jahangir A. M. Khan ◽  
Ziaul Islam ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Inpatient Care ◽  
Household Survey ◽  
Poverty Line ◽  
Cross Sectional Study ◽  
Hospital Inpatient ◽  
Cross Sectional ◽  
Protection Scheme ◽  
The Government ◽  
Hospital Inpatient Care

Abstract Background The below poverty line (BPL) population in rural Bangladesh have low access to hospital inpatient-care (IPC) services. The Government of Bangladesh (GoB) launched pilot Shasthyo Suroksha Karmasuchi (SSK) at Kalihati Upazila of Tangail district in 2016 aiming to improve IPC access of the BPL population and financial protection for healthcare. The GoB funded scheme provides IPC for 78 diseases and outpatient consultation through an existing health facility. In this study, we aimed to assess the level of healthcare utilization among the scheme beneficiaries and identify the associated factors with utilization. MethodsThis was an exploratory study with a cross-sectional household survey conducted from July to September 2018 among 806 sampled households using a structured questionnaire. Data on illness and healthcare utilization was collected from the selected households for the last 90 days of the interview date. A logistic regression model was applied to determine the factors associated with healthcare utilization from SSK facility. ResultsOverall, 8% of the ill patients in the last 90 days prior to survey sought healthcare from SSK facilities (n=639; total patients who sought care), 28% from medically trained providers (MTPs), and 64% from non-MTPs. Of the 23 (3.6%) patients who sought inpatient care (IPC), less than half (10 patients) of them utilized IPC under SSK. Individuals with accident/injury, unemployed, having knowledge about SSK, non-BPL status, were more likely to utilize healthcare from SSK facility. Individuals reside more than 15 km away from facility, had 4-5 family members, and above secondary level education were less likely to utilize care from SSK facility. Conclusions It is evident that healthcare utilization of beneficiaries from the SSK scheme was very low. Effective strategies for enhancing knowledge on SSK benefits and precise BPL households targeting can be instrumental in increasing utilization of the scheme. The scheme also has a potential to bring the individuals under its coverage who utilize healthcare from other MTP and non-MTP.

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