COMPARING KNOWLEDGE AND USE OF HEALTH SERVICES OF MIGRANTS FROM RURAL AND URBAN AREAS IN KUNMING CITY, CHINA

2010 ◽  
Vol 42 (6) ◽  
pp. 743-756 ◽  
Author(s):  
XIAOLIN WEI ◽  
STEPHEN PEARSON ◽  
ZHANXIN ZHANG ◽  
JIANGMEI QIN ◽  
NANCY GEREIN ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Urban Residents ◽  
Financing System ◽  
Rural Residents ◽  
Rural Migrants ◽  
Utilization Of Health Services ◽  
Urban Migrants ◽  
Township Hospitals ◽  
High Level

SummaryThis paper compares the knowledge and utilization of health services among rural residents, urban residents, rural migrants and urban migrants in a large Chinese city. Data were obtained from a questionnaire survey of 2765 individuals (1951 heads of households and 814 spouses) in Guandu district, Kunming, in 2005. The determinants of their knowledge and utilization of health services were analysed using multivariate logistic regression. First, the migrant population was less likely to know of, or utilize, high-level hospitals and township hospitals than residents. Migrants were more likely to utilize private rather than public services for general health care and delivery care. Second, there was a difference between rural migrants and urban migrants in terms of knowledge and utilization of health services. Rural migrants utilized more low-cost private clinics, but had less knowledge about sources of condoms than urban migrants. Finally, rural residents had more knowledge and utilization of township hospitals than urban residents. This latter group were more likely to utilize high-level hospitals. Migrants' access to health care in urban China is understood better using a dual rural–urban and migrant–resident analytical framework. Rural migrants are the most disadvantaged in their access to urban health care. Further reform of the registered residence system and urban public financing system is recommended. Better information on services and their utilization should be provided to migrants and residents.

Overconcern and Overtreatment

PEDIATRICS ◽  
1980 ◽  
Vol 65 (4) ◽  
pp. 863-863
Author(s):  
Frank J. Volpe
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Professionals ◽  
American Association ◽  
Marketing Effort ◽  
Utilization Of Services ◽  
Utilization Of Health Services

Recently I received the pamphlet "Age 3 - Age 7" from the American Association of Orthodontists. It strikes me as a not-so-subtle marketing effort to increase the business of orthodontists. Could it be that pediatricians are being asked to do their marketing for them? At a time when health care professionals should be doing their utmost to decrease costs and unnecessary utilization of health services, this pamphlet encourages increased utilization of services of questionable worth.

scholarly journals Management by geographical area or management specialised by disorder? A mixed-methods evaluation of the effects of an organisational intervention on secondary mental health care for common mental disorder

2016 ◽  
Vol 4 (9) ◽  
pp. 1-114 ◽  
Author(s):  
Alex D Tulloch ◽  
Bryony Soper ◽  
Anke Görzig ◽  
Sophie Pettit ◽  
Leonardo Koeser ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Geographical Area ◽  
Care Quality ◽  
Research Centre ◽  
Individual Treatment ◽  
Care Pathways ◽  
High Level

BackgroundIn 2010, South London and Maudsley NHS Foundation Trust (SLaM) established a programme replacing the borough directorates responsible for adult mental health services with three Clinical Academic Groups (CAGs), each of which took on a subset of adult services straddling all four boroughs. Care pathways were also introduced. We studied the Mood Anxiety and Personality CAG, which took on assessment and treatment teams and psychotherapy services.ObjectivesWe aimed (1) to understand the CAG programme using realistic evaluation and (2) to assess whether or not it led to changes in activity and health-care quality.MethodsQualitative analysis was based on interviews and project documents. Quantitative analyses were based on electronic patient records and compared care in community mental health teams (CMHTs) and psychotherapy teams before and after CAG implementation. Analyses of activity covered caseload, counts of new episodes, episode length and number of contacts per episode. We also looked at CMHT costs. Analyses of effectiveness covered processes (pharmacological and psychological treatment of depression in CMHTs) and outcomes (effect on the Health of the Nation Outcome Scales total score or the Clinical Outcomes in Routine Evaluation 10-item version total score). Analyses of safety examined the rates of self-harm among current or recent CMHT patients. Patient centredness was represented by waiting time.ResultsThe first core component of SLaM’s CAG programme was the CAG restructuring itself. The second was the promotion of care pathways; interpreted as ‘high level pathways’, these schematised processes of referral, assessment, treatment, reassessment and discharge, but abstracted from the details of treatment. The three mechanisms of the CAG restructuring were increasing oversight, making teams fit the template of team types defined for each CAG (‘CAG compliance’) and changing financial accounts by grouping services in new ways; these mechanisms resulted in further reconfigurations. The use of high-level pathways supported service redesign and performance management. In CMHTs and psychotherapy teams activity tended to decrease, but this was probably not because of the CAG programme. CMHT costs were largely unchanged. There was no evidence that the CAG programme altered effectiveness or safety. Effects on waiting times varied but these were reduced in some cases. Overall, therefore, the CAG programme appeared to have had few effects on quality. We attributed this to the limited effect of the programme on individual treatment.ConclusionsSLaM’s CAG programme had clear effects on service reconfiguration at team level, with high-level pathways changing the ways that managers conceptualised their work. However, our quantitative work indicated no clear effects on quality. Thinking about how to use care pathways in ways that complement ‘high-level’ pathways by supporting the delivery of evidence-based treatments is a strategy that could help SLaM and other providers. Future research should look at the genesis of organisational change and how this is altered through implementation; it should also look at the effectiveness of care pathways in mental health services.FundingThe research was supported by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and was performed using infrastructure provided by the NIHR South London and Maudsley and Institute of Psychiatry Biomedical Research Centre.

Ecological Consciousness Setting during China Urbanization

2011 ◽  
Vol 361-363 ◽  
pp. 853-860
Author(s):  
Qiu Zhong ◽  
Guo Qing Shi
Keyword(s):  
Ecological Environment ◽  
Urban Residents ◽  
Anova Analysis ◽  
Ecological Consciousness ◽  
Rural Residents ◽  
Migration Experience ◽  
Urban And Rural Residents ◽  
Urban Migrants ◽  
Awareness Change ◽  
Environment Condition

China is facing ecological revolution now. The basis of the revolution is establishing the ecological consciousness. Different level of ecological consciousness in urban and rural area raised our attention. According to different environment conditions and based on pollution theory, we try to find out the cornerstone of setting ecological consciousness during this changing time. Since China is on the fast urbanization period, environmental awareness change on rural-urban migrants can be this key. This paper focused on which factor(s) have significant effect to ecological consciousness. Urban and Rural residents were interviewed for data collecting, and for deep research, three groups (Urban Residents Group, Rural residents Group and Migrants Group) are split based on responders’ migration experience. In this paper, ANOVA analysis and regression analysis are used. Based on pollution-driven theory, two models are given to compare the explanation strengths between within and without theory variables. We found that pollution experience and relative pollute have important effect on eco-consciousness. So Ecological Consciousness is not straight influenced by environment condition, but people think about the deterioration. We considered that, the cornerstone of setting ecological consciousness is recognizing the crisis and disruption of ecological environment.

Perceptions of “Male Sensitive” Health Services Among Men in Trinidad and Tobago

2020 ◽  
pp. 104365962096861
Author(s):  
Oscar Noel Ocho ◽  
Cynthia Archer Gift
Keyword(s):  
Health Care ◽  
Health Services ◽  
Focus Groups ◽  
Trinidad And Tobago ◽  
Health Care Providers ◽  
Service Providers ◽  
Care Providers ◽  
Utilization Of Health Services ◽  
Semistructured Interviews ◽  
And Behavior

Introduction While Caribbean researchers have explored masculinity, socialization, and behavior, the literature has been silent on masculinity and “male sensitive” health services. This study explored masculinity and perceptions of “male sensitive” health services. Method An interpretative, phenomenological, qualitative design that used 14 focus groups and 12 semistructured interviews among men between the ages 18 and 65 years. Results The notion of “male sensitive” services were more of preferences like having more females, timeliness, and privacy of services rather than a specific set of services unique to men. Services were expected to be professional, offered in private spaces, timely, and as an “all in one” service with more male service providers. Discussion Male utilization of health services may be a problem if they are not considered “sensitive” to their needs. This has implications for the reorientation of services, as well as, personnel, including increased involvement of males as health care providers.

scholarly journals Does the type of health insurance enrollment affect provider choice, utilization and health care expenditures?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Esso-Hanam Atake
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Health Care Expenditures ◽  
Health Centers ◽  
Health Insurance System ◽  
Public Insurance ◽  
Elderly Individuals ◽  
Utilization Of Health Services ◽  
Insurance Enrollment

Abstract Background Two of the objectives of Universal Health Coverage are equity in access to health services and protection from financial risks. This paper seeks to examine whether the type of health insurance enrollment affects the utilization of health services, choice of provider and financial protection of households in Togo. Methods Data were obtained from a cross-sectional, representative household survey involving 1180 insured households that had reported either illness in the household in the 4 weeks preceding the survey or hospitalization in the 12 months preceding the survey. A nested logit model was used to account for the utilization of health services and provider choice, and methods of assessing catastrophic health care expenditures were used to analyze the level of household financial protection. Results Policyholders of private health insurance use private health care facilities more than policyholders of public health insurance. The main reasons for not using health centers among households with public insurance were out-of-pocket payments (49.19%), waiting time (36.80%), and distance to the nearest health center (36.76%). Furthermore, on average, households with public insurance spent a higher proportion of their total monthly nonfood expenditures on health care than those with private insurance. We find that the type of insurance, share of expenditures allocated to food, distance to the nearest health center, and waiting time significantly impact the choice of provider. Regardless of the type of health insurance, elderly individuals avoid using private health centers and referral hospitals due to the high cost. Conclusion We found that a multiple health insurance system results in a multilevel health system that is not equitable for everyone. The capacity of the health insurance system to provide equitable health care services and protect its members from catastrophic health care expenditures should be at the core of health care reform. This study recommends raising awareness of the criteria for the reimbursement of medical procedures within the framework of public insurance and promoting specific health insurance mechanisms for elderly individuals. Careful attention should be paid to ensuring universal education and literacy as a means of improving access to and the use of health care.

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