Patterns of health service utilisation among the Australian population with cancer compared with the general population

2020 ◽  
Vol 44 (3) ◽  
pp. 470 ◽  
Author(s):  
Huah Shin Ng ◽  
Bogda Koczwara ◽  
David Roder ◽  
Raymond Javan Chan ◽  
Agnes Vitry
Keyword(s):  
General Population ◽  
Health Service ◽  
Health Services ◽  
Chronic Diseases ◽  
Health Service Utilisation ◽  
Control Group ◽  
Service Utilisation ◽  
Australian Population ◽  
Delivery Of Care ◽  
Barriers And Enablers

Objective The aim of this study was to describe patterns of health service utilisation among the Australian population with cancer compared with the general population. Methods Data for all respondents aged ≥25 years from two successive National Health Surveys conducted between 2011 and 2014 were analysed. Respondents with a history of cancer were identified as the cancer group, whereas all other respondents who did not report having had a cancer were included in the non-cancer control group. Comparisons were made between the two groups using logistic regression models. Results The population with cancer was more likely to report having consulted their general practitioner, specialist, chemist, dietician, naturopath, nurse, optometrist, dentist, audiologist and other health professionals than the non-cancer population. The cancer population was also more likely to be admitted to hospital and to have visited an out-patient clinic, emergency department and day clinic. The presence of comorbidity and a current cancer were associated with a greater likelihood of receiving health services among the population with cancer. Conclusion The population with cancer used health services significantly more than the non-cancer population. Further studies are urgently needed to identify optimal approaches to delivery of care for this population, including barriers and enablers for their implementation. What is known about the topic? Multimorbidity is highly prevalent among the cancer population due to risk factors shared between cancer and other chronic diseases, and the development of new conditions resulting from cancer treatment and cancer complications. However, the Australian healthcare system is not set up optimally to address issues related to multimorbidity. What does this paper add? This study is the first step in quantifying health services use by the population with cancer compared with the general population without cancer. Cancer survivors have an increased need for specific health services, particularly among those with multimorbidity. What are the implications for practitioners? The development of integrated care models to manage multiple chronic diseases aligned with the Australian National Strategic Framework for Chronic Conditions is warranted. Further studies are urgently needed to identify optimal approaches to delivery of care for this population, including barriers and enablers for their implementation.

Barriers to and facilitators of health services utilisation by refugees in resettlement countries: an overview of systematic reviews

2020 ◽  
Vol 44 (1) ◽  
pp. 132 ◽  
Author(s):  
Jamuna Parajuli ◽  
Dell Horey
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Services ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Health Service Utilisation ◽  
Barriers And Facilitators ◽  
Service Utilisation ◽  
Knowledge And Skills ◽  
Overview Of Systematic Reviews

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.

scholarly journals Using Linked Data to Estimate the True Number of Individuals Impacted by Residential Fire

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Nargess Ghassempour ◽  
Lara A Harvey ◽  
W. Kathy Tannous
Keyword(s):  
Emergency Department ◽  
Health Service ◽  
Health Services ◽  
Hospital Admissions ◽  
Population Based ◽  
Health Service Utilisation ◽  
Service Utilisation ◽  
Residential Fire ◽  
True Number ◽  
Residential Fires

IntroductionResidential fires remain a significant global public health problem. It is recognised that the reported number of residential fires, fire-related injuries and deaths significantly underestimate the true number. Australian population-based surveys show that around two-thirds of respondents who experience a residential fire are unwilling to call fire services, and studies from the US and New Zealand highlight that many individuals who access medical treatment for fire-related injuries do not have an associated fire incident report. Objectives and ApproachThis population-based study aimed to quantify the total number of residential fires, fire-related injuries and associated health service utilisation. The cohort included all persons residing at a residential address in New South Wales, Australia, which experienced a fire between 1 January 2005 - 31 December 2014. The cohort comprised linked person-level data from eight administrative datasets and includes information about nature of fire, first responder use (Fire and Rescue (FRNSW) and ambulance services), health service utilisation (emergency department, hospital and burns outpatient clinic) and health outcomes. ResultsOver the study period, FRNSW responded to 42,491 residential-fire incidents, involving 42,160 individuals with some individuals reporting multiple times. In total, 3,382 individuals used one or more health service and 154 individuals died. Of individuals who contacted FRNSW, 1,661 (3.9%) used health services;ambulance (n=1,101), emergency department (n=1,114), hospital admissions (n=168). There were 95 deaths. There were 1,721 (51%) additional individuals who used one or more health service as a result of a residential-fire that did not contact FRNSW and 59 additional deaths were identified. Conclusion / ImplicationsThis study found that more than half of individuals who used health services for residential fire-related injuries did not have an associated fire report, highlighting the importance of data linkage for accurate communication to policy makers and the public on the prevalence and impact of residential-fires.

scholarly journals Health service utilisation associated with chronic breathlessness: random population sample

2021 ◽  
pp. 00415-2021
Author(s):  
David C. Currow ◽  
Sungwon Chang ◽  
Magnus Ekström ◽  
Ann Hutchinson ◽  
Tim Luckett ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Hospital Admission ◽  
Demographic Data ◽  
Population Sample ◽  
Health Service Utilisation ◽  
Self Report ◽  
Systematic Sampling ◽  
Service Utilisation ◽  
Cross Sectional

Most health service utilisation studies are of people with specific diagnoses or demographic characteristics, and rarely of specific chronic symptoms. Does population-level health service utilisation increase in people with chronic breathlessness?MethodsCross-sectional analysis of the South Australian Health Omnibus Survey (HOS) 2017, a multi-stage, clustered area systematic sampling survey of adults where questions are administered face-to-face in respondents’ homes. Self-report of health service utilisation in the previous 3 months (medical consultations, ED, hospital admission), chronic breathlessness (severity, duration; modified Medical Research Council (mMRC) breathlessness scale) and demographic data were used to predict self-reported health service utilisation.ResultsA total of 2898 people were included (49.0% men; median age 48.0 years (IQR 32.0, 63.0); 64.1% educated beyond school; 55.4% in work; 73.5% had outpatient contact; 6.3% had a hospital admission in the previous three months). Chronic breathlessness (mMRC ≥1) was reported by 8.8% of respondents. In bivariable analyses, people with greater contact with health services were older, and a higher proportion were overweight/obese and had more severe chronic breathlessness. In multivariable analyses, chronic breathlessness and older age were positively associated with outpatient care and inpatient care, and people with chronic breathlessness were hospitalised for longer, incidence rate ratio 2.5 (95%CI: 1.4, 4.5).AnswerThere is a significant association between worse chronic breathlessness and increased health service utilisation. There is a need for greater understanding of factors that initiate contact with health services.

scholarly journals Low and unequal use of outpatient health services in public primary health care facilities in southern Ethiopia: a facility-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiwot Abera Areru ◽  
Mesay Hailu Dangisso ◽  
Bernt Lindtjørn
Keyword(s):  
Health Service ◽  
Health Services ◽  
Health Facilities ◽  
Health Service Utilisation ◽  
Southern Ethiopia ◽  
Service Utilisation ◽  
Cross Sectional ◽  
Health Authorities ◽  
Utilisation Rate ◽  
Children Under 5

Abstract Background Outpatient department visits per individual for each year are one of the core indicators of healthcare delivery to assess accessibility or quality of services. In addition, this study aimed to assess health service utilisation and disease patterns in southern Ethiopia, by including the health authorities’ suggestions to improve the services. No study has assessed this in Ethiopia previously. Methods An institution-based cross-sectional design study was done in 65 primary health care units in Dale and Wonsho districts, in Sidama region, for all patients visiting health facilities from 1 July 2017 to 30 June 2018. We estimated the utilisation rate as visits per person per year, the odds ratio for health use and proportions of diseases’ diagnoses. The results of our study were presented to local health authorities, and their suggestions for improvements were incorporated into the analysis. Result A total of 81,129 patients visited the health facilities. The annual outpatient health service utilisation was 0.18 (95% CI: 0.18–0.19) new visits per person per year. The health service utilisation rate per year for the rural population was lower than the urban utilisation by 91% (OR = 0.09; 95% CI: 0.08–0.09). Children in the age group of 5–14 years had lower odds of health service utilisation by 78% (OR = 0.22; 95% CI: 0.21–0.23), compared to children under 5 years of age. Females were four times (OR = 4.17; 95% CI: 4.09–4.25) more likely to utilise health services than males. Febrile illness constituted 17.9% (14,847 of 83,148) of the diagnoses in all age groups. Almost half of the febrile cases, 46.5% (3827 of 8233), were among children under 5 years of age. There were very few cases of non-communicable diseases diagnosed in the health facilities. The health authorities suggested improving diagnostic capacities at health centres, enhancing health professionals’ skill and attitudes, and improving affordability and physical accessibility of the services. Conclusion The health service utilisation rate was low in Sidama. The use of health services was lower among rural residents, men, children and elderly, and health post users. Improving the quality, affordability and accessibility of the health services, by involving responsible stakeholders could increase service usage.

scholarly journals Barriers and Enablers of Health Service Utilisation for Childhood Skin Infections in Remote Aboriginal Communities of Western Australia

2020 ◽  
Vol 17 (3) ◽  
pp. 808 ◽  
Author(s):  
David Hendrickx ◽  
Ingrid Amgarth-Duff ◽  
Asha C Bowen ◽  
Jonathan R Carapetis ◽  
Robby Chibawe ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Western Australia ◽  
Service Providers ◽  
Health Service Utilisation ◽  
Penicillin G ◽  
Service Utilisation ◽  
Skin Infections ◽  
Aboriginal Communities ◽  
Wide Range

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.

scholarly journals Health anxiety in Australia: prevalence, comorbidity, disability and service use

2013 ◽  
Vol 202 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Matthew Sunderland ◽  
Jill M. Newby ◽  
Gavin Andrews
Keyword(s):  
Health Service ◽  
Service Use ◽  
Clinical Investigation ◽  
Smoking Status ◽  
Health Anxiety ◽  
Significant Proportion ◽  
Epidemiological Data ◽  
Health Service Utilisation ◽  
Service Utilisation ◽  
Australian Population

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.

scholarly journals Longitudinal Youth in Transition Study (LYiTS): protocol for a multicentre prospective cohort study of youth transitioning out of child and adolescent mental health services at age 18

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e035744 ◽  
Author(s):  
Kristin Cleverley ◽  
Kathryn J Bennett ◽  
Sarah Brennenstuhl ◽  
Amy Cheung ◽  
Joanna Henderson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Psychiatric Symptoms ◽  
Child And Adolescent ◽  
Health Service Utilisation ◽  
Service Utilisation ◽  
Transition Study

IntroductionTransition between health services is widely recognised as a problematic hurdle. Yet, the factors necessary for successful transition out of child and adolescent mental health services (CAMHS) as youth reach the service boundary at age 18 are poorly understood. Further, fragmentation and variability among the services provided by mental health organisations serve to exacerbate mental illness and create unnecessary challenges for youth and their families. The primary aim of the Longitudinal Youth in Transition Study (LYiTS) is to describe and model changes in psychiatric symptoms, functioning and health service utilisation at the transition out of CAMHS at age 18 and to identify key elements of the transition process that are amendable to interventions aimed at ensuring continuity of care.Methods and analysisA prospective longitudinal cohort study will be conducted to examine the association between psychiatric symptoms, functioning and mental health and health service use of youth aged 16–18 as they transition out of child mental health services at age 18. We will recruit a sample of (n=350) participants from child and adolescent psychiatric programmes at two hospital and two community mental health sites and conduct assessments annually for 3 years using standardised measures of psychiatric symptoms, functioning and health service utilisation.Ethics and disseminationEthics approval has been obtained at all four recruitment sites. We will disseminate the results through conferences, open access publications and webinars.

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