Trends in the location of the HIV-positive population in Australia: Implications for access to healthcare services and delivery

Sexual Health ◽  
2010 ◽  
Vol 7 (2) ◽  
pp. 154 ◽  
Author(s):  
Marina Carman ◽  
Jeffrey Grierson ◽  
Marian Pitts ◽  
Michael Hurley ◽  
Jennifer Power
Keyword(s):  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Capital City ◽  
Service Development ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Service Access ◽  
Longitudinal Data Collection ◽  
Positive Population

Background: Examining existing and potential trends in the HIV-positive population in Australia is important for current and future healthcare service development and delivery. Methods: A new analysis of existing data on this population from the HIV Futures 5 survey was based on linking a geographic breakdown of respondents based on ‘area type’ – capital city or inner suburban, outer suburban, regional centre and rural – with patterns of healthcare service access. In addition, the distance between the postcode of the respondent’s residence and the postcode of the doctor seen for HIV-related treatment was calculated. An analysis of ‘area type’ by income and age was also conducted. Results: The ‘area type’ analysis showed important differences in patterns of access to antiretroviral prescriptions and choice of provider for HIV-related and general healthcare. The median distance travelled to see a doctor for HIV-related treatment was higher for those living in outer suburbs than those living in regional centres. Discussion: Differences in service use appear to be related to geographic accessibility of different service types. However, there may be other important social, economic and cultural factors involved. Ageing and socio-economic pressures may be influencing a move away from inner suburban areas where most HIV-specific care is located. This new analysis assists in finding the right balance between increasing the accessibility of HIV-specific services and ‘mainstreaming’. Longitudinal data collection would further assist in tracking trends in geographic location, and how often and at what intervals people living with HIV utilise healthcare services.

Gender Differences in Youth Suicide and Healthcare Service Use

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 290-298 ◽  
Author(s):  
Samantha Gontijo Guerra ◽  
Helen-Maria Vasiliadis
Keyword(s):  
Mental Health ◽  
Gender Differences ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Outpatient Services ◽  
Health Related ◽  
Healthcare Service Use ◽  
Ed Visits

Abstract. Background: Healthcare service use among suicide decedents must be well characterized and understood since a key strategy for preventing suicide is to improve healthcare providers' ability to effectively detect and treat those in need. Aims: To determine gender differences in healthcare service use 12 months prior to suicide. Method: Data for 1,231 young Quebec residents (≤ 25 years) who died by suicide between 2000 and 2007 were collected from public health insurance agency databases and coroner registers. Healthcare visits were categorized according to the setting (emergency department [ED], outpatient, and hospital) and their nature (mental health vs. non-mental health). Results: Girls were more likely than boys (82.5% vs. 74.9%, p = .011) to have used healthcare services in the year prior to death. A higher proportion of girls had used outpatient services (79.0% vs. 69.5%, p = .003), had been hospitalized (25.7% vs. 15.6%, p < .001) and had received a mental health-related diagnosis (46.7% vs. 33.1%, p < .001). However, no gender differences were observed in ED visits (59.5% vs. 54.5%, p = .150). Conclusion: There is an important proportion of suicide decedents who did not receive a mental health diagnosis and healthcare services in the year prior to death. Future studies should focus on examining gender-specific individual and health system barriers among suicide decedents as well as the quality of care offered regarding detection and treatment.

Impact of hospital atmosphere on perceived health care outcome

2015 ◽  
Vol 28 (2) ◽  
pp. 129-140 ◽  
Author(s):  
Ritu Narang ◽  
Pia Polsa ◽  
Alabi Soneye ◽  
Wei Fuxiang
Keyword(s):  
Service Quality ◽  
Healthcare Service ◽  
Service Use ◽  
Service Providers ◽  
Healthcare Quality ◽  
Clinical Effectiveness ◽  
Healthcare Services ◽  
Content Type ◽  
The People ◽  
Developed Nations

Purpose – Healthcare service quality studies primarily examine the relationships between patients ' perceived quality and satisfaction with healthcare services, clinical effectiveness, service use, recommendations and value for money. These studies suggest that patient-independent quality dimensions (structure, process and outcome) are antecedents to quality. The purpose of this paper is to propose an alternative by looking at the relationship between hospital atmosphere and healthcare quality with perceived outcome. Design/methodology/approach – Data were collected from Finland, India, Nigeria and the People ' s Republic of China. Regression analysis used perceived outcome as the dependent variable and atmosphere and healthcare service quality as independent variables. Findings – Results showed that atmosphere and healthcare service quality have a statistically significant relationship with patient perceived outcomes. Research limitations/implications – The sample size was small and the sampling units were selected on convenience; thus, caution must be exercised in generalizing the findings. Practical implications – The study determined that service quality and atmosphere are considered significant for developing and developed nations. This result could have significant implications for policy makers and service providers developing healthcare quality and hospital atmosphere. Originality/value – Studies concentrate on healthcare outcome primarily regarding population health status, mortality, morbidity, customer satisfaction, loyalty, quality of life, customer behavior and consumption. However, the study exposes how patients perceive their health after treatment. Furthermore, the authors develop the healthcare service literature by considering atmosphere and perceived outcome.

scholarly journals Trends in the utilization of youth primary healthcare services and psychological distress

2020 ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract BackgroundPsychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need.MethodsThis study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. ResultsWe found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 500 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.ConclusionsOur findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

State of the (positive) nation: findings from the fourth national Australian HIV futures survey

2007 ◽  
Vol 18 (9) ◽  
pp. 622-625 ◽  
Author(s):  
J W Grierson ◽  
M K Pitts ◽  
R D Thorpe
Keyword(s):  
Health Condition ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Social Variables ◽  
Major Health ◽  
Health And Wellbeing ◽  
Anonymous Questionnaire ◽  
Living With Hiv ◽  
Positive Population ◽  
Hiv Aids

This paper characterises the health and wellbeing of people living with HIV/AIDS (PLWHA) in Australia. The HIV Futures 4 Survey is a self-complete anonymous questionnaire distributed through multiple sites. Data were collected on health, clinical and social variables. There were 1059 responses, approximately 8% of the estimated HIV-positive population. Respondents were aged between 18 and 92 years and 77% were homosexual men. In total, 60% reported a viral load of <500 copies/mL and 83% a CD4 count of over 250 cells/ μL. A total of 44% reported another major health condition and 35% a mental health condition. A total of 71% were using antiretroviral therapy. More than half of the respondents had stopped working because of HIV and 25% were living in poverty. In conclusion, adequate planning for the future of our response to HIV/AIDS relies in no small part on our access to detailed information about how the epidemic affects those with the virus.

scholarly journals Systems modelling to support the complex nature of healthcare services

2020 ◽  
Author(s):  
Per Engelseth ◽  
B. E. White ◽  
Ingunn Mundal ◽  
Trude Fløystad Eines ◽  
Duangpun Kritchanchai
Keyword(s):  
Information Technology ◽  
Complex Systems ◽  
Systems Thinking ◽  
Technology Use ◽  
Healthcare Service ◽  
Contingency Theory ◽  
Healthcare Services ◽  
Service Development ◽  
Complex Nature ◽  
Complex Systems Thinking

AbstractHealthcare is a service commonly associated with lacking performance in relation to output and the economy of production. Contingency theory and complex systems thinking are approaches here combined to study the logistics of healthcare service flows. Contingency theory directs attention to networked interdependencies while complex systems thinking concerns process emergence and flexible resource use in supporting logistics. This hybrid form of analysis gives conceptual direction to information technology development and use to support the logistics of healthcare services. Three small examples of healthcare service as logistics processes in their as-is state are provided and analysed based on the developed analytical framework. These illustrate in detail what exemplifies complexity in this industry. Given the inherently complex nature of many types of healthcare services, this discussion concerns how to conceptually model information systems in healthcare services as a complex system. This chosen complexity-sensitive approach of service logistics constitutes a basis for information technology enabled healthcare service development sensitive to this type of service provision directing focus to the emergent features of healthcare service needs. It is also a basis for further investigation into this topic of information technology use to support the inherent logistical complexity of healthcare services.

scholarly journals Disability, Caste and Intersectionality: Does Co-Existence of Disability and Caste Compound Marginalization for Women Seeking Maternal Healthcare in Southern Nepal?

2021 ◽  
Author(s):  
Hridaya Raj Devkota ◽  
Andrew Clarke ◽  
Emily Murray ◽  
Maria Kett ◽  
Nora Groce
Keyword(s):  
Service Utilization ◽  
Healthcare Service ◽  
Healthcare Services ◽  
Household Wealth ◽  
Service Development ◽  
Maternal Healthcare ◽  
Women With Disabilities ◽  
Disabled Women ◽  
Dalit Women ◽  
Natal Care

Background: Disability and caste are two different forms of oppression, however Dalits and people with disabilities commonly face similar types of marginalities. Dalit women with disabilities may experience double discrimination because of the intersectionality of disability and caste. This study examines whether the disability and caste identity of women together affects and compounds the utilization of maternal healthcare services. Methods: A cross-sectional survey was conducted using a semi-structured questionnaire among a total of 354 Dalit and non-Dalit women, with and without a disability aged between 15 &ndash; 49 years. Maternal healthcare service utilization was assessed by Ante-Natal Care (ANC), health facility (HF) delivery, and Post-Natal Care (PNC) during the last pregnancy. Logistic regression was performed to detect the predictors of service utilization and identify whether disability and caste were associated with service utilization. First, disability and caste were fitted separately in models. Secondly, the intersectionality of disability and caste was tested by the inclusion of disability*caste interaction term. Finally, the confounding effect of socio-demographic factors was investigated. Results: Out of surveyed women, 73% had 4+ ANC visits, 65% had HF delivery and 29% had a PNC visit during their last pregnancy. Women with a disability had lower odds of HF delivery (OR 0.50, CI 0.30 &ndash; 0.84) and PNC (OR 0.47, CI 0.25 &ndash; 0.88) than women without a disability. Adjustment for women&rsquo;s age and household wealth explained associations in HF delivery by women with disabilities. There was no association between caste and service utilization. Disability overrode caste and there was no other evidence of effect modification by women&rsquo;s caste status in the utilization. However, a weak interaction effect in the utilization of ANC services was found in the caste group by their education (OR 0.19, 95% CI 0.05 &ndash; 0.74). Conclusions: Disabled women &ndash; whether Dalit or non-Dalit - had lower rates of utilizing all maternal healthcare services than non-disabled women. However, Dalit women with disabilities were more likely to receive PNC than non-Dalit women with disabilities. Increasing equity in maternal healthcare service utilization requires that traditional approaches to service development and program intervention to be re-examined and more nuanced interventions considered to ensure improved access and outcome among all vulnerable groups.

scholarly journals Trends in the utilization of youth primary healthcare services and psychological distress

2020 ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract Background Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need.Methods This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. Results We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 300 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.Conclusions Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

scholarly journals Trends in the utilization of youth primary healthcare services for psychological distress

2020 ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract Background Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the relationship between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need. Methods This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 ( n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time.Results We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 300 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.Conclusions Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

scholarly journals Structural vulnerabilities and healthcare services integration

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Bent Steenberg
Keyword(s):  
Life Histories ◽  
Significant Proportion ◽  
Healthcare Services ◽  
Medical Pluralism ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Structural Factors ◽  
Migrant Communities ◽  
Collective Narratives ◽  
Cultural Estrangement

Home to one fifth of all people living with HIV, South Africa carries the world’s heaviest burden of this disease. While a significant proportion of those infected are immigrants from other African high-prevalence countries, little is known about how these migrants engage with healthcare systems in shifting cultural and clinical settings. This article draws on fieldwork from migrant communities and twenty-one ethnographic life histories told by HIV-positive Mozambicans in a major South African HIV clinic. From their collective narratives, a range of structural vulnerabilities are found that limit immigrants’ access to, and proper integration within, healthcare services. These include perilous migration, xenophobia and deportation, exclusion and exploitation, language barriers, medical pluralism, cultural estrangement, social isolation, and the stigmas of being HIV-positive. In conjunction, these structural factors may delay treatment-seeking and inhibit drug adherence, which could increase rates of morbidity and mortality as well as contribute to viral mutation and antiretroviral drug resistance.

scholarly journals “Accessibility”: A new narrative of healthcare services for people living with HIV in the capital city of Indonesia

2021 ◽  
Vol 7 (3) ◽  
pp. 227-234
Author(s):  
Mahathir Mahathir ◽  
Wiwin Wiarsih ◽  
Henny Permatasari
Keyword(s):  
Sampling Technique ◽  
Phenomenological Approach ◽  
Healthcare Services ◽  
Capital City ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Service Outcomes ◽  
Qualitative Phenomenological ◽  
Living With Hiv

Background: The progress of the fight against HIV is highlighted by significant change. HIV of the past is different from HIV of the present. Healthcare services have played an essential role in achieving the optimal goals needed to end the HIV epidemic. However, people living with HIV and those at risk of catching it (PLWH) often misunderstand the rapid growth of HIV healthcare service options.Objective: This study aimed to explore the experiences of PLWH in the healthcare services featured in this study.Methods: A qualitative phenomenological approach was used. Semi-structured interviews were conducted in 2017 with 12 PLWH who engaged with healthcare services in Jakarta, Indonesia, by using a purposive sampling technique. Semi-structured questions were asked which related to their experiences of using the services. Stevick Colaizzi Keen method was used to extract the thematic analysis of the study.Results: The study developed four essential themes of PLWH healthcare use. They were accessibility, availability at all healthcare levels, comprehensiveness of service, and affordability.Conclusion: Providing accessible healthcare services is considered essential by PLWH. It is also pivotal to helping people feel positive about the community-related healthcare services on offer. Nurse-led HIV services must maintain this progress by continuously evaluating the quality-of-service outcomes and promoting the accessibility of the services to the broader population.

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