Effectiveness of home- and community-based services in decreasing health care service and expenditure in Taiwan

Abstract Background Whether long-term care service use decreases older adults’ health care service use and cost has been a strong interest among aging countries, including Taiwan. The current study examined the impact of continuous use of HCBS offered by Taiwan’s LTC plan 2.0 on older adults’ health service utilization and cost overtime. Methods This study used the LTC Plan 2.0 database and the National Health Insurance Plan claim dataset, and included 151,548 clients who had applied for and were evaluated for LTC services for the first time from 2017 through 2019 and continuously used any LTC Plan 2.0 services for six months. Outcome variables were users’ health service utilization and health care cost 12 months before and after starting to continuously use HCBS. Latent class analysis and generalized estimating equations were used to investigate the influences of different service use patterns on the changes in physical functions. Results Three subgroups of LTC recipients with different use patterns, including home-based personal care (home-based PC) services (n = 107324, 70.8%), professional care services (n = 30466, 20.1%), and community care services (n = 13794, 9.1%) were identified. When compared to care recipients in the community care group, those in the home-based PC group had more emergency room expenditures (1 point/month, p< 0.05) but less hospitalization expenditures (38 points/month, p<0.001), while the professional care group had less emergency room and hospitalization expenditures (3 and 138 points/month, p< 0.001). Conclusion Those receiving professional care and home care services spent less on health care service utilization.

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Use of health care services 6 months following major trauma

Australian Health Review ◽

10.1071/ah070628 ◽

2007 ◽

Vol 31 (4) ◽

pp. 628 ◽

Cited By ~ 10

Author(s):

Belinda J Gabbe ◽

Ann M Sutherland ◽

Owen D Williamson ◽

Peter A Cameron

Keyword(s):

Health Care ◽

Health Care Services ◽

Service Use ◽

Major Trauma ◽

Injury Severity ◽

Care Service ◽

Health Care Service ◽

Trauma Patients ◽

Care Services ◽

Use Of Health Care

To establish the use of health care services 6 months following major trauma, 243 blunt major trauma patients were recruited during their acute hospital stay and followed up by telephone interview at 6 months post-injury. Data collected at 6 months included health care service usage and their level of disability according to the Glasgow Outcome Scale ? Extended (GOSE). Ninety-four percent of patients were living in the community at 6 months, and most (69%) reported continued use of health care services. Of those with ongoing disability, non-compensable patients were significantly more likely (OR 3.7; 95% CI, 1.6?8.6) to have ceased health care service use than compensable patients, independent of injury severity.

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From Their Perspective: The Connection between Life Stressors and Health Care Service Use Patterns of Homeless Frequent Users of the Emergency Department

Health & Social Work ◽

10.1093/hsw/hlz010 ◽

2019 ◽

Vol 44 (2) ◽

pp. 113-122 ◽

Cited By ~ 6

Author(s):

Megan Moore ◽

Kelsey M Conrick ◽

Ashok Reddy ◽

Ann Allen ◽

Craig Jaffe

Keyword(s):

Health Care ◽

Emergency Department ◽

Service Utilization ◽

Health Care System ◽

Service Use ◽

Care Service ◽

Health Care Service ◽

Frequent Users ◽

Medical Needs ◽

Care System

Abstract The perspective of homeless adults on their health care service utilization is not well studied. This article describes a study that used in-depth, semistructured interviews with 18 individuals to highlight the viewpoints of homeless people who are frequent users of the emergency department (ED) about the influence of life events on service utilization. Participants reported high levels of pain and comorbid psychiatric, substance use, and medical conditions. They also reported an identifiable pattern of health care utilization, often centered on a crisis event, influenced by high perceived medical needs, inability to cope after crisis, predisposing vulnerability from social determinants of health, and health care system factors. A social work case management intervention often led to a period of stability and use of ED alternatives. Modifiable targets for intervention at the health care system and local levels include improving trust and convenience of ED alternatives, enhancing consistency of care at ED-alternative sites, and educating those at risk of frequent ED use about community alternatives.

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Conventional health care service utilization among cancer survivors that visit traditional and complementary providers in the Tromsø study: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-021-07445-6 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Kiwumulo Nakandi ◽

Dana Mora ◽

Trine Stub ◽

Agnete E. Kristoffersen

Keyword(s):

Health Care ◽

Cancer Survivors ◽

Cancer Patients ◽

Service Utilization ◽

Health Care Services ◽

Care Service ◽

Health Care Service ◽

Care Services ◽

Conventional Health Care ◽

Health Care Service Utilization

Abstract Background Traditional and complementary medicine (T&CM) is commonly used among cancer patients worldwide. Cancer patients in Norway mainly visit T&CM providers in addition to conventional health care services. It is not known how their utilization of T&CM providers influences their use of conventional health care services. The aim of this study was to investigate the difference between the utilization of conventional health care services among cancer survivors that visit T&CM providers and those that do not, and their associated factors. Method Health care service utilization data were obtained from cancer survivors 40 years and above participating in the Tromsø Study: Tromsø 7 conducted in 2015–2016. Data were collected from self-administered questionnaires. Pearson chi-square tests, Fisher exact tests, t-test, and logistic regression were used, with the significance level considered at p < 0.05. Results Of 1553 individuals, 10% (n = 155) reported visiting T&CM providers in the past 12 months. As both cancer survivors visiting and not visiting T&CM providers were frequent users of conventional health care, no significant differences were found in the overall use of conventional health care (98.1vs.94.5%, p = .056). Users of T&CM providers were however more likely to visit physiotherapists (40.1% vs 25%, p < .001), emergency rooms (29.2% vs 16.5%, p < .001), chiropractors (17% vs 6%, p < .001), and psychologist/psychiatrist (8.9% vs 3.4%, p < .001). They also had more frequent visits to conventional health care (11.45 vs 8.31 yearly visits, p = 0.014), particularly to general practitioners (5.21 visits vs. 3.94 visits, p = .002). Conclusion Results from this study show that visits to T&CM providers are associated with more visits to conventional health care services among cancer survivors. Further studies are needed to investigate the reasons for this high use behavior.

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EFFECT OF INDIVIDUAL AND COMMUNITY FACTORS ON MATERNAL HEALTH CARE SERVICE USE IN INDIA: A MULTILEVEL APPROACH

Journal of Biosocial Science ◽

10.1017/s0021932015000048 ◽

2015 ◽

Vol 48 (1) ◽

pp. 1-19 ◽

Cited By ~ 14

Author(s):

AWDHESH YADAV ◽

RANJANA KESARWANI

Keyword(s):

Health Care ◽

Maternal Health ◽

Health Care Services ◽

Service Use ◽

Care Service ◽

Health Care Service ◽

Maternal Health Care ◽

Community Level ◽

Care Services ◽

Maternal Health Care Services

SummaryThis study aimed to assess empirically the influence of individual and community (neighbourhood) factors on the use of maternal health care services in India through three outcomes: utilization of full antenatal care (ANC) services, safe delivery and utilization of postnatal care services. Data were from the third round of the National Family Health Survey (2005–06). The study sample constituted ever-married women aged 15–49 from 29 Indian states. Multilevel logistic regression analysis was performed for the three outcomes of interest accounting for individual- and community-level factors associated with the use of maternal health care services. A substantial amount of variation was observed at the community level. About 45%, 51% and 62% of the total variance in the use of full ANC, safe delivery and postnatal care, respectively, could be attributed to differences across the community. There was significant variation in the use of maternal health care services at the individual level, with socioeconomic status and mother's education being the most prominent factors associated with the use of maternal health care services. At the community level, urban residence and poverty concentration were found to be significantly associated with maternal health care service use. The results suggest that an increased focus on community-level interventions could lead to an increase in the utilization of maternal health care services in India.

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Health Status and Health Service Utilization among Vietnamese Farmers in a Mountainous Province

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16234768 ◽

2019 ◽

Vol 16 (23) ◽

pp. 4768 ◽

Cited By ~ 2

Author(s):

Diep Ngoc Nguyen ◽

Long Hoang Nguyen ◽

Cuong Tat Nguyen ◽

Hai Quang Pham ◽

Jongnam Hwang ◽

...

Keyword(s):

Health Care ◽

Health Status ◽

Health Service ◽

Service Utilization ◽

Health Service Utilization ◽

Service Use ◽

Care Service ◽

Health Care Service ◽

The Self ◽

Self Rated Health

Problems of poor health status and low health service use among farmers in mountainous areas have not been fully investigated. A cross-sectional study was conducted in Son La, a mountainous province in Vietnam, to assess the self-rated health and health care service utilization among farmers. Visual analogue scale (VAS) was used to measure the self-rated health. Multivariate Tobit, Poisson, and logistic regression were employed to identify related factors. Among 197 farmers, the mean VAS score was 67.8 (SD = 15.5). Approximately 40% of participants reported health problems, and the most popular morbidity was hypertension—56.4%. There were 28.9% and 50.3% of farmers using inpatient and outpatient treatments in the last 12 months, respectively. Age, educational level, family income, marital status, alcohol use, and source of information have been identified as associated factors with self-rated health status and morbidities, while age, gender, education, and morbidities were related to health service utilization. Data indicated a high proportion of health issues and a high rate of health care service use among farmers in a mountainous area of Vietnam. Adaptable health policies and prevention programs or preventive health services should be implemented regularly in mountainous regions to protect farmers from the onset of morbidities and to enhance their health.

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EPA Guidance on Building Trust in Mental Health Services

European Psychiatry ◽

10.1016/j.eurpsy.2014.01.001 ◽

2014 ◽

Vol 29 (2) ◽

pp. 83-100 ◽

Cited By ~ 27

Author(s):

W. Gaebel ◽

M. Muijen ◽

A.E. Baumann ◽

D. Bhugra ◽

D. Wasserman ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Service Utilization ◽

Health Care Services ◽

Care Service ◽

Health Care Service ◽

Mental Health Care Service ◽

Care Services ◽

Health Care Service Utilization

AbstractPurposeTo advance mental health care use by developing recommendations to increase trust from the general public and patients, those who have been in contact with services, those who have never been in contact and those who care for their families in the mental health care system.MethodsWe performed a systematic literature search and the retrieved documents were evaluated by two independent reviewers. Evidence tables were generated and recommendations were developed in an expert and stakeholder consensus process.ResultsWe developed five recommendations which may increase trust in mental health care services and advance mental health care service utilization.DiscussionTrust is a mutual, complex, multidimensional and dynamic interrelationship of a multitude of factors. Its components may vary between individuals and over time. They may include, among others, age, place of residence, ethnicity, culture, experiences as a service user, and type of disorder. For mental health care services, issues of knowledge about mental health services, confidentiality, continuity of treatment, dignity, safety and avoidance of stigma and coercion are central elements to increase trust.ConclusionEvidence-based recommendations to increase mutual trust of service users and psychiatrists have been developed and may help to increase mental health care service utilization.

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The impact of HCBS use patterns on older aduts’ physical function among continuous service users

Innovation in Aging ◽

10.1093/geroni/igab046.3641 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 1026-1027

Author(s):

Ya-Mei Chen ◽

Shih-Cyuan Wu ◽

Kuan-Ming Chen ◽

Chen-Wei Hsiang ◽

Shiau-Fang Chao ◽

...

Keyword(s):

Physical Function ◽

Community Care ◽

Care Group ◽

Term Care ◽

Use Patterns ◽

Care Services ◽

Care Recipients ◽

Home Based ◽

Professional Care ◽

The Impact

Abstract Background Taiwan, one of the fastest aging countries in the world, provides home-and community-based services (HCBS) care recipients through the second 10-Year Long-Term Care Plans (LTC Plans 2.0). The current study aimed to examine the impact of continuous use of HCBS offered by LTC plan 2.0 on older adults’ physical function change overtime. Methods This study used the LTC Plan 2.0 database and the National Health Insurance Plan claim dataset, and included 157,682 clients who had applied for and were evaluated for LTC services for the first time from 2018 through 2020 and continuously used any LTC Plan 2.0 services for six months. Outcome variables were measured by activities ofdaily living (ADLs) and instrumental activities of daily living (IADLs) between baseline assessment and the assessment after the six months of serivce utilization. Latent class analysis and generalized estimating equations were used to investigate the influences of different service use patterns on the changes in physical functions. Results Three subgroups of LTC recipients with different use patterns, including home-based personal care (home-based PC) services (n = 111,976; 71.01%), professional care services (n = 31,584; 20.03%), and community care services (n = 14,122; 8.96%) were identified. When compared to care recipients in the community care group, those in the home-based PC group improved more in IADL scores, and the professional care group improved more ADL scores. Conclusion Those receiving more professional services made more progress in ADL ability, but those in home-based PC made more progress in IADL ability.

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