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

2019 ◽  
Vol 44 (2) ◽  
pp. 113-122 ◽  
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.

scholarly journals A review of the public-funded primary health care facilities for children in the pluralistic health care settings of Barbados, a Caribbean island

2015 ◽  
Vol 17 (02) ◽  
pp. 157-165
Author(s):  
Anders L. Nielsen ◽  
Alok Kumar
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care System ◽  
Care Service ◽  
Health Care Service ◽  
Care Providers ◽  
Ministry Of Health ◽  
The Public ◽  
Primary Health ◽  
Care System

AimThe major objectives of this study were to evaluate the existing pediatrics health care service provisions and utilizations of the public polyclinics in Barbados. Furthermore, the aim was to assess if the existing manpower resources were adequate.BackgroundBarbados has a mixed health care system consisting of both a socialized and a private health care system. The Ministry of Health commissioned a needs assessment survey of the pediatrics primary health care at the public polyclinics.MethodsPrimary data were collected through interviews with the public primary health care providers. Secondary data were collected from the Barbados Census Data and Ministry of Health statistics. Data were analyzed to assess the pediatrics primary health care service utilization and adequacy of existing resources at the polyclinics.FindingsIn 2012, there were 62 934 visits from children <16 years of age to the public polyclinics in Barbados and this accounted for 39.1% of all visits (both adults and children) to the polyclinics. An overall 16.7% of the visits were from children less than five years old to the Well Child Clinic for immunization and for growth and development monitoring; 32% of all physician consultations at the polyclinics were for children <16 years. Utilization of health services by children at the polyclinics was 5245 visits/month. Given an expected monthly demand for 10 822 visits from children, the polyclinics serve 48.5% of the primary health care demand for children in Barbados.ConclusionsThe public polyclinics play a pivotal role in the pluralistic primary health care system in Barbados. They fulfill nearly half of all the primary care demand and more importantly provides for almost the entire immunization demand, and thereby ensuring high coverage.The existing resources, if used optimally, would reduce the long consultation time observed in this setting, and thereby increase the capacity considerably.

scholarly journals Delivery of Health Care Service in the Organization of Islamic Cooperation (OIC) Member States and Regional Diversity: A Bootstrap Dea Analysis

2019 ◽  
Vol 5 (1) ◽  
pp. 59-66
Author(s):  
Nabila Asghar ◽  
Majid Ali ◽  
Fatima Farooq ◽  
Urooj Talpur
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Health Care Services ◽  
Care Service ◽  
Health Care Service ◽  
Allocative Efficiency ◽  
Truncated Regression ◽  
Regression Approach ◽  
Care System

For the last few decades, demographic changes require new and expensive medical innovations, which ultimately put the health care system under financial pressure. Therefore, provision of efficient services for the sustainability in health care system is mandatory. The objective of this study is to explore the performance of health care services provided in 55 OIC member countries during 2011 and 2015.The bootstrap Data Envelopment Analysis and Truncated regression approach have been applied to observe the health system and estimate the efficiency score  in 55 OIC member countries. The findings of DEA show that cost efficiency (CE), technical efficiency (TE) and allocative efficiency (AE) of health care system of OIC member countries on average are 0.52, 0.72, and 0.70, respectively. It indicates that OIC countries are not good at selecting cost efficient input mix. The results of truncated regression approach indicate that out-pocket health expenditures is the most important determinant relative to other indicators. It is suggested that it is hard to improve the overall health system at most efficient level. For this purpose there is a need to educate the mass and provide the better opportunities so that people can earn handsome amount, through which they may have better health care.

Indicating Fields of Inequalities Regarding the Access to Health Benefits

2014 ◽  
pp. 27-41
Author(s):  
Krzysztof Landa ◽  
Karolina Skora ◽  
Iwona Zaczyk
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care System ◽  
Care Service ◽  
Health Care Service ◽  
Health Benefits ◽  
Access To Health Services ◽  
Web Portal ◽  
Access To Health ◽  
Care System

Restrictions to health services in Poland inspired the establishment of the Watch Health Care Foundation (WHC). The fundamental disease of the system is the disproportion between the amount of the funds and the contents of the package. It causes the same “symptoms” and leads to the same pathological phenomena everywhere: queues and other forms of rationing (“guaranteed”) health benefits, corruption, and making use of privileges. The foundation uses the potential of the information society and available infrastructure (Web portal, www.watchealthcare.eu), and all activities are presented on the Website with the aim of influencing the health care system. On the basis of reports of limited access to health services, a registry of patient problems was created in the WHC Web portal, which aims to show what the biggest gaps in access to health services are – this is a way of showing the patient and health care system the needs and also one possible approach to continuous education of the health care service consumers targeted at health care system improvement.

scholarly journals Defining Health Service Eco-System “Infection”: A Critical Analysis of Patient Surveys

2018 ◽  
Vol 13 (9) ◽  
pp. 118 ◽  
Author(s):  
Maria V. Ciasullo ◽  
Orlando Troisi ◽  
Silvia Cosimato ◽  
Alex Douglas
Keyword(s):  
Health Care ◽  
Health Service ◽  
Literature Review ◽  
Health Care System ◽  
Care Service ◽  
Health Care Service ◽  
Assessment Tools ◽  
System Perspective ◽  
Patient Surveys ◽  
Care System

Purpose – This paper focuses on the analysis of the most common tools that health care organizations use to assess the quality of the delivered services, the patient surveys. In line with the results of a systematic literature review on the issue, the study embraces service ecosystem perspective to understand why these surveys are unable to grasp actors’ disposition to co-create value for the health care system. Methodology – An in-depth literature review based on PRISMA framework explored 34 works on the topic of patient surveys in order to trace the evolution of the relationship users/providers and to highlight the criticalities related to the adoption of patient surveys in service-oriented era. The study discusses critically their efficacy to understand how they can affect (positively or negatively) the viability of a health care service eco-system. Findings – The literature review highlights patient surveys inability in grasping the real perception that patients have of experienced services and in involving them in value co-creation, through their engagement in service design and delivery. Moreover, the results reveal the need to adopt Service Dominant (S-D) Logic and service eco-system perspective to reread the traditional tools to measure quality in healthcare. For this reason, the metaphor of health service eco-system “infection” is launched, depicting the negative influence of patient satisfaction surveys on value co-creation and the subsequent service eco-system viability. Practical implications – The study shows that assuming a service eco-system perspective based on S-D logic, health care system should boost and preserve value co-creation processes. Moreover, institutions should foster those “rules of the game” that institutionalize the contribution of health providers to value co-creation, defining specific strategies to avoid the “infections” of health care service eco-system, e.g. investing and promoting non-detrimental tools.Originality – This study represents one of the first attempts to reread the tools used to assess patient embracing a service eco-system perspective. Interesting implications have been presented in terms of the negative effect that traditional assessment tools have on providers, patients and the whole society.

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

2019 ◽  
Vol 16 (23) ◽  
pp. 4768 ◽  
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.

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

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1009-1010
Author(s):  
Ya-Mei Chen ◽  
Shih-Cyuan Wu ◽  
Shiau-Fang Chao ◽  
Kuan-Ming Chen ◽  
Chen-Wei Hsiang ◽  
...  
Keyword(s):  
Health Care ◽  
Service Utilization ◽  
Service Use ◽  
Care Service ◽  
Health Care Service ◽  
Care Group ◽  
Use Patterns ◽  
Care Services ◽  
Home Based ◽  
Professional Care

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.

A National Study of Health Care Service Utilization and Substance Use After the 2010 Chilean Earthquake

2014 ◽  
Vol 65 (11) ◽  
pp. 1392-1395 ◽  
Author(s):  
Dana Rose Garfin ◽  
Vanessa Juth ◽  
Roxane Cohen Silver ◽  
Francisco Javier Ugalde ◽  
Heiko Linn ◽  
...  
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Service Utilization ◽  
Care Service ◽  
Health Care Service ◽  
National Study ◽  
Health Care Service Utilization ◽  
Chilean Earthquake
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