Understanding the Barriers of Violence Victims’ Health Care Use

2020 ◽  
Vol 61 (4) ◽  
pp. 470-485
Author(s):  
Keith L. Hullenaar ◽  
Michelle Frisco
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Injury Severity ◽  
Health Care Use ◽  
Situational Factors ◽  
Care Seeking ◽  
Care Providers ◽  
Crime Victimization ◽  
Serious Injury ◽  
Formal Health Care

Violence is a leading cause of death among U.S. adults under age 45. There are also 3.3 million living violence victims, most of whom forgo formal health care when injured. We developed and tested a framework to understand why. We argue that violence victims must consider their need for care and three situational factors of victimization that may serve as barriers for care seeking: the victim’s relationship to the offender, their victimization history, and the offense committed (sexual vs. nonsexual). In analyses of 9,912 violent victimizations from 8,635 participants in the National Crime Victimization Survey from 1993 to 2017, we found that injury severity and situational factors of victimization independently and interactively predict formal health care use. Even when serious injury occurs, victimizations involving known offenders, repeat victimizations, and sexual violence are less likely than their counterparts to result in formal health care use. We discuss the implications of these findings for victims and health care providers.

scholarly journals Prevalence and Patterns of Health Care Use Among Poor Older People Under the Livelihood Empowerment Against Poverty Program in the Atwima Nwabiagya District of Ghana

2019 ◽  
Vol 5 ◽  
pp. 233372141985545 ◽  
Author(s):  
Williams Agyemang-Duah ◽  
Charles Peprah ◽  
Francis Arthur-Holmes
Keyword(s):  
Health Care ◽  
Health Services ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Expenditure ◽  
Well Being ◽  
Health Care Use ◽  
Public Health Care ◽  
Care Providers ◽  
Health Lifestyle

In spite of the growing literature on prevalence and patterns of health care use in later life globally, studies have generally overlooked subjective standpoints of vulnerable Ghanaian older people obstructing the achievement of the United Nations’ health-related Sustainable Development Goals. We examined the prevalence and patterns of health care use among poor older people in the Atwima Nwabiagya District of Ghana. Cross-sectional data were obtained from an Aging, Health, Lifestyle and Health Services Survey conducted between June 1 and 20, 2018 ( N = 200). Chi-square and Fisher’s exact tests were carried out to estimate the differences between gender and health care utilization with significant level of less than or equal to 0.05. Whereas, 85% of the respondents utilized health care, females were higher utilizers (88% vs. 75%) but males significantly incurred higher health care expenditure. The majority utilized health services on monthly basis (38%) and consulted public health care providers (77%). While 68% utilized services from hospitals, most sourced health information from family members (54%) and financed their health care through personal income (45%). The study found that the Livelihood Empowerment Against Poverty grant played a little role in reducing health poverty. Stakeholders should review social programs that target poor older people in order to improve their well-being and utilization of health care.

scholarly journals Health care seeking behaviour of pulmonary tuberculosis patients in Jabalpur district, Madhya Pradesh

2020 ◽  
Vol 7 (2) ◽  
pp. 521
Author(s):  
Rupesh Sahu ◽  
Prashant Verma ◽  
Pradeep K. Kasar
Keyword(s):  
Health Care ◽  
Pulmonary Tuberculosis ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Care Seeking ◽  
Health Providers ◽  
Care Providers ◽  
Tuberculosis Control ◽  
First Choice

Background: Successful tuberculosis control requires specific behaviors from patients and health providers. Therefore, understanding behaviors is fundamental to design interventions to strengthen tuberculosis control programs, including communication interventions. The aim of this study was to assess the healthcare-seeking behavior of pulmonary tuberculosis (PTB) patients in Jabalpur district.Methods: Cross-sectional study was conducted among category I new sputum positive PTB patients identified from nine designated microscopy centres from November 2013 to October 2014. Calculated sample size of 135 with a multistage random sampling method was used. Student’s t-test and Chi-square test were used along with descriptive statistics.Results: Mean age of patients was 33.87 (14.3) years, males constituted 66.7%, 72.5% patients belonged to below class IV socioeconomic status. Cough was experienced by 91.1% subjects, followed by fever (69.6%). First action was consulting a health care provider (HCP) in 41.5% followed by self-medication (21.5%). It took two attempts for 76% of patients to reach a formal health care provider. Private health care providers were consulted as first choice among HCPs by 86.7% patients, initial diagnosis was made by them in 25.9% cases. Sixty-three percent of patients were not satisfied with care at government hospitals, 41.5% had not heard of tuberculosis before their diagnosis, 59.5% of patients got information about tuberculosis from their relatives suffering from it.Conclusions: Cough is the most common and earliest symptom responsible for seeking care in pulmonary tuberculosis. Government health facilities contribute maximum to diagnosis but private health facility is the first choice for initial consultation. Patients’ perception of suggestive symptoms needs to be changed.

scholarly journals Sensations, symptoms, and then what? Early bodily experiences prior to diagnosis of lung cancer

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249114
Author(s):  
Britt-Marie Bernhardson ◽  
Carol Tishelman ◽  
Birgit H. Rasmussen ◽  
Senada Hajdarevic ◽  
Marlene Malmström ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Health Care ◽  
Health Care Providers ◽  
Care Seeking ◽  
Care Providers ◽  
Long Duration ◽  
Degree Of Disability ◽  
Bodily Sensations ◽  
Diagnosis Of Lung Cancer ◽  
Key Indicators

Lung cancer (LC) generally lacks unique core symptoms or signs. However, there are a multitude of bodily sensations that are often non-specific, not easily understood, and many times initially not recognized as indicative of LC by the affected person, which often leads to late diagnosis. In this international qualitative study, we inductively analyzed retrospective accounts of 61 people diagnosed with LC in Denmark, England and Sweden. Using the bodily sensations they most commonly spoke about (tiredness, breathlessness, pain, and cough), we constructed four sensation-based cases to understand the pre-diagnostic processes of reasoning and practice triggered by these key indicators of LC. We thereafter critically applied Hay’s model of sensations to symptoms transformation, examining its central concepts of duration, disability and vulnerability, to support understanding of these processes. We found that while duration and disability are clearly relevant, vulnerability is more implicitly expressed in relation to perceived threat. Tiredness, even when of long duration and causing disability, was often related to normal aging, rather than a health threat. Regardless of duration, breathlessness was disturbing and threatening enough to lead to care-seeking. Pain varied by location, duration and degree of disability, and thus also varied in degree of threat perceived. Preconceived, but unmet expectations of what LC-related cough and pain would entail could cause delays by misleading participants; if cough lasted long enough, it could trigger health care contact. Duration, disability, and sense of threat, rather than vulnerability, were found to be relevant concepts for understanding the trajectory to diagnosis for LC among these participants. The process by which an individual, their family and health care providers legitimize sensations, allowing them to be seen as potential symptoms of disease, is also an essential, but varying part of the diagnostic processes described here.

scholarly journals Perceptions about preconception care among health care providers in Ibadan, southwest Nigeria - A qualitative study

2019 ◽  
Author(s):  
Oludoyinmola Omobolade Ojifinni ◽  
Latifat Ibisomi
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Providers ◽  
Pregnancy Outcomes ◽  
Preconception Care ◽  
Reproductive Age ◽  
Care Seeking ◽  
Care Providers ◽  
Medical Problems ◽  
Potential Benefits

Abstract Background: Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. Research has shown that PCC services are minimally available and yet to be fully integrated into maternal health services in Nigeria. This study explored the perceptions about PCC services among health care providers in Ibadan, Nigeria. Methods: This was a case study research among 26 health care providers – 16 specialist physicians and nine nurses covering 10 specialties: Obstetrics/Gynaecology, Cardiology, Endocrinology among others at the primary, secondary and tertiary health care levels. In-depth interviews were digitally recorded, transcribed verbatim and analysed on MAXQDA using thematic analysis. Results: Six main themes were identified from the data – scope of PCC, people who require PCC, where PCC services can be provided, acceptability of PCC services, relevance of PCC to different specialties including gynaecologists, cardiologists, nephrologists, psychiatrists and possible benefits of PCC. PCC was viewed as care for women, men and couples before pregnancy to optimise health status and ensure positive pregnancy outcomes. Almost all participants stated that PCC services should be offered at all three levels of health care with referral when needed from the lower to higher levels. The prevailing opinion on the circumstances when PCC is required was that although all people of reproductive age would benefit, those who had medical problems such as hypertension, sickle cell disease, diabetes and infertility would benefit more. Participants opined that delayed health care seeking observed in the community may influence acceptability of PCC especially for people without known pre-existing conditions. All specialist physicians identified the relevance of PCC to their practice and identified potential benefits of PCC. The potential benefits outlined included opportunity to plan and prepare for pregnancy to ensure positive pregnancy outcomes. Conclusion: Preconception care is perceived as being more important for promoting positive pregnancy outcomes in people with known medical problems and is relevant to different specialities of medical practice. Provision of the service will however require establishment of guidelines and its uptake will depend on acceptability to people with known medical problems who will benefit from the service.

scholarly journals Health Care Access and Utilization for American Indian Elders: A Concept-Mapping Study

2019 ◽  
Vol 76 (1) ◽  
pp. 141-151 ◽  
Author(s):  
David H Sommerfeld ◽  
Elise Trott Jaramillo ◽  
Erik Lujan ◽  
Emily Haozous ◽  
Cathleen E Willging
Keyword(s):  
Health Care ◽  
American Indian ◽  
Concept Mapping ◽  
Health Care Providers ◽  
Health Care Access ◽  
National Policy ◽  
Health Care Use ◽  
Care Providers ◽  
Factors Affecting ◽  
Care Access

Abstract Objectives Inequities in access to and utilization of health care greatly influence the health and quality of life of American Indian elders (AIEs). This study explores the importance and perceived prevalence of factors affecting health care use within this population and assesses the changeability of these factors to produce a list of action items that are timely and relevant to improving health care access and utilization. Method Concept mapping was conducted with AIEs (n = 65) and professional stakeholders (n = 50), including tribal leaders, administrators of public-sector health systems, outreach workers, and health care providers. Data were analyzed using multidimensional scaling and cluster analyses. Results The final concept-map model comprised nine thematic clusters related to factors affecting elder health care: Difficulties Obtaining and Using Insurance; Insecurity from Lack of Knowledge; Limited Availability of Services; Scheduling Challenges; Provider Issues and Relationships; Family and Emotional Challenges; Health-Related Self-Efficacy and Knowledge; Accessibility and Transportation Barriers; and Tribal/National Policy. Discussion Findings suggest that improvements in access to and utilization of health care among AIEs will require actions across multiple domains, including health system navigation services, workforce improvements, and tribal, state, and federal policy. A multilevel socioecological approach is necessary to organize and undertake these actions.

scholarly journals MEETING SOCIAL NEEDS TO IMPROVE HEALTH OUTCOMES: PARTNERSHIPS BETWEEN COMMUNITY-BASED ORGS AND HEALTH CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S499-S500
Author(s):  
Traci L Wilson ◽  
Suzanne R Kunkel ◽  
Jane Straker ◽  
Marisa Scala-Foley ◽  
Elizabeth Blair
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Social Services ◽  
Health Care Providers ◽  
Health Care Use ◽  
Social Needs ◽  
Care Providers ◽  
Community Based ◽  
Cross Sectional ◽  
Improve Health

Abstract Unmet social needs negatively affect individual and population health, and better integration of community-based supports and health systems is a promising approach to improve health outcomes and avoid unnecessary health care use. Community-based organizations (CBOs) such as Area Agencies on Aging (AAAs) and Centers for Independent Living (CILs), as providers and coordinators of social services, are well-positioned within their communities to coordinate care and provide for unmet social needs. Partnerships between CBOs and health care entities have clear potential to improve health care outcomes while also reducing expenditures. This paper will present a cross-sectional analysis of a national survey of AAAs, CILS, and other CBOs at two time points (2017: n=593; 2018: n=763) to understand the extent, type, and evolution of CBO engagement with health care providers. In addition, longitudinal analysis (n=374) shows movement at the organization level: 33% of organizations who did not have a contract at T1 but were pursuing one had achieved a contract by T2. This presentation will: describe details of the services delivered, contracting arrangements, and populations served under CBO/health care contracts, as well as challenges experienced by CBOs; examine differences by state and organizational structure; and discuss the implications of state policy on integrated care and contracting.

Supported motherhood? An examination of the cultural context of male participation in maternal health care among tribal communities in India

2019 ◽  
Vol 52 (3) ◽  
pp. 452-471 ◽  
Author(s):  
Suresh Jungari ◽  
Balram Paswan
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Providers ◽  
Cultural Context ◽  
Maternal Health Care ◽  
Primary Data ◽  
Care Seeking ◽  
Care Providers ◽  
Male Participation ◽  
Tribal Communities

AbstractIn many cultural settings worldwide, within families, men tend to be responsible for important choices relating to the allocation of household resources and care-seeking behaviour that directly impact on the health of women and newborns. This study examines the extent of male participation in antenatal care (ANC), delivery, postnatal care (PNC), household chores and providing food to wives among tribal communities in India. In addition, health care providers’ views on male participation in maternal health were examined. Primary data were collected from 385 men aged 15–49 from rural Gadchiroli District in Maharashtra, India. Interviews of 385 men whose wives had delivered a child within the previous 2 years were conducted between November 2014 and March 2015. Bivariate and multivariate analyses were done. The results showed that the tribal men’s participation in maternal health care was minimal. Around 22% of the men reported accompanying their wives to ANC, 25% were present at the time of delivery of their children and 25% accompanied their wives to PNC. Participation in household work, and support for wives in other ways, were slightly better. The main reason given by men for not participating in maternal health care was that they didn’t think it was necessary, believing that all maternal health issues were women’s concern. Health care providers among these tribal communities in India should encourage men to participate in issues related to maternal health care.

scholarly journals Experiences of Uncertainty in Men With an Elevated PSA

2016 ◽  
Vol 11 (1) ◽  
pp. 24-34 ◽  
Author(s):  
Caitlin Biddle ◽  
Alicia Brasel ◽  
Willie Underwood ◽  
Heather Orom
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Information Exchange ◽  
Specific Antigen ◽  
Significant Proportion ◽  
Management Plan ◽  
Care Seeking ◽  
Care Providers ◽  
Self Monitoring ◽  
Semistructured Interviews

A significant proportion of men, ages 50 to 70 years, have, and continue to receive prostate specific antigen (PSA) tests to screen for prostate cancer (PCa). Approximately 70% of men with an elevated PSA level will not subsequently be diagnosed with PCa. Semistructured interviews were conducted with 13 men with an elevated PSA level who had not been diagnosed with PCa. Uncertainty was prominent in men’s reactions to the PSA results, stemming from unanswered questions about the PSA test, PCa risk, and confusion about their management plan. Uncertainty was exacerbated or reduced depending on whether health care providers communicated in lay and empathetic ways, and provided opportunities for question asking. To manage uncertainty, men engaged in information and health care seeking, self-monitoring, and defensive cognition. Results inform strategies for meeting informational needs of men with an elevated PSA and confirm the primary importance of physician communication behavior for open information exchange and uncertainty reduction.

scholarly journals Family planning: formal health care providers' challenges in the district of Antananarivo Avaradrano

2013 ◽  
Vol 1 (3) ◽  
pp. 1
Author(s):  
Barbara Vololonarivelo ◽  
JeanFlorent Rafamatanantsoa ◽  
Valry Andriantoky ◽  
Julio Rakotonirina ◽  
Antso Raherinandrasana ◽  
...  
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Health Care Providers ◽  
Care Providers ◽  
Formal Health Care

scholarly journals Understanding the Puzzle of Primary Health-care Use: Evidence from India

2021 ◽  
Author(s):  
Pramod Kumar Sur
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Health Care Use ◽  
Public Health Care ◽  
Private Health Care ◽  
Care Providers ◽  
Care Services ◽  
Primary Health

In India, households' use of primary health-care services presents a puzzle. Even though most private health-care providers have no formal medical qualifications, a significant fraction of households use fee-charging private health-care services, which are not covered by insurance. Although the absence of public health-care providers could partially explain the high use of the private sector, this cannot be the only explanation. The private share of health-care use is even higher in markets where qualified doctors offer free care through public clinics; despite this free service, the majority of health-care visits are made to providers with no formal medical qualifications. This paper examines the reasons for the existence of this puzzle in India. Combining contemporary household-level data with archival records, I examine the aggressive family planning program implemented during the emergency rule in the 1970s and explore whether the coercion, disinformation, and carelessness involved in implementing the program could partly explain the puzzle. Exploiting the timing of the emergency rule, state-level variation in the number of sterilizations, and an instrumental variable approach, I show that the states heavily affected by the sterilization policy have a lower level of public health-care usage today. I demonstrate the mechanism for this practice by showing that the states heavily affected by forced sterilizations have a lower level of confidence in government hospitals and doctors and a higher level of confidence in private hospitals and doctors in providing good treatment.

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