Determinants of Health-seeking Behaviour in Northeast India

2019 ◽  
Vol 21 (2) ◽  
pp. 234-257 ◽  
Author(s):  
Sapana Ngangbam ◽  
Archana K. Roy
Keyword(s):  
Primary Healthcare ◽  
Urban Areas ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Northeast India ◽  
Sample Survey ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
The Cost

India’s northeast region comprises eight states, which, together, is home to 3.8 per cent of the country’s population. The quality of healthcare and manpower availability remains a cause for concern in the region, affecting the overall health-seeking behaviour of the people. This study attempts to understand the determinants of utilization of healthcare services in Northeast India. Healthcare and morbidity data for this study are based on a Northeast India sample from the National Sample Survey Organization’s (NSSO’s) health consumption data (2014). Probit, multinomial and mixed conditional logit models were employed in the study. In Northeast India, uneducated, higher-aged, Schedule Castes/Schedule Tribes (SCs/STs), Muslims, rural people and district people are served less by medical institutions and because of poor road connectivity they either remain untreated or seek care at underequipped primary healthcare services, while their counterparts utilize private facilities mostly for outpatient care and either public hospital or private facilities for inpatient care. There is also a tendency to substitute alternative healthcare when the cost of an inpatient healthcare service rises. To protect the interest of marginalized people and achieve the target of accessible, affordable and quality healthcare, the government needs to strengthen the primary healthcare in rural areas and improve the quality of healthcare in urban areas without increasing the cost of treatment.

scholarly journals Do We Get What We Pay For? Examining the Relationship Between Payments and Clinical Outcomes in High-Volume Elective Surgery in a Commercially-Insured Population

2020 ◽  
Vol 57 ◽  
pp. 004695802096878
Author(s):  
Madison Arenchild ◽  
Anaeze C. Offodile ◽  
Lee Revere
Keyword(s):  
Elective Surgery ◽  
High Volume ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Care Provision ◽  
Quality Outcomes ◽  
Prolonged Length ◽  
The Cost ◽  
The Relationship

Studies evaluating the cost and quality of healthcare services have produced inconsistent results. We seek to determine if higher paid hospitals have higher quality outcomes compared to those receiving lower payments, after accounting for clinical and market level factors. Using inpatient commercial claims from the IBM® MarketScan® Research Databases, we used an ordinal logistic regression to analyze the association between hospital median payments for elective hip and knee procedures and 3 quality outcomes: prolonged length of stay, complication rate, and 30-day readmission rate. Patient-level and market factor covariates were appropriately adjusted. Hospital-level payments were found to be not significantly correlated with hospital quality of care. This research suggests that higher payments cannot predict higher quality outcomes. This finding has implications for provider-payer negotiations, value-based insurance designs, strategies to increase high-value care provision, and consumer choices in an increasingly consumer-oriented healthcare landscape.

scholarly journals Perceptions of Good-Quality Antenatal Care and Birthing Services among Postpartum Women in Nepal

2021 ◽  
Vol 18 (13) ◽  
pp. 6876
Author(s):  
Sushma Rajbanshi ◽  
Mohd Noor Norhayati ◽  
Nik Hussain Nik Hazlina
Keyword(s):  
Quality Of Care ◽  
Low Socioeconomic Status ◽  
Healthcare Providers ◽  
Healthcare Facility ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Interpersonal Behavior ◽  
Postpartum Women ◽  
Health Seeking

Patient complaints and dissatisfaction should be taken seriously and used as an opportunity to provide acceptable services. Mounting evidence shows that the perception of the quality of healthcare services impacts health-seeking behaviors. This study explores the perceptions of good-quality antenatal and birthing services among postpartum women. A qualitative study using phenomenological inquiry was conducted in the Morang district, Nepal. The study participants were postpartum women with at least one high-risk factor who refused the referral hospital’s birth advice. A total of 14 women were purposively selected and interviewed in-depth. NVivo 12 Plus software was used for systematic coding, and thematic analysis was performed manually. Three themes emerged: (i) women’s opinions and satisfactory factors of health services, (ii) expectations of the health facility and staff, and (iii) a lack of suggestions to improve the quality of care. Women did not have many expectations from the healthcare facility or the healthcare providers and could not express what good quality of care meant for them. Women from low socioeconomic status and marginalized ethnicities lack knowledge of their basic reproductive rights. These women judge the quality of care in terms of staff interpersonal behavior and personal experiences. Women will not demand quality services if they lack an understanding of their basic health rights.

scholarly journals Satisfaction with quality of healthcare at primary healthcare settings: Perspectives of patients with type 2 diabetes mellitus

2020 ◽  
Vol 76 (1) ◽  
Author(s):  
Tania Steyl
Keyword(s):  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Primary Healthcare ◽  
Well Being ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Healthcare Management ◽  
Healthcare Settings

Background: Measuring client satisfaction is part of the quality assurance process and has become an integral part of healthcare management strategies globally. It is essential for improvement of amenities in healthcare facilities.Objectives: The aim of this study was to assess patients with type 2 diabetes’ satisfaction with healthcare services at primary healthcare settings in the Cape Metropolitan district, Western Cape, South Africa.Methods: This cross-sectional study used proportionate stratified random sampling. The Patient Survey for Quality of Care scale was used to assess patients with type 2 diabetes’ satisfaction with quality of care received. Descriptive and inferential statistics were employed in the analysis of the quantitative data. The open-ended question was analysed qualitatively.Results: The majority of patients were satisfied with the overall quality of care. Dissatisfaction was reported for waiting time to get appointments at the clinic, to see a healthcare professional on the same day and clarity of instructions for managing their diabetes.Conclusion: Employing more staff in the multidisciplinary team and improving health information by developing staff through continuous education could foster more positive experiences and provide care that contributes to the well-being of patients.Clinical implications: Addressing patients’ views regarding quality of healthcare services could assist in overall improvement of healthcare provision through the rectification of the system weaknesses. Satisfaction with quality of care could positively affect adherence to treatment protocols that could lead to better quality of life of patients with type 2 diabetes.

scholarly journals A qualitative inquiry of access to and quality of primary healthcare in seven communities in East and West Africa (SevenCEWA): perspectives of stakeholders, healthcare providers and users

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Soter Ameh ◽  
Bolarinwa Oladimeji Akeem ◽  
Caleb Ochimana ◽  
Abayomi Olabayo Oluwasanu ◽  
Shukri F. Mohamed ◽  
...  
Keyword(s):  
Health Insurance ◽  
West Africa ◽  
Primary Healthcare ◽  
A Priori ◽  
Healthcare Providers ◽  
Health Coverage ◽  
Health Seeking ◽  
East And West ◽  
Universal Health

Abstract Background Universal health coverage is one of the Sustainable Development Goal targets known to improve population health and reduce financial burden. There is little qualitative data on access to and quality of primary healthcare in East and West Africa. The aim of this study was to describe the viewpoints of healthcare users, healthcare providers and other stakeholders on health-seeking behaviour, access to and quality of healthcare in seven communities in East and West Africa. Methods A qualitative study was conducted in four communities in Nigeria and one community each in Kenya, Uganda and Tanzania in 2018. Purposive sampling was used to recruit: 155 respondents (mostly healthcare users) for 24 focus group discussions, 25 healthcare users, healthcare providers and stakeholders for in-depth interviews and 11 healthcare providers and stakeholders for key informant interviews. The conceptual framework in this study combined elements of the Health Belief Model, Health Care Utilisation Model, four ‘As’ of access to care, and pathway model to better understand the a priori themes on access to and quality of primary healthcare as well as health-seeking behaviours of the study respondents. A content analysis of the data was done using MAXQDA 2018 qualitative software to identify these a priori themes and emerging themes. Results Access to primary healthcare in the seven communities was limited, especially use of health insurance. Quality of care was perceived to be unacceptable in public facilities whereas cost of care was unaffordable in private facilities. Health providers and users as well as stakeholders highlighted shortage of equipment, frequent drug stock-outs and long waiting times as major issues, but had varying opinions on satisfaction with care. Use of herbal medicines and other traditional treatments delayed or deterred seeking modern healthcare in the Nigerian sites. Conclusions There was a substantial gap in primary healthcare coverage and quality in the selected communities in rural and urban East and West Africa. Alternative models of healthcare delivery that address social and health inequities, through affordable health insurance, can be used to fill this gap and facilitate achieving universal health coverage.

scholarly journals Association of patients’ perception of quality of healthcare received and colorectal cancer screening uptake: An analysis of two national surveys in the United States

2020 ◽  
Author(s):  
Karan Chawla ◽  
Angesom Kibreab ◽  
Victor & Scott ◽  
Edward L. Lee ◽  
Farshad Aduli ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
The United States ◽  
Crc Screening ◽  
Fair Poor ◽  
National Trends

Objective: It is unknown whether patients’ ratings of the quality of healthcare services they receive truly correlate with the quality of care from their providers. Understanding this association can potentiate improvement in healthcare delivery. We evaluated the association between patients’ ratings of the quality of healthcare services received and uptake of colorectal cancer (CRC) screening. Subject and Methods: We used two iterations of the Health Information National Trends Survey (HINTS) of adults in the United States. HINTS 2007 (4,007 respondents; weighted population=75,397,128) evaluated whether respondents were up-to-date with CRC screening while HINTS 4 cycle 3 (1,562 respondents; weighted population=76,628,000) evaluated whether participants had ever received CRC screening in the past. All included respondents from both surveys were at least 50 years of age, had no history of CRC, and had rated the quality of healthcare services that they had received at their healthcare provider’s office in the previous 12 months. Results: HINTS 2007 data showed that respondents who rated their healthcare as good, or fair/poor were significantly less likely to be up to date with CRC screening compared to those who rated their healthcare as excellent. We found comparable results from analysis of HINTS 4 cycle 3 data with poorer uptake of CRC screening as the healthcare quality ratings of respondents’ reduced. Conclusion: Our study suggested that patients who reported receiving lower quality of healthcare services were less likely to have undergone and be compliant with CRC screening recommendations. It is important to pay close attention to patient feedback surveys in order to improve healthcare delivery.

MEASURING SPATIAL HEALTHCARE FACILITIES ACCESSIBILITY USING TWO-STEP FLOATING CATCHMENT ANALYSIS (2SFCA) (Case Study: Cianjur Regency, Indonesia)

2021 ◽  
pp. 11
Author(s):  
Muhamad Iqbal Januadi Putra ◽  
Nabila Dety Novia Utami
Keyword(s):  
Travel Time ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Spatial Accessibility ◽  
Healthcare Facilities ◽  
Spatial Disparities ◽  
Time Threshold

The presence of healthcare facilities is quite essential to provide good healthcare services in a particular area, however, the existence of healthcare facilities is not evenly distributed in Cianjur Regency. This condition leads to the disparities of healthcare facilities across the Cianjur Regency. In this paper, we aim to measure and map the spatial disparities of healthcare facilities using a Two-Step Floating Catchment Analysis (2SFCA). This method can calculate the magnitude of spatial accessibility for healthcare facilities by formulating the travel time threshold and the quality of healthcare facilities across the study area. This research shows the result that the spatial accessibility of healthcare facilities in the Cianjur Regency is not evenly distributed across the districts. The spatial accessibility value resulted from 2SFCA is ranging from 0- 3.97. A low value indicates low spatial accessibility, while a higher value shows good accessibility. The majority of districts in the Cianjur Regency have the spatial accessibility value 0-0.5 (86%). Meanwhile, only a few have the higher value; value 0.5-0.99 as much as 6.6%, 0.99-1.49 as 3.3%, and 3.48-3.97 has a percentage of 3.3%. Also, this analysis results in the cluster of good spatial accessibility in healthcare facilities, namely the Pagelaran District and Cipanas District. Interestingly, the downtown of Cianjur Regency has lower spatial accessibility compared to both areas.

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