scholarly journals Access to Home and Community Health Services for Older Adults With Serious, Life-Limiting Illness: A Study Protocol

2020 ◽  
Vol 38 (1) ◽  
pp. 12-18
Author(s):  
Jacob D. Hill ◽  
Allison M. Cuthel ◽  
Corita R. Grudzen
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Health Services ◽  
Health Care Utilization ◽  
Qualitative Interviews ◽  
Community Health Services ◽  
Community Services ◽  
Care Utilization ◽  
Service Availability ◽  
Access To Services

Objectives: The objective of this study is to identify contextual access factors to home and community health services for end-of-life support for older adults with serious life-limiting illness, as well as determine if access to home and community services is associated with health-care utilization. Design: This study includes an environmental scan, grey literature review, qualitative interviews, and health-care utilization analysis. This study is a subproject of the Grudzen et al. Primary Palliative Care for Emergency Medicine (PRIM-ER) study. Settings/Location: Analysis will include data collection from 17 health systems implementing the PRIM-ER intervention. Participants: For the qualitative interviews, one emergency medicine (EM) physician and one EM nurse will be interviewed from each of the 17 participating health systems. For the health-care utilization analysis, we will use the Senior Care Services Scale (SCSS), American Hospital Association Annual Survey of Hospitals (AHA-ASH), and Medicare claims for all emergency department (ED) visits for serious illness who present at each participating health system. Outcome Measures: The contextual analysis will obtain data on home and community services, such as hospice, home health services, assisted living, integrative medicine services, etc., available around each health system’s highest volume ED, federal and state regulations influencing access to services, as well as EM provider perspectives on access to services. The health-care utilization analysis will determine if SCSS scores, which measure service availability, are associated with health-care usage. High or low SCSS scores are determined by comparing health system service availability on the AHA-ASH to the national median SCSS value.

Community health services and health care utilization in rural Bangladesh

1989 ◽  
Vol 29 (12) ◽  
pp. 1343-1349 ◽  
Author(s):  
Ruhul Amin ◽  
Shifiq A. Chowdhury ◽  
G.M. Kamal ◽  
J. Chowdhury
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Utilization ◽  
Community Health ◽  
Community Health Services ◽  
Care Utilization ◽  
Rural Bangladesh

scholarly journals Analysis of the Effect of Health Insurance on Health Care Utilization in Rwanda

2021 ◽  
Author(s):  
Roger Muremyi ◽  
Dominique Haughton ◽  
François Niragire ◽  
Ignace Kabano
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Health Care Utilization ◽  
Health Care Services ◽  
Insurance Coverage ◽  
Secondary Data ◽  
Living Condition ◽  
Care Utilization ◽  
Health Coverage

In Rwanda, more than 90% of the population is insured for health care. Despite the comprehensiveness of health insurance coverage in Rwanda, some health services at partner institutions are not available, causing insured patients to pay unintended cost. We aimed to analyze the effect of health insurance on health care utilization and factors associated with the use of health care services in Rwanda. This is an analysis of secondary data from the Rwanda integrated living condition survey 2016-2017. The survey gathered data from 14580 households, and decision tree and multilevel logistic regression models were applied. Among 14580 households only (20%) used health services. Heads of households aged between [56-65] years (AOR=1.28, 95% CI:1.02-1.61), aged between [66-75] years (AOR=1.52, 95% CI: 1.193-1.947), aged over 76 years (AOR=1.48, 95% CI:1.137-1.947), households with health insurance (AOR=4.57, 95% CI: 3.97-5.27) displayed a significant increase in the use of health services. This study shows evidence of the effect of health insurance on health care utilization in Rwanda: a significant increase of 4.57 times greater adjusted odds of using health services compared to those not insured. The findings from our research will guide policymakers and provide useful insights within the Rwanda context as well as for other countries that are considering moving towards universal health coverage through similar models.

Factors affecting health care utilization of immigrants living in North of Turkey

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mehmet Korkmaz ◽  
Ilknur Aydın Avci
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Utilization ◽  
Young Female ◽  
Care Utilization ◽  
Content Type ◽  
Factors Affecting ◽  
Descriptive Research ◽  
Female Immigrants ◽  
Use Of Health Services

Purpose This paper aims to determine factors affecting health-care utilization of immigrants living in North of Turkey and make a case assessment about this factors and general health status of immigrants. Design/methodology/approach This study was conducted in accordance with the principles of descriptive research. The data of the study were collected by using questionnaire consisting of 33 questions that include socio-demographic specifications, use of health services and health perception level. Findings This study was conducted with 360 immigrants. Participants, of which 61.9% were female. Immigrants who are young, female, married, have low education, have chronic illnesses, and have been in hospital before, have a better use of health services. Originality/value Immigration experiences of immigrants and their lack of equal opportunities to access health services in the community lead them to use health services at a low level.

Patterns of Health Services Use Before Age 1 in Children Later Diagnosed With ADHD

2021 ◽  
Vol 25 (12) ◽  
pp. 1639-1639
Author(s):  
Matthew Engelhard ◽  
Samuel Berchuck ◽  
Jyotsna Garg ◽  
Shelley Rusincovitch ◽  
Geraldine Dawson ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Services ◽  
Health Care Utilization ◽  
Outpatient Clinic ◽  
Hospital Admissions ◽  
Care Utilization ◽  
Health Services Use ◽  
Utilization Patterns ◽  
Services Use

Background: Children with ADHD have 2 to 3 times increased health care utilization and annual costs once diagnosed, but little is known about utilization patterns early in life, prior to diagnosis. Quantifying early health services use among children later diagnosed with ADHD could help us understand the early life impact of the disorder and uncover health care utilization patterns associated with higher ADHD risk. Methods: Electronic health record (EHR) data from the Duke University Health System (DUHS) was analyzed for patients born October 1, 2006–October 1, 2016. Those with at least two well-child visits before age 1 were grouped as ADHD or not ADHD based on retrospective billing codes. Adjusted odds ratios (AORs) for hospital admissions, procedures, emergency department (ED) visits, and outpatient clinic encounters before age 1 were compared between groups via logistic regression controlling for sex, race, and ethnicity. Results: ADHD diagnoses were identified in 1,315 (4.4%) of 29,929 patients meeting criteria. Before age 1, individuals with ADHD had 60% increased odds of hospital admission, 58% increased odds of visiting the emergency department, and 41% increased odds of procedures ( p < .0001), including 4.7-fold increased odds of blood transfusion ( p < .0001). They also had more outpatient clinic visits (μ = 14.7 vs. μ = 12.5, p < .0001), including 52% increased odds of visiting a medical specialist, 38% increased odds of visiting a surgical specialist, 70% increased odds of visiting a neonatologist, and 71% increased odds of visiting an ophthalmologist ( p < .0001 for all AORs). In addition, individuals with ADHD had 6-fold increased odds of visits related to child abuse and neglect ( p = .0010). Conclusions: Children later diagnosed with ADHD were more likely to be admitted to the hospital, visit the ED, and visit specific medical and surgical services before age 1. Future work will identify patterns of health interactions unique to ADHD to stratify ADHD risk.

scholarly journals Assessment of maternal health services utilization in Pakistan: the role of socio-demographic characteristics

2020 ◽  
Vol 14 (1) ◽  
pp. 3-7
Author(s):  
Muhammad Aslam ◽  
Maryam Sadiq ◽  
Tahir Mehmood
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Services ◽  
Health Care Utilization ◽  
Negative Binomial ◽  
Health Services Utilization ◽  
Maternal Health Care ◽  
Care Utilization ◽  
Services Utilization ◽  
Maternal Health Care Utilization

AbstractBackgroundHigh-quality prenatal care has a significant positive impact on maternal and infant health as it helps timely diagnosis and treatment of pregnancy complications.ObjectiveTo examine factors associated with the utilization of maternal health care using the optimal count regression model.MethodsA sample of 16,314 women of reproductive ages (15–49) was used. Andersen and Newman's behavioral model of health services utilization was employed for the selection of covariates. Poisson, negative binomial, zero-inflated Poisson, zero-inflated negative binomial (ZINB), Poisson hurdle, and negative binomial hurdle models were fitted and compared to identify the best model. Maternal health care utilization is found associated with maternal age and education, area of residence, domestic violence, the income level of family, access to media, knowledge about AIDS, parity, birth order, and having a child who later died.ResultsZINB model is found to be best fitted for the observed data resulting strong influence of mother's education and income level of the family on maternal health care utilization.ConclusionInterventions to improve maternal care services utilization should address individuals and systems to reduce social and economic marginalization.

scholarly journals Determinants of Maternal Health Care Utilization among Ever-Married Rabari Women of Udaipur District, Rajasthan

2017 ◽  
Vol 7 (3) ◽  
pp. 453
Author(s):  
Ayushi Sharma
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Services ◽  
Health Care Utilization ◽  
Maternal Health Services ◽  
Maternal Health Care ◽  
Control Measures ◽  
Care Utilization ◽  
Maternal Health Care Utilization ◽  
Development Goals

<div><p><strong>Background</strong>: Improving maternal health is one of the eight Millennium Development Goals. It is widely accepted that the use of maternal health services helps in reducing maternal morbidity and mortality. The utilization of maternal health services is a complex phenomenon and it is influenced by several factors. Therefore, the factors at different levels affecting the use of these services need to be clearly understood. The objective of this study was to estimate the effects of individual, community and district level characteristics on the utilization of maternal health services with special reference to antenatal care (ANC), skilled attendance at delivery and postnatal care (PNC)</p><p><strong>Methods</strong>: The present paper focuses in understanding the maternal health care utilization by the ever married Rabari women of Udaipur District, Rajasthan. A purposive random sampling method was used to collect data from 122 ever married women of age group 15-49 years by using pretested and modified demographic schedule.</p><p><strong>Results: </strong>The results of this study showed that 63.11% of the respondents used ANC during their most recent pregnancy whereas only 10.65% women received PNC within two weeks of delivery. In the last delivery, 36.06% mothers were assisted by doctors and 50.81% assisted by nurse. Regarding components of ANC utilization 85.24% women reported intake of IFA (Iron and Folic Acid) tablets during pregnancy, while 77.04% of the women received Tetanus Toxoid (TT) Injection. The study reflects that higher utilization of ANC services are there and PNC services are mostly neglected among the women. The study also reflected upon the use of Birth Control Measures (BCM) among the woman. The lesser number of sample size may bind us from recommending much. But, Mothers should be motivated continuously and with every generation of nation they give birth to, they should utilize such health services for the future of the healthy society.</p></div>

Linkage of the Canadian Study of Health and Aging to Provincial Administrative Health Care Databases in Nova Scotia

2001 ◽  
Vol 13 (S1) ◽  
pp. 147-158 ◽  
Author(s):  
Alexandra M. Yip ◽  
George Kephart ◽  
Kenneth Rockwood
Keyword(s):  
Health Care ◽  
Health Status ◽  
Nova Scotia ◽  
Health Services ◽  
Health Care Utilization ◽  
Community Dwelling ◽  
Medical Services ◽  
Care Utilization ◽  
Canadian Study ◽  
Health Card

The Canadian Study of Health and Aging (CSHA) was a cohort study that included 528 Nova Scotian community-dwelling participants. Linkage of CSHA and provincial Medical Services Insurance (MSI) data enabled examination of health care utilization in this subsample. This article discusses methodological and ethical issues of database linkage and explores variation in the use of health services by demographic variables and health status. Utilization over 24 months following baseline was extracted from MSI's physician claims, hospital discharge abstracts, and Pharmacare claims databases. Twenty-nine subjects refused consent for access to their MSI file; health card numbers for three others could not be retrieved. A significant difference in healthcare use by age and self-rated health was revealed. Linkage of population-based data with provincial administrative health care databases has the potential to guide health care planning and resource allocation. This process must include steps to ensure protection of confidentiality. Standard practices for linkage consent and routine follow-up should be adopted. The Canadian Study of Health and Aging (CSHA) began in 1991-92 to explore dementia, frailty, and adverse health outcomes (Canadian Study of Health and Aging Working Group, 1994). The original CSHA proposal included linkage to provincial administrative health care databases by the individual CSHA study centers to enhance information on health care utilization and outcomes of study participants. In Nova Scotia, the Medical Services Insurance (MSI) administration, which drew the sampling frame for the original CSHA, did not retain the list of corresponding health card numbers. Furthermore, consent for this access was not asked of participants at the time of the first interview. The objectives of this study reported here were to examine the feasibility and ethical considerations of linking data from the CSHA to MSI utilization data, and to explore variation in health services use by demographic and health status characteristics in the Nova Scotia community cohort.

scholarly journals PEMANFAATAN PELAYANAN KESEHATAN OLEH PENDERITA TUBERKULOSIS PARU DI UPTD KESEHATAN PUSKESMAS SUKAMULYA KABUPATEN CIAMIS TAHUN 2015

2017 ◽  
Vol 13 (1) ◽  
Author(s):  
Yayu Handayani ◽  
Elis Noviati ◽  
Inna Sayyidatul Husna
Keyword(s):  
Health Care ◽  
Health Services ◽  
Pulmonary Tuberculosis ◽  
Health Care Services ◽  
Community Health Services ◽  
Health Centers ◽  
Care Utilization ◽  
Tuberculosis Patients ◽  
Care Services ◽  
Descriptive Method

Pulmonary tuberculosisis an infectious disease remains a health problem in the community. Numbers of patient with pulmonary tuberculosis at Ciamis in 2013 is 1164 cases, in 2014 is 1388 cases and in 2015 is 1395 cases. UPTD Sukamulya routinely conducts health education with the aim of providing knowledge to the community. Health services at Sukamulya has a good services, but there are some peoples who feeling embrassed to check the disease in the health centre.This research used a descriptive method with the aim to describe an object of research. This research have a samples 30 respondent with instrument using a likert scale in the form of a check list with 16 questions.Based on the result of questionnaire analysis study from 30 respondents about the factors in the needs of health care utilization by patients with pulmonary tuberculosis has been showed that 4 patients with pulmonary tuberculosis (13,33%) utilize health care services properly, 25 patients with pulmonary tuberculosis (83,33%) is a harness of health care and one person wit sufficient pulmonary tuberculosis patients (3,34%) is underutilization of health services.Utilization of health services by patients with pulmonary tuberculosis at UPTD Puskesmas Sukamuya Ciamis is well done. Keywords: utilization of health services, tuberculosis, health centers

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