Health care utilization for acute illnesses in an urban setting with a refugee population in Nairobi, Kenya: a cross-sectional survey

Abstract Background Doing “more” in healthcare can be a major threat to the delivery of high-quality health care. It is important to identify the supplier-induced demand (SID) of health care. This study aims to test SID hypothesis by comparing health care utilization among patients affiliated with healthcare professionals and their counterpart patients not affiliated with healthcare professionals. Methods We used coarsened exact matching to compare the health care utilization and expenditure between patients affiliated and not affiliated with healthcare professionals. Using cross-sectional data of the China Labour-force Dynamics Survey (CLDS) in 2014, we identified 806 patients affiliated with healthcare professionals and 22,788 patients not affiliated with healthcare professionals. The main outcomes were outpatient proportion and expenditure as well as inpatient proportion and expenditure. Results The matched outpatient proportion of patients not affiliated with healthcare professionals was 0.6% higher (P = 0.754) than that of their counterparts, and the matched inpatient proportion was 1.1% lower (P = 0.167). Patients not affiliated with healthcare professionals paid significantly more (680 CNY or 111 USD, P < 0.001) than their counterparts did per outpatient visit (1126 CNY [95% CI 885–1368] vs. 446 CNY [95% CI 248–643]), while patients not affiliated with healthcare professionals paid insignificantly less (2061 CNY or 336 USD, P = 0.751) than their counterparts did per inpatient visit (15583 CNY [95% CI 12052–19115] vs. 17645 CNY [95% CI 4884–30406]). Conclusion Our results lend support to the SID hypothesis and highlight the need for policies to address the large outpatient care expenses among patients not affiliated with healthcare professionals. Our study also suggests that as the public becomes more informed, the demand of health care may persist while heath care expenditure per outpatient visit may decline sharply due to the weakened SID. To address misbehaviors and contain health care costs, it is important to realign provider incentives.

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Healthcare utilization among migrants to the UK: cross-sectional analysis of two national surveys

Journal of Health Services Research & Policy ◽

10.1177/1355819620911392 ◽

2020 ◽

Vol 26 (1) ◽

pp. 54-61 ◽

Cited By ~ 1

Author(s):

Catherine L Saunders ◽

Adam Steventon ◽

Barbara Janta ◽

Mai Stafford ◽

Carol Sinnott ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Health Care Utilization ◽

Dental Care ◽

Odds Ratio ◽

Service Planning ◽

Care Utilization ◽

Cross Sectional ◽

Objective Evidence ◽

The Uk

Objective To contribute objective evidence on health care utilization among migrants to the UK to inform policy and service planning. Methods We analysed data from Understanding Society, a household survey with fieldwork from 2015 to 2017, and the European Health Interview Survey with data collected between 2013 and 2014. We explored health service utilization among migrants to the UK across primary care, inpatient admissions and maternity care, outpatient care, mental health, dental care and physiotherapy. We adjusted for age, sex, long-term health conditions and time since moving to the UK. Results Health care utilization among migrants to the UK was lower than utilization among the UK-born population for all health care dimensions except inpatient admissions for childbirth; odds ratio (95%CI) range 0.58 (0.50–0.68) for dental care to 0.88 (0.78–0.98) for primary care). After adjusting for differences in age and self-reported health, these differences were no longer observed, except for dental care (odds ratio 0.57, 95%CI 0.49–0.66, P < 0.001). Across primary care, outpatient and inpatient care, utilization was lower among those who had recently migrated, increasing to the levels of the nonmigrant population after 10 years or more since migrating to the UK. Conclusions This study finds that newly arrived migrants tend to utilize less health care than the UK population and that this pattern was at least partly explained by better health, and younger age. Our findings contribute nationally representative evidence to inform public debate and decision-making on migration and health.

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Brand equity analysis to increase health care utilization

Journal of Public Health Research ◽

10.4081/jphr.2020.1821 ◽

2020 ◽

Author(s):

Ernawaty ◽

Kendra Wardhani K ◽

Stefanus Supriyanto ◽

Nuzulul Kusuma Putri ◽

Yeni Rahmah Husniyawati

Keyword(s):

Health Care ◽

Health Care Utilization ◽

Brand Equity ◽

Health Care Services ◽

Simple Random Sampling ◽

Cross Sectional Study ◽

Care Utilization ◽

Cross Sectional ◽

Brand Association ◽

Care Services

Background: Health care utilization is one of the key indicators in measuring performance of health care services. Strong brand equity suggests positive correlation with great attraction for consumers to use a product. Design and Methods: A cross-sectional study was conducted to identify the effects of brand equity to health care utilization. 381 students were selected by simple random sampling. Multiple logistic regression tests were used to analyze the influence between variables. Results: Findings showed that there was an influence between brand equity and health care utilization (P=0.001). In the three attributes, brand equity was known to have an influence to the utilization of health care. The highest influence of the three attributes was brand association (Exp (B) = 2.501). Conclusions: It can be concluded that brand equity affects patient visits to AHCC showing that the brand equity significantly influence patient visits. Promotion to create familiarity and good impression was required to enhance brand equity and increase health care utilization.

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Association Between a Wider Availability of Health Information and Health Care Utilization in Vietnam: Cross-Sectional Study (Preprint)

10.2196/preprints.8328 ◽

2017 ◽

Author(s):

Hoang Thuy Linh Nguyen ◽

Keiko Nakamura ◽

Kaoruko Seino ◽

Van Thang Vo

Keyword(s):

Health Care ◽

Mass Media ◽

Health Care Utilization ◽

Health Information ◽

Cross Sectional Study ◽

Care Utilization ◽

The Internet ◽

Sectional Study ◽

Cross Sectional ◽

Education Courses

BACKGROUND The rapid and widespread development of mass media sources including the Internet is occurring worldwide. Users are being confronted with a flood of health information through a wide availability of sources. Studies on how the availability of health information has triggered users’ interest in utilizing health care services remain limited within the Vietnamese population. OBJECTIVE This study examined the associations between the wider availability of sources for health information and health care utilization in Vietnam after adjusting for potential confounding variables. METHODS The data for this study were drawn from a cross-sectional study conducted over a 6-month period in Hue, a city in central Vietnam. The participants were 993 randomly selected adults aged between 18 and 60 years. Information was collected through face-to-face interviews on the types of information sources that were consulted, including traditional media (television), Internet, and health education courses, as well as the impact of such information on health care use (emergency department visits, hospitalizations, doctor visits). Multivariable logistic regression analyses were performed at a 95% confidence level. RESULTS The prevalence of watching television, using the Internet, and attending health education courses to obtain health information were 50.9% (505/993), 32.9% (327/993), and 8.7% (86/993), respectively. After further adjustments for self-reported health status, the presence of health insurance, and monthly income, respondents who watched television and used the Internet to obtain health information were 1.7 times more likely to visit a doctor (television: adjusted odds ratio [AOR] 1.69, 95% CI 1.30-2.19; Internet: AOR 1.64, 95% CI 1.23-2.19), and also significantly associated with inpatient hospitalization (P=.003). CONCLUSIONS The use of widely available mass media sources (eg, television and the Internet) to obtain health information was associated with higher health care utilization. How this interest in health-related information can be used so that it will have a beneficial effect on care-seeking behavior should be a topic of concern to further health promotion in developing countries.

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Health-seeking Behavior of Undergraduate Nursing Students and Associated Factors: A Cross-sectional Study

10.21203/rs.3.rs-816241/v1 ◽

2021 ◽

Author(s):

Gerili Zaya ◽

Shijia Li ◽

Jingyu Pan ◽

Jinyu Zhang ◽

Anita Näslindh-Ylispangar ◽

...

Keyword(s):

Health Care ◽

Nursing Students ◽

Health Care Utilization ◽

Cross Sectional Study ◽

Care Utilization ◽

Health Seeking ◽

Cross Sectional ◽

Health Seeking Behavior ◽

Health Counseling ◽

Seeking Behavior

Abstract Background Though relevant education and clinical practice could promote health-seeking behavior, nurses and nursing students may not actively seek healthcare. Methods This was a cross-sectional study using an adaptation of the self-reported Health Behavior Questionnaire (HBQ) including sociocultural background, lifestyle, self-assessment of life, health care utilization, and health counseling. 199 valid samples were acquired by convenient sampling. Univariate analysis, Spearman rank correlation, Pearson correlation, and multivariate linear regression were used to analyze the data. Results Cultural background, living with family, employment, most items in lifestyle, and all items in perceived life status were correlated with health-seeking behavior. A multivariate linear regression verified the influence of alcohol consumption, financial situation, and work situation on the experience of health care utilization, as well as the influence of physical health and interpersonal relationship on the experience of health counseling. Conclusions Less alcohol consumption, better financial situation, and better work situation are positively correlated with health care utilization. Better physical health and sounder interpersonal relationships can improve health counseling. The effect of other factors needs further exploration. Cohort studies could be used to investigate the long-term change in health-seeking behavior.

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Patterns and predictors of private and public health care utilization in an informal settlement in Nairobi, Kenya: A cross-sectional study

10.21203/rs.3.rs-15591/v1 ◽

2020 ◽

Author(s):

Elvis Wambiya ◽

Peter O Otieno ◽

Martin Kavao Mutua ◽

Hermann Pythagore Pierre Donfouet ◽

Shukri F Mohamed

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Utilization ◽

Informal Settlement ◽

Cross Sectional Study ◽

Public Health Care ◽

Care Utilization ◽

Health Seeking ◽

Cross Sectional ◽

Explanatory Variables

Abstract BackgroundKnowledge of health care utilization is particularly crucial in low-and middle-income countries where inequalities in burden of disease and access to primary health care exist. Inconclusive evidence exists on health-seeking and utilization of health facilities in the informal settlements in Kenya. This study assessed the patterns and predictors of private and public health care utilization in an urban informal settlement in Kenya.MethodsThis cross-sectional study used data from the Lown scholars study conducted between June and July 2018. It was nested within the Nairobi Urban Health and Demographic Surveillance System. Households were selected using simple random sampling and data obtained for all household members who reported having sought care for an illness in the 12 months preceding the study. Data were collected on health-seeking behaviour and explanatory variables (predisposing, enabling, and need) using an adaptation of Andersen’s conceptual framework. Health care utilization patterns by explanatory variables were described using proportions and multinomial logistic regression used to identify the predictors of private or public health care use.ResultsThree hundred and sixty-four members from 300 households sought care for an illness in the 12 months preceding the study. Almost half (47%) of the respondents sought care from private facilities while about 33% and 20% used public and other facilities, respectively. Health care utilization was influenced by enabling and need factors. Health insurance coverage was associated with private health facility use (aOR 3.06; 95% CI 1.48 – 6.31). Satisfaction with the quality of care was associated with lower use of public facilities (aOR 0.31; CI 0.11 – 0.84) while satisfaction with cost of care was associated with higher use of public facilities (aOR 2.09; CI 1.01 – 4.29). Members who reported an acute infection were more likely to use private facilities (aOR 3.07; 95% CI 1.52 – 6.18).ConclusionsHealth care utilization in the urban informal settlements favours private health facility use. As Kenya commits to achieving universal health coverage, interventions to improve health care access in informal and low-resource settlements should be modelled around enabling and need factors, particularly health care financing and quality of health care provision.

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