scholarly journals Degree of regional variation and effects of health insurance-related factors on the utilization of 24 diverse healthcare services - a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wenjia Wei ◽  
Agne Ulyte ◽  
Oliver Gruebner ◽  
Viktor von Wyl ◽  
Holger Dressel ◽  
...  

Abstract Background Regional variation in healthcare utilization could reflect unequal access to care, which may lead to detrimental consequences to quality of care and costs. The aims of this study were to a) describe the degree of regional variation in utilization of 24 diverse healthcare services in eligible populations in Switzerland, and b) identify potential drivers, especially health insurance-related factors, and explore the consistency of their effects across the services. Methods We conducted a cross-sectional study using health insurance claims data for the year of 2014. The studied 24 healthcare services were predominantly outpatient services, ranging from screening to secondary prevention. For each service, a target population was identified based on applicable clinical recommendations, and outcome variable was the use of the service. Possible influencing factors included patients’ socio-demographics, health insurance-related and clinical characteristics. For each service, we performed a comprehensive methodological approach including small area variation analysis, spatial autocorrelation analysis, and multilevel multivariable modelling using 106 mobilité spaciale regions as the higher level. We further calculated the median odds ratio in model residuals to assess the unexplained regional variation. Results Unadjusted utilization rates varied considerably across the 24 healthcare services, ranging from 3.5% (osteoporosis screening) to 76.1% (recommended thyroid disease screening sequence). The effects of health insurance-related characteristics were mostly consistent. A higher annual deductible level was mostly associated with lower utilization. Supplementary insurance, supplementary hospital insurance and having chosen a managed care model were associated with higher utilization of most services. Managed care models showed a tendency towards more recommended care. After adjusting for multiple influencing factors, the unexplained regional variation was generally small across the 24 services, with all MORs below 1.5. Conclusions The observed utilization rates seemed suboptimal for many of the selected services. For all of them, the unexplained regional variation was relatively small. Our findings confirmed the importance and consistency of effects of health insurance-related factors, indicating that healthcare utilization might be further optimized through adjustment of insurance scheme designs. Our comprehensive approach aids in the identification of regional variation and influencing factors of healthcare services use in Switzerland as well as comparable settings worldwide.

2020 ◽  
Vol 7 (2) ◽  
pp. 205510292095305
Author(s):  
Bui Thi Tu Quyen ◽  
Linh Thuy Nguyen ◽  
Vo Thi Viet Phuong ◽  
Le Tu Hoang

This cross-sectional study was conducted to identify the quality of life (QoL) and its related factors in methadone maintenance treatment (MMT) patients at four health facilities in Long An province, Vietnam in 2019. We interviewed 373 MMT patients using the WHOQOL-BREF measurement questionnaire and used their health records to collect some other data. The findings showed that the patients had a mean QoL score of 66.1 points. Factors associated with a higher QoL score included having employment, receiving support from relatives, and having health insurance. Therefore, it is recommended that patients should be assisted to participate in health insurance and supported by their relatives.


2021 ◽  
Author(s):  
Abeer Alharbi

Abstract Background Public health services in Saudi Arabia are provided free of charge to its citizens at the point of use. Recently, however, the government has realized that this model is unsustainable in the long run. Therefore, Saudi decision-makers are seeking to have a sustainable health system through the introduction of a contributory National Health Insurance that require making regular financial contributions from its members. Objective This study aims to explore the people’s willingness to pay for a National Health Insurance system in Saudi Arabia. The study also aims to understand the factors affecting their willingness or unwillingness to pay NHI, such as, their demographic and socio-economic characteristics, the type of their usual health care provider, and their satisfaction with the current healthcare services.Methods A cross-sectional study design with Contingent Valuation (CV) technique was used to measure the value of National Health Insurance based on an individual’s willingness to pay. The data were collected from 475 participants using an online survey via Google Forms between March 2021 and April 2021. Frequencies, logistic regression, and linear regression, were conducted to answer the research questions.Results The percentage of individuals who was willing to pay for NHI was higher than those who were not willing to pay (62.9%) vs (37.1%). There was a significant association between the type of usual healthcare provider and the likelihood of paying for NHI (OR CI = 0.20 to 0.51, p< 0.05=0.00). Also, there was a significant association between satisfaction with healthcare services and the likelihood of paying for NHI (OR CI = 0.02 to 0.31, p< 0.05=0.00). The median amount of money the people were willing to pay as a monthly contribution for NHI was 100 SAR (26.5 USD) with the average being 152 SAR (40 USD). There was a significant association between age and the maximum amount the participants were willing to pay (ß=-0.15,t=-2.55,p<0.05=0.01). In addition, the results show a significant relationship between income and the maximum amount of money people were willing to pay (ß=-0.25,t=3.81,p<0.05=0.001).Conclusion This study provided some evidence that most of the population of Saudi Arabia were willing to pay for NHI if implemented. The factors that appeared to influence the willingness to pay and the amount of monthly payment included the type of usual source of care, satisfaction with current public services, age, and income.


Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 7
Author(s):  
Chaewon Son ◽  
Yu-Cheol Lim ◽  
Ye-Seul Lee ◽  
Jung-Hwa Lim ◽  
Bo-Kyung Kim ◽  
...  

This study aimed to analyze current trends in healthcare utilization and medication usage in patients with insomnia. We reviewed the National Patient Sample data from the Health Insurance Review and Assessment Service to determine healthcare utilization in patients diagnosed with insomnia (International Classification of Diseases-10 codes G470, F510) between January 2010 and December 2016. There were 87,470 patients enrolled in this study who utilized healthcare services at least once during the 7-year period. Healthcare utilization trends, Korean and Western medicine (KM and WM, respectively) therapies utilized, comorbidities, and socioeconomic data were analyzed. The number of patients seeking WM or KM care for insomnia increased annually. Adults aged ≥45 years accounted for 73% of the cohort, and there were more female than male patients. KM treatment including acupuncture was the most common in KM (65.29%), while examination was the most common WM treatments (49.31%). In pharmacological therapy, sedatives and hypnotics were the most common (41.08%), followed by antianxiety (19.50%), digestive system and metabolism-related drugs (7.77%). The most common comorbidities were mental health disorders (50.56%) in WM but musculoskeletal disorders in KM (35.67%). Code G470 was used more frequently than code F510, and the difference was more evident in KM than in WM. The findings will provide valuable information for both clinicians and researchers.


2020 ◽  
Vol 04 (04) ◽  
pp. 32-39
Author(s):  
Phuong Ha Nguyen ◽  
Thi My Anh Bui ◽  
Hung Vi Nguyen

Objective: Describe the satisfaction of primary caregiver of under 6 years-old inpatients and determine some related factors at Cai Lay district hosptial, Tien Giang province in 2020. Methods: A cross-sectional study was conducted in 2020 with a total of 360 caregivers for under 6 children inpatients. The research measurement utilized a standardized tools developed by the Ministry of Health, Vietnam. Results: The main findings showed that the percentage of general satisfaction among caregivers of under 6 years-old inpatients was 67.6%, the satisfaction with infrastructure and equipment with a lowest rate with 63.2%. The factors related to patient satisfaction include economic situation, marital status, age, education level, health insurance, number of medical check-ups in the past 12 months and length of stay in hospital. Conclusion: In order to further improve the satisfaction of caregivers for under 6 children inpatients with treatment services, the attitude of medical staff with patients should be improving. Moreover, strengthening a process of maintain and upgrade infrastructure and equipment in Pediatric department and hospital. Also, there is a need of improving the quality of medical examination and treatment services covered by health insurance. Keywords: Satisfaction; primary caregiver; inpatient; pediatric patient,…


2012 ◽  
pp. 129-134
Author(s):  
Thi Lan Tran ◽  
Thi Huong Le ◽  
Xuan Ninh Nguyen

Objectives: Assess the nutritional status, worm infection status and some related factors among children aged 12-36 months of Dakrong district, Quang Tri province. Subject and method: A cross sectional study was carried out in 2010, in 680 children aged 12-36 months in 4 communes of Dakrong district, Quang Tri province. Results: The malnutrition rate was 55.0% for underweight, 66.5% for stunting and 16.2% for wasting. The prevalence of malnutrition increases by age group. The prevalence of worm infection was 31.6%, the highest prevalence was belong to Ascaris infection (24.6%), followed by Hookworm and Trichuris (6.5% and 6.2%, respectively). The prevalence of worm infection among children under two is very high (27.0%). The prevalence of worm infection was distributed quite equally between the malnutrition children group and normal children group. Recommendation: Early deworming forchildren from 12 months should be considered as important strategy against the malnutrition of children in Dakrong district, Quang Tri province


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e029931 ◽  
Author(s):  
Akihiko Narisada ◽  
Kohta Suzuki

ObjectiveTo investigate the associations among procrastination (time inconsistency), work environment and obesity-related factors in Japanese male workers.DesignCross-sectional study.SettingData were collected at two work sites of Japanese electronics manufacturing company in 2015.Participants795 full-time male workers in a Japanese electric company, aged 35–64 years, who underwent health checkups in 2015.Main outcome measuresBody mass index (BMI), adult weight change, obesity (BMI ≥25 kg/m2), adult weight gain over 10 kg (AWG10) and metabolic syndrome (MetS). Multivariable linear and logistic regression analyses were performed to assess the associations of procrastination assessed by using a one-item questionnaire and white-collar and blue-collar work with obesity-related factors.ResultsWhite-collar workers with high procrastination levels showed positive associations with BMI (B: 0.75, 95% CI 0.06 to 1.44) and adult weight change (B: 1.77, 95% CI 0.26 to 3.29), and had increased odds of AWG10 (OR: 1.85, 95% CI 1.04 to 3.29) and MetS (OR: 2.29 95% CI 1.18 to 4.44) after adjustment for age, education, work-related factors and lifestyle factors. However, such positive associations were not observed among blue-collar workers.ConclusionsProcrastination and white-collar work might have a joint effect on weight gain during adulthood and consequential obesity.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyan Wang ◽  
Xiaoling Dai ◽  
Zichuan Yao ◽  
Xianqing Zhu ◽  
Yunzhong Jiang ◽  
...  

Abstract Introduction To explore the prevalence of depressive symptoms and the associated risk factors in frontline nurses under COVID-19 pandemic. Methods This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 498 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depressive symptoms, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression. Results Of the nurses enrolled in the study, 50.90% had depressive symptoms. Three independent risk factors were identified: poor sleep quality (OR = 1.608, 95% CI: 1.384–1.896), lower optimism of psychological capital (OR = 0.879, 95% CI: 0.805–0.960) and no visiting friend constantly (OR = 0.513, 95% CI: 0.286–0.920). Conclusions This study revealed a considerable high prevalence of depressive symptoms in frontline nurses during the COVID-19 outbreak, and identified three risk factors, which were poor sleep quality, lower optimism of psychological capital, and no visiting friend constantly. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mercedes Guilabert ◽  
Alba Martínez-García ◽  
Marina Sala-González ◽  
Olga Solas ◽  
José Joaquín Mira

Abstract Objective To measure the experience of the person having a rare disease in order to identify objectives for optimal care in the health care received by these patients. Methods. A cross-sectional study was conducted in Spain involving patients associated with the Spanish Rare Diseases Federation [Federación Española de Enfermedades Raras] (FEDER). A modified version of the PREM IEXPAC [Instrumento para evaluar la Experiencia del Paciente Crónico] instrument was used (IEXPAC-rare-diseases). Scores ranged between 0 (worst experience) and 10 (best experience). Results A total of 261 caregivers (in the case of paediatric population) and patients with rare diseases (response rate 54.4%) replied. 232 (88.9%) were adult patients and 29 (11.1%) caregivers of minor patients. Most males, 227 (87%), with an average age of 38 (SD 13.6) years. The mean time since confirmation of diagnosis was 7.8 (SD 8.0) years. The score in this PREM was 3.5 points out to 10 (95%CI 3.2–3.8, SD 2.0). Caregivers of paediatric patients scored higher, except for coordination of social and healthcare services. Conclusions There are wide and important areas for improvement in the care of patients with rare diseases. This study involves a first assesment of the experience of patients with rare diseases in Spain.


2021 ◽  
pp. 205715852110096
Author(s):  
Erla Kolbrun Svavarsdottir ◽  
Gudny Bergthora Tryggvadottir ◽  
Margret Gisladottir ◽  
Ragnheidur Osk Erlendsdottir

An increasing number of children attend schools with chronic illnesses/disorders that require managing and comprehensive healthcare from school nurses during the day. Collaboration between school nurses, the school-aged child with attention-deficit hyperactivity disorder (ADHD) or asthma, and their families is needed when coordinating/managing chronic health problems in the school setting. However, involving families in the assessment and care planning processes can be challenging. The aim of this study was to survey the illness beliefs of school nurses and their perceptions of their family nursing practice skills when offering healthcare services to children with ADHD or asthma in schools. A cross-sectional study was used for a sample of 82 school nurses. The manuscript was prepared following STROBE guidelines. Results indicated that the school nurses perceived themselves to be more confident and to have better knowledge and skill in family nursing practice when offering healthcare services to families of children with ADHD in comparison to asthma.


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