Health service underutilization and its associated factors for chronic diseases patients in poverty-stricken areas in China: a multilevel analysis

Abstract Background Underutilization of health services among chronic non-communicable disease sufferers, especially for hypertension (HBP) and diabetes mellitus (DM), was considered as a significant contributing factor to substantial cases in terms of both avoidable morbidity and mortality. However, evidence on health services underutilization and its associated factors in poverty-stricken areas remain scarce based on previous literature. This study aims to describe health services underutilization for people diagnosed with chronic diseases in impoverished regions and to identify its associated factors, which are expected to provide practical implications for the implementations of interventions tailored to the specific needs of disadvantaged residents in rural China to achieve effective utilization of health services in a timely manner. Methods Data were collected from a cross-sectional survey conducted through face-to-face interviews among 2413 patients from six counties in rural central China in 2019. The Anderson behavioral model was adopted to explore the associated factors. A two-level logistic model was employed to investigate the association strengths reflected by adjusted odds ratios (AOR) and 95% confidence intervals in forest plots. Results On average, 17.58% of the respondents with HBP and 14.87% with DM had experienced health services underutilization during 1 month before the survey. Multilevel logistic regression indicated that predisposing factors (age), enabling factors (income and a regular source of care), and need factors (self-reported health score) were the common predictors of health service underutilization both for hypertensive and diabetic patients in impoverished areas, among which obtaining a regular source of care was found to be relatively determinant as a protective factor for health services underutilization after controlling for other covariates. Conclusions Our results suggested that the implementation of a series of comprehensive strategies should be addressed throughout policy-making procedures to improve the provision of regular source of care as a significant determinant for reducing health services underutilization, thus ultimately achieving equal utilization of health services in impoverished regions, especially among chronic disease patients. Our findings are expected to provide practical implications for other developing countries confronted with similar challenges resulting from underdeveloped healthcare systems and aging population structures.

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Reproductive health service utilization and associated factors among adolescents at public school in Adama town east Shewa Ethiopia; 2018

Nursing Practice Today ◽

10.18502/npt.v7i4.4037 ◽

2020 ◽

Author(s):

Abenet Menene Gurara ◽

Admasu Belay Gizaw ◽

Awoke Koyachew Ayalew ◽

Aliye Kediro Adem

Keyword(s):

Reproductive Health ◽

Health Service ◽

Health Services ◽

Health Service Utilization ◽

Associated Factors ◽

Health Services Utilization ◽

Reproductive Health Service ◽

Reproductive Health Services ◽

Services Utilization ◽

Factors Associated

Background & Aim: Reproductive health services utilization is an important component of health services in preventing adolescents’ sexual and reproductive hedgies & take corrective measures. The main purpose of this study is to determine reproductive health services utilization status and associated factors among adolescents at public schools in Adama town Ethiopia. Methods & Materials: Institution based cross-sectional study design was used with a total sample size of 367 adolescents in the schools. The sample size was proportionally allocated to grade nine, ten, eleven, and twelfth. The study subjects were selected by simple random sampling. A Standard pre-tested self-administered questionnaire was used to collect data after getting informed consent from the study participants. Data were entered and analysed using SPSS version 20 software. Descriptive statistics and Logistic regression were done to describe and identify factors associated with reproductive health services utilization. A P-value of less than 0.05 was considered to declare a level of significance. Results: The magnitude of reproductive health service utilization in this was 122(34%). Discussion with a sexual partner and peer, student’s educational status, sex, knowledge about the availability of reproductive health service were among the factors associated with the use and non-use of RH service. Conclusion: Utilization of Reproductive Health services among adolescents in the study area was low. Therefore, interventions such as advancing adolescents’ knowledge, encouraging open discussion forum, strengthening of youth centers, and school reproductive health clubs are important.

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HUBUNGAN PENDIDIKAN, AKSES PELAYANAN KESEHATAN DAN DUKUNGAN KELUARGA DENGAN PEMANFAATAN PELAYANAN KESEHATAN PENDERITA TB PARU BTA+ DI PUSKESMAS JANTI KOTA MALANG

Preventia : The Indonesian Journal of Public Health ◽

10.17977/um044v4i1p1-14 ◽

2019 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Alfreda Dinayu Purbantari ◽

Roesdiyanto Roesdiyanto ◽

Nurnaningsih Herya Ulfah

Keyword(s):

Public Health ◽

Health Service ◽

Health Services ◽

Health Center ◽

Family Support ◽

Access To Health Services ◽

Cross Sectional ◽

Education Access ◽

Utilization Of Health Services ◽

Access To Health

Abstract: Tuberculosis (TB) is a contagious disease that is still the world's attention, Until now, there is not a single country that is free of TB (Kemenkes 2011). Public Health Center (puskesmas) Janti is a puskesmas where the number of TB BTA+ sufferers increases every year while the number of treatment success rate at Puskesmas Janti decreases every year. In 2013 is 96%, in 2014 is 87,50% and in 2015 is 85,37%. Increasing the number of patients and decreasing the number of success rates of treatment indicates that the utilization of health services is less. This study aims to find out the relationship of Education, Health Service Access and Family Support with Health Service Utilization of BTA+ Pulmonary TB Patients at Public Health Center (puskesmas) Janti Malang. The design of this study is quantitative correlation with samples of all patients with TB Paru + BTA who are still doing treatment at Puskesmas Janti in September 2016 until April 2017. The analysis used correlation test and logistic regression test with cross sectional approach. The results of the research analysis found that there is a significant relationship between education, access to health services and family support together with the utilization of health services of patients Tb Paru BTA+. Based on the results of determination coefficient R2 (Nagelkerke) of 0.619, this means that education (X1), access to health services (X2), and family support (X3) has contributed 61.9% to the utilization of health services of patients with TB Paru BTA+ at Puskesmas Janti.Keywords: education, access, family support, health service utilizationAbstrak: Tuberkulosis (TB) adalah penyakit menular yang masih menjadi perhatian dunia, hingga saat ini, belum ada satu negara pun yang bebas TB (Kemenkes 2011). Puskesmas Janti adalah satu puskesmas yang berada di Kota Malang dengan jumlah pasien TB Paru BTA+ yang paling tinggi dan meningkat setiap tahun diantara puskesmas yang lain di Kota Malang, sedangkan jumlah angka keberhasilan pengobatan di Puskesmas Janti mengalami penurunan setiap tahun. Tahun 2013 sebesar 96%, pada tahun 2014 sebesar 87,50% dan pada tahun 2015 sebesar 85,37%. Peningkatan jumlah penderita dan penurunan jumlah angka keberhasilan pengobatan menunjukkan bahwa pemanfaatan pelayanan kesehatan kurang. Penelitian ini bertujuan untuk mengetahui Hubungan Pendidikan, Akses Pelayanan Kesehatan dan Dukungan Keluarga dengan Pemanfaatan Pelayanan Kesehatan Penderita TB Paru BTA+ di Puskesmas Janti Kota Malang. Rancangan penelitian ini adalah kuantitatif korelasional dengan sampel seluruh penderita TB Paru BTA+ yang masih melakukan pengobatan di Puskesmas Janti pada bulan September 2016 sampai dengan April 2017. Analisis menggunakan uji korelasi dan uji regresi logistik dengan pendekatan cross sectional. Hasil analisis penelitian di dapatkan ada hubungan yang dignifikan antara pendidikan, akses pelayanan kesehatan dan dukungan keluarga secara bersama-sama dengan pemanfaatan pelayanan kesehatan penderita Tb Paru BTA+. Berdasarkan hasil koefisien determinasi R2 (Nagelkerke) sebesar 0,619, hal ini berarti bahwa pendidikan (X1), akses pelayanan kesehatan (X2), dan dukungan keluarga (X3) memiliki kontribusi sebesar 61,9% terhadap pemanfaatan pelayanan kesehatan penderita TB Paru BTA+ di Puskesmas Janti.Kata Kunci: pendidikan, akses pelayanan kesehatan, dukungan keluarga, pemanfaatan pelayanan kesehatan penderita TB Paru BTA+

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Care in Chronic Diseases and in "Frail" Patients in General Practice

International Journal of General Practice ◽

10.14302/issn.2692-5257.ijgp-20-3375 ◽

2020 ◽

Vol 1 (1) ◽

pp. 28-31

Author(s):

Lucio Mango

Keyword(s):

Primary Care ◽

General Practice ◽

Health Service ◽

Health Services ◽

Chronic Diseases ◽

Frail Patients ◽

The World ◽

Progressive Growth ◽

At Home

The world of chronicity is an area in progressive growth that involves a considerable commitment of resources, requiring continuity of assistance for long periods of time and a strong integration of health services with social ones and those requiring residential and territorial services often not sufficiently designed and developed. The fundamental aim of the treatment of chronic systems is to keep as much as possible the patient at home and prevent or reduce the risk of institutionalization. GP could put their expertise to good use in the Complex of Primary Care Units and Territorial Functional Aggregations, reducing the costs of the health service.

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PENGARUH KEPUASAN PASIEN TENTANG PELAYANAN KEBIDANAN TERHADAP PEMANFAATAN PELAYANAN KESEHATAN DI PUSKESMAS PONTAP TAHUN 2016

Voice of Midwifery ◽

10.35906/vom.v6i08.18 ◽

2018 ◽

Vol 6 (08) ◽

pp. 1-7

Author(s):

Devi Darwin ◽

Ny. Irmayanti ◽

Tirta Nirwana

Keyword(s):

Quality Of Service ◽

Patient Satisfaction ◽

Health Service ◽

Health Services ◽

Service Utilization ◽

Health Service Utilization ◽

Statistical Test ◽

Test Analysis ◽

Utilization Of Health Services

Satisfaction is formed from a result and a comparative reference, comparing the results received with a particular standard. The comparison forms three possibilities: first is if the service is perceived to be above the expectation (quality surprise), the second when the quality of service fulfills the expectation, and the last if the service received is worse than the expected service.The influence of physical needs in patient satisfaction on the utilization of health service shows that from 89 respondents, respondents who have good physical needs about patient satisfaction on utilization of health services as much as 43 respondents and respondents who need less physical as much as 46 respondents. Based on the result of statistical test analysis, it is said that there is influence of physical requirement in patient satisfaction to health service utilization. Keywords: Satisfaction, Midwifery Services

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Survey on the use of health services by adult men: prevalence rates and associated factors

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.0296.2685 ◽

2016 ◽

Vol 24 (0) ◽

Cited By ~ 2

Author(s):

Guilherme Oliveira de Arruda ◽

Sonia Silva Marcon

Keyword(s):

Health Service ◽

Health Services ◽

Associated Factors ◽

Service Use ◽

Population Based ◽

Health Service Use ◽

Cross Sectional ◽

Adult Men ◽

Curative Care ◽

Use Of Health Services

Objective estimate the prevalence and identify factors associated with the use of health services by men between 20 and 59 years of age. Method population-based, cross-sectional domestic survey undertaken with 421 adult men, selected through systematic random sampling. The data were collected through a structured instrument and analyzed using descriptive and inferential statistics with multiple logistic regression. Results the prevalence rate of health service use during the three months before the interviews was 42.8%, being higher among unemployed men with a religious creed who used private hospitals more frequently, had been hospitalized in the previous 12 months and referred some disease. Conclusion the prevalence of health service use by adult men does not differ from other studies and was considered high. It shows to be related with the need for curative care, based on the associated factors found.

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Utilization of Reproductive Health Services and associated factors among secondary school students in Woldia Town, Northeast Ethiopia, 2020

10.21203/rs.3.rs-21716/v1 ◽

2020 ◽

Author(s):

Teshome Gebremeskel ◽

Biruk Beletew

Keyword(s):

Reproductive Health ◽

Health Service ◽

Health Services ◽

Secondary School ◽

Associated Factors ◽

Secondary School Students ◽

Dropout Rate ◽

Reproductive Health Service ◽

Reproductive Health Services ◽

School Students

Abstract Background: Despite policy actions and strategic efforts made reproductive health service uptake of youths in Ethiopia, its utilization remains low. Local evidence about the utilization of reproductive health service among adolescents and associated factors are relevant to design age-appropriate intervention strategies. Objective: The main aim of this study was to assess the utilization of reproductive health service and associated factors among adolescents in Woldia town secondary schools, Amhara, Ethiopia, 2019.Methods: Institutional based descriptive cross-sectional study was conducted on 420 secondary school students in Woldia Town from January - June 2019. A self-administered, structured questionnaire was used to collect the data. The samples were distributed proportionally and participants in each school were selected by systematic sampling technique. Bivariate and multivariable logistic regression was carried out to asses’ association between dependent and independent variables. Result: Two hundred seventy (64.3%) respondents utilize reproductive health service. Residence, educational status of the partner, presence of RHS facility in school, good knowledge level on RHS were significantly associated with the reproductive health services utilization. Conclusion and Recommendations: Knowledge of respondents on reproductive health issues in the study area was found to be low. This low service utilization might make students disposed to different reproductive health risks; STI, HIV, and unwanted pregnancy; which in turn can increase the school dropout rate, and have an impact on an individual’s future life.

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Study on the Demand and Utilization of Health Services for the Poor Elderly in China

10.21203/rs.3.rs-46192/v1 ◽

2020 ◽

Author(s):

Yanbing Zeng ◽

Weiqian Xu ◽

Bei Luo ◽

Ya Fang

Keyword(s):

Health Status ◽

Health Service ◽

Health Services ◽

Service Utilization ◽

Health Behaviour ◽

Health Service Utilization ◽

Utilization Of Health Services ◽

The Poor ◽

Inpatient Services ◽

Part Model

Abstract Background Despite historic achievements in fighting poverty over recent decades, the unmet health needs of the poor elderly are still a severe problem in China. This paper investigates the demand and utilization status of health services among the poor elderly and examines the factors that affect healthcare service utilization. Methods According to the international poverty line of each year, we selected the poor elderly from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 to create nationally representative estimates. The main outcome measures include utilization indicators for the probability and costs of outpatient/inpatient services. Based on a modified Andersen behaviour model, a two-part model is designed to investigate and analyse how predisposing factors, enabling factors, and need and health behaviour variables affect the health service utilization of the poor elderly. The prediction of marginal effect of the unconditional healthcare expenditure are estimated by jointing the model of probability and expenditure of health service utilization. Results The morbidity and chronic disease rates of the poor elderly were 16.93% and 79.43%, respectively. The visit rate of outpatient services increased from 15.05% in 2011 to 21.26% in 2015, and the hospitalization rate increased from9.87–16.89%. In terms of medical expenditures, the median cost of outpatient and inpatient services in 2015 for the poor elderly were 350 RMB and 10,000 RMB, respectively, and the out-of-pocket ratios were 85.2% and 53.3% respectively. Overall, 78.44% of the people who actually needed healthcare did not use health services, and the main reason was financial difficulties (42.32%). The two-part model showed that the poor elderly who are higher educated, have children, live in central regions, and have social security and a poor health status and who do not smoke or drink are more likely to use health services. Males who live in the eastern regions with poor self-reported health, physical disabilities and chronic diseases have more medical expenses. Margin effect analysis finds that the need factor is more important than other factors in determining health service utilization. Conclusion The poor elderly in China, as the most vulnerable group, tends to have a worse health status and a heavier medical burden. Due to a variety of constraints, the poor elderly had a lower utilization of health services. Predisposing, enabling, need and health behaviour variables should be considered when making policy and taking measures to eliminate health inequalities to improve the health service utilization and the health of the poor elderly.

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Health Service Utilization and associated factors Among Older Adults in Ambo Town, West Shoa Zone, Oromia, Ethiopia

Community Medicine and Health Education Research ◽

10.33702/cmher.201901.1.2 ◽

2019 ◽

Vol 1 (1) ◽

pp. 8-19

Author(s):

Abiru Neme Negewo ◽

Wadu Wolancho Debocha ◽

Gadisa Bekele Bedada

Keyword(s):

Older Adults ◽

Health Service ◽

Health Services ◽

Medical History ◽

Service Utilization ◽

Chronic Condition ◽

Health Service Utilization ◽

Associated Factors ◽

The Elderly ◽

History Of

In any country use of health services by elderly could vary according to the cultural, social, economic and demographic situation of the person who may need care. In certain contexts, it particularly varies with age and sex of the potential service user. However; there is paucity of information on the level and associated factors on health service utilization among elderly population in Ethiopia in general and in the study site in particular. To assess Factors Health Service Utilization and associated factors Among Older Adults in Ambo Town, West Shoa Zone, Oromia, Ethiopia. A community based cross sectional study carried out on 284 elderly populations residing in Ambo town from February- March 2018. The collected data was cleaned, coded and entered into computer and analyzed using SPSS windows version 20.0. Descriptive statistics were done to summarize data. Binary and multiple logistic regression was undertaken to determine the independent predictor of health service utilization. The following factors were identified as determinants of health service utilization among the elderly in Ambo: a medical history of at least one chronic condition (OR = 1.737; [0.425-2.562]; p < 0.000), who had reported enough money to meet their need were 75% utilize health services when compared to participants who did not have enough money to meet their need 47.3% (OR = 1.587; 95% CI = [1.236 – 2.037], p = 0.004). Age, Income, education, medical history of at least one chronic condition and poor perceived health status were the most pervasive determinants of health service utilization. These factors could help health policy makers and health service providers identify and understand the situation of the elderly and consequently create conducive environment for providing appropriate health services.

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Patterns of health service utilisation among the Australian population with cancer compared with the general population

Australian Health Review ◽

10.1071/ah18184 ◽

2020 ◽

Vol 44 (3) ◽

pp. 470 ◽

Cited By ~ 1

Author(s):

Huah Shin Ng ◽

Bogda Koczwara ◽

David Roder ◽

Raymond Javan Chan ◽

Agnes Vitry

Keyword(s):

General Population ◽

Health Service ◽

Health Services ◽

Chronic Diseases ◽

Health Service Utilisation ◽

Control Group ◽

Service Utilisation ◽

Australian Population ◽

Delivery Of Care ◽

Barriers And Enablers

Objective The aim of this study was to describe patterns of health service utilisation among the Australian population with cancer compared with the general population. Methods Data for all respondents aged ≥25 years from two successive National Health Surveys conducted between 2011 and 2014 were analysed. Respondents with a history of cancer were identified as the cancer group, whereas all other respondents who did not report having had a cancer were included in the non-cancer control group. Comparisons were made between the two groups using logistic regression models. Results The population with cancer was more likely to report having consulted their general practitioner, specialist, chemist, dietician, naturopath, nurse, optometrist, dentist, audiologist and other health professionals than the non-cancer population. The cancer population was also more likely to be admitted to hospital and to have visited an out-patient clinic, emergency department and day clinic. The presence of comorbidity and a current cancer were associated with a greater likelihood of receiving health services among the population with cancer. Conclusion The population with cancer used health services significantly more than the non-cancer population. Further studies are urgently needed to identify optimal approaches to delivery of care for this population, including barriers and enablers for their implementation. What is known about the topic? Multimorbidity is highly prevalent among the cancer population due to risk factors shared between cancer and other chronic diseases, and the development of new conditions resulting from cancer treatment and cancer complications. However, the Australian healthcare system is not set up optimally to address issues related to multimorbidity. What does this paper add? This study is the first step in quantifying health services use by the population with cancer compared with the general population without cancer. Cancer survivors have an increased need for specific health services, particularly among those with multimorbidity. What are the implications for practitioners? The development of integrated care models to manage multiple chronic diseases aligned with the Australian National Strategic Framework for Chronic Conditions is warranted. Further studies are urgently needed to identify optimal approaches to delivery of care for this population, including barriers and enablers for their implementation.

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