scholarly journals Health services utilization of Chinese patients with Huntington’s disease: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huiyi Ke ◽  
Xi Cao ◽  
Yanyan Song ◽  
Li Cao
Keyword(s):  
Logistic Regression ◽  
Health Insurance ◽  
Health Services ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Influencing Factors ◽  
Health Services Utilization ◽  
Services Utilization ◽  
Medical Visits

Abstract Background Huntington’s disease (HD) is a hereditary disease which could have a large impact on patients’ quality of life. As the neurodegenerative disorders progress, HD patients are expected to regularly take follow-up medical visits for proper treatment. This study aimed to analyze the general situation of health services utilization of Chinese HD patients and factors associated with their adherence to follow-up medical visits. Methods We collected data from a questionnaire-based investigation conducted by the Chinese Huntington’s Disease Association. Data from 232 respondents were included to investigate whether they adhered to regular follow-up medical visits and the influencing factors. Based on Andersen’s behavioral model, the independent variables were categorized into predisposing, enabling and need factors. The variables were analyzed by chi-square test and stepwise logistic regression analysis. Results Thirty-one point nine percent of the respondents had regular follow-up medical visits over the past year. Univariate analysis showed that there were significant differences with 6 factors (P < 0.05), among which, according to logistic regression, 2 enabling factors (reimbursement of health insurance, need for accompanying family members to follow-up visits) and 3 need factors (perceived stage of disease, perceived effectiveness of drugs, self-care ability) were independent influencing factors of follow-up medical behaviors of Chinese HD patients. The predisposing factors investigated here did not play a part in determining patients’ adherence to follow-up visits. Conclusions Poor adherence to medical visits among Chinese HD patients is derived from multiple factors, including reimbursement of health insurance, perceived stage of disease and effectiveness of drugs, need for accompanying family members and self-care ability. To promote HD patients’ health services utilization, the improvement of the health insurance system, the enhancement of social support and the development of therapeutic approaches still have a long way to go.

scholarly journals Health services utilization of Chinese patients with Huntington's disease: A cross-sectional study

2021 ◽  
Author(s):  
Huiyi Ke ◽  
Xi Cao ◽  
Yanyan Song ◽  
Li Cao
Keyword(s):  
Logistic Regression ◽  
Health Insurance ◽  
Health Services ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Health Services Utilization ◽  
Self Care ◽  
Services Utilization ◽  
Medical Visits

Abstract Background Huntington’s disease (HD) is a hereditary disease which could have a large impact on patients’ quality of life. As the neurodegenerative disorders progress, HD patients are expected to regularly take follow-up medical visits for proper treatment. This study aimed to analyze the general situation of health services utilization of Chinese HD patients and factors associated with their adherence to follow-up medical visits. Methods We collected data from a questionnaire-based investigation conducted by Chinese Huntington's Disease Association. Data from 232 respondents were included to investigate whether they adhered to regular follow-up medical visits and the cause and correlates. Based on Andersen’s behavioral model, the independent variables were categorized into predisposing, enabling and need factors. The variables were analyzed by chi-square test and stepwise logistic regression analysis. Results 31.9% of the respondents had regular follow-up medical visits over the past year. Univariate analysis showed there were significant differences with 6 factors (P < 0.05), among which, according to logistic regression, 2 enabling factors (reimbursement of health insurance, need for accompanying family members to follow-up visits) and 3 need factors (perceived stage of disease, perceived effectiveness of drugs, self-care ability) were independent influencing factors of follow-up medical behaviors of Chinese HD patients. The predisposing factors investigated here did not play a part in determining patients’ adherence to follow-up visits. Conclusions Poor adherence to medical visits among Chinese HD patients is derived from multiple factors, including reimbursement of health insurance, perceived stage of disease and effectiveness of drugs, need for accompanying family members and self-care ability. To promote HD patients’ health services utilization, the improvement of health insurance system, the enhancement of social support and the development of therapeutic approaches still have a way to go.

The impact of health insurance on health services utilization and health outcomes in Vietnam

2014 ◽  
Vol 9 (4) ◽  
pp. 359-382 ◽  
Author(s):  
G. Emmanuel Guindon
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Health Outcomes ◽  
Health Services Utilization ◽  
Living Standard ◽  
Outpatient Services ◽  
Services Utilization ◽  
The Poor ◽  
Inpatient Services ◽  
The Impact

AbstractIn recent years, a number of low- and middle-income country governments have introduced health insurance schemes. Yet not a great deal is known about the impact of such policy shifts. Vietnam’s recent health insurance experience including a health insurance scheme for the poor in 2003 and a compulsory scheme that provides health insurance to all children under six years of age combined with Vietnam’s commitment to universal coverage calls for research that examines the impact of health insurance. Taking advantage of Vietnam’s unique policy environment, data from the 2002, 2004 and 2006 waves of the Vietnam Household Living Standard Survey and single-difference and difference-in-differences approaches are used to assess whether access to health insurance – for the poor, for children and for students – impacts on health services utilization and health outcomes in Vietnam. For the poor and for students, results suggest health insurance increased the use of inpatient services but not of outpatient services or health outcomes. For young children, results suggest health insurance increased the use of outpatient services (including the use of preventive health services such as vaccination and check-up) but not of inpatient services.

scholarly journals Health services utilization and out-of-pocket (OOP) expenditures in public and private facilities in Pakistan: An empirical analysis of the 2013-14 OOP Health Expenditure Survey

2021 ◽  
Author(s):  
Faraz Khalid ◽  
Wajeeha Raza ◽  
David R. Hotchkiss ◽  
Rieza H. Soelaeman
Keyword(s):  
Logistic Regression ◽  
Health Services ◽  
Private Sector ◽  
Health Expenditure ◽  
Health Services Utilization ◽  
Private Provider ◽  
Care Utilization ◽  
Public And Private ◽  
Services Utilization ◽  
Expenditure Survey

Abstract Background As low- and middle-income countries progress toward Universal Health Coverage, there is an increasing focus on measuring out-of-pocket (OOP) expenditure and health services utilization within countries. While there have been several reforms to improve health services coverage and financial protection in Pakistan, there is limited empirical research comparing OOP expenditure and health services utilization between public and private facilities and exploring their determinants, a knowledge gap addressed in this study. Methods We used data from 2013-14 OOP Health Expenditure Survey, a population-based household survey carried out for Pakistan’s National Health Accounts. The analysis included 7,969 encounters from 4,293 households. We conducted bivariate analyses to describe patterns of care utilization, estimated annualized expenditures by type and sector of care, and assessed expenditure composition. We used multivariable logistic regression modeling to identify factors associated with sector of care and generalized linear model (GLM) with log link and gamma distribution to identify determinants of OOP expenditures stratified by type of care (inpatient and outpatient). Results Most encounters (82.5%) were in the private sector and were for outpatient visits (85%). Several public-private differences were observed in annualized expenditures and expenditure components. Logistic regression results indicate males, wealthier individuals, Punjab and Sindh residents, and those in smaller households were more likely to access private outpatient care. In the inpatient model, rural residents were more likely to use a private provider, while Khyber Pakhtunkhwa residents were less likely to use private care. GLM results indicate private sector inpatient expenditures were approximately PKR 6,660 (USD 61.8) higher than public sector expenditures, but no public-private differences were observed for outpatient expenditures. Several demographic factors were significantly associated with outpatient and inpatient expenditures. Of note, expenditures increased with increasing wealth, decreased with increasing household size, and differed by province and region. Conclusions This is the first study comprehensively investigating how healthcare utilization and OOP expenditures vary by sector, type of care, and socio-economic characteristics in Pakistan. The findings are expected to be particularly useful for the next phase of social health protection programs and supply side reforms, as they highlight sub-populations with higher OOP and private sector utilization.

scholarly journals Health services utilization and out-of-pocket (OOP) expenditures in public and private facilities in Pakistan: an empirical analysis of the 2013–14 OOP health expenditure survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
F. Khalid ◽  
W. Raza ◽  
D. R. Hotchkiss ◽  
R. H. Soelaeman
Keyword(s):  
Logistic Regression ◽  
Health Services ◽  
Private Sector ◽  
Health Expenditure ◽  
Health Services Utilization ◽  
Private Provider ◽  
Care Utilization ◽  
Public And Private ◽  
Services Utilization ◽  
Expenditure Survey

Abstract Background As low- and middle-income countries progress toward Universal Health Coverage, there is an increasing focus on measuring out-of-pocket (OOP) expenditure and health services utilization within countries. While there have been several reforms to improve health services coverage and financial protection in Pakistan, there is limited empirical research comparing OOP expenditure and health services utilization between public and private facilities and exploring their determinants, a knowledge gap addressed in this study. Methods We used data from 2013 to 14 OOP Health Expenditure Survey, a population-based household survey carried out for Pakistan’s National Health Accounts. The analysis included 7969 encounters from 4293 households. We conducted bivariate analyses to describe patterns of care utilization, estimated annualized expenditures by type and sector of care, and assessed expenditure composition. We used multivariable logistic regression modeling to identify factors associated with sector of care and generalized linear model (GLM) with log link and gamma distribution to identify determinants of OOP expenditures stratified by type of care (inpatient and outpatient). Results Most encounters (82.5%) were in the private sector and were for outpatient visits (85%). Several public-private differences were observed in annualized expenditures and expenditure components. Logistic regression results indicate males, wealthier individuals, Punjab and Sindh residents, and those in smaller households were more likely to access private outpatient care. In the inpatient model, rural residents were more likely to use a private provider, while Khyber Pakhtunkhwa residents were less likely to use private care. GLM results indicate private sector inpatient expenditures were approximately PKR 6660 (USD 61.8) higher than public sector expenditures, but no public-private differences were observed for outpatient expenditures. Several demographic factors were significantly associated with outpatient and inpatient expenditures. Of note, expenditures increased with increasing wealth, decreased with increasing household size, and differed by province and region. Conclusions This is the first study comprehensively investigating how healthcare utilization and OOP expenditures vary by sector, type of care, and socio-economic characteristics in Pakistan. The findings are expected to be particularly useful for the next phase of social health protection programs and supply side reforms, as they highlight sub-populations with higher OOP and private sector utilization.

Korean American health insurance and health services utilization

2001 ◽  
Vol 24 (6) ◽  
pp. 494-505 ◽  
Author(s):  
Hosihn Ryu ◽  
Wendy B. Young ◽  
Changgi Park
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Health Services Utilization ◽  
Korean American ◽  
Services Utilization

Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?

2019 ◽  
Vol 47 (1) ◽  
pp. 134-142
Author(s):  
Shiho Kino ◽  
Ichiro Kawachi
Keyword(s):  
Health Insurance ◽  
Health Literacy ◽  
Health Services ◽  
Affordable Care Act ◽  
Interaction Effect ◽  
Health Services Utilization ◽  
Services Utilization ◽  
Dental Visits ◽  
Personal Doctor ◽  
Access To Health

Background. Health insurance access and health literacy are critical components of “enabling resources” to encourage uptake of services. We sought to test whether health literacy boosts health services utilization in the context of expanded access to health insurance stemming from the Affordable Care Act. Method. We used individual-level data from 11 states included in the Behavioral Risk Factor Surveillance System 2016. We conducted a two-stage least squares instrumental variables analysis. We instrumented improved access to health insurance stemming from Affordable Care Act Medicaid expansion. As outcome variables, we examined cost as a barrier to needed care, having a personal doctor and receipt of routine health checkups, flu shots, Pap tests, mammograms, sigmoidoscopy/colonoscopy, and dental visits in the past year. We then tested whether the relation between improved health insurance access and health services utilization was moderated by health literacy. Health literacy was measured by a dichotomized scale comprising three items: difficulties obtaining advice or information about health, difficulties understating information from health professionals, and difficulties understanding written health information. Results. We found that improving health insurance access increased the likelihood of reporting a personal doctor while reducing the likelihood of reporting cost as a barrier to care. We also found an interaction effect between health insurance and health literacy on dental visits. However, there was no significant interaction effect between insurance access and health literacy for preventive services utilization. Conclusion. Health literacy did not explain why people fail to access preventive services even when they obtain access to insurance, with the sole possible exception of dental visits among individuals with high literacy.

scholarly journals Prenatal exposure to the 2009 pandemic H1N1 influenza vaccine on health outcomes in children

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Jessy Donelle ◽  
Laura Walsh ◽  
Kumanan Wilson ◽  
Jeff Kwong ◽  
Steven Hawken ◽  
...  
Keyword(s):  
Health Services ◽  
Influenza Vaccine ◽  
Health Outcomes ◽  
Prenatal Exposure ◽  
Health Services Utilization ◽  
Respiratory Infections ◽  
Vaccine Uptake ◽  
Pediatric Health ◽  
Services Utilization

IntroductionDuring the 2009 H1N1 pandemic, less than half of pregnant women in Ontario received the recommended influenza vaccine. Commonly-cited reasons for low vaccine uptake include misconceptions about the possible impact of maternal influenza infection and vaccine safety. Providing data on previously understudied pediatric health outcomes may help increase vaccine uptake. Objectives and ApproachWe conducted a retrospective cohort study of all live births from November 2nd, 2009 to October 31st, 2010 using the BORN Ontario province-wide birth registry containing information on H1N1 vaccination. These data were deterministically/probabilistically linked with several health administrative databases held at the Institute for Clinical Evaluative Sciences to ascertain specific immune-related pediatric health outcomes and health services utilization over 5 years of follow-up. Negative binomial regression models were used to evaluate the association between prenatal H1N1 vaccination and outcomes. Stabilized inverse probability of treatment weights (sIPTW) derived from the propensity scores were used to adjust for potential confounding. ResultsThe study cohort included 104,310 eligible infants, 31,310 (30%) of whom were born to H1N1-vaccinated women. Median follow-up time was 5 years. Using sIPTWs we were able to achieve good balance of baseline measured covariates across exposure groups, with no absolute standardized differences larger than 7%. The sIPTW-adjusted analyses indicated no significant associations between prenatal exposure to H1N1 vaccination and upper respiratory infections (adjusted rate ratio [aRR] 1.01; 95% confidence interval [CI] 0.98-1.03), lower respiratory infections (aRR 1.00; 95%CI 0.96-1.04), otitis media (aRR 1.04; 95%CI 1.00-1.07), all infections (aRR 1.00; 95%CI 0.98-1.03), and rates of urgent and in-patient health services utilization (aRR 1.00; 95%CI 0.98-1.02). Conclusion/ImplicationsOur primary findings suggest there are no associations between prenatal exposure to H1N1 vaccination and (1) the development of several immune-related health outcomes in children; (2) rates of health services utilization. Furthermore, our study provides new evidence on the long-term safety of influenza vaccination during pregnancy, which is currently lacking.

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