Correction to: Determinants of healthcare seeking and out-of-pocket expenditures in a “free” healthcare system: evidence from rural Malawi

Abstract Historically, patients have held a passive role within healthcare, seeking consultation from and following the directions of providers and their care teams. However, changes in culture, education, and technology are making it possible for patients to proactively develop and implement technologies and approaches for health management and quality of life enhancement—to act as patient informaticians. This perspective reviews the societal shifts facilitating the evolution of patient informaticians as discrete actors within healthcare, describes the work of patient informaticians and how this work differs from that of other patient roles (eg, patient advocates), considers examples of patient informaticians in action, and defines patient informaticians’ position relative to the healthcare system.

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Healthcare Seeking Among Swedish Patients in Opioid Substitution Treatment – a Mixed Methods Study on Barriers and Facilitators

10.21203/rs.3.rs-850461/v1 ◽

2021 ◽

Author(s):

Katja Troberg ◽

Karin Lundqvist ◽

Helena Hansson ◽

Anders Håkansson ◽

Disa Dahlman

Keyword(s):

Mixed Methods ◽

Healthcare System ◽

Primary Healthcare ◽

Ageing Population ◽

Substitution Treatment ◽

Opioid Substitution Treatment ◽

Healthcare Seeking ◽

Healthcare Needs ◽

Unmet Healthcare Needs ◽

Opioid Substitution

Abstract Background: Patients in opioid substitution treatment (OST) have poorer health than the general population. Thus, they do not seek somatic health care to the extent that is medically motivated. Barriers hindering patients from seeking medical help through the conventional healthcare system result in a high degree of unmet healthcare needs. Barriers to and facilitators of OST patients’ healthcare seeking have been sparsely examined.Methods: Mixed methods were employed. The quantitative part consisted of a cross-sectional questionnaire covering questions on physical health, healthcare seeking, and barriers thereof, which was collected from 209 patients in OST. A sub-sample of eleven OST patients participated in semi-structured interviews, for the qualitative part of the study, covering experience of healthcare, lifestyle and self-images, expectations and ideals of Swedish healthcare. Results: Confirmed by qualitative data, quantitative data revealed deprioritization, fear of stigma and of being treated badly, and problems in navigation throughout the healthcare system, leading to unsuccessful establishment of contact, being most common reasons for not seeking somatic healthcare. Thus, interviewees provided a deeper knowledge of the barriers stigma, lack of means to prioritize health and difficulties navigating throughout the healthcare system, leading to resignation and deprioritization. On-site primary healthcare seemed to contribute to increased access and utilization of healthcare.Conclusion: Individual and structural barriers decreasing access to healthcare lead to increased inequalities in healthcare utilization, adding to an already deteriorating health of this ageing population. Integration of on-site primary healthcare and OST could provide acceptable and accessible healthcare. Further investigations into this subject need to be conducted.

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Public–private partnerships for universal health coverage? The future of “free health” in Sri Lanka

Globalization and Health ◽

10.1186/s12992-019-0522-6 ◽

2019 ◽

Vol 15 (S1) ◽

Author(s):

Ramya Kumar

Keyword(s):

Sri Lanka ◽

Healthcare System ◽

Universal Health Coverage ◽

Historical Context ◽

Health Indicators ◽

Public Private Partnerships ◽

Health Coverage ◽

Private Interests ◽

Free Healthcare ◽

Universal Health

AbstractSri Lanka reports impressive health indicators compared to its peers in the South Asian region. Maternal and infant mortality are relatively low, and several intractable communicable diseases have been eliminated. The publicly financed and delivered “free” healthcare system has been critical to these health achievements. Placing the country’s healthcare system in historical context, this commentary analyses the contradictions and political tensions surrounding Sri Lanka’s 2018 Universal Health Coverage (UHC) policy, with attention to the Ministry of Health’s plans for public–private partnerships (PPP). As economic exigencies and private interests increasingly erode the 1951 “Free Health” policy, this commentary calls for a re-envisioning of UHC that can meet people’s aspirations for health and social justice.

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Higher rate of culture-confirmed Campylobacter infections in Australia than in the USA: is this due to differences in healthcare-seeking behaviour or stool culture frequency?

Epidemiology and Infection ◽

10.1017/s0950268809990161 ◽

2009 ◽

Vol 137 (12) ◽

pp. 1751-1758 ◽

Cited By ~ 10

Author(s):

H. VALLY ◽

G. HALL ◽

E. SCALLAN ◽

M. D. KIRK ◽

F. J. ANGULO

Keyword(s):

Healthcare System ◽

Case Control ◽

Stool Culture ◽

Population Surveys ◽

Case Control Studies ◽

Healthcare Seeking ◽

Symptom Profiles ◽

The Usa ◽

Using Data ◽

Campylobacter Infections

SUMMARYLaboratory-based surveillance by OzFoodNet in Australia and FoodNet in the USA indicated that the incidence of Campylobacter infections in 2001 in Australia was about nine times higher than in the USA. We assessed whether this disparity could be explained by differences in the frequency of stool culturing. Using data from population surveys of diarrhoea and symptom profiles for Campylobacter from case-control studies, indices of healthcare behaviour taking into account the severity of Campylobacter infections were calculated. These suggest that culture-confirmed Campylobacter infections underestimate the incidence of community cases by similar ratios in the two countries. The incidence of Campylobacter infections in Australia was about 12 times higher than in the USA after consideration of healthcare system differences.

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How Can One Strengthen a Tiered Healthcare System through Health System Reform? Lessons Learnt from Beijing, China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218040 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8040

Author(s):

Shuduo Zhou ◽

Jin Xu ◽

Xiaochen Ma ◽

Beibei Yuan ◽

Xiaoyun Liu ◽

...

Keyword(s):

Primary Care ◽

Ambulatory Care ◽

Healthcare System ◽

Primary Healthcare ◽

Healthcare Facilities ◽

Healthcare Seeking ◽

Seeking Behavior ◽

Tertiary Hospitals ◽

Healthcare Seeking Behavior ◽

The Impact

How one can reshape the current healthcare sector into a tiered healthcare system with clarified division of functions between primary care facilities and hospitals, and improve the utilization of primary care, is a worldwide problem, especially for the low and middle-income countries (LMICs). This paper aimed to evaluate the impact of the Beijing Reform on healthcare-seeking behavior and tried to explain the mechanism of the change of patient flow. In this before and after study, we evaluated the changes of outpatient visits and inpatient visits among different levels of health facilities. Using the monitored and statistical data of 373 healthcare institutions 1-year before and 1-year after the Beijing Reform, interrupted time series analysis was applied to evaluate the impact of the reform on healthcare-seeking behavior. Semi-structured interviews were used to further explore the mechanisms of the changes. One year after the reform, the flow of outpatients changed from tertiary hospitals to community health centers with an 11.90% decrease of outpatients in tertiary hospitals compared to a 15.01% increase in primary healthcare facilities. The number of ambulatory care visits in primary healthcare (PHC) showed a significant upward trend (P < 0.10), and the reform had a significant impact on the average number of ambulatory care visits per institution in Beijing’s tertiary hospitals (p < 0.10). We concluded that the Beijing Reform has attracted a substantial number of ambulatory care visits from hospitals to primary healthcare facilities in the short-term. Comprehensive reform policies were necessary to align incentives among relative stakeholders, which was a critical lesson for other provinces in China and other LMICs.

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‘The Good Citizen’

Anthropology in Action ◽

10.3167/aia.2017.240102 ◽

2017 ◽

Vol 24 (1) ◽

pp. 6-12 ◽

Cited By ~ 4

Author(s):

Sara Marie Hebsgaard Offersen ◽

Peter Vedsted ◽

Rikke Sand Andersen

Keyword(s):

Public Health ◽

Middle Class ◽

Welfare State ◽

Everyday Life ◽

Healthcare System ◽

Healthcare Seeking ◽

Good Citizen ◽

Individual Health ◽

Bodily Sensations ◽

Moral Relation

AbstractThis article explores how healthcare-seeking practices and the transformation of bodily sensations into symptoms are embedded in what we term a ‘moral sensescape’ of everyday life. Based on fieldwork in a suburban middle-class neighbourhood in Denmark, we discuss how a moral relation between the Danish welfare state and the middle-class population is embodied in a responsibility for individual health. Overall, we identify a striving to be a ‘good citizen’; this entails conflicting moral possibilities in relation to experiencing, interpreting and acting on bodily sensations. We examine how people meet the conflicting moral possibilities of complying with current public health rhetoric on proper healthcare seeking, including timely presentation of symptoms, and simultaneously try to avoid misusing the healthcare system and be characterised as overly worried or even as a hypochondriac; this challenge constitutes complex navigational routes through the moral sensescape of the Danish middle class.

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Can a Multitiered Copayment System Affect People’s Healthcare-seeking Behavior? A Case Study of Wenzhou, China

10.21203/rs.3.rs-673272/v1 ◽

2021 ◽

Author(s):

Lizheng Ge ◽

Yunyun Huang ◽

Tingke Xu ◽

Qianru Zhao ◽

Chun Chen ◽

...

Keyword(s):

Medical Care ◽

Healthcare System ◽

Tertiary Care ◽

Care Facility ◽

Healthcare Services ◽

Health Seeking ◽

Medical Care System ◽

Healthcare Seeking ◽

Seeking Behavior ◽

Healthcare Seeking Behavior

Abstract Background. Facilitating the primary health care (PHC) system and maintaining people’s reasonable health-seeking behavior are key to establishing a sustainable healthcare system. China has employed a multitiered copayment system to incentivize the public to utilize PHC services through its hierarchical medical care system; however, most people still prefer visiting tertiary care hospitals. Methods. This preliminary study was conducted in 2016 on 1831 individuals from four regions of Wenzhou in Zhejiang Province to explore the effect and influencing factors of the multitiered copayment system that drives their primary healthcare-seeking behavior. We question whether a quality gap in healthcare services influences the minimal effect of the multitiered copayment system, which existing literature has considered as an important factor in the lack of reform in the Chinese healthcare system. We discuss the effect of the policy following the current situation in which there exists a large gap and further consider the hypothetical situation of a reduced gap in the future. Result. The results indicate that the initial effects of the multitiered copayment system was limited. However, they become more pronounced after the equalization of the quality of healthcare services. Moreover, the main determinants in people’s selection of PHC institutions changed from age and needs variables (self-rated health status) to age and enabling variables (distance to a medical care facility). Conclusion. This study confirms that changes in the quality gap in healthcare services influence the multitiered copayment system. Hence, reducing this gap can help to achieve the intended outcome of the tiered healthcare insurance schedule.

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