scholarly journals VARIATION OF COMORBIDITIES IN ROMANIA AT THE LAU2 LEVEL, A CROSS-SECTIONAL ANALYSIS

2019 ◽  
Vol 7 ◽  
pp. 790-793
Author(s):  
Adrian Pana ◽  
Bogdan-Vasile Ileanu
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Local Level ◽  
Health Indicators ◽  
Care Utilization ◽  
Population Number ◽  
Cross Sectional ◽  
Care Services ◽  
Diagnostic Coding ◽  
Referral Hospitals

Introduction: Romania is still lagging behind in regard to main health indicators when compared to average values of European Union countries with a disproportionate share of disability due mainly to chronic diseases. There are tools available to quantify the negative health outcomes due to comorbidities, and among them the Elixhauser Index was found to be the best to predict health care utilization and expenditures. Objective: To measure the extent of comorbidities at the LAU2 level using the Elixhauser Index. Methods: All relevant comorbidities at the local level were summed-up using the Elixhauser index. This was followed with standardization by population number and then by 10-year age group. Due to large oscillation from one year to another during the 2014-2016 period, the geometrical mean was computed, then few measures of the variation such as decile ratio and variation coefficient were also computed. Results: High variability of comorbidities is observed at the local level (LAU2). Clusters of comorbidities concentration are found near medical university centers and localities in non-MUC districts located at the furthest distance from the county residential center. Conclusions: Several factors such as proximity to referral hospitals, increased accessibility to these hospitals due to low control at primary healthcare levels, availability of diagnostic technologies and different diagnostic coding patterns, as well as isolation and unavailability of primary health care services are listed as possible factors that can explain these results.

scholarly journals Brand equity analysis to increase health care utilization

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.

scholarly journals An epidemiological study regarding availability and utilization of public health care services in slum in Amritsar city

2019 ◽  
Vol 6 (6) ◽  
pp. 2396
Author(s):  
Richa Verma ◽  
Tejbir Singh ◽  
Mohan Lal ◽  
Jasleen Kaur ◽  
Sanjeev Mahajan ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Economic Status ◽  
Health Indicators ◽  
Public Health Care ◽  
Cross Sectional ◽  
Government Health ◽  
Care Services ◽  
The Government

Background: Low level of education of the slum dwellers along-with poor socio- economic status and pathetic environmental conditions lead to their poor health indicators. Since the National Urban Health Mission (NUHM) was launched in 2013, the health services are still in their initial stages. Assessment of the availability as well as the utilization of health care services of the urban slums is the need of the hour.Methods: The cross-sectional study was conducted in randomly selected slum in Amritsar city. All the houses were enumerated and visited by the interviewer herself. The eldest adult member of the family was selected as key respondent and written, informed consent was obtained. Predesigned questionnaire was used to collect the data which was then compiled and analyzed using statistical tests.Results: Out of the total respondents, one third respondents had knowledge about the government health center nearby (statistically significant) while out of these, only one third utilized the services at the center (statistically non-significant). Almost half of the respondents had knowledge about the medical camps and out of these, two-thirds utilized the services at medical camps.Conclusions: Overall utilization of services is poor. More respondents were aware of the medical camps than the static government health facility and utilization of medical camps was also more. So the static health services under NUHM need to be further strengthened.

Impact of restricting access to health care services on Syrian refugees in Jordan: evidence from cross-sectional surveys

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ibraheem Khaled Abu Siam ◽  
María Rubio Gómez
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Care Cost ◽  
Syrian Refugees ◽  
Cross Sectional ◽  
Content Type ◽  
Care Access ◽  
Care Services

Purpose Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan. Design/methodology/approach This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact. Findings The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake. Originality/value Understanding access barriers to health services and its negative short-term and long-term impact on refugees’ health status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.

scholarly journals Pharmaceutical care in Brazil’s primary health care

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Patricia Sodré Araújo ◽  
Ediná Alves Costa ◽  
Augusto Afonso Guerra Junior ◽  
Francisco de Assis Acurcio ◽  
Ione Aquemi Guibu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Pharmaceutical Care ◽  
Health Care Services ◽  
Cross Sectional ◽  
Educational Activities ◽  
Health Team ◽  
Care Services ◽  
Primary Health

OBJECTIVE: To characterize the activities of clinical nature developed by pharmacists in basic health units and their participation in educational activities aiming at health promotion. METHODS: This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015), a cross-sectional and exploratory study, of evaluative nature, consisting of a survey of information in a representative sample of cities, stratified by the Brazilian regions that constitute domains of study, and a subsample of primary health care services. The interviewed pharmacists (n=285) were responsible for the delivery of medicines and were interviewed in person with the use of a script. The characterization of the activities of clinical nature was based on information from pharmacists who declared to perform them, and on participation in educational activities aiming at health promotion, according to information from all pharmacists. The results are presented in frequency and their 95% confidence intervals. RESULTS: From the interviewed subjects, 21.3% said they perform activities of clinical nature. Of these, more than 80% considered them very important; the majority does not dispose of specific places to perform them, which hinders privacy and confidentiality in these activities. The main denominations were “pharmaceutical guidance” and “pharmaceutical care.” The registration of activities is mainly made in the users’ medical records, computerized system, and in a specific document filed at the pharmacy, impairing the circulation of information among professionals. Most pharmacists performed these activities mainly along with physicians and nurses; 24.7% rarely participated in meetings with the health team, and 19.7% have never participated. CONCLUSIONS: Activities of clinical nature performed by pharmacists in Brazil are still incipient. The difficulties found point out to the professionals’ improvisation and effort. The small participation in educational activities of health promotion indicates little integration of pharmacists with the health team and of pharmaceutical services with other health actions

scholarly journals Wealth Status, Health Insurance, and Maternal Health Care Utilization in Africa: Evidence from Gabon

2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
N’doh Ashken Sanogo ◽  
Sanni Yaya
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Maternal Health ◽  
Health Care Services ◽  
Insurance Coverage ◽  
Maternal Health Care ◽  
Care Utilization ◽  
Services Utilization ◽  
Maternal Health Care Utilization ◽  
Care Services

Background. To achieve the universal health coverage among other Sustainable Development Goals, African countries have shown the commitment by implementing strategies to improve access and coverage of health care services whose access is still very low. The achievement of universal health care requires the provision and availability of an adequate financing system. This study explored the wealth-related association of compulsory health insurance on maternal health care utilization in Gabon. Methods. The study used the 6th round of Gabon Demographic and Health Surveys (GDHSs)—2012 data to explore three outcome measures of maternal health care utilization extracted on number of antenatal care (ANC) visits during pregnancy, place of birth delivery, and postnatal health care. The dependent variable was women with health insurance coverage against those without. Logistic regression and propensity scoring matching analysed associations of health insurance coverage on women’s utilization of health care. Results. Mean (+/− SD) age of women respondents of reproductive age was 29 years (9.9). The proportion of at least 4 antenatal care visits was 69.2%, facility-based delivery was 84.7%, and postnatal care utilization was 67.9%. The analysis of data showed disparities in maternal health care services utilization. The GDHS showed maternal age, and geographical region was significantly associated with maternal health care service utilization. A high proportion of urban dwellers and Christian women used maternal health care services. According to the wealth index, maternal health services utilization was higher in women from wealthy households compared to lower households wealth index (ANC (Conc. Index = 0.117; p≤0.001), facility-based delivery (Conc. Index = 0.069; p≤0.001), and postnatal care (Conc. Index = 0.075; p≤0.001), respectively). With regard to health care insurance coverage, women with health insurance were more likely to use ANC and facility-based delivery services than those without (concentration indices for ANC and facility-based delivery were statistically significant; ANC: z-stat = 2.69; p=0.007; Conc. Index: 0.125 vs. 0.096 and facility-based delivery: z-stat = 3.38; p=0.001; Conc. Index: 0.076 vs. 0.053, respectively). Conclusion. Women enrollment in health insurance and improved household’s financial status can improve key maternal health services utilization.

Factors Affecting the Utilization of Maternal and Child Health Care Services in Tribal Dominated Population States of India

2020 ◽  
pp. 0272684X2097285
Author(s):  
Bal Govind Chauhan ◽  
Suresh Jungari
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Services ◽  
Maternal Health Services ◽  
Care Utilization ◽  
Factors Affecting ◽  
Safe Delivery ◽  
Care Services ◽  
Post Natal Care ◽  
And Child Health

The present study intended to examine that factors affecting the utilization of maternal health services in the Three tribal-dominated states of India namely Madhya Pradesh, Jharkhand and Chhattisgarh. The study used National Family Health Survey (NFHS-4) data. Both bivariate and multivariate techniques have been applied for data analysis. Logistic regression techniques and concentration curve and index have been used . Findings of the study indicate that there were wider socio-economic differential exits in the utilization of MCH services (full ANC, Safe delivery and post-natal care) in all the three states under study. The regression result shows that the tribal population is less likely to utilize maternal and child health care services than other Caste groups. The economic inequality in accessing the all three components of maternal health care utilization was higher in the Jharkhand than Madhya Pradesh and Chhattisgarh. Further, economic inequality was higher in accessing the full ANC than safe delivery and post-natal care across all the states under study. From policy point of view, the government schemes to provide maternal health services to tribal communities should consider the community-level factors affecting maternal health care utilization and should extend its operations in the small villages.

scholarly journals The ecology of medical care in Norway: wide use of general practitioners may not necessarily keep patients out of hospitals

2012 ◽  
Vol 1 (2) ◽  
pp. 28 ◽  
Author(s):  
Anne Helen Hansen ◽  
Peder A. Halvorsen ◽  
Olav Helge Førde
Keyword(s):  
Health Care ◽  
General Practitioner ◽  
General Practitioners ◽  
Health Care Services ◽  
Medical Providers ◽  
Specialist Care ◽  
Cross Sectional ◽  
Care Services ◽  
And Gender ◽  
Complementary And Alternative

<em>Background</em>. Our aim was to investigate the pattern of self reported symptoms and utilisation of health care services in Norway. <em>Design and methods.</em> With data from the cross-sectional Tromsø Study (2007-8), we estimated population proportions reporting symptoms and use of seven different health services. By logistic regression we estimated differences according to age and gender. <em>Results</em>. 12,982 persons aged 30-87 years participated, 65.7% of those invited. More than 900/1000 reported symptoms or health problems in a year as well as in a month, and 214/1000 and 816/1000 visited a general practitioner once or more in a month and a year, respectively. The corresponding figures were 91/1000 and 421/1000 for specialist outpatient visits, and 14/1000 and 116/1000 for hospitalisations. Physiotherapists were visited by 210/1000, chiropractors by 76/1000, complementary and alternative medical providers by 127/1000, and dentists by 692/1000 in a year. Women used most health care services more than men, but genders used hospitalisations and chiropractors equally. Utilisation of all services increased with age, except chiropractors, dentists and complementary and alternative medical providers. <em>Conclusions</em>. Almost the entire population reported health related problems during the previous year, and most residents visited a general practitioner. Yet there were high rates of inpatient and outpatient specialist utilisation. We suggest that wide use of general practitioners may not necessarily keep patients out of specialist care and hospitals.

scholarly journals Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of claims data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andreas Niedermaier ◽  
Anna Freiberg ◽  
Daniel Tiller ◽  
Andreas Wienke ◽  
Amand Führer
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Asylum Seekers ◽  
Health Care Services ◽  
Claims Data ◽  
Care Utilization ◽  
Care Services ◽  
Outpatient Sector ◽  
Analysis Of Claims Data ◽  
Care Costs

Abstract Background Asylum seekers are a vulnerable group with special needs in health care due to their migration history and pre-, peri- and postmigratory social determinants of health. However, in Germany access to health care is restricted for asylum seekers by law and administrative regulations. Methods Using claims data generated in the billing process of health care services provided to asylum seekers, we explore their utilization of health care services in the outpatient sector. We describe the utilization of outpatient specialties, prevalences of diagnoses, prescribed drugs and other health care services, as well as total costs of health care provision. Results The estimated prevalence for visiting an ambulatory physician at least once per year was 67.5% [95%-Confidence-Interval (CI): 65.1–69.9%], with a notably higher prevalence for women than men. The diagnoses with the highest one-year prevalence were “Acute upper respiratory infections” (16.1% [14.5–18.0%]), “Abdominal and pelvic pain” (15.6% [13.9–17.4%]) and “Dorsalgia” (13.8% [12.2–15.5%]). A total of 21% of all prescriptions were for common pain killers. Women received more diagnoses across most diagnosis groups and prescribed drugs from all types than men. Less than half (45.3%) of all health care costs were generated in the outpatient sector. Conclusion The analysis of claims data held in a municipal social services office is a novel approach to gain better insight into asylum seekers’ utilization of health services on an individual level. Compared to regularly insured patients, four characteristics in health care utilization by asylum seekers were identified: low utilization of ambulatory physicians; a gender gap in almost all services, with higher utilization by women; frequent prescription of pain killers; and a low proportion of overall health care costs generated in the outpatient sector. Further research is needed to describe structural and individual factors producing these anomalies.

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