scholarly journals Mothers of children with major congenital anomalies have increased health care utilization over a 20-year post-birth time horizon

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260962
Author(s):  
Nirav R. Shah ◽  
Kyung Mi Kim ◽  
Venus Wong ◽  
Eyal Cohen ◽  
Sarah Rosenbaum ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Rate Ratio ◽  
Time Horizon ◽  
Care Utilization ◽  
Inpatient Service ◽  
Care Services ◽  
Adjusted Rate ◽  
Adjusted Rate Ratio ◽  
Birth Time

Objective This population-based, matched cohort study aimed to evaluate utilization of health care services by mothers of children with major congenital anomalies (MCAs), compared to mothers of children without MCAs over a 20-year post-birth time horizon in Denmark. Methods Our analytic sample included mothers who gave birth to an infant with a MCA (n = 23,927) and a cohort of mothers matched to them by maternal age, parity and infant’s year of birth (n = 239,076). Primary outcomes were period prevalence and mothers’ quantity of health care utilization (primary, inpatient, outpatient, surgical, and psychiatric services) stratified by their child’s age (i.e., ages 0–6 = before school, ages 7–13 = pre-school + primary education, and ages 14–18 = secondary education or higher). The secondary outcome measure was length of hospital stays. Outcome measures were adjusted for maternal age at delivery, parity, marital status, income quartile, level of education in the year prior to the index birth, previous spontaneous abortions, maternal pregnancy complications, maternal diabetes, hypertension, alcohol-related diseases, and maternal smoking. Results In both cohorts the majority of mothers were between 26 and 35 years of age, married, and employed, and 47% were primiparous. Mothers of infants with anomalies had greater utilization of outpatient, inpatient, surgical, and psychiatric services, compared with mothers in the matched cohort. Inpatient service utilization was greater in the exposed cohort up to 13 years after a child’s birth, with the highest risk in the first six years after birth [adjusted risk ratio, 1.13; 95% confidence interval (CI), 1.12–1.14], with a decrease over time. Regarding the quantity of health care utilization, the greatest difference between the two groups was in inpatient service utilization, with a 39% increased rate in the exposed cohort during the first six years after birth (adjusted rate ratio, 1.39; 95% CI, 1.37–1.42). During the first 6 years after birth, mothers of children with anomalies stayed a median of 6 days (interquartile range [IQR], 3–13) in hospital overall, while the comparison cohort stayed a median of 4 days (IQR, 2–7) in hospital overall. Rates of utilization of outpatient clinics (adjusted rate ratio, 1.36; 95% CI, 1.29–1.42), as well as inpatient (adjusted rate ratio, 1.77; 95% CI, 1.68–1.87), and surgical services (adjusted rate ratio, 1.33; 95% CI, 1.26–1.41) was higher in mothers of children with multiple-organ MCAs during 0 to 6 years after birth. Among mothers at the lowest income levels, utilization of psychiatric clinic services increased to 59% and when their child was 7 to 13 years of age (adjusted rate ratio, 1.59; 95% CI, 1.24–2.03). Conclusion Mothers of infants with a major congenital anomaly had greater health care utilization across services. Health care utilization decreased over time or remained stable for outpatient, inpatient, and surgical care services, whereas psychiatric utilization increased for up to 13 years after an affected child’s birth. Healthcare utilization was significantly elevated among mothers of children with multiple MCAs and among those at the lowest income levels.

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 Gender Differences in Health Care Utilization Among the Elderly

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Gordana Gajovic ◽  
Katarina Janicijevic ◽  
Dragana Andric ◽  
Olivera Djurovic ◽  
Svetlana Radevic
Keyword(s):  
Health Care ◽  
Gender Differences ◽  
Primary Health Care ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Older Population ◽  
Female Population ◽  
Care Services ◽  
Primary Health ◽  
Region Of Residence

Abstract The unstoppable process of demographic aging of population has profound consequences on the economic, health, social and political spheres of society, because of the specific and diverse needs of the older population. The aim of the study was to examine gender differences of health care utilization among elderly in Serbia. The survey was conducted as a part of the national study “Health Survey of the Serbian population” in 2013. In the past year, 87.4% of the older population visited their chosen doctor. Women were significantly more likely to use primary health care compared to men, while the frequency of hospitalization is significantly higher in men. When it comes to female population, age, region of residence and financial situation stood out as the most important predictors of primary care services usage. In men, the residence stood out as the most important predictor of primary health care services usage. Multivariate binary logistic regression distinguishes gender, education and region of residence as the most important factors associated with hospital treatment.

scholarly journals Assessing the Impact of a Novel Integrated Palliative Care and Medical Oncology Inpatient Service on Health Care Utilization before Hospice Enrollment

2019 ◽  
Vol 22 (4) ◽  
pp. 420-423 ◽  
Author(s):  
Emily M. Ray ◽  
Richard F. Riedel ◽  
Thomas W. LeBlanc ◽  
Christel N. Rushing ◽  
Anthony N. Galanos
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Utilization ◽  
Medical Oncology ◽  
Care Utilization ◽  
Inpatient Service ◽  
The Impact

Health Behaviors, Physical Health, and Health Care Utilization in Children With ADHD

2018 ◽  
Vol 24 (7) ◽  
pp. 1011-1019 ◽  
Author(s):  
Se Jin Park ◽  
Hyesue Jang ◽  
Yeeun Lee ◽  
Chul Eung Kim ◽  
Subin Park
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Physical Health ◽  
Health Care Services ◽  
Care Utilization ◽  
Care Needs ◽  
Children With Adhd ◽  
Care Services

Objective: To compare health behaviors, physical health outcomes, and health care utilization between children with and without ADHD. Method: In this cross-sectional study, we obtained data for children with and without ADHD from the Korean National Health and Nutrition Examination Survey. To investigate the association between ADHD and health outcomes, we estimated the adjusted prevalence ratios (APRs) in these groups. Results: Among 10,838 children aged 7 to 18 years with and without ADHD, those with ADHD had significantly higher APRs for overall health problems, physical illness, and injuries than those without ADHD. Despite having health care needs, children with ADHD were less likely than those without ADHD to use health care services. However, there were no significant associations between most health behaviors and ADHD. Conclusion: Increased efforts are needed to provide quality health care services to address the medical conditions of children with ADHD and to enhance their health care utilization when needed.

The association of generalized anxiety disorder and Somatic Symptoms with frequent attendance to health care services

2017 ◽  
Vol 52 (2) ◽  
pp. 147-159 ◽  
Author(s):  
Tero S Kujanpää ◽  
Jari Jokelainen ◽  
Juha P Auvinen ◽  
Markku J Timonen
Keyword(s):  
Health Care ◽  
Anxiety Disorder ◽  
Health Care Utilization ◽  
Generalized Anxiety Disorder ◽  
Health Care Services ◽  
Somatic Symptoms ◽  
Care Utilization ◽  
Generalized Anxiety ◽  
Care Services ◽  
Frequent Attendance

Objective Generalized anxiety disorder is associated with higher rate of physical comorbities, unexplained symptoms, and health care utilization. However, the role of somatic symptoms in determining health care utilization is unclear. The present study aims to assess the association of frequent attendance of health care services between generalized anxiety disorder symptoms and somatic symptoms. Method This study was conducted cross-sectionally using the material of the 46-year follow-up survey of the Northern Finland Birth Cohort 1966. Altogether, 5585 cohort members responded to the questionnaires concerning health care utilization, illness history, physical symptoms, and generalized anxiety disorder-7 screening tool. Odds ratios belonging to the highest decile in health care utilization were calculated for generalized anxiety disorder symptoms and all (n = 4) somatic symptoms of Hopkins Symptom Checklist-25 controlled for confounding factors. Results Adjusted Odds ratios for being frequent attender of health care services were 2.29 (95% CI 1.58–3.31) for generalized anxiety disorder symptoms and 1.28 (95% CI 0.99–1.64), 1.94 (95% CI 1.46–2.58), 2.33 (95% CI 1.65–3.28), and 3.64 (95% CI 2.15–6.18) for 1, 2, 3, and 4 somatic symptoms, respectively. People with generalized anxiety disorder symptoms had on average a higher number of somatic symptoms (1.8) than other cohort members (0.9). Moreover, 1.6% of people without somatic symptoms tested positive for generalized anxiety disorder, meanwhile 22.6% of people with four somatic symptoms tested positive for generalized anxiety disorder. Conclusions Both generalized anxiety disorder symptoms and somatic symptoms are associated with a higher risk for being a health care frequent attender.

Food Insecurity and Health Care Utilization Among Older Adults

2016 ◽  
Vol 36 (12) ◽  
pp. 1415-1432 ◽  
Author(s):  
Vibha Bhargava ◽  
Jung Sun Lee
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Utilization ◽  
Food Insecurity ◽  
Health Care Services ◽  
Performance Outcomes ◽  
Home Health ◽  
Care Utilization ◽  
Assistance Programs ◽  
Care Services

This study examined the relationship between food insecurity and health care utilization (physician, inpatient, emergency room, and home health visits) among older adults. Survey data collected from Georgia Advanced Performance Outcomes Measures Project 6 linked to the Centers for Medicare and Medicaid Services (GA Advanced POMP6-CMS) data 2008 ( N = 957) were analyzed. Nearly one half of the sample (48.3%) was food insecure. Food insecure individuals were significantly less likely than food secure individuals to have any physician (69.7% vs. 80.2%) and home health visits (24.9% vs. 32.3%) during 2008. However, there were no significant differences in levels of health care utilization by food secure and food insecure older adults. Food secure and food insecure older adults utilized comparable levels of health care services. Public assistance programs such as Medicare and meal services targeted toward older adults may enable economically constrained, food insecure older adults to access needed health care services.

scholarly journals Determinants of Maternal Health Care Utilization in the Era of Free Maternity Services in Busia County, Kenya

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
B. Wafula ◽  
J. Arudo ◽  
M. Kipmerewo
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Utilization ◽  
Health Facility ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Care Utilization ◽  
Maternal Health Care Utilization ◽  
Care Services ◽  
Maternal Health Care Services

Purpose. The main objective was to establish determinants of maternal health care utilization and specifically to assess the trends of maternal health care utilization and determine the predictors of maternal health care service utilization in the era of free maternity policy in Busia County. Methodology. It was a cross-sectional study design. The study was conducted between February and April 2019. The research targeted mothers within childbearing age of 15-49 years and a sample size of 634 mothers was used. Quantitative data were analyzed using SPSS version 22.0. Descriptive statistics was used to describe results on socio-demographic characteristics while inferential statistics employed bivariate and multivariate logistic regressions to investigate determinants of maternal health care utilization. Odds ratio was used to test the strength of association, and a p-value of ≤ 0.05 considered as statistically significant.  Results. In 2010, FANC increased by 5.6% from 2010 (pre-free maternity period) to 2017 (post-free maternity era). There was also an increase of 2.2% cases of health facility deliveries during pre-free maternity period (2010) and post-free maternity period (2017). Eleven predictors of maternal health care utilization were identified. Among them were respondent being a farmer (OR = 2.6; 95% CI: 1.4-4.8; p = 0.002), the status of the infrastructure of the nearest health facility maternity being good (OR = 3.2; 95% CI: 1.1-9.6; p = 0.03), fare for the public vehicle being USD 0.2 (OR = 3.4; 95% CI: 1.6-7.1; p = 0.001), all maternal health services being available in the nearest health facility (OR = 3.1; 95% CI: 1.8-5.4; p<0.0001), difficulty to attend MCH services due to non-suitability of working days (OR = 2.7; 95% CI: 1.5-4.7; p=0.0008), there being some services that clients pay for (OR = 3.3; 95% CI: 1.5-7.4; p=0.004), services being provided by nurses (midwives) (OR = 2.3; 95% CI: 1.0-4.9; p=0.04) , baby checkup being done within 24 hours by nurses (OR = 18.8; 95% CI: 8.0-44.0; p<0.0001. In conclusion, free maternity care program has led to increased utilization of facility ANC visits and deliveries in the study area. Barriers related to utilization of maternal health care services included unreliable transport especially at night, limited infrastructure and low socio-economic status of the women in the study area. National and county governments need to put in place strategies which will help them to jointly assess, map and plan investments to improve utilization of maternal health care services through prioritizing investments in human resource, infrastructure and commodities based on the anticipated demand for such services. A unique contribution to theory, practice, and policy: The study findings identified key factors that are unique to the mothers in Busia County on predisposing factors, enabling factors and the need characteristics that determine utilization of maternal health care in the era of Free Maternity services in the study area. These results contribute to both maternal health care utilization and policy change that could directly meet the social setting, geographical location and cultural needs of the people of Busia County.

scholarly journals Health Care Utilization and Expenditure in War Survivors

2020 ◽  
Vol 23 (4Suppl1) ◽  
pp. S9-S15
Author(s):  
Batool Mousavi ◽  
Farzaneh Maftoon ◽  
Mohammadreza Soroush ◽  
Kazem Mohammad ◽  
Reza Majdzadeh
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Physician Visit ◽  
National Level ◽  
Care Utilization ◽  
Cross Sectional ◽  
Physician Visits ◽  
Care Services ◽  
Validated Questionnaire ◽  
War Survivors

Background: To describe the utilization and out-of-pocket (OOP) payments of war survivors receiving health care services and its determinants. Methods: A cross-sectional study was carried out by systematic random sampling at national level (n = 3079) on healthcare utilization in war survivors on their last received services. A validated questionnaire was used to gather the information of inpatient and outpatient healthcare services and OOP payment. The data were analyzed to indicate the determinants of health utilization and expenses. Results: Health care utilization was reported in 91.6% (n = 2822). The majority (82.5%) received one or two services in their last visits, mostly related to physician visits and medications (65.97%). Health care utilization was higher than general population annually, especially in physician visit (6.6 versus 4.89), medication (5.1 versus 3.6), and hospitalization (0.78 versus 0.15). About 20.2% (n = 599) of the study population paid out of their pocket for their last medical care services. The frequency of OOP payment was greater for physician visit and medication. Payment for hospitalization, imaging, and lab tests were more significantly associated with proceeding to reimburse the expenses (P<0.001). The median OOP payment was US$10.8 (interquartile range US$20.6). Gender (P=0.003), area of residence (P=0.01) and being war victims (P=0.005) were the significant determinants for both OOP payments and reclaiming the expenditure. Higher amount of payments (P<0.001) and more received health services (P=0.002) were also important factors in reclaiming the expenditure. Conclusion: Both outpatient services and hospital admission are more frequent among war survivors compared to the general Iranian population. Future studies should attempt to explore the reasons.

Infection-related health care utilization among people with and without multiple sclerosis

2016 ◽  
Vol 23 (11) ◽  
pp. 1506-1516 ◽  
Author(s):  
José MA Wijnands ◽  
Elaine Kingwell ◽  
Feng Zhu ◽  
Yinshan Zhao ◽  
John D Fisk ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Utilization ◽  
Age Groups ◽  
Population Based ◽  
Care Utilization ◽  
Prescription Data ◽  
Physician Visits ◽  
Intestinal Infections ◽  
Adjusted Rate

Background: Little is known about infection risk in multiple sclerosis (MS). Objective: We examined infection-related health care utilization in people with and without MS. Methods: Using population-based health administrative data from British Columbia, Canada, people with MS were followed from their first demyelinating claim (1996–2013) until death, emigration, or study end (2013). Infection-related hospital, physician, and prescription data of MS cases were compared with sex-, age-, and geographically matched controls using adjusted regression models. Sex and age differences (18–39, 40–49, 50–59, 60+ years) were explored. Results: Relative to 35,837 controls, 7179 MS cases were over twice as likely to be hospitalized for infection (adjusted odds ratio: 2.39; 95% confidence interval (CI): 2.16–2.65), had 41% more physician visits (adjusted rate ratio (aRR): 1.41; 95% CI: 1.36–1.47), and filled 57% more infection-related prescriptions (aRR: 1.57; 95% CI: 1.49–1.65). Utilization was disproportionately higher in MS men than women and was elevated across all ages. MS cases had nearly twice as many physician visits and two to three times more hospitalizations for pneumonia, urinary system infections, and skin infections (aRRs ranged from 1.6 to 3.3) and over twice as many hospitalizations for intestinal infections (aRR = 2.6) and sepsis (aRR = 2.2). Conclusion: Infection-related health care utilization was increased in people with MS across all age groups, with a higher burden for men.

scholarly journals An application of the behavioral model to the utilization of health care services in Turkey: A focus on equity

2020 ◽  
pp. 6-6
Author(s):  
Dilek Başar ◽  
Selcen Öztürk ◽  
İsmail Cakmak
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Utilization ◽  
Health Care Services ◽  
Behavioral Model ◽  
System Structure ◽  
Equal Treatment ◽  
Care Utilization ◽  
Marginal Effect ◽  
Care Services

The aim of this study is to investigate the equity phenomenon, which can be defined as an equal treatment for equal need irrespective of socio-economic status, in the utilization of health care services in Turkey (for out-patient and in-patient treatment services, separately) in the context of the behavioral model. We have used the ?Health Surveys? obtained from the Turkish Statistical Institute for 2010, 2012 and 2014. The equity phenomenon and the determinants of the health care utilization are investigated by using the probit model. The findings indicate that the need variable has the largest marginal effect in magnitude for all types of health care. This implies that the health system structure in Turkey is based on need and, therefore, equity exists in the utilization of health care services. We have also found that health insurance has the second largest marginal effect after the need variable. This means that policy makers should focus on enabling factors, especially the coverage of health insurance and the level of income to increase health care utilization of the disadvantaged segments of the population.

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