scholarly journals URBAN-RURAL DISPARITY: THE UTILIZATION OF PRIMARY HEALTHCARE CENTERS AMONG ELDERLY IN EAST JAVA, INDONESIA

2019 ◽  
Vol 7 (2) ◽  
pp. 147 ◽  
Author(s):  
Ratna Dwi Wulandari ◽  
Agung Dwi Laksono
Keyword(s):  
Primary Healthcare ◽  
Rural Areas ◽  
Health Research ◽  
Urban Areas ◽  
The Elderly ◽  
Utilization Of Health Services ◽  
Healthcare Center ◽  
Urban Rural ◽  
Primary Healthcare Centers ◽  
Primary Healthcare Center

Background: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output.Aim: This study analyzed the urban-rural disparity in the utilization of primary healthcare center by the elderly.Method: This study used in the 2013 Basic Health Research raw data. The 2013 Basic Health Research was designed as a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province participated. Data were analyzed using Multinomial Logistic Regression tests.Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). The elderly who have a primary school and under education have the possibility of 1.558 times more utilizing outpatients in primary healthcare centers than the elderly who have college education levels (OR 1.558; 95% CI 1.001-2.424).Conclusion: There was a disparity between urban and rural areas in the utilization of outpatient primary healthcare centers in East Java by the elderly. Policymakers in East Java are recommended to improve facilities and infrastructure of the primary healthcare centers in rural areas by paying attention to the results of this study.Keywords: elderly, urban-rural disparities, primary healthcare center, healthcare utilization, inpatient-outpatient. 

scholarly journals Urban-Rural Disparities in The Utilization of Primary Health Care Center Among Elderly in East Java, Indonesia

2019 ◽  
Author(s):  
Ratna Dwi Wulandari ◽  
Agung Dwi Laksono
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Elderly People ◽  
Rural Areas ◽  
Urban Areas ◽  
The Elderly ◽  
Utilization Of Health Services ◽  
Primary Health ◽  
Urban Rural

Introduction: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output. Aim: This study was intended to analyze urban-rural disparity in the utilization of primary health care or puskesmas use by the elderly.Methods: This study was used the 2013 Riskesdas (Indonesian Basic Health Survey) raw data. The 2013 Riskesdas was designed a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province were obtained. Data were analyzed using Multinomial Logistic Regression tests.Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). The elderly who have a primary school and under education have the possibility of 1.558 times more utilizing outpatients in the puskesmas than the elderly who have college education levels (OR 1.558; 95% CI 1.001-2.424). Conclusions: There was a disparity between urban and rural areas in the utilization of outpatient puskesmas in East Java by the elderly. Policy makers in East Java are recommended to improve facilities and infrastructure of the puskesmas in rural areas by paying attention to the results of this study.

scholarly journals THE IMPLEMENTATION OF CLINICAL PROCEDURES IN THE VERTICAL REFERRAL SYSTEM IN A PRIMARY HEALTHCARE CENTER

2019 ◽  
Vol 7 (1) ◽  
pp. 73 ◽  
Author(s):  
Nadia Damayanti Soeripto
Keyword(s):  
Health Facility ◽  
Primary Healthcare ◽  
Outpatient Clinics ◽  
Referral System ◽  
Clinical Procedures ◽  
Healthcare Center ◽  
To Come ◽  
Primary Healthcare Centers ◽  
Primary Healthcare Center

Background: A referral system in the era of National Health Insurance starts from first-level primary health facility. The high number of referral in one of primary healthcare centers in Surabaya indicates that the implementation of the vertical referral system has not gone well.Aim: To determine the conformity of the vertical referral system to the clinical procedures at the general outpatient clinics of the the primary healthcare center based on the National Referral System Guidelines.Methods: This study was an observational descriptive study and used implementation research method, which conducted in August 2018. This study was conducted in one of primary healthcare centers in Surabaya. This study used triangulated data, such as the review of reference documents, interviews with referral officers, and direct observation.Results: Out of 7 regulations in the clinical procedures of referral system according to the National Referral System Guidelines, only 2 regulations were not run by the at the general outpatient clinics of the primary healthcare center. For example, patients being referred did not come to the primary healthcare center on their own instead of requesting their family to come. Also, the doctors in the primary healthcare center referred the patients by themselves. However, according to the guidlines, before referring patients, the doctors should contact the referred health facilities.Conclusion: The implementation of clinical procedures in the vertical referral system in the primary healthcare center in Surabaya is broadly in accordance with the existing regulations and guidelines. However, it is necessary to do some improvement. It is recommended that they should re-contact the referral health facility before referring the patients to improve the quality of communication and provide more education to the patients’ family so that they bring the patients to do check-up when the the referral is extended. Keywords: Clinical procedure, Primary healthcare center, Vertical referral system. 

scholarly journals Neurotoxic snakebites at a primary healthcare center in Nepal: an experience of a PAHS graduate

2020 ◽  
Vol 7 (2) ◽  
pp. 85-90
Author(s):  
Carmina Shrestha ◽  
Sajan Acharya
Keyword(s):  
Supportive Care ◽  
South Asia ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Health Sciences ◽  
Medical Graduates ◽  
Healthcare Center ◽  
Primary Healthcare Center

Nepal has one of the highest snakebite fatalities in South Asia. Most bites occur in rural areas where there is a lack of both adequate facilities for treatment and transport. Despite several limitations, prompt access and focus on supportive care are the major strengths of peripheral healthcare centers. Here we present the management of two cases of neurotoxic snakebites. Timely intervention can save lives in case of snakebites; hence establishment of snakebite treatment centers in the periphery can mitigate the problem of delay in care. Patan Academy of Health Sciences can contribute by training medical graduates in snakebite management.

scholarly journals Primary healthcare centers engagement in tuberculosis treatment in Ukraine

2019 ◽  
Vol 13 (07.1) ◽  
pp. 83S-88S
Author(s):  
Evgenia Geliukh ◽  
Dilyara Nabirova ◽  
Karapet Davtyan ◽  
Svetlana Yesypenko ◽  
Rony Zachariah
Keyword(s):  
Treatment Outcomes ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Urban Areas ◽  
Healthcare Facilities ◽  
Adjusted Risk ◽  
Tb Treatment ◽  
Adjusted Risk Ratio ◽  
Binomial Regression ◽  
Primary Healthcare Centers

Introduction: We assessed the influence of a result-based financing (RBF) model, which included incentives for Primary Healthcare facilities on TB treatment outcomes. Methodology: We compared TB patients > 17 years and their treatment outcomes among those who did and did not benefit from RBF-model in 14 districts of Odeska oblast, Ukraine in 2017. Log-binomial regression was used to examine factors associated with being included in RBF-model. Results: Of 2,269 reported TB patients, 308 (14%) were included in RBF-model. Most patients in the RBF-model were from rural areas 229 (74%), unemployed 218 (71%), and HIV-infected 131 (43%). Individuals from urban areas (Adjusted risk ratio, ARR =0.9, 95% Confidence Interval, CI:0.89-0.94), having drug-resistant TB (ARR = 0.3, 95% CI: 0.18-0.45), and relapse TB (ARR = 0.6, 95% CI:0.40-0.83) were less likely to be included in RBF-model. Favorable outcomes in new/relapse cases with RBF-model was 89% compared with 41% (p < 0.001) without RBF. Similarly, for other retreatment this was 83% versus 40% (p < 0.001). Failures in the no-RBF group was 29% for new and relapse cases while for other retreatment cases, it was 26% (significantly higher than in the RBF-model). Conclusion: RBF-model is effective in achieving high levels of favorable TB treatment outcomes. Almost three-in-ten TB patients in non-RBF category failed TB treatment despite having drug-susceptible TB. Efforts are now needed to include it within ongoing public health reforms and assess the feasibility of scaling-up this intervention through implementation research and dedicated funding.

scholarly journals Urban–Rural Differences in Long-Term Care Service Status and Needs Among Home-Based Elderly People in China

2020 ◽  
Vol 17 (5) ◽  
pp. 1701
Author(s):  
Liangwen Zhang ◽  
Yanbing Zeng ◽  
Lixia Wang ◽  
Ya Fang
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
The Elderly ◽  
Influential Factors ◽  
Term Care ◽  
Home Based ◽  
Urban Rural ◽  
Young Old

Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban–rural differences. This study aims to evaluate the differences of LTC current status and needs between urban–rural areas and age groups, and to identify influencing factors causing the different LTC needs. Methods: The data come from the Chinese Longitudinal Health Longevity Survey in 2014. A total of 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees (p < 0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health and having less autonomy had higher anticipated needs for LTC services (OR > 1, p < 0.01). Compared with the young-old in rural areas, the young-old in urban areas were prone to live alone (OR = 1.61, p < 0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1 < OR < 1.69, p < 0.05). Conclusions: The aged cohort in urban–rural distinction were facing an increasing need for immediate care due to the inadequate support being provided, especially among rural elderly. The oldest elderly in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support, health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China.

scholarly journals ANALYSIS OF ACCEPTANCE OF E-HEALTH APPLICATION BY USERS IN PRIMARY HEALTHCARE CENTER IN SURABAYA CITY

2021 ◽  
Vol 16 (1) ◽  
pp. 66
Author(s):  
Ni Made Mira Wahyu Astani ◽  
Ni Luh Putu Arum Puspitaning Ati ◽  
Ernawaty Ernawaty
Keyword(s):  
Primary Healthcare ◽  
Technical Assistance ◽  
Design Method ◽  
Cross Sectional ◽  
Utaut Model ◽  
Healthcare Center ◽  
Health Application ◽  
Primary Healthcare Centers ◽  
Primary Healthcare Center ◽  
Health Applications

This study used the observational quantitative method to analyze the acceptance of information technology  in the form of thee-Health. The theory of acceptance was further analyzed using the Unified Theory of Acceptance and Use of Technology (UTAUT) model. UTAUT model is the latest unified model that is an appropriate to explain the acceptance and use of information systems. The research objective was to analyze perceptions of the use of e-Health applications in the Surabaya City Health Center. The research design method used was cross-sectional design. The selected samples of 100 people were determined by multistage sampling in primary healthcare centers in every area of Surabaya. The independent variables in this study were performance expectancy, effort expectancy, social influence and behavioral intention while the dependent variable was the use of e-Health applications. Data were collected through questionnaires delivered via interviews. The results showed that the lowest indicator of acceptance by the users  was the time needed to input data category to the e-Health application. This study concludes that the acceptance of e-Health by users primary healthcare centers in Surabaya is low. This study suggests a more widespread dissemination of information regarding the benefits of the use of e-Health along with technical assistance and guidance on the use of e-Health applications.Keywords: UTAUT Model, e-Health application, primary healthcare center, acceptance

scholarly journals FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF CHILDREN UNDER FIVE YEARS OF AGE IN GUNUNGSITOLI IDANOI PRIMARY HEALTHCARE CENTER

2020 ◽  
Vol 15 (3) ◽  
pp. 315
Author(s):  
Novrin Senselia Putri Ziliwu ◽  
Lina Dewi Anggraeni ◽  
Rosa Nora Lina
Keyword(s):  
Nutritional Status ◽  
Primary Healthcare ◽  
Employment Status ◽  
Children Under Five ◽  
Under Five ◽  
Factors Associated ◽  
Healthcare Center ◽  
Nutritional Status Of Children ◽  
Primary Healthcare Centers ◽  
Primary Healthcare Center

The number of children under five years of age suffering from underweight was 28.0% in Gunungsitoli district. Out of six primary Healthcare centers in the district, Gunungsitoli Idanoi Primary Healthcare Center Healthcarewas one of the six primary healthcare centers with the highest malnutrition prevalence. Sixty-four children under five years of age there Healthcaresuffered from malnutrition. This study aimed to identify factors associated with the nutritional status of children under five in Gunungsitoli Idanoi Primary Healthcare Center, Gunungsitoli district. It was an analytical survey with a cross-sectional approach conducted in Gunungsitoli Idanoi Primary Healthcare Center in February 2019. Data were collected using a questionnaire. This study had samples as many as 246 mothers of children under five years of age selected using a purposive random sampling technique. The bivariate analysis indicates the nutritional status of children under five was significantly associated with mother’s employment status (p=0.043) and family size (p=0.015). While the nutritional status of children under five had no significant association with mother’s knowledge of nutrition (p=0.485), mother’s education (p=0.616), family income (p=0.511), infectious disease (p=0.913), and history of breastfeeding (p=0.847). Mother’s employment status and family size affected the nutritional status of children under five. The primary Healthcare center should cooperate with stakeholders across sectors, especially conduct training for improving economic business skills of the people in the village, and promote family planning program for couples of childbearing age. Keywords: Breastfeeding, children under five years of age, underweight, mother’s knowledge, mother’s employment.

scholarly journals Dementia-Free Life Expectancy among People over 60 Years Old by Sex, Urban and Rural Areas in Jiangxi Province, China

2020 ◽  
Vol 17 (16) ◽  
pp. 5665 ◽  
Author(s):  
Yuhang Wu ◽  
Huilie Zheng ◽  
Zhitao Liu ◽  
Shengwei Wang ◽  
Yong Liu ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
The Elderly ◽  
Jiangxi Province ◽  
Urban Men ◽  
Urban Rural ◽  
The Government ◽  
Urban And Rural Areas

Objective: To estimate and compare the dementia-free life expectancy (DemFLE) and age trends of the population over 60 in 2018 in Jiangxi Province, China, by sex and urban–rural areas. Methods: Based on the Summary of Health Statistics of Jiangxi Province in 2018 and the Sixth National Health Service survey of Jiangxi Province, the model life table is used to estimate the age-specific mortality rate by sex and urban–rural areas. DemFLE and its ratio to life expectancy (LE) were calculated using the Sullivan method. Results: In 2018, the DemFLE at age 60 was 18.48 years for men and 21.31 years for women, accounting for 96.62% and 96.67% of their LE. LE and DemFLE were higher for those in urban areas than in rural areas, except for men aged 90 and above; higher in women than in men, except for people in rural areas aged 90 and above. In urban areas, DemFLE/LE was higher for women than for men; the opposite was observed in rural areas. Urban women had a higher DemFLE/LE than rural women did, urban men had a lower DemFLE/LE than rural men did. Conclusions: With increased LE, DemFLE also increases, but with older age and over time, DemFLE/LE gradually decreases. The effect of dementia on elderly adults becomes more serious. It is necessary for the government to implement a series of prevention strategies to improve the quality of life and health awareness of the elderly. Elderly urban men and elderly rural women need more attention and health care.

scholarly journals The urban-rural disparity in the prevalence and risk factors of hypertension among the elderly in China—a cross-sectional study

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e8015 ◽  
Author(s):  
Hongxun Song ◽  
Da Feng ◽  
Ruoxi Wang ◽  
Jian Yang ◽  
Yuanqing Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Rural Population ◽  
Urban Areas ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Stratified Sample ◽  
Urban Rural ◽  
Urban And Rural Areas

Introduction This study aimed to assess the prevalence of hypertension and to explore the disparities of its risk factors among urban and rural elderly. Method Data of hypertensive patients were collected from the China Health and Retirement Longitudinal Study (CHARLS) 2015. Stratified sample households were selected from 450 villages or communities of 150 counties from 28 provinces. Multivariable logistic regression was performed to analyze the factors correlated with hypertension. Results Prevalence of HBP was 47.6% (95% CI [45.2%–50.1%]) in total and it was close between urban and rural population (48.6% vs 47.2%). Factors associated with HBP were different between urban and rural areas. In urban areas, hypertension was significantly associated with literacy and diabetes in both genders, high BMI level and smoke quitters in males, and physical activity and dyslipidemia in females. In rural areas, hypertension was significantly associated with older age, higher BMI level in both males and females, and dyslipidemia in males. Conclusions The prevalence are about the same among urban and rural residents, but their risk factors vary from each other. Disparity in the risk factors between urban and rural population should be taken into consideration for further intervention.

Urban–Rural Dichotomy in Planning: Review of Legal Framework in Four States of India

2021 ◽  
pp. 001955612110016
Author(s):  
Anurima Mukherjee Basu ◽  
Rutool Sharma
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Planning Process ◽  
Legal Framework ◽  
Quantum Jump ◽  
Class 1 ◽  
Urban Settlements ◽  
Urban Rural ◽  
Territorial Approach ◽  
Sizeable Number

Current urbanisation trends in India show a quantum jump in number of ‘census towns’, which are not statutorily declared as urban areas, but have acquired all characteristics of urban settlements. Sizeable number of such census towns are not located near any Class 1 city. Lack of proper and timely planning has led to unplanned growth of these settlements. This article is based on a review of planning legislations, institutional framework and planning process of four states in India. The present article analyses the scope and limitations of the planning process adopted in the rapidly urbanising rural areas of these states. The findings reveal that states are still following a conventional approach to planning that treats ‘urban’ and ‘rural’ as separate categories and highlights the need for adopting an integrated territorial approach to planning of settlements.

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